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Role-relationship models for case formulation

M J Horowitz1, T Eells, J Singer

  • 1Department of Psychiatry, University of California, San Francisco, USA.

Archives of General Psychiatry
|August 1, 1995
PubMed
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This study introduces a multiple-selves approach to personality disorder formulation. This method helps clinicians define core contradictions in belief, improving diagnosis and treatment planning for complex personality disorders.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Personality disorders are prevalent and complicate psychiatric symptom disorders.
  • Diagnosing personality disorders is challenging due to difficulties in defining unitary core traits.
  • A multiple-selves approach aids in identifying core belief contradictions in patients.

Purpose of the Study:

  • To present a configurational system for case formulation in personality disorders.
  • To demonstrate how a multiple-selves approach can clarify complex personality structures.
  • To facilitate more effective diagnosis and treatment planning for personality disorders.

Main Methods:

  • Utilized a configurational system with states and person schemas.
  • Observed recurrent elements of identity, attribution, and action in self/other transactions and stories.

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  • Systematically arranged these elements as role relationship models for different behavioral states.

    • Main Results:

    • Achieved reliable and valid individualized formulations using configurations of role relationship models.
    • Clarified the complexity of personality disorders by inferring diverse self and other beliefs.
    • Explained cyclic repetitions of maladaptive interpersonal behavior patterns through enduring, erroneous beliefs.

    Conclusions:

    • The role relationship models method provides a structured approach to personality disorder formulation.
    • This formulation method is compatible with integrative treatment planning.
    • The approach enhances understanding and management of personality disorders.