Is cognitive case formulation science or science fiction?

Bieling, Peter J.; Kuyken, Willem

doi:10.1093/clipsy.10.1.52

Cited by 174Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

Is cognitive case formulation science or science fiction?

Bieling, Peter J., Kuyken, Willem·2003·Clinical Psychology: Science and Practice

DOI 10.1093/clipsy.10.1.52

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Abstract

As with all systematic models of therapy, cognitive therapy distills a theory to the understanding of particular cases through the case formulation method. This article sets out criteria to evaluate whether cognitive case formulation follows the process of scientific inquiry, and it questions whether the formulation method meets these criteria. In terms of the evidence base for the cognitive theory that underpins cognitive case formulation, the research suggests that although the descriptive elements of cognitive theory are substantiated, the explanatory elements have received less support. In terms of the scientific status of the cognitive case formulation process, current evidence for the reliability of the cognitive case formulation method is modest, at best. There is a striking paucity of research examining the validity of cognitive case formulations or the impact of cognitive case formulation on therapy outcome. Implications for the clinical use of cognitive case formulation within a scientistpractitioner model are discussed, and potential programs of research to evaluate the case formulation method are described. Key words: depression, anxiety, personality disorder, cognitive therapy, case formulation, cognitive models.

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Changes in CCRT pervasiveness during psychotherapy.
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Cognitive Specificity in Social Anxiety and Depression: Self-Statements, Self-Focused Attention, and Dysfunctional Attitudes
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THE SPECIFICITY OF COGNITIVE PERSONALITY DIMENSIONS IN CLUSTER C PERSONALITY DISORDERS
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Depressed and normal individuals differ both in selection and in perceived tonal quality of positive-negative messages.
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When do infants expect?
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What is the point of a formulation?
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Stability of the CCRT from before psychotherapy starts to the early sessions.
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Book Review. Cognitive Therapy of Borderline Personality Disorder
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Acceptance and commitment therapy: model, processes and outcomes
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.006 · Cited by 6,587 · see citing works
Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies
Hayes, S. C. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80013-3 · Cited by 2,493 · see citing works
Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies – Republished Article
Hayes, S. C. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.11.006 · Cited by 785 · see citing works
Acceptance and mindfulness-based therapy: New wave or old hat?
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Toward Guidelines for Evidence-Based Assessment of Depression in Children and Adolescents
Klein, D. N., Dougherty, L. R., & Olino, T. M. (2005) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3403_3 · Cited by 363 · see citing works
Untitled work
(2004) · Cited by 283 · see citing works
“Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry
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A process-based approach to psychological diagnosis and treatment:The conceptual and treatment utility of an extended evolutionary meta model
Hayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101908 · Cited by 227 · see citing works
The reliability and quality of cognitive case formulation
Kuyken, W., Fothergill, C. D., Musa, M., & Chadwick, P. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.08.007 · Cited by 165 · see citing works
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Disorder specific and trans-diagnostic case conceptualisation
Dudley, R. E. J., Kuyken, W., & Padesky, C. A. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.07.005 · Cited by 113 · see citing works
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The Science and Practice of Case Conceptualization
Kuyken, W., Padesky, C. A., & Dudley, R. (2008) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465808004815 · Cited by 98 · see citing works
