Building an Operational Definition of Grounding.

Disorders with dissociative features are characterized by disruption of both branches of the autonomic nervous system, which may result in intense episodes of emotional dysregulation that induce a dissociative response. In clinical settings, grounding techniques are frequently cited as a primary approach to attenuate dissociative episodes within treatment sessions. However, grounding techniques have not been subjected to efficacy studies due to a lack of consensus regarding a measurable operational definition. This critical review analyzed the literature on grounding techniques with the intent to develop an operational definition of the term. Literature searches within ProQuest and PubMed yielded 1,894 results; 19 sources were identified for review following removal of duplicates and textual analysis. Sources were sorted into three categories: grounding techniques defined (21.05%, n = 4), mentioned (63.16%, n = 12), and described (15.79%, n = 3). Analysis of sources informed the development of an operational definition of grounding techniques, with emphasis on facilitation of physiological equilibrium, as well as tentative treatment guidelines for the implementation of grounding techniques in therapeutic settings.