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UBC Theses and Dissertations

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UBC Theses and Dissertations

Storying the impact of participating in a psychological treatment intervention for provoked vestibulodynia, 5 years later : a narrative inquiry Marsh, Adrienne


Provoked vestibulodynia (PVD) is the most common cause of coital pain in reproductive aged women who continue to experience significant barriers to accurate diagnosis and effective treatment. Psychological interventions have been accumulating research support as effective for improving pain symptoms and the well-documented negative psychological and sexual sequelae of PVD. Quantitative results from a recent RCT comparing eight-week group MBCT with group CBT (‘COMFORT study’) with 130 PVD-diagnosed women, showed both interventions significantly improved pain symptoms, sexual functioning, psychological and sexual distress, (Brotto et al. 2019). Research suggests individual women may benefit differently from change oriented therapeutic modalities like CBT or acceptance-based therapeutic modalities like MBCT, and that non-modality specific elements of program delivery may account for some of the documented positive impacts. There are few qualitative inquiries exploring how women with PVD experience their participation in psychological interventions or which aspects of programming they attribute to personal change. The current study used a narrative inquiry to provide insight into how 8 women experienced the COMFORT program and may be unique in providing their perspective more than 5 years after participation. Women storied their experiences via semi-structured interviews, with responses audio recorded, transcribed verbatim and constructed into eight narratives in collaboration with interviewees who provided feedback, edits and approval of the final versions presented here in full. Thematic analyses across cases revealed common themes related to the difficult journey to diagnosis and treatment, the painful disruption of symptoms to their identity, psychological and sexual functioning and intimate relationships, perceived benefits of participating, and suggestions for improving treatment for women with PVD. Women reveal how personal histories, beliefs, and individual, relational and cultural contexts impacted their treatment experiences, the benefits they attributed to participating, challenges they experienced before, during and after their participation and their ideas about what constituted treatment ‘success’. These narratives contextualize quantitative findings, may help to inform future empirical inquiries, provide information that may be useful in clinical contexts and lend further support to the importance of including qualitative research into treatment program evaluation and sexual health research more generally.

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