‘Like walking with someone as opposed to trying to catch up to them’—Dynamics at play when clinicians and young people formulate together

Abstract

AbstractObjectiveThe aim of the present study was to explore the social process of formulation in talk therapy between young people and clinicians.DesignQualitative semi‐structured interview study.MethodTen young people (male = 6, female = 4, age range = 16–23 years) and nine clinicians from various disciplines within a youth mental health service were interviewed. Constructivist grounded theory was used for the analysis.ResultsFour themes were constructed from the data; a ‘level playing field’ between young person and clinician enables formulation, formulating is a constant process of getting it right and getting it wrong, emotional expression and attunement get us closer to each other and to understanding, and ‘formulation versus diagnosis’ can create tension in the therapy room. The constructivist grounded theory devised demonstrated how the dynamics of power, collaboration, openness, and the therapeutic relationship are constantly in flux during the process of formulation.ConclusionThe paper presents a constructivist grounded theory which incorporates dynamics relating to power, collaboration, and openness. The importance of the therapeutic relationship is also emphasised. The theory encourages continuous and recursive personal reflection by the therapist as to how they can be optimally attuned to the dynamics of power, collaboration, and openness with young people.