Vicious Cycle - Responses And Consequences
Formulation is a key component of talking therapies and vicious cycles have long been recognized in psychotherapy as key mechanisms that perpetuate psychopathology. Identifying and mapping out vicious cycles can serve many therapeutic functions including: simplifying complex difficulties, making them more manageable; illustrating how problems manifest in different ways; normalizing ways of coping with difficulties; identifying maladaptive responses that perpetuate problems; identifying adaptive responses that can be strengthened or shaped into more helpful strategies; helping clients to gain distance from their difficulties; pinpointing ways to intervene. This Vicious Cycle – Responses And Consequences worksheet provides a client-friendly framework for understanding and mapping out the reasons why a problem persists across various situations. It helps clients identify specific responses to a difficulty that sustain or exacerbate it, leading to persistent challenges.
Download or send
Choose your language
Professional version
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Client version
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
Editable version (PPT)
An editable Microsoft PowerPoint version of the resource.
Translation Template
Are you a qualified therapist who would like to help with our translation project?
Tags
Languages this resource is available in
Techniques associated with this resource
Mechanisms associated with this resource
Introduction & Theoretical Background
Formulation in talking therapies
Formulations (also known as case formulations, case conceptualizations, and working hypotheses) are a central component of most talking therapies and a key skill for mental health professionals (DCP, 2010; RCP, 2017; Sperry & Sperry, 2012). In essence, a formulation is a way to make sense of an individual’s difficulties. It is a provisional account or hypothesis, informed by psychological theory, about what an individual is struggling with and why (Johnstone & Dallos, 2014). A formulation is also a tool that therapists use to relate theory to practice (Butler, 1998). Sperry and Sperry (2012, p. 4) describe formulations as:
A method and clinical strategy for obtaining and organizing information about a client, understanding and explaining the client’s situation and maladaptive patterns, guiding and focusing treatment, anticipating challenges and roadblocks, and preparing for successful termination.
Formulation is a fundamental part of most (if not all) therapeutic
Therapist Guidance
"I’d like to explore with you what might keep this issue going. One way we can do that is by drawing a diagram. Can we give it a try?"
Step 1: Explore the client’s experience
Problem
Ask the client to describe the problem they are struggling with. Problems can be defined as a diagnosis, or in other ways, such as in terms of troubling beliefs, behaviors, feelings, physical sensations, or patterns of interaction. While diagnoses are clear and succinct, other descriptions are more personalized and capture clients’ subjective experiences of the problem. Encourage the client to describe the problem in the most meaningful way possible, such as:
"Let’s start by describing the problem you are experiencing. How would you put it in your own words?"
Response
Ask the client to describe the typical ways they respond to the problem or try to cope with it. These responses might include ways
References And Further Reading
- Arntz, A., Rauner, M., & Van den Hout, M. (1995). “If I feel anxious, there must be danger”: Ex-consequentia reasoning in inferring danger in anxiety disorders. Behaviour Research and Therapy, 33, 917-925. DOI: 10.1016/0005-7967(95)00032-S.
- Bakker, G. M. (2008). Problem‐maintaining circles: Case illustrations of formulations that truly guide therapy. Clinical Psychologist, 12, 30-39. DOI: 10.1080/13284200802069050.
- Barry, T. J., Vervliet, B., & Hermans, D. (2015). An integrative review of attention biases and their contribution to treatment for anxiety disorders. Frontiers in Psychology, 6, 968. DOI: 10.3389/fpsyg.2015.00968.
- Beck, A. T., Rush, J. A., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
- Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford.
- Burns, D. D., & Good, M. F. (1980). The new mood therapy. New York, William Morrow.
- Butler, G. (1998). Clinical formulation. In: A. S. Bellack and M. Hersen (Eds.), Comprehensive Clinical Psychology (pp.1-23).