The clinician presents the hypothesis to the patient. “Let me see if I have this right. Is it possible that...” The patient corrects, clarifies, or confirms.
When therapy stalls, you reformulate. The patient isn’t “resistant”; your hypothesis is wrong or incomplete. What factor did you miss? A new trauma disclosure? A secondary gain? case conceptualization and case formulation
Client: “John,” 35-year-old male, software engineer. Presenting Problem: Intense rage outbursts at his wife when she asks about his workday. The clinician presents the hypothesis to the patient