- The function of dissociation
- The role of early traumatic stress and insecure attachment
- The neurobiology of trauma and dissociation
- What dissociation looks like in therapy
- What to expect - how working with dissociated clients is different
- A review of current research, risks and treatment limitations
- How to recognize subtle signs of dissociation in trauma survivors
- Dissociative Experiences Scale
- Adult Attachment Interview
- Adverse Childhood Experiences Questionnaire
A Phase Oriented Approach to Establish Safety, Increase Stabilization and Reduce Symptoms
- Establishing safety
- Teaching clients to recognize dissociation
- Implementing effective grounding and containment skills
- Bring dissociating clients back to the body with mindfulness and relaxation techniques
- Simple ways to re-engage clients when they “check-out” during therapy
- How therapists can prevent colluding with avoidance
- Maximize attunement and build trust - exercises that get clients to open up
- Handling crises and risk management
- Culturally sensitive trauma work
Using Evidence-Based Treatments with Dissociating Clients:
Managing Dissociation When Using CBT, DBT and EMDR
CBT
- Identifying, recognizing and challenging negative core beliefs that triggers dissociative reactions
- Techniques to recognize and shift negative thoughts about the world
- Breaking down destructive beliefs that lead to distressing emotions and trigger dissociation
Dialectical Behavior Therapy
- Distress tolerance skills to decrease triggers and bring clients back to the here and now
- Self-sooth to IMPROVE the moment
- Paced Breathing
- Emotion Regulation skills to increase emotional awareness and change unwanted emotions
- Developing skills to regulate vulnerable emotions
Eye Movement Desensitization and Reprocessing
- Should I use “EMDR with dissociating clients?”
- Advanced training required
- Grounding and calm place techniques
Vicarious Trauma and the Clinician
- Recognizing the signs and symptoms of vicarious trauma
- Managing clinician self-doubt and shame
- Clinician self-care
- Maintaining healthy therapeutic boundaries
- Clinicians getting support