Integrating Overt Difficulties and Underlying Mechanisms

According to Persons's (1989) case formulation model, overt difficulties and underlying mechanisms are closely linked. Indeed, just as underlying negative beliefs may influence one's cognitions, behavior, and mood, overt difficulties may serve to reinforce one's underlying beliefs. Yet, in contrast to overt difficulties, which may be relatively accessible to patients and amenable to assessment by clinicians, it is more difficult to access and identify these underlying core beliefs. As such, it is important to emphasize that formulations of the underlying psychological mechanisms should be considered working hypotheses to be evaluated over the course of therapy.

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