NHS PORTAL
This page is for NHS health professionals such as Psychiatrists, GP's and Clinical Leads who are looking to make a referral to The CTAD Clinic for assessment /diagnosis or treatment.
NHS Cheshire & Merseyside ICB
The CTAD Clinic is funded to provide assessments and dissociation therapy for patients registered with a mental health team in the Cheshire & Merseyside ICB catchment areas. For those patients in Cheshire only a different contract is in place; please follow the relevant guidance below to make a referral.
There is no waiting list for assessment; however, there is a waiting list for dissociation therapy for Cheshire ICB patients.
Other areas of the UK (including Wirral and Merseyside)
The CTAD Clinic accepts funded NHS referrals from across the UK, for which either face-to-face or online assessment and therapy is available. Please get in touch for details of what can be arranged within your own local NHS ICB catchment area.
There is no waiting list for assessment; however, there is a waiting list for dissociation therapy for NHS referrals received from outside Cheshire.
General information regarding dissociative disorders can be found at: https://www.nhs.uk/conditions/dissociative-disorders
Referrals are to be made using the following information:
Update for Cheshire referrals: Cheshire referrals now need to be routed through the CWP mental health services. We are still awaiting the full referral pathway so please contact the CWP for further details.
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 mike.lloyd3@nhs.net or Enquiries.cheshire-psychology@nhs.net
A video describing the referral, assessment and diagnostic process is available here.
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 buttons:
These can be downloaded, completed and scored using the 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
As part of the referral process into the clinic, we require that these forms are completed by the person being referred and returned to us by the health professional considering making the referral. 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.
Therapy
Should the recommendations 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 an NHS ICB, reports will be provided on progress and outcomes, measured using a checklist for people seen to review progress.
