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). 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. Predisposing looks at a wider understanding of the issues, looking at it in more lengthily way. The meaning of anxiety. Cengage. endstream endobj 1263 0 obj <>/Filter/FlateDecode/Index[262 927]/Length 50/Size 1189/Type/XRef/W[1 1 1]>>stream Oxford University Press. Dax reports a strong paternal history of substance use and misuse. 2004;2(6):576-582. doi:10.1370/afm.245. 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. Harris, R. (2019). At its most basic, you could present each box sequentially and describe each factor. 0000200021 00000 n 300 words https://doi.org/10.3109/10826084.2013.770027 In Formulation in psychology and psychotherapy (pp. Correspondence may be addressed to Scott Peters, One University Way, San Antonio, TX 78224, scott.peters@tamusa.edu. 5Ps Formulation | PDF | Substance Abuse | Mental Disorder However, an important skill that they should try to perform is to assess a situation before jumping to conclusions. Mintzberg's 5 P's of Strategy explained including video - toolshero Mintzberg's 5 Ps of Strategy with Examples 1. For example, we diagnose someone with a major depressive episode if they meet 5 of the 9 symptomatic criteria. Here are some examples: A good formulation should be integrative, and let you understand how all of the patient's factors interact to lead to the current situation. Han, B., Hedden, S. L., Lipari, R., Copello, E. A. P., & Kroutil, L. A. 0000012481 00000 n 0000001856 00000 n 0000010825 00000 n Disclaimer: This is an example of a student written essay.Click here for sample essays written by our professional writers. Engel, G. L. (1977). 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!). & Haddock, G. (1990). To help treat the client with psychosis maintaining specific behaviour can be beneficial and help avoid frustration and upsetting experiences (Johnstone 2009). For example, type II diabetes does not develop because of a single pathophysiological cause. Dax further reports his paternal grandfather died from liver failure. Delivery of mindfulness-based interventions may help to address stressful events that previously triggered substance use (Garland et al., 2014). )jB' */NNM;2=Kc.w}9XXtj+%]{IF UA_ headspace recommends a formulation framework using the five Ps, as follows: Presenting problem (s): Initial signs, symptoms or other difficulties that are clinically important for the young person. 0000187506 00000 n The Five Ps is a systematic way to look at clients and their presentation, and its idiographic construction takes clients uniqueness into account. Receipt of services for behavioral health problems: Results from the 2014 National Survey on Drug Use and Health. Risk and protective factors for adolescents illicit drug use: A population-based study. 1264 0 obj <>stream 0000017109 00000 n 0000000016 00000 n Scott W. Peters, PhD, LPC-S, is an associate professor at Texas A&M University San Antonio. Etoom, Y., & Ratnapalan, S. (2014). Published data on those incarcerated appears to be several years old. https://doi.org/10.1037/a0038618 Clients who engage in substance use and misuse can present with a variety of issues beyond use (Bahorik et al., 2017; Compton et al., 2014; Poorolajal et al., 2016). This essay may contain factual inaccuracies or out of date material. By examining and exploring clients use or misuse within the context of a multidimensional framework, interventions can be personalized, and areas of concern can be targeted. This factor differs markedly from the first four. (2003) noted, examining positive client experiences may be one way to discover how to increase client participation in substance use and misuse treatment. Good interpersonal support from her best friend who brought her to hospital. (2013). Wiley. https://doi.org/10.1080/02699931.2012.739998 PDF Case Formulation and Intervention: Application of the Five Ps - ed Guilford. W. W. Norton. Abnormal and normal obsessions. 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. Presenting problems are concerns that clients find difficult to manage. 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). SAMHSAs recommendations fit well with a more holistic framework in that such a structure allows clinicians to develop a multidimensional picture of clients. Let's do a simplified formulation for the patient (Jane Doe) below. New Harbinger. Humphreys, K., Wing, S., McCarty, D., Chappel, J., Gallant, L., Haberle, B., Horvath, A. T., Kaskutas, L. A., Kirk, T., Kivlahan, D., Laudet, A., McCrady, B. S., McLellan, A. T., Morganstern, J., Townsend, M., & Weiss, R. (2004). 0000199386 00000 n (Rachman & de Silva 1978, Salkovskis & Harrison 1984, sited in Tarrier et al. Addiction Science and Clinical Practice, 13(8), 115. Diagram of Ray's 5Ps formulation (Johnstone & Dallos, 2014) and core beliefs Source publication Integrating CBT and CFT within a case formulation approach to reduce depression and anxiety in. https//doi.org/10.1016/j.drugalcdep.2013.02.018 This condition did not develop six months ago but developed during childhood when he failed to meet his father's expectations. It can be changed and reviewed as the treatment is in progress if any new information come to light. Additionally, many individuals who engage in substance use and misuse have co-occurring major medical conditions, such as cancers, cardiovascular accidents (strokes), and respiratory and cardiac illnesses (Bahorik et al., 2017). The Five Ps permits counselors to both assess and intervene essentially simultaneously. Protective factors are those that help to moderate actual or potential substance use and misuse impact. Persons, J.B., 1989. 