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Minding the Gap: Complex Relational Trauma Survivors' Experiences Navigating Healthcare.

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Title: Minding the Gap: Complex Relational Trauma Survivors' Experiences Navigating Healthcare.
Authors: Smart, Colette M.1,2 (AUTHOR) csmart@uvic.ca, Gaudry, Mitchell L.1,3 (AUTHOR), Marefat, Nika1 (AUTHOR), Herod, Lori4 (AUTHOR), Lazar, Jessica5 (AUTHOR), Gillihan, Malachi6 (AUTHOR)
Source: Inquiry (00469580). 6/11/2026, Vol. 63, p1-12. 12p.
Subject Terms: *Health services accessibility, *Qualitative research, *Mental health services, *Content analysis, *Research methodology, Post-traumatic stress disorder, Dental care, Social determinants of health, Research funding, Interviewing, Statistical sampling, Descriptive statistics, Emotional trauma, Patient-centered care, Thematic analysis, Patient-professional relations, Medical needs assessment, Data analysis software, Patients' attitudes
Geographic Terms: Canada, United States
Abstract: Introduction: Complex relational trauma (CRT) occurs in close relationships where adversity is prolonged, repeated and inescapable. Despite the known connections between CRT and adverse health outcomes, anecdotal reports from survivors indicate that education on CRT is not translating into more effective clinical practice, resulting in substandard and even harmful experiences of healthcare. Methods: Using a patient-oriented research methodology, we recruited N = 13 participants with CRT from Canada and the United States. The sample was primarily female (N = 9), with a range of ages (20-69 years) and races/ethnicities. Participants completed a demographic questionnaire and participated in an individual qualitative healthcare interview. Data were analyzed using a hybrid inductive/deductive thematic analysis using NVivo 15. Results: In terms of both mental and medical healthcare, similar themes emerged, including structural and financial barriers to care, experiences of invisibility, invalidation, and re-traumatization, identification of factors that supported safety, trust, and disclosure, as well as a need for specialized understanding of CRT as distinct from PTSD. Meta-themes that emerged included a need for practitioners to better understand the intersection of physical and mental health concerns in persons with CRT, as well as more integrative and holistic care. Conclusions: People with CRT report that they are not currently being well served in the healthcare system. Future research should ascertain providers/trainees' knowledge and skill base regarding CRT, which can inform on opportunities for further education. Findings also suggest that survivors would benefit from efforts to address siloed care, which undermines effective pathways to health and well-being in survivors. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Minding the Gap: Complex Relational Trauma Survivors' Experiences Navigating Healthcare.
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  Data: <searchLink fieldCode="AR" term="%22Smart%2C+Colette+M%2E%22">Smart, Colette M.</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<i> csmart@uvic.ca</i><br /><searchLink fieldCode="AR" term="%22Gaudry%2C+Mitchell+L%2E%22">Gaudry, Mitchell L.</searchLink><relatesTo>1,3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marefat%2C+Nika%22">Marefat, Nika</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Herod%2C+Lori%22">Herod, Lori</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lazar%2C+Jessica%22">Lazar, Jessica</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gillihan%2C+Malachi%22">Gillihan, Malachi</searchLink><relatesTo>6</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Inquiry+%2800469580%29%22">Inquiry (00469580)</searchLink>. 6/11/2026, Vol. 63, p1-12. 12p.
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  Data: *<searchLink fieldCode="DE" term="%22Health+services+accessibility%22">Health services accessibility</searchLink><br />*<searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br />*<searchLink fieldCode="DE" term="%22Mental+health+services%22">Mental health services</searchLink><br />*<searchLink fieldCode="DE" term="%22Content+analysis%22">Content analysis</searchLink><br />*<searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Post-traumatic+stress+disorder%22">Post-traumatic stress disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Dental+care%22">Dental care</searchLink><br /><searchLink fieldCode="DE" term="%22Social+determinants+of+health%22">Social determinants of health</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+trauma%22">Emotional trauma</searchLink><br /><searchLink fieldCode="DE" term="%22Patient-centered+care%22">Patient-centered care</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Patient-professional+relations%22">Patient-professional relations</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+needs+assessment%22">Medical needs assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+attitudes%22">Patients' attitudes</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink><br /><searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
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  Label: Abstract
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  Data: Introduction: Complex relational trauma (CRT) occurs in close relationships where adversity is prolonged, repeated and inescapable. Despite the known connections between CRT and adverse health outcomes, anecdotal reports from survivors indicate that education on CRT is not translating into more effective clinical practice, resulting in substandard and even harmful experiences of healthcare. Methods: Using a patient-oriented research methodology, we recruited N = 13 participants with CRT from Canada and the United States. The sample was primarily female (N = 9), with a range of ages (20-69 years) and races/ethnicities. Participants completed a demographic questionnaire and participated in an individual qualitative healthcare interview. Data were analyzed using a hybrid inductive/deductive thematic analysis using NVivo 15. Results: In terms of both mental and medical healthcare, similar themes emerged, including structural and financial barriers to care, experiences of invisibility, invalidation, and re-traumatization, identification of factors that supported safety, trust, and disclosure, as well as a need for specialized understanding of CRT as distinct from PTSD. Meta-themes that emerged included a need for practitioners to better understand the intersection of physical and mental health concerns in persons with CRT, as well as more integrative and holistic care. Conclusions: People with CRT report that they are not currently being well served in the healthcare system. Future research should ascertain providers/trainees' knowledge and skill base regarding CRT, which can inform on opportunities for further education. Findings also suggest that survivors would benefit from efforts to address siloed care, which undermines effective pathways to health and well-being in survivors. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=194543631
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        Value: 10.1177/00469580261453985
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      – Code: eng
        Text: English
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        PageCount: 12
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      – SubjectFull: Health services accessibility
        Type: general
      – SubjectFull: Qualitative research
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      – SubjectFull: Mental health services
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      – SubjectFull: Content analysis
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      – SubjectFull: Research methodology
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      – SubjectFull: United States
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              Text: 6/11/2026
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