{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:53:07Z","timestamp":1781484787041,"version":"3.54.1"},"reference-count":53,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Mental Health & Substance Use (MHSU), Island Health, Vancouver Island, BC, Canada"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Complex relational trauma (CRT) occurs in close relationships where adversity is prolonged, repeated and inescapable. Despite the known connections between CRT and adverse health outcomes, anecdotal reports from survivors indicate that education on CRT is not translating into more effective clinical practice, resulting in substandard and even harmful experiences of healthcare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a patient-oriented research methodology, we recruited N = 13 participants with CRT from Canada and the United States. The sample was primarily female (N = 9), with a range of ages (20-69 years) and races\/ethnicities. Participants completed a demographic questionnaire and participated in an individual qualitative healthcare interview. Data were analyzed using a hybrid inductive\/deductive thematic analysis using NVivo 15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In terms of both mental and medical healthcare, similar themes emerged, including structural and financial barriers to care, experiences of invisibility, invalidation, and re-traumatization, identification of factors that supported safety, trust, and disclosure, as well as a need for specialized understanding of CRT as distinct from PTSD. Meta-themes that emerged included a need for practitioners to better understand the intersection of physical and mental health concerns in persons with CRT, as well as more integrative and holistic care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>People with CRT report that they are not currently being well served in the healthcare system. Future research should ascertain providers\/trainees\u2019 knowledge and skill base regarding CRT, which can inform on opportunities for further education. Findings also suggest that survivors would benefit from efforts to address siloed care, which undermines effective pathways to health and well-being in survivors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00469580261453985","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:29:58Z","timestamp":1781242198000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Minding the Gap: Complex Relational Trauma Survivors\u2019 Experiences Navigating Healthcare"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2439-4425","authenticated-orcid":false,"given":"Colette M.","family":"Smart","sequence":"first","affiliation":[{"name":"University of Victoria"},{"name":"Island Health, Vancouver Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell L.","family":"Gaudry","sequence":"additional","affiliation":[{"name":"University of Victoria"},{"name":"New School for Social Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nika","family":"Marefat","sequence":"additional","affiliation":[{"name":"University of Victoria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Herod","sequence":"additional","affiliation":[{"name":"Out of the Storm, Online Complex Relational Trauma Forum"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Lazar","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malachi","family":"Gillihan","sequence":"additional","affiliation":[{"name":"California Institute of Integral Studies"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_3_9_2_2","volume-title":"Trauma and Recovery: The Aftermath of Violence\u2014From Domestic Abuse to Political Terror","author":"Herman J","year":"1992","unstructured":"Herman J. 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