I n a p p r o p r i a t e S exual B e h a v io u rs E x p e rie n c e d by S p e e c h -L a n g u a g e P a th o lo g ists and A u d io lo g is ts in S o u th A frica 5 INAPPROPRIATE SEXUAL BEHAVIOURS EXPERIENCED BY SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS IN SOUTH AFRICA K a ren Levin and L o ren T ra u b S peech P ath o lo g y and A u d io lo g y U n iv ersity o f the W itw ate rsra n d a b s t r a c t The exp erien c e o f in a p p ro p ria te s e x u a l b eh a vio u rs (ISB) b y h ea lth ca re p ro fe s s io n a ls has b een id e n tifie d in te rn a tio n a lly as a se rio u s is­ sue. This s tu d y in v estig a ted the ex te n t o f IS B d ire c te d to w a rd s s p e ec h -la n g u a g e p a th o lo g ists a n d /o r a u d io lo g ists (SLP /A s) in S o u th A f­ rica. as w ell as th e so u rces a n d th e effects o f ISB, th e re sp o n ses o f th e SL P /A s, a n d th e p e r c e p tio n s o f th e S L P /A s with r e g a rd to th eir a b ilitv to m a n a g e IS B experiences. F ifty -six q u a lifie d S L P /A s a n d 62 stu d e n t S L P /A s c o m p le te d a q u estio n n a ire b a se d on sim ila r stu d ies co n d u c te d in C anada a n d N ew Zealand. M o st o f the resp o n d en ts h a d e x p e r ie n c e d ISB, m o stly o f a m ild to m o d era te nature, at s o m e p o in t in th eir careers, a n d so m e h a d ex p e rie n c e d se v e re IS B in the w orkplace. IS B o c c u rre d in a va riety o f w o r k contexts. The so u rc es o f IS B in c lu d ed clients a n d /o r th eir fa m ily m em bers, as w ell as c o llea g u e s a n d em ployers. A ra n g e o fp e r s o n a l a n d w o r k -re la te d effects re su lte d a n d th e re sp o n d en ts to o k the le a st a sse rtiv e strategy' in th e m a n a g em en t o f th e ir IS B exp erien ces. The re su lts re fle c te d that S L P /A s in S outh A fric a are p o o r ly in fo rm e d w ith re g a rd to th e ir leg a l rights a n d resp o n sib ilities, as w ell as stra teg ie s to d ea l w ith u n w a n ted se x u ­ a lly re la te d experiences. IS B o u g h t to b e r e co g n ise d as a se rio u s issue in c lin ic a l p r a c tic e in South A frica by SLP/As, p r o fe ss io n a l bodies as w ell as tra in in g institutions. The results a re in line with p re v io u s resea rch on IS B exp erien ces b y S L P /A s a n d o th e r h ea lth ca re p r o fe s ­ sionals. Key w ords: sexual h arassm en t; sp eech p ath o lo g y and au d io lo g y ; p ro fe ssio n a l-p atie n t relatio n sh ip s IN T R O D U C T IO N S exual h ara ssm e n t is a u b iq u ito u s p h en o m en o n th at p e r­ vades all lev els o f society. N o tw ith stan d in g w id e ran g in g deb ates on sexual harassm en t, the d efin itio n is b ro ad and co n tro v ersial b ecau se the ex p erien ce is p erso n al and in d iv id u alised . T he S outh A frican L ab o u r R elatio n s A ct o f 1995, section 2 03(2) o f the D e­ p artm en t o f L ab o u r (1 9 9 5 ) d efin es sexual h ara ssm e n t as u n ­ w anted co n d u ct o f a sexual nature w hich is p ersisten t (alth o u g h a single in cid en t o f h arassm en t can c o n stitu te sexual h arassm en t). A cco rd in g to the A ct, the b eh a v io u r can only be d ee m e d as h a r­ assm ent i f the recip ien t has m ade it clear th at the b e h a v io u r is co n sid ered offensive. In ad d itio n , cen tral to the A ct is the co n d i­ tion th at the p eip etrato r should have kn o w n th at th e b eh a v io u r is regarded as un accep tab le. In co n trast, the U n ite d S tates E qual E m ploym ent O p p o rtu n ity C o m m issio n (1980) w ith in the Civil Rights A ct o f 1964 (E E O C ) reco g n ises that the p erp e tra to r m ay be co m p letely u n aw are th a t his o r h er b eh a v io u r is o ffen siv e or co n stitu tes sexual h ara ssm e n t or m ay be co m p letely u n aw a re that his or h er actio n s co u ld be u n law fu l, and fu rth erm o re, the E E O C reco g n ises th a t it m ay not be p o ssib le for the rec ip ien t to express in an y w ay that the b eh a v io u rs