A formulation framework can assist in understanding the broader context for the young person.
A formulation tells us more about a young person and the context and effects of their strengths and difficulties. This is because the way a young person describes their symptoms may be similar across many difficulties. A diagnosis alone is not sufficient to determine the best intervention, especially where comorbidities are present.
Formulation aims to understand a young person’s strengths and difficulties in view of their understanding of things, social circumstances, relationships, life events, and history and development.
This allows for an individualised intervention to be developed in collaboration with the young person and their family that is effective, flexible and culturally-appropriate. Where possible, family and friends should be involved in assessment as they can often provide collateral information, another perspective and can support a young person’s recovery.
headspace recommends a formulation framework using the five Ps, as follows:
Presenting problem(s): Initial signs, symptoms or other difficulties that are clinically important for the young person. (e.g. low mood)
Predisposing factors: Aspects of the young person’s background that make him/her susceptible to presenting with the given problems (e.g. history of mental illness in family)
Precipitating factors: Immediate issues or events that have caused the young person to present with or experience these problems or symptoms at this time (e.g. recent life experiences/stressors, bullying etc.)
Perpetuating factors: Factors that cause the young person’s symptoms/problems to continue or to progressively get worse (e.g. conflict in home, low social support, poor coping strategies, bullying)
Protective factors: Factors that help to improve the young person’s situation or symptoms (e.g. supportive relationships, friendships and strengths)