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Collaborative empiricism in cognitive therapy: A definition and theory for the relationship construct.
Tee, J., & Kazantzis, N. (2011) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2010.01234.x · Cited by 93 · see citing works
Therapist Competence, Comorbidity and Cognitive-Behavioral Therapy for Depression
Kuyken, W., & Tsivrikos, D. (2008) · Psychotherapy and Psychosomatics · doi:10.1159/000172619 · Cited by 89 · see citing works
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A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders
Sburlati, E. S., Schniering, C. A., Lyneham, H. J., & Rapee, R. M. (2011) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-011-0083-6 · Cited by 89 · see citing works
Clients' experience of case formulation in cognitive behaviour therapy for psychosis
Pain, C. M., Chadwick, P., & Abba, N. (2007) · British Journal of Clinical Psychology · doi:10.1348/014466507x235962 · Cited by 87 · see citing works
Sudden gains in cognitive–behavior therapy for treatment-resistant depression: Processes of change.
Abel, A., Hayes, A. M., Henley, W., & Kuyken, W. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000101 · Cited by 76 · see citing works
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Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies
Ayers, S., McKenzie‐McHarg, K., & Eagle, A. (2007) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/01674820601142957 · Cited by 66 · see citing works
Applying Evidence-Based Principles From CBT to Sport Psychology
McArdle, S., & Moore, P. (2012) · The Sport Psychologist · doi:10.1123/tsp.26.2.299 · Cited by 56 · see citing works
The HCR-20 Version 3: A Case Study in Risk Formulation
Logan, C. (2014) · International Journal of Forensic Mental Health · doi:10.1080/14999013.2014.906516 · Cited by 54 · see citing works
Efficacy of narrative reformulation during cognitive analytic therapy for depression: Randomized dismantling trial
Kellett, S., Stockton, C., Marshall, H., Hall, J., Jennings, C., & Delgadillo, J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.05.070 · Cited by 50 · see citing works
Case conceptualization research in cognitive behavior therapy: A state of the science review
Easden, M. H., & Kazantzis, N. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22516 · Cited by 49 · see citing works
Expert reasoning in psychotherapy case formulation
Eells, T. D., Lombart, K. G., Salsman, N. L., Kendjelic, E. M., Schneiderman, C. T., & Lucas, C. P. (2011) · Psychotherapy Research · doi:10.1080/10503307.2010.539284 · Cited by 49 · see citing works
How reliable are case formulations? A systematic literature review
Flinn, L. C., Braham, L. G., & das Nair, R. (2014) · British Journal of Clinical Psychology · doi:10.1111/bjc.12073 · Cited by 47 · see citing works
What Do People with Psychosis Think Caused their Psychosis? A Q Methodology Study
Dudley, R. E. J., Siitarinen, J., James, I. A., & Dodgson, G. (2008) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465808004955 · Cited by 47 · see citing works
An evaluation of case formulation training and consultation with probation officers
Minoudis, P., Craissati, J., Shaw, J., McMurran, M., Freestone, M. C., Chuan, S. J., & Leonard, A. (2013) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.1890 · Cited by 39 · see citing works
Biopsychosocial Case Formulation for People with Intellectual Disabilities and Mental Health Problems: A Pilot Study of A Training Workshop for Direct Care Staff
Ingham, B., Clarke, L., & James, I. A. (2008) · The British Journal of Mental Subnormality · doi:10.1179/096979508799103323 · Cited by 37 · see citing works
Validation of Idiosyncratic Cognitive Schema in Cognitive Case Formulations: An Intraindividual Idiographic Approach.
Mumma, G. H. (2004) · Psychological Assessment · doi:10.1037/1040-3590.16.3.211 · Cited by 37 · see citing works
Validity Issues in Cognitive-Behavioral Case Formulation
Mumma, G. H. (2011) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000054 · Cited by 35 · see citing works
Formulation in eating disorder focused family therapy: why, when and how?
Baudinet, J., Simic, M., & Eisler, I. (2021) · Journal of Eating Disorders · doi:10.1186/s40337-021-00451-3 · Cited by 37 · see citing works
Reformulation in cognitive analytic therapy: Effects on the working alliance and the client's perspective on change
Shine, L., & Westacott, M. C. (2009) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608309x471334 · Cited by 34 · see citing works
