Working with Dissociation in Clinical Practice Guidance for Mental Health Professionals and Multi-Disciplinary Teams

Section I: Core Knowledge and Skills in Working with Trauma- Related Dissociation

1 Understanding Trauma- Related Dissociation
Louise Harriss, Paul Langthorne, Mike LLoyd and Helena Crockford

2 Screening and Assessment of Dissociation
Paul Langthorne, Louise Hariss, Mike Lloyd and Helena Crockford

3 The Multidisciplinary Context of Care for People with Dissociative Difficulties
Helena Crockford, Paul Langthorne, Andrew Holding, Gordon Barclay, Angela Dhanda, Beth Ryan, Amanda Green and Kelly Simpson

4 Psychological Therapy for Complex Dissociation
Stuart Mitchell, Andrew Holding, Paula Biles and Roxanna Mohtashemi

5 Working with Children and Adolescents with Complex Dissociation
Lynne Ryan, Vicky Sutton and Melanie Goodwin

6 Establishing Safeness: Working with Safety Concerns and Trauma-Related Dissociation
Paul Langthorne and Richard Barber

7 Dissociation and Co Morbid Complexity: Psychosis, Autism and OCD
Angela Kennedy, Emma Černis, Ruth Leaper, Darren James, Paul Langthorne, Helena Crockford, Vivian Okoye and Anthony Redhead

Section II: Dissociation- Informed Care for Specific Populations and Contexts

8 Dissociation and Physical Health
Jo Burrell, Fiona Summers, Paul Langthorne, Rachel Sabin-Farrell and Elizabeth Gallant

9 Dissociation in the Perinatal Contex: Meeting the Needs of Mothers and Babies
Janice Rigby

10 Dissociation and People with a Learning Disability
Reed Cappleman and Pat Frankish

11 Dissociation in Older People
Claire Lee

12 Dissociation and Eating Disorders
Hannah Wilson, Caroline Wyatt and Melanie Bash

13 Dissociation, Harmfulness and Violence: Altered States of Consciousness as Offence- Related Factors
Jon Taylor

14 Working with Trauma- based Dissociation in Independent Practice
Andrew Rayner, Mike Lloyd, Remy Aquarone and Melanie Goodwin

Section III: Dissociation- Informed Practice: Consolidating Change

15 Cross- Cultural Considerations and Culturally Informed Practice with Trauma- Related Dissociation
Kiki Hassen

16 Considerations for Service Leads, Commissioners and Organisations
Paul Langthorne and Helena Crockford

17 Towards a Training and Competency Framework for Mental Health Professionals Working with Trauma-Based Dissociation
Helena Crockford, Paul Langthorne and Melanie Goodwin

18 Epilogue: ‘Do No Harm’: An Expert- by- Experience Perspective
Melanie Goodwin

Biography

Helena A. Crockford, past-chair of the ACP-UK Complex Mental Health Network is a Consultant Clinical Psychologist, Attachment-Based Psychoanalytic Psychotherapist and MBT Supervisor with 30+ years working in NHS complex mental health settings.

Melanie Goodwin is an Expert-by-Experience, co-founder of First Person Plural (1997 – 2023) and past-Trustee of European Society for Trauma and Dissociation-UK. She raises awareness of complex dissociation and DID through writing, speaking at conferences, developing resources, and co-delivering training alongside clinicians across public, private and voluntary service sectors.

Paul Langthorne is a Clinical Psychologist working in NHS community mental health services with many years experience of supporting people who experience trauma-related dissociation. He is planning a NIHR programme of clinical research that aims to develop the evidence-base for dissociation-informed NHS pathways of care which better meet peoples’ needs.

'So much expertise collected together fills me with hope. This book usefully combines essentials of understanding, recognising, and working with traumatic dissociation with practical specialist chapters. It has something for everyone whatever your profession, level of knowledge or stage of career. I wish it had been available during the decades of my own re-traumatising journey through mental health services and eventually into recovery. I believe that many of the dissociative trauma survivors I met and worked alongside during the 26 years of First Person Plural’s existence would echo this sentiment."

