Assessing the utility of the Clinical Behavioral Case Conceptualization categories: A contextual behavioral based formulation model

Case conceptualization is a basic assessment tool in evidence-based clinical practice. Over the years, an extensive number of case conceptualizations have been developed; however, only a small number of those models met high-quality criteria in terms of validity and reliability. The Clinical Behavioral Case Conceptualization (CBCC) has shown good content and construct validity, as well as some preliminary evidence in treatment utility. Nonetheless, a further examination of CBCC categories' utility in identifying key explanatory processes by therapists is needed. Three independent raters assessed 171-case conceptualizations to establish whether CBCC descriptive (problem description) and explanatory categories (predisposition, precipitants acquisition, and maintenance) facilitate organizing and explaining clinical cases. Reviewers' consensus on the contribution of each category to clinical conceptualization was calculated by the Light's Kappa index. Findings indicated that CBCC descriptive and explanatory categories were significantly useful, with the exception of the precipitants category. In addition, acquisition and maintenance were the main categories that reviewers found as helpful in explaining clinical cases in the sample studied. We discuss CBCC utility for designing and establishing behaviorally oriented interventions and present methodological recommendations for future research on CBCC quality and ecological validity.

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