Chapter 7: Case Conceptualization and Treatment Planning
Chapter Overview
The authors discuss the principles, the models, and the documentation formats for biosychosocial case
conceptualization and treatment planning. The authors provide an explanation for how multicultural,
ethical, and legal concerns are incorporated into both case conceptualization and treatment planning.
Key Words
Case Conceptualization – Name given to the narrative that integrates description and explanation of
mental health problems. Its primary goal is to provide a hypothesis of causal mechanisms, which in turn,
guides treatment decisions.
Predisposing Factors – Any elements that make one person more likely to respond in a particular way to a
life circumstance.
Schemas – Deep cognitive structures or core beliefs.
Antecedents – Events that occur before a behavior or a set of behaviors.
Protective Factors – Prevent problems either from developing or from getting worse.
Multiple Choice Questions
1. Which of the following statements is correct with regard to case conceptualization?
a) It summarizes a case and identifies important issues for complex cases.
b) It integrates the description and explanation of mental health problems.
c) There is no agreed upon definition of case conceptualization by practitioners.
d) It is regarded as a core clinical skill.
e) All of the above
2. All of the following are benefits of case conceptualization, EXCEPT
a) It helps to guide the selection of interventions for treatment.
b) It allows practitioners to provide treatment with minimal one-on-one interactions with clients.
c) It helps validate and normalize a client’s issues.
d) It helps to identify the causes and effects of a client’s presenting problems.
3. The following are all elements of Case Conceptualization EXCEPT
a) Details about empirically supported treatments (EST).
b) Information about the precipitating, predisposing, perpetuating, and protective factors of the
current problems.
c) Decisions about specific treatment interventions.
d) Descriptions of the client’s symptoms, disorders and problems.
4. A diagnosis by itself is used to…
a) Provide guidance to counselors in a variety of situations.
b) Give clients the perception that their problems are normal and treatable.
c) Serve primarily as a basis for decision-making within a treatment plan.
d) Provide insight into the underlying cause of a client’s problem.
e) All of the above
5. Which of the following components are included in Person’s Case Conceptualization for Cognitive-
Behavioral Therapy?
a) the problem list
b) the precipitants of current problems
c) an explanation of central conflicts and themes
d) Both A & B
e) All of the above
6. Which of the following best explains the ideal structure and format of a case conceptualization?
a) It should generally be simple to save time and avoid the risk of over-complicating a client’s
treatment.
b) It should provide a balance between the complexity of a client’s situation and the overlying
concepts by which the treatment is based on.
c) It should be as detailed as possible to avoid misunderstanding and overlooking important
dimensions of a client’s issues or needs.
d) It should be structured enough to ensure that clients can understand and follow the outline of
their treatment with little difficulty.
7. Case Conceptualization begins with…
a) Establishing a healthy therapeutic relationship with a client
b) Developing a treatment plan to provide service to a client
c) Determining the appropriate model by which to base the treatment on
d) Assessing a client to determine her/his individual needs
8. Which of the following is true about causal factors in case conceptualization?
a) Causal factors do not give an explanation for why a client has specific problems or symptoms
b) Causal factors must remain consistent throughout a client’s treatment
c) Counselors typically want to use as few causal factors as possible
d) Counselors want to use as many causal factors as possible
9. A strong case conceptualization should give answers to all of the following questions EXCEPT
a) What are the client’s problems?
b) What events or situation precipitated the problems?
c) Why are the problems occurring?
d) What are the client’s irrational beliefs?
e) What are the client’s strengths?
10. When structuring a treatment plan, counselors should…
a) Clearly identify the problems, goals, and objectives of the plan
b) Disregard any previous treatment given to the client as it may not be relevant to the client’s
current issues
c) Base the plan solely on the client’s DSM diagnosis
d) Keep the plan confidential from the client to ensure the quality of the plan’s effectiveness
11. Client objectives on a treatment plan should be all of the following EXCEPT
a) Measureable
b) General
c) Attainable
d) Time-limited
12. Which of the following describes the relationship between a case conceptualization and a treatment
plan?
a) They are created independently of each other
b) A case conceptualization cannot begin without first creating the treatment plan
c) A treatment plan addresses the problems identified in the case conceptualization
d) If the case conceptualization is not accurate, the treatment plan will have no merit
e) None of the above
13. From of a cognitive theoretical perspective, which of the following could be a causal factor for a
client’s symptoms?
a) Poor diet
b) Core beliefs
c) Problematic relationship patterns
d) Both B & C
e) All of the above
14. Which of the following statements best describes the relationship between case conceptualization
and theories of psychotherapy?
a) Case conceptualization is not transferable across many different theories
b) A case cannot be conceptualized once a particular theory has been selected
c) Case conceptualization can be used by counselors of all theoretical orientations
d) Counselors trained in certain theoretical orientations will struggle with case conceptualization
15. Which of the following is an ethical consideration of diagnosis?
a) Diagnosis overlooks social stressors that may be affecting a client.
b) Diagnosis disregards diversity and cultural issues.
c) Diagnosis is just one step in a comprehensive evaluation.
d) Diagnosis fails to recognize a client’s strengths and abilities.
e) All of the above
Activities
1. Have the students view a video that contains characters with clinically diagnosable conditions and/or
diversity or cultural issues. Lists of movies are available on-line. Have the students develop a case
conceptualization of a character from the video with a model outlined in the chapter.
2. Using the internet, have students look up examples of 2 or 3 case conceptualizations and make a list of
the strengths and weaknesses of the examples they found. Have the students bring their lists to class and
discuss their results.
3. Have students break up into groups of 4 or 5. Give one student the role of the client and a scenario
describing why they have come to see a counselor. Give another student the role of the counselor. The
two students will role play a counseling session for a few minutes while the rest of the group observes.
After time is up, the groups discuss some things that they might include in a case conceptualization for
this client.
Discussion Questions
1. Rate yourself on a scale of 1-10 on your understanding of case conceptualization. Discuss what you
believe you need to learn to become more effective in this area, as well as ideas for improving your case
conceptualization skills.
2. Refer to the example of “Gail’s” case conceptualization in the textbook. Discuss possible multicultural
issues you might consider in Gail’s case (Examples: gender, age, able-bodiedness, spirituality).
3. Discuss the ethical and multicultural issues surrounding diagnosis in case conceptualization.
Multiple Choice Questions – Answer Key