Developing support for people with complex trauma, personality disorders and dissociative conditions
Within the Access Wellbeing transformation programme, work has been taking place in the local NHS to develop new and improved ways of supporting people with mental health conditions linked to complex trauma. These will be part of a new support offer called Thriving Together, which is currently in development and will soon be available more widely across Dorset.
Please note that the teams within our Access Wellbeing hubs and drop-in spaces are not trained trauma specialists and cannot offer specialist complex trauma treatment. However, they can provide a listening ear and help you to find other services and groups that provide more specialist support where needed.
The emerging Thriving Together pathways will provide psychologically informed interventions and support for people with experiences of trauma, dissociation and complex emotional and relational needs – sometimes described as personality disorders and/or complex post-traumatic stress disorder (PTSD).
In the past, people with these conditions have not always had access to the same support as others, so this vital work will aim to address that, with flexible, accessible support options rooted in lived experience and trauma-informed principles. The new pathways have been co-produced to build support that is centred around improved access, shared literacy, and a better understanding of complex trauma and the impact it has on people’s lives. Critically, this approach recognises that trauma-informed culture isn’t just about services – it’s about creating environments where people feel seen, safe, and like they belong.
There are several key components to this work:
Building Your Life
Central to Thriving Together is the principle that we will work with each person to build their life in a way that encompasses their values and interests, providing a sense of purpose and belonging. This may involve exploring their interests, work, relationships and community connections. Occupational therapists and peer specialists will be integral to this offer, working with each individual to discuss any areas of their life that they would like to build.
Peer support
The new approach recognises the vital role of lived experience in shaping and delivering support. Peer specialists will work with staff to strengthen trauma-informed practice, and will also provide direct support to people in the community.
A team of peer specialists have already been recruited to support this work. They offer non-clinical, relational support, helping people to build trust, navigate services, and successfully engage with clinical support. Peer specialists can also provide practical support where it might be needed in social factors such as employment or relationships. A recruitment plan is in place to recruit further peer specialists.
Therapeutic offers and interventions
The new approach will improve access to psychologically informed practice for people with conditions linked to complex trauma. Alongside the current provision, additional specialist clinical support options include:
Flourish: specialist treatment for complex PTSD
Flourish is a new clinical offer designed to support people with more complicated presentations of post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD), who would not benefit from usual PTSD treatment through NHS Talking Therapies (Steps2Wellbeing). This psychological treatment uses evidence-based treatments of trauma-focused cognitive behavioural therapy (TF-CBT) and eye movement desensitisation reprocessing (EMDR). Lived experience support also plays a key role in the offer.
As part of the Flourish offer, mental health practitioners, Flourish therapists and peer support specialists will work collaboratively to provide robust assessment and referral processes.
The first pilot of Flourish began in June 2023, after a gap was identified between support provided by NHS Talking Therapies and Community Mental Health Teams (CMHTs). The pilot demonstrated that this approach supported individuals to overcome their traumatic experiences and move forward in their lives productively. Flourish was further developed in September 2024, and provision is currently being rolled out across Dorset.
Structured clinical management (SCM)
Structured clinical management (SCM) is an evidence-based intervention that can be used effectively to support people with certain personality disorders. It usually involves three phases with regular sessions that help to strengthen skills in problem solving and managing emotions.
Specialist support for dissociative disorders
Currently, support for individuals with dissociative identity disorder (DID) in Dorset is limited. In response to this gap, Dorset HealthCare has invested in training, upskilling staff and developing a dedicated care pathway that recognises the validity of DID and aims to improve access to appropriate assessment and treatment. This new pathway will provide a structured, evidence-based approach aligned with international guidelines.
The offer at the Specialist level will support individuals with a suspected or confirmed diagnosis of dissociative identify disorder (DID), partial DID, or other specified dissociative disorder (OSDD) and who are experiencing severe and enduring dissociative symptoms, to help ensure they receive the comprehensive care they need.
For those people needing support at the Universal or Focused level, the Thriving Together Advisory Group (TTAG) has dedicated capacity to advise on cases linked to dissociation, utilising experts in the area to ensure that barriers to support are removed and appropriate support across the pathway is available. The Dorset Recovery Education Centre (REC) has expanded the offer of courses on dissociative conditions, which have historically been oversubscribed.
As part of this initiative, new training on dissociative disorders and DID was introduced and made available to staff across Universal, Focused, and Specialist services, with the goal of raising awareness, enhancing understanding, and equipping teams with the knowledge and skills needed to better support individuals living with these complex conditions.
Safe spaces for strengthening skills
The new approach will include additional flexible options that complement, but do not replace, formal therapy, including practical workshops that will provide safe spaces to build and refresh skills, without requiring full therapy.
Access to recovery education
New courses and resources have been developed with the Recovery Education Centre (REC) that have a specific focus on trauma and safety to support this work. We will be providing more details on these, and the REC in the next edition of our bulletin.
Thriving Together Advisory Group (TTAG)
The Thriving Together Advisory Group (TTAG) provides a weekly dedicated space for case reviews, reflection, debrief, and support for care planning and staff. The group is made up of professionals and peer specialists, and includes clinicians and allied health professionals.
The TTAG has co-designed key principles, access routes and processes to support its work and following successful pilots, the group is now live.
More Info
We will provide more information on the different elements of the Thriving Together model, as well as details on how professionals can help people to access support, in future communications.
This work forms part of the new model of care for Access Wellbeing, and spans both Focused and Specialist support. Visit our About Us page for more information the different areas of support within the model.