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Two case-conceptualization grids that organize what you know about a client into a structure you can both look at together. Useful in intake, in re-formulation moments, and in supervision.

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5 Ps formulation

Five stacked rows, each one a row of clinical inquiry:
  • Presenting — what brought them in
  • Predisposing — vulnerabilities and early experiences
  • Precipitating — what triggered the current episode
  • Perpetuating — what’s keeping it going
  • Protective — strengths, supports, resilience
Color-coded so the rows separate visually — Presenting in indigo, Predisposing in blue, Precipitating in amber, Perpetuating in red, Protective in green. Use it for: intake-stage case formulation, especially when you’re trying to give the client a coherent narrative of how they got here. The 5 Ps grid is the standard most clinical psychology training maps to; clients often respond well to seeing their experience laid out as a structure rather than as a list of problems. The Protective row in green at the bottom is deliberate — ending on strengths reframes the formulation from a problem list to a working hypothesis. Drop it during intake or any re-formulation moment — when a new event has changed the picture, or when the original formulation isn’t explaining what’s happening anymore.

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Cross-section formulation

A cognitive case-formulation in cross-section: a central Situation across the top, with a downward arrow into a 2×2 grid of:
  • Thoughts (blue)
  • Feelings (red)
  • Body (amber)
  • Behaviors (green)
This is the same Beck cognitive-formulation shape used in standard CBT training, but laid out as a snapshot of a specific situation rather than a generic model. Use it for: a specific incident the client is bringing in — they describe a panic attack, an argument, a moment of overwhelm — and you work through the four domains to map what was happening at every level during that moment. Differs from the hot cross bun (CBT presets) in that the hot cross bun emphasizes bidirectional influence between nodes; the cross-section emphasizes that the situation produces all four responses simultaneously. The hot cross bun is for ongoing maintenance cycles; the cross-section is for a specific incident.

Presets overview

All 29 worksheets.

CBT presets

Hot cross bun and cognitive triangle.

Trauma + somatic

Polyvagal ladder and window of tolerance.