are unw elcom e. A s w ell as the d ifficu lties inherent in fo rm alised d e fin i­ tions o f sexual harassm en t, b lu rrin g o f b o u n d arie s o ccurs in p e r­ sonal exp erien ce and p erc ep tio n s in th at u n w an ted sexual b eh a v ­ iours are n o t alw ays co n stru ed by the recip ien t as being o f a h a r­ assin g nature (W illiam s, de S eriere & B o d in g to n , 1999). In re c ­ og n itio n o f the alien atin g and ju d g e m e n ta l im p licatio n s o f the term ‘h a ra ss m e n t’, M cC o m as, H erb ert, G iaco m in , K aplan & D ul- berg (1 9 9 3 ) used the term ‘in ap p ro p ria te p atien t sexual b e h a v ­ io u rs’ in th e ir in v estig atio n o f the ex p erien ce o f in ap p ro p riate sexual b eh av io u rs (IS B ) b y p h y sio th erap ists in C anada. T heir findings, as w ell as th o se o f W illiam s et al. (1 9 9 9 ) in N e w Z ea­ land w ho id e n tified the ex p e rien c e o f ISB b y sp e ec h -la n g u ag e p ath o lo g ists, co n firm e d th at reh a b ilita tio n th e rap ists do not a l­ w ays c o n stru e the exp erien ce o f ISB as sexual harassm en t. T he ab sen ce o f a un iv ersal d efin itio n is ev id en t in the vast literatu re th at d eb ates te rm in o lo g y an d sem an tics in sexual h arassm en t and also in in tern atio n al legal texts and d ep o sitio n s w hich lack c o n ­ sisten cy an d agreem ent. In the ab sen ce o f a u n iv ersal d efin itio n , m o d els o f sexual h ara ssm e n t can help to clarify the b o u n d aries b etw e en w hat is ac ce p ta b le and w h at is u n ac ce p ta b le, w hich h elp s to d eterm in e p erc ep tio n s o f h arassm en t (M cC o m as et al., 1993). O n e o f the m o st c o m m o n ly u sed m odels d ifferen tiates ‘q u id pro quo h ara ss­ m e n t’ from ‘h o stile en v iro n m en t h a ra ss m e n t’. Q uid pro quo h a r­ assm en t in v o lv es a p erso n in a su p erio r p o sitio n u sin g sexual h ara ssm e n t as an ex p ressio n o f p o w er to achieve his or h er aims. In co n trast, h o stile e n v iro n m en t h arassm en t o ccurs w hen an equal p eer en g ag es in sexual b eh a v io u rs th at create a h o stile en v iro n ­ ment. T his d iffe ren tia tio n is reflected in the d efin itio n s p ro v id ed b y the S o u th A frican L ab o u r R elatio n s A ct (D e p artm e n t o f L a­ bour, 1995), th e E E O C (1980), as w ell as the C o m m o n w ealth Sexual D isc rim in atio n A ct (1 9 8 4 ) w hich co n stitu tes fed eral law in A ustralia. M cC o m as et al. (1 9 9 3 ) m ade use o f a sim ilar m odel in th e ir stu d y in C an ad a w hich ex am ined the ex ten t and n atu re o f ISB d irec ted at p h y sio th erap ists. T h ey co n clu d ed th at m o st ISB w'as d irec ted b y equal peers, or n o n -su p erio rs, and thus fell into th e categ o ry o f h o stile e n v iro n m en t harassm en t. H ow ever, th eir resp o n d en ts d id no t identify- th e ir ex p e rien c es o f ISB as h ara ss­ m ent. T h e ex p erien ce o f b o th q u id p ro quo h arassm en t as w ell as h o stile en v iro n m en t h arassm en t has been reported w id ely by h ealth care p ro fe ssio n a ls in tern atio n ally , such as nurses (H en d erso n , 2003; M adison & M in ich ie llo , 2001; T ang, Y ik, C h eu n g , C h o i & A u, 1996); p h y sio th erap ists (M cC o m as et al., 1993; O ’S ullivan & W eerak o o n , 1999); p h arm acists (B ro ed el- Z augg, S haffer, M aw er & Sullivan, 1999); and m edical doctors (R ecu p ero , H eru, Price, & A lves, 2004; V u k o v ich , 1996). R e­ search ers estim ate that alm o st one in every tw o w o m en ex p e ri­ The South African Journal o f Communication Disorders, Vol. 53, 2006 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 6 Karen Levin and Loren Traub ence ISB at some point in their working lives (Fitzgerald, 1993; Gutek, 1985). A study conducted by the Institute o f Directors in 1992 estim ated that 76% o f South African women experience ISB in the workplace (Vetten, 2001). Therefore the professions o speech pathology and audiology, which are predom inantly ema e professions in South Africa, cannot ignore ISB as a professiona issue because the experience o f ISB poses a serious n s k to both the emotional and physical w ell-being o f a person (Schneider Swann & Fitzgerald, 1997). However, despite the fem in.sation o f some professions such as speech pathology and audiology Roth- stein (1993) in his com m entary on M cComas et al. s (1993) study argued that ISB should be viewed as a professional issue, and cited B ruckner (1993) who argued that ISB is n ot prim arily a w om en’s issue. The experience o f ISB is a serious professional issue b e­ cause o f the extent o f the harm that it can cause (M cCom as et al., 1993). Some theorists, particularly w ithin the psychological as opposed to the legal paradigm , argue that the consequences, rather than the intentions, are the determ ining factors in the defi­ nition o f harassm ent (Fitzgerald, 1993; G utek & Koss, 1993; M adison & M inichiello, 2001). The consequences o f the experi­ ence o f ISB, whether the person defines the experience as harass­ ment or not, include a range o f negative effects in the workplace, such as decreased m orale, increased absenteeism , decreased job satisfaction, jo b loss, and deteriorating relationships with co­ workers (Schneider et al., 1997). Furthermore, the experience o f ISB often has a serious effect on peo p le’s physical and emotional health and the more severe the ISB the m ore severe the reactions (G utek & K oss, 1993; Schneider et al., 1997). The reactions re­ ported by both m en and wom en who have been the recipients o f ISB include anxiety, depression, sleep disturbance, w eight loss or gain, loss o f appetite, headaches, feelings o f frustration, fear, an­ ger, em barrassm ent, shock, alienation, and loss o f self-esteem (M cCom as et al., 1993; Schneider et al., 1997). A ccording to Schneider et al. (1997), ISB m ay lead to sym ptom s o f post- traumatic stress disorder. They wrote that people who experience sexual harassment exhibit sim ilar psychological effects as victims o f trauma. Furtherm ore, people who have experienced ISB in the workplace are likely to experience it on an on-going basis rather than as an isolated incident. R othstein’s (1993) view o f ISB as a professional issue provided a lens through w hich the m anagem ent o f the experience o f ISB m ay be viewed. The healthcare practitioner’s experience o f ISB results from m ultifaceted interactions o f a com plex array o f factors including personal, environm ental, and societal influ­ ences, underscored by their role as professionals. This role begins in education and a num ber o f studies have show n that student health care professionals are at risk for experiencing high levels o f ISB (M cCom as et al., 1993; Recupero et al., 2004; Vukovich, 1996; W illiam s et al., 1999). ISB that is experienced in the w ork­ place o f the healthcare professional m ay be influenced by the setting, the nature o f the work, as well as the clients. The settings in w hich healthcare professionals’ w ork place them at risk for the experience o f ISB, are places such as consulting rooms, quiet audiology booths, and hospital wards. Close physical contact is necessary in m any aspects o f healthcare. Healthcare workers m ay provide-a sym pathetic ear to clients and/or their caregivers and fam ily members, and transference is a w ell-docum ented phe­ nom enon in healthcare provision. Sexual control problem s may be experienced b y the clients served by healthcare professionals, such as patients with brain injury (Bezeau, Bogod & Mateer, 2004; Lawrie & Jillings, 2004; Philips & Schneider, 1993), and severe learning disabilities (M urphy, 2003). Recently, m odels for effective m anagem ent o f ISB with people who have sexual behav­ iour control issues have been described in the literature (B ezeau et al., 2004; Lawrie & Jillings, 2004). ISB was identified as a serious professional issue in speech-language pathology by W illiam s et al. (1999) who investi­ gated the experiences o f ISB by mem bers o f the N ew Zealand Speech-Language T herapists’ A ssociation as well as third and fourth year students studying speech-language pathology. W il­ liam s et al. did not include audiologists in their study. M ore than tw o-thirds o f the students and alm ost 85% o f the qualified speech- language pathologists reported at least one experience o f ISB. The current study was designed to determine the experiences o f ISB directed to SLP/As in South A frica because variables that impinge on professional practice m ay differ in different geo-political con­ texts. M ETH O D O LO G Y Aim s The prim ary aim o f this study was to investigate the extent and nature o f the experience o f ISB b y qualified speech-language pathologists and audiologists (SLP/A) as well as students studying speech-language pathology and/or audiology in South Africa. The study aim ed to determ ine (a) the extent o f SLP/As experience with ISB; (b) the type o f IS B encountered; (c) the sources o f ISB in their w orkplace (d) SLP/As perceptions o f the consequences o f their ISB experiences, (e) the strategies em ployed by SLP/As to m anage their ISB experiences, and (f) SLP/As perceptions with regard to their preparedness to deal with ISB in the professional setting. Research design This study took the form o f a postal survey research design because the aim was to partially replicate the study conducted by W illiam s et a l.( l999) in N ew Zealand who adapted a question­ naire developed b y M Com as et al. (1993). A survey design was appropriate for this study because it allowed the researchers to access a large sample. The anonym ity assured by the design gave the respondents m ore opportunity to answer honestly questions w hich related to very personal inform ation on a sensitive topic (Babbie, 1995). One o f the disadvantages o f survey research is that the answers m ay be unreliable as a result o f m isunderstanding o f the question o r the irrelevance o f the question to the respon­ dents. Furtherm ore, the researcher has little control over when and w here the questionnaire is answered. The respondents m ay leave questions unanswered, not understand questions or not answ er the questionnaire in privacy. However, the survey had been used successfully by M cCom as et al. (1993) as well as W illiam s et al. (1999). E thical considerations The researchers were granted perm ission to conduct this research by the Ethics Com m ittee (Humanities) o f the U niversity o f the W itwatersrand. B ecause o f the sensitive nature o f some o f the questions that could evoke difficulties for the respondents, a list o f available counselling services was attached to the question­ naire. Included in the inform ation letter that was attached to each questionnaire was an assurance o f confidentiality and anonym ity o f the participants. The participants were inform ed that participa­ tion in this study was voluntary and that their com pletion o f the D ie Suid-Afrikaanse Tydskrif vir Kommunikasieafwykings, Vol. 53, 2006 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) Inappropriate Sexual Behaviours Experienced by Speech-Language Pathologists and Audiologists in South Africa 7 questionnaire was interpreted as their consent to participate in the study. They were asked to avoid including any identifying infor­ m ation in the questionnaire, and were asked to mail the responses in a sealed envelope directly to the researchers. Participants Participant Selection Criteria Participants were required to be SLP/As w orking in South A frica or SLP/A students at South African universities. The students were required to be in their third or fourth year o f study because they w ould have had contact w ith clinical w ork by this level o f study. Sam pling Q ualified SLP/As. A m ailing list o f all registered SLP/As was obtained through the South A frican Speech Language and Hearing A ssociation (SASLHA). Systematic sam pling was used to gain a representative sample from the larger population. This requires less time, and is cheaper and more practical than simple random sampling. H