Working with Complex Trauma Integrating a Phased Stage Approach with Psychodynamic Therapy: Assessment and Formulation
- Dzmitry Karpuk
- Dec 16, 2025
- 2 min read
Updated: Jan 15
Article type: Practice and Training Guide
Author: Adela Stockton
Affiliation: COSCA Accredited Counsellor & BACP Registered Psychodynamic Therapist, Clinical Supervisor, Private Practice, Glasgow, Scotland.
Corresponding Author: Adela Stockton, adelastockton@gmail.com
Published: 15 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 is 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
© 2025 The Author(s).
Published by the Complex Trauma Institute under the Creative Commons
Attribution–NonCommercial–NoDerivatives 4.0 International Licence (CC BY-NC-ND 4.0)
Published in: Perspectives on Complex Trauma
Volume 6, Issue 1 (2025)
ISSN 2635-0807
Comments