Therapeutic Assessment Case Study: Treatment of a Woman Diagnosed With Metastatic Cancer and Attachment Trauma

Smith, Justin D.; George, Carol

doi:10.1080/00223891.2012.656860

Cited by 31Psychological Testing and AssessmentPsychoanalysis and Psychopathology ResearchPsychotherapy Techniques and Applications

Therapeutic Assessment Case Study: Treatment of a Woman Diagnosed With Metastatic Cancer and Attachment Trauma

Smith, Justin D., George, Carol·2012·Journal of Personality Assessment

DOI 10.1080/00223891.2012.656860

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Abstract

This article presents a Therapeutic Assessment (TA) case study of a woman recovering from 4 years of intense medical treatment for stage IV cancer. The inclusion and utility of using the Adult Attachment Projective Picture System (AAP) in the TA is highlighted. The client's attachment classification as unresolved helped identify that her current experiences with dissociation and problems restructuring her life following cancer remission were related to severe childhood sexual abuse, which she had suppressed for decades. The AAP also provided information regarding the unconscious defensive processes the client employed to cope with attachment distress and her inability to find comfort and support from others. These findings were instrumental in guiding the subsequent psychotherapy. The TA process, particularly the assessor-client relationship, facilitated an experience of containing her previously unintegrated and dysregulated affect. A single-case experiment using daily measurements suggested that participation in TA coincided with symptomatic improvements in multiple domains. These improvements were maintained during 4 months of biweekly psychotherapy after the completion of the TA. This case illustrates the applicability of the TA model in health care settings, demonstrates the usefulness of the AAP in the context of TA, and provides empirical support for the effectiveness of the TA model in initiating symptom improvement.

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C/TA has been shown to positively influence recovery from anxiety symptoms.
“These include compliance with treatment [36], therapeutic alliance with a subsequent therapist [32, 37], and the client’s satisfaction with treatment [38], as well as recovery from anxiety symptoms [39, 40], improved self-esteem [41–43], and lower levels of self-criticism [39].”
From Results of a randomized controlled superiority trial of the effect of modified collaborative assessment vs. standard assessment on patients’ readiness for psychotherapy (CO-ASSM-RCT) (2024) · cites this paper as [40]
C/TA has been shown to decrease anxiety symptoms.
“decreased anxiety symptoms [34, 35]”
From Social phobia and evasiveness: trial protocol for a randomized controlled feasibility and superiority trial of the effect of Modified Collaborative Assessment vs. standard assessment on patients’ readiness for psychotherapy (CO-ASSM-RCT) (2023) · cites this paper as [35]

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Aschieri, F., & Smith, J. D. (2012) · Journal of Personality Assessment · doi:10.1080/00223891.2011.627964 · Cited by 38 · see citing works
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Authors: Smith, J. D., & George, C.
Affiliations: University of Oregon (US)
Mills College (US)
ORCID: Smith, Justin D.
George, Carol
Venue: Journal of Personality Assessment
Publisher: Informa UK Limited
Published: 2012-02-22
Volume: 94
Issue: 4
Pages: 331-344
ISSN: 0022-3891 (ISSN-L)
1532-7752
DOI: 10.1080/00223891.2012.656860
OpenAlex: W2070870630
Cited by: 31
References: 66
Citations by year: 2026: 2 · 2025: 1 · 2024: 3 · 2023: 5 · 2021: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 4 · 2012: 1
FWCI: 4.03
Type: journal article
Language: en
Open access: closed
Locations: Journal of Personality Assessment (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: therapeutic assessment, Adult Attachment Projective Picture System, attachment trauma, metastatic cancer, child sexual abuse, dissociation, unresolved attachment, defensive processes, emotion regulation, psychotherapy outcome, symptom improvement, healthcare settings, single-case experiments
MeSH terms: Adaptation, Psychological, Female, Humans, Life Change Events, Melanoma, Middle Aged, Object Attachment, Psychotherapy, Brief, Remission Induction, Remission, Spontaneous, Repression, Psychology, Skin Neoplasms, Stress Disorders, Post-Traumatic, Feedback, Psychological, Qualitative Research, Adult Survivors of Child Abuse, Self Report

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Therapeutic Assessment Case Study: Treatment of a Woman Diagnosed With Metastatic Cancer and Attachment Trauma

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