CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS
The DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5-TR, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
RESOURCES
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
TO PREPARE
- Review this week’s Learning Resources on dissociative disorders.
- Use the Walden Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment.
THE ASSIGNMENT (2–3 PAGES)
- Explain the controversy that surrounds dissociative disorders.
- Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
- Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
- Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
BY DAY 7 OF WEEK 9
Submit your Assignment
SUBMISSION INFORMATION
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- To submit your completed assignment, save your Assignment as WK9Assgn+last name+first initial.
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6665_Week9_Assignment_Rubric
NRNP_6665_Week9_Assignment_Rubric
CriteriaRatingsPts
This criterion is linked to a Learning OutcomeIn 2–3 pages, address the following:• Explain the controversy that surrounds dissociative disorders.
15 to >13.0 pts
Excellent
The response includes an accurate and concise explanation of the controversy within the field related to dissociative disorders.
13 to >11.0 pts
Good
The response includes an accurate explanation of the controversy within the field related to dissociative disorders.
11 to >10.0 pts
Fair
The response includes a somewhat vague or inaccurate explanation of the controversy within the field related to dissociative disorders.
10 to >0 pts
Poor
The response includes a vague or inaccurate explanation of the controversy within the field related to dissociative disorders. Or the response is missing.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
15 pts
This criterion is linked to a Learning Outcome• Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
25 to >22.0 pts
Excellent
The response includes a thorough and well-organized explanation of the student’s professional beliefs about dissociative disorders. Rationale demonstrates critical thinking and is strongly supported with three scholarly references.
22 to >19.0 pts
Good
The response includes a well-organized explanation of the student’s professional beliefs about dissociative disorders. Rationale is clear and appropriately supported with three scholarly references.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
19 to >17.0 pts
Fair
The response includes a somewhat vague explanation of the student’s professional beliefs about dissociative disorders. Rationale is somewhat unclear and references either provide weak support for the rationale or are not scholarly/current.
17 to >0 pts
Poor
The response includes a vague explanation of the student’s professional beliefs about dissociative disorders. Rationale is unclear and references are inappropriate. Or the response is missing.
25 pts
This criterion is linked to a Learning Outcome• Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
30 to >26.0 pts
Excellent
The response includes an accurate and concise explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
26 to >23.0 pts
Good
The response includes an accurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
23 to >20.0 pts
Fair
The response includes a somewhat vague or incomplete explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
20 to >0 pts
Poor
The response includes a vague or inaccurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. Or the response is missing.
30 pts
This criterion is linked to a Learning Outcome• Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
15 to >13.0 pts
Excellent
The response includes an accurate and concise explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
13 to >11.0 pts
Good
The response includes an accurate explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important.
11 to >10.0 pts
Fair
The response includes a somewhat vague or incomplete explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
10 to >0 pts
Poor
The response includes a vague and inaccurate explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important. Or, response is missing.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
15 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
3.5 to >3.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
3 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good
Contains one or two grammar, spelling, and punctuation errors
3.5 to >3.0 pts
Fair
Contains three or four grammar, spelling, and punctuation errors
3 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
5 to >4.0 pts
Excellent
Uses correct APA format with no errors
4 to >3.5 pts
Good
Contains one or two APA format errors
3.5 to >3.0 pts
Fair
Contains three or four APA format errors
3 to >0 pts
Poor
Contains many (five or more) APA format errors
5 pts
Total Points: 100
Comprehensive Essay Example on Controversy Associated With Dissociative Disorders
Dissociative disorders are mental health conditions in which individuals experience a discontinuity/disruption of motor control, memory, consciousness, perception, behavior, emotions, and identity (American Psychiatric Association [APA], 2019). These symptoms can impair psychological functioning and are experienced as unwanted intrusions into behaviors and awareness, leading to discontinuity of subjective experiences and inability to gain control of mental functions. Dissociative disorders are common with traumatic experiences and proximity to trauma. This assignment evaluates the controversy surrounding dissociative disorders.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
The Controversy
The controversy surrounding dissociative disorders centers on whether these disorders are independent conditions or related to psychological stressors/trauma. In the DSM-5, dissociative disorders are closely related to a stressor or trauma-related disorders but are not part of these disorders (Boland & Verduin, 2021). The association explains the close relationship between the dissociative and the stressor or trauma-related diagnostic classes, especially early-life trauma and/or cumulative trauma. For instance, posttraumatic and acute stress disorders have dissociative symptoms, including derealisation or depersonalization, flashbacks, amnesia, and numbing (APA, 2019). Therefore, the discussion on whether dissociative disorders are artefactual conditions and are merely founded on confabulated trauma memories. Skeptics would argue that dissociative disorders are based on fantasies associated with iatrogenesis and other cultural factors, which is not supported by the literature. Despite these counterarguments, dissociative disorders are common and closely associated with trauma and stressor-related condition, but with slightly different presentations. (Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
