van Boekel, L. C., Brouwers, E. P. M., van Weeghel, J., & Garretsen, H. F. L. (2013). For the year 2016, the Centers for Disease Control and Prevention (CDC) found that 18% of the U.S. population aged 12 and older had used illicit substances or misused prescription medications (CDC, 2018). This can result in lack of access to treatment services, contributing to increased stress. The biopsychosocial model considers the 4 Ps for each of the biological, psychological, and social factors: The 4 Ps can be laid out in a 3 x 4 table to systematically do formulation and identity factors. After being told she was fired from her job, she went home and self-harmed to cope with the distress of this loss. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638323/pdf/nihms734766.pdf Based on these factors, dialectical behavioural therapy would be the most helpful for this patient. For some, receiving substance use and misuse services can be stigmatizing. Are mindfulness-based interventions effective for substance use disorders? 0000243959 00000 n Based on these factors, the following [treatment and management] would be the most helpful for this patient. An investigation of stigma in individuals receiving treatment for substance abuse. Substance use and misuse has significant impact on the occupational sector as well. Incorporating the Five Ps, with its holistic framework, may prove attractive to clients and counselors, thus potentially increasing the numbers of clients engaged in substance use and misuse treatment. (2020, April 21). In the context of this article, the word abusable indicates substances that when taken are pleasurable enough to result in excessive dosing or increased frequency of intake (Linden, 2011). However, patient has the following [protective factors], which may be a good prognostic factor. Disclaimer: This is an example of a student written essay.Click here for sample essays written by our professional writers. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. (2018). *sbJ&KcO0gfk1/G0isFuHe/Mcmf&*=QMh[pN[-.jzJ{g).k!1 M{[RSXn.+LhWi*z@-pMOcF52zZ#f!CSn^X&hN>nRu-w&7g5{P2C*.Es7@,IR35qHfwKxgGeK4QVBa?%(72e]7_/y!>$=Lx3ljHlGZL6eai7@*T!'HX)cE https://doi.org/10.1016/j.janxdis.2015.09.005 1189 0 obj <> endobj 0000000016 00000 n CBT case formulations often have 5 ingredients: Presenting problem (s) Predisposing factors which made the individual vulnerable to the problem Precipitating factors which triggered the problem Perpetuating factors such as mechanisms which keep a problem going or unintended consequences of an attempt to cope with the problem Protective factors Drayton, M., Birchwood, M. and Trower, P., 1998. She also appears to use alcohol as a way of managing distressing emotions, but does not have any psychological coping strategies. Jane has been working at a start up company for the past 2 years. Rachman, S. and de Silva, P., 1978. Published data on those incarcerated appears to be several years old. For Dax, he shares that when he and his wife argue, it follows a very predictable pattern. Journal of Clinical Psychology, 74(3), 356384. First and foremost, it should be emphasized that this particular framework has not been empirically tested with client substance use and misuse. (2013). She also drank 10 beers prior to arriving in the hospital. 0000011422 00000 n Hypotheses are generated about the origins and causes of a patient's symptoms. 0000006894 00000 n Here you can choose which regional hub you wish to view, providing you with the most relevant information we have for your specific region. https://doi.org/10.1186/s13722-018-0110-8 Predisposing Factors Friendly Formulation - Psychology Tools Substance Use & Misuse, 53(4), 596605. [1][2] Biopsychosocial formulation combines biological, psychological, and social factors to understand a patient, and uses this to guide both treatment and prognosis. The officers evaluated him, detained him, and subsequently arrested him for driving while intoxicated. 0000155834 00000 n To position his business, John may consult the 5 Ps of marketing in the following manner: Product: By-the-hour jet ski rentals for people who are in the city for a short duration of time. https://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.htm Currently, there are a variety of empirically based interventions for treating clients who engage in substance use and misuse. Many formulation models are administered within a cognitive behavioral grounding (Chadwick et al., 2003; Easden & Kazantzis, 2018; Persons et al., 2013). (2015). It has been documented that 90% of the population at some point have intrusive thoughts, or feel paranoid and feel people are doing things on purpose towards them. Client substance use and misuse is a significant problem in the United States, and it continues to cause difficulty for individuals, families, and society. Poverty, low socioeconomic status, teenage parenthood, or poor access to health care? Ingram, B. L. (2012). 0000238450 00000 n Here's what the completed table would look like with the psychological factors incorporated. The idiographic/nomothetic dichotomy: Tracing historical origins of contemporary confusions. Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Another potential limitation is that the Five Ps may not be particularly beneficial for substance use and misuse in which there is clinical evidence of an SUD that includes significant withdrawal symptoms. This is to ensure that the client understand any reason for change from what was originally agreed. Haynes, S. N., Leisen, M. B., & Blaine, D. D. (1997). Among those are 12-step programs (Humphreys et al., 2004), mindfulness-based interventions (Chiesa & Serretti, 2014), evidence-based approaches such as cognitive behavioral therapy (McHugh et al., 2010), and family counseling (OFarrell & Clements, 2012). At the end of his workday, he and his wife got into an argument over the phone about an upcoming diagnostic test and the possible results. Family therapy and the treatment of substance use disorders: The family matters model. Formulation: A multiperspective model. https://doi.org/10.17744/mehc.30.1.j40256207h0581t1 0000014220 00000 n These can be in the form of personal characteristics such as tenacity, intellect, or insight. Routledge. The internal and external factors that maintain the current problems. Once the protective factors are identified, the ensuing conversation provides opportunities to imagine future outcomes in which protective factors may come into play should situations occur that the client finds problematic. In addition, mindfulness strategies can assist in helping Dax to cognitively diffuse from present to future events (Harris, 2019). This has further exacerbated her alcohol use disorder. Cengage. Aggression and Violent Behavior, 15(5), 325333. Previous studies using frameworks to formulate have often used cognitive behavioral therapy as the primary intervention (Chadwick et al., 2003; Persons et al., 2013). apply to your case. Protective factors are those that help to moderate actual or potential substance use and misuse impact. Cognitive behavioral therapists use individually tailored formulations as a framework with which to understand their patients' difficulties and to plan effective treatment. Some of these evidence-based approaches will be demonstrated later in a case illustration. What are the 5 Ps of case formulation? 