How reliable are case formulations?: a systematic literature review

Flinn, Lucinda; Braham, Louise; das Nair, Roshan

Abstract

Objectives: This systematic literature review investigated the inter-rater and test–retest reliability of case formulations. We considered the reliability of case formulations across a range of theoretical modalities and the general quality of the primary research studies.

Methods: A systematic search of five electronic databases was conducted in addition to reference list trawling to find studies that assessed the reliability of case formulation. This yielded 18 studies for review. A methodological quality assessment tool was developed to assess the quality of studies, which informed interpretation of the findings.

Results: Results indicated inter-rater reliability mainly ranging from slight (.1–.4) to substantial (.81–1.0). Some studies highlighted that training and increased experience led to higher levels of agreement. In general, psychodynamic formulations appeared to generate somewhat increased levels of reliability than cognitive or behavioural formulations; however, these studies also included methods that may have served to inflate reliability, for example, pooling the scores of judges. Only one study investigated the test–retest reliability of case formulations yielding support for the stability of formulations over a 3-month period.

Conclusions: Reliability of case formulations is varied across a range of theoretical modalities, but can be improved; however, further research is required to strengthen our conclusions.

Citation

Flinn, L., Braham, L., & das Nair, R. (2015). How reliable are case formulations?: a systematic literature review. British Journal of Clinical Psychology, 54(3), https://doi.org/10.1111/bjc.12073

• Journal Article Type: Article
• Acceptance Date: Oct 31, 2014
• Online Publication Date: Dec 16, 2014
• Publication Date: Jul 24, 2015
• Deposit Date: Jul 15, 2016
• Publicly Available Date: Jul 15, 2016
• Journal: British Journal of Clinical Psychology
• Print ISSN: 0144-6657
• Electronic ISSN: 2044-8260
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 54
• Issue: 3
• DOI: https://doi.org/10.1111/bjc.12073
• Keywords: case formulation; case conceptualization; reliability
• Public URL: https://nottingham-repository.worktribe.com/output/756293
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/bjc.12073/abstract
• Additional Information: This is the peer reviewed version of the following article: Flinn, L., Braham, L. and das Nair, R. (2015), How reliable are case formulations? A systematic literature review. British Journal of Clinical Psychology, 54: 266–290, which has been published in final form at doi: 10.1111/bjc.12073. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.