3 Formulation Models Every Psychology Graduate Should Know
If you're applying for Assistant Psychologist roles or getting ready for doctoral applications, you've definitely seen "understanding of psychological formulation" listed somewhere in the job description. It comes up in interviews, and honestly, it can feel a bit abstract when you're early in your psychology career.
You don't need years of clinical experience to understand formulation. What you need is familiarity with a few key models that help you think psychologically about the difficulties people face. These models give you a framework for organising information, making sense of someone's experiences, and thinking about how you might help.
The CBT Hot Cross Bun
The CBT Hot Cross Bun is probably the most accessible formulation model. It's simple, visual, and helps you see how different parts of someone's experience link together and keep a problem going.
The model has four parts:
Thoughts – what's going through someone's mind
Feelings – the emotions they're experiencing
Physical sensations – what's happening in their body
Behaviors – what they do (or avoid doing) in response
These four elements sit in a cycle, each one influencing the others. If someone's having a panic attack, for example, they might notice their heart racing (physical), think "something's seriously wrong with me" (thought), feel terrified (emotion), and leave the situation quickly (behavior). That behavior might give short-term relief but reinforces the belief that the situation was dangerous, keeping the cycle going.
Why it's useful for APs: Even if you've never done CBT yourself, this model helps you think about patterns. You can use it to make sense of case discussions, think through what might be maintaining someone's difficulties, or structure your reflections on observations you've made.
Genograms
A genogram is essentially a family tree with psychological information layered in. It maps out family relationships, significant events, patterns across generations, and the context someone's grown up in.
You'll see genograms used in systemic therapy, CAMHS services, and any service where family dynamics or intergenerational patterns matter. They're particularly useful when working with children and young people, since understanding the family system is often essential to understanding what's going on for the child or young person.
A genogram might include:
Family structure (who's who, marriages, separations, deaths)
Relationship quality (close, distant, conflictual)
Significant events (bereavements, trauma, mental health difficulties)
Cultural or religious context
Patterns that repeat across generations
Why it's useful for APs: Genograms help you think systemically rather than just focusing on the individual, which is important if you want to become a more holistic practitioner. They're also something you can reasonably create or contribute to as an AP, gathering family history, asking about relationships, mapping out context. It's collaborative work that doesn't necessarily require years and years of training.
The 5Ps
Longitudinal formulations look at someone's difficulties over time. Instead of just focusing on what's maintaining the problem right now, they help you understand how someone got here, what happened earlier in life, what vulnerabilities developed, what triggered the current difficulties, and how things have unfolded since.
This is where models like the 5 Ps come in:
Presenting problem – what's happening now
Predisposing factors – early experiences or vulnerabilities that made someone more susceptible
Precipitating factors – what triggered the current difficulties
Perpetuating factors – what's keeping the problem going
Protective factors – strengths, resources, things that help
Longitudinal formulations are moreso based on the CBT model but can be also integrative. You're not necessarily tied to one therapeutic model, you're pulling together biological, psychological, social, developmental, and contextual factors to build a full picture.
Why it's useful for APs: The 5 Ps give you a structure for thinking about complexity without getting lost. You can use this framework to organise case notes, think through assessment information, or make sense of why someone's struggling now even if things seem relatively stable on the surface. It's also a model that works across services and populations, so it's genuinely transferable.
How to Learn These Models (Without Clinical Experience)
You don't need to have run therapy sessions to understand formulation. Here's how you can build your knowledge:
Read case studies and examples. Books like Case Formulation in Cognitive Behavioural Therapy by Martell or Systemic Family Therapy by Dallos & Draper include worked examples you can learn from.
Practice with hypothetical cases. Take a case vignette from a textbook or journal article and try creating a formulation yourself. What would you include? How would you organise the information?
Reflect on observations. If you've shadowed clinicians or attended MDT meetings, think back to how they talked about clients. What frameworks were they using, even implicitly?
Discuss with supervisors or peers. If you're in a support worker or voluntary role, ask your supervisor if you can talk through how they think about the people you're working with. You're not doing therapy, but you can still learn how to think psychologically.
Use formulation in your reflections. Even if you're not creating formulations in your role, you can apply these models to your own learning. Reflect on a difficult interaction or observation using a hot cross bun. Think about your own professional development using the 5 Ps.
Final Thoughts
Formulation isn't something you master overnight, and no one expects you to at AP level (I even struggle sometimes in my final year of training!). What matters is that you're thinking psychologically, you're familiar with some accessible models, and you can talk about why formulation matters without overstating what you've done.
The models I've covered here, CBT hot cross bun, genograms, and longitudinal formulations like the 5 Ps are solid starting points. They're practical, they're used across services, and they give you language to talk about psychological thinking in applications and interviews.
