This case study presents case conceptualization, therapeutic intervention, and the subjective and objective therapeutic progress of a 14-year-old adolescent hospitalized with posttraumatic stress disorder (PTSD) following emotional, physical, and sexual abuse by his father. The adaptive information processing (AIP) model that informs eye movement desensitization and reprocessing (EMDR) therapy and the theory of structural dissociation of the personality (TSDP) were used to conceptualize and guide the treatment. Stabilization and orientation to the present were essential to integrate his traumatic memories into a life narrative, and this became a major goal and an outcome of treatment. A single-case AB design was applied in assessing the impact of intervention. The UCLA PTSD Symptom Scale, Strengths and Difficulties Questionnaire—HEL (SDQ-HEL), State-Trait Anxiety Inventory (STAI), and Dissociative Experiences Scale II were administered at 5 different time points to assess changes in the youth’s subjective emotional state and indicated substantial improvement. In addition, objective behavior change (using O’Neill’s Behavior Checklist) was recorded on a daily basis for 7 months and showed a large decrease in the frequency of targeted maladaptive behaviors. The article describes the treatment process which helped the youth to regain a sense of time; establish a coherent sense of self; and maintain adaptive perceptions, emotions, attitudes, and behaviors.

In this presentation we illustrate the effects of combining eye movement desensitization and reprocessing (E.M.D.R) therapy and theory of structural dissociation of the personality (T.S.D.P) on dissociative and post-traumatic stress disorder (P.T.S.D) symptoms. We first briefly describe both theories and conclude why combining them in the treatment of severely traumatized adolescents with PTSD may be beneficial.E.M.D.R therapy is an empirically valid treatment for P.T.S.D, based on numerous randomized controlled trials and several meta-analyses (e.g. Chen, Zhang, Hu, & Liang, 2015; Nijdam & Olff, 2016). The E.M.D.R Therapy Standard Protocol has eight specific phases.Phase 1: History taking and building the therapeutic alliance and creating a case conceptualization based on the past, the present and future.Phase 2: Client stabilization and preparation.Phase 3: Assessment activation of traumatic memory network.Phase 4: Desensitization of traumatic memory with the use of bi-lateral stimulation up to adaptive resolution while monitoring level of disturbance.Phase 5: Installation allows an increase of connections and generalizations to positive cognitive networks.Phase 6: Body scanning is used to monitor and clear any residual disturbing feelings in the body.Phase 7: Closure ensures client stability at the end of an EMDR session and between incomplete sessions.Phase 8: Reevaluation takes place at the beginning of the next session and it assesses treatment effects.According to T.S.D.P each human being has an integrative capacity to deal with traumatic experiences. The integrative capacity entails two major mental actions, namely synthesis and realization. Synthesis can be thought of as the way one perceives, compares, differentiates and/or categorizes internal and external experiences in the present and over time. Realization is a higher level mental action that entails awareness of reality, accepting it and adapting to it. It entails (1) personification or a sense of ownership and knowing ‘this is what happened to me’ and knowing feelings and thoughts about it and (2) presentification being grounded in the present while able to integrate the past and the possibilities of the future. Knowing that this has happened in the past and the present and future is no longer dictated by the traumatic past (van der Hart, Nijenhuis & Steele, 2006). Integration can be thought of as staying in the present while describing a past whole life narrative and owning experience. Thus, the person can express and feel his/her painful experience and memories without avoiding them and allowing phobias to keep memories at bay. According to T.S.D.P, the failure to integrate traumatic experiences basically yields a structural dissociation of the personality into two or more mental systems (van der Hart et al., 2006).The three-phase oriented treatment of T.S.D.P includes: (i) history, assessment, stabilization, symptom reduction and skills building; (ii) treatment of traumatic memories; and (iii) personality reintegration and rehabilitatio...

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