Treatment Challenges: Lessons Learned


Therapy with people who have been severely traumatized presents challenges to both the client and the therapist. The intensity of emotional and physical needs of trauma survivors with complex PTSD and Dissociative Disorders confront therapists with challenges of how best to manage those issues – for both the client and for the therapist. Theories and techniques often take a back seat to recurrent emergencies, self-harm and suicidal behaviors. Even without those, the therapy is intense by nature of the trauma the person needs to address and heal. The workshop will cover: Challenges that come from the clients – what they bring into the therapeutic relationship, the ways they have learned to be in order to survive and the areas where they were not given what they needed to grow. Challenges that come from the therapist – their own normal limitations of time and energy, and the additional stress from personal life issues that impact their practice such as health issues, moving, and retirement. In the afternoon, the workshop will cover Self-harm and suicidal behavior. How to work with it, and what happens to the therapist when a client suicides. The afternoon will end with an emphasis on the most important things that help us all stay in this field in a healthy manner, and do our best work with our clients.

This session was originally presented as a live conference session in June 2020.

Target Audience


Learning Objectives

At the conclusion of this session participants will be able to:

  • Identify common challenges brought to therapy by clients with complex PTSD and Dissociative diagnoses
  • Identify the challenges present in assessing and working with suicidal clients who are dissociative
  • Identify common therapist reactions to a client suicide, and discuss strategies to work through that loss
Course summary
Available credit: 
  • 4.50 ISSTD Certificate Program
    This program is eligible for 4.50 credits in the ISSTD Certificate Program.
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Presenter: Lynette Danylchuk, PhD
Presenter Bio: Lynette Danylchuk, PhD, has been working in the trauma field since mid-80, starting with Vietnam Vets and people with DID. She served 12 years on the original Board of Directors of Survivorship, and then worked for the Board of the Star Foundation for several more years. She had her private practice in San Mateo, California, where, in addition to working with clients, she did (and continues to do) periodic consultation and teaching where she sees a need, including a local graduate school, juvenile hall, or the county trauma-informed services conference. Lynette has been adjunct faculty to graduate schools in the San Francisco area where she has taught, and been a dissertation chairperson. She has given keynote speeches and workshops across the state and at annual conferences of the International Society for the Study of Trauma and Dissociation (ISSTD).

Available Credit

  • 4.50 ISSTD Certificate Program
    This program is eligible for 4.50 credits in the ISSTD Certificate Program.


ISSTD Member cost:
Your Price:
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"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 to receive the appropriate discount code.