Any kind of crisis experience is complex and has a rich phenomenology and structure. The complexity of managing people who have faced or are facing crises is reflected in the fact that professionals involved in working with crisis survivors must be highly qualified due to the requirements imposed on them under these conditions. Sexual violence is one of the most dangerous and difficult situations in which a person can find him or herself because it always means psychological violence. The victims of sexual assault are diverse and can be both women and men, children and the elderly; therefore, specialists must be skilled in working with individuals of different ages, sexes, backgrounds, and worldviews. This paper aims to examine the behaviors of people who have experienced sexual assault, consider the recommended strategies for combating this crisis, and evaluate their effectiveness.
Background Information
The sexual abuse of a person at any age brings psychological suffering as well as multiple problems. Moreover, the consequences of harassment or abuse can be extremely varied and unpredictable. This form of a crisis can have devastating long-term effects on the victim, including the emergence of behavioral problems and low self-esteem (Kanel, 2014). Sexual assault has no boundaries, and many psychologists and researchers today emphasize that this type of violence has reached epidemic proportions. In particular, the statistics of violence against children suggest that one in every four girls under the age of 18 has been subjected to sexual violence at least once in her life, along with one in every six underage boys. The prevalence of social media networks and their active use by minors has also contributed to another tragic fact: One in every five children has suffered from harassment by other Internet users (Regehr, Alaggia, Dennis, Pitts, & Saini, 2013).
The significance of the situation lies in the fact that almost 70% of sexual abuse victims are under 17 years old. Statistics have also revealed one significant trend: Almost 85% of prisoners were victims of sexual abuse as children. The minors’ case is made even more challenging to combat because they tend to be victimized by the people they trust the most (e.g., family members, close friends, family friends). The complexity of such cases is that children are not likely to talk about the actions performed towards them, meaning that the actual statistics might be even worse (Regehr et al., 2013). Moreover, even though a child might not always recognize which actions are illegal or inappropriate, such conduct almost always affects the minor’s psychological health. The consequences of such crises can be reflected later and leave a lasting negative impact for decades.
More than 58% of females have experienced sexual harassment or attack regarding cases of violence against women. Almost all of the women in this category have gone through several forms of violence at the same time (e.g., sexual, physical, psychological) (Sullivan Everstine & Everstine, 2013). Most importantly, almost 90% of all women in the world have experienced or have witnessed violence. In addition to these alarming statistics, men can also be sexual abuse victims—either by women or by other men. For example, there have been cases when men have experienced sexual assault in prison. Also, older people may fall victim to harassment. As a rule, these victims experience abuse from family members or close friends (Sullivan Everstine & Everstine, 2013). These statistics reveal the complexity and criticality of sexual assault in the country and the world in general and the need to take immediate action to stop the crisis.
The Manifestation of Crisis and Impact on People
Every crisis situation manifests itself in different ways depending on various factors such as gender, age, and the conditions in which the violence has occurred. As a rule, most sexual assault victims have post-traumatic stress disorder (PTSD), which is a normal psychological and physiological reaction to strong trauma. The manifestations of PTSD may appear not only immediately after the act of violence but also after any severe stress (e.g., war, car accident, other assault) (Beck Hansen, Hansen, Nielsen, & Elklit, 2016). This syndrome manifests recurring memories of the traumatic event, which may be accompanied by sharp changes in mood, nightmares, a lack of interest in life, and in the most severe cases—hallucinations (Foa, Gillihan, & Bryant, 2013). Many people also suffer from prolonged depression or feelings of panic and anxiety.
In cases where rape occurs, another common manifestation of this crisis is rape trauma syndrome, the reactions of which can be drastically different from person to person. Some people become isolated and start denying the incident (Kanel, 2014). Other individuals react expressively and display feelings like anger or strong sadness. Also, people suffering from rape trauma syndrome may reject any assistance and express hostility toward professionals who want to help them.
In general, the victims of sexual assault show different coping strategies. Factors such as positive self-esteem, success in career or studies, an effective support system of professionals and family, and security often help a person cope with the trauma much more quickly. The core danger of this type of crisis is that if a person does not receive the necessary help and support, it can lead to tragic consequences and protracted psychological and physiological health (Kanel, 2014). Unfortunately, not every individual can cope with such a strong shock, and many people experience rape trauma syndrome for several years or even for an entire lifetime.
Consequences
The problems caused by sexual trauma can have psychological, social, sexual, and physiological nature. Very often, all four types occur at the same time. Many victims, especially those who have a more sensitive psyche, experience various psychological problems such as anxiety, panic attacks, difficulty sleeping, nightmares, irritability and outbursts of anger, and shock reactions when touched (Sullivan Everstine & Everstine, 2013). Often, children and young women experience self-doubt and may become disgusted with their bodies. These issues can lead to destructive behavior, which may be expressed in the use of drugs, excessive sports activity, and even such occupations as prostitution. In terms of social impact, the traumatic event can cause the victim to distrust other people and a feeling of inability to control his or her relationships with family, friends, and acquaintances, often leading to isolation.
Also, sexual assault victims frequently experience sexual problems (Sullivan Everstine & Everstine, 2013). Certain words or actions can trigger memories of the traumatic episode, and sexual desire may be accompanied by disgust. Nausea and headaches may accompany the person for a long time and pain in the neck and shoulders. Frequently, these aches are chronic and appear to have no physiological basis.
In the case of children, eating disorders also pose a great threat to health. Both refusal to eat and excessive eating can cause additional consequences for minors’ psychological and physiological health (Sullivan Everstine & Everstine, 2013). In general, sensations are the natural reactions of the body. They are associated with such mechanisms as the denial and repression of the painful experience, the mental experience of trauma, and increased irritability. Many psychologists claim that the most active assistance should be provided during the first months because, after that period, it becomes more difficult to mitigate the negative consequences to the victim’s health.
