Treatment for childhood and adolescent dissociation: A systematic review.

Abstract

Objective: Dissociative symptoms are linked to experiences of trauma, often originating in childhood and adolescence. Dissociative disorders are associated with a high burden of illness and a poor quality of life. Despite evidence suggesting that early intervention can improve outcomes, little research exists on the treatment of dissociative disorders in childhood and adolescence. The current study aimed to systematically review the existing body of literature to identify current treatments applied within child and adolescent populations diagnosed with a dissociative disorder. Method: This review was conducted in line with PRISMA guidelines. Databases were searched for relevant publications, resulting in 3,064 papers to be screened. Articles were included if they involved child or adolescent populations experiencing dissociation and undergoing treatment. Seven articles were included in the current review: two quantitative and five case studies. Results: Treatment duration varied greatly, ranging from 1 to 29 months. Treatments were mostly combinations of psychotherapy, dialectical behavior therapy, eye movement desensitization and reprocessing, as well as adjunctive therapies such as mindfulness and psychoeducation. Conclusions: Our study demonstrated that the literature on current treatment for children and adolescents is clearly scarce, with only seven studies, five of which were case studies and two of which were over 20 years old. The treatments used for dissociation in children and adolescents experiencing dissociation were varied, but psychotherapy was the most used treatment method. This review has revealed that there is no clear framework that exists for the treatment of dissociation in child and adolescent patients, despite the need for one. Clinical Impact StatementDissociation is thought to occur after a traumatic event(s) and can result in poor quality of life. This systematic review highlights the scant existing literature on treatment methods for children and adolescents with dissociative disorders. Seven articles described various treatments including psychotherapy, dialectical behavior therapy, eye movement desensitization and reprocessing, as well as adjunctive therapies such as mindfulness and psychoeducation. Our review revealed there is no clear treatment protocol available to clinicians dealing with children and adolescents experiencing dissociative disorders, that treatment that has been studied is individualized, and more research needs to be conducted to better understand treatment pathways.