Trauma-Related Dissociation and Dissociative Disorders: Assessment and Treatment Strategies for Some of the Most Misunderstood Disorders in the DSM

CPD

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Greg Nooney, MSW, ACSW, LISW, LCSW Related seminars and products

Narrative Space LLC

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Greg Nooney, MSW, ACSW, LISW, LCSW, has worked with clients with serious mental illness and dissociative disorders for over 35 years. He’s received specialized training in treating severely dissociated clients and is the author of Diagnosing and Treating Dissociative Identity Disorder: A Guide for Social Workers and All Frontline Staff (National Association of Social Workers Press, 2021).

A highly respected trainer on trauma-related dissociation, dissociative identity disorder, ethics, narrative therapy practices, treating severe trauma, and burnout, Greg shares his years of knowledge and clinical experience with professionals at seminars and conferences throughout the country.

He has worked in mental health centers, psychiatric hospitals, private practice and most recently at Burgess Health Center where he was the director of the mental health section for a decade. He is an adjunct instructor at the University of Iowa School of Social Work and has served as a field instructor for Master of Social Work Students at the University of Iowa, University of Nebraska, and the University of North Carolina. Greg earned his master’s in social work from Loyola University in Chicago and is available to provide workshops and trainings as well as supervision to social workers, and consultations for therapists working with clients with DID. He can be contacted through his website at www.gregnooney.com.

Speaker Disclosures:
Financial: Greg Nooney has employment relationships with the University of Iowa School of Social Work and Burgess Mental Health. He receives royalties as a published author. Greg Nooney receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Greg Nooney is a member of the National Association of Social Workers.

Objectives

1. Demonstrate how the relationship between developmental trauma and dissociation can inform clinical assessment and diagnosis of dissociative disorders.
2. Articulate how the clinician can reduce the possibility of countertransference by regulating their reactions in-session.
3. Design treatment plans that ground dissociative clients with relaxation techniques and mindfulness.
4. Analyze the clinical implications of suicidal alters and connect this information to techniques that can help prevent and manage suicidal crises in severely dissociated clients.
5. Develop strategies for integrating support systems into the lives of clients with Dissociative Identity Disorder, and communicate how this approach can improve treatment outcomes.
6. Formulate treatment plans for trauma that are individualized to clients with dissociative disorders

Outline

Developmental Trauma, Symptomology and Risk Factors

• The role of early traumatic stress and insecure attachment
• Types of Dissociative Disorders and symptomology
• Dissociative Amnesia, Depersonalization Disorder,
• Dissociative Identity Disorder
• Populations at risk for dissociative issues
• The controversy – misconceptions and false memories

Clinical Assessment Tools for Trauma and Dissociative Disorders

• Adult Attachment Interview
• Adverse Childhood Experiences Questionnaire
• Dissociative Experiences Scale
• Identifying co-occurring disorders
• Avoiding false negatives and false positives in diagnosing DID

Problems and Solutions in the Treatment of People with Dissociative Disorders

• Maximize attunement with clients who are dissociating
• Getting client buy in
• How to establish trust and cooperation
• Manage issues that can interfere in therapy
• Compassion fatigue
• Modulating your own reactions
• The dangers of vicarious trauma
• Identify and address implicit biases
• Maintain therapeutic limits and boundaries
• Engagement of alternate identities in DID

Therapeutic Techniques that Develop Stability and Safety for Dissociating Clients

• Calming practices to ground the dissociative client
• Conscious breathing
• Relaxation techniques
• Mindfulness
• Working with clients facing continued abuse
• Techniques to manage suicidal crises – account for the suicidal alter
• Don’t let “crises of the week” keep you from reaching treatment goals
• Build support systems with WRAP plans (Wellness Recovery Action Plan)

Specific Trauma Work for Dissociative Disorder Treatment Plans

• Differences in working with DID clients
• The role of resourcing in trauma
• Calm clients and create personal safety with TF-CBT
• Eye Movement Desensitization and Reprocessing (EMDR)
• Somatic approaches – connect memory to the body

Limitations of the Research and Potential Treatment Risks

• Feasibility of randomized prospective double-blind placebo-controlled studies
• Ethical, financial, and logistical constraints
• Trauma, disorganized attachment and research data
• Potential risks in treating trauma and Dissociative disorders

Target Audience

• Counselors
• Social Workers
• Psychologists
• Case Managers
• Therapists
• Marriage & Family Therapists
• Addiction Counselors
• Mental Health Professionals
• Crisis Intervention Specialists
• Nurses