Table 1 Components to consider minimization of re-traumatization (adapted with permission from Subramanian and Green 2015)

Safety

• Knock on the door and ask permission to enter the patient’s room

• Meet with the person before they disrobe

• Ask the person to disrobe only when necessary or only partially disrobe

• Clearly identify and provide washrooms

• Take time to familiarize the person with the physical environment

• Ask about comfort level with lighting

• Share control

• Show respect

• Use a warm and compassionate manner to build rapport

Trustworthiness

• Explain all procedures in terms the person can understand

• Tell the person what to expect and how long it will take

• Ask the person what he or she wants

Choice

• Ask if you can touch them each time

• Ask before you invite in additional staff

• Ask if you can close the door

• Allow the person to decide where to sit in the room

• Explain the rationale for each procedure. What the procedure will feel like and make appropriate modifications to reduce re-traumatization

• Obtain consent for each part of the exam performed

Collaboration

• Ask “what are your top worries or concerns” and address these first if possible

• Share information

• Encourage the person to make decisions about treatment

Empowerment

• Ask “what happened to you,” not “what is wrong with you?”

• Never ask “why” questions as they imply fault

• Take time with the person, so he or she feels genuinely heard

• Ask if the person has preferences related to or has had difficulty with a particular procedure

• Ask the person what you should know before you begin the procedure

• Ask if there is a way you can make the procedure easier for him or her

• Ask if there is a way you can make the person relax: like a different position

• Pay attention to body cues; many survivors have been conditioned to be passive and defer to authority and so may not disclose distress during a procedure