Triumph Program Successfully Treats Patients with Post-Traumatic and Dissociative Symptoms

As a former co-service chief at the internationally recognized Sheppard Pratt Health System Trauma Disorders unit, and now the creator and director of the Triumph Program at Silver Hill Hospital, Emily E. Haas, MD, is recognized as an expert in diagnosing and treating complex trauma and dissociative disorders. The Triumph Program, which opened in November 2023, is one of very few residential programs in the United States that effectively treats adults with complex trauma and dissociative symptoms.

“Whether it’s turning into our driveway and not remembering the drive or simply daydreaming, mild dissociation happens to everyone,” Dr. Haas says. “Dissociation is a disconnect between an individual’s thoughts, feelings, memories, experiences, actions, and their general sense of who they are. Pathologic dissociation is when that disconnection from oneself and one’s surroundings and experiences is so significant that it impairs an individual’s ability to function. This form of dissociation often develops as a defense to help someone survive trauma,” she explains.

After the trauma has ended, dissociative symptoms continue to function as a defense to protect the person from an awareness that the trauma happened. This is a necessary survival strategy in the case of child abuse, where the child remains dependent on an adult caretaker who has hurt them.

“Survivors of trauma are very adaptive and resilient people. Their dissociative disorder is just one piece of what helped them survive. However, over time these dissociative symptoms that helped them survive no longer serve that same purpose and often start to impair functioning. Individuals may then develop compensatory strategies to cope with that functional impairment.” says Dr. Haas.

For example, they may make lists or develop a strict routine to compensate for their memory difficulties. “This can make it harder to diagnose post-traumatic and dissociative disorders as the symptoms may not be as overt.”

“We know that trauma and dissociative disorders are under recognized and under diagnosed,” says Dr. Haas. She notes that research indicates around 2% to 3% of the US population has a dissociative disorder, while other research suggests this could be up to 18% of the population.

Trauma is also extremely common, with 70% of US adults experiencing it at least once in their lives, and around 73% of these experiencing dissociative symptoms within hours to weeks after the traumatic event. These statistics are why Dr. Haas believes there’s a considerable need for programs that treat complex trauma and dissociation.

A Comprehensive Approach

The Triumph Program is geared toward patients with a primary trauma or dissociative disorder, such as post-traumatic stress disorder (PTSD), complex PTSD, depersonalization/derealization disorder, other specified dissociative disorder, or dissociative identity disorder (DID).

The program has a six-week minimum stay, with 12 weeks recommended, and employs a variety of therapeutic modalities including trauma symptom management skills, psychodynamic groups, dialectical behavior therapy (DBT), cognitive processing therapy (CPT), experiential therapies, and psychoeducational groups. Dr. Haas has trained the entire Triumph staff with whom she continues to collaborate to adapt and evolve the curriculum to address the Triumph residents’ needs.

Triumph follows the tri-phasic approach to treating trauma — safety and stabilization, memory processing, and integration — with a focus on the first phase. The primary goals are to establish safety and to stabilize symptoms of trauma and dissociation, along with comorbid conditions and symptoms such as mood, anxiety, disordered eating impulses, obsessive-compulsive, substance use issues, and chronic self-harm or suicidality.

Though medications are an important component in managing symptoms, Dr. Haas says psychotherapy is the backbone of trauma treatment. “Trauma fundamentally changes how we think, how our body responds, how we feel in relationships, and how we react emotionally to different situations. It impacts us in all these different areas of our body, our mind, and our life,” she says. “We have to first and foremost help people feel safe again, and medications alone can’t do that.” The ability to feel and be safe occurs through talk therapy, she says, and that comes from having experiences with another person — in this case the therapist — that are safe.

As the Triumph Program continues to evolve, Dr. Haas finds deep satisfaction in her work. “When someone comes in and they’ve been so severely hurt by another human and we get to help them have relief from that, it’s so very rewarding,” she says. “You get to see someone come in feeling the worst they’ve ever felt and leave feeling like a new person, finally feeling hopeful again and that’s just amazing.”

Dr. Haas and her team have implemented several small changes since the Triumph program was established to enhance its effectiveness. For example, an additional staff member was added to the group sessions to coach a patient if they get distressed during the session. Additionally, patients who struggle with safety issues while on the inpatient unit get seen by a therapist so that they can get specialized treatment before they get to the residential program. Furthermore, additional group sessions were added where patients in the residential program vote on the discussion topics. Every change in the program has resonated with the patients. The curriculum is effective as the patients are assessed every three weeks and progress is noted upon discharge.

Sharing the Wisdom

In addition to directing the Triumph program, Dr. Haas is committed to imparting her wealth of experiential knowledge to other mental health professionals. “With such highly specialized treatment, and the ‘demand’ for complex trauma and dissociation services outweighing the current ‘supply’ of experienced clinicians,” says Dr. Haas, “it’s critical to share knowledge and expand our pool of professional resources.”  Recent educational presentations by Dr. Haas include the Silver Hill Academy for Research and Education (SHARE) Grand Rounds series (“More Than Ungrounded: The Assessment and Treatment of Dissociative Disorders”; De-escalation of Post-Traumatic and Dissociative Crises); Project ECHO;  and a workshop with the Women’s Mental Health Division of Columbia University.  

References and Referrals

Dr. Haas recommends the following references for colleagues seeking additional support to learn about trauma and dissociative identity disorders.

• International Society for the Study of Trauma and Dissociation
• Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists [book]
• Finding Solid Ground programs and workbooks.

Her additional advice to colleagues is to “remain curious about the possibility of something else being in the picture” when treating hard-to-diagnose patients. “Dissociative Disorders can easily be missed, and the symptoms might not be overt,” explains Dr. Haas. “The symptoms help the disorder stay hidden from awareness, of not just the patient, but also from providers.”

99% percent of the patients treated at Silver Hill Hospital for PTSD and Dissociative Disorders are from out of state including international patients.

For colleagues who would like to refer families and patients to the Triumph program, Dr. Haas recommends reaching out to the admission coordinator, Neena Zezima, LMSW by calling 866-542-4455.