Angelina Baslari
This paper approaches dissociation through the lens of a counselling psychologist trainee, by exploring how Cognitive Behaviour Therapy (CBT) might fit to the philosophy of counselling psychology and what this suggests for delivering therapy to patients with dissociation. The actual identification of the three main areas; assessment/formulation; therapeutic interventions/containment; looking forward (working towards uncomfortable feelings) as a particular challenge in my own experience was the main aim and the contribution of the current paper.
Research has established the link between dissociation and trauma. Studies in the area of dissociation are limited mainly due to ethical and funding challenges researchers face, and due to the fact that dissociation comorbid with other mental health disorders. CBT is considered a gold standard which has gained political and cultural dominance as a treatment for mental health disorders in the UK because it is supported by numerous randomised controlled trials (RCTs). Research indicates that individuals with high levels of dissociative symptoms may drop out of current CBT therapies and are generally less responsive to treatment; thus, CBT therapies may not be effective for these patients. The ISSTD proposed that initially the main focus for therapists should be placed on establishing a therapeutic alliance, educating patients about diagnosis and symptoms and explaining the process of treatment.
My personal reflections have been provided throughout. This paper considers some of the potential implications for future practice, and concludes that by acknowledging the complexity of the dissociative symptomatology including comorbidity with other mental disorders should make trainees feel less overwhelmed and disempowered. However, further research is considered vital.
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