Characteristics of optimal clinical case formulations. The linchpin concept

Being able to discern the presence of a central organizing linchpin in a given clinical case represents a highly advantageous state of affairs. One can, by virtue of this, proceed in a very efficient and economical, as opposed to piecemeal, fashion. Further, one can achieve this economy and efficiency without paying the price of superficiality, since one is getting to what might be termed "the heart of the matter" in the client's case. Finally, one has in a linchpin formulation a central blueprint that provides (a) a clear, constant goal for therapist and client; (b) a clarification for clients of both their power and of where and how they would best target their efforts; and (c) a vast heuristic suggestiveness as to how one might proceed therapeutically to bring about important change.