Working with Complex Trauma Integrating a Phased Stage Approach with Psychodynamic Therapy: Assessment and Formulation
Updated: Sep 7
Practice and Training Article · Open Access
Adela Stockton
COSCA Accredited Counsellor & BACP Registered Psychodynamic Therapist, Clinical Supervisor, Private Practice, Glasgow, Scotland.
Corresponding author: Adela Stockton, adelastockton@gmail.com
Perspectives on Complex Trauma, Volume 6, Issue 1 (2025)
Published: December 2025
Abstract
This paper aims to explore the theoretical and clinical development of working with Complex Trauma (CT) through the integration of a phased-stage structure with the psychodynamic approach. The focus will be on Assessment and Formulation. While reputed for its non-directional method, it could be suggested that the psychodynamic model might not lend itself well to incorporating a therapeutic structure, such as a phased-stage system, with its clearly directive requirements. The use of transference and countertransference, which are fundamental to psychodynamic work, is however inherently body-focused; this may provide a framework for integrating a phased-stage approach and Embodied Reprocessing (ER) practices when working with CT. Furthermore, the boundaries that are firmly held in psychodynamic practice support the establishment of psychological safety (Jacobs, 2024; Bridges, 1999). The recognised need for client stabilisation while working with CT is paramount and physiologically necessary in order that the therapeutic process may proceed safely and, therefore, ethically (Rothschild, 2021; Steele et al., 2005; Fisher, 1999). Indeed, a recent study by Foreman et al. (2024) supports the theory that stabilisation can be useful in the reduction of CT symptoms.
Trauma specialised psychodynamic therapist, Adela Stockton, discusses the compatibilities and challenges of incorporating directed bodywork and additional support resources into her clinical practice during Assessment and Formulation, while remaining fundamentally true to psychodynamic thinking.
Keywords: complex trauma; psychodynamic psychotherapy; assessment and formulation; stabilisation; phased treatment; embodied reprocessing
Cite this article
Stockton, A. (2025). Working with complex trauma integrating a phased stage approach with psychodynamic therapy: Assessment and formulation. Perspectives on Complex Trauma, 6(1). https://www.complextraumainstitute.org/post/working-with-complex-trauma-integrating-aphased-stage-approach-with-psychodynamictherapy-assessment
Copyright and licence
© 2025 The Author(s).
This article is licensed under the Creative Commons Attribution–NonCommercial–NoDerivatives 4.0 International Licence (CC BY-NC-ND 4.0).
Published by the Complex Trauma Institute.
ISSN 2635-0807