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ForwardWhen Treatment Takes a Village: Specialized Inpatient Treatment for Complex Trauma and DID
Abstract:
Inpatient care represents a major opportunity to offer effective stabilization for individuals with complex trauma. Yet, many general psychiatric units are not designed to meet the needs of patients with chronic dissociation, self-harm, emotion dysregulation, or developmental trauma. This webinar focuses on how we have translated and operationalized Phase 1 of the tri-phasic model of trauma treatment—establishing safety, emotional regulation, and symptom stabilization—into a structured inpatient model of care.
Drawing on our work in dedicated trauma-focused inpatient settings, we will explore the clinical, structural, and cultural adaptations necessary to support this population effectively. We will share how we organized our inpatient treatment model around the core goals of Phase 1, including helping patients gain control over dissociative symptoms, manage suicidal and self-injurious impulses, improve sleep and distress tolerance, and build the capacity to participate in relationships—including the treatment relationship itself.
Our approach emphasizes coordinated, trauma-informed care across psychiatry, nursing, psychotherapy, occupational therapy, and case management. Rather than highlighting individual techniques or modalities, we will focus on system-wide strategies for delivering consistent, skill-oriented, and non-pathologizing care within a fast-paced hospital environment. This includes aligning language, boundaries, and expectations across disciplines; emphasizing collaboration rather than hierarchy; and supporting staff in maintaining a stance of therapeutic steadiness in the face of intense affect, attachment disruptions, and polarized dynamics.
We will also discuss how the physical space, unit structure, and staffing patterns can reinforce—or undermine—the goals of trauma stabilization. Through case examples and team reflections, we will examine the challenges of delivering Phase 1 care within the constraints of inpatient psychiatry, and how our team developed creative responses to impasses in treatment, environmental stressors, and organizational demands.
Finally, we will share reflections on how unit culture, shared mission, and role clarity contribute to sustainable, ethical care of complex trauma patients in an acute setting. We will touch briefly on the emerging literature supporting trauma-specialized inpatient programs, and invite discussion about the future of inpatient care for this population.
This webinar is intended for clinicians and administrators who want to strengthen trauma-informed practices in acute settings, and who are curious about how the foundational principles of trauma recovery can be implemented even in the most time-limited care environments.
Potential to Distress: Yes
Target Audience
Beginning/Introductory
Those seeking to participate in this webinar must be licensed mental health professionals (psychiatrists, psychologists, clinical social workers, mental health counselors, accredited psychotherapists, etc.). ISSTD staff will audit license information prior to the start of the course and may request additional documentation for your license.
We do accept students enrolled in a program of study leading to a degree or certification in the mental health field and who have an interest in trauma and dissociation. Students must submit proof of student status such as a transcript or registration record. For those who have completed their degree and are currently in the pre-licensure stage practicing under the license of another clinician, you must provide the name and license information for the person you are working with. Documentation should be sent to ISSTD staff at cfas@isst-d.org before registering.
Learning Objectives
Upon Completion of this webinar, participants will be able to
- Describe the core principles of Phase 1 trauma treatment within the tri-phasic model, with a focus on safety, stabilization, and symptom regulation in individuals with complex trauma and dissociation
- Identify key adaptations needed to implement Phase 1 care in an inpatient psychiatric setting, including structural, clinical, and cultural elements that support emotional regulation and crisis containment
- Explain how multidisciplinary teams can align roles and interventions to deliver consistent, trauma-informed care across psychiatry, nursing, psychotherapy, and adjunctive services
- Discuss common clinical and organizational challenges in stabilizing patients with severe trauma histories in an acute care environment, and evaluate strategies to address treatment impasses, team polarization, and system limitations
- Assess the impact of unit culture, physical space, and staff coordination on the effectiveness and sustainability of trauma-specialized inpatient care
Outline
Minutes 0-30: introduction to inpatient psychiatric treatment
Distinguish from other intensive treatment models
Admission / retention criteria
General services / interventions offered. Focus on: Nursing role, Psychiatrist role, Therapy services (OT, Case management, group therapy, indiv tx, etc)
Staff and unit structure
Types of inpatient treatment (general, specialty)
Focus on reducing symptoms and expedient discharge (not tx alliance)
Minutes 30-45: begin TDU focus: introduction to the structure of / staff roles involved with trauma-specialized inpatient care
Reference the larger history of the concept of specialized inpatient units for those with DID/Complex Trauma, using the units we have both been associated with long-term as an example
TDU staff structure
Brief notes on useful physical structure
Minutes 45-145:
Psychiatrist + therapist- approach to diagnosis , arc of typical treatment / common kinds of impasse, dealing with severe self-harm and suicidality, use of symptom tracking tools and other therapy assignments, salient team / group dynamics, approach to inpatient, psychotherapy vs outpatient therapy, overview of psychiatry rounds / elaborate on role of psychiatrist, overview of 3x/week psychotherapy, approaches to medication management
