Cognitive-Behavioral Case Formulation and Treatment Design: A Problem-Solving Approach

This user-friendly guide will help the clinician develop Cognitive-Behavioral treatment plans for 11 common psychological disorders (e.g., major depressive disorder, generalized anxiety, borderline personality disorder, anger problems). Based on a problem-solving model and empirical literature, the authors focus on two major clinical tasks involved in this process: case formulation and treatment design. They delineate short-term goals, long-term goals, treatment targets, and potential interventions.

Appendices include "quick guides to CBT treatment planning" for the 11 disorders and selected major CBT clinical intervention strategies noted throughout the book.

Because patients rarely present a classic textbook case, trying to fit together a treatment plan from the textbooks can be frustrating, especially when there's additional pressure for efficiency from managed-care policies. The three authors (two of them are associated with Drexel U. and one is in private practice) guide therapists through a model of clinical decision-making that takes variability into account to solve problems. They set out a process for determining short-term goals, long-term goals, treatment targets, and potential interventions for treatment targets for 11 common disorders and problems, including major depressive disorder, anxiety, obsessive-compulsive disorder, post-traumatic stress, borderline personality, and anger problems. Annotation © 2004 Book News, Inc., Portland, OR

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Reviewer:Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description:This book provides a guide for designing treatment for common psychological disorders from a cognitive-behavioral model, more specifically, a problem-solving approach.
Purpose:According to the authors, ..."we decided to write a book that can help guide the therapist through the process of cognitive-behavioral formulation and treatment design that takes such variability into account. As such, we will first present a model of clinical decision-making based on a problem-solving paradigm." They add: "We will then provide step-by-step guides in treatment planning. Specifically, within the context of the problem-solving model, and based on the empirical literature, we will delineate (a) short-term goals, (b) long-term goals, (c) treatment targets, and (d) potential interventions for treatment targets regarding each of 11 common disorders and psychological problems (e.g., major depressive disorder, generalized anxiety, borderline personality disorder, anger problems)." The book meets these worthy objectives in a somewhat superficial manner. Perhaps it is because they tried to tackle too much in a small volume.
Audience:According to the authors, this book "is written for the practicing mental health professional who is interested in applying cognitive-behavior therapy (CBT) interventions in an outpatient setting. Our goal is to provide a user-friendly guide that can help the clinician develop CBT treatment plans for 11 common psychological problems." The authors are indeed credible authorities in the subject matter of the book.
Features:The book begins with and explanation of the problem-solving model and how it relates to cognitive-behavioral therapy. It then discusses 11 psychological disorders and problems, suggesting assessment tools and providing specific therapy goals and outcome measures. This book is excellent in spelling out specific outcome goals for each disorder. However, these goals are not discussed at length and one would need to consult other books in order to learn the specific techniques, such as relaxation training, respiratory control, self-control therapy, etc. Neither does the book provide case examples. Two useful appendixes are included: Quick Guide to Treatment Targets and Description of Selected Cognitive-Behavioral Strategies. A shortcoming of this book is that it tries to tackle too many disorders, resulting in a superficial treatment of each. Yet it does give a nice overall guide to treatment, giving therapists good ideas in order to plan their work.
Assessment:I enjoyed this book because the authors provide excellent treatment strategies, along with outcome goals and measures. It is easy to read and covers a wide range of disorders. However, its strength is also its weakness, i.e. trying to cover too much ground can result in superficial treatment. Case examples would be helpful in illuminating the approach.

Arthur M. Nezu, PhD, ABPP, is Professor of Psychology, Medicine, and Public Health at Drexel University.

Christine Maguth Nezu, PhD, ABPP, is professor of psychology and associate professor of medicine at Drexel University. She has contributed to scores of scientific publications, has presented extensively at professional conferences around the world, and has participated on the editorial boards of leading psychology journals. Dr. Maguth Nezu is board certified in cognitive and behavioral psychology and is currently president-elect of the American Board of Professional Psychology. She serves on the board of directors of both the American Board of Cognitive and Behavioral Psychology and the American Academy of Cognitive and Behavioral Psychology. Her clinical research has been supported by federal, private, and state-funded agencies and she has served as a grant reviewer for the National Institutes of Health. She has been a practicing psychologist for over two decades.

Elizabeth R. Lombardo, PhD, was a practicing physical therapist for the Baltimore Veteran's Affairs Medical Center and adjunct faculty member in physical therapy at the University of Maryland before pursing her career in psychology. Since obtaining her doctorate in clinical psychology, Dr. Lombardo has completed a postdoctoral fellowship in clinical health psychology at the University of Texas Southwestern Medical Center in Dallas and is currently in private practice.