Clinical Social Work

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These 3 domain names are FOR SALE: http://www.ClinicalSocialWork.com/ http://www.ClinicalSocialWorker.com/ http://www.ClinicalSocialWorkers.com/ You may submit your bid to Pat@PatMcClendon.com for consideration. "Recommendations for Home of the Innocents (HOTI) Regarding Therapeutic Intervention" By: Patricia D. McClendon, MSSW candidate Date: August 16, 1992 Note: I wrote up this brief paper to present to my field placement supervisor and her supervisors in regards to unrecognized and untreated dissociative disorders in their agency's client population. I relied on mostly quoted material because quite honestly, I didn't expect them to believe me. HOTI is an emergency shelter for abused and neglected children, so what I have written here, I believe, would apply to all such facilities. Introduction Since many children at HOTI (Home of the Innocents) have histories of physical, sexual, emotional abuse, as well as, neglect and abandonment issues - careful psychiatric evaluations are imperative. All child victims of abuse or significant trauma should be evaluated for dissociative disorders, as well as, other psychiatric disorders. In light of the recent increase and/or increase in reporting of child abuse, the importance of prudent evaluation is essential. Diagnoses given to the victims undoubtedly influence how others (family, friends, communities, and professionals) view them and treat them. An erroneous diagnosis can doom these child victims to a lifetime of inappropriate psychiatric treatment, as well as, stigmas of being beyond help for the rest of their lives. A diagnosis now can certainly influence further evaluations from being objective. Early intervention and treatment of children who are dissociative can turn the tide in reducing child abuse in future generations. Definition of Dissociation "Dissociation can be defined as a complex psychological process, with psychodynamic triggers, that produces an alteration in the person's consciousness. During this process, thoughts, feelings, and experiences are not integrated into the individual's awareness or memory in the normal way." 1 In 1984, (Braun) proposed a speculative concept of multiple personality and other dissociative phenomena. It brought together a number of approaches to understanding dissociation under the rubric of neuropsychophysiologic (NPP) state-dependent learning (SDL). In that paper, (Braun) proposed that multiple personality disorder represents an extreme point on a continuum of response patterns that includes hypnosis, repression, ego states, and dissociative disorders. Although multiple personality disorder has its place on the continuum, neither hypnosis nor dissociation alone can create multiple personality. Multiple personality disorder is created by means of repeated dissociations that occur under extreme stress, usually the extreme stress of child abuse. These dissociations often have similar NPP affective states that allow them to be linked together, permitting the association of facts, the development of congruent, stable memories, ranges of emotion, and response patterns. Central to the proposal is that the linked affective states are NPP-based.

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