Synopsis
Build a concise, testable account of why the person's difficulties arose, why they persist, what protects recovery and how those hypotheses determine a shared, proportionate plan without confusing formulation with diagnosis.
- Diagnosis describes a recognised syndrome; formulation explains this person's problems in context and links hypotheses to actions. The two complement but do not replace each other.
- Define the current problems and their chronology before organising evidence into predisposing, precipitating, perpetuating and protective influences.
- Cover biological factors such as genetics, neurodevelopment, illness, sleep, pain, reproductive change, medicines and substances without treating biology as destiny.
Key red flags
A long psychosocial narrative must not obscure sudden confusion, focal neurology, catatonia, withdrawal or another time-critical physical cause.
Investigation priorities
Specify symptoms, functional effects, baseline, onset, turning points and intervention responses.
Understand the person's account, language, priorities, cultural meaning, feared consequences and preferred help.
Management branches
Assessment has established an initial history, mental state, function and immediate risk.
- Define a small number of current problems and place their onset, changes and consequences on a dated timeline.
- Organise relevant vulnerability, triggers, maintaining loops and protective resources across biological, psychological and social domains.