Women’s pathways into forensic settings differ from men’s. In particular, women in forensic settings, whether in prison, hospital, or the community frequently share histories of multiple trauma and attachment disturbances, often leading to profound difficulties in relating to others, despite a wish to do so. Consequently, effective engagement with such women requires gender-sensitive techniques, both in assessment and treatment. They are likely to view authority figures with suspicion and to be wary of engaging in a clinical interview whether for risk assessment, evaluation for a court report or another psychological issue, including treatment viability. They may have told their stories countless times before, and yet feel that they have never been heard, or seen. Communication is often indirect, rather than verbal, as the women may express their distress through behavioral disturbance including severe self-harm, aggression, and verbal assaults. This can challenge and confuse practitioners, and may also disguise a wish for care and emotional contact. This article explores the question of how to elicit trust and cooperation within the clinical interview and identify effective techniques for establishing therapeutic rapport. It focuses both on the experience of the clinicians, including their countertransference feelings, and the experience of the women being interviewed.