Recovery from sexual assault: an innovative two-stage group therapy model

This article describes an innovative two-stage model of sexual assault therapy groups for women in a university setting. This model is recommended for use in various settings and includes a supportive therapy group and two specialized therapy groups, one for childhood sexual abuse survivors and the other for sexual assault (acquaintance rape and stranger rape) survivors. Theoretical underpinnings of the model are discussed in addition to practical aspects of group development such as elements of an effective group, screening of potential members, and marketing and recruitment techniques.     

Healing the Wounds of the Mahantdori

The magnitude of the Mahantdori, or Cambodian holocaust, must be understood by therapists who are trying to help the survivors deal with the illness and injuries that are a product of this destruction. This paper presents an overview of the events that have come to be known as the Mahantdori and a model for treating the multiple levels of trauma with which the Cambodian family must deal. The Contextual Model of Family Therapy, as described by Ivan Borzormenyi-Nagy, is used as the structure for helping to rebuild trust within the family while at the same time treating the injuries of the individual family members. The changing role of Cambodian women and their need to form new support groups because of their devastating loss of family are described.     

Quality of relationships and structural properties of social support networks of female survivors of abuse

The purposes of this study were to examine the structural properties of the social support networks of female survivors of violence and abuse and to investigate the quality of the relationship, and specific level of satisfaction, survivors have with their social support networks. Participants averaged 5.8 persons in their social support networks. Their levels of satisfaction with the emotional, practical, financial, guidance, and socializing support they received from members of their social support networks were higher with respect to close friends and coworkers than with respect to family members and professionals (e.g., attorneys and social workers). The most common type of support provided by close friends who were themselves victims of abuse was emotional, guidance, and socializing support, and the most satisfying support was the financial and practical help that came from parents or family. An interesting finding was the significant presence of men in the survivors' social support networks. Overall satisfaction with the quality of support from the social support networks was high, and satisfaction with support from men was comparable, if not higher, than support from women. Multiple regression models revealed that satisfaction with support networks was a potent predictor of self-esteem, emotional health, and loneliness. Intimacy, especially in terms of exclusiveness and trust or loyalty, with at least a few members of the support network contributed significantly to the variance in self-esteem, emotional health, and loneliness among the abused women. The size of the support network also emerged as a limited contributor to well-being. Implications and applications are discussed for professionals working with female survivors of abuse.     

African American Women’s Limited Knowledge and Experiences with Genetic Counseling for Hereditary Breast Cancer

Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n?=?13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n?=?8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community.     

Anger of women incest survivors

Adult women survivors of incest (n = 68) were compared to other women (n = 93) with respect to several questionnaire measures of manifest anger. The vast majority of the research participants were white, middle class, heterosexual, and Michigan residents. Incest survivors were angrier than other women, both in general and at their parents. Anger toward mother and anger toward father were comparable. Few incest survivors blamed either parent for the incest, except in those speciflc cases where the parent was a perpetrator. Not surprisingly, incest survivors were particularly angry at parent perpetrators when they were held responsible for the abuse. Incest occurred in families where other traumas were present, and the extent of these other traumas was also associated with increased anger at parents. Women who identified with feminism and who had participated in therapy were angrier at their parents than were other women. Therapy implications of these results were discussed.This paper is based on a doctoral dissertation submitted to the University of Michigan by the first author, under the supervision of the second author. The help and encouragement of committee members Margaret Buttenheim, Kathleen Faller, and Sheryl Olson are gratefully acknowledged. Howard Gottlieb, Judith Ballou, Donna Silbert, and Robert Daniels also contributed substantially to this research.Financial support was provided by the Society for the Psychological Study of Social Issues, the Horace D. Rackham School of Graduate Studies, and the Department of Psychology at the University of Michigan.     

Group Therapy as an Ecological Bridge to New Community for Trauma Survivors

Abstract

Group therapy counteracts the isolating effects of interpersonal trauma and enables survivors to connect with sources of resilience within themselves and others. By providing an alternative relational experience in which the survivor and her safety are valued, groups empower members to establish self-affirming and supportive relationships in their outside lives. The current paper reviews the psychological impact of chronic interpersonal violence and the relevant literature regarding group therapy for trauma survivors. We describe an approach to group treatment for complexly traumatized patients developed at the Victims of Violence Program, and through a clinical vignette, illustrate some of the ways in which group therapy can expand the relational world of survivors.     

Intimate Partner Violence in African Immigrant Communities in the United States: Reflections from the IDVAAC African Women’s Round Table on Domestic Violence

African women face many challenges when they come to the United States due to the immigration experience, acculturation, and leaving family members in countries of origin. Intimate partner violence (IPV) complicates African women’s experience within their home countries as well as in the United States. There is little literature on IPV in African ethnic groups. This information is even sparser regarding IPV among African immigrant and refugee communities in the United States. To better address the needs of these communities, the Institute on Domestic Violence in the African American Community brought together service providers and survivors representing 16 different African countries to attend a roundtable and explore issues of IPV. This article highlights the unique challenges they identified.     