Bridging the gap between practice guidelines and the therapy room: Community-derived practice adaptations for psychological services with transgender and gender diverse adults in the central United States.
Hope, D. A., Holt, N. R., Woodruff, N., Mocarski, R. A., Meyer, H. M., Puckett, J. A., Eyer, J. C., Craig, S. L., Feldman, J., Irwin, J., et al. (2022) · Professional Psychology Research and Practice · doi:10.1037/pro0000448 · Cited by 34 · see citing works
Comparing the Validity of Alternative Cognitive Case Formulations: A Latent Variable, Multivariate Time Series Approach
Mumma, G. H., & Mooney, S. (2007) · Cognitive Therapy and Research · doi:10.1007/s10608-006-9062-5 · Cited by 33 · see citing works
Theoretical and Evidence‐Based Approaches to Case Formulation
Eells, T. D., & Lombart, K. G. (2011) · Wiley eBooks · doi:10.1002/9781119977018.ch1 · Cited by 34 · see citing works
The utility of case formulation in treatment decision making; the effect of experience and expertise
Dudley, R. E. J., Ingham, B., Sowerby, K., & Freeston, M. H. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.01.009 · Cited by 33 · see citing works
Clients’ experiences of formulation in cognitive behaviour therapy
Redhead, S., Johnstone, L., & Nightingale, J. (2015) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12054 · Cited by 32 · see citing works
Entrenamiento psicológico para la mejora de la atención y la autoconfianza en un futbolista
Zafra, A. O., & Dominguez-Igual, J. J. (2016) · Revista de Psicología Aplicada al Deporte y el Ejercicio Físico · doi:10.5093/rpadef2016a4 · Cited by 31 · see citing works
A literature review of Case Formulation to inform Mental Health practice
Rainforth, M., & Laurenson, M. (2013) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12069 · Cited by 31 · see citing works
Use of Simulated Multidisciplinary Treatment Teams and Client Actors to Teach Case Conceptualization and Treatment Planning Skills
Osborn, C. J., Dean, E. P., & Petruzzi, M. (2004) · Counselor Education and Supervision · doi:10.1002/j.1556-6978.2004.tb01865.x · Cited by 28 · see citing works
Stability and Change in Cognitive Behavior Therapy: Considering the Implications of ACT and RFT
Hayes, S. C. (2005) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-005-0007-9 · Cited by 29 · see citing works
Evaluating acceptance and commitment therapy: An analysis of a recent critique.
Gaudiano, B. A. (2011) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0100927 · Cited by 26 · see citing works
Rate of Agreement Between Clinicians on the Content of a Cognitive Formulation of Delusional Beliefs: The Effect of Qualifications and Experience
Dudley, R. E. J., Park, I., James, I. A., & Dodgson, G. (2010) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465809990658 · Cited by 26 · see citing works
A new conception and subsequent taxonomy of clinical psychological problems
Bakker, G. (2019) · BMC Psychology · doi:10.1186/s40359-019-0318-8 · Cited by 27 · see citing works
Case Mis‐Conceptualization in Psychological Treatment: An Enduring Clinical Problem
Ridley, C. R., Jeffrey, C. E., & Roberson, R. B. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22354 · Cited by 25 · see citing works
Therapist competence in case conceptualization and outcome in CBT for depression
Easden, M. H., & Fletcher, R. B. (2018) · Psychotherapy Research · doi:10.1080/10503307.2018.1540895 · Cited by 25 · see citing works
Handbook of evidence-based psychotherapies : a guide for research and practice
Freeman, C., & Power, M. (2007) · Cited by 25 · see citing works
Advances in Cognitive-Behavioural Therapy for Unipolar Depression
Kuyken, W., Dalgleish, T., & Holden, E. (2007) · Canadian journal of psychiatry. Revue canadienne de psychiatrie · doi:10.1177/070674370705200103 · Cited by 24 · see citing works
Self-citation
A cognitive behavioral case formulation framework for treatment planning in anxiety disorders
Boschen, M. J., & Oei, T. P. S. (2007) · Depression and Anxiety · doi:10.1002/da.20301 · Cited by 23 · see citing works
Assessing Trainee Clinical Psychologists' Clinical Competence
Tweed, A. E., Graber, R., & Wang, M. (2010) · Psychology Learning & Teaching · doi:10.2304/plat.2010.9.2.50 · Cited by 23 · see citing works
A literature review exploring the efficacy of case formulations in clinical practice. What are the themes and pertinent issues?
Aston, R. (2009) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x09000178 · Cited by 22 · see citing works
Formulation in Clinical Risk Assessment and Management
Logan, C., Nathan, R., & Brown, A. (2011) · doi:10.1002/9781119991175.ch10 · Cited by 22 · see citing works
