Case formulation-driven psychotherapy.

A case formulation–driven approach to psychotherapy addresses many of the difficulties clinicians experience when using empirically supported treatment (EST) protocols to treat complex cases. A formulation-driven approach provides the flexibility required to work effectively with complex cases by allowing clinicians to make intervention decisions guided by theory and by the results of continuous assessment rather than simply by the list of interventions described in the EST protocol. To strengthen the empirical foundation of case formulation–driven psychotherapy, the therapist can use a hypothesis-testing approach to each case, rely on evidence-based nomothetic formulations and therapies as templates for the idiographic formulation and treatment plan, and rely on other empirical findings to guide formulation, intervention, and clinical decision making. Recently developed EST protocols for complex cases include some of the key elements of case formulation–driven psychotherapy.