Psych CASC / OSCE · Professional — formulation
Co-construct a formulation with the patient — CASC communication station
MRCPsych/FRANZCP-style CASC: elicit the person's explanatory model, build a shared 4P formulation, include strengths, check cultural meaning, and map a bio-psycho-social plan and safety net.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in outpatient clinic. [1]
Candidate instructions. The person asks why they feel this way. Collaboratively develop a simple formulation using predisposing, precipitating, perpetuating, and protective factors across biological, psychological, and social domains. Use plain language. Include strengths. Explore cultural or personal meaning of the illness. Agree a shared plan (biological, psychological, social, safety). Avoid blame and jargon piles. Check understanding and invite corrections. [1][2][3]
References5ShowHide
- [1]Macneil CA, Hasty MK, Conus P, et al. Is diagnosis enough to guide interventions in mental health? Using case formulation in clinical practice BMC Med, 2012.PMID 23016556
- [2]Owen G What is formulation in psychiatry? Psychol Med, 2023.PMID 36878884
- [3]Kuyken W, Beshai S, Dudley R, et al. Assessing Competence in Collaborative Case Conceptualization: Development and Preliminary Psychometric Properties of the Collaborative Case Conceptualization Rating Scale Behav Cogn Psychother, 2016.PMID 25629820
- [4]Krishan Aggarwal N, Chen D, Lewis-Fernández R If You Don't Ask, They Don't Tell: The Cultural Formulation Interview and Patient Perceptions of the Clinical Relationship Am J Psychother, 2022.PMID 35430870
- [5]Lewis-Fernández R, Aggarwal NK, Lam PC, et al. Feasibility, acceptability and clinical utility of the Cultural Formulation Interview: mixed-methods results from the DSM-5 international field trial Br J Psychiatry, 2017.PMID 28104738