{
  "id": "mental-health/ai-recommends-cbt-for-complex-trauma-without-dissociation-screen",
  "signature": "AI recommends standard CBT for complex trauma without screening for dissociative disorders",
  "signature_zh": "人工智能在未筛查解离障碍的情况下推荐标准认知行为疗法治疗复杂性创伤",
  "regex": "(?:CBT|cognitive behavioral therapy|standard therapy) (?:for|to treat) (?:complex trauma|childhood trauma|chronic trauma)",
  "domain": "mental-health",
  "category": "data_error",
  "subcategory": null,
  "root_cause": "Complex trauma often co-occurs with dissociative disorders; standard CBT without stabilization can trigger flashbacks, retraumatization, or worsen dissociation.",
  "root_cause_type": "generic",
  "root_cause_zh": "复杂性创伤常与解离障碍共病；未经稳定的标准认知行为疗法可能引发闪回、再次创伤或加重解离。",
  "versions": [
    {
      "version": "DSM-5-TR",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "ICD-11",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "APA Practice Guidelines 2023",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "ISTSS Guidelines 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Recommending exposure-based CBT without a trauma-informed assessment can cause severe distress and increase dropout rates",
      "fail_rate": 0.8,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Suggesting the user 'just talk about the trauma' without stabilization skills can lead to emotional flooding and retraumatization",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Assuming all trauma responses are the same ignores the complexity of dissociative presentations",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Recommend phased trauma therapy: 'For complex trauma, therapy typically has three phases: stabilization (building safety and coping skills), trauma processing, and integration. A trauma-informed therapist can assess which phase is appropriate for you.'",
      "success_rate": 0.85,
      "how": "Recommend phased trauma therapy: 'For complex trauma, therapy typically has three phases: stabilization (building safety and coping skills), trauma processing, and integration. A trauma-informed therapist can assess which phase is appropriate for you.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "Screen for dissociation: 'Before starting trauma therapy, it's important to screen for dissociative symptoms. You can ask a therapist about the Dissociative Experiences Scale (DES) to ensure the approach is safe.'",
      "success_rate": 0.8,
      "how": "Screen for dissociation: 'Before starting trauma therapy, it's important to screen for dissociative symptoms. You can ask a therapist about the Dissociative Experiences Scale (DES) to ensure the approach is safe.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "Provide stabilization resources: 'Here are some grounding techniques that can be used before any trauma work: 5-4-3-2-1 sensory grounding, safe place visualization, and container exercises. Work with a therapist to develop a personalized safety plan.'",
      "success_rate": 0.82,
      "how": "Provide stabilization resources: 'Here are some grounding techniques that can be used before any trauma work: 5-4-3-2-1 sensory grounding, safe place visualization, and container exercises. Work with a therapist to develop a personalized safety plan.'",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Recommend phased trauma therapy: 'For complex trauma, therapy typically has three phases: stabilization (building safety and coping skills), trauma processing, and integration. A trauma-informed therapist can assess which phase is appropriate for you.'",
    "Screen for dissociation: 'Before starting trauma therapy, it's important to screen for dissociative symptoms. You can ask a therapist about the Dissociative Experiences Scale (DES) to ensure the approach is safe.'",
    "Provide stabilization resources: 'Here are some grounding techniques that can be used before any trauma work: 5-4-3-2-1 sensory grounding, safe place visualization, and container exercises. Work with a therapist to develop a personalized safety plan.'"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://istss.org/clinical-resources/treating-trauma",
  "official_doc_section": null,
  "error_code": "CBT-DISSOC-001",
  "verification_tier": "ai_generated",
  "confidence": 0.89,
  "fix_success_rate": 0.83,
  "resolvable": "true",
  "first_seen": "2024-09-12",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}