Case formulation in cognitive and behavioural therapy

Abstract

Personality disorders are complex developmental disorders associated with persistent and pervasive ways of thinking and feeling about oneself and others and behaving that cause distress or impairment in how an individual functions in many aspects of life. The DSM-5 also refers to an emerging model of personality disorders based on levels of impairment in functioning and the personality traits related to impaired functioning. Functioning is assessed in two domains: Self, which includes Identity and Self-Direction, and Interpersonal, which includes Empathy and Intimacy. Case formulation is the abstraction of key features of a clinical case that guide idiographic treatment. It is often rationalized as a reaction to the limits of psychiatric diagnosis whether as an alternative or complementary approach. Personality disorders may be understood on three levels: the diagnostic level summarizes concerns and may be required to access therapeutic services; the basic trait level identifies heritable biological characteristics that influence emotional, behavioural, and interpersonal development; and the process level reveals the psychosocial processes by which heritable traits may interact with the social environment over the lifespan to produce personality disorder. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: chapter)