owever, it is not as accurate as simple ran­ dom sam pling and it m ay result in a cyclical order o f sampling, which m ay result in a biased sam ple (Babbie, 1995). A lthough this m ethod o f sam pling results in a sample o f convenience, the researchers were intent on surveying SLP/As nationally. The questionnaire was m ailed to 78 qualified SLP/As. Student SLP/As. The questionnaire was distributed to 262 students in the third and fourth year o f study at all South African universities that train SLP/As. R esponse rate Q ualified SLP/As. According to Babbie (1995), a 50% response rate for postal surveys allows for adequate analysis and provides an accurate representation o f the subjects. Fifty-six questionnaires were returned by qualified SLP/As, w hich yielded a response rate o f 71.7%. This high response rate implies that the respondents had an interest in this topic and alludes to the im por­ tance o f the experience o f ISB in clinical practice in South Africa. A ll o f the responses received were from female SLP/As. It is po s­ sible that no male SLP/As received a questionnaire as a result o f the sam pling procedure w hich did n ot take into account the few male SLP/As in South Africa. The lack o f inform ation with re ­ gard to the experiences o f male SLP/As in South A frica is an im portant lim itation o f this study, given the num ber o f studies that have dem onstrated that male health care workers experience ISB (Broedel-Zaugg et al., 1999; M adison & M inichiello, 2001; M cCom as et al., 1993). ; Student SLP/As. Sixty-two questionnaires were returned by student SLP/As w hich yields a response rate o f 23.6 %. All the universities that were included in the survey were represented in the sample. The low return rate renders the data unrepresenta­ tive o f the student population and therefore leads to difficulties in the interpretation o f the results. It is possible that the students had not been exposed to any o f the behaviours targeted in this study. Alternatively, perhaps the poor response rate was due to the fact that the survey was conducted at a particular time o f year in the university tim etable which included exam inations followed b y a vacation period. The researchers acknowledge that this poor return rate is a lim itation o f the study, and that the generalisability o f the results to the general student population is restricted. As w ith the qualified SLP/As all the respondents were female and thus the results can only be generalised to the female population o f student SLP/As. I D escription o f participants Fifty-six qualified SLP/As and 62 student SLP/As partici­ pated in the study. The dem ographic data o f the qualified SLP/As are sum m arised in Table 1. The qualified SLP/As ranged in age from 20-65 years, and in experience from new graduates to clini­ cians with more than 20 years experience. The participants w orked in a variety o f settings. The sam pling m ethod m ight have been inappropriate to some extent in that w ork contexts were n ot necessarily represented fairly. For example, only one respondent worked in a university setting. Fifty-seven o f the student SLP/As ranged in age from 20-24 years and five were betw een 26 and 30 years o f age. Sixteen students were in third year and 46 students w ere in fourth year. Table 1: Dem ographic D ata o f Q ualified SLP/As A ge in years N 2 0 -2 5 5 26-30 27 3 1 - 5 0 19 50+ 5 Y ears in practice N 0-5 18 6 - 1 0 12 1 1 -2 0 11 2 0 + 15 Place o f w ork N University 5 School 18 Hospital 16 Private Practice 2 0 Rehabilitation unit 5 Procedure Q uestionnaire Design W illiam s et al. (1999) adapted a questionnaire developed by M cCom as et al. (1993) who investigated ISB directed at physiotherapists in Canada. N either M cComas et al. nor W illiams et al. published their questionnaires, and thus the present re­ searchers developed a questionnaire based on the reports o f W il­ liams et al. and M cCom as et al. W orkplace settings w ere defined as they exist in South A frica as well as to accom m odate audiolo­ gists who were