Helping People Make Sense of Their Problems

The 2018 International Mental Health Conference is almost upon us again, this year the conference will be held over the 8th – 10th August at the RACV Royal Pines on the Gold Coast, Queensland.

This annual conference is now in its 19th year and continues to be the pinnacle event in the mental health industry. The Conference provides an invaluable opportunity to build relationships and to share knowledge, research and latest policies.

Dr Mark Franks, Senior Clinical Psychologist, ACT Health joins us at the conference to discuss ‘Using Psychological Formulation in Inpatient Mental Health Settings - Helping People Make Sense of Their Problems’.


Inpatient mental health settings are traditionally guided by the medical model, with treatment focussing primarily on diagnosis and pharmacological interventions. However, people often feel labelled and not fully understood as individuals. The aim of this presentation, based on the author’s clinical experience, is to outline the benefits of using psychological formulation on inpatient mental health settings.

The presentation will outline the core components of a psychological formulation, which include:

Present Problems - Focussing on individual symptoms (as opposed to diagnosis) that are problematic for the person, along with life stressors that are exacerbating distress. Drawing these out in a CBT based vicious cycle provides ideas for recovery using the metaphor of “breaking the cycle”.

Vulnerability Factors e.g. childhood trauma, invalidating family environments, developmental difficulties, biological predispositions.

Moving Forward - Focussing on a person’s values, goals, dreams and aspirations. Here, the importance of resilience is acknowledged. People who present to inpatient units often possess great resilience that can facilitate recovery.

The presentation will focus on how to construct a formulation on an inpatient setting. If a person is able to engage, the preferred approach of the author is to construct a formulation with the person collaboratively in sessions in the form of a “shared understanding” or “psychological jigsaw puzzle”. Whilst some people are clearly too unwell, a formulation may still be constructed based on file reviews and collateral information.

The benefits of formulation on inpatient settings will be discussed. A good individualised formulation helps people enhance their understanding of their problems and promote ideas for recovery, thus empowering and instilling hope. Formulation also supports the MDT, for example in case reviews, risk management and treatment planning.

To conclude, whilst further research is needed, anecdotal evidence has shown that there is a place for using formulation alongside psychiatric diagnosis in inpatient settings.


Dr Mark Franks is a Senior Clinical Psychologist currently working at ACT Health, Canberra. Dr Franks has worked across a range of clinical settings in the UK, Australia and New Zealand, with people experiencing complex and severe psychological difficulties. These settings include early Intervention for psychosis, inpatient settings, as well as working with the Pacific Island peoples of Auckland, New Zealand. The current presentation was inspired by therapeutic work that Dr Franks undertook at Canberra's Adult Mental Health Unit, fuelled by his passion for helping people fully understand more about their psychological difficulties, and empowering them in the recovery process.

For further information on the 19th International Mental Health Conference and to secure your spot please visit


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