A grounded theory of how service users experience and make use of formulation in therapy for psychosis

Objectives: This study set out to explore service user experiences of formulation during individual therapy for psychosis, and develop a grounded theory of the processes involved.

Method: Semi structured interviews were undertaken with 11 service users and two clinical psychologists with experience of formulation in therapy for psychosis.
Design: Grounded theory was used to examine the qualitative data collected.

Results: An emerging model was constructed to conceptualise the processes that occur during the sharing of a formulation. ‘Linking previous experiences with current ways of being’ and ‘Building the therapeutic relationship’ emerged as core, reciprocally influential processes. ‘Making use of new understandings’ was also identified as an important process.

Conclusions: The findings suggest that formulations should be developed collaboratively and progressively with service users, and that care should be given to the emotions that arise as a result. Further research is necessary to elaborate our understanding of formulation given the importance placed on it in United Kingdom clinical psychology.