Organizing Disorganization: Case Conceptualization for Structural Dissociation
One of the greatest challenges in working with complex dissociative disorders is to provide a step-wise, rational, and relatively steady treatment approach. Chaos, crises, avoidance strategies, resistances, intense transference and countertransference, conflicts among dissociative parts, and a disorganized attachment style are only a few issues that contribute to difficulties in maintaining a stable therapy. We will explore specific ways to conceptualize a case that offers the therapist a meta-view of how the client is organized, opening a path toward a rational treatment plan. We will explore how to assess specific prognostic factors and set collaborative therapeutic goals. We will discuss general guidelines about how treatment might differ when there is more than one part that functions in daily life; which parts to work with first; when it is better to work with all, some or only one part at a time; steps toward integration even before traumatic memories can be addressed; and effective ways to work with particular types of parts.
At the conclusion of this session participants will be able to:
- List at least five prognostic factors to assess when planning treatment with a client who has a dissociative disorder.
- Discuss rationale for working with all parts, some parts, or only one part at a time, and when each might be appropriate over the course of treatment.
- Make a treatment plan for a client with a dissociative disorder based on prognostic factors, including comorbidity, and on the inner organization of the client.
Presenter: Kathy Steele, MN, CS
Presenter Bio: Kathy Steele, MN, CS has been in private practice in Atlanta, Georgia for over three decades, specializing in the treatment of complex trauma, dissociation, attachment difficulties, and the challenges of complicated therapies. She is an adjunct faculty at Emory University, and is a Fellow and past President of the ISSTD. She is the recipient of a number of awards for her clinical and published works. Kathy has (co) authored three books with her Dutch colleagues, including The Haunted Self (2006), Coping with Trauma-related Dissociation (2011), and most recently Treating Trauma-related Dissociation: A Practical, Integrative Approach (2017).
- 1.50 ISSTD Certificate ProgramThis program is eligible for 1.50 credits in the ISSTD Certificate Program.
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