Does it come up with the formulation itself?

No. The factor sections hold what you said, and the summary only connects those factors as your working understanding, hedged as you hedged it. No factor and no inference is added.

Do I have to dictate the four Ps in order?

No. Reason it through as you would aloud. What you describe as long-standing, as a trigger, as keeping the problem going or as a strength goes under its heading.

Does the formulation quote the client's own words?

Only where you do, and briefly, for a key disclosure. In the example, “not allowed” is the client's phrase as the clinician reported it. The rest is paraphrase.

Is a case formulation the same as a diagnosis here?

No. It describes factors and how they connect. Diagnostic language appears only if you used it, hedged as you hedged it.

Dictate your reasoning. Get it back as a 4 Ps formulation.

Verbato writes a 4 Ps case formulation from your dictated reasoning. A 4 Ps case formulation explains a client's difficulties through four kinds of factor: predisposing, what made them vulnerable; precipitating, what set them off; perpetuating, what keeps them going; and protective, what helps.

For clinicians who think a case through in the 4 Ps.

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What you say, and the 4 Ps case formulation you get back

Illustrative example

The transcript excerpt and the document are written to show the format. Every name, figure and quote is invented.

What you say · transcript excerpt

what keeps it going is the checking he goes over his work again and again late into the evening and he avoids asking colleagues for help on the protective side he has a manager he describes as fair and he exercises regularly three times a week my working understanding is that long-held perfectionistic standards activated by the new role are being maintained by the checking and the avoidance

appears in this excerpt

What comes back · 4 Ps case formulation

Presenting problem

Persistent worry and difficulty concentrating at work, over the past 6 months.

Predisposing factors

The client described a childhood in which mistakes were "not allowed". Family history: not discussed.

Precipitating factors

A promotion 6 months ago to a role with public reporting duties.

Perpetuating factors

Checking work repeatedly late into the evening; avoiding asking colleagues for help. (appears in this excerpt)

Protective factors

A manager the client described as fair; regular exercise three times a week. (appears in this excerpt)

Formulation summary

The clinician's working understanding is that long-held perfectionistic standards, activated by the new role, are maintained by checking and avoidance. (appears in this excerpt)

Illustrative example

End of the illustrative example. Neither the excerpt nor the document was produced by Verbato.

How your 4 Ps case formulation is written

A factor you did not discuss is marked “not discussed”, never inferred.
The summary connects only the factors above. It introduces no new one.
Protective factors are written as specifically as the difficulties.
The formulation opens with the problem as the client framed it.

Your format, not ours

The sections of your 4 Ps case formulation and the way it is written are yours to change. To fix a document, say what is wrong in your own words.

1You correct it
“Call the last section ‘Working hypothesis’.”
That 4 Ps case formulation changes. Nothing else does.
2You say it again
Make the same correction on a later 4 Ps case formulation and Verbato asks: “You've changed this before. Always?”
3You decide
Answer “Always” and it is kept as a rule, applied from your next 4 Ps case formulation on. Answer “Just this once” and nothing is kept. Documents already written stay as they are, and nothing becomes a rule unless you confirm it.
4Your rules
I call the “Formulation summary” section “Working hypothesis”.Undo
Every rule you have kept is listed, and you can undo any of them. An undone rule stops applying from your next 4 Ps case formulation.

How it works

Upload a file, paste a link, record in your browser, or send a voice note by Telegram or email. Verbato makes a word-for-word transcript, which you can edit and which stays beside the document. Your 4 Ps case formulation is written from it, in minutes.

Recording limits

A recording made in your browser can run up to 30 min on every plan; a longer session goes in as a file you upload. A free account takes recordings of up to 40 min each; for longer ones, see pricing.

Your recording

Deleted after 7 days by default, together with its transcript and documents. You can keep a project longer, up to your plan's limit. Deleting a recording leaves a receipt you can download. Nothing you record is used to train or improve AI models.

Questions about the 4 Ps case formulation

Does it come up with the formulation itself?: No. The factor sections hold what you said, and the summary only connects those factors as your working understanding, hedged as you hedged it. No factor and no inference is added.
Do I have to dictate the four Ps in order?: No. Reason it through as you would aloud. What you describe as long-standing, as a trigger, as keeping the problem going or as a strength goes under its heading.
Does the formulation quote the client's own words?: Only where you do, and briefly, for a key disclosure. In the example, “not allowed” is the client's phrase as the clinician reported it. The rest is paraphrase.
Is a case formulation the same as a diagnosis here?: No. It describes factors and how they connect. Diagnostic language appears only if you used it, hedged as you hedged it.

Think the case through aloud. Read it back in order.

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