The Dissociation-Responsive Therapy Model: A Qualitative Meta-Analysis

April 15, 2027

Abstract

It is common to encounter clients with complex dissociation in the therapy room. However, stigma about dissociation is pervasive and, relatedly, therapists are seldom trained in treating dissociative clients. This webinar overviews the importance of tailoring treatment to clients with dissociation, the development and content of the dissociation-responsive therapy model, and practical clinical guidance for practicing psychotherapy with clients who dissociate. The dissociation-responsive therapy model was developed through a qualitative meta-analysis of therapists’ experiences working with clients complex dissociation, examining how therapists enact responsiveness with their clients with dissociation – that is, how they tailor treatment when their clients are dissociative. A systematic search and likely author search were conducted and ultimately, 16 articles were included in the meta-analysis. A critical-constructivist grounded theory method was used to analyze patterns across articles and then principles for responsive clinical practice were developed. Results represented the dissociation-responsive therapy model, a four-phase model of how therapists can tailor treatment to dissociative clients to meet their needs. In Phase 1, therapists focus on alliance-building actions tailored to dissociative clients, including establishing themselves as safe in ways that differentiate the relationship from clients’ histories of trauma and invalidation, as well as affirming clients as experts on their own experiences. In this phase, therapists also facilitate clients with dissociative-self states to develop an internal alliance with all self-states. In Phase 2, therapists help clients develop self-directed skills to manage dissociation, overwhelming emotions, and safety concerns before engaging in deeper trauma work. Through psychoeducation, grounding, and emotion regulation, clients gradually learn to rely less on dissociation and more on their own coping capacities. In Phase 3, therapists bear witness to clients’ trauma- and dissociation-related experiences while addressing and repairing the stigma, oppression, and systemic invalidation that they often experience. In Phase 4, therapists gradually help clients move through dissociative blocks to access and process previously avoided emotions, including shame, anger, fear, pain, and grief. Phases are progressive yet iterative. Across the phases, therapists honor dissociation as an incredible coping mechanism while supporting clients in developing their agency over relying less on it. To illustrate this model for attendees, demonstrations of in-session moments representative of each phase will be presented. This model builds on prior clinical models for treating clients with dissociation. It can guide therapists of all levels of training and theoretical orientations to better meet the needs of dissociative clients’ moment-to-moment in sessions and in treatment planning.

Potential to Distress: No

Target Audience

Those seeking to participate in this webinar must be licensed mental health professionals (psychiatrists, psychologists, clinical social workers, mental health counselors, accredited psychotherapists, etc.). ISSTD staff will audit license information prior to the start of the course and may request additional documentation for your license.

We do accept students enrolled in a program of study leading to a degree or certification in the mental health field and who have an interest in trauma and dissociation. Students must submit proof of student status such as a transcript or registration record. For those who have completed their degree and are currently in the pre-licensure stage practicing under the license of another clinician, you must provide the name and license information for the person you are working with. Documentation should be sent to ISSTD staff at [email protected] before registering. 

This webinar content is at the Beginning/Introductory level.

Learning Objectives

Upon Completion of this webinar, participants will be able to: 

  1. Explain why enacting the therapist responsiveness is important when working with clients who experience dissociation
  2. Identify three alliance-building actions that therapists can use to support dissociative clients with engaging in therapy
  3. Describe three strategies that therapists can use to help dissociative clients build skills to manage symptoms, enhance safety, and rely less on dissociation before processing trauma
  4. Describe the stigma related to dissociation and the ways therapists can repair stigma-related harm
  5. Explain two interventions that therapists can use to help dissociative clients access, tolerate, and process emotions

Course summary

Available credit: 
  • 1.50 APA
    The International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
  • 1.50 ASWB ACE
    The International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/20/2024 – 08/20/2027. Social workers completing this course receive 1.50 continuing education credits.
  • 1.50 ISSTD Certificate Program
    This program is eligible for 1.50 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.
Course opens: 
09/01/2026
Course expires: 
12/31/2050
Event starts: 
04/15/2027 - 5:00pm EDT
Event ends: 
04/15/2027 - 6:30pm EDT
ISSTD Member cost:
$35.00
Your Price:
$35.00
Rating: 
0

Program Timeline

1. Background: Definitions, interfaces and subgroups (5 minutes)
2. Literature review of measurement of dissociation (5 minutes)
3. Our research (Korzekwa & Dell): Study 1, N=21. (20 minutes)
4. Our Research (Korzekwa & Dell): Study 2, n=49 (20 minutes)
5. Laddis, Dell & Korzekwa. (20 minutes)
6. Etiology of Dissociation in BPD by subgroup (15 minutes)
7. Descriptive In Depth Review of each Dissociative Diagnosis in BPD with Cases (20 minutes)
8. Question & Answer (15 minutes)
 

