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SW 313 Dissociative Identity Disorder
Transcript of SW 313 Dissociative Identity Disorder
Disorder Client Presents for Assessment Client attends first therapy session Client attends a third therapy session
and discloses more about
her family and culture Referred by primary care doctor to Knox County Mental Health Clinic
Reoccurring visit prompted by physical injury
Asian woman mid 30's
Social Worker- Jasmine Brown
Client- Sonya Elsberry
- All names have been change to uphold confidentiality between client and social worker. Identifies as Chinese- American
1st generation immigrant
Ancestral Folk religion
Inability to speak fluent Mandarin like parents Based on traumatic experiences disclosed in assessment and various affect indicators the client is diagnosed with...
Dissociative Identity Disorder Dissociative Identity Disorder History Various interventions can be used in treatment
Holistic Approaches are usually more effect
During this session Social Worker will use Creative Therapy
Other Common Therapies are :
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy Clinical Hypnosis Creative Therapy Information shared with therapist indicate that various cultural factors may contribute to the clients development of
Dissociative Identity Disorder Cultural Factors Ideas
Rarely seek mental health services
Expressed problems are mainly tied to healthcare concerns
Normalized occurrence of problems
Feelings of Shame
Hereditary of Environmental Causes Cultural Factors Beliefs and Traditions
Considered a western problem
Positive Health Image
Historical avoidance of conflict
Strong Patriarchal Lineage
Familial stigma In any helping profession, there are many codes and values that must be followed to ensure proper care of client. Various Ethical Issues often occur when treating Dissociative Identity Disorder. Ethical Issues Commitment to clients (and their conditions)
Delayed advocacy for client or lack thereof
Personal prejudices vs. professional commitment
Set boundaries with client
Informed consent Cultural competence and social diversity
General competence of disorder (not fully understanding)
Conflicts of interest
Personal prejudices vs. professional commitment
Privacy and confidentiality Ethical Issues Ethical Issues Derogatory language
Respect for clients and their conditions
Interruption of services
“Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary.”
Self care vs. client care
Know your limits
Terminations of services References Cheung, M., Leung, P., & Tsui, V. (2012). Help-seeking behaviors among Chinese Americans with depressive symptoms. Social Work, 57(1), 61+. Retrieved from: http://go.galegroup.com/ps/i.do?id=GALE%7CA294900195&v=2.1&u=tel_a_pstcc&it=r&p=AONE&sw=w
Congress, E. P. (2004). Cultural and ethical issues in working with culturally diverse patients and their families: the use of the culturagram to promote cultural competent practice in health care settings. The Haworth Social Work Practice Press, 39 (3/4), 249-262.
Johnson, D. R. (1987, April). The role of the creative arts therapies in the diagnosis and treatment of psychological trauma. The Arts of Psychothearpy, 14(1), 7-13. doi:10.1016/0197-4556(87)90030-X,
Mayo Clinic Foundation . Retrieved on 20 November 2012.
National Alliance on Mental Health (NAMI). Retrieved on 23 November 2012.
Spring, C. (2011). A guide to working with dissociative identity disorder. Healthcare Counseling and Psychotherapy Journal, 44-46.
http://www.ncbi.nlm.nih.gov/pubmed/18185968 Dissociative Personality Disorders (Multiple Personality Disorders) have been seen in caves during the Paleolithic Cave Era, as paintings of shamans changing into animal or embodying spirits.
.In 1791 during the French Revolution, the first written account of DPD was written. The case involved a 20 year old woman living in Germany whom began to speak perfect French to include behaving like an Aristocrat and even spoke German with a French accent.
When she was the "French Woman" she remembered everything she did but as the "German Woman" she denied any knowledge of the "French Woman." Dissociative Identity Disorder History cont. . In 1980, the decade of work by the pioneers in the field of multiple personality culminated in the publication of the DSM-III by the American Psychiatric Association in 1980. The DSM-III created a separate category for the dissociative disorders and set forth the criteria for a diagnosis of Multiple Personality Disorder. . Personality disorders are grouped into 3 clusters. Cluster A involves odd or eccentric behaviour; Cluster B dramatic or erratic behaviour; Cluster C anxious or inhibited behaviour.
Dissociative Identity Disorder (DID) (known in the past as Multiple Personality Disorder-MPD) and other Dissociative Disorders are now understood to be fairly common effects of severe trauma in early childhood. The most common cause is extreme, repeated physical, sexual, and/or emotional abuse.
Dissociation is a disconnection between a person's thoughts, memories, feelings, actions, or sense of who he or she is. dissociation include daydreaming, highway hypnosis, or "getting lost" in a book or movie, all of which involve "losing touch" with awareness of one's immediate surroundings. Disorder Information Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience any of the following symptoms:
•Sleep disorders (insomnia, night terrors, and sleep walking)
•Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
•Alcohol and drug abuse
•Compulsions and rituals
•Psychotic-like symptoms (including auditory and visual hallucinations)
A prototypical example of a seemingly woman-specific disease is hysteria. “The seemingly dominance of dissociative disorders in women may also depend on the socio-cultural context, because men with dissociative disorders usually do not enter the general health system, but rather the legal system.” Dissociative Identity Disorder Info Cognitive Behavioral Therapy (CBT) is a form of treatment that focuses on examining the relationships between thoughts, feelings and behaviors. By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping. (NAMI,2012)
CBT’s focus on thoughts and beliefs is applicable to a wide variety of symptoms
Quickly helps you identify and cope with specific concerns.
Allows you to view challenging situations more clearly and respond to them in a more effective way. Hypnosis is a method of communication that induces a trance or a trance-like state. Hypnosis can be conducted by one individual addressing another, or it may be conducted with the self (self-hypnosis)(Pearson, 2010).
Formulates feelings, memories, images and internal self-talk that will lead to mutually-agreed-upon outcomes.
Makes client feel more relaxed thus open to evaluation Helps people who might have difficulty expressing their thoughts and feelings.
Unique contribution to the diagnosis and treatment of these disorders because victims of psychological trauma, like children, schizophrenics,brain-damaged, elderly, and the developmentally delayed, have difficulty expressing their experiences directly and effectively through words (Johnson, 1987)