Schema therapy for DID

Schema therapy considers the development of DID as a result of chronic early childhood maltreatment, abuse, and/or neglect in individuals prone to developing dissociative responses to stress. The changes in behavior and emotions are seen as an expression of several often recurring, rigid moods or schema modes. Switching between different states can be accompanied by a strong sense of discontinuity in emotional experience and in thinking about oneself and others.

  • The goal of treatment is to grow the patient in the child modes by meeting basic needs, and through trauma processing, the punitive and critical modes to give way to more functional conscience functions, to gain more control over other dysfunctional modes, and finally to grow the healthy part of the patient.

  • Schema Therapy (ST) is an integrative treatment that combines cognitive behavioral therapy (thinking and doing), interpersonal (therapeutic relationship) and experiential (experience) techniques. The function of behavior in different modes and the underlying basic emotional needs are central.

  • Schema therapy for DID is adapted to the specific treatment needs of these patients, including attention to the extreme avoidance that affects these patients, among other things through a strong emphasis on experiential techniques. Metaphors and stories help to understand and validate basic needs, feelings, thoughts, and behavior. Traumatic experiences are processed through Imaginary Rescripting.


  • This approach offers an integrated treatment in a relatively short time. The treatment is not only aimed at stabilizing symptoms, but also pays relatively quickly attention to processing trauma, overcoming complaints and further recovery.

  • There is recognition of the experiences of DID patients of identity fragmentation and amnesia, while no separate, autonomously functioning personality states, each with their own memory system, are assumed.

Source: GGZ Healthcare Standard Dissociative Disorders

The design of the study

The research employs a so-called single-case-series design. In this type of design, patients are closely followed; measurements take place very regularly. The design is an "within-subjects" design; a comparison is not made between persons or groups, but a comparison is made within persons, namely in their functioning during the baseline (no treatment), during the exploration phase (no active treatment, but attention to the complaints / problems) functioning during active treatment as well as after treatment. Broadly speaking, a treatment is effective for this person if there is a clear difference between functioning in the baseline versus exploration phase and functioning afterwards.. 


This study has been made possible by Stichting tot Steun VCVGZ, RINO Zuid, and the involved institutions.