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Counseling After a Sexual Assault

November 21st, 2023

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“Sexual violence affects one in three women and one in four men over the course of their lifetimes”, this estimation from the United States Centers for Disease Control and Prevention (CDC) is devastating. Sexual assault can be extremely stressful and scary; as often, the survivor's life is being threatened and they are facing emotional and physical harm. As much as a survivor tries to protect themself during a sexual assault, they are out of control in an extremely vulnerable situation. After such a terrifying experience, a person’s life can be severely disrupted, from how they act at work, how they feel about themself when they are alone, to how they interact with loved ones in their personal life. However, receiving help from a trained mental health professional can help.

Types of Treatment for Sexual Assault Survivors

Sexual assault is a traumatic experience. Thus, when a survivor seeks counseling after such trauma, it is more than likely they will be treated for symptoms consistent with posttraumatic stress disorder (PTSD), anxiety disorders, depression, suicidal ideation, sexual dysfunction, and/or substance use disorder. Certain studies have found that 90% of sexual assault survivors experience symptoms of PTSD two weeks after the assault. However, it is important to note that symptoms of PTSD can begin long after being assaulted and last for any amount of time. Additionally, symptoms of PTSD do not usually go away without intervention.

Below you will find more information on three types of evidenced based treatments that are empirically validated and proven to help and support sexual assault survivors.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

TF-CBT is a therapeutic model commonly used with children, adolescents, and families who have been victims of sexual assault - please refer to the graphic for more information on what to be aware of if you believe your child is being sexually abused by somebody in your (or their) life. TF-CBT focuses on the trauma narrative, ultimately allowing the patient and therapist to evaluate and challenge negative automatic thoughts and cognitive distortions. However, before the patient focuses on the trauma narrative, the therapist must provide the patient with effective and efficient relaxation skills to replace the trauma response with. This is a vital part of the therapeutic process because the patient must be able to cope with any unhelpful responses while processing the event, so as not to re-traumatize the patient. Lastly, a strong, stable patient-therapist relationship is essential within this model so that the patient feels safe and secure.

What is predatory grooming

What is predatory grooming?

Grooming is a process, that is commonly used by child sex offenders, to gain a child’s trust in efforts to eventually sexually abuse that child.

What does this process look like?

1. The predator will target a child who is vulnerable due to emotional neediness and low self-confidence.

2. The predator will attempt to gain the child trust and distance the child from their caretaker(s).

3. The predator will attempt to fill a need that is not being met by someone else in the child’s life.

4. Nonsexual touching leads to sexual abuse.

5. The predator uses threats and guilt to maintain control and secrecy.

Psychodynamic Psychotherapy

Cowan et al. (2020) states the key features of psychodynamic psychotherapy are,

  • Focus on emotions and the bodily expression of emotion
  • Exploration of trauma avoidance
  • Identification of recurring themes and patterns
  • Discussion of past experiences
  • Focus on personal relationships
  • Focus on the relationship between the therapist and patient
  • Exploration of wishes, dreams, and fantasies

In this model of therapy – and with a patient who is experiencing life-disrupting symptoms from a sexual assault – the therapist will continue to utilize these key features while also focusing on building a relationship based on empathy, trust, safety, and understanding. A strong bond is essential between the therapist and patient because feelings and emotions that are brought up when processing trauma can be confusing and re-traumatizing; however, nonjudgmental exploration can be helpful and bring about clarification of past, current, and future emotions and actions. This clarification is meant to help the patient understand the meaning of the sexual assault, related to their sense of self and how they view the world moving forward.

Eye Movement Desensitization and Processing (EMDR)

Therapist directed lateral eye movements, using various rhythmic techniques, are used to desensitize the patient to distress caused by memories of the sexual assault. According to the U.S. Department of Veterans Affairs, “In EMDR, you will pay attention to a back-and-forth movement or sound while you call to mind the upsetting memory until shifts occur in the way that you experience that memory and more information from the past is processed.” Again, creating a strong, warm therapist-patient bond is essential in this treatment model, so the patient can feel safe enough to share their experience of sexual assault.

5 Benefits of Therapy After Sexual Assault

5 Benefits of Therapy After Sexual Assault

  • A greater sense of control, power, and self-awareness.
  • An ability to overcome negative self-talk, guilt, and shame (among various other emotions) and move forward in a meaningful way.
  • The capability to recognize what you need when you feel a certain emotion.
  • A safe place to release uncomfortable emotions, feelings, and thoughts.
  • Having healthy ways to cope with unhelpful thoughts, emotions, and behaviors.

To conclude, psychotherapy has been proven effective in treating uncomfortable symptoms resulting from sexual assault. Three evidenced based treatment options to consider when looking for a sexual assault therapist are TF-CBT, psychodynamic psychotherapy, and EMDR. Some common factors to expect from a therapeutic alliance with a sexual assault therapist are feelings of safety, compassion, non-judgmental responses, and a sense that your feelings are being normalized and validated. Therapy should be a safe place for you to go – and although the journey to healing can be difficult, it is any therapist’s hope that the feeling of relief and control will be worth the hard work and dedication you have devoted to yourself.

Sources used:

https://www.abct.org/fact-sheets/sexual-assault/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239557/

https://www.ptsd.va.gov/understand_tx/emdr.asp

https://www.icmec.org/wp-content/uploads/2016/05/Behaviors-of-Sexual-Predators-Grooming.pdf

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