Chapter. Other approaches observe substance use and misuse from a family or systems perspective, looking at familial patterns such as communication and normalization of substance use (Bacon, 2019). We would anticipate when engaging in treatment, the patient may have [resistance/transference/countertransference]. 0000119626 00000 n Precipitating and perpetuating factors: the stressor of losing her job has reactivated these more primitive defense mechanisms and coping strategies. She was suddenly fired from her job today due to conflicts at work with co-workers and being late at work several times from sleeping in. 0000006894 00000 n Substance Use & Misuse, 49(5), 492512. Example of the 5 P's of Marketing John is considering operating a jet ski shop catering to travelers and tourists. Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: A meta-analysis. Like most things in medicine, there are multifactorial causes of diseases, illnesses, and disorders. Jane Doe is a 30-year-old female who presents with acute suicidal ideation in the context of a job loss. Diagram of Ray's 5Ps formulation (Johnstone & Dallos - ResearchGate Results from the 2016 National Survey on Drug Use and Health: Detailed tables. https://doi.org/10.1177/0017896918763462 We're here to answer any questions you have about our services. According to Read et. 1264 0 obj <>stream Additionally, Dax often struggles with strong and painful emotions, and alcohol helps to address them. https://doi.org/10.1093/oxfordhb/9780199935291.013.57 Narrative therapy to therapeutic ends. Dax reports a strong paternal history of substance use and misuse. Science, 196(4286), 129-136. Disclaimer: This is an example of a student written essay.Click here for sample essays written by our professional writers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638323/pdf/nihms734766.pdf startxref Sara is unequivocal in her confidence in Zoes cardiologist and his competence. 0000000016 00000 n The clinician may also seek more information on the cause of the reported stress between him and his wife. https://doi.org/10.1111/j.1521-0391.2011.00187.x Review of outcome research on marital and family therapy in treatment for alcoholism. Mintzberg's 5 P's of Strategy explained including video - toolshero 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. A review of CBT treatments for substance use disorders. Nurcombe B, Drell M, Leonard H, et al. The five Ps allow consultants to evaluate and intervene at . Early attachment experience and recovery from psychosis. Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Case Formulation and Intervention: Application of the Five Ps Framework 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). This likely led to an attachment style that was likely insecure and disorganized. It may include past difficulties and experiences if these are relevant to the present. Counselling with reality therapy (2nd ed.). Weerasekera, P. (1993). The following pages describe two approaches to documenting the formulation using the 5Ps structure, including a narrative and flowchart. Although these statistics are significant, it should be noted that Most people who use abusable drugs, even most people who use them nonmedically, do so in a reasonably controlled fashion and without much harm to themselves or anyone else (Kleiman et al., 2011, p. 2). What is a psychiatric case formulation? 0000245206 00000 n At the end of his workday, he and his wife got into an argument over the phone about an upcoming diagnostic test and the possible results. 0000238491 00000 n (Rachman & de Silva 1978, Salkovskis & Harrison 1984, sited in Tarrier et al. 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. It can be changed and reviewed as the treatment is in progress if any new information come to light. 0000016414 00000 n Fundamental Changes in DSM-5 Dimensional Approach The conundrum with categories No plagiarism, guaranteed! The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry. 0000017109 00000 n Type. However, the patient has protective factors including psychological mindedness and previous response to therapy, which is a good prognostic factor. Easden, M. H., & Kazantzis, N. (2018). Hypotheses are generated about the origins and causes of a patient's symptoms. The more cases you go through (and more of the sample formulations below) the more comfortable you will be with formulating! Problem areas reported by substance abusing individuals and their concerned significant others. Formulation: A multiperspective model. What are the 5 ps In formulation? - TheNewsIndependent 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. Formulation in psychology and psychotherapy: Making sense of peoples problems (2nd ed.). Clinical Psychology 5 P Case Formulation (Macneil et al., 2012) Your mindset for intervention should be geared towards CBT - in NHS IAPT services this would be 'your' approach along with assessment as part of your case formulation. Substance use and misuse has significant impact on the occupational sector as well. 0000239101 00000 n https://www.apa.org/pubs/journals/pas/index Do you have a 2:1 degree or higher? 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. Case formulation, also referred to as conceptualization, is a skill new counselors often lack (Liese & Esterline, 2015). In addition, there may be clients who are simply not ready or able to address some or most of the dimensions of the Five Ps. (2018). Examining the two groups experiences using the Five Ps may provide insight to assist counselor training programs related to substance use and misuse skill development. Psychology Essay Example: Case Study Using 5P's Model - speedypaper Academic Press. Family therapy and the treatment of substance use disorders: The family matters model. 