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THE PATIENT, S,1 HAD BEEN with the Adolescent Inpatient Division for 10 months when the therapist she had been seeing took a 3-month maternity leave. The family of the patient was requesting intensive, four times a week psychotherapy with a therapist experienced in working with dissociative identity disorder.
S and I met on her hospital unit to see if we could work together. S had consulted with an expert on dissociative disorders the month prior to this meeting and understood she had a dissociative disorder and seven alter personalities. She was eager, she said, to get her emotions under control. She would get upset and “trash” her room for no apparent reason. She never wanted to see her parents again but was devastated if she couldn't talk to them on the phone or see them daily. We agreed to work together in her therapist's absence.
S had come to our facility at age 17 from a short-term hospital following a crisis in her foster care home. The foster care placement had been court ordered after S reported to a school counselor that her father had sexually abused her. The accusation, documented in the public record, was found unsubstantiated, but the Juvenile Court Judge was concerned and ordered the Department of Social Services to remain S's guardian until S's twenty-first birthday. S's parents were devastated but remained supportive of their daughter and her treatment.