There is one part to this TMA. On the following pages you will find guidance on how to complete this assignment. This TMA contributes 15% towards your overall assessment score. It is not possible to substitute this assignment.

Task: Write a formulation report

In this TMA you are asked to write a formulation report, drawing on a mindfulness approach, that aims to advise on an intervention strategy that would be applicable to the client in the case study.

Word limit: 2000 words

In the following pages, you will find:

• learning outcomes addressed by this assignment
• student notes, including the case study for this assignment
• suggestions of relevant material from the module
• a checklist to ensure you have done everything required for this assignment.

Learning outcomes

The module learning outcomes assessed by TMA 04 are as follows:

Knowledge and understanding

• A systematic and critical understanding of current debates and new insights in theory and practice in counselling and forensic psychology.
• A systematic and critical understanding of the types of evidence and research methods used in counselling and forensic psychology.
• An understanding of the importance of ethical issues in researching and practicing counselling and forensic psychology.
• A critical understanding of how psychological theories and research are applied in practical and professional contexts in counselling and forensic psychology.

Cognitive skills

• Construct arguments with appropriate use of relevant concepts, theories and evidence.
• Identify and select evidence from a variety of sources.
• Interpret, analyse and critically evaluate the contributions of different kinds of evidence, recognising the possible limitations of sources.
• Apply concepts and theories to inform understanding of practice in counselling and forensic psychology.

Key skills

• Select, summarise, synthesise and appropriately reference information from different sources, including primary texts and secondary sources.
• Present written material in a coherently organised form, with developed arguments and information in logical sequence, and communicated effectively in a variety of forms.
• Develop both technical and non-technical skills, including the use of information technology to search for and access electronic resources, and to process, prepare and present information.
• Demonstrate the skills of independent learning to improve performance: plan, monitor, learn from feedback, and reflect on the process of learning to evaluate personal strengths and weaknesses.

Practical and/or professional skills

• Identify and work towards targets for personal academic career development and plan future personal development in counselling and forensic psychology.
• Communicate knowledge and/or findings in an appropriate way for particular audiences and present arguable and reasoned conclusions.
• Employ evidence based and logical reasoning to examine practical, theoretical and ethical issues, particularly in relation to issues concerning practice in counselling and forensic psychology.
• Use appropriate knowledge and skills to make professional judgements and plan appropriate interventions in practice.

Student notes

Case study

Sophie

You are working as a psychologist at an adult category B prison and you have your first session with Sophie, a 31-year-old female offender who is serving a three-year sentence for supplying class A drugs. Her probation officer has referred her to you for therapy because she believes that Sophie could benefit from it. She would like you to assess Sophie’s suitability for therapy and provide a formulation report that demonstrates how it could help her to overcome her offending behaviour.

Sophie’s history and background

Sophie told you that she had a difficult childhood. Her dad was an alcoholic who was often violent towards her mum, and towards her and her two younger brothers. When Sophie was about seven, things became so bad that they had to move out of the council house where they were living and into a refuge. Sophie didn’t see much of her dad after that, but things didn’t get much better as her mum had several boyfriends who were similar to her father. Her mum’s boyfriends also had unpredictable moods and resorted to verbal abuse or physical violence towards Sophie and the other children. Sophie said that she did not have a good relationship with her mum whom she felt did not have much time for her and her brothers. When Sophie was ten, Social Services placed all three children into care.

Sophie described experiences of neglect and bad treatment while in care and on a variety of foster placements. She described being treated by some of the families she was placed with as ‘slave labour’ and that she was forced to work for them all the time. This was an unstable period in Sophie’s life when she also became separated from her two brothers and lived in different children’s homes and foster placements. Sophie told you that from these experiences in her childhood she learned not to trust other people, and that you must look after yourself because nobody else will do so.

Sophie didn’t do well at school; she often truanted and began hanging out with boys who were older than her, drinking alcohol and smoking weed. When Sophie was 16 she became pregnant and gave birth to a baby boy, Olaf. After she gave birth she moved out of the children’s home that she was living in with her son, and into a flat provided by the council. Although she had no ongoing intimate relationship with the father of her son, he stayed in touch with them and visited occasionally. Sophie described this as a major positive development in her life and enjoyed being a mother to her son. However, the flat that Sophie moved to was in a different town and she became increasingly lonely. She began to miss the company provided by the people she used to hang out with. She started to try and find ways of being able to meet up with them again, placing her son with neighbours and friends whenever she could.

A couple of years later she met a man called Alexei, who initially gave her a lot of attention. The relationship developed to the extent that Alexei spent most evenings with her. Alexei was involved in dealing and supplying drugs and Sophie became drawn into his work, which became quite lucrative, enabling them to drive a nice car and go abroad for their holidays; something that Sophie had never experienced before. Eventually Sophie was able to give up her flat and move into Alexei’s house. Although she had some concerns about Alexei’s extensive dealing and supplying network and the kind of people who would visit the house, she was able to dismiss these worries because of the better standard of living they were now having.

This all changed early one morning after a visit from the Drugs Squad. She and Alexei were arrested for dealing and supplying class A drugs. Following an investigation, they were both prosecuted and each given lengthy prison sentences.

Sophie’s current situation

She arrived at the prison three months ago and has found it difficult to settle and make friendships. Things got worse for Sophie after an incident in the kitchen when the fellow workers accused her of being lazy and gave her the more difficult jobs to do. She has also began to take some drugs (e.g. ‘spice’) when she can get them, but she regrets it afterwards as they only provide temporary relief and in the long-term make her feel worse.

