‘Finding solid ground’ in inpatient treatment for dissociative disorder patients followed by transition to outpatient treatment settings: A one-year follow-up pilot study

Background: Effective treatments for patients with complex dissociative disorders (CDDs) are urgently needed. The psychoeducational programme Finding Solid Ground (FSG) has been shown to be effective as an adjunct to individual outpatient therapy.

Objective: This naturalistic pilot study evaluates changes in adaptive capacities and symptoms in adults with CDDs during a 1 year follow-up period, including a 3 month inpatient FSG-based treatment followed by patients’ continuation of the FSG programme in their outpatient treatment setting.

Method: Thirty adult patients with CDDs were included in the study. Patients were admitted in four consecutive groups to the inpatient FSG-based programme, combining group and individual therapy. FSG has 30 topics, each consisting of a short educational video, a psychoeducational script, and written and practical exercises. Patients completed eight topics during the inpatient stay and continued with the remaining topics during their 9 month outpatient period. Changes in adaptive capacities and symptoms were explored, using mixed-model analysis and calculating reliable change.

Results: Patients completed on average 19 of the 30 topics during the 1 year study period. They improved with large effect sizes on adaptive capacities, post-traumatic stress disorder (PTSD) symptoms, and self-compassion; a moderate effect size on difficulties in emotion regulation; and a small effect size on dissociation. The majority reliably improved on adaptive capacities, PTSD symptoms, difficulties in emotion regulation, and self-compassion; while almost one-third reliably improved on dissociation. Deterioration rates were small. The highest improvement rates were observed in patients who had completed the highest number of FSG topics.

Conclusions: This naturalistic pilot study shows the feasibility of the FSG programme in an inpatient treatment context, followed by patients’ continuation of the programme in their local treatment setting. The results also suggest that progress with FSG topics is associated with better outcomes. Further studies are needed to replicate the findings.