Nursing: elaborate on role of trauma-specialized nursing, adjunctive services such as PT, OT, and art therapy: Approaches to de-escalation, self-harm, Sleep hygiene / managing nightmare, Capacity to teach skills and reinforce primary team’s interventions, Leading groups , Special topics, Capacity to join rounds, Evenings and weekends
Other therapies: SW/case management, art therapy, OT
Minutes 145-180: General Considerations
Elements of the TDU that helped us succeed: Sense of ownership, connection, shared mission, that expertise is valued on the team, Comments on inpatient vs outpatient care
Admission criteria, Prognostic factors, Preparing for discharge
Presenter: Sarah Wentling, PsyD
Presenter Bio: Dr. Sarah Wentling is a licensed clinical psychologist specializing in trauma-informed care, dissociative disorders, and co-occurring mental health challenges. She has extensive experience across inpatient, outpatient, and university settings and is dedicated to fostering resilience and holistic wellness. Dr. Wentling currently serves as the Director of Clinical Services and Coordinator of Trauma-Informed Services at the Towson University Counseling Center. Previously, she served as Lead Psychologist at University of Maryland Medical System’s Inpatient Child & Adolescent Psychiatry and Sheppard Pratt’s Trauma Disorders Unit, where she supervised clinical teams, developed trauma-focused programs, and provided expert consultation. Dr. Wentling also maintains a private practice providing long-term psychotherapy services. A passionate educator and speaker, Dr. Wentling has delivered training on trauma-focused interventions to mental health professionals, educators, and institutions. She holds a Psy.D. from William James College with a specialization in Children & Families of Adversity and Resilience. Committed to advancing trauma-informed care, Dr. Wentling integrates research, education, and leadership to enhance clinical outcomes and community well-being. Dr. Wentling lives in Baltimore, Maryland with her husband and daughter.
Presenter: Benjamin Israel, MD
Presenter Bio: "Dr. Israel is an Assistant Professor at the University of Maryland School of Medicine,Department of Psychiatry. Dr. Israel founded and directs UMD’s trauma-focused addictions psychiatry outpatient clinic in urban Baltimore. Dr. Israel is the clinic’s co-Principal Investigator on efforts to improve trauma-informed healthcare. He also sees patients living with complex trauma for long-term psychotherapy. He is the lead author of recent critical reviews exploring trauma-responsive addictions treatment, clinical leadership, and public health. His work includes exploring potential roles for AI to enhance trauma-informed practice. He sits on the board of the International Society for the Study of Trauma and Dissociation and is Associate Editor of the Journal of Trauma and Dissociation. Dr. Israel supervises psychiatry and psychotherapy trainees at all levels. He lives in Baltimore, Maryland, with his wife and their two sons.
Presenter: Briana Snyder, PhD, RN, PMH-BC, CHPN, CNE, RYT 200
Presenter Bio: Briana L. Snyder, PhD, RN, PMH-BC, CHPN, CNE, RYT 200 graduated with her PhD in Nursing from the University of Missouri (USA) in 2017, where she received the International Society for the Study of Trauma and Dissociation (ISSTD) David Caul Research Grant to fund her dissertation work on the experiences of women with dissociative identity disorder (DID) who experience intimate partner violence. She is currently an associate professor and the graduate program director in the Department of Nursing at Towson University in Maryland (USA). She teaches undergraduate and graduate psychiatric-mental health nursing and nursing research. Dr. Snyder is a board-certified psychiatric-mental health nurse with 15 years of experience on the inpatient Trauma Disorders Unit at Sheppard Pratt Hospital in Maryland (USA), where she worked with adults with dissociative disorders and other trauma-related disorders. She has published research related to the care of individuals with dissociative disorders in various peer-reviewed journals, including the European Journal of Trauma and Dissociation, Archives of Psychiatric Nursing, American Nurse Journal, Journal of Psychosocial Nursing, Psychological Trauma, and more. In 2023, Dr. Snyder was awarded the ISSTD Distinguished Achievement Award, in recognition of her work. She currently maintains clinical practice as a board-certified hospice and palliative nurse at Gilchrist Center in Towson, Maryland (USA).
Available Credit
- 3.00 APAThe International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
- 3.00 ASWB ACEThe International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/20/2024 – 08/20/2027. Social workers completing this course receive 3.00 continuing education credits.
- 3.00 ISSTD Certificate ProgramThis program is eligible for 3.00 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.
Price
"Your Price" above reflects your final price based on your membership status and career level.
- ISSTD defines a student as those enrolled in a program of study leading to a degree or certification in the mental health field and who have an interest in trauma and dissociation.
- ISSTD defines an emerging professional as mental health professionals who have completed an advanced degree and are in the first three years of their career (or first three years after graduation for researchers).
- If you do not fall into one of the above categories please register as Professional/Retired.
These prices are for Tier I countries. For a list of countries by Tier click here. If you are located in a country that falls into Tier II-VI please contact ISSTD at cfas@isst-d.org to receive the appropriate discount code.
Registration Policies
Cancellations prior to the webinar are subject to a $10 cancellation fee. No refunds are provided for no shows. The deadline for cancellations with a refund is November 10, 2025 at 5:00pm US Eastern Time. Requests for cancellation should be sent to cfas@isst-d.org.
For additional webinar policies including completion requirements, filing grievances, requesting a disability accommodation, and awarding of certificates of credits, please visit our Webinar Policies page.