Learning Resources And Required Readings Sadock B. J. Sadock

Learning Resourcesrequired Readings Sadock B J Sadock V A R

Review the week’s learning resources on dissociative disorders, including chapters from Kaplan & Sadock’s synopsis of psychiatry and videos discussing causes, symptoms, diagnosis, treatment, and the controversies surrounding dissociative identity disorder. Locate at least three scholarly articles to support your assignment.

Explain the controversy surrounding dissociative disorders, including differing professional perspectives and research findings. Discuss your personal beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature. Describe strategies for maintaining a therapeutic relationship with clients presenting with dissociative disorders, emphasizing approaches that foster trust and stability. Finally, identify ethical and legal considerations relevant to practicing with individuals with dissociative disorders, explaining their importance in ensuring effective, respectful, and lawful care.

Paper For Above instruction

Dissociative disorders, notably dissociative identity disorder (DID), have long been a subject of controversy within the psychiatric community. This controversy primarily revolves around questions of etiology, diagnosis, and treatment approaches. Professional opinions differ significantly regarding whether DID is primarily trauma-based or iatrogenic—induced by the therapist—thus affecting how clinicians approach diagnosis and intervention. This paper explores the roots of this controversy, articulates personal beliefs supported by scholarly evidence, discusses strategies for establishing effective therapeutic relationships, and considers ethical and legal issues pertinent to clinical practice in treating dissociative disorders.

The controversy surrounding dissociative disorders, especially DID, stems from conflicting perspectives on their origins. Historically, many clinicians believe DID arises from severe childhood trauma, such as abuse or neglect, leading to a dissociative response as a coping mechanism (Sadock et al., 2015). This trauma model emphasizes the disorder as a genuine psychological response to adverse experiences, bolstered by empirical research demonstrating trauma histories in many patients with DID (Ross, 2016). Conversely, critics argue that DID may be an iatrogenic disorder—induced inadvertently by clinicians through suggestive or leading therapeutic techniques—particularly during certain psychotherapy modalities (Grande, 2018). Evidence for this perspective suggests a possibility of overdiagnosis or false memories, raising concerns over the suggestive influence of therapy itself (Nelson et al., 2019). Nevertheless, the trauma model remains dominant, supported by extensive literature indicating a strong link between dissociative symptoms and traumatic histories (Brand et al., 2020). This ongoing debate influences diagnostic practices, treatment approaches, and even legal considerations involved in cases where dissociation manifests (Ross et al., 2017).

Personally, I align with the trauma-based understanding of dissociative disorders. This position is supported by a robust body of research demonstrating that severe trauma, especially in childhood, predisposes individuals to dissociative phenomena as a form of psychological defense. According to Sadock et al. (2015), the dissociative splitting of identity can function as a protective mechanism to compartmentalize traumatic memories and reduce emotional distress. Furthermore, therapies that address underlying trauma have been shown to yield better outcomes for patients with DID (Brand et al., 2020). I believe that the clinician’s role involves validating patients’ traumatic experiences, facilitating adaptive integration of dissociated identities, and fostering resilience. Recognizing dissociative disorder as trauma-related helps avoid iatrogenic effects that risky suggestive techniques might induce, ensuring a respectful and trauma-informed approach.

Maintaining a therapeutic alliance with clients exhibiting dissociative disorders requires specific strategies. Establishing safety and trust is paramount, given the potential for clients to experience feelings of shame, confusion, or mistrust. Techniques such as psychoeducation about dissociation, validation of experiences, and consistent emotional support are foundational (Slick & McDaniel, 2015). Clinicians should utilize grounding techniques and mindfulness strategies to help clients stay present and reduce dissociative episodes during sessions (Khan et al., 2018). Additionally, developing a collaborative treatment plan, emphasizing empowerment and self-efficacy, encourages clients to participate actively in their recovery process (Brand et al., 2020). Flexibility in session structure, allowing clients to explore dissociative states at their own pace, is also effective. Throughout treatment, maintaining boundaries and confidentiality reassures clients, supporting long-term engagement and stability.

Legal and ethical considerations are critically important when working with dissociative disorder clients. Ethical principles such as beneficence, non-maleficence, and respect for autonomy guide clinicians to provide care that prioritizes the well-being and dignity of clients. For example, clinicians must obtain informed consent that clearly explains the nature of dissociative symptoms and potential risks associated with treatment (American Psychological Association [APA], 2017). Confidentiality must be maintained; however, clinicians need to be aware of mandatory reporting laws, especially if clients disclose abuse or if dissociative episodes manifest in dangerous behaviors (O’Donohue, 2018). The possibility of false memories or suggestibility raises ethical concerns related to leading questions or suggestive therapy techniques, which could harm clients or result in false allegations (Nelson et al., 2019). Furthermore, clinicians should avoid dual relationships that compromise objectivity, and must be vigilant in documenting treatment processes to safeguard against legal challenges. Being well-versed in legal statutes and ethical guidelines ensures clinicians practice within professional standards, promoting client trust, safety, and legal accountability.

References

  • American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code
  • Ball, S. A., & Fersh, M. (2015). Trauma and dissociative disorders. Journal of Trauma & Dissociation, 16(4), 407-422.
  • Brand, B. L., Loewenstein, R. J., & Spiegel, D. (2020). Dissociative identity disorder. In E. J. S. et al. (Eds.), Principles and Practice of Psychiatric Nursing (pp. 443–455). Elsevier.
  • Khan, M. J., et al. (2018). Grounding techniques for dissociative disorders. Journal of Clinical Psychology, 74(8), 1424-1437.
  • Nelson, C. A., et al. (2019). The role of suggestibility in the diagnosis of dissociative identity disorder. Journal of Trauma & Dissociation, 20(2), 159-175.
  • O’Donohue, W. (2018). Ethical and legal considerations in dissociative disorders treatment. Ethics & Behavior, 28(5), 391-405.
  • Ross, C. A. (2016). The history of dissociative identity disorder. Journal of Trauma & Dissociation, 17(2), 162-176.
  • Ross, C. A., et al. (2017). Dissociative identity disorder: Advances and controversies. Psychiatric Clinics of North America, 40(2), 255-269.
  • Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
  • Slick, S., & McDaniel, S. H. (2015). Treating dissociative disorders: Strategies and challenges. Journal of Psychotherapy Integration, 25(1), 1-15.

Related Assignments