Psychotherapy and case management for multiple personality disorder. Synthesis for continuity of care

Patients with MPD are often difficult to manage in the community. These patients have a chaotic lifestyle with acting out behaviors and traumatic relationships. They have difficulty in managing time, maintaining good function, and being safe. The prognosis is good, however, with intensive psychotherapy. Still, containment of the treatment, which is often stormy, is a difficult task. Clinical case management is a treatment modality that strives to bring order out of chaos, stabilize the patient in the community, and encourage the highest level of function during treatment. It is useful to conceptualize case management as a framework for MPD psychotherapy, both to contain the therapy and to be drawn on for strength and resources. The stages of MPD therapy can be intertwined with the core case management functions of assessing, planning, linking to resources, monitoring, and advocacy to facilitate continuity of care for the patient. The synthesis of psychotherapy and case management can decrease chaos for both the patient and therapist, facilitate the patient's function on a daily basis, and increase connectedness for the patient and needed services. There is an art and a subtlety to the synthesis that grows with awareness and experience of the therapist/case manager. It is a synthesis worthy of development and implementation.