The traumatized client has suddenly changed demeanor and voice pitch. Which of the following is true about the use of touch with a client with dissociative identity disorder?

Choice A reason: While touch can sometimes convey security, in dissociative identity disorder (DID), touch may trigger traumatic memories or cause distress if not consented to. Therefore, assuming touch will always provide security is unsafe and not therapeutic. Choice B reason: Touching only when in the client’s line of vision may reduce surprise, but it does not address the fundamental issue of consent. Even if the client sees the nurse, the act of touching without permission can still be intrusive and retraumatizing. Choice C reason: The best practice is to avoid touching without explicit permission. Clients with DID often have histories of trauma, and unwanted touch can trigger dissociation or flashbacks. Seeking permission respects boundaries, promotes trust, and ensures safety in therapeutic interactions. Choice D reason: Informing the client that touch is friendly and supportive may help in some contexts, but it still bypasses the client’s autonomy. Without permission, even well-intentioned touch can be harmful. Consent is the critical factor in maintaining therapeutic safety.