A MODEL OF THE RETRAUMATIZATION PROCESS: A META-SYNTHESIS OF CHILDHOOD SEXUAL ABUSE SURVIVORS' EXPERIENCES IN HEALTHCARE

Abstract

Childhood sexual abuse survivors frequently report feeling retraumatized during routine healthcare encounters. The goal of this study was to develop a model to aid in understanding difficulties abuse survivors face when accessing healthcare. Meta-synthesis was used to combine data from 15 qualitative studies. The resultant Healthcare Retraumatization Model postulates that retraumatization is a cyclical process with four interrelated subprocesses: hypersensitivity to threats to safety, exposure to triggers, post-traumatic stress reactions, and avoidant coping. Hypersensitivity can cause abuse survivors to feel threatened in situations which require trust and evoke vulnerability, powerlessness, or loss of control. Triggers are situations that cause abuse survivors to feel threatened and elicit stress reactions. Survivors typically cope by employing avoidant coping strategies originally developed during childhood to survive their abuse. Without intervention, retraumatization can result in unhealthy outcomes due to the negative effects of stress on survivors' mental and physical health along with interruptions in healthcare.