Fiorenzo Ranieri
In clinical work with adults and adolescents, one of the main challenges is understanding how a traumatic or excessively distressing event has changed a person’s life. We are not concerned only with symptoms, but with the disruption of existential continuity: relationships, energy, everyday functioning, self-perception, and the capacity to imagine the future.
This change is often silent. It may not emerge during initial clinical interviews and can remain hidden for months, sometimes even years.
Within a psychotherapeutic approach, the clinical interview remains the primary tool for understanding the subjective dimension of trauma, the way in which the person speaks about it (or does not speak about it), the quality of relationships, the bodily and emotional experiences associated with the event, and the capacity to represent it mentally.
The clinical encounter — particularly during adolescence — provides a space in which the therapist can directly observe aspects that no questionnaire can fully capture: emotional fluctuations, defensive patterns, brief episodes of withdrawal, and sudden lapses of attention when a painful memory is approached.
Alongside the clinical interview, however, certain instruments can provide a complementary perspective. They do not replace the therapeutic relationship, but they make it possible to explore areas that often remain obscure because the person does not know how to describe them, does not consider them important, minimises or normalises them, or because they emerge only when investigated through specific questions.
Brief instruments, which can also be administered as semi-structured interviews, allow us to explore — sensitively and using an internationally shared language — the dimensions most affected by trauma: everyday functioning, perceived quality of life, social participation, and the feeling of still being “oneself”. Continue reading Assessing Trauma: WHOQOL-BREF and WHODAS 2.0 for Adults and Adolescents