The Case Formulation Approach to Cognitive-Behavior Therapy » (New Edition)

Jacqueline B. Persons, PhD, is Director of the San Francisco Bay Area Center for Cognitive Therapy and Clinical Professor in the Department of Psychology at the University of California, Berkeley. She is a clinician, teacher, researcher, writer, and scientist-practitioner. She maintains an active clinical practice, providing cognitive-behavior therapy for mood and anxiety disorders and related problems, and teaches and provides clinical supervision to students and professionals in many settings. Dr. Persons conducts research on the mechanisms underpinning symptoms of depression and anxiety and on the process and outcome of cognitive-behavior therapy, especially as it is implemented in routine clinical practice. Her first book, Cognitive Therapy in Practice: A Case Formulation Approach, published by W. W. Norton in 1989, is widely considered a classic. She is past president of the Association for Advancement of Behavior Therapy (now the Association for Behavioral and Cognitive Therapies) and of the Society for a Science of Clinical Psychology, a section of the Society of Clinical Psychology of the American Psychological Association.

This eagerly awaited book shows how skillful case formulation addresses a critical challenge in psychotherapy today: how to use empirically supported therapies (ESTs) in real-world clinical contexts. The author explains the basic theories of cognition, learning, and emotion that underlie available ESTs and shows how the theories also guide systematic case formulation. By crafting a sound formulation and continually refining and monitoring it as treatment progresses, the therapist can smoothly "shift theoretical gears" and weave together elements of different ESTs to meet the needs of individual patients, who typically present with multiple problems. Hands-on tools, reproducibles, and many concrete examples are included.

Doody Review Services

Reviewer:Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description:This book describes how to apply empirically supported therapies (ESTs) within the cognitive-behavioral tradition to individual clients. The author encourages therapists to understand formulations and techniques that underlie the various therapies. However, Dr. Persons urges the reader to not merely use a step-by-step manualized approach, which may not fit all clients, but design a plan that will meet the needs of the individual.
Purpose:The author notes that this book expands and elaborates on her earlier writings on case formulation, including a 1989 book, Cognitive Therapy in Practice: A Case Formulation Approach (W.W. Norton, 1989). She points out, "the most significant advance over my earlier work is that I now embed the case formulation in a larger framework of clinical hypotheses testing." She recommends that "clinicians examine the EST protocols to understand the formulations that underpin them and how the interventions in the protocol flow out of the formulations. Then they can use that information (not the step-by-step procedures of the protocol itself) to guide their work.
Audience:The intended audience includes practitioners, students, and residents in clinical psychology, psychiatry, counseling, and social work. It can serve as a text in graduate-level courses on cognitive-behavior therapy and in clinical practice. The author, director of the San Francisco Bay Area Center for Cognitive Therapy and professor at the University of California, Berkeley, conducts research in cognitive-behavior therapy.
Features:An introduction to case formulation begins the book. Next, three theoretical orientations are discussed including cognitive theories, learning theories, and emotion theories. Finally, the therapeutic process is explored in depth. This part looks at assessing the problem and formulating personality dynamics and treatment goals. The author discusses how to monitor treatment progress and deal with treatment failure. The figures are extremely helpful in understanding what case formulation is all about and there is a limited photocopy license to reproduce certain forms, which include thought record, treatment/evaluation agreement, adult intake questionnaire, and case formulation worksheet. These forms are invaluable, especially to beginning therapists who get a chance to see how a seasoned veteran designs basic documents. The book is easy to read and walks the reader slowly but surely through the process of formulating treatment cases. Chapter six is a great example of where to start when developing a comprehensive treatment program. It uses case material and explains the rationale so readers can understand exactly how to do it. Chapter eight, on the therapeutic relationship, is also well done. It's not common to see a cognitive-behavioral approach focus on the therapeutic relationship. The author shows how to use the relationship effectively in therapy and how to handle problems.
Assessment:This excellent book describes treatment formulation and the therapeutic process well, from a cognitive-behavioral framework. The reproducible forms are extremely helpful, especially for new therapists who are beginning a private practice. All-in-all, the author helps us to look at the therapeutic process in cognitive-behavioral terms and design it with each specific client in mind, and not in terms of a general protocol. This is very refreshing, to say the least.

1 What Is the Case Formulation Approach to Cognitive-Behavior Therapy? 1

2 Cognitive Theories and Their Clinical Implications 17

3 Learning Theories and Their Clinical Implications 41

4 Emotion Theories and Their Clinical Implications 66

5 Beginning the Therapeutic Relationship and Obtaining a Problem List and Diagnosis 90

6 Developing an Initial Case Formulation and Setting Treatment Goals 126

7 Using the Formulation to Develop a Treatment Plan and Obtain the Patient's Consent to It 150

8 The Therapeutic Relationship 167

9 Monitoring Progress 182

10 Decision Making in the Therapy Session 202

11 Handling Nonadherence and Treatment Failure 215

12 Decision Making over the Course of Therapy 232

References 247

Index 267