Practice Guidelines for Treatment of C-PTSD and Dissociative Disorders with Therapeutic Flexibility

Wed, September 23 | 3:00 PM EDT– 4:00 PM EDT

Topic: Direct Service | Knowledge Level: Advanced

S. Michele Cohen, MA, PhD, LPC, LCPC and Ann Marie Babb

This presentation will address some of the issues when working with persons living with C-PTSD and dissociative disorders. Characteristically, abusers use a combination of fear, shaming, and conditioning to ensure their victims remain silent. Abusers have a strong interest in denial of abuse and in attempts to discredit the accounts of victims. This conditioning can be called several things: Brainwashing, Grooming, Stockholm Syndrome. This conditioning can lead to significant mental health hurdles and labels and barriers to exiting their situation. Individuals who have been deeply hurt by traumatizing, silencing, non-validating, and blaming abusers need access to systems of care, protection and justice that are knowledgeable, understanding, accepting, and validating, and which can offer interventions that become part of the solution rather than part of the problem. The presenters will discuss how they design treatment modalities that include the need for "therapeutic flexibility" by the therapist, family, and other care team members. Practices related to therapeutic flexibility start with understanding that the person being helped must be included in all stages of therapeutic engagement/treatment planning. Care team members need to work collaboratively and honestly/transparently share all input, fears, concerns, and successes when possible. Engagement with the person includes work in traditional and non-traditional settings utilizing several treatment approaches (talk, sensory integration, exposure therapy, etc.). Developing clear goals and recognizing the benefit of out-of-the-box approaches will create an environment for safety, growth, and healing.

Presentation Objectives

• Briefly define C-PTSD and the scale of dissociative disorders and how they relate to therapeutic flexibility by understanding "out of the box" diagnosis and how therapeutic flexibility is necessary
• Describe how conditioning happens especially in childhood sexual exploitation and interpersonal familial violence
• Discuss how grooming, Stockholm Syndrome, and trauma bonding can create barriers to exiting situations and getting proper treatment.
• Describe the stance of therapeutic flexibility and why it is important for those who have experienced trafficking or CSEC
• Explore the challenges associated with the lack of properly trained therapist and inpatient care units
• Share real life scenarios and allow for conversation about out of the box solutions