Clinical Care in the Age of #MeToo and the Dr. Ford – Kavanaugh Case
Tuesday, October 30, 2018
Although rates of sexual violence may be declining overall, survivors’ disclosures of sexual violence may be increasing as a result of growing societal awareness (Department of Justice, 2015). Many individuals have been spurred by current events to seek out mental health resources after sexual violence, often disclosing past sexual violence for the first time. As clinicians, what can we do to best support clients who disclose?
- Believe your clients. Clients’ sharing of their stories is an act of bravery and vulnerability. Validate your clients’ experience by providing psychoeducation on the neurobiology of traumatic memory (Hardy, Young, & Holmes, 2009; Johnsen & Asbjørnsen, 2008).
- Remind survivors that sexual violence is not their fault. Negative responses to disclosures increase survivors’ sense of self-blame (Ullman & Najdowski, 2011). When interviewing survivors, use questions that convey care and support, not blame. Use open-ended questions that allow survivors to direct how they share their stories (e.g., Tell me more about what happened to you,” rather than “What were you doing before the assault happened?”).
- Empower survivors with options and choices. Survivors have valid reasons to report sexual violence to legal authorities (e.g., hoping to protect themselves or others from future crimes), but they also have valid reasons to not report (e.g., fearing retaliation, stigmatization, or mistreatment from medical and criminal justice systems, etc.; Department of Justice, 2013; Maier, 2008; Miller, Canales, Amacker, Backstrom, & Gidycz, 2011). Indeed, many survivors of sexual violence who do report face revictimization by the legal process itself (Campbell, 2013). This revictimization by the criminal justice system may be especially pernicious for survivors of color (Dylan, Regehr, & Alaggia, 2008; Tillman, Bryant-Davis, Smith, & Marks, 2010). As clinicians, remember that survivors are the experts of their own stories. If you choose to offer information about legal options and reporting, acknowledge survivors’ capacity to make choices based on their personal expertise on the situation.*
Using your clinical judgment, evidence-based practice, and information about a client’s background, identities, and preferences can provide essential support for clients. Providing receptive, empathetic, and empowering responses to disclosures of sexual violence can be restorative sources of healing and clarity for survivors.
*Please keep in mind state and federal laws about mandated reporting when working with minors and/or the elderly, and, as always, thoroughly explain your mandated reporting responsibilities throughout the treatment process.
Campbell, R. (2013). The psychological impact of rape victims’ experiences with the legal, medical, and mental health systems. Applied ethics in mental health care: An interdisciplinary reader, 149-178.
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, Female Victims of Sexual Violence, 1994-2010 (2013).
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, National Crime Victimization Survey, 2010-2014 (2015).
Maier, S. L. (2008). “I Have Heard Horrible Stories...” Rape Victim Advocates' Perceptions of the Revictimization of Rape Victims by the Police and Medical System. Violence against women, 14(7), 786-808.
Dylan, A., Regehr, C., & Alaggia, R. (2008). And justice for all? Aboriginal victims of sexual violence. Violence against women, 14(6), 678-696.
Hardy, A., Young, K., & Holmes, E. A. (2009). Does trauma memory play a role in the experience of reporting sexual assault during police interviews? An exploratory study. Memory, 17(8), 783-788.
Johnsen, G. E., & Asbjørnsen, A. E. (2008). Consistent impaired verbal memory in PTSD: a meta-analysis. Journal of Affective Disorders, 111(1), 74-82.
Miller, A. K., Canales, E. J., Amacker, A. M., Backstrom, T. L., & Gidycz, C. A. (2011). Stigma-threat motivated nondisclosure of sexual assault and sexual revictimization: A prospective analysis. Psychology of Women Quarterly, 35(1), 119-128.
Tillman, S., Bryant-Davis, T., Smith, K., & Marks, A. (2010). Shattering silence: Exploring barriers to disclosure for African American sexual assault survivors. Trauma, Violence, & Abuse, 11(2), 59-70.
Ullman, S. E., & Najdowski, C. J. (2011). Prospective changes in attributions of self-blame and social reactions to women’s disclosures of adult sexual assault. Journal of Interpersonal Violence, 26(10), 1934-1962.