Guidelines for Treating Dissociative Identity Disorder in Adults (2005)
See Treatment Guidelines on ISSD website

Copyright 1994, 1997, and 2005 by the International Society for the Study of Dissociation. The Guidelines may be reproduced without the written permission of the International Society for the Study of Dissociation (ISSD) as long as this copyright notice is included and the address of the ISSD is included with the copy. Violations are subject to prosecution under federal copyright laws.

INTRODUCTION

I. EPIDEMIOLOGY, CLINICAL DIAGNOSIS, AND DIAGNOSTIC PROCEDURES
A. Diagnostic Criteria for Dissociative Identity Disorder (DID)
B. Terminology and Definitions
C. Alternate Identities: Definitions and Conceptual Issues
D. Diagnostic Interviewing
E. Measures of Dissociation
Clinician Administered Measures
Clinician-Administered Structured Interviews
Self-Report Instruments
F. Other Psychological Tests
G. False Positive Diagnoses of DID

II. GOALS OF TREATMENT
A. Integrated Functioning as the Goal of Treatment
B. Treatment Outcome, Treatment Trajectories and Cost Effectiveness for DID

III. PHASE ORIENTED TREATMENT APPROACH
1. The Phase of Establishing Safety Stabilization and Symptom Reduction
Suicide Risk
Clinical Management of Safety Issues
Stabilization and Symptom Reduction
Working with Alternate Identities
Trust and the Therapeutic Alliance
2. The Phase of Focused Work on Traumatic Memories
3. The Phase of Integration and Rehabilitation

IV. TREATMENT MODALITIES
A. Framework for Outpatient Treatment
Duration of Treatment
Types of Treatment for DID
B. Inpatient Treatment
C. Partial Hospital or Residential Treatment
D. Group Therapy
E. Pharmacotherapy
F. Medical and Somatoform Co-Morbidity in DID
Somatization and Somatoform Disorders
Psychophysiological Differences Among Alternate Identities
Treatment Considerations
G. Hypnosis as a Facilitator of Psychotherapy
H. Eye Movement Desensitization and Reprocessing (EMDR)
I. Expressive and Rehabilitation Adjunctive Treatments
J. Electroconvulsive Therapy
K. Pharmacologically-Facilitated Interviews
L. Psychosurgery

V. SPECIAL TREATMENT ISSUES
A. Informed Consent
B. Boundary Issues in the Psychotherapy of DID
Crisis Management
Physical Contact with the Patient
C. Validity of Patients’ Memories of Child Abuse
D. “Ritual” Abuse

VI. OTHER ISSUES
A. Publications and Interactions with the Media
B. Patients’ Spiritual and Philosophical Issues
C. DID Patients as Parents

CONCLUSIONS

REFERENCES

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