not surveyed by W illiam s et al. Additionally, the participants were asked to indicate whether they perceived the behaviour to be sym ptom atic o f the clien t’s condition. Hence, the current study was a partial replication o f W illiam s et al. The re­ searchers acknow ledge the lim itations im plied by a lack o f pilot­ ing the questionnaire w hich was the result o f time pressure to com plete the study. Although the researchers w ere aware that English is not the home language o f all SLP/As in the country, the questionnaire was produced in English only and home language was n ot a con­ sideration in the participant selection criteria. The reasons for this lim itation were the time and financial constraints im posed by the study. H owever, m ost o f the professional literature that is con­ sulted by SLP/As is in English, and therefore SLP/As are pre­ sum ed to have a fairly good reading com prehension level o f E ng­ lish. O f note is that five com pleted questionnaires had comments written in Afrikaans in the open-ended sections. The researchers The South African Journal o f Communication Disorders, Vol. 53, 2006 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 8 Karen Levin and Loren Traub acknowledge that the language o f the questionnaire m ight have lim ited the num ber and/or quality o f the responses. The inform ation letter that was attached to the question­ naire em phasised that the questionnaire pertained to the experi­ ence o f ISB in the workplace only. The questionnaire was pre­ sented with the topic o f the research as ‘The Experience o f Inap­ propriate Sexual B ehaviour in the W orkplace’, which served to rem ind the respondents that the survey was focussed on the workplace. The questionnaire consisted o f a total o f five sections, w hich included both open and closed type questions. N on- exhaustive categories were added to ensure that all possible re­ sponses were catered for (Babbie, 1995). This took the form o f “other” and “add any com m ents” . The first section consisted o f a set o f questions to deter­ m ine the biographical data o f the respondents. The information that was sought included gender, age, years o f experience or year o f study (for students) and place o f work. No inform ation was sought with regard to variables such as hom e language, cultural background, gender identity, race, or ethnicity because o f the scope o f the study. H owever, this information m ight have con­ tributed to the depth o f the analyses and the inform ation that was obtained. The second section consisted o f a set o f questions to determ ine the types o f ISB experienced by the participants. These took the form o f yes/no questions. This section was based on the questions published by W illiam s et al. (1999), w hich de­ scribed and classified ISB as mild, moderate, o r severe. The third section consisted o f a set o f questions to determ ine from whom the ISB was experienced as well as in w hich contexts it was ex­ perienced. The fourth section consisted o f a set o f open-ended questions to determ ine the effects on the participants as a result o f the experience o f ISB. The final section consisted o f a set o f closed-ended and open-ended questions to determ ine the various ways in which ISB was m anaged and what the respondents felt about training at an undergraduate level. One closed-ended ques­ tion asked respondents w hether they had know ledge about the law in South A frica regarding ISB. Respondents were invited to add any extra comments. (See appendix for copy o f the question­ naire). D istribution o f Q uestionnaire Q ualified SLP/As. M ost o f the questionnaires were sent by mail. Tw enty questionnaires were hand delivered to the par­ ticipants to reduce the postage costs. To ensure the participants’ confidentiality, the com pleted questionnaires were n ot personally collected by the researchers but were returned by mail. A ll ques­ tionnaires included a stamped, addressed return envelope. Student SLP/As. Questionnaires, along with the covering letters, were distributed