EASY-TO-UNDERSTAND SUMMARY:
FINDING SOLID GROUND PROGRAM
What is the Finding Solid Ground program, and how is it unique?
​Finding Solid Ground is a program that Ruth Lanius co-developed with Bethany Brand and Hygge Schielke, and they co-authored the book for clinicians and workbook for clients on this innovative approach for helping people with dissociative disorders. Finding Solid Ground is the first research-backed program for trauma-related dissociative disorders.​​​
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Unlike trauma treatments that focus solely on narrative or exposure-based work, Finding Solid Ground begins by helping clients build the foundational skills needed for emotional and relational safety. The book and workbook guide therapists and clients through the program, which provides an evidence-informed, practical, and accessible approach for the stabilization and treatment of patients with complex trauma and dissociation. You can learn more about the book and workbook on our Books page.
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The Finding Solid Ground program teaches 4 crucial skills:
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Grounding
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Separating past from present
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Healthy ways of regulating emotions
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Getting healthy needs met safely
Critically, we learned from the patients in the randomized controlled trial that we conducted (which you can read about below) that you need to help people feel grounded first before they can successfully continue with the rest of the Finding Solid Ground program.
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Who is the program designed to help?
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Finding Solid Ground is a program for people experiencing complex trauma symptoms and dissociative disorders.​
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Complex trauma refers to repeated and prolonged exposure to traumatic events - often during childhood, and at the hands of parents and/or other early attachment figures. Dissociative disorders, including the dissociative subtype of PTSD, involve feelings of significant disconnection, including disconnection from one’s body, emotions, memories, surroundings, and/or personal identity. Typically, this type of disconnection begins as a way to endure terrifying events when physical escape is not possible, for example during physical abuse, military combat, or a horrific car accident.
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At its core, dissociation is a survival response, and one that can become automatic whenever a threat, or perceived threat, is present or approaching. While this response can help someone get through horrible experiences, it is difficult to “turn off”, even after the person is safe and the threat is long gone. Dissociation can really disrupt people’s lives by interfering with their ability to emotionally connect with family and friends, to notice sensations in their own body (hunger, pain, etc.), to know who they are/what they want, and to navigate their environment, to name just a few examples. For this reason, it is important for us to find an effective treatment for dissociative disorders.
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How and why was the program developed?
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The question is, how can complex trauma and dissociation be treated most effectively? There are some good approaches out there, but the order and pacing of these approaches are very important. Better guidance is desperately needed. In response to this need, a team of trauma and dissociation experts (including Dr. Lanius) created a web-based program providing education about trauma and dissociation, and skill-building instruction to help dissociative patients and their therapists move toward recovery. This was originally called Treatment of Patients with Dissociative Disorders (TOP DD), but after some input from early participants this program developed into the Finding Solid Ground (FSG) program. FSG is intended to be used in addition to trauma-informed psychotherapy with a person’s own therapist.
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To learn more about the Finding Solid Ground program, you can explore these resources:
How effective is the Finding Solid Ground program that we co-developed for complex trauma and dissociation?
Brand, B. L., Schielke, H. J., Putnam, K., Pierorazio, N. A., Nester, M. S., Robertson, J., Myrick, A. C., Loewenstein, R. J., Putnam, F. W., Steele, K., Boon, S., & Lanius, R. A. (2025). A randomized controlled trial assists individuals with complex trauma and dissociation in Finding Solid Ground. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://dx.doi.org/10.1037/tra0001871
This summary explains a randomized controlled trial that we conducted to evaluate the Finding Solid Ground program for people experiencing complex trauma symptoms and dissociative disorders.​​​​​​​
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How was the study designed?
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This study was a randomized controlled trial, or RCT, comparing the mental health results of all 291 participants using the FSG program. An RCT is a study in which participants are randomly assigned to one group or another to see how effective a treatment is - in this case, the FSG program. Being randomly assigned is meant to help make sure the groups are similar in age, gender, race, mental health details, etc., so that any differences between the groups at the end of the study can be attributed to the treatment. For this study, all participants first completed a psychological assessment so that the research team had a picture of their mental health before FSG. Before beginning the program, the 2 groups in this study were quite similar, including similarly high levels of dissociation.
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After assessment, half of the participants were asked to start following the FSG program immediately (along with their usual psychotherapy with their own therapists) - we can refer to these people as the “treatment group”. The other half of the participants had a delayed start to FSG, beginning the program after 6 months, but continuing with their usual psychotherapy throughout - we can refer to these participants as the “waitlist group”. This was important because we could see that the Finding Solid Ground program resulted in significant improvements in the first 6 months for the group of people who did it, while the group of people who did not do Finding Solid Ground for those first 6 months did not show meaningful improvement. This shows that the Finding Solid Ground program brought about meaningful improvements for individuals with trauma-related dissociation and that these improvements can be attributed to the Finding Solid Ground program, not due to naturally improving over time nor patients’ individual psychotherapy.
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After 6 months, all participants were re-assessed and the researchers compared results between the 2 groups (i.e., those in the treatment group compared to those on the waitlist). Then, after 12 months the participants were assessed once again, and researchers compared the treatment group’s pre- and 12-month assessment results to see if their mental health had changed/improved.
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Who was involved in the study?
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291 patient-therapist teams from around the world participated in this large-scale, real-world study.
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Unlike many clinical trials, this one did not exclude individuals with high suicidality, self-harm, multiple comorbidities, or recent hospitalizations.
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In fact, 70% of the participants had a complex dissociative disorder. This means that the results of this study reflect real-world clients with safety issues and the results are highly relevant to the populations that many clinicians find most challenging to treat.
