Multiple perspectives on multiple selves: investigating clinicians' knowledge, beliefs, and experiences related to dissociative identity disorder

Dissociative identity disorder (DID) is a complex, posttraumatic developmental disorder that has received varying research attention in the last 30 years (Brand & Loewenstein, 2010). Despite increased awareness and understanding of DID, patients with this disorder spend an average of nearly seven years in the mental health system before receiving an accurate diagnosis (Putnam et al., 1986). Delayed and incorrect diagnosis is associated with costly, ineffective, and/or inappropriate treatments (Leonard & Tiller, 2016). Clinician factors believed to contribute to delayed DID diagnosis include skepticism or disbelief as well as lack of training and knowledge (Brand et al., 2016). While significant research on this topic was conducted 15 to 30 years ago, few studies have assessed the current stance of practitioners, and even less research has explored factors underlying variation in their beliefs, knowledge, training, and experience. Accordingly, this study investigated clinicians’ knowledge, beliefs, training, and clinical experiences related to DID through a mixed-methods design. Eighty-three U.S. mental health professionals recruited from eight professional organizations completed an online survey that included demographic questions as well as a DID questionnaire. Descriptive analyses indicated that participants demonstrated varying levels of disbelief, knowledge, training, and experience related to DID. While most participants believed DID is a valid disorder (73.5%), only 38.4% were likely or extremely likely to believe a new patient who reports having the diagnosis. Thematic analyses (Braun & Clarke, 2006) revealed that, though stigma persists, most participants believed in the trauma model of DID. Findings suggest that many clinicians, especially those specializing in trauma, dissociative disorders, and/or psychodynamic therapy, find it challenging yet rewarding to work with DID, believe awareness about DID is an important area of research, and want to increase their awareness and knowledge about DID. Implications for DID assessment and treatment, as well as for future research, clinician training, and supervision are explored.Psy.D.Includes bibliographical referencesby Jenna N. Blewi