{"id":2010,"date":"2019-08-28T10:56:58","date_gmt":"2019-08-28T00:56:58","guid":{"rendered":"http:\/\/blog.amt.org.au\/?p=2010"},"modified":"2019-08-28T10:57:10","modified_gmt":"2019-08-28T00:57:10","slug":"working-with-clients-who-have-experienced-assault-part-1","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2019\/08\/28\/working-with-clients-who-have-experienced-assault-part-1\/","title":{"rendered":"Working With Clients Who Have Experienced Assault Part 1"},"content":{"rendered":"\n<p><em>Content Warning: assault, sexual assault, rape.<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">By Robert Libbey<\/h2>\n\n\n\n<p>Practising as a Massage Therapist is an interesting and\nfulfilling career. Most therapists are comfortable treating from an orthopaedic\nperspective, testing and assessing functionality of patients and determining a\ncourse of treatment and rehabilitation. We help patients from all walks of life:\nyoung, less young, inactive, more active, weekend warrior, elite athlete,\ndisabled, those challenged with pain and discomfort and so on. <\/p>\n\n\n\n<p>This article discusses people living with a type of injury\nyou unknowingly see regularly in your practice. And I will offer my\nprofessional perspective from treating patients suffering from this injury\nduring my 25-year career. <\/p>\n\n\n\n<p>It\u2019s important for us as therapists to be knowledgeable\nabout assault\/violence and the various forms it takes. This subject matter is\nextensive. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>What is Assault?<\/strong><\/h4>\n\n\n\n<p>Assault occurs in many forms, locations, is committed by\nboth sexes and can be classified into the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>current and previous partner violence and\nemotional abuse since the age of 15<\/li><li>stalking since the age of 15<\/li><li>physical and sexual abuse before the age of 15<\/li><li>witnessing violence between a parent and partner\nbefore the age of 15<\/li><li>lifetime experience of sexual harassment <\/li><li>general feelings of safety. <\/li><\/ul>\n\n\n\n<p>Globally, the statistics are similar for most countries that\nhave reported. Although for other countries the research just doesn\u2019t exist. <\/p>\n\n\n\n<p>This is a subject that many are unwilling to come forward to\ntalk about. <\/p>\n\n\n\n<p>According to the World Health Organization (WHO), sexual\nviolence remains highly stigmatised in all settings. Even when studies take\ncare to address the sensitivity of the topic, it is likely that the levels of\ndisclosure will be influenced by respondents\u2019 perceptions about the level of\nstigma associated with any disclosure, and the perceived repercussions of\nothers knowing about this violence. <\/p>\n\n\n\n<p>The person living with this injury is not typically\ndiscussed in massage therapy curricula nor is it discussed much, if at all, in\nother forms of manual therapy curricula globally. <\/p>\n\n\n\n<p>The person seeking treatment is typically female (1 in 4\nwomen, 1 in 17 men) over 15yrs old, acquired this injury by someone (male or\nfemale) they knew\/know intimately (1 in 4 women, 1 in 13 men) or by a stranger\n(1 in 11 women, 1 in 4 men), while in their own house (40-55%). <\/p>\n\n\n\n<p>The event causing the injury may have happened once or it\nmay have been, or is currently, recurring. <\/p>\n\n\n\n<p>Men are more likely to be physically assaulted by a male\nstranger at a place of entertainment or recreation. 9 out of 10 times the\nperson suffering with this injury has not told anyone about it. <\/p>\n\n\n\n<p>According to <a href=\"https:\/\/victimsofcrime.org\/library\/crime-information-and-statistics\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">The National Center for Victims of Crime<\/a> (USA), 1 in 5 girls and 1 in 20 boys is a victim of child sexual abuse. Further, each year in the U.S., 321,500 Americans ages 12 or older are sexually assaulted or raped, according to the Rape, Abuse and Incest National Network.<\/p>\n\n\n\n<p><em>In Australia, 17% of\nwomen and 4% of men experienced sexual assault since the age of 15. A study\nfound 20.6% of women and 10.5% of men reported non-penetrative childhood sexual\nassault by the age of 16, and 7.9% of women and 7.5% of men reported\npenetrative childhood sexual abuse by the age of 16.<\/em><\/p>\n\n\n\n<p><em>15% of women had been\nsexually assaulted by a known person, compared to 4% who were assaulted by a\nstranger.<\/em><\/p>\n\n\n\n<p><em>Girls between 10 and\n14 represent the greatest proportion of victims of sexual violence, followed by\nwomen aged 15-24. <\/em><\/p>\n\n\n\n<p><em>Indigenous women are\nover-represented as victims of interpersonal violence.