Survivors’ Advice to Service Providers: How to Best Serve Survivors of Sexual Assault

Recognizing the relatively low rate at which sexual assault survivors seek services, researchers in the last decade have turned their attention to better understanding survivors’ experiences with victim services. Surprisingly, limited research has directly asked sexual assault survivors for recommendations on how to improve victim services, including both criminal justice and community-based services. The current study builds on the existing literature to gather input from women survivors that can translate into ways to improve victim services. As part of a larger longitudinal study, the current investigation asked 224 ethnically diverse adult (aged 18–62) women survivors of recent sexual assault to provide recommendations for how victim services can best serve survivors of sexual assault at multiple time points. Nearly all women in the study (91%) offered specific recommendations on how to improve victim services. Recommendations included ensuring availability of a female provider, improving communication with survivors as well as within and between service providers, helping survivors obtain resources, believing and not blaming survivors, demonstrating greater understanding of trauma-related responses and approaching survivors with greater compassion, and implementing better training on effectively working with survivors. Implications for victim service provision are discussed.     

癌症生存者生活质量及影响因素的调查分析

探讨不同癌症生存者的生活质量状况及其影响因素,对癌症部位、患病时间不同的癌症生存者148名,采用生活质量问卷(EORTCQLQ-30)进行测量。结果:不同年龄组之间RF、EF、SL和FI得分有统计学差异;男女患者在SF、AP和QOL方面有统计学差异。不同文化程度患者之间PF、RF、FA、NV和AP有统计学差异。患病时间与总体生活质量(QOL)之间相关性有统计学意义。不同种类癌症患者之间SF、DY、AP得分有统计学差异。有无复发或转移、是否接受手术治疗以及目前是否正在进行化疗均会对癌症生存者的生活质量产生影响。结论:人口学特征及疾病等因素均会不同程度的影响到癌症生存者的生活质量,提示医务人员应根据癌症生存者不同的特点进行有的放矢的治疗和护理,在延长其生存时间的同时也应注意提高其生活质量。     

Suicide bereavement and recovery patterns compared with nonsuicide bereavement patterns

This study compared bereavement experiences of suicide survivors with those of other survivors. The primary focus of investigation was upon grief reactions suggested to be unique to suicide bereavement and upon quality of grief resolution 2-4 years after death. Fifty-seven women and men, between the ages of 24 and 48, who had experienced the death of a marital partner were interviewed. Subjects were assigned to one of four groups by mode of death (suicide, accident, unanticipated natural, and expected natural). Analyses of variance and Scheffe procedures indicated no significant differences among survivors on frequencies of grief reactions considered common to all bereavements. The suicide survivors were significantly different from all others on certain grief measures, including rejection and unique grief reactions. On various other grief measures, significant differences were indicated among the groups of survivors. Four primary conclusions, implications of the findings, and limitations of the study are discussed.     

'Them' and 'us': the experiences of women with metastatic disease in mixed-stage versus stage-specific breast cancer support groups

The objective of this study was to explore the experiences of women with metastatic breast cancer (MBC) in mixed-stage and stage-specific groups. Interpretative phenomenological analysis (IPA) was used to examine 15 interviews from eight women with MBC. The interviewees felt that their experiences were very much different from those of women with primary breast cancer (BC), because of their different prognoses. In mixed-stage groups, the interviewees described feeling silenced, marginalised and helpless. They did not receive support in these groups because survivors of primary BC are often afraid to face the idea of metastasis. In stage-specific MBC groups, on the other hand, women were able to talk openly and were understood by others with whom they identified. They became more informed about issues related to their illness. Seeing others living well despite MBC made them feel more hopeful. Although there are some disadvantages of participating in stage-specific groups, the findings suggest that, overall, stage-specific groups are more helpful to women with MBC than mixed-stage groups. These findings have implications for the provision of group support for this population.     

‘Them’ and ‘us’: The experiences of women with metastatic disease in mixed-stage versus stage-specific breast cancer support groups

The objective of this study was to explore the experiences of women with metastatic breast cancer (MBC) in mixed-stage and stage-specific groups. Interpretative phenomenological analysis (IPA) was used to examine 15 interviews from eight women with MBC. The interviewees felt that their experiences were very much different from those of women with primary breast cancer (BC), because of their different prognoses. In mixed-stage groups, the interviewees described feeling silenced, marginalised and helpless. They did not receive support in these groups because survivors of primary BC are often afraid to face the idea of metastasis. In stage-specific MBC groups, on the other hand, women were able to talk openly and were understood by others with whom they identified. They became more informed about issues related to their illness. Seeing others living well despite MBC made them feel more hopeful. Although there are some disadvantages of participating in stage-specific groups, the findings suggest that, overall, stage-specific groups are more helpful to women with MBC than mixed-stage groups. These findings have implications for the provision of group support for this population.     

