Establishing Therapeutic Relationships with Clients with Dissociative Disorders

Establishing and maintaining therapeutic relationships with dissociative disorder patients requires the use of several strategies psychoeducation, grounding skills, and cognitive and sensory awareness. Psychoeducation is a technique that is used in acknowledging and normalizing the symptoms of the patients and relating them with their daily life dysfunction. It enables an understanding of the patients and their relatives about the important role of coping skills in therapy and intellectual strengths (Subramanyam et al., 2020).

Grounding skills are key in helping the patient in detachment from emotional pain and regain focus. This technique helps shift the patient’s attention from negative emotions to focus on the present time. They are taught coping responses such as hand washing that detach them from strong emotions. Cognitive awareness is the strategy of asking cognitive-oriented questions like, “Where am I? When is today?” Lastly, sensory awareness is a technique that involves the use of the five senses to anchor to the present moment; for instance, feeling the back of the chair and describing the texture of the chair (Subramanyam et al., 2020).

Ethical and Legal Considerations

Ethical and legal considerations to be on the lookout for when dealing with dissociative disorders include confidentiality. The patient may share sensitive information about their past, which should be handled with strict confidentiality (Rocchio, 2020). Obtaining consent from the patient on all aspects of assessment and treatment is important, with the client understanding the potential benefits and risks. Also, it is important to ensure that one does not implant false memories in the patient through the use of evidence-based techniques. A mental health professional should look into the legal recommendations of the area of jurisdiction. For instance, as noted by Rocchio (2020), mental health professionals are required to report to relevant authorities in suspected cases of child abuse.

References

Blihar, D., Delgado, E., Buryak, M., Gonzalez, M., & Waechter, R. (2020). A systematic review of the neuroanatomy of dissociative identity disorder. European Journal of Trauma & Dissociation, 4(3), 100148. https://doi.org/10.1016/j.ejtd.2020.100148

Dimitrova, L., Fernando, V., Vissia, E. M., Nijenhuis, E. R. S., Draijer, N., & Reinders, A. A. T. S. (2020). Sleep, trauma, fantasy and cognition in dissociative identity disorder, post-traumatic stress disorder and healthy controls: a replication and extension study. European Journal of Psychotraumatology, 11(1), 1705599. https://doi.org/10.1080/20008198.2019.1705599