Azikiwe, N., Wright, J., Cheng, T., & D’Angelo, L. J. (2005). Management of rape victims (regarding STD treatment and pregnancy prevention): Do academic emergency departments practice what they preach? Journal of Adolescent Health, 36, 446-448.

This study examined the difference between institutional policy and practice concerning the role of emergency contraception (EC) and STD-screening for sexual assault cases in 85 emergency departments. Results showed that 60% of emergency departments screen for STDs. Additionally, 85.9% provide EC counseling, 87.7% administer the first dose in the emergency department, and 64.7% offer HIV postexposure prophylaxis (PEP). Interestingly, only 67.9% of emergency departments have an EC policy and only 55.3% have a nonoccupational HIV PEP policy. As such, the majority of academic emergency departments are apparently offering EC counseling, EC treatment, and HIV PEP to victims of sexual assault, despite the absence of institutional policies.

Topics: Medical response; treatment; victim services

Basile, K. C., Lang, K. S., Bartenfeld, T. A., & Clinton-Sherrod, M. (2005). Evaluability assessment of the rape prevention and education program: Summary of findings and recommendations. Journal of Women’s Health, 14, 201-207.

This article provides a baseline evaluation of the CDC’s Rape Prevention and Education (RPE) Program by drawing upon the evaluability assessment approach, as designed by Wholey (1979) and Rutman (1980). As such, the assessment discussed herein measured goals and objectives of the RPE grant, the use of funds, and barriers impacting the implementation of the grant. The primary goal of the program includes the reduction of sexual assault rates as initiated through educational and awareness-enhancing programs. Funds were found to be most often allocated toward trainings and informational materials, with prevention programs and evaluation activities also prominent. The barrier cited by 87% of respondents centered around community reactions to issues of sexual violence. Recommendations highlighted performance measures and systematic data collection, as well as technical assistance, training, strategic planning, and evaluability.

Topics: Evaluation; prevention; victim services

Bergen, R. K. (1996). Wife rape: Understanding the response of survivors and service providers. Newbury Park, CA: Sage Publications, Inc.

This book focuses on wife rape, victims help-seeking behaviors, and responses of service providers. The author provides an in-depth look at two organizations who provide services to this population. Two case studies explore the responses of workers at a battered women's shelter and rape crisis center to the problem of wife rape. Questions that guide this research are: (a) How do women understand and define their experiences of wife rape? (b) What is the response of agencies to women who seek their help?

Chapter 5: Providing services to wife rape survivors – Current trends and future directions
This chapter explores how women's organizations respond to marital rape. The results of a survey sent to battered women's shelters, rape crisis centers, and combination programs across the United States are analyzed. Ways in which agencies can improve services to survivors of wife rape are discussed. Policy recommendations in the areas of outreach, staff and volunteer training, and the inclusion of wife rape in an organization's agenda are detailed.

Topics: Marital rape; rape crisis centers; victim services

Burgess, A. W., & Morgenbesser, L. I. (2005). Sexual violence and seniors. Brief Treatment and Crisis Intervention, 5, 193-202.

Sexual violence against women aged 60 years and older has not garnered enough attention. In this article, the authors outline key issues related to the risk factors, psychological and physical impact, role of forensic services, and therapy unique to elderly victims of sexual assault. That is, reasons why the literature on sexual violence has overlooked elderly victims are reviewed. Additionally, the authors discuss: early recognition and detection tactics, intervention services addressing signs and symptoms of physical and emotional trauma, specifics concerning forensic examinations on elderly victims, therapy focusing on individual counseling (concerning rape trauma symptoms and rape trauma syndrome), group counseling and music therapy, living situations (independent/assisted living or nursing home), interventions for relatives of abused elderly, prevention suggestions, crisis intervention, and recommendations for nursing home staff – e.g., the need to establish behavioral baselines upon admission of new residents in order to identify victimization responses should abuse occur within the nursing home.

Topics: Disabled; elderly; victim services

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., Dorey, H., Naegeli, M., Grubstein, L. K., Bennett, K. K., Bonter, F., et al. (2004). An empowerment evaluation model for sexual assault programs: Empirical evidence of effectiveness. American Journal of Community Psychology, 34, 251-262.

This paper describes the Sexual Assault and Rape Prevention (SARP) Evaluation Project that was designed to provide evaluation training and consultation to all state-funded rape prevention and victim services programs in Michigan. The SARP project was a community-based collaboration that utilized an empowerment evaluation approach. A review of the empowerment evaluation literature is provided and effectiveness of the SARP project is examined. Results suggested that the evaluation model was effective in assisting the majority of rape prevention and victim services programs develop, implement, and sustain evaluation activities. Limitations of an empowerment evaluation approach are discussed.

