Psychotherapy case formulation for patients with aggressive behaviours in clinical settings: an adaptation of the Multimodal Functional Model

Abstract

Aggressive behaviours are commonly observed in clinical settings, making it crucial to employ advanced assessment tools to accurately evaluate the likelihood of such behaviour. This article aims to present an assessment framework for developing a psychotherapy case formulation for patients with aggressive behaviours within the context of clinical setting. Recognising the disparities in the usage of aggression, as well as the comorbid nature of aggressive behaviours in patients with various psychopathologies, we propose an integrative framework that addresses these inconsistencies. The framework utilises the Hunter et al.’s (2008) Multimodal Functional Model as a foundation to which we integrated seven other models that are the I3 Model, the Algebra of Aggression model, the General Aggression Model, the Social Information Processing model, the Response Evaluation and Decision model, the Integrative Cognitive Model, and the nosographic model of mental disorders according to DSM-5. All these models were integrated into a comprehensive and expanded version of the Hunter et al.’s multimodal functional analysis worksheet, which combines the bio-psycho-social modalities of behaviour analysis in five factors that are instigation, vulnerability, reinforcement, habit strength, and inhibition. Additionally, case study example is provided to illustrate the development of a case formulation, which serves as a foundation for establishing therapeutic goals and implementing appropriate interventions. By incorporating a comprehensive understanding of aggression and utilising an adaptation of the multimodal functional analysis worksheet, this approach provides clinicians with a robust foundation for formulating effective therapeutic strategies.