SUPPORTING MALE SURIVORS

background information

• Good Practice Guidelines for Mainstream Sexual Violence Crisis Services - Working with Men  (David Mitchell, 2015)  
• Foster, G., Boyd, C., & O'Leary, P. (2012). Improving policy and practice responses for men sexually abused in childhood. ACSSA Wrap, 12. 1-20
• Sullivan, M (2010 - 2011). An Exploration of Service Delivery to Male Survivors of Sexual Abuse. Mankind, UK http://www.wcmt.org.uk/sites/default/files/migrated-reports/840_1.pdf

Essential Learning - What we need to know

Specialist workforce development should start with debunking the myths and stereotypes surrounding male victims/survivors.

"Unless this area is addressed by professionals in their professional development their ability to both engage with and otherwise support male victims of CSA will be severely compromised."

Myths and stereotypes  

• Societal beliefs about males being self-reliant and dominant, relatively immune to expressions of vulnerability or helplessness are commonly understood and believed. For many survivors seeking help is almost unimaginable, almost a worse outcome than non-disclosure (Barnett et al, 2011; Romano & De Luca, 2001). Situations where the abuser is  female can considerably worsen the contradiction between societal expectations, self-image and the experience of abuse (Davies, 2002).  
• The belief that survivors move on to perpetrate abuse on others, creating a cycle of abuse. That is, the victim moves on to become a perpetrator. Olgoff et al (2012) report that this assumption is incorrect. They cite research that found 95% of survivors do not move on to become perpetrators (Olgoff et al, 2012). Regardless of the accuracy of this belief, that it actually exists contributes to male survivors not disclosing their experience of CSA (Nicholls, 2014).  
• The lack of belief that males are sexually abused and the belief that sexual abuse has little effect on males or at least that abuse is not as severe for males as it is for females.  
• One specific gender stereotype is the view commonly held which sees males as seeking and appreciating early sexual experiences regardless of the nature of these experiences (Stemple & Meyer, 2014). The isolation, anxiety, depression and self blame resulting from this myth can lead to a loss of hope and subsequent suicidality.  
• Questions or self examination about sexual orientation, particularly for heterosexual males. This is especially common if the victim sustained an erection during anal penetration  (Stemple & Meyer, 2014). This can also involve doubts about sexual orientation if a heterosexual man was not a willing partner to a woman who wanted sex (Davies, 2002).  
• The refusal of society to believe that female offenders exist (Saradjian & Cortoni, 2010), or to believe that female offending is in some way less traumatic than male perpetration.  

Understanding male victims/survivors

• There is a huge need for further research into understanding the impacts on males  and what the best approaches are when supporting male victim/survivors  (Sullivan 2011).
• What we do know from male victims/survivors is the significance and impact of fear, shame, guilt and humiliation.  Often men present with intense anger, and beneath this is deep sadness. 

"The first thing to understand is the anger, even rage that invariably underpins male victim's response to CSA.  Victims are acutely aware of this anger as well as the fear it creates in them. Professionals need to be aware that anger is an emotion that is common in male victims of CSA and such negative emotions should be validated and not discounted. Further this anger should be an expected response underpinning engagement with male victims. Professionals need to be comfortable and empathic with the expression of anger and not immediately equate this with a potential for violence. The expression of anger should certainly not be inhibited by professionals. Anger must be seen as part of the process of the victim coming to understand and link the complexity of their lives with the original abuse"  (Mitchell, 2015, p. 5)

Understanding the complex issues associated with sexuality.    

• Sexuality is about complete awareness of self acceptance.

