A Web-based Psychoeducation Program for People with Pathological Dissociation: Development and Pilot Testing

Figures & data

Table 1. Elements of the web-based psychoeducation program.

Number	Psychoeducation elements	Examples of relevant literature
1	Safety issues, trigger management and crisis planning	Brand et al., 2012; Fisher, 1999; International Society for the Study of Trauma and Dissociation, 2011
2	Education about the impacts of trauma and stress	Herman, 1992; Phoenix, 2007
3	Education about the condition (e.g., diagnosis), treatment options and the hope of recovery	Herman, 1992; Phoenix, 2007
4	Education about the concept of dissociation	Ross & Halpern, 2009; Van der Hart et al., 2006
5	Promoting internal (intrapersonal/inter-personality) communication and cooperation and integration of the personality	International Society for the Study of Trauma and Dissociation, 2011; Van der Hart et al., 2006
6	Identifying and coping with symptoms	Brand et al., 2012; Fisher, 1999; Whitworth, 2016
7	Self-help skills and coping strategies	Fisher, 1999; Whitworth, 2016
8	Decreasing shame and confusion and dispelling myths and stigma	Fisher, 1999; Whitworth, 2016
9	Understanding and resolving interpersonal problems	Brand et al., 2012; Ross & Halpern, 2009
10	Self-care and living well	Stige, 2011

Table 2. Mean differences in pretest and posttest scores on outcome measures.

	Intent-to-treat analysis (N = 40)
	Pretest		Posttest
Variables	Mean	SD	Mean	SD	t	p	Cohen’s d	Cohen’s d 95% CI
DES-T Total	44.81	23.23	42.47	25.18	1.841	0.073	0.09	[−0.01, 0.19]
PCL-5 Total	57.40	12.07	53.03	15.08	2.632	0.012	0.31	[0.07, 0.55]
PHQ-9 Total	17.60	4.43	16.18	6.14	2.322	0.026	0.25	[0.04, 0.46]
CR Total	18.58	3.51	19.93	4.12	−2.623	0.012	−0.35	[−0.62, −0.08]
	Completers analysis (N = 25)
	Pretest		Posttest
Variables	Mean	SD	Mean	SD	t	p	Cohen’s d	Cohen’s d 95% CI
DES-T Total	43.00	21.80	39.25	24.69	1.876	0.073	0.15	[−0.01, 0.32]
PCL-5 Total	57.68	11.02	50.68	15.46	2.763	0.011	0.50	[0.12, 0.88]
PHQ-9 Total	17.48	4.22	15.2	6.68	2.405	0.024	0.37	[0.06, 0.68]
CR Total	18.24	3.39	20.4	4.33	−2.753	0.011	−0.55	[−0.96, −0.13]

Notes: DES-T = The Dissociative Experiences Scale-Taxon; PCL-5 = The Post-traumatic Stress Disorder Checklist for DSM-5; PHQ-9 = The Patient Health Questionnaire-9; CR = The Clinical Recovery (“Mastering my illness”) subscale of the Recovery Assessment Scale – Domains and Stages.

Table 3. Satisfaction with a web-based psychoeducation program for pathological dissociation (N = 25).

The Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I)	Does not apply to me (%)	Does rather not apply to me (%)	Does partly apply to me (%)	Does totally apply to me (%)
1. The program I attended was of high quality	8	16	44	32
2. I received the kind of program I wanted	12	12	48	28
3. The program has met my needs	16	20	40	24
4. I would recommend this program to a friend, if he or she were in need of similar help	12	20	36	32
5. I am satisfied with the amount of help I received through the program	12	40	16	32
6. The program helped me deal with my problems more effectively	20	20	36	24
7. In an overall, general sense, I am satisfied with the program	16	8	36	40
8. I would come back to such a program if I were to seek help again	20	12	36	32
Overall feedback	Strongly disagree (%)	Disagree (%)	Agree (%)	Strongly agree (%)
1. Do you think the web-based psychoeducation for pathological dissociation (WPPD) program can help you understand your conditions?	0	16	52	32
2. Do you think the WPPD program can help you manage your conditions?	12	24	52	12
3. Do you think the WPPD program can help you remain hopeful for recovery?	0	32	40	28
4. Do you think the WPPD program is easy-to-use?	8	8	36	48

Brand, B. L. , Myrick, A. C. , Loewenstein, R. J. , Classen, C. C. , Lanius, R. , McNary, S. W. , … Putnam, F. W. (2012). A survey of practices and recommended treatment interventions among expert therapists treating patients with dissociative identity disorder and dissociative disorder not otherwise specified. Psychological Trauma: Theory, Research, Practice, and Policy , 4(5), 490. https://doi.org/10.1037/a0026487

 Web of Science ®Google Scholar

Fisher, J. (1999). The work of stabilization in trauma treatment . Paper presented at Trauma Center Lecture Series, Boston, MA. http://janinafisher.com/pdfs/stabilize.pdf

 Google Scholar

International Society for the Study of Trauma and Dissociation . (2011). Guidelines for treating dissociative identity disorder in adults, Third Revision. Journal of Trauma & Dissociation , 12(2), 115–187. https://doi.org/10.1080/15299732.2011.537247

 PubMed Web of Science ®Google Scholar

Herman, J. L. (1992). Trauma and recovery . New York, NY: Basic Books.

 Google Scholar

Phoenix, B. J. (2007). Psychoeducation for survivors of trauma. Perspectives in Psychiatric Care , 43(3), 123–131. https://doi.org/10.1111/j.1744-6163.2007.00121.x

 PubMed Web of Science ®Google Scholar

Ross, C. A. , & Halpern, N. (2009). Trauma model therapy: A treatment approach for trauma, dissociation and complex comorbidity . Manitou Communications.

 Google Scholar

Van der Hart, O. , Nijenhuis, E. R. , & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization . W.W. Norton.

 Google Scholar

Whitworth, J. D. (2016). The role of psychoeducation in trauma recovery: Recommendations for content and delivery. Journal of Evidence-Informed Social Work , 13(5), 442–451. https://doi.org/10.1080/23761407.2016.1166852

 PubMed Web of Science ®Google Scholar

Stige, S. H. (2011). A stabilization group approach for heterogeneous populations of trauma clients. Journal of Aggression, Maltreatment & Trauma , 20(8), 886–903. https://doi.org/10.1080/10926771.2011.627583

 PubMedGoogle Scholar