Collage of Three People with SCI Speaking to the Camera.

(SCIRE logo appears on top right corner. In the center, words “Sexual Health and SCI” appear above the words “The PLISSIT Model.”)

(Collage of three people with SCI speaking to the camera.)

Male Narrator: People with SCI may or may not experience Sexual Health issues.

(Clinician listening to a man with SCI speak.)

But during various stages of recovery all clinicians can initiate a conversation regarding sexual health to ensure that a person’s full health needs are being met.

(An image of the PLISSIT Model of Sexual Functioning, an inverted triangle cut into four sections, is displayed. At the base, the biggest section of the triangle is named “Permission.” Going down the triangle, the second section is named “Limited Information,” the third section is named “Specific Suggestions,” and the last section, at the tip, is named “Intensive Therapy.”

The PLISSIT model represents the stages of questioning and intervention that all clinicians can use to help them address sexual health concerns responsibly and effectively.

The PLISSIT model takes into account the different levels of expertise and knowledge practitioners may have with regards to sexual health issues.

Some people with SCI may not need to move beyond information, especially during the early stages of their injury.

(Cut to scene of a nurse introducing a man with SCI to a “Pregnancy and Spinal Cord Injury” booklet.)

But for others, access to intensive therapy may be a high priority.

(The word “Permission” appears in bold, enumerated with a 1.)

The first step in addressing sexual health issues is to get permission to talk about it.

(Man with SCI speaking to a clinician.)

When first initiating a discussion about sexual health, having an open and normalizing demeanor can ease a person’s concerns and make it more possible for them to access specialized sexual health services if need-be.

You may say, “It is common for someone after a SCI to experience many physical changes, including their sexual responsiveness.”

(Cut to scene of a woman with SCI choosing her clothes.)

Or that “having questions about body image, attractiveness, or child bearing ability is normal.”

(A PLISSIT model appears with the “Permission” section filled with 6 people icons.)

At this level, almost any clinician working with SCI can provide the support and reassurance to allow for more information gathering or discovery.

(Return to scene of clinician introducing a booklet to a man with SCI.)

If you know where Sexual Health Services are in the region, you can be a part of Limited Information.

Information offered at an opportune time may open the door to a much needed consultation later.

Clients may choose to access sexual health education through different ways, and that will give them options to educate themselves about their health care.

(Return to PLISSIT model with 4 people icons added in the “Limited Information” section.)

You do not have to have specific training specialized or expertise in sexual health to provide Limited Information.

But it does require awareness of where your patients can go to address any sexual health issues they are having.

Specific Suggestions.

(Scene featuring two women, one of which is sitting on a wheelchair, chatting in a park.)

To offer specific suggestions, you must have training and expertise in Sexual Health.

(Return to PLISSIT model. 2 people icons are added to the “Specific Suggestions” section.)

Practitioners tend to be physicians, nurses, nurse practitioners, with some training and experience in treating sexual health concerns.

(Return to scene of man with SCI listening to a clinician.)

The suggestions offered may be general, such as activities, exercise regimens, or enhancement aids, or they may be specific, such as engaging couples counselling or how to deal with catheters, for example.

4. Intensive therapy.

(Return to PLISSIT model. 1 person is added in the “Intensive Therapy” section.)

Intensive therapy can only be done with clinicians with specialized training in Sexual Health and knowledge about issues specific to sexual health and Spinal Cord Injury.

(Camera scans the exterior of a rehabilitation centre before shifting to a shot focusing on a clinician listening to a patient.)

These specialized clinicians would typically be found in dedicated rehabilitation centres.

They would take a full sexual history and likely would conduct a physical exam also as secondary complications, medications and other issues can affect a person’s sexual health.

The Sexual Health clinician will ensure that the patient accesses all necessary services that arise from the consultation.

This could include referrals to other medical professionals—psychologist, a bowel and bladder specialist, a cardiologist, or a doctor in physical medicine.

(Camera follows a woman wheeling to a patio.)

Most everyone working with people with SCI will encounter patients that wantto address or improve their sexual health.

(Cut to a scene of a man with SCI speaking to a clinician.)

It is possible to open a dialogue and give the patient permission for patients to discuss their sexual health concerns as long as you are respectful and ask permission to ask.

(Words “To Learn More Visit scireproject.com” and “Follow us @SCIREProject” appear on screen.)

(Transition to new slide with bolded words “Thank You to” above the words “Clinicians: Dr. Stacy Elliot, Bonnie Venables RN, Patricia Mills” and “Participants: Brad Jacobsen, Bobby Brar, Teri Thorson, Christina Cassady, Felicity Curin and Finn Victor Winterfield, Lance Blanco, Matthew Querée, Shannon Sproule and the rest of the SCIRE Team.” Below: Logos of the Rick Hansen Institute, University of British Columbia, icord, and Ontario Neurotrauma Foundation.)

(Words “Created by MerilinPaart at the Knowledge Mobilization Studio at the Centre for Hip Health and Mobility” appear with the Knowledge Mobilization Studio logo before screen dips to black.)