As previously mentioned, participant responses were predominantly positive regarding conceptualisation, with higher ratios of “benefit‐ or, value‐coded” responses noted within four specific clusters or subthemes, namely: The level of conceptualisation use; the pursuit of further education of case conceptualisation; the selection and use of conceptualisation compatible therapeutic tools; and the qualities accredited to conceptualisation by practitioners.
1. Level of case conceptualisation use.
Almost all respondents (n=45; 98%) stipulated that they are using case conceptualisation in their everyday practice; in fact, most are using it in every case, and session as indicated by the following examples:
“All the time” (Respondent’s three, five, & 18).
“All the time for every case. Use a generic formulation for the disorder and an individual conceptualisation for each person I see.” (Respondent 33)
“All the time, after an initial assessment will check with client in 2nd session then periodically as we go through therapy.” (Respondent 37)
“Formualte [sic] during and following assessment; CBT concwptualisation [sic] is ongoing work,” (Respondent 38)
With the following respondents making reference to the view that case conceptualisation has further added utility, or value, in complex cases:
“I generally try and conceptualise all my cases but do tend to apply it a lot more to complex cases,” (Respondent 16)
“Every client, more cognitive detail with more complex cases.” (Respondent 17)
“Use in most instances ‐ but particularly in complex cases.” (Respondent 25)
Case‐level conceptualisation is a complex and time‐consuming process; and yet, as indicated by the above respondents; practitioners are utilising it “all the time”. Therefore, this is the first indicator that respondents value conceptualisation.
2. Pursuit of continued learning about case conceptualisation.
An additional indicator of value was noted in the fact that many practitioners (n=32; 89%) had pursued further study in the area in order to increase their understanding of the concept. Some (n=25; 69%) by completing workshops and/or attending conferences; including those by renowned CBT case conceptualisation experts; as indicated by the below responses:
“Schema training, anxiety disorders, RET training, Padesky Conference”
(Respondent one)
“Variety of disorder‐specific training workshops with case examples and
conceptualisations.” (Respondent three)
“Several (conferences), can’t remember them all but have included Keith Dobson, Judith Beck, Christine Padesky.” (Respondent 13)
Furthermore, almost all respondents (n=31; 97%) had read some form of literature about case conceptualisation; as indicated by the following:
“Keep up to date on articles and books within the field.” (Respondent five)
“I have academic books on various types of case formulation that I read as I need to.” (Respondent 36)
Reading is an important way for practitioners to stay aware of new research (a component that should be incorporated into any conceptualisation); but reading can also provide guidance; or develop skill as described by the following respondents:
“Read to develop skill and understanding,” (Respondent six)
“Read books and articles for guidance.” (Respondent 14)
The above statement indicate that practitioners are actively engaging in further education in order to increase their skill and understanding of conceptualisation; something they would not be likely to do if they did not value it.
3. The selection and use of conceptualisation compatible therapeutic tools. An additional indicator of value was the already high level of use of CBT conceptualisation specific tools and measures, with the majority (n=24, 65%) of respondents utilising these tools. In particular, respondents identified and stated that they utilised a variety of conceptualisation models; for example:
“(I) use 5part model as part of assement [sic] session” (Respondent eight)
“I elicit automatic thoughts through thought records and five part models” and “I might use Jeffrey youngs [sic] Schema questionnaire for certain clients” (Respondent 19)
“I use models such as Clark’s panic cycle, Beck’s cognitive conceptualisation forms, 5 part model, Rapee and Helmberg’s (1997) social anxiety model. I use thought records and monitoring forms mostly from Greenberger and Padesky (1995).” (Respondent 31)
“I use ABRA case formulation tool,” (Respondent 35)
As well as the following respondents who made reference to utilising normed measures in order to assist in the conceptualisation process:
“I might also do some additional screening questionnaires that are disorder‐ specific.” (Respondent five)
“It depends on the client, but I might use... the ATQ or DAS to get at thoughts and attitudes” (Respondent 19)
The aforementioned models and measures are designed specifically for use in the development of conceptualisation; or to assist the practitioner to elicit information required for effective conceptualisation; furthermore utilising normed measures is time‐consuming and in some cases, complicated. The fact that respondents are aware of these models; that they are actively utilising them; and that practitioners are willing to spend the time and effort required to form a case‐level conceptualisation; further indicates that they attach value to the process.
4. The qualities accredited to conceptualisation by practitioners.
Finally, the below references about the qualities that practitioners accredit to conceptualisation confirmed that practitioners value conceptualisation as a therapeutic process; for example:
“It is the thepretical [sic] framework we use to help us make sense”
(Respondent two)
“The conceptualisation drives the entire treatment.” (Respondent 19)
“Very often the conceptualistaion [sic] is at the core of therapeutic change.” (Respondent 20)
“It’s the basis of ongoing therapy,” (Respondent 25)
Specifically, practitioners identified numerous qualities of conceptualisation as beneficial to their self, their client, or the therapeutic process. These are fully‐explored as separate sub‐themes under the second category of “practitioner perceived benefits of conceptualisation”.