"Finding Solid Ground" in Inpatient Treatment for Dissociative Disorder Patients Followed by Transition to Outpatient Treatment Settings: A 1-year Follow-up Pilot Study

Inpatient Group and Individual Trauma- and Dissociation Informed Stabilization Therapy for Adult Survivors of Childhood Trauma

The purpose of the pilot is to examine the usefulness of the psychoeducational program, Finding Solid Ground, for patients with dissociative disorders in a naturalistc observational study, involving a 3-months inpatient treatment followed by patients continuation with the program in their local outpatient settings, by examining outcome of main trauma-related symptoms and adaptive coping. In addition, performing focus-group interviews with the patient groups at discharge and at follow-up, to gain information on their subjective experiences from participating in the program. The patients' therapists in the outpatient settings are invited to give written feedback on their experiences from working with FSG.

Study Overview

• Status: Completed
• Conditions: Dissociative Identity Disorder; Dissociative Disorder Not Otherwise Specified (DDNOS); PTSD and Trauma-related Symptoms
• Intervention / Treatment: Behavioral: Psychotherapy

Detailed Description

Adult survivors of childhood trauma have complex and diverse symptoms profiles. A subgroup develop a complex dissociative disorder. Modum Bad has for years offered a 3-months inpatient treatment program for this patient group. Patients leave the hospital after this treatment period and continue with treatment in their local outpatient settings. They come back for a 5-days follow-up 9 months after discharge from the residential setting. The aim of the pilot study is to examine changes in posttraumatic and dissociative symptoms and adaptive coping in this patient-group within the described naturalistic context, following patients' participation in Finding Solid Ground (FSG). FSG is developed by dr Bethany Brand, dr. Hygge Schielke, and dr Ruth Lanius (2022), and designed for this patient-group. It has 30 topics. Patients start up with FSG and complete 8 topics in the inpatient setting, and are offered to continue with the remaining topics during the outpatient period in collaboration with local treatment providers. 32 patients were recruited. Two of them were not included: one did not want to participate, and the other patient had a different focus in her treatment than FSG. Patients were assigned from referrals to the residential Department for Trauma treatment, Modum Bad, in Norway. As part of the usual clinical practice they were referred to our treatment group if they had a complex dissociative disorder in need of stabilization. The inpatient treatment lasts for 11 weeks and combines group- and individual therapies with different treatment modalities, all within the framework of FSG. Patients came back for a 5-days follow-up stay, 9 months after discharge from the inpatient treatment.

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• Norway
  • Buskerud
    • Vikersund, Buskerud, Norway, 3370
      • Modum Bad, Psychiatric clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

They are selected from patients referred to treatment in the Department for Trauma Treatment, Modum Bad, and have been routinely evaluated for treatment in this department, diagnosed with a dissociative disorder and in need of stabilisational interventions.

Description

Inclusion Criteria:

• The study include adults (minimum age of 18 years) with a complex dissociative disorder related to childhood trauma. All patients had received outpatient therapy with insufficient effect. Patients were diagnosed with at DSM-IV dissociative disorder, transformed to the ICD-10 dissociative disorders.

Exclusion Criteria:

• Ongoing psychosis, severe ongoing drug addiction, very disturbed group functioning, ongoing severe life crisis, mental disability, severe unsafe behavior (suicidality, self-harm).

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Adults with compelx dissociative disorders and histories of childhood trauma; All group and individual therapies were in line with the model presented in Finding Solid Ground, developed by dr. Bethany Brand et al. (2022). Patients were admitted for the inpatient pre-planned treatment for a 3-months period, continue with therapy in their local outpatient settings after discharge from the inpatient period, and come back for a 5-days follow-up stay 9 months after discharge from the inpatient treatment.

