Review of The case formulation approach to cognitive-behavior therapy

Reviews the book, The case formulation approach to cognitive-behavior therapy by Jacqueline B. Persons (see record 2008-13011-000). This book places case formulation as its core organizing principle for cognitive-behavior therapy (CBT). Explicitly framing case formulation in a hypothesis-testing context, Persons helps bridge the gap between those advocating strict adherence to manual-driven, empirically supported therapies (ESTs) and those who find such constraints impractical and less than optimal. Her guiding principle is to use ESTs to the extent that one can but to adapt them idiographically as one must to address the array of problems presented by the specific individual being treated. Persons' case formulation model is deceptively simple. It involves four basic components: (a) symptoms, disorders, and problems; (b) mechanisms; (c) precipitants; and (d) the origins of the mechanisms. Persons provides a fresh outlook on all these familiar components. In addition to providing step-by-step instruction for developing the formulation, Persons includes discussions of goal setting, which is organized in categories focused on mechanism change or learning compensatory strategies; treatment plan development; monitoring progress; decision making in the session; and handling nonadherence and treatment failure. A major strength of the book is the focus on the patient-therapist relationship. Persons repeatedly returns to the importance of establishing a positive working alliance and also discusses the opportunities that arise in efforts to re-establish a positive alliance following a rupture. The book is well organized, clearly written, contains up-to-date research references, and is replete with clinical examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved).