"Finding Solid Ground" in Inpatient Treatment for Dissociative Disorder Patients Followed by Transition to Outpatient Treatment Settings: A 1-year Follow-up Pilot Study

Inpatient Group and Individual Trauma- and Dissociation Informed Stabilization Therapy for Adult Survivors of Childhood Trauma

The purpose of the pilot is to examine the usefulness of the psychoeducational program, Finding Solid Ground, for patients with dissociative disorders in a naturalistc observational study, involving a 3-months inpatient treatment followed by patients continuation with the program in their local outpatient settings, by examining outcome of main trauma-related symptoms and adaptive coping. In addition, performing focus-group interviews with the patient groups at discharge and at follow-up, to gain information on their subjective experiences from participating in the program. The patients' therapists in the outpatient settings are invited to give written feedback on their experiences from working with FSG.

Adult survivors of childhood trauma have complex and diverse symptoms profiles. A subgroup develop a complex dissociative disorder. Modum Bad has for years offered a 3-months inpatient treatment program for this patient group. Patients leave the hospital after this treatment period and continue with treatment in their local outpatient settings. They come back for a 5-days follow-up 9 months after discharge from the residential setting. The aim of the pilot study is to examine changes in posttraumatic and dissociative symptoms and adaptive coping in this patient-group within the described naturalistic context, following patients' participation in Finding Solid Ground (FSG). FSG is developed by dr Bethany Brand, dr. Hygge Schielke, and dr Ruth Lanius (2022), and designed for this patient-group. It has 30 topics. Patients start up with FSG and complete 8 topics in the inpatient setting, and are offered to continue with the remaining topics during the outpatient period in collaboration with local treatment providers. 32 patients were recruited. Two of them were not included: one did not want to participate, and the other patient had a different focus in her treatment than FSG. Patients were assigned from referrals to the residential Department for Trauma treatment, Modum Bad, in Norway. As part of the usual clinical practice they were referred to our treatment group if they had a complex dissociative disorder in need of stabilization. The inpatient treatment lasts for 11 weeks and combines group- and individual therapies with different treatment modalities, all within the framework of FSG. Patients came back for a 5-days follow-up stay, 9 months after discharge from the inpatient treatment.

Inclusion Criteria:

• The study include adults (minimum age of 18 years) with a complex dissociative disorder related to childhood trauma. All patients had received outpatient therapy with insufficient effect. Patients were diagnosed with at DSM-IV dissociative disorder, transformed to the ICD-10 dissociative disorders.

Exclusion Criteria:

• Ongoing psychosis, severe ongoing drug addiction, very disturbed group functioning, ongoing severe life crisis, mental disability, severe unsafe behavior (suicidality, self-harm).