Clinical resource for qualified practitioners. For client-facing information, visit our client page or TraumaDirectory.org.
Clinical Resources & Professional Development

The clinical framework you weren't taught in training

Specialist training and supervision for therapists working with dissociative disorders and complex trauma. Clinical resources grounded in current research and what actually works in the room.

See all training offers → List on TraumaDirectory.org →

10+ years specialising exclusively in DID, OSDD, and complex trauma. Grounded in ISSTD guidelines, current research, and what actually works in the room.

From supervisees

"I had worked with trauma clients for five years before coming to Julia for supervision. The clinical framework she brought immediately changed how I worked with dissociative presentations. I finally understood what I was seeing."

BACP Accredited Counsellor, trauma-informed practice, UK

"The most clinically impactful supervision I have had. Julia holds both the theory and the relational complexity in a way I have not found elsewhere. My confidence with this client group has transformed."

Psychotherapist, Schema Therapy, private practice

"Having a supervisor who specialises in DID means no part of what I bring feels too complex. The consultation is always grounded, practical, and deeply human."

Clinical Psychologist, EMDR practitioner

Training & Supervision Supervision Join Directory Structural Dissociation Diagnostic Tools Treatment Phases In-Session Techniques Research Vault
Dr. Julia Andre

Who you're learning with

Dr. Julia Andre

I'm a Registered Clinical Psychologist with over 10 years of specialist practice in DID, OSDD, and complex trauma. My clinical work sits at the intersection of structural dissociation theory, Schema Therapy, and parts-based approaches: the frameworks that actually move the needle with this client group.

I train and supervise because the gap between what therapists are taught and what dissociation actually looks like in the room is causing real harm to clients who go unrecognised for years, and to therapists who carry this work alone.

Registered Clinical Psychologist · HCPC Advanced Accredited Schema Therapist EMDR Certified ISSTD Certified Registered Psychologist · HKPS Registered Supervisor · RAPPS

Training & Supervision

Get confident with the cases that are hardest to hold

Three offers, each building on the last. Start anywhere. Most people start with the webinar.

Webinar 90 minutes · Next: Sept 2026

When Therapy Stalls and Clients Disappear: A Clinical Framework for Hidden Dissociation

You're doing everything right, and the therapy still isn't moving. Your client shuts down, goes flat, or simply isn't there. This 90-minute session gives you a clinical framework to recognise hidden dissociation in the clients you're already seeing, understand why the work keeps stalling, and know what to do next.

  • ✓ Live 90-minute session
  • ✓ Lifetime replay access
  • ✓ Q&A included
  • ✓ Runs September & March each year
  • ✓ Live via Zoom · times to suit Asia & Europe
HK$950 one-off approx. US$122
Join the waitlist →
Recommended
Intensive 4 weeks · Next: Jan 2027

Dissociative Intensive

You can see the dissociation. Now you need to know what to do with it. Four weekly live sessions that take you from recognition to active clinical work: mapping parts, working with rigid and hostile EPs, navigating the therapeutic relationship, and keeping treatment moving when it wants to collapse.

  • ✓ 4 x 90-minute live sessions
  • ✓ Small group (max 12)
  • ✓ Session recordings included
  • ✓ Runs January & September each year
  • ✓ Live via Zoom · Asia & Europe time options
HK$3,900 per cohort approx. US$500
Reserve a place →
Supervision 6-month cohort

Group Supervision: Complex Dissociation & Parts Work

A fixed cohort of six practitioners meeting monthly for six months. The group builds a shared clinical language, cases deepen over time, and you leave each session knowing what to do next with your most complex clients.

  • ✓ 6 monthly sessions of 90 minutes
  • ✓ Fixed group of 6, same people throughout
  • ✓ Case conceptualisation & formulation
  • ✓ New cohorts start January & July

Two groups per cohort

🌏 Asia-Pacific Lunchtime HKT · Asia-friendly
🌍 Europe Evening HKT · Europe hours
HK$9,000 for 6 months approx. US$1,155 · HK$1,500/month

Only 6 places per group. Cohorts fill quickly.

