Assignment: Sexual Abuse and Trauma

Assignment: Sexual Abuse and Trauma

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Rita is a 22-year-old, heterosexual, Latina female working in the hospitality industry at a resort. She is the youngest of five children and lives at home with her parents. Rita has dated in the past but never developed a serious relationship. She is close to her immediate and extended family as well as to her female friends in the Latino community. Although her parents and three of her siblings were born in the Dominican Republic, Rita was born in the United States.

A year ago, Rita was sexually assaulted by an acquaintance of a male coworker. Rita and a female coworker met Juan and Bob after work at a local bar for a light meal and a few drinks. Because Rita had to get up early to work her shift the next day, Bob offered to drive her home. Instead of taking Rita directly home, however, he drove to a desolate spot nearby and assaulted her. Afterward, Bob threatened to harm her family if she did not remain silent and proceeded to drive her home. Although Rita did not tell her family what happened, she did call our agency hotline the next day to discuss her options. Because Rita’s assault occurred within the 5-day window for forensic evidence collection of this kind, Rita consented to activation of the county’s sexual assault response team (SART). Although she agreed to have an advocate and the sexual assault nurse examiner (SANE) meet her at the hospital, Rita tearfully stated that she did not want to file a police report at that time because she did not want to upset her family. The nurse examiner interviewed Rita, collected evidence, recorded any injuries, administered antibiotics for possible sexually transmitted infections, and gave Rita emergency contraception in case of pregnancy. The advocate stayed with Rita during the procedure, supporting her and validating her experience, and gave her a referral for individual crisis counseling at our agency.

My treatment goals for Rita included alleviation of rape trauma syndrome symptoms that included shame and self-blame, validation of self-worth and empowerment, and processing how it would feel to disclose to others when the time felt right. In addition, Rita would receive important information regarding state policy and procedure for victims of sexual assault that would assist her in deciding when and how to report the crime if she chose to do so.

My treatment involved crisis intervention and stabilization along with emotional support and validation surrounding her experience. Managing her trauma and acute stress symptoms were key to her recovery. Those symptoms included guilt, shame, emotional shock, powerlessness, anxiety, fear, anger, and doubting her judgment. We processed Rita’s emotional dysregulation and sense of outrage over what happened. Over the weeks that followed, we also explored Rita’s relationship to her immediate and extended family and how they had high expectations for her and her future. Rita’s shame over the assault prevented her from telling her family for fear they would also be shamed and judge her for accepting a ride from someone she did not know well. We discussed the policy for reporting a sexual assault to the police in our state and how Rita only had a 90-day window to report the crime after her forensic evidence was obtained. After 90 days, the forensic kit would be destroyed.

The problem with the current 90-day hold policy in our state for victims like Rita is that a person in crisis experiences strong and conflicting emotions and is faced with an acute sense of disequilibrium and disorientation. This, in turn, affects her or his ability to retain information and make decisions. The person, therefore, has barely enough time to make sense of what happened to her or him, let alone decide what to do about it. The 90-day hold policy may not afford a traumatized victim of sexual assault enough time to make a decision to report to law enforcement.

I utilized a strengths-based model in my treatment with Rita to help her address the decision to report the crime. A strengths-based framework is client-led with a focus on future outcomes and strengths that the client brings to a problem or crisis. It is an effective helping strategy that builds on a person’s resiliency and ego strength. An integrative strengths-based intervention can contribute to the development of a positive outcome for clients in crisis.

I counseled Rita for 6 months. After 5 months, Rita felt strong enough to disclose to her family and file a report with the police. However, because the 90-day window had closed by the time she was stabilized and emotionally ready to file, her forensic evidence was unavailable.