Esme Michael-Anna e.michaelanna@gmail.com 027 330 6077 The Osteopathic Management of Patients who have Experienced Sexual Violation Esme Michael-Anna e.michaelanna@gmail.com 027 330 6077

Contents Where I am at Objective of the Study Three Stories Definitions Relevance/Gap Methods Interview Questions Conclusion Feedback and Questions

Where I am at… Proposal being summitted 8 June 2017 Ethics Form A 5 July 2017

Research Objective This research project aims to investigate the current knowledge, skills, attitudes and confidence held by New Zealand osteopaths regarding the management of patients who have experienced sexual violation, with a view to ascertain whether osteopaths, as primary healthcare practitioners, are adequately equipped to manage such patients.

Three Stories… Patient 1 – Male patient triggered by touch Patient 2 – The dangers of transference Patient 3 – The different touch and permission experienced felt by a survivor of sexual abuse

What do I Mean by Sexual Violation Sexual Abuse Sexual Assault Sexual Violence Sexual Violation

Relevance? NZ Statistics: Approximately 1 in 5 New Zealand women have experienced a serious sexual assault 1 in 7 boys experience sexual abuse by adulthood Sadly it prevalent  (Help Foundation, 2017b; The New Zealand Family Violence Clearinghouse 2016a)

Relevance? Psychological distress – depression, anxiety, PTSD are common Not all patients experience psychological trauma However, there are indications that patient who have experienced sexual violation experience touch therapy differently and this can negatively effect their reaction to treatment (Schachter, Stalker and Teram, 1999)

Relevance? WHO recommends that all professionals working in any spectrum of healthcare be trained to detect and handle cases of sexual violence with ‘sensitivity and efficiency’ (WHO World Report on Violence and Health, Krug et al., 2002) NZ osteopaths have little training in this area Apparent disparity of opinion on this subject within the profession of osteopathy Initial search showed little research in this area

Methods Qualitative methodology with underpinning philosophy of phenomenology Semi- structured interviews - up to 10 Looking for an ‘information rich’ range of lived experience Recruiting osteopaths who have been registered and practising in the field 3 plus years

Interview Questions - Feedback What is your understanding of sexual violation, particularly in New Zealand? What training have you had regarding the management of patients who have experienced sexual violation? What skills do you have for managing patients who have experienced sexual violation? How do you view your patients who have experienced sexual violation? Have you ever had to manage the situation of disclosure of sexual violence before? If the answer is yes: Please tell me about it? If not implicit in the participant’s answer, ask: Do you feel you managed it well? Badly?

Interview Questions - Feedback Please tell me about any other direct experiences you have had regarding managing patients who have experienced sexual violation? How confident do you feel in your ability to manage patents who have experienced sexual violation? Where would you refer a patient who was in distress or struggling with their experience of sexual violation? What professional support is available for you regarding managing patients who have experienced sexual violation? Do you think it is important to know how to manage patients who have experienced sexual violation? Why? or Please expand on your thinking about this. Is there anything else you would like to share with me about this topic?

Conclusion A preliminary look at how osteopaths in NZ manage patients with a history of sexual violation.

Feedback and Questions Comments on my research process Any areas I should be aware of for handling in my proposal and ethics Do you have any contacts who might be interested in being interviewed for this project – networks (Looking for an ‘information rich’ range of lived experience) Any ideas about my questions Any resources I might not have thought of yet

References Help Foundation (2017a). Sexual Abuse Myths Busted. Retrieved from http://helpauckland.org.nz/get-info/myth-busting Help Foundation (2017b). Sexual Abuse Statistics. Retrieved from http://helpauckland.org.nz/get-info/statistics Krug, E. G., Dahlberg, L. L. Mercy, J. A., Zwi, A. B. & Lozano, R. (Eds.) (2002). World Report on Violence and Health. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/violence_injury_prevention /violence/world_report/en/ Stalker, C. A., Schachter, C. L. & Teram, E. (1999). Facilitating Effective Relationships Between Survivors of Childhood Sexual Abuse and Health Care Professionals. Affilia, 14(2), 176-198. doi:10.1177/08861099922093590 Taylor, B. & Francis, K. (2013). Qualitative Research in the Health Sciences: Methodologies, Methods and Processes. Oxon, United Kingdom: Routledge. The New Zealand Family Violence Clearinghouse (2016a). Data Summary: Adult Sexual Abuse. Auckland University, New Zealand. Retrieved from https:// nzfvc.org.nz/ The New Zealand Family Violence Clearinghouse (2016b). Data Summary: Child Sexual Abuse. Auckland University, New Zealand. Retrieved from https:// nzfvc.org.nz/