Case 3

A 32-year-old female Air Force sergeant, who works as a mental health technician, experienced and reported an episode of military sexual trauma. At the beginning of treatment, she is assigned a male clinician but makes it clear that she would prefer working with a female clinician. The only female provider in the clinic has limited experience treating PTSD and is not trained in an evidence-based psychotherapy.

3.1: In the course of treating individuals with sexual trauma, the most ethically defensible decision regarding this situation is to:

A. Defer to the patient’s request, because helping the patient feel that she has regained control over her life is of the utmost importance in treating trauma.
B. Explain to the patient that your credentials make you fully qualified to manage her care and that the female provider is not trained in evidence- based psychotherapy.
C. Discuss with the patient the risks and potential benefits of attempting to work together for a predetermined period of time.
D. Defer to the clinic manager to make the decision.
E. Use your best judgment as an experienced clinician.

3.2: Continuing with a male provider could potentially retraumatize the patient. Alternatively, working with a male provider could be beneficial by enhancing the patient’s capacity to manage her fear of men. Which of the following is the best answer regarding this scenario?

A. Assume that the experience of working with a male provider as a form of exposure will be beneficial for the patient.
B. Support the patient’s choice of a female provider, even though the female provider is not certified in an evidence-based psychotherapy.
C. Given that provider gender is not specifically validated in research on exposure therapies, the provider should not consider this “exposure” as something that could help the patient.
D. Discuss with the patient the risks and potential benefits of working with a male provider who has training in evidence-based psychotherapy.
E. Inform the patient that your facility does not support requests that could be considered gender biased.