Therapeutic impact of case formulation in Beck's cognitive therapy for depression.

Within the field of clinical psychology, case formulation (CF) is considered central to the treatment of individuals with psychological difficulties (Bieling & Kuyken. 2002). The importance of formulation has also been emphasised in a number of psychological therapies, particularly CBT (Persons, 1989). Within CBT, CF is reported to play many roles in the therapeutic process with the aim of securing improved treatment outcomes. This review identified sixteen quantitative studies that examined the relationship between CF and outcomes in CBT. Contrary to expectations. no (statistical) evidence was found to Support the relationship: it was only through personal interviews that clients reported CF to have an impact on them. Quantitative studies, however. may be criticised for viewing treatment outcome exclusively in terms of changes in symptom presentation. To understand the impact of CF on treatment outcomes, studies need to assess aspects of therapeutic change beyond the narrow focus of symptomatology and relief from symptoms.