Developing competence in the controversial area of dissociative disorders
This research explores the question of how a psychologist develops competence in the assessment and treatment of Dissociative Disorders, when it is one of the most controversial areas in mental health. Graduate coursework and supervised structured practica and internship experiences are the traditional method of developing competence as a psychologist. Unfortunately, doctoral programs do not generally provide this type of training in the assessment and treatment of clients with trauma and abuse histories who may have developed a dissociative disorder. Controversy exists regarding the validity of the diagnosis, appropriate assessment and treatment of dissociation, and whether a patient can lose and later recover traumatic memories. Skeptics argue that dissociative disorders are actually iatrogenic in nature, and that therapists who treat dissociation are creating a False Memory Syndrome. Psychologists who assess and treat dissociative disorders: hypothesize a trauma base for the disorders; they do not accept the existence of a False Memory Syndrome; and they believe that clients with dissociative disorders are under-diagnosed and receive inappropriate treatment. Amid this controversy psychologists must decide whether or not to provide service for patients with dissociation, or to be at risk of unethical practice if they fail to recognize, assess and treat or refer patients with a dissociative disorder. The 16 Ph.D. Fellows of the International Society for the Study of Dissociation were sent a questionnaire inquiring about their training, experiences in treating patients with dissociation, the impact of the controversies on the treatment of dissociative disordered patients, and the ethical and legal issues relative to the controversies surrounding dissociative disorders. A qualitative analysis of the responses to the questionnaire identified the following themes: inappropriate treatment of dissociative clients by therapists with inadequate training, need for specific training for psychologists to develop competence to treat these disorders, concerns about the involvement of skeptics in litigation against therapists who treat dissociation, and the challenges and rewards of providing services to dissociative patients. This study resulted in specific recommendations regarding the training of psychologists to develop competence in assessing and treating dissociative disorders, and practical suggestions for managing the ethical and treatment issues.
James C Kneff,
"Developing competence in the controversial area of dissociative disorders"
ETD Collection for Tennessee State University.