Finding Solid Ground – Stabilization Program for Trauma-Related Dissociation

Overview

Finding Solid Ground is a structured, psychoeducational stabilization program specifically designed for individuals with trauma-related dissociation. Developed by Dr. Bethany Brand, Dr. Ruth Lanius, and other experts in dissociation, it provides a step-by-step, skills-based framework that can be delivered in group or individual formats. Its goal is to help clients strengthen safety, self-regulation, and cooperative functioning between dissociative parts before engaging in direct trauma memory work.

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Foundational Principles

• Phase-Oriented Trauma Treatment: Finding Solid Ground aligns with the first phase—Safety and Stabilization—of the treatment guidelines for complex trauma and dissociation.
• Parts-Informed: Uses concepts from structural dissociation theory, normalizing internal divisions as survival adaptations.
• Psychoeducation as Empowerment: Knowledge about dissociation, triggers, and nervous system functioning reduces shame and increases self-awareness.
• Skills First: Emphasis on practical coping and grounding tools to reduce crises and promote everyday functioning.

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Core Components

1. Understanding Dissociation
   • Education about how trauma impacts memory, identity, and bodily states.
   • Framing dissociation as protective, not pathological.
2. Grounding and Orientation Skills
   • Techniques for returning to the present (sensory orientation, movement, visual cues).
   • Progressive practice to reduce time spent in dissociative states.
3. Emotion Regulation Strategies
   • Identifying triggers and early signs of dysregulation.
   • Using breath, posture, and self-talk to down-regulate activation.
4. Building Internal Communication
   • Introducing ways for parts to share information safely.
   • Negotiating cooperation and reducing internal conflict.
5. Safety Planning
   • Developing personal crisis plans.
   • Identifying safe people, places, and coping sequences.

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Clinical Applications

• Dissociative identity disorder (DID) and other specified dissociative disorder (OSDD)
• Complex PTSD with dissociative symptoms
• Clients in early therapy stages who are destabilized by direct trauma work
• Outpatient, inpatient, and partial hospitalization programs

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Empirical Evidence

• Practice-Based Reports: Clinicians report improved daily functioning, reduced crisis events, and increased therapy engagement after program completion.
• Program Evaluations: Preliminary outcomes from group implementations show enhanced use of grounding skills, better emotional regulation, and less reliance on emergency services.
• Research Status: Formal peer-reviewed RCTs are limited, but the program content is consistent with established, evidence-informed stabilization practices for dissociation.

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Neurobiological Mechanisms

• Enhanced Prefrontal Engagement: Repeated grounding practices strengthen top-down regulation over subcortical threat circuits.
• Autonomic Flexibility: Regulation skills target sympathetic–parasympathetic balance, widening the window of tolerance.
• Implicit Memory Modulation: Internal communication tools help transform overwhelming implicit material into manageable, explicit awareness.

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Strengths and Limitations

Strengths

• Specifically tailored for dissociation—a population often underserved by generic trauma programs.
• Flexible delivery format: can be adapted to different cultural contexts and therapy settings.
• Builds a solid base for later trauma processing, reducing risk of retraumatization.

Limitations

• Does not address trauma memories directly; requires follow-up phases.
• Client progress depends on regular practice between sessions.
• Research evidence is emerging rather than fully established.

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Clinical Tips

• Introduce the program early in therapy for clients with high dissociation scores.
• Encourage a skills journal to track which grounding methods work best.
• Use visual aids (handouts, diagrams of the nervous system) to reinforce learning.
• Coordinate with the client’s therapist to integrate skills into ongoing individual work.

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References

• Brand, B. L, Schielke, H. J., Schiavone, F., & Lanius, R. A. (2022). Finding solid ground: Overcoming obstacles in trauma treatment. Oxford University Press. https://doi.org/10.1093/med-psych/9780190636081.001.0001
• Steele, K., Boon, S., & van der Hart, O. (2017). Treating Trauma-Related Dissociation: A Practical, Integrative Approach. W.W. Norton.
• Fisher, J. (2017). Healing the Fragmented Selves of Trauma Survivors. Routledge.
• ISSTD (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation, 12(2), 115–187.