SEXUAL TRAUMA DOES NOT END WHEN THE EVENT IS OVER. IT CAN CONTINUE IN MEMORY, IN THE BODY, IN RELATIONSHIPS, AND IN THE BASIC SENSE OF SAFETY.

CICA Assessment for Survivors of Sexual Abuse or Assault with Dr Comfort Shields

CICA Assessment for Survivors of Sexual Abuse or Assault

Specialist psychological assessment and report writing for survivors of sexual trauma in Harley Street, London and online

For many survivors of sexual abuse or assault, the difficulty is not only what happened, but the long aftermath of what happened. Sexual trauma can alter the nervous system, self-esteem, memory, trust, bodily safety, sexuality, identity, and the capacity to feel at home in one’s own life. Some people experience clear symptoms of PTSD. Others live with more complex and chronic effects: dissociation, shame, emotional overwhelm, difficulty concentrating, disturbed sleep, relationship difficulties, panic, numbness, self-blame, or a deep and often private sense of unreality.

A CICA psychological assessment is not simply an administrative exercise. At its best, it is a careful clinical process that considers the psychological impact of trauma and how that impact has affected daily functioning over time. The task is not merely to name symptoms, but to understand them properly and to describe them in a clear, professional report.

I offer specialist psychological assessments and reports for survivors of sexual abuse or assault seeking evidence for a Criminal Injuries Compensation Authority (CICA) claim.

Who may need a CICA assessment after sexual trauma?

Some people seek a psychological report soon after an assault. Others do so years later, after the effects have become clearer, or after they have finally found language for what they have been living with. There is no single correct timeline for understanding trauma. Many survivors minimise the impact for a long time, or feel that because they continued functioning outwardly, their suffering is somehow less legitimate. It is not.

A CICA assessment may be appropriate if you are making a claim relating to sexual assault, rape, childhood sexual abuse, repeated sexual abuse, coercive sexual violence, or another form of sexually traumatic experience, and psychological injury is part of the claim.

The purpose of the assessment is to consider the mental health consequences of what happened and to document them carefully and professionally.

What psychological effects may be relevant?

Sexual trauma can affect people in many different ways. Depending on the history, the timing, the duration, the relational context, and the person’s wider vulnerabilities and strengths, the psychological consequences may include:

• post-traumatic stress disorder (PTSD)
• complex post-traumatic stress disorder (C-PTSD)
• dissociation, including depersonalisation or derealisation
• depression and low mood
• panic, anxiety, and hypervigilance
• sleep disturbance and nightmares
• shame, self-blame, and a harsh internal critic
• sexual difficulties, avoidance, disgust, or fear around intimacy
• relationship instability, mistrust, or difficulty feeling safe with others
• functional impairment affecting work, study, social life, and everyday tasks

Not every survivor presents in the same way. Some are visibly distressed. Others appear highly capable but are internally organised around fear, numbness, or profound self-surveillance. An assessment should be able to recognise both overt and less obvious forms of trauma-related difficulty.

What the assessment involves

In my practice, a CICA assessment for sexual abuse or assault is approached with seriousness, sensitivity, and clinical precision. The process is designed to gather relevant information carefully without becoming careless, rushed, or reductive.

The assessment commonly includes:

• a detailed clinical interview covering trauma history, current symptoms, functioning, and relevant background
• consideration of whether symptoms are consistent with PTSD, C-PTSD, dissociation, depression, anxiety, or related trauma presentations
• psychometric measures completed in advance where appropriate
• consideration of functional impairment across work, study, relationships, and daily life
• a written psychological report setting out findings, diagnostic impressions where appropriate, and the impact of the trauma

Where dissociation is clinically relevant, this may also be explored specifically, since survivors of sexual trauma sometimes struggle not only with fear and shame, but with altered states of consciousness, emotional disconnection, memory fragmentation, or a sense of feeling unreal.

A note on childhood sexual abuse and complex trauma

When the abuse occurred in childhood, the assessment often needs to consider more than a single event. Childhood sexual abuse may shape the developing personality, attachment system, sense of bodily ownership, and underlying experience of safety. Survivors may live with longstanding shame, confusion, dissociation, disturbed boundaries, chronic hypervigilance, and difficulties in intimacy that are not well captured by a simple list of symptoms.

In such cases, it may be necessary to consider whether the presentation is more consistent with complex trauma or C-PTSD, particularly where there have been repeated interpersonal violations, emotional captivity, or long-term consequences across many areas of life.

Why specialist trauma understanding matters

Survivors of sexual abuse or assault are sometimes misunderstood in clinical and legal contexts. The effects of trauma do not always appear tidy, linear, or immediately legible. A person may minimise. They may become vague or fragmented when recounting what happened. They may seem composed while carrying severe internal distress. They may blame themselves. They may not identify their difficulties as trauma at all. Or they may have symptoms that are easily misread unless the assessor has a good grasp of PTSD, C-PTSD, dissociation, and shame-based trauma responses.

A specialist trauma assessment should be able to think properly about these complexities. It should not flatten the person into a checklist, but nor should it become vague. It needs both clinical depth and professional clarity.

My approach

I am a Chartered Clinical Psychologist and psychodynamic and humanistic psychotherapist practising in the Harley Street Medical District, Central London. My work includes specialist trauma assessment and report writing for adults affected by sexual abuse, sexual assault, childhood trauma, PTSD, C-PTSD, and dissociation.

I approach this work with clinical seriousness and care. Sexual trauma is not only something that happened in the past. It often reorganises the emotional life in the present: how safe the body feels, whether one can trust, how much shame is carried, how memory is held, and what kind of self has had to develop around the injury. For that reason, I aim to assess not only symptoms, but the broader psychological impact and functional consequences of the trauma.

My reports are written in a clear, professional style and grounded in trauma-informed clinical assessment.

Appointments, timing, and fees

CICA assessments are available in Harley Street, London, and in some cases online, depending on the circumstances. Please see my fees page for current pricing and payment arrangements. Assessment work is typically arranged in stages, with payment required in advance in line with the published terms.

If you are seeking a report for a CICA claim relating to sexual abuse or assault, you are welcome to get in touch for information about the next steps.