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DID - Dissociative Identity Disorder: Ethically Unsplitting the Split Personality Post Test

Psychologist, Ohio MFT and Counselor Post Test:
Only Psychologists, Ohio MFT's and Ohio Counselors taking this course for credit need to complete these additional questions below to be in compliance with their Boards. requirements. If you are not a psychologist, Ohio MFT or Ohio Counselor please return to the original Answer Booklet. You do not need to complete the additional questions below.

Audio Transcript Questions The answer to Question 1 is found in Track 1 of the Course Content. The Answer to Question 2 is found in Track 2 of the Course Content... and so on. Select correct answer from below. Place letter on the blank line before the corresponding question.
Important Note! Underlined numbers below are links to that Section. If you leave this page, use your "Back" button to return to your answers, rather than clicking on a new "Answer Booklet" link. Or use Ctrl-N to open a new window and use a separate window to review content.

Please note every section does not have an additional question below. Some sections may have more than one question.


1.1 Why might ‘direct inquiry’ be hard for a therapist to use with a client who has dissociative identity disorder?
2.1 How may the age of the personality be useful for a therapist to know?
3.1 What are some common problems with making a behavioral contract with DID clients?
4.1 What is likely present in every DID client’s personality system?
6.1 What are two ways to help your client gain control over switching?
7.1 What clients might the ‘being real with clients’ technique benefit?
8.1 What are some advantages of the ‘Talking Through’ technique when talking to a DID client?
9.1 What is the ‘Talking through’ technique helpful for?
10.1 Why might the internal self-helper be useful?
11.1 What ‘personality’ is found in the majority of DID clients?
12.1 What are some factors that determine manifestations of resistance?
12.2 What may be some resistance seen in early treatment with DID clients?
13.1 What might be some forms of ‘maps’ for clients to track their behaviors?
14.1 What type of images might be useful to foster fusion or integration with a DID client?

A. In understanding his or her behavior, level of abstraction, and role in the system
B. Because you need to find out specific part of the client you would like to speak with
C. The capacity for internal conversations
D. The whether certain child alters understand the contract due mitigating circumstances, and the use of innappropriate consequences
E. DID clients who are unable to tolerate the traditional unresponsive, neutral therapeutic stance advocated by psychoanalytic theory
F. Overcoming host fears and facilitation of the switching process
G. To ensure that as many alters as possible are actually listening
H. Saves time and energy, addresses the client as a whole, help you reach alter personalities that you may not even suspect exist
I. Internal persecutor personality
J. Useful in implementing therapeutic strategies for eventual unification and integration of the personality system
K. Blaming others, mistrusting or having paranoid feelings, acting out, using a significant other to oppose treatment, denying emotional problems, having financial or time problems, fearing treatment and the therapist
L. Relationship between the client and therapist, the point in the course of the therapy such as early or late in treatment, the traumatic material that the resistance is concealing, the client’s personality system, and the circumstances of the treatment
M. Images of embrace, dance, other shared activities can be productive, images of the blending together of light or the flowing together of water
N. Mercator projection maps, pie charts, architectural blueprints, organization personnel chards, target-like arrangement of concentric circles, and lists

Course Content Manual Questions The answer to Question 15 is found in Section 15 of the Course Content. The Answer to Question 16 is found in Section 16 of the Course Content... and so on. Select correct answer from below. Place letter on the blank line before the corresponding question

Please note every section does not have an additional question below. Some sections may have more than one question.


15.1 What are different types of dissociative disorders?
15.2 What might be some feelings DID clients may experience when they self-injure?
15.3 Self-inflicted violence can be an effective tool for managing dissociation in what two directions?
16.1 The choice of stance and selection of techniques often will be made in connection with a study of the patient’s what?
17.1 What is a central therapeutic objective and one particularly dependent on the strength of the therapeutic alliance?
18.1 What are some consequences due to a person who holds his/her body in low regard?
18.2 What may be a major resource to the patient’s life and to the therapy?
18.3 According to Ross, how may humor be helpful for clients?
19.1 According to Kohlenberg, being somebody else may provide means of escape or avoidance from what?
20.1 According to some Sackeim, when might DID become apparent to a professional or others?
20.2 What are some physical symptoms that clients may experience during a therapy session?
21.1 What is one way for a therapist to get acquainted with the various personalities?
21.2 The formation in childhood of personalities is an extreme representation of what?
21.3 Why has making the diagnosis of DID remained so concealed and seemingly difficult?
22.1 What are four major therapeutic orienting strategies that might diminish the likelihood of the abreactive work overpowering DID patients?
23.1 What might be one of the most important aspect of therapy for DID patients?
23.2 What is Klufht’s 'rule of thirds'?
24.1 Why might it be useful for a DID client to keep a journal for 20-30 minutes per day in a free-associative manner?
25.1 What are some examples of identity alteration?
25.2 Identity alteration in DID is characterized by...
25.3 What are the three sources that the evidence for identity alteration might come from?

A. Emotionally numb, detached from themselves, dead inside, feeling little or no physical pain, feeling more alive, more real, more grounded following the act
B. Dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative disorder not otherwise specified
C. Ego strength, track record, character style, and an appreciation of what tasks often accomplish by techniques
D. To facilitate it when emotions are overwhelming, to diminish it when one feels too disconnected from oneself and the world
E. Negative introjects, self-deprecating internal commentary, shame, humiliation, fear, internally directed anger, distressing flashback phenomena, the need for self-soothing using self harming options, recurrent frightening disconnections associated with depersonalization/derealization or sexually connected triggers
F. Providing a safe and integrative landing for such divergent emotions that frequently are embodied within a fragmented and unevolved self
G. Helps form a treatment alliance, disrupts negative transference, has an antidepressant effect and may even benefit the immune system
H. Functional partners
I. When different people attend meetings, or therapy
J. Physical or emotional trauma
K. Requesting the DID patient do a ‘mapping of personalities’
L. Pain complaints, paralysis, blindness
M. Because only 6% of DID patients present in such clear cut ways
N. A child’s desire to not be alone to face overwhelming experiences and to either have a ‘buddy to take the hit,’ a ‘strong protector’ to mediate with the outside world or a ‘friend’ with whom to run away
O. Ensuring that they leave the session in a relatively safe and contained frame of mind
P. 1. Extensive cognitive restructuring, which has already been described in the suppression-of-affect section of this paper 2. The use of fractionated, rather than full abreaction 3. The promotion of the work among personalities that have common affective, sensory, cognitive or behavioral themes, also called like clusters of personalities 4. The use of temporary blending of personalities to encourage habituation to strong sensations and affects
Q. Allows additional ventilation, communication among the alters, revelation of additional alters, and sharing by alters as yet unable, unwilling, or unprepared to enter treatment
R. This rule holds that if one is deliberately planning to work with painful material, one should make sure that this work begins in the first third of the session and ends by the end of the second third of the session, preserving the last third of the session for processing what has been dealt with and re-stabilizing the patient
S. Reports of identity alteration from the subject, feedback from relatives or friends, and behavioral indications
T. Use of different names, finding possessions that one cannot remember acquiring, and possessing a skill that one cannot remember having learned
U. Its complexity, distinctness, the ability of the states to take control of behavior, and the interconnection with other dissociative symptoms assessed in the SCID-D-R

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