Campbell, R. (2006). Rape survivors’ experiences with the legal and medical systems: Do rape victim advocates make a difference? Violence Against Women, 12, 30-45. [Posted December 2006.]

Key Points: Survivors of sexual assault who were assisted by rape crisis center advocates received more medical and legal services, and were less distressed by their interactions with law enforcement and medical personnel.  

Abstract: This study looked at women who were treated in emergency rooms after reporting rape. Two hospitals were included in the study: one had a policy of paging a rape crisis advocate when a victim arrived, and the other did not. Participants included 36 women who worked with rape victim advocates and 45 who did not.

Survivors were asked about medical and legal services that were offered, secondary victimization behaviors by medical and law enforcement staff, and their emotional responses to the secondary victimization.

Victims who worked with advocates had more police reports taken (59% vs. 41%) and were less likely to experience secondary victimization behaviors from medical and legal personnel. They were more likely to be offered emergency contraception (33% vs. 14%) and information about/treatment for STDs. They were less likely to blame themselves for the assault (54% vs. 82%) and less reluctant to seek further help (67% vs. 91%).

The author recommended that rape crisis centers continue to work with medical and legal systems to streamline response systems and increase the use of advocate services.

Topics: Rape crisis centers; secondary victimization; victim services

Campbell, R., Barnes, H. E., Ahrens, C. E., Wasco, S. M., Zaragoza-Diesfeld, Y., & Sefl, T. (1999). Community services for rape survivors enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67, 847-858.

Despite the availability of community services geared toward addressing the aftermath of a sexual assault, many survivors feel as if the experience of seeking assistance from legal, medical, and mental health systems only extends the trauma (i.e., secondary victimization). This study examined the relationship between such secondary victimization and post-traumatic stress (PTS) symptoms among 102 female rape survivors. Analyses concerning social system contact and rape survivor’s psychological well-being revealed that the group most at risk for high PTSD levels postrape were survivors of nonstranger rape who had received minimal assistance from the legal or medical system and had experienced victim-blaming behaviors from system personnel. Although this group had the highest PTSD levels of all survivors in the study, they did show a decrease in their PTSD levels after obtaining continued assistance from the mental health system.

Topics: Effects; secondary victimization; victim services

Campbell, R. & Raja, S. (2005). The sexual assault and secondary victimization of female veterans: Help-seeking experiences with military and civilian social systems. Psychology of Women Quarterly, 29, 97-106. [Posted April 2007.]

Key Points: Among women veterans and reservists, 39% had been sexually assaulted at least once in adulthood.

Abstract: The study sample consisted of 268 primarily low income, African-American (77%) female veterans and reservists seeking medical care at a VA clinic. Out of 104 sexual assaults described, 38% occurred while a woman was in military service, and 82% of those were committed by a military peer or supervisor.

Similar numbers of victims of military and non-military assault sought medical treatment after an attack. Although military medical providers engaged in fewer secondary victimization behaviors than non-military providers, victims were more likely to have negative feelings after treatment by military medical personnel. Military victims were more likely to have reported the assault to legal personnel (59%) than non-military victims (26%). Both groups experienced similar overall levels of legal secondary victimization. All victims who encountered any secondary victimization behaviors reported more post-traumatic stress symptoms.

In light of the high prevalence rates, the researchers recommended that the VA expand services such as the Women Veterans’ Comprehensive Health Centers to create environments where women can receive respectful and appropriate treatment.

Topics: Disclosure; military; secondary victimization

Campbell, R., Wasco, S. M., Ahrens, C. E., Sefl, T., & Barnes, H. E. (2001). Preventing the “second rape”: Rape survivors’ experiences with community service providers. Journal of Interpersonal Violence, 16, 1239-1259.

Survivors of rape are all too often subject to inadequate or even distressing responses from the social systems they turn to postassault. This study addresses the perceived and objective community responses as reported by 102 women (mean age = 34.29 years) recruited via fliers, posters, and presentations given in representative regions of Chicago. Interviews began with open-ended questions concerning the assault, followed by structured questions that addressed the postassault contact with legal, medical, mental health, rape crisis center, or religious social systems. That is, the structured questions concentrated on service delivery outcomes related to contact with any of the aforementioned social systems and required participants to rate (on a 7-point scale) the healing or hurtful quality of the service provided to them. Posttraumatic stress and depression were measured using the Symptom Checklist 90 Revised, Crime-Related PTSD scale, and the Center for Epidemiological Studies Depression Scale. Results revealed an alarming paucity in the services provided by the legal and medical systems – especially those provided to ethnic minority women and victims of nonstranger rape. For example, White women, victims of stranger rape, and victims who were physically injured or threatened with a weapon during the assault were more likely to have their cases prosecuted than were minority women, victims of nonstranger rape, and victims who were not physically injured or threatened with a weapon. Furthermore, White women were more likely to receive information about STDs and HIV during their interaction with the medical system than were minority women. On the other hand, religious support systems, rape crisis centers, and mental health systems, were less likely to demonstrate such discrepancies among survivors. Contact with these sources appeared to be more healing, in contrast to the legal and medical healthcare services which notably increased survivors’ psychological and physical distress. Recommendations provided by the authors include: the need for coordinated service programs across the various social systems, professional training for service providers, and increased publicity for rape crisis centers.

Topics: Secondary victimization; victim services

Konradi, A., & Burger, T. (2000). Having the last word: An examination of rape survivors’ participation in sentencing. Violence Against Women, 6, 351-395.

The authors discuss the relationship between victims rights legislation and concerns about women's experiences with rape prosecution. The study is in interview format and focuses on rape survivors discussing both their participation in the criminal justice proceedings and their emotional investment in prosecution. The authors then identify four motivations survivors may have for writing the court and attending or speaking at sentencing. Finally, the authors explain how rape survivors’ emotional states, prior involvement in court events, and the social support they receive leads them to engage selectively in sentencing activities.

Topics: Legal responses; secondary victimization

McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131-149.

The authors present a new constructivist self-development theory for understanding therapists' reactions to clients' traumatic material. This theory is contrasted with previous conceptualizations such as burnout and counter-transference. The phenomenon termed "vicarious traumatization" can be understood as related both to the graphic and painful material that trauma clients often present and to the therapist's unique cognitive schemata or beliefs, expectations, and assumptions about self and others. Therapists may experience disruptions in their schemata of dependency, safety, power, independence, esteem, intimacy, and/or frame of reference. Ways that therapists can transform and integrate clients' traumatic material in order to provide the best services to clients, as well as to protect themselves against serious harmful effects, are discussed.

Topics: Secondary victimization

Updated 08/01/07