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Also discussing the expectations of appropriate behaviour so that there are no boundary violations.) /Pg 7 0 R /K [20] >> endobj 43 0 obj << /Type /StructElem /S /H1 /T (mbodied Communication) /E (mbodied Communication) /Pg 7 0 R /K [21] >> endobj 44 0 obj << /Type /StructElem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g 7 0 R /K [22] >> endobj 45 0 obj << /Type /StructElem /S /H1 /T (tructural Frames) /E (tructural Frames) /Pg 7 0 R /K [23] >> endobj 46 0 obj << /Type /StructElem /S /H6 /T (Institutional discourses, constraints, and protocols should be modified so that they do not threaten the feeling of safety and foster the negotiation of safety. Stigma should be addressed. ) /E (Institutional discourses, constraints, and protocols should be modified so that they do not threaten the feeling of safety and foster the negotiation of safety. Stigma should be addressed. ) /Pg 7 0 R /K [24] >> endobj 47 0 obj << /Type /StructElem /S /Figure /P 14 0 R /Pg 7 0 R /K [49] >> endobj 48 0 obj << /Type /StructElem /S /Figure /P 14 0 R /Pg 7 0 R /K [50] >> endobj 49 0 obj << /Type /StructElem /S /P /E (01) /Pg 7 0 R /K [0] >> endobj 50 0 obj << /Type /StructElem /S /H3 /T (Aim/Research Question) /E (Aim/Research Question) /Pg 7 0 R /K [1] >> endobj 51 0 obj << /Type /StructElem /S /H6 /T ( This review aims to synthesize qualitative research and answer the following research question: How is safety negotiated in the therapeutic alliance for both service providers and clients who are experiencing trauma-related distress in an inter-cultural context?) /E ( This review aims to synthesize qualitative research and answer the following research question: How is safety negotiated in the therapeutic alliance for both service providers and clients who are experiencing trauma-related distress in an inter-cultural context?) /Pg 7 0 R /K [2] >> endobj 52 0 obj << /Type /StructElem /S /P /E (02) /Pg 7 0 R /K [3] >> endobj 53 0 obj << /Type /StructElem /S /H3 /T (Method) /E (Method) /Pg 7 0 R /K [4] >> endobj 54 0 obj << /Type /StructElem /S /H6 /T (A pre-planned search of five databases \(Embase, MEDLINE, CINAHL, PsycINFO, and Applied Social Sciences Index\) was conducted on June 2021 and updated on June 2022. This search consisted of free-text keywords along with database-specific subject headings related to the concepts of trauma, therapeutic alliance, and qualitative research. Meta-ethnography was used to synthesize the findings of qualitative studies \(Noblit & Hare, 1988\).) /E (A pre-planned search of five databases \(Embase, MEDLINE, CINAHL, PsycINFO, and Applied Social Sciences Index\) was conducted on June 2021 and updated on June 2022. This search consisted of free-text keywords along with database-specific subject headings related to the concepts of trauma, therapeutic alliance, and qualitative research. Meta-ethnography was used to synthesize the findings of qualitative studies \(Noblit & Hare, 1988\).) /Pg 7 0 R /K [5] >> endobj 55 0 obj << /Type /StructElem /S /P /E (03) /Pg 7 0 R /K [35] >> endobj 56 0 obj << /Type /StructElem /S /H3 /T (Results) /E (Results) /Pg 7 0 R /K [36] >> endobj 57 0 obj << /Type /StructElem /S /H6 /T (16 studies were selected. Both traumatic distress and safety were experienced and managed through a web of relationships. Providers often mirrored the traumatic distress of their clients when they empathetically engaged with them in trauma therapy. The fear, suspicion, and stigma accompanying this distress created tensions regarding the internal and external boundaries of both providers and clients. Specific strategies used to bridge cultural differences created further boundary tensions around cultural and role conflicts. An adequate negotiation of these boundary conflicts fostered the feeling of safety in therapy. However, the structural frames of therapy, institutions, and larger society often hindered this process in the alliance.) /E (16 studies were selected. Both traumatic distress and safety were experienced and managed through a web of relationships. Providers often mirrored the traumatic distress of their clients when they empathetically engaged with them in trauma therapy. The fear, suspicion, and stigma accompanying this distress