Building Strong Case Formulations: The Biopsychosocial Model & 5 Ps
In Episode 1.6 of Psychiatry Boot Camp, we explore one of the most essential yet under-taught skills in psychiatry: case formulation.
Whether you’re writing a note, presenting on rounds, or preparing for boards, the ability to thoughtfully synthesize patient information into a meaningful biopsychosocial narrative is what transforms a data collector into a diagnostician.
To guide us, we’re joined by Dr. Jyotsna Ranga, Program Director for the Adult Psychiatry Residency and the Child & Adolescent Psychiatry Fellowship at Creighton University. A dedicated educator and clinician, Dr. Ranga brings clarity and structure to a topic that often feels abstract to learners.
🧠 What You’ll Learn in This Episode:
✔️ What case formulation is—and what it’s not
✔️ How to use the biopsychosocial model to structure your thinking
✔️ Understanding and applying the Five Ps framework:
• Presenting problem
• Predisposing factors
• Precipitating factors
• Perpetuating factors
• Protective factors
✔️ How formulation differs from diagnosis and why both matter
✔️ Tips for organizing and presenting your formulation clearly
✔️ Practical examples and sample formulations
✔️ How to integrate formulation into clinical decision-making
📌 Why Case Formulation Matters:
A good case formulation goes beyond labeling symptoms—it tells the patient’s story. It explains why this patient is experiencing these symptoms at this time. It identifies the relevant biological, psychological, and social forces at play, and helps guide targeted, holistic treatment planning.
Unlike the DSM, which focuses on criteria, formulation gives us context and meaning. It supports personalized psychiatry and clinical humility—both essential for responsible care.
Dr. Ranga’s approach simplifies this complex process, providing learners with a repeatable framework they can use in clinical practice, exams, and case presentations.
👩⚕️ About Dr. Jyotsna Ranga:
• Program Director, Adult Psychiatry & CAP Fellowship – Creighton University
• Passionate educator with a focus on resident development
• Known for her clarity in teaching formulation, psychotherapy, and clinical reasoning
• Committed to advancing psychiatry through structured, compassionate education
🎯 Who Should Watch This Episode:
• Psychiatry residents and medical students
• Nurse practitioners, PAs, and therapists in mental health
• Social workers and psychologists learning integrative case writing
• Educators seeking a clear framework to teach formulation
• Anyone preparing for oral boards or clinical presentations
This episode is also great for multidisciplinary teams learning to speak the same clinical language when approaching complex cases.
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🔗 SimplePractice
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💬 Discussion Prompt:
How do you approach case formulation in your setting? Do you use the Five Ps, psychodynamic models, or other approaches? Let us know in the comments.
📌 Timestamps (Suggested Layout):
00:00 – What Is Case Formulation?
03:00 – Overview of the Biopsychosocial Model
06:30 – The Five Ps Explained
11:10 – Case Example: Formulation in Action
15:45 – How Formulation Guides Treatment Planning
19:20 – Teaching and Documenting Formulations
23:00 – Final Thoughts from Dr. Ranga
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