3 Hour Workshop

Atypical Dissociative Disorders in Children and Adolescents

Sunday, March 25
1:30 PM - 5:00 PM
Location: Salon 1

There are atypical cases of dissociation in children and adolescents that do not have commonly recognized trauma histories, i.e. interpersonal violence, or may have a singular incident of trauma that may be unrecognized factor for dissociation. For example, these children can experience prebirth/preverbal/early trauma or medical trauma, neglect, attachment disruption or impairment. They may have highly sensitized parents with their own trauma histories that impair their ability to effectively manage and soothe their infant’s needs causing them to become fearful and dysregulated.  Children who also have temperaments that internalize stress and rely on their imaginative capacity to live in their internal world to escape from overwhelming environmental stressors are more prone to rely on dissociation. The atypical dissociative child or adolescent often comes to the attention of mental health community due to unresponsive treatment to impervious comorbid symptoms, i.e. eating disorders, obsessive compulsive, destructive behaviors. Children with aggression or life endangering symptoms will often receive a plethora of medications with significant side effects and little efficacy compounding the psychological complexity.  The underlying dissociative mechanisms that perpetuate these symptoms are unrecognized, and therefore untreated. Understanding and being alert to “non-typical” pathways for development of dissociation and subtle but crucial signs are paramount for successful intervention.  

             This workshop will describe various pathways of developing dissociation that are atypical and therefore overlooked. Careful history gathering and questioning parents and children about often a wide spectrum of traumatic events, the timing of symptom presentations, and the underlying dissociative dynamics that are driving the symptoms resistant to treatment will be discussed.  Uncovering dissociative influences, i.e. self-states, operating “behind the scenes” associated with the trauma and perpetuating the symptoms and caretaker’s role will be illustrated with clinical cases, artwork and DVDs.  A variety of successful and creative interventions tailored to the needs of the dissociative children and adolescents that lead to integration will be presented.

This workshop will also address guidelines on when and what types of medications to administer safely to dissociative children and adolescents for management of dangerous or debilitating symptom and compliment the treatment process.  A discussion on medical induced dissociation will also be covered.

Learning Objectives:

Frances S. Waters

Cllinical Social Worker
Private Practice
Marquettte, MI

Frances S. Waters, DCSW, LMSW, LMFT, is an internationally recognized trainer, consultant, and clinician in the area of childhood trauma, abuse, and dissociation, and has presented extensively, including training programs in Europe, Africa, South-America, and North-America. She specialized in the field of child abuse for 40 years.
Ms. Waters is past President of The International Society for the Study of Trauma & Dissociation (ISSTD) and has served on many committees with ISSD, including currently co-chair of ISSTD’s Child & Adolescent Committee, and Faculty Director of the Child Adolescent Psychotherapy Training Programs. She also serves on Editorial Board of the Journal of Child & Adolescent Trauma, contributing guest editor for the Journal of Trauma and Dissociation, and on the national Advisory Board of the Leadership Council on Child Abuse and Interpersonal Violence.
Ms. Waters is author of Healing the Fractured Child: Diagnosing and Treating Dissociative Youth (2016) and has published many chapters and articles on childhood trauma and dissociation.

Ms. Waters is the executive producer of two training videos, The Traumatized Child: Understanding and Parenting the Traumatized Child, and Trauma & Dissociation in Children that is geared toward child forensic evaluators and prosecutors.

Ms. Waters received the 2008 Media Award from American Professional Society on Abuse of Children for her production of Trauma and Dissociation in Children, and ISSTD’s Presidential Award for her faculty directorship of ISSTD’s Psychotherapy Training Course on Child & Adolescent Trauma and Dissociation. She is a fellow of ISSTD. She maintains a private practice in Marquette, MI.


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Renee Potgieter Marks

Clinical Lead
Integrate Families
Huddersfield, England

Renée Potgieter (Marks) is working as Consultant Therapist and Clinical Lead at Integrate Families in the North of England. Integrate Families is the National Centre for Children with Complex Trauma and Dissociation in England. Renée is a national and international trainer on the topic of attachment, emotional regulation, complex trauma and dissociation in children and adolescents. She is a member of the Child and Adolescents Committee of the ISSTD and also an accredited trainer for their on-line training. Renée is the chair of the Child and Adolescent Committee of the European Society on Trauma and Dissociation (ESTD) and specialises in the more serious and complicated population of traumatised children and adolescents. Since 2016 Renée has been involved in a new on-line hybrid training specifically with the aim to raise awareness of trauma and dissociation in children and provide treatment strategies. Renée is also an expert witness and provides clinical supervision and consultation to different agencies and therapists internationally.


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Adrian J. Stierum

Child and adolescent psychiatrist
FIVOOR, Forensic and Intensive Psychiatry, Rotterdam

Dr. Adrian J. Stierum M.D. is working as a child and adolescent psychiatrist in Rotterdam, the Netherlands. He is also a child psychotherapist and EMDR therapist.
He is treating acute and chronically traumatized children and adolescents with dissociative disorders and other psychiatric disorders.
He is treating victims and perpatrators of sexual violence.
Together with Frances S. Waters he has written a chapter about psychopharmacological interventions with children and adolescents with a
dissociative disorder and complex trauma in ‘Healing the Fractured Child’ (Frances S. Waters. Springer 2016. ISBN 9780826199638)
He contributed as a co-editor to ‘Psychofarmaca in de KJP’ (G.C.Dieleman, B.Dierckx, M.B.Hofstra. Van Gorcum 2011. ISBN 9789023247234) the Dutch guideline for psychopharmacological treatment of children and adolescents.
He is working in a Forensic FACT team for youth with severe behavioral problems and psychiatric disorders.
For the Dutch justice department he examines young perpetrators and victims of severe (sexual) violence since 2002.
He is a member of the child and adolescent special interest group and the child and adolescent committee of the ISSTD since 2011.


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Atypical Dissociative Disorders in Children and Adolescents

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