To begin, there will be an overview of how an initial assessment of a patient/client ought to be done, what ought to be included in any clinical assessment of a patient/client in assessing diagnosis and judging appropriate treatment recommendations. The breadth and depth of any assessment will depend on the patient/client concerned, but also on the clinician: the clinician’s profession and competences; what the clinician judges to be their role and responsibility in the assessment. The ‘bare minimum’ will be covered, followed by how different client and clinician variables would call for more depth or breadth in the various components of an overall assessment. The overall concern is with what person has this “illness,” and not with what “illness” this person has. Apart from historical and symptomatic ‘checklists’, which remind us what ought to be considered, ways to elicit useful information will also be explored: how to do it, how not to do it, facilitating collaboration, fostering openness. Special attention will be given to the typical history and symptomatology of chronic posttraumatic and dissociative conditions.

From there, the webinar moves to focus on assessment tools, from screening tools to in-depth structured interviews. Having taken a comprehensive history, the clinician will begin to formulate questions about the nature of the person’s distress. Is this person dissociative, and if so, in what way? Assessment tools are useful throughout therapy, to help clarify the person’s experience and how they have attempted to manage their behavior and emotions. These tools assist the therapist and client, and when used appropriately, enhance the therapeutic relationship.

Following formal assessment, the webinar will continue with discussion on “psychodynamic case formulation” – conceptualizations that will inform therapy. Having obtained an in-depth assessment, the therapist now needs to reflect on the client, what the experienced interactions might disclose, what may have been revealed in how they answered questions and told their history or perhaps seemingly omitted; any repeating patterns they present, and then putting together a “story” to make some hypotheses or inferences, however tentative. These formulations will continue throughout the therapy, but will mostly be discussed in terms of the information gained from the first assessment phase. Some of the issues explored include: pre-existing “transference”, especially if the client was in previous therapy; their experience of the treatment frame and any frame “violations”; the shifts in affective states within the formal assessment; transference, countertransference and enactments; verbal and non-verbal cues, possible manifestations of unconscious material, how trauma and dissociation impact their lives and the assessment process, and other phenomena. Examples will be discussed to illustrate the concepts. The final part of the webinar will focus on a summary of the salient issues raised by each of the presenters and a round-table discussion by the moderator and presenters. Time will be left for questions and answers with all four presenters.