APPENDIX 4: FORMULATION TEMPLATE
Name	
	School		
Year Group	
	Key school staff		
	
Other agencies involved (please list each agency according to the correct column/involvement)	
Agency with prior involvement, now discharged (how long ago)

	Agencies with current active involvement (level/focus of involvement)

	Agencies at referral Stage (approx. date of referral)	
Attendance	
What is the chronology of attendance?
To complete – please start at the end (1—6) to identify the current % of attendance
Then work backwards in time; in the top row identify what term you’re referring to using the Year group and academic term. In the bottom row insert the %.
Example: 1. Current Term: Year 9, Spring: 76%, 2. Term Year 9 Winter: 89%.   

Chronology of attendance
6.Term:	
5.Term:	
4.Term:	
3.Term:	
2.Term:	
1.Current Term:

	

	

Have there been any noteworthy events during any specific times in this pupil’s chronology?
	
Description of behaviour	
Are there any patterns to Non-Engagement e.g. particular lessons or days?
When did the behaviour first occur?
What does the behaviour look like? What does the child/young person say about specific fears and difficulties?
	
Risk factors school, child and family	
Using the risk factor analysis (Appendix 1) record relevance risk factors

	
Strengths and protective factors	
What strengths does the CYP person have?
What are the CYP’s aspirations or ambitions?
What positive relationships do they have at home and school?
What positive experiences have they had at school?
What was different about the times when the young person was able to get to school?
What has been helpful in the past?

	
Formulation and integration of various factors	
What is people’s understanding of why the young person is demonstrating these behaviours?
Are there any differences of views?

	
Function of behaviour	
These are based on Kearney’s (2008) four factors.  Is the behaviour:
•	To avoid something or situations that elicits negative feelings or high levels of stress?
•	To escape difficult social situations
•	To get attention from or spend more time with significant others (e.g. change in family dynamic, concerned about the wellbeing of a parent).
•	To spend more time out of school as it is more fun or stimulating (e.g. play computer games, hang out with friends).
Are there any maintaining factors?