Assessment and Diagnosis
To assist with the referral for assessment and/or diagnosis of a dissociative disorder, there are two screening instruments available to begin the process, the Dissociative Experiences Scale (DES) and the Somatoform Dissociation Questionnaire (SDQ). Both are self report measures, freely available via download by clicking on the following headings:
These can be downloaded, completed and sent back to The CTAD Clinic for scoring, or completed via
a scoring tool, The DES Taxon, available for download here:
When scoring, enter the results from each question of the DES into the rows on the spreadsheet.
All 28 items will provide an overall score. If this is >30, further assessment is indicated. If the second score,
made up of 8 specific items, is also >30, this indicates the presence of a more significant dissociative disorder.
Scores between 40-50 on the SDQ indicate dissociation, scores >50 indicate the likelihood of a more
significant dissociative disorder
Should the scores indicate further assessment, the diagnostic process can begin.
Following referral, contact will be made with the referred person by phone or letter to make an appointment.
Referrers will receive details of this appointment, during which The CTAD Clinic provides a one-hour initial assessment, followed by a diagnostic interview, using the Structured Clinical Interview for Dissociative Disorders.
A report is then written with a diagnosis, if appropriate, and a further one-hour session held to go through the results and explain what everything means.
The diagnosis relies upon the presence of the following:
Dissociative Amnesia, Depersonalisation, Derealisation, Dissociative Fugue, Identity Confusion, Identity Alteration and/or Conversion symptoms.
Should the receommendations of the completed assessment indicate the need for a therapeutic intervention, The CTAD Clinic offers a complete therapy service, linking into existing teams a person may be part of, such as IAPT, community mental health teams, eating disorder, substance use services, and GPs.
Therapy follows the International Society for the Study of Trauma and Dissociation guidelines for the treatment of dissociative disorders. This means the Phase Treatment Approach is adopted, beginning with building stabilisation, then trauma exploration where appropriate, and finally into integration. Integration means many things to many people, and we do not have a single approach to this, it is absolutely about what the person wishes to achieve. For Dissociative Identity Disorder, for example, some people wish to keep their parts (or others, alters) following therapy ending, others wish to combine them into the one self.
Where possible, therapy takes place on a weekly basis, and is supported by e-mail contact between sessions as needed. We do not provide an out-of-hours or crisis service, so this would need to be established with local NHS services if necessary.
If funded by a CCG, reports will be provided on progress and outcomes, measured using a checklist for people seen to review progress.
This page is for GPs looking to make a referral to The CTAD Clinic for assessment /diagnosis or treatment. This portal can also be used by mental health professionals wishing to refer, such as Psychiatrists or Practice Managers. Funded referrals are currently only received from referrers within the West Cheshire Clinical Commissioning Group (CCG) catchment area, meaning the person referred must have a GP located in this area.
If you wanting to refer from outside this area, please get in touch for details of what can be arranged within your own local CCG catchment area.
General information regarding dissociative disorders can be found at: https://www.nhs.uk/conditions/dissociative-disorders/
Referrals are to be made via e-mail using the following information: gallery/gp referral pathway.pdf
(a new proforma for this is currently being developed)
In addition to making general enquiries, the CTAD Clinic Service Specification Document
is also available for referrers to access,
please e-mail for this, using firstname.lastname@example.org
A video describing the referral, assessment and diagnostic process
is available here.