Balancing Methodological Rigor and the Needs of Research Participants: A Debate on Alternative Approaches to Sensitive Research.

Despite growing consideration of the needs of research participants in studies related to sensitive issues, discussions of alternative ways to design sensitive research are scarce. Structured as an exchange between two researchers who used different approaches in their studies with childhood sexual abuse survivors, in this article, we seek to advance understanding of methodological and ethical issues in designing sensitive research. The first perspective, which is termed protective, promotes the gradual progression of participants from a treatment phase into a research phase, with the ongoing presence of a researcher and a social worker in both phases. In the second perspective, which is termed minimalist, we argue for clear boundaries between research and treatment processes, limiting the responsibility of researchers to ensuring that professional support is available to participants who experience emotional difficulties. Following rebuttals, lessons are drawn for ethical balancing between methodological rigor and the needs of participants.

Practical ways psychotherapy can support physical healthcare experiences for male survivors of childhood sexual abuse.

Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse (Schachter, Stalker, Teram, Lasiuk, & Danilkewich, 2009), which is intended to help healthcare providers from all disciplines understand the effect of child sexual abuse on some survivors' abilities to access and benefit from health care. This paper discusses what psychotherapists can learn from the healthcare experiences of the male survivors who participated in this project. It also offers practical suggestions for supporting male clients who experience difficulty seeking treatment for physical health concerns.

Towards malecentric communication: sensitizing health professionals to the realities of male childhood sexual abuse survivors.

This article extends earlier reports of an ongoing qualitative inquiry on childhood sexual abuse survivors' experiences with health professionals. In this paper, we aim to enhance understanding of male survivors' experience. While male and female participants express similar anxieties and fears about their encounters with health professionals, there are gender-based differences related to the perceptions of victimhood and manhood; guilt and shame; homophobia; disclosure of abuse; and the expression of vulnerability. The implications of these differences for sensitive health care practice are analyzed within the context of gender relationships and the differential socialization of men. Malecentric communication is proposed as a method for addressing the specific experiences of male survivors in their encounters with health professionals.

The case for integrating grounded theory and participatory action research: empowering clients to inform professional practice.

Grounded theory and participatory action research methods are distinct approaches to qualitative inquiry. Although grounded theory has been conceptualized in constructivist terms, it has elements of positivist thinking with an image of neutral search for objective truth through rigorous data collection and analysis. Participatory action research is based on a critique of this image and calls for more inclusive research processes. It questions the possibility of objective social sciences and aspires to engage people actively in all stages of generating knowledge. The authors applied both approaches in a project designed to explore the experiences of female survivors of childhood sexual abuse with physical therapy and subsequently develop a handbook on sensitive practice for clinicians that takes into consideration the needs and perspectives of these clients. Building on this experience, they argue that the integration of grounded theory and participatory action research can empower clients to inform professional practice.

Providing dental care to survivors of childhood sexual abuse: treatment considerations for the practitioner.

BACKGROUND: Adults who experienced childhood sexual abuse frequently find dental treatment difficult to tolerate. Increased understanding of common long-term effects of this trauma may help dental professionals to respond more sensitively to patients who have experienced it. METHODS: The authors recruited 58 men and 19 women with self-reported histories of childhood sexual abuse from social agencies serving this population and interviewed the participants about their experiences with health care professionals, including dentists. The authors analyzed interview transcripts using the constant comparative method to identify main themes and patterns. RESULTS: Participants reported aspects of dental treatment that can be particularly difficult for them and offered ideas about how dental health professionals could make the experience more tolerable for them. The data analysis produced suggestions about how dentists might respond sensitively to patients who frequently cancel appointments, are distressed by certain body positions, need a sense of control and fear judgment. The authors also report participants' thoughts about questions from dental practitioners regarding a history of childhood sexual abuse. CONCLUSIONS: Adults who report a history of childhood sexual abuse are more likely to experience dental treatment more positively when dental professionals have some understanding of the long-term effects of such abuse, including how it can affect dental treatment interactions. Such knowledge enables dental professioinals to respond to their needs in a sensitive manner.

Women survivors of child sexual abuse. How can health professionals promote healing?

OBJECTIVE: To explore how health professionals can practise in ways sensitive to adult women survivors of child sexual abuse. DESIGN: Qualitative semistructured in-depth interviews. SETTING: Small and midsize cities in Ontario and Saskatchewan. PARTICIPANTS: Twenty-seven women survivors of childhood sexual abuse. METHODS: Respondents were asked about their experiences with physical therapists and other health professionals and asked how practice could be sensitive to their needs as survivors. A grounded-theory approach was used. After independent analyses, researchers achieved consensus on the main themes. Findings were checked with participants, other survivors, and mental health professionals. MAIN FINDINGS: A crucial theme was the need to feel safe when consulting any health professional. Participants described specific ways for clinicians to facilitate the feeling of safety. Disclosure of abuse history was another key theme; analysis revealed no one "right way" to inquire about it. CONCLUSION: Women survivors of child sexual abuse want safe, accepting environments and sensitive, informed health professionals with whom to work in partnership on all their health concerns.