to the SLP/A students at the U niversity o f the W itw atersrand in their private m ailing boxes at the univer­ sity by the researchers. The students were asked in the inform a­ tion letter that was attached to the questionnaire to place their sealed and com pleted questionnaires in a box allocated for this purpose. To ensure anonymity, they were asked to place the com pleted questionnaire in the envelope with which they had been provided and to seal it. For the students at the other univer­ sities, each head o f departm ent was m ailed a batch o f question­ naires, with a letter requesting that the questionnaires be distrib­ uted to all third and fourth year students. The inform ation letter to all students requested that the questionnaires should be m ailed directly to the researchers in the stam ped return envelope which was attached to the questionnaire. The questionnaire was analysed using descriptive statistics to summarise, organise and describe the data. Frequency counts were com pleted for each section o f the questionnaire, resulting in descriptive data that accounted for the frequency o f occurrence o f ISB, the effects o f the ISB, the contexts in which ISB was experi­ enced as well as the m anagem ent strategies that were employed. A broad thematic analysis was com pleted on the open-ended re­ sponses in line with the aims o f the study and the themes that were identified, as well as personal stories, were analysed to com ple­ m ent the quantitative data (Pidgeon & Henwood, 1996). M cCom as et al. (1993) categorised the severity o f ISB which resulted in their division o f the questions that they posed to their respondents into mild, m oderate and severe categories. Because the questions that were em ployed in the current study were almost identical to those used by M cCom as et al., severity o f the ISB was analysed as per their categories. The results o f the qualified SLP/As and student SLP/As were analysed separately because o f their possible differ­ ences with regard to age as well as clinical experience. Reliability and validity In order to control for the threat o f researcher bias and to enhance the reliability o f the analyses, a. second rater was em ­ ployed to analyse the responses (Babbie, 1995). The rater, a quali­ fied SLP/A, was fam iliar with the research topic, as well as the W illiam s et al. (1999) study. The rater was given access to the raw data first and subsequently read the researchers’ analyses o f the data. M ost o f the data was analysed quantitatively and was there­ fore indisputable. H ow ever the qualitative data, generated by the open-ended questions and com m ents that were m ade by the re­ spondents, were open to interpreter bias (Babbie, 1995). Further­ more, the qualitative data w ere used to support the interpretation o f the quantitative data. In order to control for researcher bias the rater and the researchers discussed how best to represent the re­ sults and w rite up the findings (Pidgeon & Henwood, 1996). RESULTS The results are presented in five sections as per the aim s o f the study. < I Severity and frequency o f the experience o f ISB I The experiences o f ISB were categorised as mild, m oderate or severe as per M cCom as et al. (1993). The data revealed that 55% o f the qualified SLP/As and 45% o f the student SLP/As had experienced ISB at least once in their professional lives. Tlie types and severity o f ISB experiences are reflected in Table 2. M ild ISB was experienced by 55% o f the qualified SLP/As and 42% o f the student SLP/As. W illiam s et al. (1999) reported that m ild ISBs were underreported because the SLPs did not con­ sider m ild behaviours to be offensive. It is possible that under­ reporting occurred in the present study. M oderate ISB was experi­ enced by 41% o f the qualified SLP/As and 16% o f the student SLP/As. Severe ISB was reported by 26% o f the qualified SLP/As and 8% o f the student SLP/As. The classification o f severity is an arbitrary one and in a w ay minimises the experiences in the m ild category and draws