Instructions for Australian and New Zealand trainees in developing skills in formulation: a systematic review of local evidence

Objective: To examine the peer-reviewed literature on psychiatric formulation. Methods: The term (formula*) was used to systematically search Australasian Psychiatry, Australian and New Zealand Journal of Psychiatry, British Journal of Psychiatry, BJPsych Bulletin, American Journal of Psychiatry and Academic Psychiatry. The resulting papers were reviewed. Results: Of the 42 papers located, 22 (52%) were published between 2002 and 2019; 90% papers were published in Australasian Psychiatry (15), Academic Psychiatry (12) or BJPsych Bulletin (10), journals that focus on training and clinical practice. The papers varied in their aims and recommendations and not all justified the need for formulation. Formulation was recommended as a necessity for training, a communication tool and a guide to treatment. No article provided evidence for the superiority of any type of formulation, and the role of consumers in formulation was conspicuously lacking. Conclusion: There are many ways to structure formulation. However, the existing literature does not support any particular approach. More consideration needs to be given to the needs of consumers in conceptualising and practicing formulation.