"Heterosexual males questioning their sexual orientation following abuse by a male perpetrator is common and causes considerable ongoing distress in victims. This distress presents in differing ways, for example men moving on to despise male homosexuals. Alternatively if the perpetrator is female this also impacts on the victim's questioning of "normal" relationships and sexual behaviour. Difficulties in future relationships with a female are a common occurrence. If the male victim is homosexual the impact the abuse has on the victim's understanding and experience of future relationships with male partners is similarly affected" (Mitchell, 2016, p. 12)

Understanding barriers to engaging with support services

A sense of mistrust in relation to professional services and government agencies is often reported by male survivors in relation to accessing support. Many of the men we work with have had negative responses from the Police over the years, especially when first disclosing and it can be more difficult if the offender was a female...many are completely reluctant to put in a complaint (Ken Clearwater, 2016). 

Another difficulty is for  the men who have been in care (as children) and have been sexually, physically and emotionally abused by those who were supposed to look after them so their trust of any one to do with the system was the enemy. Remembering in many cases it was the Police and white social workers who took them from their homes (Ken Clearwater, 2016). 

There is a contrast between the rules of masculinity and what it takes to engage in  therapeutic services: Psychotherapy versus Masculinity

Psychotherapy

• Disclosing private experience
• Relinquishing control
• Nonsexual intimacy
• Showing weakness
• Experiencing shame
• Acting vulnerable
• Seeking help
• Expressing feelings
• Being introspective
• Addressing relationship conflict
• Confronting pain
• Acknowledging failure
• Admitting ignorance

Essential Practice - What we need to do

On the frontline

• Believe: If a male approaches you the most important thing is to believe the disclosure and ensure that they are in a safe place. One of the biggest struggles most have is when people say allegations when in reality the abuse is a fact (Ken Clearwater, 2016).
• The survivor's need for genuine and honest information: Provide comprehensive information. Be honest and transparent about processes. This will not only aid in reducing anxiety and fear associated with the unknown but will also reduce (in part) barriers related to mistrust. 

Let them know how difficult the process is of (going to court). Avoid making any promises...What seemed most important was that the client understood the process and had some degree of control in how it was managed...There is no mistrust with DSAC once men know and understand their role (Ken Clearwater, 2016). 

• Provide a variety of support options with flexibility:
  • This may include offering a range of counselling and support face-to-face, telephone, email, live chat and/or group programs
  • Flexible appointment times: Offering evening appointments in particular for full-time working men can enhance access to support services for male survivors
  • Offer a choice of service provider, in particular prioritising an option of gender choice for male survivors  
  • Provide structure during the session, use a professional competent approach balanced with a laid back friendly manner being proactive and sensitive. 

Crisis support services

• Training for all staff into the particular needs of male survivors.  
• The physical environment
  • Create a more male friendly entrance and waiting room using posters and relevant information.  This does not mean stereotypical car or sports magazines, more a newspaper and inclusive service information for men and families, and avoiding material which portrays men as perpetrators.  
• Strengthen interagency processes and communication
  • Develop genuine partnerships with local service providers that support referrals and avoid unnecessary repetition of personal information. 

Sector development

• A commitment to workforce development and expansion of services to support the unique needs of male survivors (designing, developing and marketing services specifically to men).  

Evidence suggests that in order to support healing and recovery it is necessary to create gender appropriate services and interventions that:

• Reach out and engage men. An informative male focused website can be key to acknowledging their experience, emotions, and informing clients of support services available. Likewise online e-counselling, telephone support and helplines are also considered important, especially for those living in remote areas.
• Address barriers to men's help seeking.
• Assist men and their families to build supportive relationships.
• Provide opportunities for group support.
• Develop public discussions that offer hope for an improved future.
• Service developments should consider diversity: acknowledging and adapting services to meet the differences in men's cultural and sexual identities. Male victims/survivors of sexual victimisation are a diverse group with diverse needs, especially given that the men who are most likely to have experienced child sexual abuse and to face difficulties in accessing support are men who are socially disadvantaged. That is, indigenous men, men with disability, mental illness, same-sex attracted, from culturally and linguistically diverse communities, men in prison, in military, rural and regional, young, and male sex workers.

Relevant References - other related research