Case conceptualization template pdf 2025

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  1. Click ‘Get Form’ to open the case conceptualization template in the editor.
  2. Begin by filling in the therapist's name, client/case number, and date at the top of the form. This establishes a clear reference for your documentation.
  3. In Section I, provide an introduction to the client and significant others. Include details such as age, ethnicity, and occupation. Use an asterisk (*) next to individuals present in the session.
  4. For Section II, describe the presenting concerns from both the client's and broader system's perspectives. This helps clarify the issues at hand.
  5. In Section III, outline recent background information and historical context that may influence current dynamics. This section is crucial for understanding underlying factors.
  6. Proceed to Section IV to assess systemic interactions. Document strengths and patterns within family structures, including communication styles and problem interaction patterns.
  7. Complete Sections V and VI by constructing a genogram and summarizing client perspectives on agreement and disagreement regarding assessments.

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These elements are described in terms of eight Ps: presentation, predisposition (including culture), precipitants, protective factors and strengths, pattern, perpetuants, (treatment) plan, and prognosis.
The four Ps of case formulation (predisposing, precipitating, perpetuating, and protective factors) also provide a useful framework for organizing the factors that may contribute to the development of anticipatory distress (Barker, 1988; Carr, 1999; Winters, Hanson, Stoyanova, 2007).
What should I include? A good case conceptualization includes a description of symptoms, diagnosis (if applicable), developmental history, family and relationship dynamics, traumas, coping skills, motivation for change, and goals. It helps determine the factors perpetuating the issues and maintaining the status quo.
Based on the developmental psychopathology perspective, factors in this review were hypothesized to fall under the four Ps of case formulation: predisposing (e.g., genetics and temperament), precipitating (e.g., negative pain experiences), perpetuating (e.g., parent behavior, parent anxiety, child behavior, and child
It would be helpful to have an instrument with strong psychometrics, and one that especially addresses the 7Ps (Presentation, Pattern, Predisposing factors, Precipitating factors, Perpetuating factors, Protective factors, Prognosis/Plan) of case conceptualization.
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