Principle 7: Specialist sexual violence response

Victims / survivors and communities are best served by specialist services due to the particular dynamics and high level impacts from sexual violence.

The high levels of traumatization with which many survivors present, and the proliferation of rape myths mean that services can cause harm to survivors.  Specialisation reduces the risk of this through a service’s capacity to provide trauma-informed care and avoid both enactment of rape myth and replication of the dynamics of sexual violence.  Fiscal and other trends and pressures may point to reducing specialization, but the following factors point to the need to maintain this principle.     

There is potential for high negative impacts of sexual violence on quality of life, psychological functioning, and relationships. For example, the DSM V lists survivors of rape as having one of the highest prevalences of Posttraumatic Stress Disorder.

Early intervention is critical as the difficulties arising from sexual violence can have a deteriorating course due to both the physiological factors associated with trauma responses – the “kindling” effect whereby there is increasing hyper arousal at lower trigger thresholds – and the interplays of psychological and social factors e.g., social withdrawal due to lack of sense of safety in the world leads to less positive experiences of the world, which, along with emotional numbing, can lead to depression.

Informed and appropriate early intervention is essential[1] – ill-conceived early intervention, such as some models of Critical Stress Debriefing, has been shown to have the potential to cause further harm following trauma.

Many survivors seek sexual violence specific responses.  In one evaluation, the most common reasons survivors gave for contacting the sexual assault centre were psychological symptoms and needs, most commonly anxiety or depression 66.4%, wanting to talk with someone who understood 32.8%, and flashbacks or nightmares 16.8%.[2]

Survivor feedback about services supports specialization: In an Australian study, survivors rated the services provided by specialist services highly for both the specialist knowledge brought and the way that it was offered with an emphasis on emotional care and support. [3]

In a US study, victims/survivors reported all aspects of the sexual violence support services to be positive. Particular aspects mentioned were the staff, the counsellors, staff being non- judgmental, believing victims, promoting recovery and/or coping skills and feelings of safety and comfort. Respondents reported that the biggest difficulties that they had faced were emotional issues and talking about the experience.[4] Much of this feedback suggested the need for specialisation.

Trauma-informed services are designed to be responsive and respectful to the needs of victims/survivors, and to avoid trauma-related dynamics that may be re-traumatising for those seeking help.

One study presented a tool which aims to provide guidance on creating an organisational culture of trauma-informed care. It suggested this can be achieved by incorporating an understanding of the prevalence and impact of trauma and the complex paths to healing and recovery in all aspects of service delivery. Five key principles were identified, which included: safety, trustworthiness, choice, collaboration, and empowerment[5].

In addition to providing trauma-informed care, services need to be able to provide sexual violence specific care as cultural ambivalence about sexual violence can easily play out in the responses of service providers. When such responses occur at this  time of high vulnerability, a person may have little resilience and so be easily harmed by such ambivalence.

For example, the service provider who idly wonders “what were you doing there anyway?” or “why didn’t you leave when he first began to pressure you?” can inadvertently reinforce a process of self-blame. The service provider who thinks that many complaints of sexual violence are false brings this filter to their normal processes of selective attention when listening to the survivor’s disclosure. Negative responses to disclosures can have a range of consequences, including increasing the severity of the impacts, leaving the survivor isolated and unwilling to risk seeking other support, and delaying any further disclosures – for days, months, years or decades.

It might be expected that general social services or mental health services could provide a specialist response to sexual violence, however, wide prevalence of cultural ambivalence and a historical lack of recognition of the role of trauma in the etiology of mental health difficulties, mean that much work has needed to be invested in teaching clinicians how to ask about sexual violence in a way that assists people to feel safe enough to disclose[6].

Cultural ambivalence also plays out in families so it is helpful to have specialist guidance available for them as well.

There are specific legal and court procedures which relate to sexual violence so it is in the interests of survivors and their supporters to receive accurate information.[7]

Specialist sexual violence services tend to provide a range of services, being almost a one-stop shop for sexual violence (excluding police and most medical responses). This is helpful not only for survivors and their families, but also for communities. When the local school teacher or youth group leader suspects sexual violence but needs to consult, there is a place to go.

If I had available to me in 1993, someone advocating on my behalf when I first disclosed to the police about historic rapes, I know I would not have lost 14 years of my life going through 2 deposition hearings and 5 trials.
- Louise Nicholas (Survivor Advocate)

1.  Hawkins, S., & Taylor, K. (2015). The changing landscape of domestic and sexual violence services: All-Party Parliamentary Group on Domestic and Sexual Violence Inquiry. Bristol: Women’s Aid Federation of England.
2.  Monroe, L.M., Kinney, L., Weist, M., Dafeamekpor, D., & Reynolds, M. (2005). The experience of sexual assault: Findings from a statewide victim needs assessment. Journal of Interpersonal Violence, 20, 767- 776.
3.  Lievore, D. (2005). No longer silent: a study of women’s help-seeking decisions and service responses to sexual assault. Canberra, Australian Institute of Criminology.
4.  Monroe, L.M., Kinney, L., Weist, M., Dafeamekpor, D., & Reynolds, M. (2005). The experience of sexual assault: Findings from a statewide victim needs assessment. Journal of Interpersonal Violence, 20, 767- 776.
5. Fallot, R. D., & Harris, M. (2009). Creating Cultures of Trauma-Informed Care (CCTIC): A self-assessment and planning tool. Retrieved from the University of Iowa http://www.healthcare.uiowa.edu/icmh/documents/CCTICSelf-AssessmentandPlanningProtocol10709.pdf
6. Read, J., Hammersley, P., & Rudegair, T. (2007). Why, when and how to ask about childhood abuse.
   Advances in Psychiatric Treatment, 13, 101-110.
7. Henderson, S. (2012). The pros and cons of providing dedicated sexual violence services: A literature review. Scotland: Rape Crisis Scotland.

practice examples

Most centres around the country were established as specialist centres and remain so. Some have begun to provide other services in response to funding possibilities (often family violence services) or in response to needs identified in their communities or by survivors.[8]  

8. Te Ohaaki a Hine: National Network Ending Sexual Violence Together – Tauiwi Caucus. (2009). Tauiwi Response to Sexual Violence: Mainstream Crisis Support and Recovery and Support Services and Pacific Services. NZ: Report to Ministry of Social Development.