<\/em><\/p>\n\n\n\n<p><em>Police figures show\nthat interpersonal violence per head of population increases the further one\nlives from a capital city.<\/em><\/p>\n\n\n\n<p>(<a href=\"http:\/\/www.casa.org.au\/casa_pdf.php?document=statistics\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">source<\/a>)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Some Positive Change, But Not Much\u2026 <\/h4>\n\n\n\n<p><em>The proportion of Australians experiencing violence in\nthe last 12 months, has declined over the last decade, decreasing from 8.3% in\n2005 to 5.4% in 2016. This decline was driven by a drop in experiences of\nphysical violence, falling from 7.5% in 2005 to 4.5% in 2016.<\/em><\/p>\n\n\n\n<p><em>For men the proportion experiencing physical violence\nin the last 12 months has almost halved since 2005, decreasing from 10% in 2005\nto 5.4% in 2016. For women, the proportion has fallen from 4.7% in 2005 to 3.5%\nin 2016.<\/em><\/p>\n\n\n\n<p><em>Over a shorter time period, since 2012, the proportion\nof men experiencing physical violence in the last 12 months decreased, falling\nfrom 8.5% in 2012 to 5.4% in 2016. The proportion of women experiencing\nphysical violence in the last 12 months decreased from 4.6% in 2012 to 3.5% in\n2016.<\/em><\/p>\n\n\n\n<p><em>The proportion of women experiencing sexual violence\nin the last 12 months has remained steady between 2005 and 2016 (1.6% in 2005\ncompared to 1.8% in 2016). However since 2012, there has been an increase, from\n1.2% in 2012 to 1.8% in 2016.<\/em><\/p>\n\n\n\n<p>87% of women who experienced\nsexual violence by a male did not contact police.<\/p>\n\n\n\n<p>(<a href=\"https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/mf\/4906.0\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Source<\/a>)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>What Does Management of this Injury Look Like from a Massage Therapy Clinical Perspective?<\/strong><\/h4>\n\n\n\n<p>Remember, we are not only therapists but also patients.\nAlways consider how you as a patient would feel during an appointment with you\nas the therapist. It is important to remember that patients\u2019 have a level of\nexpectation from you, from the treatment and of the treatment environment. <\/p>\n\n\n\n<p>Standards of Practice define the basic level of expected\ntreatment from therapists and the safe, ethical, and competent delivery of\ncare. When discussing Standards of Practice, we are primarily concerned with\ncreating boundaries and obtaining informed consent to practice. Standards of\nPractice governing massage therapists differ globally so it\u2019s best that you\ninform yourself of the standards that apply to you. <\/p>\n\n\n\n<p>(Editor: Boundaries and Informed Consent are included in the <a href=\"http:\/\/www.amt.org.au\/downloads\/practice-resources\/AMT-code-of-practice-final.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">AMT Code of Practice<\/a>. Also refer to the <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"http:\/\/www.amt.org.au\/amt\/code-of-practice.html\" target=\"_blank\">AMT Code of Ethics<\/a>.)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Boundaries <\/strong><\/h4>\n\n\n\n<p>Sexual trauma is a severe boundary violation. An important\npart of recovery and healing is re-establishing what healthy connection and\nboundaries look and feel like. <\/p>\n\n\n\n<p>The therapeutic relationship that exists between a health professional and a patient is inherently unbalanced in terms of power. In the 1996 article \u201c<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11363821\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Power Imbalances and Therapy<\/a>\u201d, Karla Kennedy Boyd, PhD informs us that within a functional therapeutic relationship, patients invest therapists with power and therapists use their privilege and power to help patients empower themselves. Therapy is impeded when the therapist fails to consider societal power dynamics, such as race, age, gender, religion, sexual orientation, ethnicity, cultural beliefs, ability, values, lifestyle and perception of dominant cultures. If the therapist fails to acknowledge and explore the power dynamics within the therapeutic relationship, there is potential for devaluation of the patients\u2019 personal values and perceptions. It is the responsibility of the massage therapist to recognise and manage this power imbalance to provide patient-centred, safe, ethical, competent, and effective care. <\/p>\n\n\n\n<p>Establishing both psychological and physical boundaries\ninforms patients of what to expect when seeking care from you. Although massage\ntherapy is a physical form of treatment, we know that it not only affects the patient\u2019s\nphysical body, but that it also affects the patient psychologically and\nemotionally. Communicating and forming clear boundaries ensures professional\nand respectful patient safety, comfort and dignity. <\/p>\n\n\n\n<p>If your practice is like mine, we serve a diverse community\nrich with individual and cultural differences. Each patient presents with their\nown cultural and individual levels of comfort with touch and physical contact.