What Have Been the Experiences of Female Survivors of Interpersonal Trauma on the Survive & Thrive Course
Condition: Interpersonal Trauma
MeSH terms: Wounds and Injuries
Study type: Interventional

Summary: 
      The study is aimed to explore female patients' experience of the Survive & Thrive course that
      has been designed for survivors of interpersonal trauma (e.g. childhood sexual abuse,
      domestic abuse, rape, physical abuse, neglect, harassment, stalking and similar). The course
      aims to help attendees develop an understanding of the normal range of reactions to trauma
      and introduce new ways of coping. It is a 10 week course that is structured to utilise
      cognitive behavioural skills training while delivering psychoeducation on how a history of
      victimisation can impacts on the survivors life. Female adult participants who attended the
      Survive & Thrive course will be invited to take part in a 30-45 minutes semi-structured
      interview exploring their experience of the course. The aim is to interview 12 participants;
      those individuals attended 6 or more sessions. Access to some demographic information will be
      gained through the Survive & Thrive team to gain additional insight to the participant's
      course experience. The rationale for this study is to evaluate the effectiveness of the
      Survive & Thrive course as a treatment option within the Stepped Care Approach for survivors
      of interpersonal trauma. There is an increasing number of individuals being exposed to
      traumatic life events. Most research has concentrated on the individual psychological input
      for patients with trauma history. Courtois and Ford (2009) argued that at a service level,
      group therapy is more efficient than individual as it can be offered more broadly. There is
      however limited research on the effectiveness of manualised approaches for the mental health
      and behavioural problems. Research shows that safety and stabilisation in trauma survivors
      can be achieved through psychoeducational approaches which emphasise present-time, coping
      strategies/skills, elimination of self-harming behaviour, control over acute symptoms, and
      increased self-care (Lubin & Johnson, 1997). Findings from this study will be published.
    

Detailed description: 
      Design The proposed research is a qualitative study using a purposive sample (participants
      have a position of shared experience), consisting of semi-structured interviews and some
      demographic information will be collected from the Survive & Thrive database.

      Procedures All the procedures planned for this research project have been considered in
      detail to ensure that they follow the highest standards in the BPS (2009) ethical guidelines
      and the Health & Care Professions Council (HCPC, 2012) standards of proficiency. Initially,
      the Survive & Thrive database will be screened by the Survive & Thrive course team for female
      patients who have attended any 6 or more sessions out of the 10. These sessions are not
      required to be consecutive. Each session co-facilitators record attendance that is then
      stored on the Survive & Thrive SMF. They will be sent a letter informing them of this study
      along with a participants' information sheet and a reply slip passing on their note of
      interest to be contacted by the CI about the study (please see attached documents). This
      letter will be sent by the Survive & Thrive team leader who was in prior contact with the
      patients and her name has been on prior correspondence with them. It will provide them with
      space to specify their preferred method of contact. A pre-paid envelope addressed to the CI
      will be provided. Once reply slip is received, I will contact them to offer further
      information about the study and arrange to meet with them to complete the consent form and to
      conduct the semi-structured interview. Please see attached forms that will be sent out to
      potential participants.

      Additionally, co-facilitators will inform current patients about this study at the beginning
      of week 6 of the Survive & Thrive course and hand out the information sheet and reply slip.
      At the beginning of week 7, co-facilitators will ask patients to pass on the reply slip if
      they would like to be contacted by the CI to find out more about the study. The
      co-facilitators will be provided with an additional form that they will complete along with
      the attendance sheet (please see attached). This form will enable monitoring of who was
      informed of the study and who has agreed to be contacted in relation to it. All of the
      entries in this form will be initialled and dated by the Survive & Thrive co-facilitators.
      The CI will not have access to these forms and will only be provided with information &
      contact numbers for individuals who have shown interest in the study and agreed to be
      contacted in relation to it. When the CI contacts potential participants (upon receiving a
      reply slip) who have shown interest, it will be specified that the interview will be arranged
      after the 10th week of the course (once the course is completed). The potential participants
      had to attend during this time any 6 sessions or more of the 10 (not required to be
      consecutive).

      If they agree to be contacted regarding this study, the CI will then contact them. The CI
      will provide them with additional information regarding the study that is detailed in the
      participant information sheet. Participants will be assured that all data is stored securely
      and confidentially. The demographic data will be given a code along with the interview
      transcript to match the two data sets.

      Once the participants agree to take part, arrangements to meet at one of the clinical rooms
      will be made. At this point they will confirm their consent to participate in the study by
      signing the consent form. After they sign the consent form they will take part in the
      semi-structured interview. Lastly, the participants will take part in a brief off-tape
      discussion regarding their experience of the interview and thanked for their participation. A
      list of contact recommendations of who to contact if participants became distressed or would
      like further support/opportunity to speak about the topics discussed during the interview
      will be provided to them at the end of the interview.

      Material Semi-structured interviews will be conducted. The choice of questions considered how
      best to reflect the chosen data analysis in IPA that is entirely concerned with understanding
      individuals' experiences, feelings, and meaning-making. Thus, the selected questions are
      concentrated on emotions, values, and priorities.

      Methods of analysis The proposed method of analysis for this research project is
      Interpretative Phenomenological Analysis (IPA), a method that has particular resonance for
      psychologists within qualitative research. It offers an established, systematic, and
      phenomenologically-focused approach to the interpretation of first-person accounts. It is a
      meaning-focused qualitative method that is committed to the understanding of the first-person
      perspective of their experience from the third-person position through inter-subjective
      inquiry and analysis.

      Analysis of the data gathered will begin with transcribing the twelve 30-45minutes
      semi-structured interviews (by the Service admin staff who types up clinical letters). A
      decision to use the NHS admin staff for transcribing of the interviews was made due to a time
      restriction on this research and to ensure for confidentiality of the data. This will provide
      some time security as well as ensuring that the transcript will be to the highest standard.
      Once the interviews are transcribed, the audio recording will be deleted. I will then start
      familiarising myself with the transcriptions. This will be followed by a cyclical process of
      synthesis and analysis which will involve the reading and re-reading of the transcripts
      followed by exploratory manual coding (no use of software) of anything of interest within the
      transcript that allows me to identify the specific ways each participant talks about, thinks
      about and understands their experience. This step is followed by identifying the emerging
      themes throughout the transcripts. Once these are identified I will draw a map of the
      emerging themes to provide a structure for writing up the information and clustering all the
      themes that are repeated.

      Once this is completed I will go back over the gained information and start making sense of
      the data by connecting patterns and making connections between recurrent themes by looking
      at, for example, how these recurrent themes inter-relate. I will attempt to conceptualise the
      connections and patterns and use this to organise the data, and draw relationships between
      them. The production of a summary table is seen as a beneficial next step to gain a clear and
      systematic overview of thematic clusters, together with keywords and the locations of
      relevant quotations. Afterwards the interpretative part of the IPA, that has recently been
      divided into two distinct levels, begins. The first level is a more descriptive, empathic
      level, aiming to enter the participants' world, while the second level is seen as more
      critically interrogative of the participants' views, in order to gain further insight into
      their nature, meaning and origins. I will aim to draw predominantly on the first level of
      interpretation of the data as the second has received some ethical criticism around the
      imposition of meaning upon data.

      Once writing up the findings some example quotations will be used to represent recurrent
      themes, to offer readers an insight into the survivors of interpersonal trauma who attended
      Survive & Thrive course thinking patterns. Excel (Microsoft office) program will then be used
      to conduct how many themes occur across how many participants.
    

Intervention name(s): Semi-structured interviews
Intervention type(s): Other
Intervention description(s): Each participant will attend a 30-45 minute semi-structured interview conducted by the CI
Intervention model: Single Group Assignment
Intervention model description: Qualitative Study - semi-structured interviews
Masking: None (Open Label)
Primary purpose: Other