Forensic case formulation: Theoretical, ethical and practical issues
Davies, J., Black, S., Bentley, N., & Nagi, C. (2013) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.1882 · Cited by 20 · see citing works
Exploring the Effect of Case Formulation Driven CBT for Children with Anxiety Disorders: A Feasibility Study
Esbjørn, B. H., Reinholdt-Dunne, M. L., Nielsen, S. K., Smith, A. C., Breinholst, S., & Leth, I. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465813000702 · Cited by 21 · see citing works
Complex forensic case formulation in recovery‐oriented services: Some implications for routine practice
Moore, E., & Drennan, G. (2013) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.1885 · Cited by 21 · see citing works
Assessing Competence in Collaborative Case Conceptualization: Development and Preliminary Psychometric Properties of the Collaborative Case Conceptualization Rating Scale (CCC-RS)
Kuyken, W., Beshai, S., Dudley, R. E. J., Abel, A., Görg, N., Gower, P., McManus, F. V., & Padesky, C. A. (2015) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465814000691 · Cited by 21 · see citing works
Self-citation
Social Cognitive Personality Assessment: A Case Conceptualization Procedure and Illustration
Scott, W. D., & Cervone, D. (2015) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2015.01.003 · Cited by 20 · see citing works
The Content, Quality and Impact of Cognitive Behavioural Case Formulation During Treatment of Obsessive Compulsive Disorder
Nattrass, A., Kellett, S., Hardy, G. E., & Ricketts, T. (2014) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246581400006x · Cited by 20 · see citing works
Does coaching psychology need the concept of formulation?
Lane, D. A., & Corrie, S. (2009) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2009.4.2.195 · Cited by 20 · see citing works
Diagnosis and formulation: what should we tell the students?
Carey, T. A., & Pilgrim, D. M. (2010) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.695 · Cited by 20 · see citing works
Incremental Validity of Cognitions in a Clinical Case Formulation: An Intraindividual Test in a Case Example
Mumma, G. H., & Mooney, S. (2006) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-006-9024-y · Cited by 20 · see citing works
The acceptability and feasibility of an anxiety reduction intervention for emergency department patients with non-cardiac chest pain
Webster, R., Thompson, A. R., Norman, P., & Goodacre, S. W. (2016) · Psychology Health & Medicine · doi:10.1080/13548506.2016.1144891 · Cited by 19 · see citing works
Examination of self patterns: framing an alternative phenomenological interview for use in mental health research and clinical practice
Daly, A., Ritunnano, R., Gallagher, S., Kirmayer, L. J., Dam, N. T. V., & Kleinman, J. J. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1390885 · Cited by 20 · see citing works
Offender Personality Disorder Pathway: Evaluation of Team Consultation
McMullan, E., Ramsden, J., & Lowton, M. (2014) · Mental Health Review Journal · doi:10.1108/mhrj-12-2013-0041 · Cited by 18 · see citing works
Written case formulations in the treatment of anorexia nervosa: Evidence for therapeutic benefits
Allen, K. L., O'Hara, C., Bartholdy, S., Renwick, B., Keyes, A., Lose, A., Kenyon, M., DeJong, H., Broadbent, H. J., Loomes, R., et al. (2016) · International Journal of Eating Disorders · doi:10.1002/eat.22561 · Cited by 18 · see citing works
Nonspecific Factors and the Efficacy of Psychosocial Treatments for Anger.
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Authors: Bieling, P. J., & Kuyken, W.
Affiliations: St. Joseph’s Healthcare Hamilton (CA)
University of Exeter (GB)
ORCID: Bieling, Peter J.
Kuyken, Willem
Venue: Clinical Psychology: Science and Practice
Publisher: American Psychological Association (APA)
Published: 2003
Volume: 10
Issue: 1
Pages: 52-69
ISSN: 0969-5893 (ISSN-L)
1468-2850
DOI: 10.1093/clipsy.10.1.52
OpenAlex: W2056187445
Cited by: 174
References: 163
Citations by year: 2026: 2 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 11 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 9 · 2016: 15 · 2015: 8 · 2014: 8 · 2013: 11 · 2012: 6
FWCI: 6.61
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 4626 d)
Locations: Clinical Psychology Science and Practice (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords: cognitive therapy, scientific validity, reliability statistics, treatment outcomes, scientist-practitioner model, cognitive models, depression, anxiety, personality disorders, evidence base

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