Cognitive behavioural case formulation in bipolar disorder

This chapter examines issues related to working with people seeking asylum using cognitive behaviour therapy (CBT) with a focus on engagement, assessment, case formulation and intervention. It argues that transdiagnostic formulation should be driven by the context of refugee experiences to understand how trauma, migration, transition, loss and psychological well-being interact. Uses of narrative and testimony interventions are aimed at posttraumatic stress disorder (PTSD) specific formulations. When working with people seeking asylum, it is important to be sensitive when assessing their history, especially when their coping strategies focus on avoidance. Initial stage interventions focus on developing safety, control and trust during engagement, assessment and psycho-education. Assessment and formulation is still part of the safety stage of Herman’s conceptualisation, with the goals of normalising reactions, validating experiences and developing a respectful therapeutic relationship. Using Herman’s concept of a process of recovery, therapists can order their interventions around the three stages: safety, transformation and reconnection. © 2016 Nicholas Tarrier and Judith Johnson.