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In CBT, the Five Ps formulation enables the clinician and patient to integrate etiological, longitudinal and cross-sectional factors through looking together at the Presenting Problem, with Predisposing, Precipitating, Perpetuating and Protective Factors.
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.
The biopsychosocial model of wellness and medicine examines how the three aspects biological, psychological and social occupy roles in relative health or disease.
The biopsychosocial interview assesses the client on three different dimensions (the three factors) which are: biological, psychological, and social. The biological dimension of the biopsychosocial interview is about the clients medical or genetic issues and developmental and physical characteristics.
An example of this is someone with depression and liver problems. Depression does not directly cause liver problems. However, someone with depression is more likely to abuse alcohol and so, therefore, could develop liver damage. The social component of the biopsychosocial method covers a wide range of social factors.
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At its most basic, you could present each box sequentially and describe each factor. Most learners will use this method as it is the most simple. It is usually presented as Predisposing Precipitating Perpetuating Protective factors.
The 5Ps highlight an approach that incorporates Presenting, Predisposing, Precipitating, Perpetuating, and Protective factors to a consumers presentation.
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).

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