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Advances in Psychiatric Treatment (2006) 12: 265-267
© 2006 The Royal College of Psychiatrists

Over-formalising the formulation?

INVITED COMMENTARY ON: TEACHING PSYCHODYNAMIC FORMULATION TO PSYCHIATRIC TRAINEES

Richard Lucas

Richard Lucas is consultant psychiatrist/psychoanalyst at St Ann’s Hospital in north London (St Ann’s Road, London N15 3TH, UK. Email:. Richardnlucas1{at}aol.com). He has a particular interest in the application of analytic concepts towards understanding psychosis.

In their recent articles in APT Mace & Binyon described a four-level approach to the teaching of the psychodynamic formulation. The fourth level requires development of confidence in the use of an operationalised psychodynamic diagnostics (OPD) manual. Here I critically reconsider the aspects necessary to develop the ability to arrive at a psychodynamic formulation. I argue that as one develops more sophistication and clinical confidence, one needs to move from a manualised to a more open-minded reflective mode.




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