Longitudinal Formulation (Beckian)

When to Use

Use when early experiences, core beliefs, and conditional assumptions are relevant to understanding the client's current difficulties. Typically developed in sessions 3-6 once you have sufficient history to map developmental pathways. Essential for depression presentations involving long-standing low self-esteem, recurrent episodes, or personality factors.

How to Introduce

Build on the cross-sectional formulation: 'We've mapped out what keeps your depression going now. Let's also look at how these patterns developed over time, connecting your earlier experiences to the beliefs and rules you carry today. This helps us understand not just the 'what' but the 'why.'

Adaptations

For clients who find exploring early experiences distressing, go at their pace and offer choice about which areas to explore. For those with extensive adverse experiences, be selective rather than comprehensive; focus on the experiences most relevant to current maintaining beliefs. Consider using a timeline approach for clients with complex histories.

Not appropriate if the client is in acute crisis or lacks emotional regulation skills to manage historical material. Avoid detailed exploration of traumatic events without a trauma-informed framework. Be cautious with clients who may use historical exploration as an avoidance strategy to avoid current behavioural change.

Clinical Tips

The longitudinal formulation should explain how the client's core beliefs developed, what rules and assumptions they created to cope, and what critical incidents triggered the current episode. It provides the rationale for core belief work. Treat it as a living document that evolves as therapy progresses rather than a fixed product.