The document discusses formulations in solution focused therapy. It notes that traditionally, formulations focus on client problems, their causes, and how they should be treated, taking an expert-driven approach. However, a solution focused formulation would instead focus on the client's goals and strengths, and see the client as the expert in their own life. A solution focused formulation involves identifying where the client wants to get to, the competencies they have to get there, and knowing when they have arrived at their goals.

1. SOLUTION FOCUSED
FORMULATIONS
E. Veronica (Vicky) Bliss
Southport & Ormskirk NHS Trust
Brief Therapy Support Svc. Ltd
E. V. Bliss, September 2013

2. THE STARTING POINT
• Are there any publications that clarify the
SF position on formulations? (Suzi Curtis)
E. V. Bliss, September 2013

3. SO I THOUGHT I’D BETTER
WRITE ONE
• No interdisciplinary agreement as to what
constitutes a formulation
• No literature on effectiveness
• Nothing linked to outcomes
• But everyone thinks it’s important
E. V. Bliss, September 2013

4. DESCRIPTIONS OF
FORMULATING
• Core Skill of Psychologists
• Critical skill of psychiatrists
• Central to organising assessment findings
• Central to interpreting meaning of client’s
issues
• An iterative process
• Involves working WITH client
E. V. Bliss, September 2013

5. DESCRIPTIONS OF A
FORMULATION
• Central aspect of good, competent
care
• Explain client’s problems
• Gives road map for treatment
• Provides yardstick by which treatment
efficacy can be measured
• Is central to ethical interventions
E. V. Bliss, September 2013

6. I NOTICED
• Definite focus on client problems, where
they came from, how they
developed, what maintains them and how
they ought to be treated
• Definite Expert-driven
• Entirely related to therapist’s view of
behaviour change
• Clear fit with medicalization of mental ill
health
E. V. Bliss, September 2013

7. HOW IS A PERSON TO MAKE
SENSE OF VARIOUS
FORMULATIONS?
• Attachment
troubles?
• Crooked Thinking?
• Chemical
Imbalance?
• Flawed Parenting?
• Repressed Trauma?
• Irrationality?
• Unrealistic?
E. V. Bliss, September 2013

8. DO SF’ERS WANT TO
FORMULATE?
• We could be seen as unethical without it?
• It seems an excellent idea to be able to
show how our conversations with others
flow from principles we hold about ‘reality’
and ‘change’
• It could ensure SF workers are competent
and properly trained?
• It places us within the therapeutic field
alongside the ‘big’ players?
E. V. Bliss, September 2013

9. DO SF’ERS WANT TO
FORMULATE PROBLEMS?
Nah
E. V. Bliss, September 2013

10. FORMULATIONS WITH A
DIFFERENCE
• SF initial ‘formulation’ would always be:
• Sarah is expert in her own life
• Sarah knows what she wants to change and
keep
• Sarah already has skills that have helped her
cope so far, and these can be used to attain
future goals
• Sarah will know when she’s moving forward
Talk talk talk talk
E. V. Bliss, September 2013

11. END OF 1ST SESSION
FORMULATION
• Sarah has survived this long with humour and hope
intact by playing music, by talking to her mother, by
staying quiet, by believing in herself, and by putting on
foot in front of the other every damned day no matter
what.
• In the long term, she wonders if she should be single
again
• In the short term, she’d like to notice herself feeling
more energetic in the morning
E. V. Bliss, September 2013

12. E. V. Bliss, September 2013

13. Sarah
• Single?
• Feel energy in
morning
• What else?
• What else?
• Seeing funny side
• Music
• Talking to mum
• Quietness
• Bullied at school /
work
• Lost jobs
• Bullied in marriage
• Self-
medicates/alcohol
• Set aside iTunes
money
• Let mum in on how
to help
• What else?
• What else?
E. V. Bliss, September 2013

14. SO IT TURNS OUT
• That an SF formulation (according to Bliss)
Involves:
• Knowing where the person wants
to get to
• Identifying competencies to get there
• Knowing when they’ve arrived
E. V. Bliss, September 2013

15. PLEASE CONTACT VICKY
• E. Veronica (Vicky) Bliss
Clinical Psychologist
Brief Therapy Support Services, Ltd
106 Deepdale Road
Preston, Lancashire
PR1 5AR
01772-200589
vicky@btss.org.uk
brief.therapyservices@nhs.net
www.btss.org.uk
E. V. Bliss, September 2013