Osteopathy and patients who have experienced sexual violence : management, treatment and self-care

Abstract

This thesis is a preliminary inquiry into the knowledge, skills, attitudes and confidence held by New Zealand registered osteopaths when managing and treating patients who have experienced sexual violence. The overall intention is to benefit the New Zealand osteopathy profession by contributing to the improvement of osteopathic healthcare services for patients who suffer sexual trauma. While there is a large literature in the field of sexual violence and healthcare, little research has been undertaken to specifically explore the manual therapies, including osteopathy, in relation to this topic. The study aims to address this gap by investigating sexual violence from an osteopathic perspective. The project, employing a qualitative approach and descriptive phenomenological psychological method, undertook in-depth interviews with five practising osteopaths. An analysis of the resulting data identified seven themes related to sexual violence and osteopathic management and treatment: the illness experience, the mind-body connection, clinical relevance, scope of practice, therapeutic response, power dynamics and professional resilience. Overall, this thematic analysis revealed that all participants had encountered patients with a history of sexual violence, held favourable attitudes towards them and commendable knowledge, skills and confidence in this area of practice. However, all the respondents had initially experienced professional insecurity regarding sexual trauma due to a lack of formal training, and all had developed their current abilities through self-guided education, informal peer exchange and individual clinical experience that was sometimes negative. This research thesis therefore supports the contention, found in the current literature, that healthcare practitioners such as osteopaths frequently encounter victims of sexual violence in the context of clinical practice, that in some cases this history is impacting on patient health, and that practitioners are often not appropriately educated to manage such encounters. It concludes that the New Zealand osteopathy community would benefit from professional training, at the student level and beyond and possibly encompassing the themes identified in this preliminary investigation. Such training would ensure that osteopathy practitioners are formally prepared and therefore consistently able to manage the complexities of sexual trauma, and potentially make a more profound contribution to patient recovery from sexual violence.