Team psychological formulation to create a shared understanding of distress: a qualitative study in an older people’s mental health inpatient setting

Abstract

Purpose: Team psychological formulation is an organisational intervention aimed at developing a shared understanding of a person’s mental health difficulties. There is a lack of evidence regarding the therapeutic value of this approach for older people. The purpose of this paper is to explore how older people and their carers experience a cognitive-behavioural approach to team psychological formulation, within a mental health inpatient service in the UK. Design/methodology/approach: A qualitative study using interpretative phenomenological analysis was undertaken. In total, 13 participants were interviewed: five older people/carer dyads, two lone older people and one lone carer. Findings: Three overarching themes emerged: “Emotional impact of formulation” captured the mixed emotions that the process evoked in participants. “Making sense?” reflected the therapeutic value that participants experienced and what held them back from making gains in their recovery. “Disempowered people trapped in a biomedical world” illustrated the negative aspects of ward care, which hindered recovery. Research limitations/implications: The findings provide insights into the therapeutic value of team psychological formulation and the difficulties in facilitating the process effectively. More consistency is required to ensure that team formulation is standardised. Further research into the outcomes of the approach for older people is recommended. Practical implications: Recommendations are proposed for how team psychological formulation can be conducted effectively, using the mnemonic “SETUP”. Originality/value: This study focussed on older people’s and their carers’ own perspectives regarding the team psychological formulation approach.