Helping Complex Dissociative Patients Stabilize and Find Solid Ground


Monday 14th, Wednesday 16th, Monday 21st e Wednesday 23rd November 2022

16 hours of Specialist Training 

Bethany Brand, Hugo Schielke, and Ruth Lanius developed a treatment intervention that has shown promise in stabilizing highly dissociative clients called the Finding Solid Ground Program.



Finding Solid Ground Program

16 hours of Specialist Training 

Few clinicians have received training in treatment approaches for traumatized clients who experience complex dissociative symptoms, even though these clients having extremely high rates of self-injury, hospitalizations, and suicide attempts.

Bethany Brand, Hugo Schielke, and Ruth Lanius developed a treatment intervention that has shown promise in stabilizing highly dissociative clients called the Finding Solid Ground Program.

They will discuss the promising findings from the international treatment studies called the Treatment of Patients with Dissociative Disorders (TOP DD) studies that assessed the Finding Solid Ground program

These prospective studies show that phasic, trauma-based treatment is associated with decreased symptoms of PTSD and dissociation, self-harm, suicide attempts, hospitalizations, and treatment costs. The presenters will discuss the findings from the recent TOP DD Network study, which is a web-based program for dissociative disorders (DD) patients and their therapists, and which is currently being evaluated by a randomized controlled trial. They will share crucial insights gleaned from the study about the most common triggers and functions of unsafe behavior and the approach that enhanced these clients’ ability to regulate emotions, manage symptoms, and stabilize safety

The Finding Solid Ground Program is a practical, step-by-step approach to stabilization that clients and clinicians have found highly useful. 

The Finding Solid Ground program, and this training, will help clinicians conceptualize their clients’ risky and unsafe behaviors, and develop practical interventions that are useful in stabilizing dissociative clients.  The researchers, who are highly skilled clinicians, will present the Finding Solid Ground program in detail.

Using clients’ journaling, artwork, and research surveys, the presenters will share clients’ perspectives on the experience of surviving trauma by having developed disowned, unintegrated self-states, and their reactions to participating in the TOP DD Network studies and Finding Solid Ground program.  There will be many opportunities to learn the strategies in the program through role plays.


Learning Objectives

  1. List common triggers for unsafe behavior in individuals with complex dissociative symptoms
  2. Discuss the primary findings of the TOP DD Network study
  3. Describe the approach to stabilization that is taught in the Finding Solid Ground program, which is the educational program that was used in the TOP DD Network study
  4. Explain why clients are taught management of PTSD in the Finding Solid Ground program
  5. Describe how containment helps with intrusive PTSD symptoms
  6. Explain how to help clients who are very ambivalent about getting safer work through their ambivalence
  7. List ways to help patients get grounded



The Foundations of Treating Complex, Dissociative Patients: Research- and Neurobiologically-Informed Treatment Approaches

From 3.00pm to 7.00pm (Italian Time), with Bethany Brand and Ruth Lanius

  1. We will provide an overview of the complex trauma research and the impact of trauma on the brain. We will review expert recommendations for interventions that are crucial in early, present- focused trauma treatment. 
  2. We will describe how and why we developed the TOP DD studies, as well as the Finding Solid Ground Program. The Finding Solid Ground program is a consumer-, therapist-, and research-informed program for trauma survivors who are overwhelmed with dissociation, PTSD, and unsafe urges and behavior. The interventions and the program are guided by an understanding of the neurobiological impact of trauma. We will discuss the findings about the most common triggers for unsafe behavior and how the Finding Solid Ground addresses those triggers.
  3. More than a decade’s worth of research and input from clinicians and people living with dissociative reactions informed the development of the Finding Solid Ground program. We will review the TOP DD studies and their findings, then describe the format and structure of the current, cutting-edge TOP DD randomized controlled trial that is underway. 
  4. Role plays – The leaders will engage in role plays of dissociative individuals who struggle with dissociation, safety, and dissociation, yet do not want to “give up” self-harm and dissociation.

Early interventions in the Finding Solid Ground Program: How to Intervene with Highly Dissociative Clients Who Slip Into the Traumatic Past

