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Ethical Dilemmas in the Treatment of Complex Trauma and Dissociation: Video Course


Speaker: Kathy Steele

Product: Video Course
Price: £135

CPD Hours: 6

Video course packs, including all notes are available immediately on booking. The access links are part of your ticket. Online video access remains available for 1 year from the date you receive the video course.

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As therapists, we can encounter a wide gamut of difficult, ethical dilemmas when we are working with traumatised clients – dilemmas that can be challenging to resolve even when we are guided by our respective professional, ethical codes.
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Full Course Information

This intellectually stimulating and highly practical 2-part seminar with Kathy Steele starts by first exploring the intersection of our own and professional ethics and how we can reconcile the differences between them. With the help of case vignettes, we address a number of questions and clinical conundrums:

  • What are the factors that impact the development of our ethical positions? How do we manage when our morality or legal restrictions conflict with our professional ethics?
    • We will explore many clinical issues that involve mindful ethical decision-making, including reporting issues when our clients have the potential to abuse others, or when they continue to be abused in the present, and confidentiality issues when family members, friends, or others outside the mental health field are involved in helping our clients.
  • What ethical dilemmas are we confronted with when clients engage in chronic self-harm or suicidality?
  • What are effective and ethical ways to use the therapeutic relationship to help our clients without being caretaking or withdrawn?
  • What is our responsibility to be aware of our own countertransferences and manage subtle attitudes and actions toward our clients?
  • What are the ethics of continuing to see clients that we are not helping?

Specifically, we will explore ethical dilemmas in the following areas of work:

  • Revictimization, self-harm, and suicidality:
    • The therapist is often in a dilemma about how to help patients who continue to be abused but are unable or unwilling to stop contact.
    • We will explore how to manage our countertransference tendency to rescue, and to help the patient develop agency. We will also explore the dilemmas of ongoing self-harm and chronic suicidality and how we can respond rationally.
  • Boundary and dependency:
    • Dependency is often a problem in therapy with highly traumatized individuals.
    • We will explore ways to ethically maintain boundaries while supporting the client to gain more self-agency and utilize available supports, while taking care of ourselves as therapists.
  • Sense of Separateness of Parts, for DID Clients:
    • Is the whole person responsible for what one part does?
    • We will discuss a rational approach to treating DID as a whole person with responsibility for his/her own behaviour, while still acknowledging a sense of separateness.
  • Intense re-enactments and countertransference:
    • The most intense countertransference – both positive and negative – can occur in therapists who treat highly traumatized individuals.
    • We will learn how to identify re-enactments and ways to address them ethically and therapeutically.
  • Differences in short- and long-term therapy:
    • The therapist has an ethical obligation not to open up issues that cannot be treated with a time-limited frame.
    • We will explore how and what to address in shorter-term therapies for highly complex clients.
  • Reporting and confidentiality:
    • Traumatized clients often present us with highly complex situations that involve grey areas of reporting.
    • When do we need to report a patient’s mistreatment of his/her own children? How does that impact the therapeutic relationship?
    • How do we manage the complicated requests for us to speak or intervene with partners, children, friends, clergy, and management at the patient’s work?
    • What do we do if the client refuses for us to contact other treatment providers?

About the speaker

Kathy Steele, MN, CS has been treating complex trauma, dissociation, and attachment issues since 1985. She is in private practice with Metropolitan Psychotherapy Services and is Adjunct Faculty at Emory University in Atlanta, Georgia, US.  Ms. Steele is a Past President and Fellow of the International Society for the Study of Trauma and Dissociation (ISSTD), and has also previously served on the Board of the International Society for Traumatic Stress Studies (ISTSS). She has been involved with developing treatment guidelines for Dissociative Disorders and well as for Complex Posttraumatic Stress Disorder. Ms. Steele has received a number of awards for her work, including the 2010 Lifetime Achievement Award from ISSTD, an Emory University Distinguished Alumni Award in 2006, and the 2011 Cornelia B. Wilbur Award for Outstanding Clinical Contributions.  She is known for her humor, compassion, respect, and depth of knowledge as a clinician and teacher, and for her capacity to present complex issues in easily understood and clear ways using an integrative psychotherapy model that draws from both traditional and somatic approaches. She is sought as a consultant and supervisor, and as an international lecturer.

She has co-authored three books as part of the acclaimed Norton Series on Interpersonal Neurobiology: The Haunted Self: Structural dissociation of the personality and chronic traumatization (2006, Van der Hart, Nijenhuis, & Steele – W. W. Norton); Coping with trauma-related dissociation: Skills training for patients and therapists (2011, Boon, Steele, & Van der Hart – W. W. Norton); and most recently, Treating trauma-related dissociation: A practical, integrative approach (2017, Steele, Boon, & Van der Hart – W. W. Norton). She has also (co)authored numerous book chapters and journal articles.


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