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The treatment of clients with dissociative identity disorder (DID), or multiple personality disorder, is a specialized area requiring a great deal of experience (Putnam 1989). The complexity of these clients’ presentations, the chaotic alterations in their behavior and interactions with others, and the bizarre nature of their symptoms justify referring these clients to clinicians who specialize in treatment of DID. Unfortunately, traumatized clients often do not come to therapists with a sign that identifies them as having DID. They often are unaware of the disorder. Thus, it is common for DID symptoms to present well into treatment, when referral to another clinician may be too disruptive for a client. Therefore, clinicians using a trauma-centered approach should be sure to make a thorough evaluation of dissociative symptoms as part of their initial assessment but also need to know how to handle and treat clients with DID that emerges during the course of trauma-centered psychotherapy.
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