Assessment and Diagnosis
Assessment of a dissociative disorder begins with two screening instruments, the Dissociative Experiences Scale and the Somatoform Dissociation Questionnaire. 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. Should the scores indicate
further assessment, the diagnostic process can begin. CTAD 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.
CTAD 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 others. This may include attending and supporting the person with Psychiatric Reviews, known as CPAs (Care Programme Approach).
While some people self-refer and fund themselves through treatment, we are working on establishing Service Level Agreements with Clinical Commissioning Groups to provide funding where local NHS mental services are not able to meet the demand for therapy by people with dissociative disorders.
Therapy takes place in a quiet room with no disturbance within the clinic base. We take time to understand the difficulties that dissociation can bring and will not begin any trauma work until it is agreed that it is safe to do so. 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. However, we do not provide a 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. We offer a checklist for people seen to demonstrate this progress; such information is often helpful to building a case for therapy funding.
Working therapeutically with a person who has complex trauma and dissociative difficulties can be quite isolating. There is always a need for regular and knowledegable supervision, and we at CTAD understand the importance of this. We can offer a supervisory service to any professional working with dissociation, either by face-to-face contacts at the Clinic or via online communication, such as Skype. Finding a good supervisor for a therapist is not always simple in this field, and we can help.
There are many services in the UK looking to improve how they work with complex trauma and dissociation. However, services can be spread out and there are no absolute policies or guidelines for how services are meant to operate. CTAD has been involved in looking at and training staff to understand how to work therapeutically with dissociation. We are supported by Experts-by-Experience who can provide insight and solutions to a variety of problems a service may encounter.
CTAD will visit the team and work through operational policies, discuss with staff and service users their experiences of being in the service, assess the level of awareness and training present and provide a full report outlining areas of strength and areas requiring further development. We will also provide recommendations for any changes needed.
Set out below are the range of services that The CTAD Clinic offers. Please get in touch with us for availability and prices.