So what happens if a male arrives and says I have erectile dysfunction, how would you deal with that?
Participant 6:
That would be difficult especially if we have just met I don’t know how to be honest. I can say I would like to but I don’t know when I’m actually sitting there what I would actually do. I think I would ask questions around it in a very unengaged manner, very distant because I know I have to professionally.
The personal aspect would be taken out of that and as such it would make it difficult for me to empathise because I would be distancing myself.
Interviewer:
So if we look at some of the things: you rushed over it, overlooked, avoided?
Participant 6:
Reworded it inappropriately, where it actually doesn’t answer the question;
Interviewer:
So what would you do differently when broaching the subject of sexual health?
Participant 6:
I would ask directly. I would not look for other words to substitute to make it easier, because it’s not making it easier for them it’s making it easier for me to ask. So I justified it by saying it makes it easier for the client, in fact it’s making it easier for me to not be direct. So I think that’s the best.
Interviewer:
So how do we get to a point of being direct about it, do we need more education, do we need to normalise the topic?
Participant 6:
I definitely need education with the client, the importance of bringing it up, definitely a lot of exposure, to desensitise it for oneself.
Interviewer:
So what do you think would be helpful within your training to equip you to deal with sensitive topics around sexual health?
Participant 6:
I think to be given the link between it, I think we were but I didn’t catch it, to be given the link right in the beginning and not find it out ourselves of why it’s important because I think if we know in terms of objectively of why it’s important it doesn’t seem like it’s an invasion of one's privacy as just asking that because it’s on a piece of paper and you don’t understand why.
Interviewer:
So a better understanding of what am I trying to understand about this person.
Participant 7 Interviewer:
If we look at the knowledge of the interview process and the content what was your experience when conducting your first interview with your client….generally?
Participant 7:
As a whole, the very first time, it was anxiety provoking to ensure that all the information needed was made available, just to make sure that I covered each and every aspect.
198 Interviewer:
So do you think that your anxiety was around needing to cover the entire content?
Participant 7:
Yes to make sure that all the important information was provided and that I didn’t miss anything especially what was being said by the client in terms of me having to ask the questions.
Interviewer:
So did you go through a process of orienting your client, to the therapy process and specifically around sensitive topics, did you do any orienting around that?
Participant 7:
No not around sensitive topics. In the orientation process: we are going to collect. It was just made mention to the client that information will be gathered, family, school, education, career etc, but no specific mention that it might be sensitive information.
Interviewer:
Do you think you were adequately prepared for conducting your initial interviews with the goal of acquiring the person’s whole psychological history?
Participant 7:
The very first one I saw I would say no, simply because in my mind it was more getting the right information. Also conducting an adequate mental state examination, so at that stage it was trying to negotiate: you’re asking the person the questions, you’re trying to get the information, trying to assess the client, so yes that was the problem with that.
Interviewer:
So do you think training prepared you at all for the interview, schedule, did that assist you? The structure, did that assist?
Participant 7:
The structure did assist you know... reading about it helps you so much but eventually it becomes a practical experience in that the more interviews you carry out the better you are at understanding the gathering of information.
Interviewer:
So only experience really can assist you?
Participant 7:
In my opinion, yes, the literature is helpful but I think only experience is the best help.
Interviewer:
So when you got to sensitive topics did training help you with dealing with sensitive topics?
Participant 7:
No it wasn’t from training it had to be my own comfort to ask the question and hide my anxiety around asking the questions around sensitive.
Interviewer:
So were you anxious to ask around sexual functioning, sexual history?
Participant 7:
I must say the first two clients I saw at the clinic were child clients so I definitely had to avoid that, the third one was an adult and this was the first time I had to ask this question. I was hiding my anxiety and listening to what was being said.
Interviewer:
And why did you feel that anxiety around asking specifically sexual history?
Participant 7:
199 I think because it’s not a topic you discuss with just anyone and being a new clinician I didn’t have the confidence in order to ask that question without showing my anxiety. So now I’m more comfortable with it, I ask on a daily basis I feel more confident around questioning but I think it stems from my confidence as a clinician.
Interviewer:
So not in particular to your own challenges around sexuality or sexual issues, more around being a new clinician?
Participant 7:
Yes as a new clinician, I think that’s what it was.
Interviewer:
So actually having to speak about sexual history, sexual functioning, sexual health, that was never a problem?
Participant 7:
No that wasn’t the problem, even back then it wasn’t a problem it just was that I was a new clinician, I had to navigate the water in how to formally ask the question and some of the answers they were going to give to me.
Interviewer:
What were you afraid of, or what was it that created the anxiety in having to ask about that? What were you concerned about, asides that fact that you were a new clinician?
Participant 7:
I think the problem was that I didn’t have the right to ask the question back then, and also it was difficult to talk to someone that was brand new to me about something that is such an intimate part of their lives.
Interviewer:
But did you feel comfortable about speaking to them about suicidal thoughts, alcohol use, drug use, over counter medication?
Participant 7:
The only other one was asking around forensic history, had they had any prior arrests etc.
Interviewer:
But talking about suicidal thoughts that could also be seen to be quite intimate and quite personal?
Participant 7:
Yes probably it was intimate and personal but there was quite a psychological background as to why I was asking that question, so that was important to my work. So the forensic history of had they been arrested previously. Had they been sexually active in a normal sense... that had nothing really to do with my practise.
Interviewer:
So then it’s about understanding as to why questions are asked, as you said you found there was a psychological backing to why you were asking about suicidal ideation or alcohol abuse. So does that mean then... that you didn’t perhaps at the time see the importance or the relevance of asking around sexual functioning and sexual history?
Participant 7:
Thinking about that probably yes perhaps I wasn’t bound by the need to understand the sexual history in relation to their psychological functioning.
Interviewer: