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ward-based intervention showed limited capacity to identify risk factors for falls: a dedicated clinic was more successful. The use of a portable computer with a programme to screen fallers for risk factors is worthy of consideration.

As a result of the psychologically intolerable nature of their early childhood experiences, victims of ritual abuse frequently develop multiple personality disorder (MPD). Therapists who treat these victims often assume that all MPD stems from a system of spontaneously created defenses against overwhelming trauma. As a result, these therapists tend to focus on treating the post-traumatic stress elements of the disorder and on integrating alter personalities. Recent experience with victims of ritual abuse suggests the presence of “cult-created” multiplicity, in which the cult deliberately creates alter personalities to serve its purposes, often outside of the awareness of the victim's host personality. Each cult-created alter is programmed to serve a particular cult function such as maintaining contact with the cult, reporting information to the cult, self-injuring if cult injunctions are broken, and disrupting the therapeutic process that could lead to the individual breaking free of the cult. A majority of ritual abuse victims in psychotherapy may maintain cult contact unbeknownst to either the host personality or the treating therapist.

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