“True Enough” Formulations: The MAPS Approach

Abstract

Clinical case formulation is at the core of competent care. When appropriately constructed it is grounded in best practices and serves as an explanatory model, a prescriptive road map, and a yardstick for all interventions. Despite the key role of formulations, many clinicians struggle with their construction and usage. The author offers a new model described as the MAPS approach. This framework, which is pragmatic, driven by clinical data, and process oriented, helps clinicians develop a "true enough" core formulation focusing on the most salient clinical elements that must be addressed. Its graphic nature helps reinforce the interrelated systems nature of psychiatric work and directs the clinician to a restricted number of specific areas that both inform the "core formulation" and serve as the targets for care. This comprehensive model, which includes evaluation, formulation, treatment planning, and treatment monitoring, readily complements and dovetails with the full range of treatment approaches.