Clinical Case Formulations

Tracking

You are following what the client says, allowing them to tell the story freely in their own style without interference. Your verbal responses (open questions to encourage more storytelling, close questions for clarification, and paraphrasing to show you understand) follow directly from what the client just said. You do not make a leap to a different topic. You match the client's tempo, choice of language, and body posture.

Visual (V)

‘I see what you mean’ or ‘I can picture that clearly’

Auditory (A)

‘I hear you’ or ‘that sounds very important’

Kinesthetic (K)

Experiences in our bodies, including emotions, bodily sensations, movement, and the sense of touch. "I feel what you are saying" or "I grasp what you mean."

Leading

You select a topic to focus on, but you avoid bombarding the client with questions

Deletion (metamodel)

Some details are missing from the clients statement. The counselor uses brief information-gathering questions like where, when, of what, by whom.

C: I am Afriand

Q: Of what specifically

C: that he will say something mean to me

Lack of Referential Index (Metamodel)

Vague pronoun, vague plural, or abstract noun. The could or asks for identification of the specific people or things that are being referred to.

C: Men can’t be trusted

Q: which man, specifically can’t you trust?

C: I can’t trust Joe; I caught him in several lies

Unspecified Verb (metamodel)

Vague about the observable actions and behaviors. Ask how to elicit specific actions and behaviors.

C: He bullies other kids

Q: How specifically does he bully them?

C:He threatens to hit them if they don’t give him some of their lunch

Nominalization (metamodel)

An ongoing process that is turned into a static thing by using an abstract noun. Replace the noun with a verb, then ask how to specify the verb

C: our relationship is dull

Q: how specifically are you relating?

C: we spend the evenings and weekends in separate rooms watching different TVS

Universal Quantifier (metamodel)

Over generalization; all or nothing thinking. Exaggerate the word or ask for an exception. In the answer, the client either recognizes it is an overgeneralization or provides information to prove that it is a valid representation of experience.

C: I’m never included

Q: Never? or have you ever been included?

C: I can remember two times when they invited me

Modal Operator (metamodel)

Imposed limits; shoulds and cant’s. For cant’s search for obstacle; for shoulds imagine consequences of not obeying “should”

C: I can’t tell him how I feel

Q: What stops you?

C: I have a fear of discovering that I care more than he does

Mind reading (metamodel)

making assumptions about another person’s feelings, thoughts, or intentions. Search for sensory data that support the assumption; this can challenge the client to stop mind reading.

C: He wants me to fail

Q: How specifically do you know?

C: I guess I don’t really know, i never asked him how he feels about it.

Cause-Effect Errors (metamodel)

There is a faulty assumption that A causes B or that A prevents B. Challenge the casual link and search for disconfirming data; you may need to ask several questions to get the client to recognize that there is no proof of causation.

C: she makes me feel guilty

Q: how are your guilty feelings caused by her?

C: I guess I let her get to me. I suppose I could just feel sorry for her.

Lost Performative (metamodel)

Imposed values; an unexamined platitude. Inquire about source of belief. You want the client to challenge the truth of the statement or to take responsibility for choosing it as a personal value or preference

C: vacations are a waste of money

Q: According to whom?

C: my parents always said that, but they were very poor, and i have lots of money and I can decide to spend it the way I want.