Decentralizing Treatment: Task Sharing to Accelerate & Expand Care for Dissociative Clients

Abstract
Dissociative disorders are among the most complex and underserved conditions in mental health care, often resulting in long waitlists, provider scarcity, and fragmented treatment. This presentation explores a task-sharing model that decentralizes care by integrating paraprofessionals, specifically trauma coaches, into the treatment infrastructure to expand access and expedite support for individuals with dissociative disorders. Grounded in public health and global mental health frameworks, task sharing refers to the strategic distribution of therapeutic tasks traditionally reserved for licensed clinicians to trained paraprofessionals. For dissociative clients, who frequently require intensive psychoeducation, grounding strategies, and systems navigation, trauma coaching offers a scalable, complementary service that can reduce burden on clinicians while improving continuity of care.

This presentation will share findings from a qualitative study examining trauma coaching as an innovative support mechanism for people with trauma. The study explored experiences from trauma coaches, focusing on perceived effectiveness, role clarity, and interprofessional collaboration. Results indicate that trauma coaching enhances stabilization, supports therapeutic goals, and helps clients remain engaged in long-term care by offering consistent, trauma-informed guidance outside of traditional psychotherapy. Both clients and providers reported reduced overwhelm, improved access to care, and greater emotional regulation when coaching was integrated.

The findings suggest that incorporating trained paraprofessionals into a layered care system holds promise for addressing the widespread under-treatment of dissociative disorders. This presentation will also address ethical considerations, training standards, and collaborative models of care, including protocols for clinician-coach coordination. Attendees will gain a nuanced understanding of how task sharing can improve equity, sustainability, and responsiveness within trauma treatment systems, particularly for populations historically left behind by conventional models or who reside in resource-scares areas. Other benefits will be discussed including mitigating provider burnout through increased support and decreased professional isolation, the capacity to delegate tasks, task-shared post-trauma support meetings, and how to cushion the treatment process through augmentative support.