Skip to main content Accessibility help

Can a control model approach assist case formulation in psychotherapy?

  • Christopher G. Spratt (a1) and Timothy A. Carey (a2)

This paper looks at issues regarding case formulation in psychotherapy. Case formulation is well recognized as being helpful in the conceptualizing of psychological problems and as a useful tool in the practice of cognitive therapy. Control, as opposed to behaviour, is increasingly being seen as that human process most relevant to psychopathology. We look at the diagnosis and treatment of a small number of people, treated in a naturalistic setting, who were selected without any specific criteria other than being people whose problems were treated using the Method of Levels, a form of cognitive therapy based on the principles of Perceptual Control Theory, and who completed both pre- and post-treatment questionnaires. We then consider how the problems these people presented with, and their treatment, might be formulated as a result of taking this approach.

Corresponding author
*Author for correspondence: Mr C. G. Spratt, NHS Fife, Locality Mental Health Team, Randolph Lodge, 2 College Street, Buckhaven, Leven, Fife KY8 1JX, UK. (email:
Hide All
Andrews, G, Crino, R,, Hunt C, Lampe, L, Page, A (1994). The Treatment of Anxiety Disorders: Clinician's Guide and Patient Manuals. Cambridge University Press.
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.
Appelbaum, SA (1990). The relationship between assessment and psychotherapy. Journal of Personality Assessment 54, 791801.
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.
Beck, JS (1985). Cognitive Therapy: Basics and Beyond. New York: The Guilford Press.
Bohart, AC, Tallman, K (1996). The active client: therapy as self-help. Journal of Humanistic Psychology 36, 730.
BABCP (2007). About CBT. British Association for Behavioural and Cognitive Psychotherapies (http:/ Accessed 7 February 2009.
Bruch, M (1998). The development of case formulation approaches. In: Beyond Diagnosis: Case Formulation Approaches in CBT (ed. Bruch, M. and Bond, F. W.), pp. 118. Chichester: John Wiley & Sons Ltd.
Carey, TA (2006). Method of Levels: How to Do Psychotherapy without Getting in the Way. Hayward, CA: Living Control Systems Publishing.
Carey, TA (2008 a). Perceptual control theory and the method of levels: further contributions to a transdiagnostic perspective. International Journal of Cognitive Therapy 1, 237255.
Carey, TA (2008 b). Hold That Thought: Two Steps to Effective Counselling and Psychotherapy with the Method of Levels. St Louis: New View.
Casper, F (1996). Understanding Relationship and Problems: An Introduction to Psychotherapeutic Plan Analysis. Berne: Huber.
Flavell, JH (1976). Metacognitive aspects of problem solving. In: The Nature of Intelligence (ed. Resnick, L. B.), pp.231236. Hillsdale, NJ: Erlbaum.
DiGiuseppe, R (2005). Anger as a disorder: moving beyond DSM-IV-TR. Address at The New York Academy of Sciences, New York.
Grawe, K (1998). Psychological Therapy. Göttingen: Hogrefe.
Greenberger, D, Padesky, CA (1996). Mind over Mood: Change How You Feel by Changing the Way You Think. New York: The Guilford Press.
Harvey, A, Watkins, E, Mansell, W, Shafran, R (2004). Cognitive Behavioural Processes Across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment. Oxford: Oxford University Press.
Higginson, S, Mansell, W (2008). What is the mechanism of psychological change? A qualitative analysis of six individuals who experienced personal change and recovery. Psychology and Psychotherapy: Theory, Research and Practice 81, 309328.
Hyer, L (2008). New wine in old bottles: the transdiagnostic model in the case of Geoffrey. Pragmatic Case Studies in Psychotherapy 4 (module 3, article 3), 4469.
Jenkins, P, Keter, V, Stone, J (2004). Psychotherapy and the Law. Questions and Answers for Counsellors and Therapists. London: Whurr.
Kuyken, W, Fothergill, CD, Musa, M, Chadwick, P (2005). The reliability and quality of cognitive case formulation. Behaviour Research and Therapy 43, 11871201.
Mace, C (1995). The Art and Science of Assessment in Psychotherapy. London, New York: Routledge.
Malatesta, VJ (1995). Case formulation enhances treatment effectiveness. Behavior Therapist 18, 201203.
Mansell, W (2005). Control theory and psychopathology: an integrative approach. Psychology and Psychotherapy: Theory, Research and Practice 78, 140.
Mansell, W, Harvey, A, Watkins, Shafran R (2009). Conceptual foundations of the transdiagnostic approach. Journal of Cognitive Psychotherapy 6, 619.
Marken, RS (2002). Looking at behavior through control theory glasses. Review of General Psychology 6, 260270.
Mellor-Clark, J, Barkham, M, Connell, J, Evans, C (1999). Practice-based evidence and need for a standardised evaluation system: informing the design of the CORE System. European Journal of Psychotherapy, Counselling and Health 2, 357374.
Morency, L-P, Christoudias, CM, Darrell, T (2006). Recognizing gaze aversion gestures in embodied conversational discourse. ICMI, 2–4 November, Banff, Alberta, Canada.
Powers, WT (1992). CT psychology and social organizations. In: Living Control Systems II: Selected Papers of William T. Powers (ed. Powers, W. T.), pp. 91127. New Canaan, CT: Benchmark Publications.
Powers, WT (2005). Behavior: The Control of Perception. New Canaan, CT: Benchmark Publications.
Renner, W, Leibetseder, M (2000). The relationship of personal conflict and clinical symptoms in a high-conflict and a low-conflict subgroup: a correlational study. Psychotherapy Research 10, 321336.
Resick, PA (2001). Stress and Trauma. Hove, East Sussex: Psychology Press.
Runkel, PJ (2003). People as Living Things: The Psychology of Perceptual Control. Hayward, CA: Living Control Systems Publishing.
Spitzer, RL, Kroenke, K, Williams, JBW (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. Journal of the American Medical Association 282, 17371744.
Wells, A (1997). Cognitive Therapy of Anxiety Disorders: A Practice Manual and Conceptual Guide. Chichester: John Wiley and Sons.
WHO (1992). International Classification of Diseases. Geneva: World Health Organization.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

the Cognitive Behaviour Therapist
  • ISSN: -
  • EISSN: 1754-470X
  • URL: /core/journals/the-cognitive-behaviour-therapist
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Can a control model approach assist case formulation in psychotherapy?

  • Christopher G. Spratt (a1) and Timothy A. Carey (a2)
Submit a response


No Comments have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *