how would the therapist formulate the …

Steps in the Formulation of a Client's Problem:

Understanding of the Problem: The therapist tries to understand the full implications of the distress being experienced by the client. It is done during the first few sessions of establishing therapeutic relationship.
Identification of the Areas to be targeted for Treatment in Psychotheraphy: The theoretical formulation clearly identifies the problem areas to be targeted for therapy. Thus, if a client seeks help for inability to hold a job and reports inability to face superiors, the clinical formulation in behaviour therapy would state it as lack of assertiveness skills and anxiety. The target areas have thus been identified as inability to assert oneself and heightened anxiety.
Choice of Techniques for Treatment: The choice of techniques of treatment depends on the therapeutic system in which the therapist has been trained. However, even within this broad domain, the choice of techniques, timing of the techniques, and expectations of outcome of the therapy depend upon the clinical formulation.

The clinical formulation is an ongoing process, formulations may require reformations as clinical insights are gained in the process of therapy. Usually the first one or two sessions yield enough clinical material for the initial clinical formulation. It is not advisable to start psychotherapy without a clinical formulation.