Sophie’s mood began to deteriorate on arrival at prison, and she reports the following symptoms:

• lack of energy and enthusiasm for previously enjoyable pursuits
• missing her son, feeling like a failure and hopeless about the future
• difficulty concentrating, particularly on jobs at the prison, and day-to-day decision-making
• constantly ruminating and feeling guilty about having abandoned her son
• avoiding socialising and talking to others.

Sophie is keen to find a way of overcoming her difficulties and wants to feel more accepting of what has happened in her life and where she finds herself now. She also wants to find some things she can do to change, and focus on preparing for her life outside prison in the future, particularly to become a good mother for her son, Olaf. For the purposes of this report there is no need to include any assessment of current risk and safety, as this has already been provided in a separate report.

Focus of the assignment

TMA 04 is intended to particularly assess your skills in drawing on the concepts and ideas of a particular therapeutic approach to make sense of a client’s problems, and your knowledge of theory and practice in this approach. For this assignment you have been asked to consider the client information from the case study above and write a formulation report for this client drawing on the mindfulness approach as covered in VLE Week 20.

The idea is for you to consider the information in the case study as though you were a therapist working with the client and apply your knowledge of mindfulness to explain the presented problems and ways to work with them.

However, unlike a ‘real therapist’ you will obviously not have the opportunity to ask the client further questions, or gain further insights by observing their interaction in the therapy session. The task with this assignment is rather to use the limited information available in the case study and to construct the best formulation report you can, based on the information available.

You can interpret the information in the case study and infer assumptions.

It will generally be important to remember that there is not one ‘correct’ answer to this assignment but that your formulation report should provide a good fit between the client’s problems and the concepts and ideas you apply to them.

Structuring your report

As your formulation will provide a rationale for a psychotherapeutic intervention that is based on mindfulness, it is recommended that you should structure your report around the following themes:

1. Short summary of Sophie’s case presentation (up to 200 words)

In a maximum of 200 words, you should start the formulation report by briefly summarising Sophie’s case presentation and current problems.

2. Possible causes for the problems

Then, highlight what you think might be possible causes for her problems from a mindfulness perspective.

3. Factors maintaining the problems

You should explain what you believe are the factors that maintain Sophie’s problems in light of mindfulness theory.

4. Factors that might help facilitate change

Here you are asked to identify factors that might support and facilitate change in Sophie from a mindfulness perspective. There is no right or wrong answer here, but you must be able to justify your choice.

5. Outline ideas for interventions and ways to work with this client

You must outline a plan of treatment for Sophie including ideas for interventions and ways to work with this client. You should make reference to your previous discussion of mindfulness theory and Sophie’s experience.

You have been asked to write a report for this TMA using headings and subheadings. If you do not use the report structure then you will be unable to gain higher than a pass 4 mark.

ANSWER

TMA Case Study

Short Summary of Sophie’s Case

• Sophie’s case presents continuous suffering and experiences of loneliness, neglect, and abandonment.
• Sophie lacks emotional connection to loved ones as none has been present in her life.
• The environmental exposures plays’ an extensive role in Sophie’s current situation.
• Sophie is faced with numerous life challenges such as poverty, lack of social connection, belonging, and positive support group.

Possible Causes for the Problems

• Sophie’s inability to develop positive life support team.
• Social connection, feeling of abandonment, and neglect are major causes to Sophie’s problems.
• Past experiences seem to recur as her son is exposed to similar circumstances she grew up on with a lack of stable family and love from her mother (Smith, 2018).
• Her incarceration shows a repeat of the same experiences she endured in her life and feels guilty of having abandoned her son.
• Self-pity and guilt are major causes of problems prompting Sophie to self-isolate which only is bound to worsen the situation.

Factors Maintaining the Problems

• Lack of proper and professional diagnosis to Sophie’s problem.
• Sophie’s lack of opportunity to connect and have a positive life support system.
• Poverty and lack of proper education to help shape a course for Sophie’s life.
• Sophie’s incarceration as it promotes the feeling of guilt and exposure to difficult tasks in prison.

Factors that Might Help Facilitate Change

• Focus on the precious things Sophie has in life such as her son.
• Install the need to become a better person.
• Conduct continuous and regular therapy sessions that can help Sophie better understand herself (Fonagy, 2015).
• Create self-awareness and self-acceptance.

Ideas for Interventions and Ways to Work with the Client

• Application of psychodynamic therapeutic approach can be an effective intervention measure to Sophie’s problem (Yakeley, 2014).
• The approach can be utilized to help create Sophie’s self-awareness.
• This is attained by creating an understanding the influence of her past on the present (Gatta et al., 2019).
• Hence, help shape a new course for the future.

References

Fonagy, P. (2015). The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry, 14(2), 137-150.

Gatta, M., Miscioscia, M., Svanellini, L., Spoto, A., Difronzo, M., de Sauma, M., & Ferruzza, E. (2019). Effectiveness of brief psychodynamic therapy with children and adolescents: an outcome study. Frontiers in pediatrics, 7, 501.

Smith, E. (2018). Why should we care? Psychodynamic theory and practice in counselor preparation. The Journal of Counselor Preparation and Supervision, 11(1), 4.

Yakeley, J. (2014). Psychodynamic psychotherapy: developing the evidence base. Advances in psychiatric treatment, 20(4), 269-279.