0000241723 00000 n Routledge. van Boekel, L. C., Brouwers, E. P. M., van Weeghel, J., & Garretsen, H. F. L. (2013). 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). Lack of adaptive coping mechanisms resulted in using self-harm to cope and avoid further emotional dysregulation. 0000199386 00000 n Treating complex cases: The cognitive behavioural. Effects of treatment type on alcohol consumption partially mediated by Alcoholics Anonymous attendance. The effects of treatment for substance use problems on intimate partner violence: A review of empirical data. Abnormal and normal obsessions. Routledge.21-37). Such a framework may enhance the effectiveness of the aforementioned interventions (Wormer & Davis, 2018). Additionally, as it is a continuous process it allows the therapist to revise any incorrect hypothesis about any underlying mechanism at any stage. Dax was quite upset, cursed at her, and then hung up the phone. In addition, the vast majority of those with an SUD never receive treatment (Han et al., 2015). Mintzberg's 5 Ps of Strategy - Developing a Better Strategy - Mind Tools The approach that is highlighted in the 5Ps includes presenting, predisposing, precipitating, perpetuating, and protective factors. (2008). 300 words Here's what the completed table would look like with the psychological factors incorporated. What are perpetuating factors? 0000012481 00000 n 0000239180 00000 n https://doi.org/10.17744/mehc.30.1.j40256207h0581t1 Persons, J. - attachment theory, cognitive behavioural therapy, dialectical behavioural therapy, interpersonal therapy, psychodynamic therapy). Concurrently treating both is very complex, challenging, and expensive. Within the 'Presenting issues stage' its about looking at the current problems or issues the person is facing, to get a clear understanding of what they are and then set goals or . Professional Case Management, 17(4), 164172. 0000009229 00000 n Poverty, low socioeconomic status, teenage parenthood, or poor access to health care? The choice of the above approaches is only meant as an illustration and not as definitive ways to address this particular client. They are examples that the author chose to illustrate the Five Ps in practice. Selzer, R., & Ellen, S. (2014). 0000004306 00000 n In J. R. Brandell (Ed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860452/ It is open to modification any time during the treatment period and any new evidence that crop up at any time will be discussed with the client. Given that client substance use and misuse can be quite complicated, using various approaches within the Five Ps framework may yield positive results. Mintzberg's 5 Ps of Strategy with Examples 1. The Five Ps is a type of framework utilizing five factors developed by Macneil et al. Presenting Issue(s) - please use the DSM-What assessment tools. Delivery of mindfulness-based interventions may help to address stressful events that previously triggered substance use (Garland et al., 2014). For example, some interventions use an individual lens, such as cognitive behavioral therapy, which examines connections between thoughts, feelings, and behaviors (Morin et al., 2017). Your formulation of a patient evolves and changes as you collect more information. However, this can be done intuitively even without an in-depth understanding of these frameworks (we don't need to be Freud to do this). https://www.samhsa.gov/treatment CBT case formulations often have 5 ingredients: Presenting problem (s) Predisposing factors which made the individual vulnerable to the problem Precipitating factors which triggered the problem Perpetuating factors such as mechanisms which keep a problem going or unintended consequences of an attempt to cope with the problem Protective factors https://www.centeronaddiction.org/addiction-research/reports/behind-bars-ii-substance-abuse-and-americas-prison-population Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Alcohol Research Current Reviews, 31(2), 111118. Family therapy for drug abuse: Review and updates 20032010. 0000016707 00000 n Furthermore, the patient's difficulties can be understood as arising from the following developmental processes: which has led to the following thinking patterns: and the [precipitating event] is connected to their underlying struggles in the following way: They have the following: [protective factors], Jane Doe presents with a diagnosis of borderline personality disorder and history of depression. 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. A brief description of Dax, a hypothetical client, and the events that prompted him to seek services is followed by a detailed application of the Five Ps in addressing Daxs substance use and misuse. Sample #1: Conceptualization for CBT case This is a 35-year-old Caucasian man referred by his physician for treatment of generalized anxiety. This is where you'll need to be creative and also think more in-depth about your patient. Substance Abuse and Mental Health Services Administration. These beliefs are set off by occurrences in the client life, and once this belief is activated it can lead to automatic negative thinking. Finally, the number of U.S. adults with a comorbid SUD and mental illness has been shown to be almost 8 million, with only about 5% receiving treatment for both (SAMHSA, 2017). (2013). all (2004) it is essential to reduce stress and traumatic events for people recovering from Paranoid Schizophrenia, and start to contribute in social activities. Regrettably, most