Case Formulation in Psychiatry

Case formulation allows doctors, nurse practitioners, and nurses to see each patient’s unique story that led to their psychological breakdown. Nurse practitioners peer into the behavior of the patient and notice different details. Case formulation also takes into account the details of each patient’s past and teaches nurse practitioners to analyze why a mental disorder has manifested itself. Nurse practitioners pay close attention to detail, consult with each other, and learn to think globally by juxtaposing the facts and developing critical thinking. The scenario of treatment in such situations can differ from those already familiar, which, however, requires increased concentration and a large-scale background of knowledge from nurses. In addition, case formulation allows nurse practitioners to be culturally sensitive and treat patients with respect for their personal experiences. Case formulation expands the understanding of mental illness and allows for the active accumulation of medical experience using extraordinary examples. This method pays particular attention to the behavioral characteristics of people, their already-formed habits, and interpersonal communication.

In addition to being helpful in making a correct diagnosis, case formulation has a noticeable humanistic foundation. This method allows some patients to get rid of the stigma, especially patients whose psychological problems were caused by strong external stress. Such patients are usually afraid that their colleagues, friends, neighbors, and relatives will find out about their diagnosis. Modern society has not yet gotten rid of the stigma against people suffering from mental disorders. Because of this, psychiatrists can harm the patient by trying to help and doing only their job. Johnstone (2017) states, “Psychiatry is facing a fundamental challenge to its theory and practice with the crumbling of its cornerstone, psychiatric diagnosis” (p. 43). People associate diagnoses with hopelessness and having received it, some patients put an end to their future: “Best practice formulation is a radical act that restores agency, meaning, and hope” (Johnstone, 2017, p. 43). It seems to them that friends will turn away from them, and they will slowly slide into the marginal stratum of society.

Case formulation opens up opportunities for cooperation with the patient. Psychiatry usually disavows the patient as a subject and does not try to take into account his emotions and feelings, as well as his opinion about the treatment. Relatives under such circumstances are also often very pessimistic about treatment. The full cooperation of the patient and the nurse practitioner will allow them to quickly come to the correct diagnosis, without imposing the diagnosis on the patient and his relatives. Nurse practitioners and patients can thus share responsibility for care. They will talk together, correct mistakes in treatment and reap the benefits of successful treatment. It will be easier for them to integrate the patient back into society because this is the main final goal of treatment.

As a result, it can be assumed that the case formulation does not just help to quickly come to the correct diagnosis through conversations, interviews, and behavioral analysis. The nurse practitioner can, using this method, provide much more support and help to the patient than usual. The standard psychiatric diagnosis rarely takes into account the uniqueness of patients’ life experiences. Then the nurses’ conversations are not strictly mandatory and have little effect, outlining only general points. The standard diagnosis does not take into account the danger of social stigma for patients. This is especially true of patients employed in high and responsible positions, in which they are worried about their reputation. By adhering to the case formulation, the nurse practitioner is collaborating with the patient rather than objectifying him. The patient takes an equal part in his treatment and has an opinion on treatment issues.

References

Eells, T. D. (2022). Handbook of psychotherapy case formulation (3rd ed.). The Guilford Press.

Johnstone, L. (2017). A psychological formulation as an alternative to psychiatric diagnosis. Journal of Humanistic Psychology, 58(1), 30–46. Web.

Kramer, U. (Ed.). (2019). Case formulation for personality disorders: Tailoring psychotherapy to the individual client. Elsevier Academic Press.

Tusaie, K., & Fitzpatrick, J. (2022). Advanced practice psychiatric nursing, third edition: Integrating psychotherapy, psychopharmacology, and complementary and alternative approaches across the life span (3rd ed.). Springer Publishing Company.

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