Professional Beliefs
Although there is a strong relationship between dissociative disorders and stressor and trauma-relative disorders, the latter is distinctive in terms of its presentations and experience continuum. Usually, dissociative disorders are developed to cope with trauma, unlike other stressors and trauma-related disorders (Boland & Verduin, 2021). This means that with dissociative disorders, the stressor or traumatic source could still be present in the client’s life. For instance, children who have experienced emotional, sexual, or physical abuse for a long time develop dissociative disorders to help them cope with the present stimuli.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
The counter beliefs on dissociative disorder in the mental health professional milieu are not founded on the scientific literature. Minimal evidence supports a close relationship between dissociative disorders and trauma-related disorders (Loewenstein (2022). For instance, no psychological process can explain dissociative disorders such as amnesia from trauma. In trauma-related disorders, the contents of trauma are not well-remembered. It is the same for dissociative disorders in which unwanted intrusions into behaviors and awareness cannot be comprehended.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
Dissociative disorders are a continuum beginning from intense absorption to severe dissociation states as symptoms overlap with other disorders. This shows how complex dissociative disorders as core features usually accompany a mixture of other subjective mental health symptoms (Steele et al., 2022). Patients experience symptoms that affect personality, mood, anxiety, and functional somatic. Therefore, dissociative disorders can be overlooked, considering the polysymptomatic profile and patients’ tendency to avoid revealing trauma or dissociative symptoms. The latter refers to the psychobiological sequestration of traumatic information by altering states of consciousness. As such, the dissociation associated with dissociative disorders separates from the typical understanding and impact of traumatic events(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
Therapeutic Relationship
Individuals having traumatic experiences are likely to have difficulties developing trusting relationships. However, the therapeutic alliance is associated with successful treatment outcomes. Firestone (2018) identified empathy, respect, and collaboration are crucial strategies for developing therapeutic alliance, particularly with those individuals presenting suicide ideation. Moreover, flexibility, candidness, and effective listening are some of the best strategies for creating a therapeutic alliance with individuals diagnosed with dissociative disorders. Therefore, the therapist must have a more robust understanding of the alliance to facilitate better outcomes for affected individuals. This means that therapists should strive to help the clients to understand the importance of the therapeutic alliance on the treatment outcome. Ideally, a patient’s understanding of the therapeutic relationship with clients may contribute to better health outcomes.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
Ethical and Legal Considerations
The ethical and legal considerations for clients diagnosed with dissociative disorders include confidentiality, autonomy, and non-maleficence. Confidentiality involves keeping patient information to avoid unauthorized access, while autonomy concerns the capacity of the patients to make independent choices regarding their health (Avasthi et al., 2022). A mental health professional should ensure that the client understands confidentiality and the strategies to maintain the confidentiality of their condition. Maintaining confidentiality applies to every piece of information obtained from a client in any form, i.e., recorded, written, or verbal. Circumstances under which confidentiality can be broken and procedures involved should also be communicated to the patient. Such communication is also crucial for striking a therapeutic alliance.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
Nonmaleficence involves the need to avoid harm to the client. Basic psychotherapy models involve client collaboration and shared decision-making (Avasthi et al., 2022). However, clients can only contribute to their health by making an independent decision when the mental health professional involves them, providing vital information about their health in ways that do not cause more harm. When pursuing therapy for individuals with a traumatic past, such as sexual abuse, it could be challenging for the patient to participate. In such as case, the professional should devise crucial ways to engage the client in the therapy, mainly discussing the importance.(Comprehensive Essay Example on Controversy Associated With Dissociative Disorders)
References
American Psychiatric Association. (2019). Diagnostic and statistical manual of mental disorders (7th ed.). American Psychiatric Publishing, Inc.
Avasthi, A., Grover, S., & Nischal, A. (2022). Ethical and legal issues in psychotherapy. Indian Journal of Psychiatry, 64(Suppl 1), S47. https://doi.org/10.4103%2Findianjpsychiatry.indianjpsychiatry_50_21
Boland, R., & Verduin, M. (2021). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Lippincott Williams & Wilkins.
Firestone, L. (2018). Dissociation and therapeutic alliance. In Phenomenology of Suicide (pp. 167-186). Springer, Cham.
Loewenstein, R. J. (2022). Dissociation debates: Everything you know is wrong. Dialogues in Clinical Neuroscience. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein
Steele, K., Dorahy, M. J., & van der Hart, O. (2022). Dissociation versus alterations in consciousness. Dissociation and the Dissociative Disorders: Past, Present, Future.
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