From 3.00pm to 7.00pm (Italian Time), with Hugo Schielke

  1. Safety – We will discuss why we are presenting about safety first in this training, even though the Finding Solid Ground program first focuses on grounding. Treatment cannot help clients with unsafe behaviors if the client does not have the skills to manage emotions and symptoms. Clients need to learn how to regulate themselves. Talking early on about safety struggles can trigger urges to be unsafe, so we don’t go into it directly in group therapy, and we wait a while in the program to introduce it, but in individual therapy it’s acceptable to talk directly about it early on. 
  2. Grounding – We will present the 3 foundational grounding modules. To make progress in sessions and in their daily lives, clients must be present and not feeling too much or too little. Grounding helps with both of those things. We present very detailed guidance about grounding and working with clients who are reluctant to get grounded.
  3. Separating past from present – We present the 3 topics in this module. Even if someone is grounded, it may feel like the past is happening all over again. Clients may not be able to stay grounded and safe if they are frequently flooded with traumatic-intrusions and too much or too little emotion. Given this, grounding is required as is emotion regulation as foundation to getting safe.  
  4. Foundations – There are 5 foundations that are necessary to make progress towards safety. We will discuss how to help clients manage feeling too much including crisis level feelings that create a sense of urgency in clients. We will present an overview of the impact of trauma on the brain and an overview of how the program helps heal the impact of trauma on the brain. We will discuss ways to help traumatized clients develop self-compassion including helping them recognize and manage trauma-based thinking.  
  5. Role plays – grounding and safety in role play with leaders doing the role play

Finding Solid Ground in the Present with Self-Compassion

From 3.00pm to 7.00pm (Italian Time), with Bethany Brand and Hugo Schielke

  1. Getting and Feeling Safer – Part 1: We will discuss how to guide clients in identifying and managing triggers. We will present the Cycle of Unhealthy Behavior and how to use it with clients to improve their understanding of what leads to unhealthy behavior and how to interrupt this cycle. We will discuss helping clients recognize and plan how to manage challenging situations without engaging in high risk or unhealthy behaviors, and without dissociating. 
  2. Healthy needs: We will discuss how to help clients understand that everyone has healthy needs. Many types of unsafe behaviors are actually attempts to get needs met. We will explain how to help clients understand their healthy needs and ways to get them met safely.
  3. Continued Work on Identifying and Reducing Trauma-driven Beliefs. Many of these beliefs create roadblocks to making progress in healing and are not fair or accurate. We discuss a method for helping clients identify and work on shifting from trauma-driven to recovery-focused thinking. 
  4. Getting and Feeling Safer – Part 2: We will discuss the 3 topics in this module including working to calm the alarm system and the Window of Tolerance.  Traumatized clients tend to feel too much or too little, which we explain in this section, along with how to notice when clients are outside their Window and how to widen their Window of Tolerance.  Feeling Too Much or Too Little and Your Window of Tolerance
  5. Role plays based on these topics.

Learning to Be in Your Body After Trauma

From 3.00pm to 7.00pm (Italian Time), with Hugo Schielke

  1. Improving Relationship with Emotions, Body Sensations, Aspects of Self: This is a critically important module with six topics related to why feelings are important yet very difficult for trauma survivors. We present a method for slowly guiding clients to learn to identify, experience, and name their emotions and related sensations.
  2. Accepting Feelings and Parts: We address what it does and does not mean to accept feelings and dissociated parts and how to develop healthy relationships with emotions and dissociative parts.
  3. Dealing with Toxic Shame – We discuss how shame is a tremendously important emotion in traumatized individuals, and how to gradually work on healing toxic shame.
  4. Learning How to Allow Good Feelings and Positive Experiences: We explain why it is often difficult for trauma survivors to allow themselves to feel good and methods for developing an ability to tolerate, and gradually, enjoy feeling good. 
  5. Role plays based on these topics.



Bethany Brand, Ph.D., Professor at Towson University, is an expert in trauma disorders and dissociation. She serves on international and national task forces developing guidelines for the assessment and treatment of trauma disorders. Dr. Brand’s research focuses on a series of international dissociative disorders treatment studies (TOP DD studies), assessment methods for distinguishing dissociative disorders from other conditions including malingering, training therapists about treating trauma, and the assessment of the accuracy and adequacy of textbooks’ coverage of trauma. In her private practice, Dr. Brand treats complex trauma patients and serves as a forensic expert in trauma-related cases.


Ruth A. Lanius, M.D., Ph.D., is Psychiatry Professor and Harris-Woodman Chair at Western University of Canada, where she directs the Clinical Research Program for PTSD. Ruth has over 25 years of clinical and research experience with trauma-related disorders. Ruth has received numerous research and teaching awards, including the Banting Award for Military Health Research. She has published over 150 research articles and book chapters focusing on brain adaptations to psychological trauma and novel adjunct treatments for PTSD. Ruth has co-authored The Effects of Early Life Trauma on Health and Disease: The Hidden Epidemic and Healing the Traumatized Self: Consciousness, Neuroscience, Treatment. 


Hugo Schielke, Ph.D., is Trauma Services Development Lead for Homewood Health Centre and the Centre’s Traumatic Stress Injury & Concurrent Program in Guelph, Ontario. He specializes in the assessment and treatment of trauma-related disorders, and his work is informed by his post-doctoral fellowship at The Trauma Disorders Program at Sheppard Pratt Health System and his involvement with the California Department of State Hospitals’ Trauma-Informed Care Project. His research is focused on the treatment of trauma-related disorders, psychotherapy process, and the relational components of psychotherapy.



The event is sponsored by ESTD – European Society for Trauma and Dissociation.



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