Relational and defensive patterns

Therapeutic rupture and repair

A difficulty in collaboration, goals, tasks or trust, followed by efforts to understand and address it.

Therapeutic relationship processClinically reviewed

Interpersonal

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Treat staff and service contributions as assessable. Do not attribute a rupture entirely to patient pathology. This is practice guidance, not an efficacy claim.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Therapeutic relationship process
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S04Management

Royal Australian and New Zealand College of Psychiatrists · HTML text. Learning outcomes.

Does not establish the efficacy of every intervention suggested by this guide.

Link withheld: this source remains held and is cited as metadata only.

S05Cultural safety

Royal Australian and New Zealand College of Psychiatrists · HTML text. Purpose; key messages; cultural safety and psychiatry.

Not an ethnicity checklist. Australian and Aotearoa NZ contexts are not interchangeable.

Evidence references only. Each source's own limitations still apply.

Relational and defensive patterns

Acting out Attachment anxiety / hyperactivation Denial Displacement Family/system accommodation Idealisation / devaluation

Guide modules

Rapid clinical formulation guide Foundations, terminology and evidence limits Practical assessment-to-formulation workflow Risk formulation and management linkage Documentation templates and worked examples

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.

Relational and defensive patterns

Therapeutic rupture and repair

A difficulty in collaboration, goals, tasks or trust, followed by efforts to understand and address it.

Therapeutic relationship processClinically reviewed

Interpersonal

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Treat staff and service contributions as assessable. Do not attribute a rupture entirely to patient pathology. This is practice guidance, not an efficacy claim.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Therapeutic relationship process
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S04Management

Royal Australian and New Zealand College of Psychiatrists · HTML text. Learning outcomes.

Does not establish the efficacy of every intervention suggested by this guide.

Link withheld: this source remains held and is cited as metadata only.

S05Cultural safety

Royal Australian and New Zealand College of Psychiatrists · HTML text. Purpose; key messages; cultural safety and psychiatry.

Not an ethnicity checklist. Australian and Aotearoa NZ contexts are not interchangeable.

Evidence references only. Each source's own limitations still apply.

Relational and defensive patterns

Acting out Attachment anxiety / hyperactivation Denial Displacement Family/system accommodation Idealisation / devaluation

Guide modules

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.