Decision Aid — Locating the Floor

Clinician-facing walk-through of the same logic drawn in Decision Map — Locating the Floor. Read it as a procedure for formulation and supervision, not a script. It moves in one direction only on the page; in the room it loops — you re-locate as the case moves. Companion to A Unified Clinical Model of Psychotherapy and the Case Formulation — One Page. Held by the therapist: the floor is read from signs and patterns the client is the last to see, not asked for by self-report.

Step 0 · The gates — clear these before the floor logic runs

Three checks come first, because entering the floor logic with any of them unaddressed is unsafe. Each is a stop or a divert, not a step.

Acute risk. Active suicidality, danger to others, abuse, crisis. → Your standard risk protocol governs — assessment, safety planning, means restriction, escalation. The mattering/burdensomeness lens understands suicidal desire; it does not replace risk management. Return to this aid only when it is safe to.
Is the dial reversed? Psychosis or mania — a world over-saturated with meaning, the failure running the opposite direction to trauma. → Different standard of care, frequently medication and psychiatric referral. Do not try to loosen priors or generate prediction error here; it can destabilize.
Is the prior actually false — or is the environment the pathogen? Some predictions are accurate reads of a punishing present: the contemptuous partner, the workplace that does punish weakness, real discrimination. → Where the environment is the pathogen, the work is environmental first — safety, boundaries, exits, advocacy — and experiments wait for terrain that can actually disconfirm. Never privatize a loss the world is still inflicting. And because a prior can be false and the test still dangerous: screen for coercive control or intimate-partner violence before any relationship or disclosure experiment — a disclosure sent into a punishing relationship escalates harm regardless of the prediction. (This is the paper's second gate in Part 6.3, restated here so the aid and the locator agree.)

Only a stuck, miscalibrated prior in a safe-enough person enters the floor logic below.

Step 1 · Locate the floor — weigh the signs, don't interview

You are not asking the client which floor their problem lives on; the narrator cannot see down there. You read the floor from what shows up, weighing these signs to a primary floor and usually a secondary:

Accurate insight that changes nothing → the problem is below the floor the words are reaching. The single clearest signal. Stop supplying better explanations and change channel.
The body answers first — heat, constriction, numbness, the stomach drop, before or without words → floors 6–7.
The every-time pattern — reproduces across partners, jobs, decades, indifferent to circumstance → floor 4, a relational template, not a floor-3 belief about the current situation.
It shows up with you — the client managing you, testing you, going compliant or opaque → floor 4 has walked into the room. An opportunity, not an obstruction.
The reaction too big for the occasion → points straight at the floor where a high-precision prior just got contradicted. Follow the flare, not the topic.
The client's own verbs — "I believe / I tell myself" (glass, 1–3) · "I always end up…" (scripts, 5) · "I just shut down / my chest closes" (concrete, 6–7).

Two disciplines here. Expect more than one floor — name the primary (where change has to land) and the secondary (what it rests on). And distinguish suppression that is pathology from restraint that is ordinary dignity in the client's culture; the second is a substrate fact, not a floor to treat.

Step 2 · Formulate — the five questions, at that floor, with the client

Answer these out loud, with the person — a formulation the client co-owns is itself an intervention, and it recruits the co-investigator the experiments will need.

WHERE — which floor (Step 1). Determines what can reach it at all.
LEVER — what would re-weight the prior? Assume the corrective information has already been heard and weighted at zero; the job is precision, not new information.
OBSTACLE — which furnace move is manufacturing the confirming evidence (provoke · avoid · filter · reinterpret · withdraw effort), and how will you interrupt it?
CONDITIONS — is the dimmer up? Safety and trust are what let anything land. If the alliance can't yet hold a real test, this is the work — build safety, standing, and mattering first. No technique lands through a switched-off dimmer.
STAKES — mattering or rank? The fiercely defended priors are social. Being unwanted (sociometer) is usually the lethal, reachable one; being low (hierometer) you can't hand over, but you can change the arena.

Step 3 · Choose the move — families, not brands

Match the signature move to the floor, run it inside the alliance, and reach for the toolbox experiment that fits:

1 Narrative — re-author the binding story (narrative, logotherapy).
2 Metacognition — change the relation to thought (MBCT, metacognitive, ACT defusion).
3 Beliefs — marshal disconfirming evidence (CBT, REBT) → behavioral / disclosure experiment.
4 Relational — bring the template into the room; the corrective relationship (psychodynamic, IPT, attachment, EFT) → disclosure test, ladder first.
5 Scripts — new sequence, safety behaviors blocked (behavioral, exposure, DBT skills) → exposure as expectancy-violation.
6 Procedure–emotion — re-open the consolidated prior (EMDR, EFT, reconsolidation).
7 Body — regulate, work the felt sense (somatic, sensorimotor) → dead-air / interoceptive.
8 Substrate — name the water, assess the norm (liberation, feminist, multicultural).

Stakes overlay: mattering injured → irreplaceability inventory, the unglamorous favor; rank injured → the reference-class swap.

This column is where each tradition's signature move lands, not the therapy for the floor — cross floors freely, and norm every move to the client's culture. And remember the sequence the model insists on: the relationship turns the dimmer up; the floor-matched technique delivers the error. A correct technique through a switched-off dimmer is a signal delivered to no one; a warm alliance with nothing aimed through it is an dimmer turned up and no error.

Step 4 · Run and debrief — the six-step experiment

The signature intervention is a prediction, tested. Skipping any step wastes it (full protocol in A Unified Clinical Model of Psychotherapy Part 6.3):

Name the prediction out loud. 2. Rate confidence and make it falsifiable. 3. Write it down, before (the most-skipped, load-bearing step). 4. Run the smallest real test. 5. Compare written prediction to outcome, out loud. 6. Ask: how many times would this have to happen before you'd revise the rule?

Frame it as an experiment, never as a value. Choose experiments whose worst case is survivable, and if a well-targeted test still goes badly, process the outcome as information, not as proof — a real negative result re-opens Step 1, it doesn't confirm the prior.

Step 5 · Loop — re-locate as it moves

If the prior did not move, do not push harder on the same move; run the differential:

Wrong floor? The commonest miss — you aimed words at concrete. Re-locate.
Furnace uninterrupted? The client is manufacturing the disconfirmation you're trying to supply. Block the move first.
Dimmer still off? Not enough safety to weight the error. Back to conditions.
Stakes unmet? The change threatens a mattering or rank the person can't yet afford to lose. Address the stake.

If it did move, consolidate and generalize — vary the context so the new learning is not filed as a lone exception — then ask whether another floor is still bearing load, and re-enter at Step 1. The elevator runs both ways, and most real cases are worked floor by floor over time.