created tensions regarding the internal and external boundaries of both providers and clients. Specific strategies used to bridge cultural differences created further boundary tensions around cultural and role conflicts. An adequate negotiation of these boundary conflicts fostered the feeling of safety in therapy. However, the structural frames of therapy, institutions, and larger society often hindered this process in the alliance.) /Pg 7 0 R /K [37] >> endobj 58 0 obj << /Type /StructElem /S /P /E (04) /Pg 7 0 R /K [38] >> endobj 59 0 obj << /Type /StructElem /S /H3 /T (Limitations) /E (Limitations) /Pg 7 0 R /K [39] >> endobj 60 0 obj << /Type /StructElem /S /P /P 77 0 R /E (Limited Geographic Scope: Most studies were conducted in high-income countries, restricting the generalizability of findings.) /Pg 7 0 R /K [40] >> endobj 61 0 obj << /Type /StructElem /S /P /P 78 0 R /E (Lack of Parent-Mediated Alliance Data: There was insufficient in-depth research on parent-mediated alliances, hindering synthesis of insights.) /Pg 7 0 R /K [41] >> endobj 62 0 obj << /Type /StructElem /S /P /P 79 0 R /E (Potential for Bias in Research Focus: Focusing solely on results sections risked overlooking crucial contextual and methodological information.) /Pg 7 0 R /K [42] >> endobj 63 0 obj << /Type /StructElem /S /P /P 80 0 R /E (Excluded Important Cases: The exclusion of case reports \(like those on traumatic amputation\) resulted in a gap in the available data.) /Pg 7 0 R /K [43] >> endobj 64 0 obj << /ca 1 /BM /Normal >> endobj 65 0 obj << /CA 1 /ca 1 /LC 1 /LJ 0 /LW 2 /ML 4 /SA true /BM /Normal >> endobj 66 0 obj << /ca .4 /BM /Normal >> endobj 67 0 obj << /ca .302 /BM /Normal >> endobj 68 0 obj << /ca .502 /BM /Normal >> endobj 69 0 obj << /Type /ExtGState /ca 0.0 >> endobj 70 0 obj << /Length 293 /N 3 /Filter /FlateDecode >> stream x}JԂ(28hiRpi"VSAOHStspu+.c(#ARx@?F[V[G@`*dK$O.K o@6`O,f'˘O asx0A6vf 8{c7%opZ:u Q 0Q٣F *Ԑ(SDGACAajgrx]s PxM cvhO> endobj 72 0 obj << /Type /Font /Subtype /Type0 /BaseFont /BAAAAA+SpaceMono-Regular /Encoding /Identity-H /DescendantFonts [83 0 R] /ToUnicode 84 0 R >> endobj 73 0 obj << /Type /Font /Subtype /Type0 /BaseFont /CAAAAA+Barlow-Medium /Encoding /Identity-H /DescendantFonts [85 0 R] /ToUnicode 86 0 R >> endobj 74 0 obj << /Type /Font /Subtype /Type0 /BaseFont /DAAAAA+Barlow-Regular /Encoding /Identity-H /DescendantFonts [87 0 R] /ToUnicode 88 0 R >> endobj 75 0 obj << /Type /Font /Subtype /Type0 /BaseFont /EAAAAA+Barlow-Bold /Encoding /Identity-H /DescendantFonts [89 0 R] /ToUnicode 90 0 R >> endobj 76 0 obj << /Type /StructElem /S /L /P 14 0 R /K [91 0 R 92 0 R 93 0 R 94 0 R] /Pg 7 0 R >> endobj 77 0 obj << /Type /StructElem /S /LBody /P 91 0 R /K [60 0 R] >> endobj 78 0 obj << /Type /StructElem /S /LBody /P 92 0 R /K [61 0 R] >> endobj 79 0 obj << /Type /StructElem /S /LBody /P 93 0 R /K [62 0 R] >> endobj 80 0 obj << /Type /StructElem /S /LBody /P 94 0 R /K [63 0 R] >> endobj 81 0 obj << /Type /Font /FontDescriptor 95 0 R /BaseFont /AAAAAA+SpaceMono-Bold /Subtype /CIDFontType2 /CIDToGIDMap /Identity /CIDSystemInfo 96 0 R /DW 612 >> endobj 82 0 obj << /Length 352 /Filter /FlateDecode >> stream x]݊0l/Ii "[a> 1·_-w39$si > endobj 84 0 obj << /Length 300 /Filter /FlateDecode >> stream x]Qj0+dI0C8ԲX&Ѓef43>Fa F34{X&Xo(zh=>5q]7)Vf`0X꬚5E,`Ǹzm[; d]qޜUP|A&Q7z48Vch]B3sr]:݆ޖP!EPP%$'HI_ޣ|d$EIoG$RR-${"DTDRB[?[[eCkbZc2Di?ŵ|NJ endstream endobj 85 0 obj << /Type /Font /FontDescriptor 99 0 R /BaseFont /CAAAAA+Barlow-Medium /Subtype /CIDFontType2 /CIDToGIDMap /Identity /CIDSystemInfo 100 0 R /W [0 [438 0 0 200 630] 16 [624 607] 22 [618 0 0 0 598] 36 [565 606 0 0 645 0 260] 50 [584 0 570] 57 [708 668] 63 [622] 73 [593 0 0 613 0 0 588 0 0 0 574 0 0 641] 118 [517] 130 [547 526] 136 [547 0 0 0 538] 150 [367 543 0 0 542 0 251] 166 [240 512 238] 173 [826 542] 179 [555] 189 191 552 192 [371 0 0 488] 200 [369 0 0 538] 219 [491 743] 225 [499 476] 231 [451] 364 [566 343 544 0 0 0 523 0 527 525] 411 [271 264 348] 418 [482] 432 [400] 442 [163] 490 [677] ] /DW 291 >> endobj 86 0 obj << /Length 491 /Filter /FlateDecode >> stream x]͎0<3B2$QyNE޾7HϾ?'6C;egwN'foOuql^=}Oqb3}]֨ry=(gweoŧǶ7vƣfD2n_Ǜe1} u??>_f$P3od68fU}Y7w$H;__fD)Q* ʈd*@$J$HBMA=QZe!2K2̠% Zr" T,SAuAeMKC]-rt0 DN$D@. 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