Forensic Case Formulation

TLDR

Formulation involves integrating diverse information to create a concise account of a person’s mental health problems, guiding treatment and decision‑making, yet there is no consensus on how it should be performed or evaluated, especially in forensic settings. This paper aims to highlight specific issues in forensic case formulation and elevate its importance in mental health practice. The authors define case formulation, outline key features, establish evaluation criteria, and discuss challenges in forensic practice, offering suggestions for research‑driven improvement. They conclude with a proposed research agenda intended to stimulate further study and advancement in forensic case formulation.

Abstract

Formulation is the process or product of gathering and integrating diverse information to develop a concise account of the nature and etiology of the problems affecting a person's mental health to guide idiographic treatment design and other decision-making. Formulation is a core competency in mental health practice, including forensic mental health; however, there is no agreement concerning the details of how it should be done or how to evaluate it, either generally or more specifically with respect to forensic mental health. The purpose of this paper is to raise specific issues in the practice and evaluation of forensic case formulation, and so enhance the profile of this important area of work. In this paper, we (1) define case formulation and describe its key features, (2) specify criteria for evaluating case formulation, and (3) address challenges in forensic practice, with suggestions for advancing practice through research. We conclude with a proposed research agenda that we hope will encourage and promote activity in this important area.