This essay is in two parts: Part A and Part B. Please devote an equal word count (i.e., 1000 words) to each section.
What is evidence for the use of formulation, as used in clinical psychology practice, and how does it differ from the use of diagnosis?
How might you apply formulation to understand, and to plan treatment, for a person who presents with the difficulties in the vignette below?
Wendy is a 37-year-old woman who was dismissed from her job as a healthcare manager in a learning disabilities residential service approximately 18 months ago. She claims she was unfairly treated by her company and was blamed for an incident involving a resident: a resident assaulted Wendy but he was also injured when he was restrained by Wendy and a colleague. The incident was reported in the local papers. Wendy successfully pursued for a case of unfair dismissal three months ago, although she has not returned to work. She spends most of time in her own home because she is fearful of how people might react to her.
Wendy has sought psychological therapy because her husband is worried about her. He described how his wife is obsessed with harm coming to their two children (a boy aged 7 and a girl aged 5). Since her dismissal from work she has lost considerable weight, her sleep is impaired and she finds no enjoyment in any day-to-day activities. Her GP has prescribed anti-depressant medication, although she does not feel these have helped her symptoms. She feels that she can no longer return to her career, and that her future is very uncertain. Wendy reports that the only thing that helps her manage her anxiety is to keep busy.
On Assessment, Wendy described how she checks her windows and doors several times a day; and she feels she must check each window and external door in the house is closed each night before going to bed and she does so a minimum of three times. When her children are in a park or outside playing she has to make sure they remain visible to her at all times. She fears they will be taken by “bad people”. Wendy has felt anxious many times throughout her life but now she feels more controlled by it. She described her childhood as good but she was bullied at times in school. She likes to exercise at home and shed used to swim several times per week but this has stopped since the incident.
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