Formulation in Psychology and Psychotherapy: Making Sense of People's Problems Edited by Lucy Johnstone & Rudi Dallos. Routledge. 260pp. £18.99 (pb). ISBN 1583917004

Most clinical psychologists and psychotherapists respect case formulation as an aid to good practice. For many psychiatrists, it remains a source of anxiety and confusion. Although the former are this book's natural audience, I think it has much to offer inquiring psychiatric trainees. Comparative accounts of the psychotherapies can provide brief portraits that don't convey what their relative strengths and weaknesses are. Using the vehicle of the case formulation, this book often succeeds in describing and demonstrating key differences in how clinicians using different models think. In covering a variety of perspectives – not only cognitive–behavioural, psychodynamic, systemic and integrative, but also social inequalities and social constructivist viewpoints – each psychologist contributor has been asked to produce specimen formulations for two case vignettes: a young man expressing paranoid fears and an anxious 9-year-old girl with developmental problems (although some pass on the latter).

Its success is uneven, however. Some chapters, such as those on cognitive–behavioural therapy and systemic family work, are exemplary introductions to formulation within these models. Other authors are diverted into spending unnecessary words on outlining the principles of their model at the expense of its approach to formulation. Often, little attention is paid to how a formulation would be used to facilitate treatment within a particular model, in favour of its purely descriptive functions. The book also makes surprisingly few references to the considerable research literature on formulation. Several well-known, research-based systems are ignored altogether, as are two major international attempts to systematise psychodynamic formulation.

The book's tone may also deter some readers. As far as I could tell, amid repeated references to ‘problems’ and ‘distress’ as the basis of client's suffering, the word ‘illness’ fails to appear. The omission can arouse suspicion as to how fully the impact of pain, dependence and loss, as well as stigma, is appreciated. The editors’ credulous stance in relation to the diatribes of Jeffrey Masson may also undermine some readers’ confidence. However, the book's occasional infelicities are offset by consideration of areas of a patient's positive strength and resilience within formulation, as well as a healthy wariness concerning the dangers of allowing formulation to unduly restrict the ability to see what is in front of us.