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PACT : A protocol for assessment, mechanism‐based case formulation and treatment planning
Author(s) -
Hagmayer York,
Witteman Cilia,
Claes Laurence
Publication year - 2021
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13540
Subject(s) - pact , conceptualization , psychopathology , protocol (science) , mechanism (biology) , psychotherapist , anxiety , radiation treatment planning , psychology , treatment protocol , psychiatry , clinical psychology , medicine , computer science , alternative medicine , artificial intelligence , surgery , political science , philosophy , epistemology , pathology , law , radiation therapy
Background Proponents of clinical case formulations argue that the causes and mechanisms contributing to and maintaining a patient's problems should be analysed and integrated into a case conceptualization, on which treatment planning ought to be based. Empirical evidence shows that an individualized treatment based on a case formulation is at least sometimes better than a standardized evidence‐based treatment. Methods We argue that it is likely to improve decisions when two conditions hold: (a) knowing about the mechanisms underlying the patient's problems makes a difference for treatment, and (b) the case formulation is based on valid knowledge about mechanisms of psychopathology. Results We propose a protocol for assessment, case formulation and treatment planning (PACT), which incorporates transdiagnostic accounts of psychopathology. PACT describes a 5‐step decision making process, which aims to help clinicians to decide when to resort to evidence‐based treatments and when to construct a case formulation to individualize the treatment. Conclusion We show how PACT works in practice by discussing treatment planning for a clinical case involving symptoms of social anxiety, depression and post‐traumatic stress disorder.