do not receive treatment while incarcerated (Belenko et al., 2013). Aldao, A., & Nolen-Hoeksema, S. (2013). The need for a new medical model: a challenge for biomedicine. The Five Ps can be used in a variety of settings such as a community mental health agency, primary care clinic, and inpatient or residential treatment centers. The goals here are to both break the pattern and to facilitate healthy conversations. Family history of mental disorders and substance use, Fears of abandonment which developed early in childhood, Early parental divorce, unstable home life, history of trauma, Increase in alcohol use in the last 3 months, Re-experienced these feelings of invalidation and abandonment after being fired from work, Her lack of adaptive coping mechanisms resulted in using self-harm to cope. The next step Precipitating is used to look at both internal and external factors and discover where they are linked, from this you get a greater picture of the overall problem. An investigation of stigma in individuals receiving treatment for substance abuse. https://doi.org/10.1002/jclp.22516 https://doi.org/10.1016/j.avb.2010.01.006 Case Formulation Counselling Tutor 0000156091 00000 n 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. 0000004656 00000 n 0000003178 00000 n In psychiatry, formulation appears more complicated because human behaviour and the brain itself is extraordinarily complex. Oxford University Press. 5Ps Formulation | PDF | Substance Abuse | Mental Disorder History & Philosophy of Psychology, 13(2), 3239. https://doi.org/10.3389/fpsyt.2013.00173 Bacon, M. Bush, D. M., & Lipari, R. N. (2015, April 16). 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 can be even more problematic given the lack of health care access for large numbers of Americans (Schoen, 2013). These psychological symptoms/factors are then observed by the clinician to give a psychiatric diagnosis. Some of these evidence-based approaches will be demonstrated later in a case illustration. A concerned best friend called and talked to her this evening, and brought her to the hospital. Self-help organizations for alcohol and drug problems: Toward evidence-based practice and policy. This area explores significant occurrences that preceded or triggered the presenting problem and its consequences. There could be a discussion of alcohol use disorder being a disease, not that different from any other passed-on trait or disease. Friendly Formulation - Psychology Tools Executive functioning in alcohol use studies: A brief review of findings and challenges in assessment. Collaborative case conceptualization: Working effectively with clients in cognitive-behavioral therapy. https://www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surveillance-report.pdf (Persons, 1998). The most common and clinically practical way to formulate is through the biopsychosocial approach, first described in 1980 by George Engel. Thus, there exists a need to concurrently examine and address the potentially complex nature of client substance use and misuse. 0000013350 00000 n Protective factors are those that help to moderate actual or potential substance use and misuse impact. https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf As mentioned previously, novice counselors often lack sufficient case formulation skills (Liese & Esterline, 2015). Here is the classic grid model of biological, psychological, social factors, along with the 4 P's. Factors include (but are not limited to) the following Linden, D. J. Substance Abuse and Mental Health Services Administration. Use this table as a general guide, but don't memorize it for the sake of memorizing it! Dax presents as extremely frustrated and embarrassed at being mandated to attend counseling sessions. The compass of pleasure: How our brains make fatty foods, orgasm, exercise, marijuana, generosity, vodka, learning, and gambling feel so good. Equally if there is lack of collaboration, this can be as a result of expectations from either client or the therapist for example if the client have expectations from the therapist because he sees him as the expert and should be able to provide all the answers to his problems without him the client having an input. From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs. Perpetuating Factors 0000155905 00000 n There was a parental divorce at age 5. (2017, September 7). Clinical Psychology 5 P Case Formulation - StuDocu Substance Use & Misuse, 53(4), 596605. The ball in the pool metaphor (i.e., holding a beach ball under the water works temporarily, but eventually it pops back up) can be compared to alcohol temporarily holding those painful emotions down, eventually to resurface. Chapter 5 - Psychological Models for Case Formulation https://doi.org/10.1080/02699931.2012.739998 Are mindfulness-based interventions effective for substance use disorders? This can result in lack of access to treatment services, contributing to increased stress. In the Five Ps context, protective factors are used to potentially prevent substance use and misuse from having more negative impact as well as to increase client resilience. The patient may have a strong family history of the disease, a sedentary job, environmental exposures, and/or a nutritionally-poor diet. Within the 'Presenting issues stage' its about looking at the current problems or issues the person is facing, to get a clear understanding of what they are and then set goals or targets based around this. What we understand today is shaped by what we believe and what we have experienced in our life. It is systematic, while allowing for flexibility and creativity.