\nAssault is not isolated to any one sex, culture or community. As such, it\u2019s\nimportant to understand that each patient has their own personal sexualised\/sensitive\nareas of their body. Communicating with the patient about their personal\nboundaries helps to minimise the occurrence of unintentional or incidental\nphysical contact with those established areas.<\/p>\n\n\n\n<p>As much as we try to empathise or understand a patient, we\ncan never truly know what a patient is experiencing physically, psychologically\nor emotionally. It is important during treatment to regularly communicate and\nreaffirm that you are working within your patients\u2019 level of comfort. Be aware\nof the patient\u2019s non-verbal communication for signs of discomfort, such as:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>increasing muscle tension or tone<\/li><li>physically shifting or attempting to move away\nfrom your touch. <\/li><\/ul>\n\n\n\n<p>Verbal communication from them saying that what you are\ndoing is uncomfortable and\/or unwanted should be respected. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Informed Consent <\/strong><\/h4>\n\n\n\n<p>Informed consent involves providing the patient with\nsufficient information about the proposed treatment to enable them to decide if\nthey would like to continue with treatment. <\/p>\n\n\n\n<p>Informed Consent specific to victims of assault means that\nthe massage therapist:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>engages in shared decision-making with the\npatient<\/li><li>respects the patient\u2019s autonomy <\/li><li>obtains consent prior to delivery of treatment <\/li><li>addresses the patient\u2019s goal(s) and\nexpectation(s) in seeking treatment <\/li><li>monitors and renews consent where appropriate\nthroughout treatment <\/li><li>discontinues treatment if the patient withdraws\nconsent at any time. <\/li><\/ul>\n\n\n\n<p>Informed consent includes the massage therapist providing\ninformation about: <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>areas of the patient\u2019s body where treatment will\nbe delivered <\/li><li>options for disrobing <\/li><li>options for draping during treatment. <\/li><\/ul>\n\n\n\n<p>Remember that physical and sexual abuse does occur before\nthe age of 15. It is the responsibility of the massage therapist to inform themselves\nof the legal requirements pertaining to providing treatment to a minor, and\nensuring that the child is comfortable with the guardian\/parent accompanying\nthem to the treatment.<\/p>\n\n\n\n<p>(Editor: Refer to the section \u201c<a href=\"http:\/\/www.amt.org.au\/downloads\/practice-resources\/AMT-code-of-practice-final.pdf#page=67\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Treatment of Minors<\/a>\u201d in the AMT Code of Practice.)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>What\u2019s Your Role?<\/strong><\/h4>\n\n\n\n<p>Today more than ever, massage therapists treat from a biopsychosocial\n(BPS) perspective, recognising how psychological, emotional and physical\ndysfunctions and conditions affect the overall lifestyle of a person. Although\nwe all have the innate desire to help someone, it is not our role to help the\npatient emotionally or psychologically. We need to approach these topics\ncarefully, acknowledging where we are not counsellors\/psychologists\/psychiatrists\nnor do we receive appropriate education for the treatment of mental health\nissues or conditions. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Communication\nSuggestions <\/strong><\/h4>\n\n\n\n<p>What do you say after a patient communicates to you that\nthey are a survivor of abuse\/violence? <\/p>\n\n\n\n<p>When a patient confides in you, it\u2019s important to pause for a brief moment before you instinctually respond. According to the Journal of General Internal Medicine, <a href=\"https:\/\/link.springer.com\/article\/10.1007\/s11606-019-05247-5\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">physicians\u2019 interrupt within 11 seconds after the patient starts speaking<\/a>. Taking pause as a health care provider and fellow human-being provides you the time to remember to respond from a place of empathy rather than sympathy. <\/p>\n\n\n\n<p>How we present ourselves to our patients influences our\noutcomes and their mental and emotional state. Trust, respect, comfort of the\nenvironment and of the relationship create an opportunity where a patient feels\nsafe. Hearing our patients\u2019 stories pulls at out emotional strings. It\u2019s\nimportant to remain neutral. You may find yourself getting lost in your own\nfeelings and perspectives and creating fictional events in your own mind based\non what you\u2019ve been told. You may feel agitated, outraged, judgmental, angry,\nshame and guilt. It\u2019s a challenge that we must contain our own emotional response\nand stay neutral and be a compassionate observer. <\/p>\n\n\n\n<p>Recognise that it\u2019s respectful to communicate in a way that\nis appropriate to the patient\u2019s level of understanding, considering factors\nsuch as the patient\u2019s age, language and cultural background. It\u2019s easy to hurt\nother people and not even notice it. Words are powerful and have different\nmeaning to different people. Sometimes, we say words to other people that don\u2019t\nmean much to us, just to avoid an awkward silence or just to say \u2026 <em>something<\/em>. <\/p>\n\n\n\n<p>Although your instinct may be to respond with a sympathetic\n\u201cI\u2019m sorry,\u201d avoid saying this or something similar. You have done nothing to\nthe patient that requires an apology. A more appropriate and respectful\nresponse would be \u201cThank you for sharing with me\u201d or \u201cI appreciate that you\nshared with me.\u201d There is no awkward silence, nor any sense of pity.\nAcknowledge their story, then ask \u201cHow can I help you?\u201d This response is more\nauthentic and encourages an actionable outcome.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><strong>Listening can be challenging. As therapists, we are educated to assess and treat with a possible solution. Therapists of all kinds forget or do not recognise that listening and gentle acknowledgment is what our patients need most, not a solution. <\/strong><\/p><\/blockquote>\n\n\n\n<p>Being heard is powerful. Be conscious of the chasm between\nwhat we believe a patient may be feeling and their true feelings. Avoid\nattempting to validate what you think the patients\u2019 feelings are or guessing\nwhat they are feeling. Terminology is very individualistic so let the patient\nlabel their feelings and use their words. <\/p>\n\n\n\n<p>If you don\u2019t understand something the patient has\ncommunicated, rather than telling them what you think it sounds like, stop and\nask them what they mean. Ask them for clarification. People appreciate not\nhaving someone guess at what they feel. They appreciate being understood. <\/p>\n\n\n\n<p>Massage therapists have a unique experience with patients\ncompared to other medical professionals. We can spend up to an hour or more\nalone with a patient, communicating with them verbally and non-verbally. As the\nprofessional relationship develops over time, both therapist and patient become\ncomfortable with one another. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Vulnerability and\nTrust <\/strong><\/h4>\n\n\n\n<p>The person in front of you is taking a courageous step just\nshowing up to their first appointment. Trust is built not in huge defining\nmoments, but over time with very small moments. Therapists typically reflect on\ndifferent techniques or strategies they can utilise to treat an orthopaedic\ndysfunction. It\u2019s time to recognise that it is equally important to reflect on\nhow your verbal and non-verbal communication and interactions influence the\nbuilding of trust within the therapeutic relationship. <\/p>\n\n\n\n<p>Many of us remember growing up learning \u201cStranger\/Danger!