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Table 2 Illustrations of full case formulations, by different clinicians (1 and 2), both matched (Patient X) and mismatched (Patient Y)

From: Psychodynamic case formulations without technical language: a reliability study

Patient X Clinician 1 Mostly attached to the mother. The father was authoritarian, somewhat remote, but shared many interests and activities with the patient. A stable, secure childhood. A tendency to have difficulties making decisions since secondary school. Scared by macular bleeding in the eye early in the 20-ies. Indecisive when choosing a career (salesman, artist, author) and reluctant to marry for fear of being limited by all the responsibilities. At the same time guilt feelings for not taking responsibility. Anxiety and depression, self- doubt after giving up a romantic relationship.
Patient X Clinician 2 Grew up in a family with few open conflicts, but father’s authoritarian style seems to have affected the rest of the family. The patient was kind and smart, avoided conflicts. The patient has always had problems making decisions and been bothered by ambivalence with major life decisions like committing to a sweetheart or choosing a career as an artist etc. The romantic relationship was dominated by fear of becoming trapped in a marriage with children where the spouse would be dominant. Chose to move from the partner half a year ago to concentrate on a career as an artist. Ambivalence and anxiety/depressive symptoms for the last 1–2 months after feelings of professional failure. A patient with aggression impairment who easily becomes depressed and anxious when disappointed or irritated. Lots of worries, a strong need for proof of being good enough.
The average similarity in this matched rating (6 raters) was 5.5, range = 4–6.
Patient Y Clinician 1 Conflicted relationship to a harsh, authoritarian father. A younger brother had a closer relationship to the father. Mother was gentle and flexible and defended the children against the father. Mother became ill and the patient moved to relatives for 6 months when he was 2 years old. Remembers nothing from how he reacted. Lively, somewhat bad tempered. Always jealous of a younger brother. Many friends, restless, active. Intensely in love with a beautiful wife. Two teenage kids. Headache, irritable. Marriage conflicts for many years. But he regards headache and fatigue as non-explainable symptoms. He is like his father, but while his mother resigned, his wife does not. The patient has also symptoms when the burden of responsibilities increases.
The average similarity in this mismatched rating (6 raters) was 2.2, range = 2–3.