Case formulation – Sketchnotes for learning

This week we are working through case formulation and the 4 P’s. Rumour has it there are more P’s to come along, but for now I have this diagram which is in part inspired by sketches our unit chair Alexa Haley did during class.

Case formulation 4Ps
Sketchnote of Case Formulation 4 Ps

In the sketchnote I represent the 4P’s across a timeline (thanks Alexa) and illustrate their relationship to the point in time that a Client asks for help.

The 4P’s

Predisposing or “Risk Factors”

Underlying factors which are intrinsic to a persons life or in their past which can influence their susceptibility to the problem area.

  • Psychological: Maladaptive beliefs, low resilience, personality, intelligence
  • Biological: Medical history, family history
  • Social / Environment: Social isolation, job status, neighbourhood, family interactions

Precipitating or “Triggers”

Factors or events which trigger the event or problem area.

  • Psychological: Identity change (age, role, status)
  • Biological: Sudden illness
  • Social / Environmental: Relationship, loss, workplace stress

Perpetuating or “Maintain/Reinforce”

Those factors that enable a problem to continue, or enhance the problem.

  • Psychological: Self destructive, coping styles
  • Biological: Chronic illness, functional impairment
  • Social / Environmental: Toxic family or relationship, Maladaptive neighbourhoods

Protective or “Resilience/Strength”

Factors that help suppress or control a problem.

  • Psychological: Ability to moderation, insight, self reflectiveness
  • Biological: High intelligence, easy temperament, Good problem solving
  • Social / Environmental: Supportive social network, access to support mechanisms


HPS105 Foundations of Psychological Practice, Deakin University 2021

Illustration adapted from one created by Dr Alexa Haley HPS105 Unit Chair


I am a first year student at Deakin University studying for my Bachelor of Psychological Science, majoring in Organisational Studies (but thinking about dropping the major). This represents an output of my learning process and/or my own thoughts. It is not for the purposes of assessment or examination.

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