\u201d\nThe main threat with which stranger\/danger campaigns were started was the\nconcern of sexual abuse. The campaign continues today with the hope to solidify\nthe idea or warning that all strangers can potentially be dangerous. It is an\nexample of a moral panic that people experience regarding anyone that they are\nunfamiliar with in society. <\/p>\n\n\n\n<p>Every new patient we see has a certain level of expectation\nof what they think they are about to experience. This expectation may come from\nanother patient\u2019s experiences with you, from experiencing treatment from other\ntherapists of the same or different professions, from discussions the patient\nhas had with friends\/family\/acquaintances, and from what they\u2019ve seen on TV or\nin the movies etc. <\/p>\n\n\n\n<p><a href=\"https:\/\/www.amazon.com.au\/Thin-Book-Trust-Essential-Building-ebook\/dp\/B001PBEXFQ\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Charles Feltman<\/a> defines \u201cTrust\u201d as choosing to make something important to you vulnerable to the actions of someone else. As therapists, it is easy for us to forget that the person in front of us, who doesn\u2019t know us, is about to trust us while placing themselves in a position that is most vulnerable. Trust is an important aspect of any treatment and it\u2019s one of the strongest influencing factors in your therapeutic relationships. <\/p>\n\n\n\n<p><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.youtube.com\/watch?v=iCvmsMzlF7o\" target=\"_blank\">Brene Brown<\/a> defines \u201cVulnerability\u201d as the feeling we get when we feel uncertainty, at risk or emotionally exposed. One of the life lessons we learn is that courage is an important value. We are encouraged to be brave in anything we attempt, but in the same breath, we are also taught that vulnerability is a sign of weakness. On one hand, we are taught to be brave, but on the other hand we are taught to never expose ourselves. <\/p>\n\n\n\n<p>The reality is that there is no courage without vulnerability. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>About the Author<\/strong><\/h4>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignleft is-resized\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/07\/Robert-Libbey.png?resize=168%2C166\" alt=\"\" class=\"wp-image-970\" width=\"168\" height=\"166\"\/><\/figure><\/div>\n\n\n\n<p>Robert Libbey has been a Registered Massage Therapist (RMT) in Canada for over 25 years. He has been a Senior Clinical Examiner instructing Orthopaedic and Neurological Examination. He teaches Ligamentous Articular Strain Techniques (LAST) at international conferences and online. Along with teaching and lecturing, Robert maintains a full-time practice. Robert has a passion to advance and improve Manual Therapy education, encouraging innovation in manual skills and inspiring therapists to incorporate research into practice to better serve their community. Learn more about Robert and his courses <a href=\"https:\/\/www.lastsite.ca\/about-ligamentous-articular-strain-technique\/robert-libbey-rmt\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">here<\/a>.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Need Help?<\/strong><\/h4>\n\n\n\n<p><strong>National<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/www.1800respect.org.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">1800 RESPECT<\/a> (National Sexual Assault, Domestic Family Violence Counselling Service): 1800 737 732<\/p>\n\n\n\n<p><a href=\"https:\/\/bravehearts.org.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Bravehearts<\/a> (child protection): 1800 272 831 (limited hours)<\/p>\n\n\n\n<p>Lifeline: 13 11 14<\/p>\n\n\n\n<p><strong>ACT<\/strong><\/p>\n\n\n\n<p>Service Assisting Male Survivors of Sexual Assault (SAMSSA):\n02 6287 3935<\/p>\n\n\n\n<p><a href=\"http:\/\/www.crcc.org.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Canberra Rape Crisis Centre<\/a>: 02 62472525<\/p>\n\n\n\n<p><strong>NSW<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/www.nswrapecrisis.com.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">NSW Rape Crisis Centre<\/a>: 02 9819 6565 or (outside Sydney) 1800 424 017<\/p>\n\n\n\n<p>Domestic Violence Line (NSW Department of Communities and\nJustice): 1800 656 463 (24 hours)<\/p>\n\n\n\n<p><strong>NT<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/nt.gov.au\/wellbeing\/hospitals-health-services\/sexual-assault-referral-centres\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Sexual Assault Referral Services (SARC)<\/a>:<\/p>\n\n\n\n<p>Alice Springs: (08) 8955 4500 (Mon-Fri 8am-4.21pm) or\nafterhours 0401 114 181<\/p>\n\n\n\n<p>Darwin: (08) 8922 6472<\/p>\n\n\n\n<p>Katherine: (08) 8973 8524<\/p>\n\n\n\n<p>Tennant Creek: (08) 8962 4361<\/p>\n\n\n\n<p><strong>QLD<\/strong><\/p>\n\n\n\n<p><a href=\"http:\/\/www.brissc.org.