What Makes your Problem a Problem?
Problem Definition & Formulation
Copyright © Donald Robertson, 2011. All rights reserved.
Why is your problem problematic? One of the first tasks in cognitive-behavioural therapy (CBT) is to arrive at a reasonable definition of the problem and a hypothesis that explains it, also known as a problem “formulation” or “conceptualisation.” Cognitive-behavioural therapy emphasises the role of cognitions (thoughts, images, beliefs) and behaviour in maintaining problems, e.g., by perpetuating disturbing emotions and bodily sensations, etc. The initial steps involved in defining and formulating a problem can be summarised as follows,
- Identify a specific example of a situation where the problem occurred
- Analyse the situation into its elements, e.g., thoughts (cognition), actions (behaviour), and feelings (emotions and sensations)
- Consider the links between the elements, e.g., how do your thoughts influence your feelings?
- Look at several (2-3) other examples in the same way and try to identify common themes and recurring patterns across situations.
The questions below will help you to get started by analysing a specific situation into its elements and considering the links between them.
1. Situational Analysis
What’s a recent, typical example of a situation where the problem occurred? Where were you, when was it, who was involved and what happened?
What emotions did you feel in the situation (e.g., anger, fear, sadness)? Rate how strong each emotion was at the time (0-100%).
What bodily sensations or physical symptoms did you experience in the situation?
What did you fear might happen? What other thoughts or images did you experience at the time? Rate how strongly you believed each thought at the time (0-100%).
What did you actually do or say in the situation? Did you do anything to try to protect yourself, escape from, or cope with the problem?
2. Links between Elements
2.1. What links are there, if any, between your thoughts and emotions in the situation? How might one influence the other?
2.2. What links are there, if any, between your thoughts and behaviour in the situation?
2.3. What other links might exist between the different elements of the situation and your response?
2.4. What elements of the situation would it be best to change? How could you change them?