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Key Findings
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After 6 months, the FSG treatment group showed significant improvement in emotion regulation, PTSD symptoms, self-compassion, and the ability to adapt to/cope with change in comparison to those from the waitlist group. Further, after 12 months, the treatment group showed significant improvement in comparison to their own pre-treatment assessment.
The people in the wait list group showed similar improvements after 6 months once they began the FSG program. Results from the wait list’s 12-month timepoint were not yet available at the time of writing this paper, but once complete, these results will be reported. The improvement in participants’ mental health can be attributed to FSG rather than to the participants’ individual psychotherapy because both groups had continued with their regular psychotherapy, but only those in the treatment group showed significant improvement.
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Critically, we learned from the patients in this study that you need to help people feel grounded first - which is the first of the 4 skills in the program mentioned above - before they can successfully continue with the rest of the Finding Solid Ground program.
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How significant were the improvements?
The changes observed were statistically and clinically significant, with large effect sizes that were sustained at 12 months.
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Exceptionally Low Dropout Rate
The dropout rate was only 3.4%, which is very rare in trauma treatment research, especially in a sample with complex safety concerns and dissociative symptoms. This shows that the treatment was tolerable for the vast majority of participants.
Implications
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These results provide evidence that Finding Solid Ground can be an effective method to support patients experiencing symptoms of dissociation and complex trauma, and the therapists who work with them. For clinicians, this program offers a clear evidence-based, accessible program to working with clients who often struggle to benefit from traditional therapies—due to dissociation, safety concerns, or emotional overwhelm. For trauma survivors, this study offers hope. It shows that meaningful healing is possible — even with dissociation and a complex trauma history.
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What do people with complex dissociation find most helpful about the Finding Solid Ground program?
Pierorazio NA, Robertson JL, Snyder BL, Brand BL, Schielke HJ, Lanius RA. (2025). Helpful aspects of a psychoeducational program for individuals with complex dissociation: An update for the Finding Solid Ground program. European Journal of Trauma & Dissociation 9:3 (Sept). https://doi.org/10.1016/j.ejtd.2025.100566
Finding Solid Ground (FSG) is a treatment program designed for people struggling with complex dissociative disorders, which can arise after repeated experiences of childhood trauma, such as abuse and neglect (i.e., complex trauma). Dissociative symptoms include difficulty feeling connected to one’s body or surroundings and often occur because the person was unable to physically escape the unbearable traumas they experienced. Dissociation allows a psychological escape (via mental/physical disconnection) that was helpful during the trauma.
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However, this pattern of disconnection is difficult to turn off, and can continue into adolescence and adulthood, even when danger remains in the past. This continued disconnection can interfere with the person’s life in many ways, for example, making it difficult to develop emotional connections with family and friends, and causing challenges in attending to one’s physical needs (e.g., responding to hunger, thirst, and pain).
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Designed to be used alongside individual therapy with someone’s own therapist, FSG offers structured, online modules aimed at helping participants develop coping skills, emotional awareness, and self-compassion.
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Researchers in this study wanted to know what people thought about the FSG program, so they gathered feedback from 68 participants from a larger clinical trial. Participants reported that both the content and structure of FSG were helpful. They liked the clear information in the modules, the manageable pace, the easy-to-access and varied materials (e.g., videos, worksheets, written information), and being able to revisit topics as needed. Many participants found that the program helped them better understand their own feelings and behaviours, and they noted feeling less alone, more understood, and more hopeful about recovery. The program also strengthened the work they did with their therapists and contributed to better daily functioning and improved self-compassion.
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This study shows that Finding Solid Ground is a valuable tool for the recovery from dissociative disorders, and it reinforces the value of trauma-informed education, comfortable pacing tailored to individual clients, and therapeutic work that focuses on the present time.
Here are some quotes and testimonials from clients and therapists who completed the Finding Solid Ground program:
“We are a system so many parts have a rage of answers, but I think overall just the really gentle and regular reminders to be compassionate with ourselves along the way and educating us on the very real impacts of living with trauma. It was validating to have so many of my struggles be acknowledged and explained and then taught what could be done about them. It’s reassuring to just know that a group of professionals care so deeply about this very real and excruciating experience; to the point of creating this program. To think others will hopefully suffer less through this program in the future, brings me the most hope. Thank you so much for all the work you’re doing, thank you for giving survivors a sense of our humanity back.”
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— Finding Solid Ground participant
“My client is feeling calmer, more stable in daily activities. I am impressed by my client’s progress using the exercises.”
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— Finding Solid Ground therapist participant
"It was good to feel like this is something there’s research behind and has actually helped people - even people who are very suicidal and in crisis all the time - like me - and won't turn me away because of severity of struggles.”
— Finding Solid Ground participant
“I have seen remarkable changes since my patient learned Finding Solid Ground. She shows much better control and safety. She is much better able to identify when she is dissociating and to know what to do in those moments. There are times when atrocities of the past would come to her. Today she can get out of it quickly, by being able to separate the past from the present. I also observe her being more self-compassionate and better able to tolerate difficult and unpleasant emotions, as well as improving her internal dialogue between her different parts. Without exaggeration, the program saved her life. In a moment of crisis, she remembered Bethany’s words (from the FSG videos): “Step by step, you will get there” and just remembering it brought her out of “there and then” and allowed her to activate her crisis plan, also learned in the Finding Solid Ground program.
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You have given us a great evidence-based treatment. Sincerely, I think Finding Solid Ground will mark a before and after in the treatment of trauma and dissociation. It systematizes therapeutic interventions, allowing the therapist to improve his or her skills and confidence, and to finally help put an end to so much suffering of people who have unjustly experienced trauma.”
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— Dr. Nicolás Rodríguez M.D., EMDR Accredited Consultant, Past President of the EMDR Chile Association, Faculty at the Trauma and Dissociation Unit of the Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile
