‘Chipping in’: Clinical psychologists’ descriptions of their use of formulation in multidisciplinary team working


Stella Christofides, Clinical Psychologist, Children and Young People's Centre, 15 Homerton Row, Hackney E9 6ED, UK (e-mail: stella.christofides@eastlondon.nhs.uk).


Objectives. To investigate clinical psychologists’ accounts of their use of psychological case formulation in multidisciplinary teamwork.

Design. A qualitative study using inductive thematic analysis.

Methods. Ten clinical psychologists working in community and inpatient adult mental health services who identified themselves as using formulation in their multidisciplinary team work participated in semi-structured interviews.

Results. Psychological hypotheses were described as shared mostly through informal means such as chipping in ideas during a team discussion rather than through explicit means such as staff training or case presentations that usually only took place once participants had spent time developing their role within the team. Service context and staff's prior experience were also factors in how explicitly formulation was discussed. Participants reported that they believed that this way of working, although often not formally recognized, was valuable and improved the quality of clinical services provided.

Conclusions. More investigation into this under-researched but important area of clinical practice is needed, in order to share ideas and support good practice.