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Brisbane Rape &amp; Incest Survivors Support Centre<\/a>: (07) 3391 0004<\/p>\n\n\n\n<p><a href=\"https:\/\/www.health.qld.gov.au\/sexualassault\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Sexual Assault Help Line<\/a>: 1800 010 120<\/p>\n\n\n\n<p><strong>SA<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/www.sahealth.sa.gov.au\/wps\/wcm\/connect\/public+content\/sa+health+internet\/health+services\/yarrow+place+services\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Yarrow Place Rape &amp; Sexual Assault Service<\/a>: 1800 817 421 or afterhours (08) 8226 8787<\/p>\n\n\n\n<p><strong>Tasmania<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/laurelhouse.org.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Laurel House<\/a>: <\/p>\n\n\n\n<p>Launceston (03) 6334 2740<\/p>\n\n\n\n<p>North West: (03) 6431 9711<\/p>\n\n\n\n<p>Afterhours: 1800 697 877<\/p>\n\n\n\n<p><strong>Victoria<\/strong><\/p>\n\n\n\n<p><a href=\"http:\/\/www.sacl.com.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Sexual Assault Crisis Line<\/a>: 1800 806 292<\/p>\n\n\n\n<p><strong>WA<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/www.kemh.health.wa.gov.au\/Our-services\/Statewide-Services\/SARC\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Sexual Assault Resource Centre (SARC)<\/a>: (08) 6458 1828 or (country areas) 1800 199 888<\/p>\n\n\n\n<p><a href=\"http:\/\/www.waratah.asn.au\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Waratah Support Centre<\/a> (Bunbury): 1800 017 303 or (08) 9791 2884<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>References\/Further Reading<\/strong><\/h4>\n\n\n\n<p><a href=\"https:\/\/www.helpguide.org\/articles\/ptsd-trauma\/recovering-from-rape-and-sexual-trauma.htm\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Recovering from Rape and Sexual Trauma (opens in a new tab)\">Recovering from Rape and Sexual Trauma<\/a><\/p>\n\n\n\n<p><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.amtamassage.org\/articles\/3\/MTJ\/detail\/3484\/in-safe-hands-massage-ptsd\" target=\"_blank\">In Safe Hands &#8211; Massage and PTSD, by Ian McCafferty (2016 AMTA Massage Therapy Journal<\/a><\/p>\n\n\n\n<p><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.domesticshelters.org\/articles\/taking-care-of-you\/healing-through-massage\" target=\"_blank\">Healing Through Massage (2017), Domestic Shelters<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1933482\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Body-oriented therapy in recovery from child sexual abuse: an efficacy study, Cynthia Price, PhD, Altern Ther Health Med 2005; 11(5):46-57<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.learningmethods.com\/pdf\/ethics-survivors%20of%20abuse.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Massage and bodywork with survivors of abuse, Ben E Benjamin PhD<\/a>.<\/p>\n\n\n\n<p>Fact Sheet: <a href=\"https:\/\/acws.ca\/sites\/default\/files\/documents\/ViolenceagainstWomenandGirlsFactSheet2003.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Violence Against Women and Girls, (2002) Canadian Research Institute for the Advancement of Women<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/aifs.gov.au\/sites\/default\/files\/publication-documents\/ressum7.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Gender Equality and Violence Against Women<\/a> by Liz Wall, Australian Institute of Family Studies<\/p>\n\n\n\n<p>Fact Sheet: <a href=\"https:\/\/www.criaw-icref.ca\/en\/product\/violence-against-women-in-canada\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Violence Against Women In Canada, (2013) Canadian Research Institute for the Advancement of Women, ISSN 1917-8581<\/a> <\/p>\n\n\n\n<p>Fact Sheet: <a href=\"https:\/\/www.casa.org.au\/assets\/Documents\/What-is-sexual-assault2.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"What is sexual assault? (opens in a new tab)\">What is sexual assault?<\/a> (2019) Victorian Centres Against Sexual Assault (CASA) Forum <\/p>\n\n\n\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0193397396900040\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Field, T., Seligman, S., Scafidi, F., &amp; Schanberg, S. (1996). Alleviating posttraumatic stress in children following Hurricane Andrew. Journal of Applied Developmental Psychology, 17, 37-50<\/a>. <\/p>\n\n\n\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1360859297800022\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Field, T. et al., Effects of sexual abuse are lessened by massage therapy, Journal of Bodywork and Movement Therapies (1997) 1(2), 65-69<\/a> <\/p>\n\n\n\n<p><a href=\"https:\/\/sophia.stkate.edu\/msw_papers\/177\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Frank, DS. (2013) The Well-Embodied Professional: Attitudes around Integrating Massage Therapy &amp; Psychotherapy when Treating Trauma<\/a>. <\/p>\n\n\n\n<p><a href=\"https:\/\/www.who.int\/reproductivehealth\/publications\/violence\/9789241564625\/en\/\">Global\nand regional estimates of violence against women: prevalence and health effects\nof intimate partner violence and non-partner sexual violence, (2013) World\nHealth Organization<\/a> ISBN 978 92 4 156462 <\/p>\n\n\n\n<p><a href=\"https:\/\/www.massagetherapycanada.com\/massage-therapy-lessens-the-effects-of-sexual-abuse-1281\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Massage Therapy Lessens the Effects of Sexual Abuse<\/a>, (2009) Massage Therapy Magazine <\/p>\n\n\n\n<p><a href=\"https:\/\/www.who.int\/reproductivehealth\/publications\/violence\/9241593512\/en\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Multi-country Study on Women\u2019s Health and Domestic Violence against Women, (2005) World Health Organization<\/a> ISBN 92 4 159351 2 <\/p>\n\n\n\n<p><a href=\"https:\/\/www.bodyworkmovementtherapies.com\/article\/S1360-8592(02)90307-4\/abstract\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Price C. Body-oriented therapy as an adjunct to psychotherapy in recovery from childhood abuse: a case study. J Bodywork Move Ther. 2002;6:228\u2013236<\/a> <\/p>\n\n\n\n<p><a href=\"https:\/\/www.bodyworkmovementtherapies.com\/article\/S1360-8592(03)00077-9\/abstract\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Price C. Characteristics of women seeking bodywork as an adjunct to psychotherapy during recovery from childhood sexual abuse. J Bodywork Move Ther. 2004;8:35\u201342<\/a> <\/p>\n\n\n\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1933482\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Price C. Body-oriented therapy in recovery from child sexual abuse: an efficacy study. Altern Ther Health Med. 2005; 11(5): 46\u201357<\/a>. <\/p>\n\n\n\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1360859205000422\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Price C. Body-oriented therapy in sexual abuse recovery: a pilot-test comparison. J Bodywork Move Ther. 2005<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.cmtbc.ca\/law-standards\/standards-of-practice\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">College of Massage Therapists of British Columbia Standards of Practice<\/a>, covering <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.cmtbc.ca\/law-standards\/standards-of-practice\/boundaries-standard-of-practice\/\" target=\"_blank\">boundaries<\/a> and <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.cmtbc.ca\/law-standards\/standards-of-practice\/consent-standard-of-practice\/\" target=\"_blank\">consent<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Robert Libbey RMT shares his experience of working with clients who have experienced assault and sexual assault in part 1 of our 2 part series. Content warning: assault, sexual assault, rape<\/p>\n","protected":false},"author":1,"featured_media":2011,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[110],"tags":[482,486,487,483,145,481,484,485],"class_list":["post-2010","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-practice","tag-assault","tag-boundaries","tag-informed-consent","tag-recovery","tag-robert-libbey","tag-sexual-assault","tag-trust","tag-vulnerability"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/08\/Libbey.jpg?fit=958%2C549&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":2016,"url":"https:\/\/blog.amt.org.au\/index.php\/2019\/09\/04\/working-with-clients-who-have-experienced-assault-part-2\/","url_meta":{"origin":2010,"position":0},"title":"Working With Clients Who Have Experienced Assault Part 2","author":"admin","date":"04\/09\/2019","format":false,"excerpt":"Robert Libbey RMT shares practical advice for massage therapists working with clients who have experienced assault and sexual assault in part 2 of our series. Content warning: assault, sexual assault, rape","rel":"","context":"In &quot;Clinical Practice&quot;","block_context":{"text":"Clinical Practice","link":"https:\/\/blog.amt.org.au\/index.php\/category\/clinical-practice\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/09\/aaa-windo.jpg?fit=1101%2C561&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/09\/aaa-windo.jpg?fit=1101%2C561&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/09\/aaa-windo.jpg?fit=1101%2C561&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/09\/aaa-windo.jpg?fit=1101%2C561&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/09\/aaa-windo.jpg?fit=1101%2C561&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":2213,"url":"https:\/\/blog.amt.org.au\/index.php\/2019\/12\/05\/top-7-articles-of-2019\/","url_meta":{"origin":2010,"position":1},"title":"TOP 