ROLE-RELATIONSHIP MODELS FOR CASE FORMULATION

Background: Personality disorders are important because they occur fre quently and often complicate psychiatric symptom disorders. They are d ifficult to diagnose and formulate because unitary core traits and the mes are hard to define for individual patients. A multiple-selves appr oach helps clinicians define core contradictions in belief that are fr equently present. Method: A configurational system for case formulatio n was used with an approach of states and person schemas. Transactions and stories involving self and others were observed for recurrent ele ments of identity, attribution, and action. These elements were system atically arranged as role relationship models for each important state of behavior. Cyclic repetitions of maladaptive interpersonal behavior patterns were then explained in terms of motivations and social event s that activate enduring, but erroneous, beliefs. Results: Reliable an d valid individualized formulations were derived by means of configura tions of role relationship models. Inferring several levels of diverse self and other beliefs clarified the complexity usually found in diso rders of personality. Conclusions: The role relationship models method of formulation is compatible with integrative approaches to treatment planning.