Apply for a place →

Your journey

1

You finally see what you're looking at

One 90-minute session names what you've been seeing but couldn't explain: the stalling, the disappearing, the therapy that won't move. You leave with a clinical lens that changes how you see your caseload.

2

You know how to move the work forward

Four weeks of live clinical training in the Dissociative Intensive. You leave with a structured framework, practical tools, and confidence with the cases that previously stalled.

3

You're not holding it alone anymore

Monthly group supervision with a small fixed cohort. Bring your most complex cases. Leave with clarity, formulation, and a path forward every time.

Common questions

Is this suitable for someone still learning about dissociation? ▶

Yes. The webinar is designed as an entry point for trauma-informed therapists who are encountering dissociation in their caseload but haven't had specialist training in it. You don't need prior knowledge of structural dissociation theory. That's exactly what the session builds. The Dissociative Intensive assumes you've attended the webinar or have some familiarity with the basics, but is still accessible to practitioners earlier in their dissociation training.

What if I can't make the live session? ▶

The webinar is recorded and you get lifetime access to the replay, so missing the live session doesn't mean missing the content. For the Dissociative Intensive, session recordings are included so you can catch up if you miss a week. Live attendance is encouraged as the Q&A and group discussion are a significant part of the learning, but the recordings mean nothing is lost.

Can I join supervision without doing the webinar or Intensive first? ▶

Yes. Supervision is open to any qualified practitioner who is actively working with dissociative clients. You don't need to have completed the other offers first. If you're unsure whether it's the right fit, get in touch and we can have a brief conversation before you commit.

What time zones are the supervision groups held in? ▶

There are two groups per cohort. The Asia-Pacific group meets at lunchtime Hong Kong Time, suitable for practitioners across Asia. The London/Europe group meets in the evening Hong Kong Time, which falls during working hours for UK and European practitioners. Exact times are confirmed on registration.

Free clinical reading

Differential Diagnosis

DID or BPD? How to Tell Them Apart When It Matters Most

EMDR

EMDR with Dissociative Clients: Adaptations and What the Research Shows

Parts Work

Working with Hostile and Persecutory Parts: A Clinical Approach

Therapist Wellbeing

Vicarious Trauma and Countertransference When Working with DID

Psychopharmacology

Medication in DID: What the Evidence Says and How to Use It as an Adjunct

Be found by clients who need your specialism

  • ✓ Verified profile searchable by specialism, modality & location
  • ✓ Clients specifically searching for dissociation specialists
  • ✓ One-off payment. No subscription, no commission. Ever.
  • ✓ Early access: first 100 therapists list for $20
List your practice →

van der Hart, Nijenhuis & Steele (2006)

Theory of Structural Dissociation of the Personality

The most clinically robust framework for understanding the internal architecture of dissociative presentations. Dissociation is understood as a failure of integration of personality systems under overwhelming conditions, producing distinct but interacting structural divisions.

ANP, Apparently Normal Part

The functioning self

Manages daily life, work, relationships. Oriented toward present-day demands. Often amnesic for traumatic experiences and may be unaware of EP activity. ANP is not without distress, it carries the load of avoidance and functional demands.

EP, Emotional Part

The trauma-holding self

Remains fixed in traumatic time, holding traumatic memories, defensive action tendencies (fight, flight, freeze, fawn, collapse). EPs are not pathological, they are loyal protectors still acting on past threat assessments.

Levels of structural dissociation

The severity of structural division maps broadly onto diagnostic categories.

Level Structure Associated presentations Key clinical features
Primary 1 ANP & 1 EP PTSD, Simple Dissociative Amnesia Basic ANP/EP split; limited amnesia between states
Secondary 1 ANP & multiple EPs C-PTSD, OSDD-1a/1b, DPDR Multiple EP subsystems; complex triggers; phobia of trauma-derived parts
Tertiary Multiple ANPs & multiple EPs DID (ICD-11: 6B64 / DSM-5: 300.14) Distinct ANP subsystems with separate autobiographical memory; significant inter-part amnesia; time loss

Assessment

Diagnostic screening tools

No single measure is sufficient for diagnosis. Use a combination of self-report measures and structured clinical interview, with attention to differentials including BPD, psychosis, and somatic symptom disorders.