Instructor: Nicholas A. Pierorazio, MA
Nicholas A. Pierorazio, MA, is a PhD candidate in clinical psychology at the University of Massachusetts Boston. He graduated with his MA in clinical psychology at the University of Massachusetts Boston in 2025. His research and clinical interests focus on psychological trauma, oppression-based stress, dissociation, and their treatment. He emphasizes qualitative and mixed-methods approaches to research these areas. He has co-authored 16 peer-reviewed articles and 6 book chapters on trauma, dissociation, psychotherapy, and qualitative research methods. He has also provided multiple presentations on these topics internationally. To highlight, his work has introduced the dissociation-responsive therapy model and they have contributed to research on the Finding Solid Ground program. Nicholas previously worked as a mental health worker at Sheppard Pratt Health System’s Trauma Disorders Program, where he served on an interdisciplinary team in a specialized inpatient unit for individuals with severe trauma-related and dissociative disorders. He has also provided psychotherapy in university counseling center, private practice, and community mental health settings, and has taught and lectured in undergraduate and graduate courses. His clinical and scholarly work is grounded in a scientist-practitioner-activist framework. He is an active member of the International Society for the Study of Trauma and Dissociation (ISSTD) as well as other professional organizations, like the American Psychological Association (APA). They currently serve on ISSTD’s scientific committee. His honors include the ISSTD Outstanding Student Award, the ISSTD Pierre Janet Writing Award, and the University of Massachusetts Boston Clinical Psychology Master’s Thesis Book Award.

Instructor: Heidi M. Levitt, PhD
Heidi M. Levitt, PhD (she/her) is a Professor in the Clinical Psychology program within the Department of Psychology at The University of Massachusetts Boston.  She graduated from the clinical psychology program at York University in 1998.  She is Editor-in-Chief of Qualitative Psychology and has been an Associate Editor for Psychotherapy Research. She is a past-president of the Society of Qualitative Inquiry in Psychology (SQIP), section of Division 5 of the American Psychological Association (APA; Quantitative and Qualitative Methods). She has contributed 202 publications to the field, including 3 books, 136 articles, 56 chapters, & 7 editorials.  She has written books on qualitative reporting standards and on critical-constructivist grounded theory methods and has a forthcoming book that presents an LGBTQ+ inclusive empirically-based model of gender.   She has conducted trainings and workshops in North American, Europe, South America and Asia.  Her research has focused on LGBTQ+ gender, interventions for sexual and gender-related stigma experiences, and psychotherapy research on the experience of clients and on the intentionality and decision-making of therapists.  Within the American Psychological Association (APA), she has been awarded Fellow status in four Divisions: Division 5 [Quantitative and Qualitative Methods], Division 29 [Society for the Advancement of Psychotherapy], Division 32 [Society of Humanistic Psychology], and Division 44 [Society for the Psychology of Sexual Orientation and Gender Diversity] in recognition of "outstanding contributions" in these areas.  She received the Carl Rogers Heritage Award, given to an individual for an outstanding contribution to the theory and practice of humanistic psychology, from the APA’s Division 32. In 2020, she received the University of Massachusetts Boston Chancellor’s Award for Distinguished Scholarship as well as the Distinguished Contributions in Qualitative Inquiry Award from APA Division 5, which honors an individual with a "distinguished history of scientific contributions within the field of qualitative research methods." 

 

Available Credit

  • 1.50 APA
    The International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
  • 1.50 ASWB ACE
    The International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/20/2024 – 08/20/2027. Social workers completing this course receive 1.50 continuing education credits.
  • 1.50 ISSTD Certificate Program
    This program is eligible for 1.50 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.

Price

ISSTD Member cost:
$35.00
Your Price:
$35.00
Please login or register to take this course.

"Your Price" above reflects your final price based on your membership status and career level. 

  • ISSTD defines a student as those enrolled in a program of study leading to a degree or certification in the mental health field and who have an interest in trauma and dissociation. 
  • ISSTD defines an emerging professional as mental health professionals who have completed an advanced degree and are in the first three years of their career (or first three years after graduation for researchers).
  • If you do not fall into one of the above categories please register as Professional/Retired. 

These prices are for Tier I countries. For a list of countries by Tier click here. If you are located in a country that falls into Tier II-VI please contact ISSTD at [email protected] to receive the appropriate discount code. 

Registration Policies

Cancellations prior to the webinar are subject to a $10 cancellation fee. No refunds are provided for no shows. The deadline for cancellations with a refund is April 12, 2027 at 5:00pm US Eastern Time. Requests for cancellation should be sent to [email protected].

For additional webinar policies including completion requirements, filing grievances, requesting a disability accommodation, and awarding of certificates of credits, please visit our Webinar Policies page.