Recommended Interventions and Their Effectiveness
Importantly, the initial intervention in such a dramatic and complex situation involves communication between the crisis worker and the victim. It is essential to show empathy and assurance, emphasizing that the most important thing is that the person is alive and that all other problems will be solved gradually (Sullivan Everstine & Everstine, 2013). Moreover, it is essential to build trust to ensure that the victimized person feels secure and recognizes that they are no longer in danger. This intervention implies building a working alliance. Other primary interventions include listening and responding to the victim’s questions to know what happens next and feels as confident as possible that the required care will be furnished (James & Gilliland, 2013). At this point, the crisis worker must be patient and strive to minimize possible nervous outbursts from the victim.
Apart from these strategies, the specialist’s responsibility is to inform the individual about what measures will be taken and what procedures the victim has to undergo (e.g., medical check, police questioning). This role is significant because the victim is experiencing immense stress. He or she might be reluctant to talk to the police or have any physical contact with people, even a nursing specialist (James & Gilliland, 2013). The first two weeks are the most crucial ones, and the severity of the trauma will depend on the specialist’s effectiveness.
Primary Interventions
The victimized person might be experiencing dissociation and shock and may have certain somatic reactions, which will inevitably bring confusion both to the victim’s identity and the procedures that should be followed. Thus, the worker is responsible for providing supervision and guidance and making sure that the individual takes the necessary physical examinations and reports to the police. The psychological support for the victim should be continuous. The worker’s goal is to evaluate the person’s state of mobility and gather the necessary information in a shame-free and comforting setting (James & Gilliland, 2013). All questions asked of the victim should be closed-ended so that they do not have to discuss the disturbing moments. Notably, it is important to express empathy towards the person, so they feel sincere concern from the specialist (James & Gilliland, 2013). If this intervention is not followed, it is likely that the client will be reluctant to proceed. At this point, the worker should initiate the predisposition task. Its effectiveness depends on the attachment between the victim and the specialist and the existence of an environment that is safe, bias-free, and supportive.
Follow-up Interventions
The advanced measures imply secondary victim crisis interventions. In other words, the worker should make sure that no secondary victimization can take place. Unfortunately, family members, partners, friends, and other people might directly or involuntarily cause the individual’s second victimization due to their need to find the motive for the sexual assault (James & Gilliland, 2013). They might ask inappropriate questions and even blame the victim for the act of violence. The crisis worker’s role is to educate the family and the people close to the survivor on the appropriate conduct and explain the significance of support.
Because sexual harassment and assault can lead to PTSD, it is of paramount importance not to let the person retreat into memories of the assault and to provide assistance to family members so that they do not blame themselves for the inability to prevent the traumatic event (Beck Hansen et al., 2016). The importance of support should not be underestimated. It is crucial to determine which people can provide empathetic help to the survivor and instruct them on the relevant coping strategies (James & Gilliland, 2013). If the survivor feels safe around certain people and is capable of caring and nonjudgmental understanding, they can significantly help them overcome the emotional and psychological suffering.
It should be stressed that any sexual assault intervention should include three phases: safety, processing, and reintegration. At first, the victim should gain a feeling of security, and then he or she should receive psychoeducation to know how to let go of the traumatic memories (James & Gilliland, 2013). Finally, the worker should assist the survivor in grounding. The victim should not deny the occurrence as extinguishing the trauma is important. Through cognitive restructuring, the victim will overcome any negative or distorted beliefs connected to their personality.
Further on, skill-building is also essential. The survivor should be taught how to make self-determining choices to become more autonomous and self-reliant. It is essential to emphasize that support groups are of great help (James & Gilliland, 2013). Even though victims might refuse to join group activities at first, it is important to advise them to participate since they would be able to share their ideas and coping strategies and simply have mutual discussions with people who understand how an assaulted person feels.
Conclusion
Sexual assault is one of the strongest stressors in a person’s life and can cause long-term psychological and physiological consequences. This form of violence changes the victim’s views on life, others, and himself or herself. Frequently, survivors have weak control over themselves and their lives and suffer from an overabundance of negative emotions, thoughts, and recurring memories. Sexual violence involves intertwined medical, legal, social, and cultural problems that can lead to secondary victimization, lifelong injuries, and the inability to return to a normal life. In this regard, crisis workers aim to support and supervise survivors throughout all stages of the crisis. Sexual assault victims need to have a safe environment from the very beginning to overcome their fears as soon as possible and be healed from the psychological and physiological trauma.
References
Beck Hansen, N., Hansen, M., Nielsen, L., & Elklit, A. (2016). Positive or negative change in outlook on life following sexual assault and associations to PTSD severity. Sexual and Relationship Therapy, 32(1), 36-45.
Foa, E. B., Gillihan, S. J., & Bryant, R. A. (2013). Challenges and successes in dissemination of evidence-based treatments for posttraumatic stress: Lessons learned from prolonged exposure for PTSD. Psychological Science in the Public Interest, 14, 65-111.
James, R. K., & Gilliland, B. E. (2013). Crisis intervention strategies (7th ed.). Boston, MA: Cengage.
Kanel, K. (2014). A guide to crisis intervention. Boston, MA: Cengage.
Regehr, C., Alaggia, R., Dennis, J., Pitts, A., & Saini, M. (2013). Interventions to reduce distress in adult victims of rape and sexual violence. Research on Social Work Practice, 23(3), 257-265.
Sullivan Everstine, D., & Everstine, L. (2013). Strategic interventions for people in crisis, trauma, and disaster. Abington, UK: Routledge.