Knowing yourself is the beginning of all wisdom

An assessment undertaken by a psychologist, aiming to give better understanding of an aspect of a person's mental health, cognitive function or other aspect of psychological functioning. Assessments with Stripy Bridge aim to address the questions or issues that brought a client to our services, to promote greater understanding and to develop a shared formulation that will help our client choose their next steps.

Formulation is at the heart of clinical psychology. Psychologists work with clients to develop hypotheses about how a person's experiences, actions, feelings and context interact. Formulation is a process in which a psychologist will develop and test hypotheses, amending and updating them as needed until they have reach a meaningful understanding of a person's situation or difficulties. A good formulation makes sense of how a situation is created and maintained, is a collaboration between client and psychologist and helps clients to make decisions about what they do next. 

Formulation can be an unusual concept if you haven't come across it before. We love some of the creative ways other psychologists have explained it.  Here are some posts from social media accounts we enjoy.This 'formulation tree' by creative.clinical.psychologist Dr Juliet Young was developed for working with children and young people.  

Psy.fiction shared this post about the basic '5Ps' formulation model showing some of the factors your psychologist will consider in their formulation.

This depends on the questions we have jointly agreed to address in your assessment. However, typically an assessment will take place over a few sessions. Your psychologist will ask you questions about what brought you to seek the assessment, the things you are hoping the assessment will help with. It is almost always relevant and important to ask you questions about your past experiences, which might include your childhood, the history of any difficulties you are seeking help with and anything you have tried before. 

The majority of our assessments will involve your psychologist asking questions and encouraging you to share your thoughts and ideas. They will be developing a formualation, and will test this out with you throughout the assessment to see whether it feels relevant and helpful. The aim is to reach a shared formulation that feels helpful and relevant to you. 

As part of our assessment, we will always consider whether there are any risks to yourself or anybody else that we need to know about. This is part of our professional obligation and duty of care. 

Sometimes it is appropriate for a psychologist to give a diagnosis alongside a formulation. It depends on several factors, including:

• Whether the assessment set out to consider possible diagnoses. If it did, your psychologist will consider whether you meet criteria for diagnosis as set out in diagnostic manuals known as DSM-5 and ICD-10. These manuals are internationally recognised diagnostic criteria for different mental health and developmental conditions

• What diagnosis might apply. Psychologists can diagnose a range of conditions, but will refer on to other professionals if appropriate (e.g. psychiatrists, physical health doctors). If you are seeking a diagnosis of something specific, then we would tell you at the beginning of the assessment if this is not something we can provide, and give the option of whether to continue.

• Ability to gather the necessary information. Diagnoses are only possible when we have the information needed. In most cases, we can get this information from you in our conversation. In some cases it will be relevant to ask someone else who knows you well some questions (e.g. a parent about what you were like in childhood). We only ever do this with your consent. For a small number of assessments it is helpful for us to undertake particular assessments that involve tasks or to observe you in different situations. We would always discuss this with you. 

• Whether the diagnosis applies. If we do not believe a diagnosis applies, we will not give it. In many cases, a comprehensive formulation is much more helpful than a single word diagnosis. 

Your psychologist will talk to you about the outcome of the assessment, what it means and our recommendations for what happens next. There will be plenty of opportunity for you to ask questions or discuss the findings. For some people, improving their understanding of themselves their aim and they might not choose to do anything more. For others, the assessment might suggest that there are psychological therapies or something else that might help them. If this is the case, your psychologist will talk to you about this. There is no obligation or pressure to access these therapies via Stripy Bridge, though we can often provide them if you wish. After an assessment, we will write you a letter or report for you to keep.