FreeDES-II: Dissociative Experiences Scale
▶

28-item self-report. Broad screening for dissociative experiences. Taxon subscale (DES-T) identifies pathological dissociation with higher specificity. Score ≥30 warrants further evaluation.

Access DES-II →
FreeMID: Multidimensional Inventory of Dissociation
▶

168-item comprehensive self-report. Covers 23 dissociative scales including amnesia, identity confusion, voices, trance, and depersonalisation. One of the most thorough available instruments.

Access MID →
FreeSDQ-20: Somatoform Dissociation Questionnaire
▶

20-item measure of somatoform dissociation. Particularly useful when clients present with medically unexplained symptoms such as motor, sensory, or pain complaints.

Access SDQ-20 →
FreeDDIS: Dissociative Disorders Interview Schedule
▶

Structured clinical interview covering all major dissociative disorder categories per DSM criteria. Also screens for somatic symptoms and secondary features of DID.

Access DDIS →
Purchase requiredSCID-D: Structured Clinical Interview for DSM Dissociative Disorders
▶

Gold-standard semi-structured interview assessing the five core dissociative symptoms: amnesia, depersonalisation, derealisation, identity confusion, and identity alteration. Requires clinical training.

Purchase via APPI →
FreeDES Taxon Calculator
▶

Online calculator for the DES Taxon, identifying pathological dissociation distinct from normal dissociative experiences. Useful adjunct to full DES scoring.

Access calculator →

ISSTD Guidelines, Third Revision (2011)

Phase-based treatment model

The ISSTD Guidelines for Treating Dissociative Identity Disorder in Adults outline a phase-oriented model that remains the international clinical standard. Phases are not strictly sequential, movement is iterative and responsive to the client's window of tolerance. Medication may be used as an adjunct to address comorbid symptoms such as depression, anxiety, or sleep disturbance; it does not directly treat DID and is not a substitute for trauma-focused psychotherapy.

Phase 1Safety, stabilisation & symptom reduction
▶

Foundational and often the most substantial phase. Establish therapeutic alliance, safety, and basic stability before any trauma processing begins.

  • Assessment and psychoeducation about the diagnosis and structural dissociation
  • Crisis safety planning across the system
  • Reducing self-harm, suicidality, and dangerous behaviours
  • Grounding, containment, and window-of-tolerance skills
  • Beginning gentle contact with parts, curiosity not confrontation
  • Addressing phobia of dissociative parts and of trauma-derived affect
  • Building inner communication and cooperation
Phase 2Trauma processing
▶

Processing traumatic memories carefully, with titration and containment. No phase 2 work should begin until Phase 1 stability is established. Premature processing is a common clinical error.

  • Trauma processing with all relevant parts, not just ANP
  • Titration techniques to prevent flooding
  • EMDR protocols adapted for dissociation; fractionated processing
  • Working through grief, betrayal, and complex attachment injury
  • Reducing amnesia barriers as the system builds trust
  • Addressing traumatic transference and countertransference
Phase 3Integration & rehabilitation
▶

Integration is an ongoing process of greater unity and identity coherence. Full fusion is one possible outcome, not a requirement. Some clients achieve a well-functioning cooperative system without complete merger of parts.

  • Developing a unified or cooperative sense of identity
  • Addressing the grief of integration, loss of familiar system dynamics
  • Building a life in the present: relationships, work, meaning
  • Relapse prevention and maintaining gains
  • Fusion rituals (where pursued), intentional, never forced

Fry (2026)

Schema Therapy for DID & OSDD

Schema Therapy offers a powerful framework for understanding the unmet needs that underpin dissociative presentations, and for working with parts through the lens of schemas, modes, and limited reparenting.

