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      What is formulation in psychiatry?

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          Abstract

          The practice of formulation has been both championed and severely criticised within clinical psychiatry and interest in formulation within the teaching of clinical psychiatry is at a low ebb. This article traces the history of the biopsychosocial model, the concept of diagnostic hierarchy and the role of ‘verstehen’ (or intersubjective meaning grasping) in the clinical assessment. All three of these concepts are considered relevant to the practice of formulation. Responding to challenges aimed at these concepts, it argues that formulation in psychiatry needs resuscitating and rethinking and provides some recommendations for a practice of formulation fit for the 21st century.

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          Most cited references26

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          The need for a new medical model: a challenge for biomedicine

          G. Engel (1977)
          The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.
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            How the Laws of Physics Lie

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              The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments

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                Author and article information

                Journal
                Psychol Med
                Psychol Med
                PSM
                Psychological Medicine
                Cambridge University Press (Cambridge, UK )
                0033-2917
                1469-8978
                April 2023
                07 March 2023
                : 53
                : 5
                : 1700-1707
                Affiliations
                [1]Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , 16 De Crespigny Park, London SE5 9RJ, UK
                Author notes
                Author for correspondence: Gareth Owen, E-mail: gareth.1.owen@ 123456kcl.ac.uk
                Author information
                https://orcid.org/0000-0002-5166-9332
                Article
                S0033291723000016
                10.1017/S0033291723000016
                10106283
                36878884
                77e24bc0-ebec-4579-8277-a350cf4b013a
                © The Author(s) 2023

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                : 22 September 2022
                : 30 November 2022
                : 03 January 2023
                Page count
                Figures: 2, Tables: 3, References: 26, Pages: 8
                Categories
                Invited Review

                Clinical Psychology & Psychiatry
                formulation,biopsychosocial model,diagnostic hierarchy,verstehen,philosophy of psychiatry,medical education

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