Working with Complex Trauma Integrating a Phased Stage Approach with PsychodynamicTherapy: Assessment and Formulation

Article type: Practice and Training Guide

Author:

Adela Stockton

Affiliation:

COSCA Accredited Counsellor & BACP Registered Psychodynamic Therapist, Clinical Supervisor, Private Practice, Glasgow, Scotland.

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

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

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