Faculty PublicationsVolume 1 · Issue 4
Supervision for Complex Presentations
When a case will not resolve, the problem is more often the formulation than the intervention.
Dr. Patrice Sinclair, Ph.D.
Faculty, Clinical Residency
July 2, 2026
7 min readGraduate Professional
Cover plate reserved — Faculty Publications, Volume 1 · Issue 4
When a case will not resolve, the problem is more often the formulation than the intervention.
Practitioners bring me stuck cases and ask for a new technique. Almost always, the technique is adequate and the formulation is wrong — we are treating a problem the client does not actually have, competently.
Return to the formulation
State the presenting difficulty in one sentence. State the mechanism you believe maintains it. Then ask what evidence you have for that mechanism beyond the fact that it sounds plausible. Most stuck cases fail this test immediately.
“Stuckness is information. It usually means the case is telling you something your formulation refuses to hear.”
Rebuild from observation, not from theory, and bring the revised formulation to supervision before the next session rather than after the next disappointment.
References
References are recorded with the manuscript and published with the article.
Estimated citation
Sinclair, P. (2026). Supervision for Complex Presentations. Faculty Publications, 1(4). Holmes Knowledge Center, Holmes Training Academy™.