Case Conceptualization

Description of the Strategy

Case conceptualization is the process of utilizing the abundance of information learned about a client to develop hypotheses about the causal, maintaining, exacerbating, and mitigating variables that directly and indirectly influence clinical problems. A clinically useful case conceptualization includes two essential components. The first is basic information about presenting concerns (e.g., topographical description, frequency of occurrence, when they began) as well as details regarding the etiology and factors currently maintaining clinical problems. Based on this information, the second component is developed and includes information about the interventions thought to be most helpful for that particular client.

Case conceptualization does not exist as a specified strategy or technique with clear guidelines on effective implementation but instead is an activity that can be accomplished in multiple ways. As such, the process is not unique to behavior modification or cognitive behavior therapy with children, and instead is central to clinical endeavors pursued from any theoretical orientation. However, the variables of focus will differ based on theoretical perspective. Furthermore, case conceptualization is particularly important when operating from behavioral or cognitive-behavioral perspectives, given the idiographic nature of these schools of psychological practice.

The theoretical underpinnings of behavior modification and cognitive behavior therapy with children has led to the adoption of functional assessment as the predominant method of case conceptualization for practitioners operating from these psychological orientations. Functional assessment has been defined in various ways but essentially involves an analysis of “act-in-context.” In other words, functional assessment involves identifying contextual (i.e., environmental) variables that directly influence the emotional, cognitive, and behavioral experiences of a child or adolescent. To conduct an effective behavioral case conceptualization, clinicians focus on several relevant factors. Each is described next.