0000241121 00000 n Oftentimes, when the topic of protective factors is used in substance use and misuse, it is related to deterrence of substance use, notably with adolescents (Liao et al., 2018). There are limitations to the Five Ps framework as a way to formulate and intervene with clients substance use and misuse. SAMHSAs recommendations fit well with a more holistic framework in that such a structure allows clinicians to develop a multidimensional picture of clients. While being mandated to attend counseling, Dax shares concerns that he is afraid of what his daughters test results will show. Chapter. However, this can be done intuitively even without an in-depth understanding of these frameworks (we don't need to be Freud to do this). Regrettably, most do not receive treatment while incarcerated (Belenko et al., 2013). https://www.ncbi.nlm.nih.gov/books/NBK343542 Walsh, F. (2014). At its most basic, you could present each box sequentially and describe each factor. In his report on alcohol, drugs, and health, the U.S. Free resources to assist you with your university studies! 0000013321 00000 n The five perspectives are: A strategy has a PLAN A strategy has a PLOY A strategy has a PATTERN A strategy has a POSITION A strategy has a PERSPECTIVE Let's examine each of the 5 Ps of Strategy in turn 1. https://doi.org/10.1111/j.1521-0391.2011.00187.x 0000016414 00000 n Like most things in medicine, there are multifactorial causes of diseases, illnesses, and disorders. Clinical Psychology 5 P Case Formulation - StuDocu Concept mapping: A supervision strategy for introducing case conceptualization skills to novice therapists. Oxford Handbooks Online, 149. 0000008363 00000 n This essay may contain factual inaccuracies or out of date material. Here, the clinician may use reality-based strategies that address choice and consequences (Wubbolding & Brickell, 2017). A good biopsychosocial formulation allows you to come up with a comprehensive and holistic treatment plan for your patient. Substance use and misuse has been correlated with both higher rates of absenteeism and workplace injuries (Bush & Lipari 2015). A brief description of Dax, a hypothetical client, and the events that prompted him to seek services is followed by a detailed application of the Five Ps in addressing Daxs substance use and misuse. Additionally, he reports significant stress and conflict in his marriage as well as concerns over some upcoming diagnostic tests for their daughter related to a heart murmur. 0000012481 00000 n Results from the 2016 National Survey on Drug Use and Health: Detailed tables. 0000001856 00000 n He then withdraws and becomes sullen for a few days. Of course, the Mintzberg 5 P's of Strategy are part of an organisation's strategy, but it's also wise to look at the 5 P's as separate standpoints that all need to be considered for developing a strong and successful strategy. The next step Precipitating is used to look at both internal and external factors and discover where they are linked, from this you get a greater picture of the overall problem. Note that in this example, since the precipitating cause for acute psychosis (also applies to manic episodes) is more biological, it may be harder to identify underlying psychological factors (but that's OK too even the most biological psychiatric disorders can often be precipitated by psychosocial stressors). Chiesa, A., & Serretti, A. 0000006779 00000 n Substance use and misuse is exceedingly common and has numerous implications, both individual and societal, impacting millions of Americans directly and indirectly every year. Engel, G. L. (1977). 0000014949 00000 n Executive functioning in alcohol use studies: A brief review of findings and challenges in assessment. The therapist provides a route easiest for the client by identifying methods that build on the clients current resilience and strengths. Chadwick, P., Williams, C., & Mackenzie, J. In mental health, when there is a group of consistent symptoms seen in a population, these symptoms can be categorized into a distinct entity, called a diagnosis (this is what the DSM-5 does). 0000241723 00000 n 1. Bush, D. M., & Lipari, R. N. (2015, April 16). (2017). McHugh, R. K., Hearon, B. This likely led to an attachment style that was likely insecure and disorganized. 5 Ps narrative table, from Comprehensive Care Resource Guide: 4 : The Integrated Formulation : The Integrated formulation builds on the familiarity of the '5Ps', with the aim of specifically integrating that . Formulation is like cooking, and there is no 'right' or 'wrong' way to do it, but most get better over time with increasing clinical experience. What Are The 5 P's Of Case Formulation? - IosFuzhu (2016). Therapy, 38(1), 5981. Due to her history of abuse at age 12, she may have struggled with identity versus role confusion during that Eriksonian stage of psychosocial development. Again let's fill out the easiest parts of the table first: Now here is one potential example of a predisposing social and psychological formulation of psychosis (again, there are no right or wrong ways to formulate, it depends on the patient you have in front of you!). Molecular psychiatry, 17(4), 377-388. Addictive Behaviors, 32(7), 13311346. All rights reserved. This could be achieved with more specific and in depth trauma therapy, but given the acuity of her symptoms, this is something that would follow after DBT. Following formulation, there should be an identification of the prioritised areas of focus for care - to inform the Care Plan. Their effectiveness has been well researched, and this paper does not propose a superior way to address substance use and misuse. 0000119267 00000 n Do they have ability to be reflective or modulate their affect? Journal of Public Health, 38(3), e282e291. These are historical psychological, biological, developmental, and socio-cultural factors that increased the person's vulnerability to their current problems. This gives you a sense of their current level of functioning, prognosis, and guides your direction for treatment and management decisions.