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Case conceptualization is a critical component of diagnosis and treatment. This article introduces a comprehensive, holistic model of case conceptualization called the temporal/contextual model. This model aims to improve the accuracy, efficiency, and effectiveness of the case conceptualization process. The temporal/contextual model is applied to a case example, illustrating its efficacy in helping a client with an eating disorder.
Before counselors can decide on interventions and set goals with clients, they must have a thorough understanding of who the client is and the context within which that individual has developed and is currently living. Case conceptualization is the process by which counselors come to this understanding, by eliciting and organizing information, developing and testing hypotheses, and working collaboratively with the client toward an integrated concept of the client's life. Case conceptualization is a core competency for counselors and considered as integral to counseling effectiveness (Betan & Binder, 2010; Sperry, 2010).
Case conceptualization includes diagnosis, but this is only the beginning of the process. Once the client's presenting problem and symptoms are known, the counselor and client together begin to explore the etiology and construct a framework that allows them both to understand the nature of the symptoms and what is maintaining them. Case conceptualization gives the counselor a blueprint for how to interact with, listen to, and ultimately help the client (Seligman, 2004). Neukrug and Schwitzer (2006) define case conceptualization as a tool that helps the counselor observe, understand, and integrate a client's behaviors, emotions, and thinking. When a thorough case conceptualization is constructed, the counselor can better understand both the client's needs and their strengths and support systems. Thus, interventions are likely to be more appropriate and effective, which is a benefit in today's managed care climate, with its focus on timeliness and efficacy.
The case conceptualization developed by a counselor subsequently impacts the way in which the counseling relationship proceeds. The conceptualization guides the counselor's choice of theoretical perspective, suggests which questions need to be asked, and frames interpretation of the client's answers. By employing an organized model of case conceptualization, the counselor can more easily see clearly where the client has been, where they are now, and where it is possible for them to go.
Case conceptualization includes assessment and evaluation...