Note from Sandra: I am only taking clients for brief intensive work due to my travel schedule. My practice is not suitable for individuals who are unsettled by my travel.
Self-Referred Clients Requesting Intensive Treatment
If you already have an existing therapist, please ask them to kindly follow the referral procedure below.
The reason there needs to be a treatment team is the same reason a surgeon and internist must be on the same page for treatment coordination and dosing and continuity of care. I will not work with someone unless I know that the present therapist, if there is one, is on board with the treatment and with my doing the intensive work. I also ask the therapist’s knowledge of the case be contributed so I can have TWO sources of information going into the intensive work, which is surgical (metaphorically that is). Finally, my ability to provide follow up care is very limited, so it is critical that there be a conscientious hand off in case of any outstanding issues at the end of the intensive. This is the only responsible way for me to do this work. I have seen others do it differently with bad outcomes. Not everyone is surprised by the depth of the work, but some are, and some have their boats rocked in the process.
If you currently have no therapist, please make arrangements now for a therapist who will agree to provide follow up care in your area if it should be needed. Dr. Paulsen is typically unable to provide much follow up care and it is only rarely necessary, but we need to have a “Plan B” already in place for those cases where it is needed. In the intake interview, we will determine the appropriateness of this form of treatment for you and agree on a follow up plan if needed.
Referring Clinicians: How to Refer for an Intensive
Referring Clinicians: Thank you for your trust. I accept intensive clients for consideration for Early Trauma treatment based on several things. Please provide your treatment summary by email without identifying the name of the patient, using only initials or a pseudonym. The patient should know that pseudonym when they contact me.
Please do not just have the patient call without your providing first the following information:
1. How well known to you is this client, recent acquaintance or long?
2. Why do you think this person is suitable for brief intensive work? What are their internal resources for grounding, self-soothing, etc?
3. How dissociative are they? Have you assessed and how? The Multidimensional Inventory of Dissociation is available here.
4. Do they have the finances to pay for the work at up to $1440.00 a day for several days?
5. Will you be available for follow up care for the client after the intensive work? Sandra can provide follow up consultation easier than follow up care, in most cases. If there is a wait before the intensive, can you provide ongoing care until the intensive, and after. Please know that Sandra will typically only have occasional contact with clients after the intensive, so the follow up responsibility needs to be on the referring clinician.
6. Is the client currently fragile, brittle, suicidal, or engaging in self harm? if so they are not suitable for this work at this time.
Please send your referral email, with only patient initials or a pseudonym (which the patient should know) via Sandra’s contact page here.
NOTE: It is very common for clinicians to overlook a dissociative disorder, so I don’t just accept a clinician’s impression that the client isn’t structurally dissociative. Ideally, the referring clinician will have made a formal assessment for degree of dissociation using the MID or SCID-D or other method. If the client is revealed on Sandra’s investigation to be structurally dissociative, it will affect the course of the work. In that case, the work would focus on ego state work to deconflictualize the self system and little early trauma repair might be possible in the scheduled time. This is not the preferred outcome.
Reminder: Sandra is not taking new ongoing clients including ongoing dissociative clients, only clients suitable for the intensive format. Therefore, the only dissociative clients suitable for referral are those you know well, have stabilized and are available to support AFTER the intensive, if Sandra decides they are suitable for an intensive. Some clinicians might wish to attend the intensive collaterally in order to understand the approach Sandra will have used, to inform the ongoing care. Sandra is available for phone or email consultation to the referring therapist after the intensive at her usual fee. If the contacts required are less than ten minutes each there is no charge.