Posted: March 6th, 2023
Dissociative Disorders are a group of mental health conditions that are often misunderstood and overlooked. People with dissociative disorders may experience disruptions in consciousness, memory, identity or unusual physical experiences (American Psychiatric Association [APA], 2013). As such, these individuals are at higher risk for developing underlying psychiatric issues like depression and anxiety. This can have an impact on the therapeutic relationship if not addressed early on in treatment. It is therefore essential to understand how to effectively manage the therapeutic relationship when working with people who present with dissociative disorder.
The first step in maintaining a strong therapeutic relationship is building rapport by implementing strategies that promote trust and safety. This can include creating a warm environment by offering positive reinforcement, providing empathy and understanding their experiences without judgement (Culver et al., 2010). Additionally, it’s important to offer unconditional acceptance while setting clear boundaries so clients know what behaviors will be tolerated within the therapy session (APA, 2013). This can help build an environment where clients feel secure enough to be vulnerable about their feelings and explore potential options for recovery (Culver et al., 2010).
Another key aspect of maintaining the therapeutic alliance is providing education surrounding dissociative disorder which helps normalize their thoughts as well as reduce stigma related to treatment seeking behavior (Dell & O’Neil 2009; Putnam 1997; Spiegel 1998). Educating clients about different coping mechanisms such as mindfulness techniques or grounding exercises allows them to take ownership over their recovery process while dispelling any misperceptions they may have about their condition (Putnam 1997; Spiegel 1998). Additionally, it’s beneficial for clinicians to provide psychoeducation directly addressing cognitive distortions they may hold due to traumatic experiences associated with dissociation(Putnam 1997; Spiegel 1998).
It is also important for clinicians to prioritize open communication throughout each session by taking time regularly check-in using both verbal/nonverbal cues. These conversations should focus on exploring any changes in symptoms since last visit as well as discuss goals related treatment plans(Hoffman & Weinberger 2002 ). Furthermore, utilizing self-disclosure including personal stories and reflections can be helpful when discussing topics like trauma history or coping skills(Fofanova et al., 2005 ) . However therapists should remain mindful that this technique could potentially evoke emotional responses from client and thus should be used judiciously when necessary . Establishing consistent structure during sessions through use of reminders regarding goal setting tasks , assigning homework activities and reviewing progress can also help foster stronger connection between therapist patient dyad .
Finally , clinicians must recognize that working with patients suffering from Dissociative Disorder requires patience , compassion and dedication . It’s critical for providers maintain regular contact depending upon severity of illness via telephone calls , emails or letters which allows client reminders of overall commitment towards helping them achieve desired outcomes . In general , forming trusting relationships built upon collaboration , respect communication along insightful exploration into clients individual identity constructs will enable therapists develop sustained sense of support needed overcome diagnosis along effective path toward healing .
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