To formulate or not to formulate? A case study

Abstract

Personality disorders are common in specialist forensic mental health services and can complicate the treatment and care
of people who may also have other co-morbid mental health problems—especially because they are based on unclear and
unvalidated descriptions. The following article analyses the case of Laura who is a fictional character that represents the
presentation of several women who have received care for personality disorder(s) and other mental health problems in a
specialist forensic hospital. The assessment, formulation and care planning process conducted with Laura adhered to evidence based practice guidelines and led to reductions in aggressive behaviour and violent incidents. This case study shows how effective case formulation can be used to understand service users with complex problems including personality disorder(s) and enhance the safe and effective care provided. Overall this case highlights the necessity of consistent staff teams and clinical supervision when working with this client group.