Kathryn Livingston, BEM, Expert-by-experience, Co-founder of First Person Plural

'This response to the growth in recognition and awareness of trauma and dissociation is an impressive and significant breakthrough. A practical, comprehensive and inclusive guide to dissociation-informed care and services, it fulfils its aims to inform, empower and provide guidance for good practice. A highly accessible resource, it presents a powerful case for change supported by the clinical and research literature and illuminated by the voices of those with lived experience. It will boost knowledge, skills and confidence for practitioners, supervisors and managers in all settings and for anyone involved with survivors of trauma, including survivors themselves.'

Sue Richardson, Psychotherapist, co-founder of European Society for Trauma and Dissociation - UK.

 

'This evidence-informed treatment guide provides outstanding support to multidisciplinary professionals in assessing and responding to dissociation. Written by those with clinical expertise and lived experience, it outlines culturally competent and person-centred care across mental health services. The book addresses the diverse needs of clients including those with neurodivergence. It includes a competency and training framework aligned with national and international trauma-informed care guidelines. With a wealth of practical suggestions, clinical vignettes, and stakeholder-reviewed recommendations, it offers strategies for improving assessment and treatment outcomes, reducing harm, and supporting training among service providers.'

Professor Bethany Brand, co-author of the Finding Solid Ground program / books, and Author of The Concise Guide to the Assessment and Treatment of Trauma-related Dissociation. 

 

'Trauma-based dissociation, as a means of psychological and relational defence, is present in the lives of many people struggling with a wide variety mental health difficulties. It has a history of not being recognised or understood by services, from the individual practitioner through to the commissioning level. Dissociation, as so well described in this marvellously comprehensive book, can be a fundamental means of maintaining the best possible attachment relationships and well-being when growing up in truly dire circumstances. In adult life it can cause great difficulties with functioning, managing feelings, and the ability to form secure supportive relationships.

This book is an essential and accessible addition to the understanding of this often complex issue, including how to see the ways in which it can present across a broad range of mental health issues and with clear and thorough guidelines on thinking and practicing from a dissociation informed foundation. I highly recommend this book for all those professionals working in the field of mental health.'

Mark Linington, CEO CDS UK (Clinic for Dissociative Studies) and member of The Bowlby Centre, London.

 

'Multi-disciplinary psychiatric services may regard themselves as trauma-informed yet display a pervasive blindness to the clinical, personal, societal, economic and generational consequences of the most severe trauma-related conditions, namely the dissociative disorders, despite these being clearly described in major international classifications. This valuable book provides information from diverse sources that will make such neglect by health services harder to justify. The arguments for appropriate treatment provisions that are not re-traumatising are lucid, caring, and based in a wealth of published data as well as descriptions of personal experiences, essential reading for all providers of psychiatric services.'

Frank Corrigan, MD, FRCPsych, Developer of Deep Brain Reorienting

 

'Dissociation, often a response to the unbearable, is frequently misunderstood. As a survivor of child sexual abuse, deeply uncomfortable with the medicalisation of dissociative experience, I recognise the urgent need for practitioners working within clinical frameworks to understand dissociation in all its complexity. This book bridges the gap between the language of ‘disorder’ and the reality of survival. As someone who dissociates in medical settings - often misread as crisis or instability - it gives me hope for a shift in practitioner awareness, empathy, and support.'

Sophie Olson, Author and Founder of The Flying Child

 

‘While there is increasing recognition of dissociation in psychological therapies, there is less written about how best to work with it. In this book, the authors argue thoughtfully for a change in approach to mental health problems, and a recognition of the complex and multifaceted nature of dissociation as a route into working with difficulties that have often been with the sufferer for years. This book, very much a team effort, examines the urgent problem of how to be helpful in complex trauma.’

Dr Alasdair Forrest, Consultant Forensic Psychiatrist, Medical Psychotherapist, and Group Analyst, Aberdeen, Chair, Royal College of Psychiatrists in Scotland Psychotherapy Faculty, Chair, Training Committee of Institute of Group Analysis in Scotland