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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

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

Colette M Smart^1,2, Mitchell L Gaudry^1,3, Nika Marefat¹

¹Department of Psychology, University of Victoria, Victoria, BC, Canada.

Inquiry : a Journal of Medical Care Organization, Provision and Financing

|June 12, 2026

Summary

Complex relational trauma (CRT) survivors face significant healthcare barriers, including invisibility and invalidation. Improved clinical understanding and integrated care are crucial for effective treatment and well-being.

Keywords:

adverse childhood experiences complex PTSD healthcare patient-oriented research trauma-informed care

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Last Updated: Jun 13, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

Psychology
Healthcare Research
Trauma Studies

Background:

Complex relational trauma (CRT) involves prolonged, inescapable adversity in close relationships.
Survivors report that CRT education is not effectively improving clinical practice.
This leads to substandard and potentially harmful healthcare experiences for individuals with CRT.

Purpose of the Study:

To explore the healthcare experiences of individuals with complex relational trauma.
To identify barriers and facilitators to effective care for CRT survivors.
To inform improvements in clinical practice and healthcare delivery for this population.

Main Methods:

Patient-oriented research methodology.
Qualitative healthcare interviews with 13 participants with CRT from Canada and the US.
Hybrid inductive/deductive thematic analysis using NVivo 15.

Main Results:

Participants experienced structural/financial barriers, invisibility, invalidation, and re-traumatization in both mental and medical healthcare.
Factors supporting safety, trust, and disclosure were identified.
A need for specialized understanding of CRT, distinct from PTSD, and integrative care was highlighted.

Conclusions:

Individuals with CRT are currently underserved by the healthcare system.
Future research should assess provider knowledge and skills regarding CRT to inform education.
Addressing siloed care is essential for survivors' health and well-being.