(090) “A GIFT TO MY WORK AND MY CLIENT”: CLINICIAN ATTITUDES TOWARD THE TRIADIC MODEL MODALITY IN SURROGATE PARTNER THERAPY
Introduction The Triadic Model is an ongoing professional relationship between a clinician, client, and surrogate partner. In surrogate partner therapy (SPT), a surrogate partner is a professional who helps clients overcome challenges to emotional and physical intimacy by encouraging somatic self-awareness, teaching communication and relationship skills, and utilizing contextualized touch which can work up to and including erotic contact. Using the Triadic Model, both professionals individually work with the client and routinely collaborate to discuss the course of treatment. Previous research has shown clinicians have hesitation regarding SPT due to knowledge deficit around treatment, perceived lack of legality, and stigma surrounding SPT (Denton, 2018; AASECT, 2014). Surrogate partners have previously indicated that the success of SPT, ultimately driven by their complex and dynamic work with clients, would not be possible without the framework of the Triadic Model (Bechtold, 2020). Leaders in sex therapy have called for more research to better inform clinicians about the importance of these treatment options and their potential to benefit clients. Objective The current study investigates how the Triadic Model is situated within the discipline of clinical therapy. Specific objectives include identifying clinicians’ attitudes towards the Triadic Model and what barriers limit its utilization. Methods In 2024, an international questionnaire surveyed clinicians regarding their perspectives on working collaboratively with surrogate partners. Respondents were provided with definitions of “surrogate partner” and “the Triadic Model” before being asked to describe their thoughts and feelings about this therapeutic option. In the current study, responses were thematically coded with specific attention to whether participants expressed positive, negative, or mixed attitudes toward the Triadic Model, and if so, what reasons they discussed. The positive and negative reasons within mixed-attitude responses were identified and analyzed together with the purely positive and purely negative responses, respectively. Results Respondents (N = 134) expressed purely positive attitudes (49%), mixed attitudes (40%), purely negative attitudes (8%), and neutral/unspecified attitudes (3%). The most prevalent rationales among positive attitudes (n = 119) included the Triadic Model’s effectiveness (32%; ie, perceived client benefits) and usefulness (27%). Many positive attitudes were expressed with unspecified reasons (26%). Other rationales mentioned limits to talk therapy (8%) and a holistic approach (7%). Among negative attitudes (n = 64), the most prevalent themes were legal/regulatory concerns (30%; ie, legal ambiguity, lack of protections, lack of licensure for surrogate partners) and financial/geographic barriers (28%; these are linked due to the cost of travel). Other themes among negative attitudes were ethical/safety concerns (16%), lack of personal knowledge/training (9%), cultural stigma (6%), limited clinical applications (5%), client apprehension (3%), and unspecified reasons (3%). Conclusions Our results suggest that while many clinicians have positive attitudes toward the clinical value of SPT, there are still barriers that may prevent its widespread use. While some of the barriers we identified reflect previous findings, financial and geographic barriers may be more of a factor than previously indicated. As with most forms of sexual healthcare, our data highlight the need for more equitable structures at institutional, state, and national levels to support an accessible availability of surrogate partners working in the Triadic Model. Disclosure No.
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