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Meridian

Clinician tool

Case formulation worksheet

Organize your conceptualization with the four-P framework — predisposing, precipitating, perpetuating, and protective factors — then translate it directly into treatment implications.

Stays on this device. Everything you enter here is saved only in this browser (IndexedDB) and is never sent to Meridian or any server — it works offline. Because entries can include client information, use a private, encrypted device, and clear or export to your EHR when you're done. This is a scratchpad, not the medical record of truth.

AI-assisted — clinician review required.Prompts, checklists, and any suggested language here are a scaffold, not clinical advice. Confirm accuracy, apply your professional judgment, and follow your agency's policies and NH statute before anything enters the record.

Client

The four Ps

Map how the problem developed and why it persists. Each factor can be biological, psychological, or social.

Vulnerabilities that set the stage — genetics, temperament, early trauma, attachment, developmental history.

Triggers that brought the problem to a head now — recent losses, stressors, transitions, medical events.

What maintains the problem — avoidance, reinforcement patterns, cognitions, relationships, substance use, systemic factors.

Strengths and resources that buffer risk and support change — supports, skills, insight, values, motivation.

Biopsychosocial lens (optional)

Integrative formulation & implications

A concise narrative tying the four Ps together into a testable explanation of the client's difficulties.

How the formulation shapes goals and interventions — carry these into the Treatment plan tool.

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Meridian · New Hampshire community mental health. These templates and trackers are general professional aids, not legal advice or a substitute for clinical judgment, agency policy, or applicable statute and payer rules. Verify codes and requirements against current sources.

If a client is in immediate danger, call or text 988 or dial 911.