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Case Formulation Wizard

Five structured steps from presenting problem to intervention plan. The intake framework Jay Haley taught — now in your browser.

Why Structure Matters in Intake

Most clinicians collect too much history and not enough strategy. The first session sets the trajectory of treatment — and the questions you ask determine whether you leave that session with a clear direction or a folder full of background noise.

This wizard walks you through five dimensions of strategic case conceptualization: the problem as the client sees it, the referral context, what has already been tried, the hypothesized function of the symptom, and where you see leverage for change. These are the questions Haley insisted on — not because they are exhaustive, but because they are sufficient.

Nothing you enter here is stored anywhere. The formulation lives in your browser until you print it or close the page.

This tool is available to Rapport7 members

The Case Formulation Wizard is a member-only clinical instrument. Join to get full access to this tool, the Directive Printer, 500+ articles, and more.

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1 Problem

2 Referral

3 Solutions

4 Function

5 Leverage

Step 1: The Presenting Problem

Write this in the client's own words, not yours. What did they actually say when you asked why they're here? Don't clean it up. Don't translate it into diagnostic language. The way someone describes their problem tells you as much as the problem itself.

If this is a couple or family, note who said what. Whose version of the problem are you hearing first? That alone is clinical data.

Step 2: Referral Context

Who sent them to you, and why now? A self-referral after years of suffering is a different animal than a court mandate or a spouse's ultimatum. The referral source tells you who is most motivated for change — and it's often not the person sitting in front of you.

Note who in the system is most concerned about this problem. That person is your leverage point, whether they're in the room or not.

Step 3: Previous Attempted Solutions

What has already been tried — by the client, by previous therapists, by the family? This is not just history-taking. Every failed solution narrows the field. It tells you what not to do, and it tells you something about the structure of the problem.

Pay special attention to solutions that made things worse. A "solution" that maintains or escalates the problem is often the problem itself. That is where strategic therapy begins.

Step 4: Hypothesized Function of the Symptom

This is the heart of strategic formulation. What is the symptom doing in the system? Symptoms are not random. They organize relationships, regulate distance, express what cannot be said directly, or protect someone from something worse.

You don't need to be certain. Write your best hypothesis. Ask yourself: if this symptom disappeared tomorrow, what would change in the family or relational system? Who would be affected, and how? The answer usually points to the function.

Step 5: Leverage Points for Intervention

Given everything above, where do you see an opening? Strategic therapy does not try to change everything at once. It looks for the smallest shift that would reorganize the pattern. A change in sequence, hierarchy, or who does what — that is usually enough.

Be specific. Name the people involved, the interaction you want to alter, and the direction of change. A good leverage point is observable, achievable within the next session or two, and directly connected to the function you identified above.

Step 1 of 5

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The Case Formulation Wizard is one of several professional tools included with membership. You also get 500+ clinical articles, the Directive Printer, and weekly case supervision.

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Case Formulation Wizard

Why Structure Matters in Intake

This tool is available to Rapport7 members

Step 1: The Presenting Problem

Step 2: Referral Context

Step 3: Previous Attempted Solutions

Step 4: Hypothesized Function of the Symptom

Step 5: Leverage Points for Intervention

Case Formulation Summary

1. Presenting Problem

2. Referral Context

3. Previous Attempted Solutions

4. Hypothesized Function of the Symptom

5. Leverage Points for Intervention

Part of your Rapport7 membership