.................................................................................................................................. iv DEDICATION ............................................................................................................................... vi ACKNOWLEDGMENTS ............................................................................................................ vii LIST OF TABLES ....................................................................................................................... xiii LIST OF FIGURES ..................................................................................................................... xiv Chapter I: Introduction .................................................................................................................... 1 The Problem ................................................................................................................................ 2 Evidence-Based Practices (EBPs) ............................................................................................... 3 Trauma-focused Therapists and EBPs ........................................................................................ 6 Clinical Decision Making............................................................................................................ 7 Definition of Trauma ................................................................................................................... 9 Sexual Violence......................................................................................................................... 10 Trauma Intervention .................................................................................................................. 13 Statement of the Problem .......................................................................................................... 14 Purpose of the Study ................................................................................................................. 17 Research Questions ................................................................................................................... 19 Statement of Potential Significance .......................................................................................... 19 The Study .................................................................................................................................. 20 Data Collection .......................................................................................................................... 21 Theoretical Foundation ............................................................................................................. 22 Explication of Data.................................................................................................................... 25 Operational Definitions ............................................................................................................. 25 Summary ................................................................................................................................... 26 Organization of the Dissertation ............................................................................................... 27 Chapter II: Review of the Literature ............................................................................................. 29 Trauma History ......................................................................................................................... 32 Evolution of PTSD in the DSM ................................................................................................ 36 Current Perspectives on Evidence-Based Practices (EBPs) ...................................................... 39 Evidence-based Practice and Sexual Violence Interventions ................................................... 44 ix Trauma-focused Therapists ....................................................................................................... 46 Sexual Violence......................................................................................................................... 50 Interventions for Sexual Violence ............................................................................................. 52 EBPs and Cultural Factors ........................................................................................................ 53 Theoretical Perspectives ............................................................................................................ 54 Max van Manen’s Lived Existentials .................................................................................... 54 Phenomenology ..................................................................................................................... 55 Hermeneutic Phenomenology................................................................................................ 57 Bioecological Model of Human Development ...................................................................... 57 Integrative Systemic Approach to Trauma (ISAT) ............................................................... 58 Risk and Protective Factors Related to EBPs ........................................................................ 59 Summary ................................................................................................................................... 61 Chapter III: Methods ..................................................................................................................... 63 Introduction ............................................................................................................................... 63 Theoretical Framework ............................................................................................................. 63 Purpose of the Study ................................................................................................................. 67 Research Design ........................................................................................................................ 68 Qualitative Investigation ........................................................................................................ 69 Sample ................................................................................................................................... 70 Data Collection and Explication ............................................................................................... 71 Individual Semi-Structured Interviews .................................................................................. 71 Instrumentation.......................................................................................................................... 74 Researcher as Instrument ....................................................................................................... 74 Data Analysis ............................................................................................................................ 76 Examining Trauma-Focused Therapists Experiences ........................................................... 77 Ethical Considerations............................................................................................................... 79 Limitations ................................................................................................................................ 79 Trustworthiness of the Data and the Role of the Researcher ................................................ 80 Summary ................................................................................................................................... 81 Chapter IV: Research Findings ..................................................................................................... 83 Introduction ............................................................................................................................... 83