Unmet needs & shame

Core early schemas in DID often cluster around abandonment, abuse/mistrust, defectiveness/shame, and emotional deprivation. Parts may crystallise around specific schemas, a shame-based EP, a protector schema, a functional ANP schema.

Limited reparenting

The therapist provides, within appropriate boundaries, the consistent, attuned, corrective emotional experience that was absent in early life. This is not about meeting all needs, but meeting the needs of the therapeutic moment: validation, warmth, containment.

Affect-to-need mapping

Moving from "I feel X" to "I need Y." Anger often signals a need for protection or justice; shame may signal a need for acceptance; fear often signals a need for safety. Parts can be helped to locate their affect-to-need chain.

Healthy Adult development

Developing the Healthy Adult mode across the system, or within ANP, as an internal caregiver and mediator. This mode can communicate with EPs, set limits on punitive schemas, and advocate for all parts with compassion.

Primary reference: Fry, M. (2026). Schema Therapy for Dissociative Identity Disorder and Other Specified Dissociative Disorder. Evidence-based protocol integrating Schema Therapy with phase-based dissociation treatment.

Clinical Techniques

In-session techniques

The practical toolkit for working with dissociative systems: titration for safe trauma processing, the Internal Conference Table for parts communication, and unblending for restoring Self-leadership.

Titration menu▶

Approach traumatic material in manageable doses to prevent flooding, maintain dual awareness, and preserve the therapeutic alliance.

Distancing

Increase psychological distance from the material, watching it on an imaginary screen, moving the screen further away, shrinking it, muting the sound.

Fractionation

Process only a small piece at a time ("just the first moment, nothing more"). Stop, resource, re-evaluate window of tolerance before continuing.

Change Scene

Step out of the processing and redirect attention to a grounding object, the room, or the body in the present. Deliberate pause before re-approach.

Containment

Imagery-based. Ask the client to place material in a container (box, vault, safe) until a designated time, creating a felt sense of control over when material is accessed.

Pendulation

Somatic approach. Move attention between sensations of distress and relative ease or neutrality, building the nervous system's capacity to tolerate movement between states.

Resourcing

Activate internal or relational resources before and after contact with traumatic material. Safe place imagery, connection to a stable part, somatic anchoring.

Framing

Offer an integrating narrative: "This happened then; it is not happening now. Your body survived." Reduces present-moment threat activation of trauma recall.

Internal Conference Table▶

Structured technique for facilitating internal communication, negotiation, and cooperation across parts. Approach always with curiosity, openness, and zero pressure.

1

Ground and orient

Begin with grounding in the present. Establish dual awareness. Brief body scan.

2

Establish the space

Invite the client to imagine an internal meeting space, whatever feels right. Safe, neutral, and belonging to all parts. No part is forced to attend.

3

Open the invitation

Invite all parts to be present in whatever way feels comfortable. Emphasise no part will be overridden or removed.

4

Acknowledge each part with curiosity

Greet each part with warmth. Ask gently: What does this part need? What does it want the rest of the system to know?

5

Facilitate dialogue, not debate

The goal is understanding, not resolution. Name tensions without taking sides. Parts may have opposing agendas, and that is okay.

6

Close safely

Thank each part explicitly. Return the client fully to the present. Check in with the body. Leave adequate time for integration before the session ends.

Unblending with parts▶

Blending occurs when a part takes over executive function. Unblending restores dual awareness and Self-leadership, moving from being "in" the part to being "with" it.

Step 1

Language shift

Shift from "I feel terrified" to "Part of me feels terrified." This creates immediate psychological distance without pathologising multiplicity.

Step 2

Observing position

Invite the client to notice the part rather than be it: "Can you sense the part that feels terrified? Can you notice it from where you are sitting right now?"

Step 3

Somatic unblending

If blending is somatic, direct attention to a neutral or comfortable area of the body first. Build embodied presence before re-approaching the blended material.

Step 4

Acknowledge the part's function

Ask what this part is protecting against. Curiosity and gratitude dissolve resistance far more effectively than pushing against the blending.

Clinical considerations

Special clinical situations

Persecutory & hostile parts▶

Approach with the same curiosity applied to all parts. Hostility signals an intense need for protection or an unmet need that has not yet been witnessed. Confrontation without curiosity is rarely effective and risks rupturing alliance with the wider system.

Child parts▶

Child EPs often hold the rawest traumatic material. Approach with gentleness, warmth, and age-appropriate communication. Never rush. The therapeutic relationship with child parts is often the turning point in treatment.

Amnesia between sessions▶

Some clients will have no memory of what was processed in previous sessions. Work collaboratively on internal communication, journaling, voice notes, shared notes with the system, and revisit psychoeducation regularly.

Somatic presentations & conversion▶

Somatoform dissociation (SDQ-20) is common and often leads to years of medical investigation. Normalise the body-trauma connection without pathologising. Liaise with medical professionals where appropriate.

Suicidality & self-harm▶

Safety planning must account for the whole system, not just the presenting part. Different parts may have different relationships to self-harm. Identify which parts feel safe, which feel at risk, and build internal agreements with the ANP.

Attachment injury & relational trauma▶

When the therapist is the first safe relationship, the therapeutic relationship itself becomes a key treatment mechanism. Awareness of dependency dynamics, trauma bonding, and rupture-repair is essential.

Working through a complex case?

Supervision and consultation available

One-to-one case consultation for practitioners working with dissociative presentations. Enquire to check current availability.

Enquire about supervision →

Evidence Base

Research vault

Key papers from 2020 onwards, curated for clinical relevance. All open-access where possible.

2025 · Open Access

Recent evidence-based developments in the treatment of DID

Frontiers in Psychiatry. Comprehensive review of emerging treatment modalities with large-effect-size outcomes on dissociative symptoms.

 2024

Treatment of DID: Leveraging Neurobiology to Optimise Success

Expert Review of Neurotherapeutics. Neurobiological findings informing improved treatment strategies for DID.

 2024 · Open Access

Advancing Research on and Treatment of Dissociative Disorders

Robinson et al.. Research priorities and treatment recommendations across the dissociative disorder spectrum.

 2023 · Open Access

Schema Therapy for Dissociative Identity Disorder: A Case Report

Frontiers in Psychiatry. First published case report of Schema Therapy applied to DID, with protocol detail.

 2023 · Open Access

The Integrative Process Promoted by EMDR in Dissociative Disorders

Frontiers in Psychology. Neurobiological mechanisms of EMDR in dissociative presentations; rationale for titrated bilateral stimulation.

 2021

IFS Therapy for PTSD among Survivors of Multiple Childhood Trauma

Journal of Child Sexual Abuse. Pilot study: 92% no longer met PTSD criteria post-IFS treatment in complex trauma population.

 2024 · Open Access

Unravelling the Layers: DID as a Response to Trauma

PMC. Updated review of trauma model, aetiological research, and neuroimaging evidence supporting DID as trauma response.

 2023

Refining Experiential Techniques in Schema Therapy for Traumatised Populations

Cognitive and Behavioral Practice. Continuum of experiential techniques from gentle to intensive; clinical guidance for titration in schema work.

 2025

IFS-Informed EMDR as Treatment for Personality Structural Dissociation

Discover Psychology. Proposed integration of IFS principles into EMDR protocol for structural dissociation.

 2025 · Open Access

Effectiveness of Phase-Oriented Treatment for Trauma-Related Dissociative Disorders: A Systematic Review

European Journal of Psychotraumatology. All 19 included studies showed clinically significant improvement across dissociation, psychopathology, mental health, and general functioning, supporting the ISSTD phase model.

 2021 · Open Access

Vicarious Trauma Interventions for Trauma Service Providers: A Scoping Review

Frontiers in Psychiatry. Supervision identified as the primary protective factor against vicarious traumatisation in trauma practitioners.

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