ACT Case Formulation

Abstract

Because ACT is a contextual treatment, your attempts to conceptualize a presenting problem might be different from traditional case conceptualization models. The most important principle in contextual analysis is that you are not just assessing a particular symptom with a particular topography; you are also attempting to understand the functional impact of the presenting complaint. The same clinical complaint can function in dramatically different ways for clients. Thus, your case conceptualization and associated treatment plan may differ for clients with seemingly similar problems. For example, many patients are diagnosed with major depression, single episode (a categorical formulation) based on the number and severity of symptoms described by the patient (a topographical assessment). In clinical practice however, it is fair to say that no two depressed patients are alike. Each is unique in how their life space is organized, how depression affects their functioning (and vice versa) and how depressive beliefs and behaviors define the individual’s sense of self and external world.