7 ARTICLES OF 2019","author":"admin","date":"05\/12\/2019","format":false,"excerpt":"Revisit 7 of the best articles we've featured on AMT's blog in 2019. Which was your favourite?","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":978,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/08\/01\/case-study-injured-stuntpersons-dramatic-rehab\/","url_meta":{"origin":2010,"position":2},"title":"CASE STUDY: Injured Stuntperson\u2019s Dramatic Rehab","author":"admin","date":"01\/08\/2018","format":false,"excerpt":"What happens when an injury leaves you facing the end of your beloved career? In part 2 of his LAST articles, Canadian Registered Massage Therapist, Robert Libbey shares a case study of how he treated his client using LAST, BPS modelling and knowing when to refer. Don't miss Robert's workshops\u2026","rel":"","context":"In &quot;AMT Conference&quot;","block_context":{"text":"AMT Conference","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt-conference\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/07\/AMT-Conference-Series-3.png?fit=560%2C315&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/07\/AMT-Conference-Series-3.png?fit=560%2C315&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/07\/AMT-Conference-Series-3.png?fit=560%2C315&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":961,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/07\/25\/dissecting-the-evidence-supporting-last\/","url_meta":{"origin":2010,"position":3},"title":"Dissecting the Evidence Supporting LAST","author":"admin","date":"25\/07\/2018","format":false,"excerpt":"What is Ligamentous Articular Strain Technique and how (and why) should Massage Therapists introduce it into their treatments? Canadian Registered Massage Therapist and Educator, Robert Libbey, introduces us to LAST, which he\u2019ll be running workshops on in October 2018 in Tweed Heads, Perth and Canberra. Robert will also present at\u2026","rel":"","context":"In &quot;AMT Conference&quot;","block_context":{"text":"AMT Conference","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt-conference\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/07\/man-320276_640-291x300.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":1293,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/12\/19\/the-best-of-2018\/","url_meta":{"origin":2010,"position":4},"title":"The Best of 2018","author":"admin","date":"19\/12\/2018","format":false,"excerpt":"As the sun sets on 2018, we take a look back at some of the most read articles from AMT's blog over the last 12 months. What was your favourite?","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/12\/Best-of-2018.png?fit=560%2C315&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/12\/Best-of-2018.png?fit=560%2C315&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/12\/Best-of-2018.png?fit=560%2C315&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":491,"url":"https:\/\/blog.amt.org.au\/index.php\/2018\/01\/24\/conference-announcement-save-the-date\/","url_meta":{"origin":2010,"position":5},"title":"Conference announcement &#8211; save the date!","author":"admin","date":"24\/01\/2018","format":false,"excerpt":"We are chuffed to announce that the AMT Annual Conference will be held on October 12, 13 and 14 at the Rydges Sydney Central. The venue is located within five minutes easy walking from Central Railway Station in Sydney. That's ten minutes by rail from the airport. We've negotiated a\u2026","rel":"","context":"In &quot;AMT&quot;","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2018\/01\/rydges-sydney-central-function-hero-1-hr.jpg-300x200.jpg?resize=350%2C200","width":350,"height":200},"classes":[]}],"_links":{"self":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts\/2010","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/comments?post=2010"}],"version-history":[{"count":3,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts\/2010\/revisions"}],"predecessor-version":[{"id":2014,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/posts\/2010\/revisions\/2014"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/media\/2011"}],"wp:attachment":[{"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/media?parent=2010"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/categories?post=2010"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.amt.org.au\/index.php\/wp-json\/wp\/v2\/tags?post=2010"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}