The dominant medicalised mode of symptom-elicitation, diagnosis and treatment has dominated mental health care for many years. Psychologists, sociologists, and service-users have increasingly emphasised the poor validity, reliability and utility of this approach, and have triggered significant opposition to proposed revisions to the American Psychiatric Association's DSM franchise. The alternative to psychiatric diagnoses - operational definition of problems, followed by psychosocial case formulations - should form the basis for care planning.

Assessment and diagnosis are closely connected. Diagnosis is considered when there are doubts about mental health, whether this is described as disorder, illness or problems in living, and virtually all psychiatrists, clinical psychologists, psychoanalysts and cognitive-behavioural psychotherapists use certain diagnostic categories. This very brief historical overview will touch on major names including Freud, Jung, Kraepelin, Janet, Bleuler, Binswanger and RD Laing, and their approach to diagnosis. Some major diagnostic categories will be used as illustrations.

This presentation will give a brief over view of the Dynamic-Maturational Model of attachment and adaptation together with the various DMM assessments of attachment that have been developed for specific stages of development. Each assessment is discussed in terms of procedure, outcomes, validity, advantages and limitations, comparable procedures and areas for further research and validation. The aims are to provide clinicians with an introduction to DMM theory and the process of making a DMM assessment.

Systemic Therapists have well-established methods for assessing and treating families. Psychoanalysts, on the other hand, who work with the transference, encounter the problem of multiple family transferences. The question then becomes not 'What works for whom?' but rather 'Who is working for whom?' I will illustrate my presentation with a game you can all play at home and a clinical vignette that you might not want to replicate at home.

In this presentation, Dr Felicity de Zulueta will share with you her experience in assessing patients with complex presentations resulting from developmental or adult chronic abuse and torture. Using an attachment based understanding of PTSD, she will explain how to make use of this to elucidate how severely affected your client may be, how to measure structural dissociation and its implications for therapy as well as their likely resistance to change in therapy.

What are we assessing for? What processes are started at assessment? How can Attachment Theory and research inform the practice of assessment, and what are its strengths and weaknesses as a model for clinical work? This seminar will address these questions, with particular reference to private practice.

This workshop will follow the trajectory from initial screening and assessment to the formulation of an effective and realistic treatment programme. The screening instruments and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID D) are both a means to determine diagnosis and treatment as well as in themselves therapeutic. I will outline how a typical treatment programme is decided, the role of multi-disciplinary teams, the stages in therapy and cost implications for fund holders.

This paper will examine the ways in which a patient's intelligence, or lack thereof, can impinge upon a psychotherapy assessment. Drawing on his work with patients whose early trauma has been defended against through high intelligence, impaired cognitive functioning or autistic withdrawal, the speaker will review Freud's notion of a "certain measure of intelligence" being essential for the analytic encounter and will pose the question of who is more disabled by "unusual intelligence" in the assessment session - therapist or patient?

This seminar will explore some key tensions and dilemmas experienced by therapists when involved in those activities termed 'assessment', 'diagnosis' and 'formulation'. These dilemmas relate to the meaning of psychological distress, the meanings that our professional practices read into or impose onto these difficulties, and the ways in which therapists might relate to the medical model. The talk will also consider the potentialities that come to the fore when the phenomenological dimension is truly considered. Case examples will be used to illustrate the importance of going beyond diagnosis, engaging with clients and their distress.

Drawing on Lacan's distinction between the 'instant of the glance', the 'time for comprehending' and the 'moment of concluding' in his famous discussion of the sophism of the three prisoners, I will argue in this paper that the process of assessment and diagnosis, as it takes places within a Lacanian clinical setting, is embedded in a temporal structure of anticipated certainty. As such, Lacanian analysts are asked to formulate a diagnosis with the knowledge of their own ignorance, without ever knowing for sure that it is entirely correct, which requires them to come to terms with their own vacillation and its underlying anxiety.