Landmark RC Trial: Finding Solid Ground significantly reduces dissociation over one year

We’re delighted to share important news from the field. The first completed randomized controlled trial of Finding Solid Ground (FSG), led by Prof. Bethany Brand, has been accepted for publication in Psychological Trauma: Theory, Research, Practice, and Policy.

This is the first randomized controlled trial to show a significant reduction in dissociation over one year for people with complex dissociative disorders. This matters because whether dissociation improves with treatment has long been debated, particularly by those who favor ultra short-term treatments that skip stabilization and by critics who argue that treatment for DID is not helpful. A recent systematic review concluded that stabilization and psychoeducation trials for DID had not shown an added benefit for dissociative symptoms. That review included only the FSG interim results, before the dissociation findings reached significance. The completed trial shows a significant moderate reduction in dissociation at one year, along with large improvements in emotion regulation, PTSD symptoms, self-compassion, and adaptive capacities.

We are deeply grateful to the therapist-patient dyads from 27 countries who took part, and to the people with lived experience of trauma and dissociation who helped shape the program.

The abstract is below. I will share the link to the article as soon as it is available online.

Finding Solid Ground in Difficult Times: A Randomized Controlled Trial for Complex Trauma and Dissociation

Objective: Evidence-based treatments are scarce for complex trauma and severe dissociation. We report the results of the first completed randomized controlled trial (RCT) of Finding Solid Ground (FSG), a skills-based psychoeducation program designed to be used adjunctively with individual psychotherapy.

Method: Adults (N = 293) and their therapists from 27 countries with dissociative disorders, the dissociative subtype of posttraumatic stress disorder, or complex PTSD were randomized to Immediate access to FSG or a six-month Waitlist/treatment as usual (TAU) condition before accessing FSG. Emotion regulation, PTSD symptoms, dissociation, self-compassion, adaptive capacities, and quality of life were assessed at baseline, six months, and 12 months.

Results: At six months, the Immediate group improved significantly, while TAU alone produced no significant changes despite therapists' considerable training in trauma and dissociation. After accessing FSG, the Waitlist achieved comparable gains. At one year, improvements were large for emotion regulation, PTSD symptoms, self-compassion, and adaptive capacities, and moderate for dissociation (ds = .59–1.33). Reliable improvement at 12 months occurred in 39%–67% of participants, with minimal deterioration (1%–5%). Quality of life also improved over 12 months overall. Discontinuation was low (6.8%).

Conclusions: The most salient clinical findings were that (1) FSG combined with individual psychotherapy produces significant benefits for adults with complex trauma and dissociation, and (2) no significant gains were found with psychotherapy alone.

Ellert Nijenhuis and his team of Associates congratulate Bethany Brand, Professor Emerita of Psychology at Towson University, with co-authors Hygge Schielke, Karen Putnam, Nicholas Pierorazio, Shae Nester, Jerrica Robertson, Amie Myrick, Richard Loewenstein, Frank Putnam and Ruth Lanius for their groundbreaking work.