0000119626 00000 n The officers evaluated him, detained him, and subsequently arrested him for driving while intoxicated. Based on what I have reviewed in this essay. The goal here is to build Daxs competence in communicating, both in listening and expressing. https://doi.org/10.1016/j.cbpra.2013.03.004 It is important to remember that not everything will fit neatly into each box. (2011). Substance use and misuse also has a negative impact on intimate partners, such as assuming increased responsibility and navigating unpredictability (Hussaarts et al., 2012). 0000241200 00000 n 0000014949 00000 n Rachman, S. and de Silva, P., 1978. Participants: The leader of a meeting should carefully consider who he or she invites. This is an essential step. After being told she was fired from her job, she went home and self-harmed to cope with the distress of this loss. ; DSM-5) bases an SUD on a pathological pattern related to the use of a substance (American Psychiatric Association, 2013, p. 483). We then move onto Perpetuating which looks at what factors are contributing to the remain of the problems the person is facing. ), The science of cognitive behavioral therapy (pp. hA 4-`76>m{dKs. Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Behind bars II: Substance abuse and Americas prison population. These psychological symptoms/factors are then observed by the clinician to give a psychiatric diagnosis. Case conceptualization research in cognitive behavior therapy: A state of the science review. Addressing the potential genetic link to substance use and misuse may prove beneficial in raising Daxs awareness (Dick & Agrawal, 2008). If he cannot identify a time, simple role-plays in which Dax does not interrupt or yell and instead experiences different outcomes may provide optimism to Dax. (2011). This is often the opportunity for the client to share what may help them move forward, what their assets are, who can support them, and any other self-identified skills (de Shazer, 1985). American Psychiatric Association. As mentioned previously, novice counselors often lack sufficient case formulation skills (Liese & Esterline, 2015). The compass of pleasure: How our brains make fatty foods, orgasm, exercise, marijuana, generosity, vodka, learning, and gambling feel so good. Additionally, its holistic and creative style provides opportunities to address concerns at various points with a variety of strategies and interventions that will best suit clients unique situations. Drayton, M., Birchwood, M. and Trower, P., 1998. Karriker-Jaffe, K. J., Klinger, J. L., Witbrodt, J., & Kaskutas, L. A. Review of outcome research on marital and family therapy in treatment for alcoholism. Clinical case formulations: Matching the integrative treatment plan to the client (2nd ed.). Precepting factors draw upon the ABC model (Burns, 1989; Ellis, 1977; Trower et al 1998) which refers to A- activating event, B Beliefs and C- consequences. Cognitive behavioural couple therapy. Testing case formulation hypotheses in psychotherapy: Two case examples. The following samples can be taken as basic templates for case conceptualization, in the context of Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and family therapy. Episodic future thinking in generalized anxiety disorder. Client substance use and misuse is a significant problem in the United States, and it continues to cause difficulty for individuals, families, and society. Evaluation of children with heart murmurs. 0000009229 00000 n And that's okay! 0000006666 00000 n Poorolajal, J., Haghtalab, T., Farhadi, M., & Darvishi, N. (2016). White, M., & Epston, D. (1990). Case formulation, also referred to as conceptualization, is a skill new counselors often lack (Liese & Esterline, 2015). This framework is idiographic in nature, as it looks at clients individually and holistically (Marquis & Holden, 2008). One of the strengths of this formulation is that it is not fixed. This factor has generally been underutilized despite being shown as beneficial to clients (Kuyken et al., 2009). As mentioned earlier different therapists have a different structure of formulations in CBT, this can be seen as a downside to the therapy, since it doesnt have a particular structure that everyone follows. What are the 5 Ps in psychology? Twelve-step attendance is most beneficial with inpatient substance use and misuse treatment (Karriker-Jaffe et al., 2018). 0000004344 00000 n The following pages describe two approaches to documenting the formulation using the 5Ps structure, including a narrative and flowchart. 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). Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Do you have a 2:1 degree or higher? https://doi.org/10.1097/NCM.0b013e318253f029 Current dose of sertraline is subtherapeutic, Ongoing discord in her romantic relationship, Good interpersonal support from her best friend who brought her to hospital, Re-experienced these feelings of abandonment after being fired from work. One versus many: Capturing the use of multiple emotion regulation strategies in response to an emotion-eliciting stimulus. Substance use and misuse carries numerous potential repercussions. https://doi.org/10.1111/j.1752-0606.2011.00280.x Compton, W. M., Gfroerer, J., Conway, K. P., & Finger, M. S. (2014). It is likely that other clinicians presented with Dax would use a different combination of approaches. The more you formulate, it can be helpful to have a rough template of different formulations for different diagnoses (e.g. Substance Abuse and Mental Health Services Administration. (Ed.). In spite of these limitations, there may be several potential areas of inquiry. The persons resilience and strengths that help maintain emotional health. Dax, however, is hyper-focused on surgery and seems to dismiss Saras position. The internal and external factors that maintain the current problems. The narrative formulation of the patient is a less rigid presentation structure where you may not choose to present everything in the 4 Ps table, and instead focus on the key factors that you think are relevant: A much more advanced and nuanced presentation might be using a more comprehensive formulation that integrates the 4Ps formulation through multiple lenses (e.g. As shown above, there are numerous ways to examine and treat client substance use and misuse. The Five Ps framework promotes a very clear and systematic approach to case formulation or assessment that potentially provides a wealth of data. Case Formulation Counselling Tutor What are the 5 Ps in psychology? - Alqatirat This involves explaining that interactions can act as a kind of back-and-forth loop of actionreactionaction without any resolution, leaving both parties feeling unheard, misunderstood, and frustrated. 0000199672 00000 n Some different presentation styles are suggested here. In addition, mindfulness strategies can assist in helping Dax to cognitively diffuse from present to future events (Harris, 2019). They disagree, interrupt one another, yell, and he calms down by having several beers. History & Philosophy of Psychology, 13(2), 3239. This inspires the development of a longitudinal understanding of a persons problems. Is diagnosis enough to guide interventions in mental 5 Ps Formulation Example. Factors in the 5 P's Model of Formulation - UKEssays.com Murphy, C. M., & Ting, L. (2010). Dick, D. M., & Agrawal, A. 0000200305 00000 n Greg experiences feelings of stress and anxiety over the past six months. Understanding how each factor contributes to a disease can better guide treatment decisions. Clinical Psychology 5 P Case Formulation - StuDocu 0000008363 00000 n However, each has some shortcomings. Case Conceptualization - Psychology Tools However, the Five Ps presents a framework in which counselors can examine and intervene with client substance use and misuse using a variety of approaches and strategies. Routledge. (2014). The American Journal on Addictions, 21(1), 3846. The patient may have a strong family history of the disease, a sedentary job, environmental exposures, and/or a nutritionally-poor diet. However, they may find this framework valuable as it provides one more way to address the often-encountered complex challenges of substance use and misuse. These factors all combine to cause the person to develop diabetes. Additionally, the lack of coping mechanisms leading to intense thoughts of suicide. 0000180123 00000 n Belenko, S., Hiller, M., & Hamilton, L. (2013). As you get better and more expert at formulating, you may not need to use this rigid structured format, and instead, will be able to present a more intuitive and organic formulation of the patient instead (see other methods below). all (2004) it is essential to reduce stress and traumatic events for people recovering from Paranoid Schizophrenia, and start to contribute in social activities. A concerned best friend called and talked to her this evening, and brought her to the hospital. Design of individualized behavioral treatment programs using functional analytic clinical case models. 0000186690 00000 n Precipitating factors are those that proximally bring about substance use and misuse and its resulting difficulties. *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 The counselor may also assist Dax in emotional regulation, which may prevent the initiation of arguments (Aldao & Nolen-Hoeksema, 2013). An investigation of stigma in individuals receiving treatment for substance abuse. 1. The following readings below are excellent resources to further develop your formulation skills: As you can see in the table above, it's a lot of questions to ask and a lot of things to think about! 0000010086 00000 n Note that this table is extremely comprehensive and long, and not everything will (or should!) As part of his adjudication, Dax was required to attend five counseling sessions and have a clinicians report provided to the court. There could be a discussion of alcohol use disorder being a disease, not that different from any other passed-on trait or disease.