REFLECTIONS ON A FEMINIST RESEARCH PROJECT

This article describes the group process in a feminist research project on resiliency in adult women survivors of childhood sexual abuse. Memos written by members of the research team that were content analyzed independently provided the major source of data. Researchers' subjectivity, members' expectations for intimacy, and the role of power were examined. We describe how group members learned that taking the researcher's subjectivity into account affected our understanding of participant stories. The longing for intimacy created frustrations that needed to be acknowledged and processed by the group. Further tensions revolved around the feminist ideal of egalitarian relationships, which at times conflicted with the need for efficient decision making. We conclude with suggestions to aid feminist researchers in negotiating process issues.     

Holocaust survivors in long-term care

ABSTRACT

Little research exists on the experience of older trauma survivors in long-term care settings. This study examined the experience of Holocaust survivors in community-based and facility-based long-term care. We wished to know if Holocaust survivors had a systematically different experience in such settings compared to persons without a trauma experience in their backgrounds. Through interviews with survivors, American-born Jews in the same settings, family members, and professional staff, we learned that there were differences in certain aspects of mental health and emotional well-being and that these differences are associated with the relative lack of a network of family members as compared to American-born Jews.     

Implementing and Sustaining SHARE: An Exposure‐Based Psychotherapy Group for Incarcerated Women Survivors of Sexual Violence

Although incarcerated women are a highly victimized population, therapy for sexual violence victimization (SVV) sequela is not routinely offered in prison. SHARE is a group therapy for SVV survivors that was successfully implemented and sustained in a women’s correction center. Here, we aimed to identify implementation factors and strategies that led to SHARE’s success and describe incarcerated women’s perspectives on the program. We conducted a retrospective process evaluation using interviews structured according to EPIS, a well‐established implementation science framework. Participants (N = 22) were incarcerated women, members of the SHARE treatment team, and members of the correction center’s leadership, therapeutic team, and volunteer program. Factors that facilitated SHARE implementation varied by EPIS phase and organization. Positive inter‐organizational and interpersonal relationships were key across phases, as were the synergies between both the strengths and needs of each organization involved in implementation. Incarcerated women reported a strong need for SHARE and did not report any concerns about receiving trauma therapy in a carceral setting. Therapy for SVV sequelae, including exposure‐based therapy, is possible to implement and sustain in carceral settings. Community–academic partnerships may be a particularly feasible way to expand access to SVV therapy for incarcerated women.     

Disclosing Sexual Assault Within Social Networks: A Mixed‐Method Investigation

Most survivors of sexual assault disclose their experiences within their social networks, and these disclosure decisions can have important implications for their entry into formal systems and well‐being, but no research has directly examined these networks as a strategy to understand disclosure decisions. Using a mixed‐method approach that combined survey data, social network analysis, and interview data, we investigate whom, among potential informal responders in the social networks of college students who have experienced sexual assault, survivors contact regarding their assault, and how survivors narrate the role of networks in their decisions about whom to contact. Quantitative results suggest that characteristics of survivors, their social networks, and members of these networks are associated with disclosure decisions. Using data from social network analysis, we identified that survivors tended to disclose to a smaller proportion of their network when many network members had relationships with each other or when the network had more subgroups. Our qualitative analysis helps to contextualize these findings.     

Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

Do unto others as others have done unto you?: Perceiving sexism influences women's evaluations of stigmatized racial groups

The present research examines how making discrimination salient influences stigmatized group members' evaluations of other stigmatized groups. Specifically, three studies examine how salient sexism affects women's attitudes toward racial minorities. White women primed with sexism expressed more pro-White (relative to Black and Latino) self-report (Studies 1 and 3) and automatic (Study 2) intergroup bias, compared with White women who were not primed with sexism. Furthermore, group affirmation reduced the pro-White/antiminority bias White women expressed after exposure to sexism (Study 3), suggesting the mediating role of social identity threat. Overall, the results suggest that making discrimination salient triggers social identity threat, rather than a sense of common disadvantage, among stigmatized group members, leading to the derogation of other stigmatized groups. Implications for relations among members of different stigmatized groups are discussed.     

Standing in Between: The Healing Praxis of Mayan Women Intermediaries in Post-Genocide Guatemala

ABSTRACT

This article examines how Mayan intermediaries make meaning of their roles in accompanying Mayan women survivors of gross violations of human rights as they search for truth, justice, and reparation in post-genocide Guatemala. Using a constructivist grounded theory approach, the authors analyzed in-depth interviews with six intermediaries who worked with survivors in the context of a seven year feminist participatory and action research project. The findings reveal that healing from the legacies of armed conflict as well as from historical racialized gendered oppression are at the core of Mayan intermediaries’ work with the Mayan women survivors with whom they established an intersubjective relationship, contributing to each other’s healing. The importance of economic justice for survivors’ healing and the scant and circumscribed talk about sexual violence—the grievance central to the work with most of the survivors—emerge as important findings of this study and require future exploration.