Young person's guide to formulation
Working with psychologists - understanding you and your difficulties - ‘Formulation’
Young person’s version
“We talked and they really listened – it was good to get ideas about what might help, and come up with a plan together..” (Young person aged 15)
Understanding you and your difficulties
When you have a problem one of the really important things is to try and understand it. Where it comes from? What keeps it there? Everyone is unique and so everyone’s problems are unique too. This goes for all problems but it is particularly true for psychological problems; like really low mood (what some people might call depression), or really big worries (what some people call anxiety). You are a person after all, not just a set of problems or difficulties, or a diagnosis. Once a problem is better understood it is easier to find ways to help.
How psychologists can help
Psychologists are one of the people who can help understand problems and find ways to help. We talk with you to hear about the difficulties you want to change. We will work with you to try and get a shared view of what is going on, using the ideas we have from our training, and hearing your ideas and your understanding of the problem. We often find it helpful to get a range of ideas from talking to others who know you well – like people in your family. We call this ‘shared expertise’; you are the expert on your life, and we have expertise from our training, and from working with other young people and their families, about what might help. Sometimes we might ask you if we can talk to teachers in school and other people who might be able to help us understand things better.
Once we have talked together enough we will share our thoughts about how we understand the difficulties you want to change, and share, from what we have heard, about where the difficulties come from, what keeps them stuck, and what we think might help (psychologists sometimes call all these things a ‘formulation’ as a kind of short hand). There may be a few things to choose from that might help and we would want to hear your ideas back – the ideas is that together we can come to a better understanding than either of us on our own.
Once you and the psychologist have a shared idea about what is going on and a plan to try and change it you should be given a copy written down – this is sometimes called a ‘care plan’ - usually this plan will go to your family Doctor or GP and often a copy will go to a parent or carer.
Hearing what you want
A psychologist will be interested in what you want to be different in your life – we will want to hear your goals and wishes about what you want to change, for some people this is quite easy and they know what they want – for others it can take a bit of time to get there – as we have said everyone is unique! And sometimes just understanding the problem a little better can be helpful enough and you might not need to meet again.
What to expect
Mostly this shared understanding is just done by talking – sometimes questionnaires or activities can be helpful to get information and ideas to understand you and your difficulties better as well. Along the way you and your psychologist should share decisions about the help you are getting, offering you choices along the way, and work with you to help you make the best choices for you. From time to time it will be helpful to check out if things are heading in the right direction – and if the understanding you had at the beginning still fits. Again talking and sometimes questionnaires can help check this out. If you speak to a psychologist on your own they will tell you how they will treat the information you give them and who, if anyone, they will share it with. If they don’t tell you you should feel free to ask – this is about you after all.
Know your rights
We can’t get on with everyone all the time and sometimes understanding and talking about problems can be difficult. Good psychologists will want to hear your thoughts about how things are going. But sometimes – for good reasons – things just don’t click and you should be given an option to see a different person if you really don’t get on.
We also know that sadly sometimes things go really wrong – if they do you can make a complaint – ask the psychologist or the service manger how you do this, they will usually have a leaflet that explains how to go about it – they must tell you if you ask! Sometimes advocacy agencies (people whose job it is to help you get your voice heard) can help and all NHS hospitals and clinics have something called PALS – who are there to help you if things aren’t working out as they should. There are also good online information from organisations like YoungMinds and Rethink – you can look them up on the internet.