Making first contact: What to do with all that information! part 2

Last week I described some of the reasons for using a case formulation approach when working through initial assessment information, and today I’m going to describe one approach for organising a formulation. This is the “4 P” formulation, and it’s one that’s often used in mental health (Bolton, 2014). In the 4 P model, there are four questions to ask yourself: Preconditions – Why is this person vulnerable to this problem?Precipitating factors – Why now? This can mean “why is this person having symptoms now?” or “why is this person presenting to this person for treatment right now?”Perpetuating factors – Why is this person still ill?Protective factors – Why is this person not more ill? Remembering that people are whole people, and that pain is always multifactorial, this formulation approach incorporates diagnostic information (disease) alongside a person’s response to disease (illness). The two facets of “being unwell” go together – but not synchronously. We can have a disease and be oblivious to it (think of many forms of cancer, hypertension, Type 2 diabetes, osteoarthritis…and even Covid-19). Once we begin to experience symptoms and decide that this is not “normal” we call it illness. And if symptoms and signs begin to impinge on what we can and can’t do in life, we can call this disability or functional limitations. These in turn (more or...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Chronic pain Clinical reasoning Pain conditions Professional topics Research Science in practice biopsychosocial case formulation Occupational therapy pain management Therapeutic approaches Source Type: blogs