Cognitive analytic team formulation: learning and challenges for multidisciplinary inpatient staff
| DOI | https://doi.org/10.1108/MHRJ-01-2019-0001 |
| Pages | 85-97 |
| Published date | 02 July 2019 |
| Date | 02 July 2019 |
| Author | Rose Stratton,Ranil Tan |
| Subject Matter | Health & social care,Mental health |
Cognitive analytic team formulation:
learning and challenges for
multidisciplinary inpatient staff
Rose Stratton and Ranil Tan
Abstract
Purpose –The purpose of this paper is to understand staff experiences of cognitive analytic team
formulation, within an inpatient unit for women with a diagnosis of personality disorder.
Design/methodology/approach –In total, 16 staff completed an online questionnaire, rating their views on
how helpful formulation sessions had been in regards to ten domains. Following this, six staff participated in
semi-structured interviews exploring their experiences of the process and impact of cognitive analytic team
formulation. Transcripts were analysed using thematic analysis.
Findings –Responses from questionnaires indicated the general process of team formulation was helpful
across each domain. Interviews highlighted benefits such as an increased capacity to think and work
relationally. This was impacted upon by staff’s confidence in using the model and the practicalities of
attending sessions.
Practical implications –Team formulation has been d escribed as the facilita tion of a group of
professionals to create a shared understanding of service-users’difficulties. Team formulation continues to
demonstrate benefits for staff working within complex mental health. The challenges of this are considered,
however overall, a cognitive analytic framework seems to offer staff the opportunity to integrate learning
from a service-user’s history, and current relational difficulties, in a way that develops reflective capacity
and informs interventi on.
Originality/value –Limited research has explored the theoretical models underpinning team formulation,
and the impact for staff learning and practice. The current study develops previous work by specifically
focussing on the contribution of cognitive analytic theory to team formulation.
Keywords Thematic analysis, Personality disorder, Team formulation, Inpatient, Cognitive analytic therapy
Paper type Research paper
Introduction
Formulation is a key aspect of many psychological therapies. It is defined as a process of
collaborativesense-making, underpinned by psychological theory (Divisionof Clinical Psychology,
2011). Team basedformulation, in a variety of formats,is a development which has been explored
more recently. It is important to note that practice appears to have outstripped research, and
therefore the research base consists mostly of service evaluations.
Team formulation has been described as the “process of facilitating a group of professionals to
construct a shared understanding of a service-user’s difficulties”(J ohnstone and Dallos, 2014, p. 5).
Christofides et al. (2012) describe several different methods of team formulation including verbally
discussing service-users, sharing specific reports and formulations, informal conversations, as well
as more formal meetings designed for the staff team. Discussions around psychological formulation
are particularly relevant in the evolving context of a medical model of mental health, whereby
service-users may experience stigma and feelings of worthlessness and shame related to
their diagnosis ( Johnstone, 2014). Service-users have reported finding the medical language
un-relatable, and feeling more validated and understood when able to tell their story (Gary, 2018).
Received 3 January 2019
Revised 20 March 2019
Accepted 26 March 2019
Rose Stratton is based at
Turning Point, York, UK.
Ranil Tan is based at Leeds
and York Partnership NHS
Foundation Trust, York, UK.
DOI 10.1108/MHRJ-01-2019-0001 VOL. 24 NO. 2 2019, pp. 85-97, © Emerald Publishing Limited, ISSN 1361-9322
j
MENTALHEALTH REVIEW JOURNAL
j
PAG E 85
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