Topics: Evaluation; prevention; victim services

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

Hellman, C. & House, D. (2006). Volunteers serving victims of sexual assault. Journal of Social Psychology, 146, 117-123. [Posted October 2006.]

Key Points: Sexual violence crisis hotline and hospital advocate volunteers were most satisfied with their work when they were emotionally attached to the agency and attended monthly meetings that they found helpful. Satisfied volunteers intended to stay in their positions. 

Abstract: In this study, researchers looked at factors associated with volunteer satisfaction, commitment, and intent to continue volunteering. Twenty-eight sexual violence crisis hotline and hospital advocate volunteers filled out mail-in surveys. Satisfied volunteers were more likely to report intending to remain in their positions. Compared with less satisfied volunteers, satisfied volunteers reported higher levels of feelings of competence, social support, and emotional attachment to the agency. They also reported finding monthly agency meetings more valuable and had lower levels of exposure to victim blaming from other service providers.

This is a very small sample, but it reaches the same conclusions as previous research. The authors recommended on-going training for volunteers, including skills-building to confront victim-blaming among other service providers. By addressing these issues, volunteers may be more satisfied, which may lead to better retention.

Topics: Advocate self-care; rape crisis centers; victim services

Konradi, A. (2003). A strategy for increasing postrape medical care and forensic examination: Marketing sexual assault nurse examiners to the college population. Violence Against Women, 9, 955-988.

The goal of this study was to evaluate the processes and outcomes of a social marketing campaign that advertised sexual assault nurse examiner (SANE) services to the student body of a Midwestern university. Messages were developed that targeted rape myths and probable student-specific concerns as they related to SANE service usage. After poster advertisements with these messages were developed, they were evaluated by a class of undergraduate sociology students. After refinement, posters were displayed during two 2-week time periods in different quarters of the academic year. To target the entire student-body, posters were placed in toilet stalls of public buildings and dormitories. Television public service announcements also ran during the latter 2-week time period. For evaluation, a survey was developed and completed by a total of 653 students at the university. Findings indicated that approximately half of the students reported seeing SANE posters. On-campus residents and female students were more likely to identify as having been exposed to posters than off-campus residents and male students. Students exposed to more sources of information about SANE services, including nonposter sources, had greater knowledge about SANE services. Students who viewed themselves at high risk for sexual assault – mostly women – were more likely to assert that they would recommend SANE services to someone else. Finally, data on SANE service usage was still being collected and was therefore not included in the results. Proposed improvements for the marketing campaign included targeting messages toward men as victim allies; training professors to incorporate SANE information into their classes; and continuing to do SANE marketing campaigns during or in conjunction with sexual assault awareness events.

Topics: College; risk; victim services

Wasco, S., & Campbell, R. (2002). Emotional reactions of rape victim advocates: A multiple case study of anger and fear. Psychology of Women Quarterly, 26, 120-130.

This study evaluates rape victim advocates’ emotional responses to their work. Qualitative analysis was conducted on the emotional reactions of women who support rape victims through the criminal justice process and through other services provided after the assault (physical and mental). Results showed that women respond to individual factors and environmental factors surrounding rape with emotions of fear and anger. Also, some rape victim advocates viewed their emotional responses as beneficial to the victim specifically and within their work in general.

Topics: Advocate self-care; rape crisis centers; victim services

Wasco, S., Campbell, R., & Clark, M. (2002). A multiple case study of rape victim advocates’ self-care routines: The influence of organizational context. American Journal of Community Psychology, 30, 731-760.

The purpose of this study was to examine how rape advocates cope with their job which includes repeated exposure to rape victims and their experiences. Qualitative analysis was conducted on the types of self-care strategies used and the organizational settings of the work place of rape victim advocates. This study further evaluated the relationship between the advocates’ use of self-care strategies and organizational support provided. Results indicate that self-care routines were derived from various resources and provided the benefit of “cathartic releasing of traumatic material”, and “improving capacity to integrate traumatic material into one’s life.” Several organizational characteristics reviewed in this study were reported as being supportive. All of the victim advocates reported using self-care strategies; however, those who worked in organizations with higher levels of support were able to benefit from a combination of both self-care and organizational support methods.

Topics: Advocate self-care; rape crisis centers; victim services

Updated 08/01/07