Decision Map — Locating the Floor

Clinician-facing. A decision aid, not a decision tree: the gates are hard stops, the floor is weighed from signs rather than branched to, and the whole thing loops — you re-locate as the case moves. Companion to A Unified Clinical Model of Psychotherapy, the Case Formulation — One Page, and the text version Decision Aid — Locating the Floor. Held by the therapist, not the client — the model's own logic says the person is the last one positioned to see which floor their problem lives on.

The map

flowchart TD
    START(["Client presents"]) --> G1{"Acute risk?"}
    G1 -->|"Yes"| R1["STOP — risk protocol<br/>safety plan · means restriction · escalate<br/>the map resumes only after"]
    G1 -->|"No"| G2{"Dial reversed?<br/>psychosis / mania —<br/>world over-saturated with meaning"}
    G2 -->|"Yes"| R2["Different standard of care<br/>meds / psychiatric referral<br/>do NOT run prediction-error experiments"]
    G2 -->|"No"| G3{"Prior miscalibrated —<br/>or is the environment the pathogen?"}
    G3 -->|"Environment is the pathogen"| R3["Fix the field first<br/>safety · boundaries · exits · advocacy<br/>experiments wait for terrain that can disconfirm"]
    G3 -->|"Prior is stuck"| LOC["LOCATE the floor<br/>weigh the signs → primary + secondary<br/>(see locator grid)"]
    LOC --> F["FORMULATE — the five questions<br/>1 WHERE floor · 2 LEVER precision · 3 OBSTACLE furnace<br/>4 CONDITIONS alliance · 5 STAKES mattering / rank"]
    F --> V{"Dimmer up enough?<br/>safety / trust to hold a real test"}
    V -->|"Not yet"| B["Build the alliance first<br/>safety · standing · mattering<br/>no technique lands through a switched-off dimmer"]
    B --> V
    V -->|"Yes"| ACT["ACT — the signature move for that floor<br/>+ matched experiment · always inside the alliance<br/>(see technique menu)"]
    ACT --> M{"Did the prior move?"}
    M -->|"Not yet"| DX["Re-check:<br/>wrong floor? · furnace uninterrupted?<br/>dimmer still off? · stakes unmet?"]
    DX --> LOC
    M -->|"Yes"| C["Consolidate + generalize<br/>vary the context so it isn't filed as a lone exception"]
    C --> M2{"Another floor still bearing load?"}
    M2 -->|"Yes"| LOC
    M2 -->|"No"| DONE(["Stable enough"])

Locator grid — read the sign to the floor

You do not interview the client for their floor; you read it from what shows up. Weigh these signs; most cases yield a primary floor and a secondary.

Technique menu — the signature move that lands on each floor

Stakes overlay (Q5), laid over any floor: mattering injured → irreplaceability inventory, the unglamorous favor; rank injured → the reference-class swap. See Clinical Applications — Status, Mattering, and Rank.