Behavioral: Psychotherapy; Patients are admitted in groups of eight. During the 3-months inpatient treatment period, the program include a daily group session, and 3 weekly individual sessions with individual therapists and milieu-therapists, with focus on FSG-interventions from a trauma- and dissociation-informed perspective. FSG follows the international guidelines (ISSTD, 2011) for treatment of dissociative disorders from the International Society for the Study of Trauma and Dissociation. It uses different treatment modalities, such as live psychoeducation, psychoeducational videos, written and practical exercises, equine facilitated therapy, reflection and discussion groups. They have parallel individual therapy with therapist (psychiatrist or psychologist) and milie-therapists, and participate in physical activity and ward meetings together with other patients in the unit. All therapists are trained in trauma- and dissociation therory and treatment, as well as the FSG model.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Progress in Treatment Questionnaire (PITQ-p)	Asesses adaptive capacities. It has 32 items scored on an 11-point scale ranging from 0% to 100%. Scores are averaged. Higher scores indicate higher capacitiy for adaptive coping.	at respectively: baseline (T1); 3 months (T2); and 1-year follow-up (T3)
PTSD Checklist for DSM-5 (PCL-5)	Posttraumaticstress disorder checklist for DSM-5, scale and subscales. Sum scores range from 20-80, with higher scores indicating greater PTSD symptoms severity	assessmentsat respectively: baseline (T1); 3 months (T2); and 1-year follow-up (T3)
Difficulties in emotion regulation scale (DERS)	Difficulties in emotion regulation scale, scale and subscales. It has 36 items ranging from 1 to 5. Scores are averaged. Higher scores indicate higher level of difficulties in emotion regulation.	assessments at respectively: baseline (T1); 3 months (T2); and 1-year follow-up (T3)
Self-compassion Scale - Short Form (SCS-SF)	Self-compassion scale short form (SCS-SF) has 12 items ranging from 1 to 5. Scores are averaged. Total average socres are calculated after reverse scoring of relevant items, with higher scores indicating higher level of self-compassion.	assessments at respectively: baseline (T1); 3 months (T2); and 1-year follow-up (T3)
Dissociative Experiences Scale (DES-II)	Dissociative experiences scale - version II has 28 items ranging from 0% to 100%. Scores are averaged. Higher scores indicate higher levels of dissociation.	assessments at respectively: baseline (T1); 3 months (T2); and 1-year follow-up (T3)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hedonic deficits and interference scale (HDIS)	Includes three subscales; 1) Positive emotionality (PE); 2) Hedonic deficits (HD); 3) Negative affective interference (NAI). All subscales are scored on a scale of 1 to 10. The scores are averaged. PE has 5 items, a higher score indicates higher levels of PE; HD has 5 items, a higher score indicates higher levels of HD; NAI has 11 items, a higher score indicates higher levels of negative affective interference.	Assessment at respectively: 1) baseline (T1); 2) 3-months (T2); and 3) 1-year follow-up.

Collaborators and Investigators

• Sponsor: Modum Bad
• Investigators: Study Director: Peter Sele, PhD candidate, Modum Bad, Research Institute, Vikersund, Buskerud, Norway

Publications and helpful links

General Publications

• Pierorazio, N. A., Robertson, J. L., Snyder,B. L., Brand, J. Schielke, H. J., & Lanius, R. A. (2025). Helpful aspects of a psychoeducational program for individuals with complex dissociation: An update for the Finding Solid Ground program. https://doi.org/10.1016/j.ejtd.2025.100566

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2023
• Primary Completion (Actual): June 10, 2025
• Study Completion (Actual): June 10, 2025

Study Registration Dates

• First Submitted: December 17, 2025
• First Submitted That Met QC Criteria: February 18, 2026
• First Posted (Actual): February 25, 2026

Study Record Updates

• Last Update Posted (Actual): March 10, 2026
• Last Update Submitted That Met QC Criteria: March 7, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: outpatient; emotion regulation; inpatient; childhood trauma; dissociation; selfcompassion
• Additional Relevant MeSH Terms: Trauma and Stressor Related Disorders; Mental Disorders; Stress Disorders, Traumatic; Behavior; Social Behavior; Self-Control; Stress Disorders, Post-Traumatic; Dissociative Disorders; Dissociative Identity Disorder; Emotional Regulation; Behavioral Disciplines and Activities; Psychotherapy
• Other Study ID Numbers: FSG pilot project

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No