attention to those in the severe category. The questionnaire did not ask the respondents to rate the severity; perhaps this is a lim itation o f the categorisation strategy em ployed by M cCom as et al. A nalysis o f Data Die Suid-Afrikaanse Tydskrif vir Kommunikasieafwykings, Vol. 53, 2006 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) Inappropriate Sexual Behaviours Experienced by Speech-Language Pathologists and Audiologists in South Africa Table 2: R espondents’ R eports o f ISB E xperiences (in %) Q uestion Q ualified Student M ild ISB Have suggestive stories ever been told to you? Has an offensive jo k e ever been told to you? Have flattering rem arks about your appearance that m ade you uncom fortable ever been made? Have you been stared at in a w ay that made you uncom fortable? H ave you ever been asked for a date? Has anyone suggested that you ‘get together’ for a drink? M oderate ISB Have crude sexual rem arks been m ade to you? Have any attem pts been m ade to draw you into a discussion about your private sexual matters? Have you ever been propositioned (e.g. asked you to have sex with him or her)? Have you ever been deliberately touched (laid a hand on your bare arm or put an arm around your shoul­ ders) in a w ay that m ade you feel uncom fortable? Severe ISB Have you had genitals exposed to you? Have you had breasts exposed to you? Has anyone ever attem pted to fondle you (stroked your leg or neck, touched your breasts)? Has anyone ever made forceful attempts to touch you? H as anyone ever made forceful attempts to fondle you? Has anyone ever made forceful attempts to kiss you? Has anyone ever m ade forceful attempts to grab you? Has anyone ever m ade attem pts to have sexual intercourse with you? Has anyone ever used force to have intercourse with you? 7.1 8.9 12.5 14.2 14.2 3.5 7.1 5.3 1.7 16 5.3 0 5.3 1.7 1.7 3.5 3.5 3.5 1.7 12.9 29 32.2 17.7 6.6 0 3.2 6.4 0 11.2 1.6 3.2 3.2 3.2 0 3.2 1.6 3.2 3.2 The effects o f ISB The respondents experienced a variety o f physical and em o­ tional reactions to their experiences o f ISB as well as consequences in the work-setting. M ost o f the consequences that were reported were psychological, although the respondents experienced physical sym p­ toms as well. Some o f the consequences that were reported to have affected w ork perform ance were' serious, such as the resignation o f four SLP/As from their jobs. The; study did n ot determ ine whether the effects were long-lasting or not. I The frequency and nature o f these effects are presented in Table 3. j Sources o f ISB The findings show ed that 35% o f the qualified SLP/A s and 30% o f the student SLP/As reported that ISB was predom inantly di­ rected by clients, and o f these respondents, 28% o f the qualified SLP/ A s and 30% o f the student SLP/As perceived that the perpetrators m ight be expected to have sexual control difficulties due to their un­ derlying pathology. O ther sources o f ISB included the parents, spouses, and children o f the clients. P atient’s caregivers were reported to be the perpetrators o f ISB by 4.8% o f the student SLP/As. ISB was reported to have been perpetrated by em ployers and colleagues in senior positions by 8.9% o f the qualified SLP/As, and 5.3% o f the qualified SLP/As had experiences o f severe ISB directed at them by hospital porters. N one o f the student SLP/As reported having experi­ enced ISB from faculty w orkers or supervisors. Table 3: R espondents Reported Effects o f the Experience o f ISB Effects o f ISB Qualified SLP/As Student SLP/As W ork Perform ance D istraction 8.9 12.9 D ecreased m otivation 5.4 3 Resignation 7.1 Physical Stress 7.1 1Insom nia Fatigue 3.6 1 E m otional Stress Nervousness 17.9 17.7 . Doubt 7.1 1.6 G uilt 10.7 3.2 Em barrassm ent 0 14.5 S e lf consciousness 10.7 3.2 A voidance 8.9 19.4 Loss o f confidence 1.7 1.6 Feeling uncom fortable 14.3 22.6 Feeling anxious 7.1 3.2 The South African Journal o f Communication Disorders, Vol. 53, 2006 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 10 Karen Levin and Loren Traub i