Trauma-Related Dissociation: Safe and Effective Use of DBT, CBT and EMDR When Your Client Dissociates

CPD

Handouts

Faculty

Katelyn Baxter-Musser, LCSW, C-DBT Related seminars and products

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Katelyn Baxter-Musser, LCSW, CDBT, is a Licensed Clinical Social Worker in private practice in Maine where her areas of expertise include trauma, PTSD, abuse, domestic violence, depression, anxiety, grief and relationship issues.

In over 10 years of clinical experience, Ms. Baxter-Musser has successfully worked with dissociating clients across the spectrum of severity with techniques that ground them, bring them back to the body, and re-engage them in therapy. She formerly served as the trauma healing services clinical coordinator for La Frontera Arizona, a non-profit organization dedicated to providing behavioral health counseling, crisis intervention and support to families and individuals facing domestic violence, abuse, hate crimes and other issues.

Ms. Baxter-Musser is trained in Dialectical Behavioral Therapy, Cognitive Behavioral Therapy and is a Certified EMDR therapist. She is a member of the National Association of Social Workers, the American Academy of Experts in Traumatic Stress, the National Center for Crisis Management and the Maine Collaborative Law Alliance. She sits on the EMDRIA Standards and Training Committee and is the regional coordinator for the EMDRIA Southern Maine Regional Network.

Speaker Disclosures:
Financial: Katelyn Baxter-Musser, LCSW, CDBT, CPD, is the Owner, Operator and Trainer at Inner Awakening Counseling & Consulting and receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-Financial: Katelyn Baxter-Musser, LCSW, CDBT, CPD, is a member of the EMDRIA Standards and Training Committee, the Southern Maine EMDR Collation, the National Association of Social Workers, the American Academy of Experts in Traumatic Stress, and the National Center for Crisis Management.

Objectives

1. Assess trauma survivors for signs of dissociation with the Dissociative Experiences Scale.
2. Use psychoeducation to teach clients how to recognize signs of dissociation in themselves.
3. Develop treatment plans that include grounding and containment skills so clients can orient themselves to the present when they notice they are dissociating.
4. Integrate distress tolerance skills from DBT into treatment to decrease triggers and manage dissociative symptoms.
5. Use CBT techniques to break down destructive beliefs that can lead clients to distressing emotions and trigger dissociation.
6. Evaluate if and when EMDR should be used with clients experiencing dissociative symptomology.

Outline

• 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

• 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

Target Audience

• Counselors
• Social Workers
• Marriage and Family Therapists
• Psychiatrists
• Psychologists
• Psychotherapists
• Addiction Counselors
• Nurses