What is Rethink formulation
Rethink Formulation is a strengths-based, collaborative process to assessing, planning and evaluating our work with children, families and other professionals. It supports restorative and relational working in Leeds as part of our Leeds Practice Model.
Rethink Formulation provides a unified approach to help us to make sense of things together and to develop a shared language with which to do this. It enables us to draw on multiple perspectives and to analyse information thoroughly. With a shared understanding we can create evidenced-based plans that involve families and professionals working collaboratively to achieve sustainable outcomes.
How Rethink formulation can help to improve practice and outcomes
The Rethink formulation process can be used to encourage collaboration; to improve assessment and analysis; to support multi-agency working and to create alignment between professionals and families. It can help minimise biases, improve transparency and ensure a cultural understanding is incorporated. These circumstances can lead to better engagement, to strength-focused tailored plans and to outcomes that reduce the need for repeated service involvement.
In Leeds, practitioners, managers and leaders are utilising Rethink formulation within their day-to-day conversations with families and colleagues and their case management structures and support and supervision processes, as well as in wider systemic service planning.
Rethink formulation process
Once information has been gathered and understood using the 6Ps, we can then form a hypothesis and prioritise the perpetuating factors to work on. A hypothesis is a ‘working theory’ of what is keeping the presenting issues going, how those factors can be addressed and what addressing them will achieve.
The next stage of the process is developing goals and SMART plans. Goals are the outcomes that are hoped to be achieved (in relation to the presenting issues). SMART plans should include specific, measurable, achievable, relevant and time-bound ‘next steps’ that people involved can take to address the prioritised perpetuating factors. Goals and plans should always be aligned with the wider Leeds Practice Model.
The next steps are then implemented with the Leeds Practice Principles driving how they are implemented to ensure that practice is relational, trauma-informed and family-led.
Evaluating progress is a vital part of the process. Advances and barriers with the next steps are analysed and understood and this information then further informs the formulation and hypothesis. New next steps may then be developed and the circular process repeated until positive change in the presenting issues has occurred and sustainability plans are in place.
A formulation can travel with the family into different services, and should reduce or support any future assessments.
Rethinking what we think we know about a family and using the Rethink formulation process to develop a shared plan, that is led by the family, is key to working in a relational and sustainable way.
Rethink formulation - the 6 Ps
The Rethink formulation process starts with the 6Ps. The 6Ps are a framework for sense-making which support a curious, analytical approach. Presenting issues are identified and a shared understanding of these is developed which then informs planning.
Precipitating
What triggers things.
Predisposing
Family history, challenges and vulnerabilities.
Protective
What positives and strengths are there.
Precipitating, predisposing and protective feed into presenting issues:
Presenting issues
What is happening right now that is causing concern
Presenting issues feeds into predicting and perpetuating:
Predicting
What could happen if things don't change.
Perpetuating
What's keeping the issues going.
Perpetuating also feeds back into presenting.
Rethink formulation process
Once information has been gathered and understood using the 6Ps, we can then form a hypothesis and prioritise the perpetuating factors to work on. A hypothesis is a 'working theory' of what is keeping the presenting issues going, how those factors can be addressed and what addressing them will achieve.
The next stage of the process is developing goals and SMART plans. Goals are the outcomes that are hoped to be achieved (in relation to the presenting issues). SMART plans should include specific, measurable, achievable, relevant and time-bound 'next steps' that people involved can take to address the prioritised perpetuating factors. Goals and plans should always be aligned with the wider Leeds Practice Model.
The next steps are then implemented with the Leeds Practice Principles driving how they are implemented to ensure that practice is relational, trauma-informed and family-led.
Evaluating progress is a vital part of the process. Advances and barriers with the next steps are analysed and understood and this information then further informs the formulation and hypothesis. New next steps may then be developed and the circular process repeated until positive change in the presenting issues has occurred and sustainability plans are in place.
A formulation can travel with the family into different services, and should reduce or support any future assessments.
Rethinking what we think we know about a family and using the Rethink Formulation Process to develop a shared plan, that is led by the family, is key to working in a relational and sustainable way.
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