A Danish Model for Treating Victims of Rape and Sexual Assault: The Multidisciplinary Public Approach

High prevalence and long-lasting implications of human-inflicted trauma call for effective treatment approaches reaching clients in need of trauma-specific treatment. Numerous approaches exist, but often with limited empirical support. There is also a tendency toward segregating treatment approaches depending on type of exposure history and presenting symptoms. This might exclude clients in need of trauma-specific treatment; therefore, treatment approaches that can reach more heterogeneous groups of clients are needed. In this article, a group-based treatment approach adjusted to include clients with a wide range of trauma-related problems and traumatic experiences will be presented. A brief outline of the approach is presented, together with the theoretical and empirical background, to facilitate implementation by practitioners and empirical testing.     

The Community Response to Rape: Victims' Experiences with the Legal, Medical, and Mental Health Systems

This research examined how the legal, medical, and mental health systems respond to the needs of rape victims. A national random sample of rape victim advocates (N = 168) participated in a phone interview that assessed the resources available to victims in their communities. as well as the specific experiences of the most recent rape victim with which they had completed work. Results from hierarchical and iterative cluster analysis revealed three patterns in victims' experiences with the legal, medical, and mental health systems. One group of victims had relatively positive experiences with all three systems, a second group had beneficial outcomes with only the medical systems, and the final group had difficult encounters with all three systems. Multinominal logistic regression was then used to evaluate an ecological model predicting cluster membership. Community-level factors as well as features of the assault and characteristics of the victims predicted unique variance in victims' outcomes with the legal, medical, and mental health systems. These findings provide empirical support for a basic tenet of ecological theory: environmental structures and practices influence individual outcomes. Implications for ecological theory and interventions to improve the community response to rape victims' needs are discussed.     

Victim Gender,Number of Perpetrators,and Interpersonal Interaction in Stranger Rape: An Analysis of Direct and Moderator Effects

This study examined the direct and moderator effects of number of perpetrators and gender of victim on interpersonal behaviour in stranger rape. Crime scene behaviours representative of hostility, involvement, control, and offender penetration in rape were examined for 496 UK, police‐recorded cases of stranger rape. Cases were grouped according to victim gender (male or female) and number of perpetrators (lone or multiple). This resulted in four groups (lone female, lone male, multiple female, and multiple male) with 124 cases in each. Binary logistic regression and one‐way analysis of variance were used to investigate the relationships between the two predictor variables and 11 criterion variables. Significant direct effects of number of perpetrators were found whereby multiple perpetrator offences were more likely to involve violence and less likely to involve involvement interactions than lone perpetrator offences. Significant direct effects of victim gender were also found whereby male victims were more likely than female victims to experience hostile interactions and be threatened with a weapon and were less likely to experience offender penetration and involvement interactions. Significant crossover interactions were also found for four hostility variables. The utility of the findings are discussed in relation to crime prevention, victim support, and offender intervention. Copyright © 2013 John Wiley & Sons, Ltd.     

Young Women who Have Experienced Unwanted Pregnancy: A Multiple Case Study

Qualitative approaches were used to understand the experience of pregnancy in a group of young Xhosa women (N =10, M age = 19.70, SD = 3.20). Data is provided on their retrospective accounts of factors which contributed towards unwanted pregnancy. Thematic content analysis revealed a range of influences on pregnancy including: background, parenting and restrictions; stigma towards contraception; carelessness and ignorance; power and pressure from the partner; and shifting responsibility.     

Doing Community Research Without a Community: Creating Safe Space for Rape Survivors

This paper describes how the values of a feminist research team influenced methodological decisions in a study of rape survivors. Building upon concepts from community psychology and urban sociology, the authors created a community-based research design that respected the emotional needs of rape survivors without sacrificing methodological rigor. We developed relationships with community members in diverse settings, such as nail and hair salons, child care centers, churches, and bookstores, to advertise the study and recruit participants. Consistent with feminist approaches to interviewing, our goal was to create a safe setting for survivors to tell their stories. Although the purpose of this study was research rather than intervention, most survivors reported that participating in these interviews was healing. Our experiences in this project suggest that allowing values to influence the process of research may have beneficial outcomes for both researchers and participants.     

Power and Public Participation in a Hazardous Waste Dispute: A Community Case Study

Qualitative case study findings are presented. We examined whether public participation in a hazardous waste dispute manifested in ways consistent with theories of social power; particularly whether participatory processes or participants' experiences of them were consistent with the three-dimensional view of power (Gaventa, Power and powerlessness: quiescence and rebellion in an appalacian valley, 1980; Lukes, Power: A radical view, 1974; Parenti, Power and the powerless, 1978). Findings from four data sources collected over 3 years revealed that participatory processes manifested in ways consistent with theories of power, and participants' experiences reflected this. Results illustrated how participation was limited and how citizen influence could be manipulated via control of resources, barriers to participation, agenda setting, and shaping conceptions about what participation was possible. Implications for community research and policy related to participation in hazardous waste disputes are discussed.     

11岁选择性缄默症女孩的箱庭治疗个案研究

采用箱庭疗法对11岁选择性缄默症女孩进行心理治疗的小M研究.经过18次个体箱庭和4次家庭箱庭治疗,来访者的箱庭作品由贫瘠、单调逐渐向丰富、多样转化,由孤立、静止走向开放、动态,自我力量逐步增强.来访者的学校适应、亲子关系也发生了积极改变.箱庭治疗使来访者的内心世界由创伤走向治愈.     

A Professor's Experience With Loss: An Autobiographical Case Study

The purpose of this article is to present an autobiographical case study chronicling a psychology professor's experience with grief and the loss of her father during the early stages of her academic career. The article highlights the obstacles faced in dealing with anticipatory grief but also demonstrates how clinicians and researchers may use adverse life circumstances to develop research and applied programs centered around their experiences. Rooted in Viktor Frankl's work on logotherapy, the author demonstrates how traumatic experiences can help psychologists find meaning and purpose in their work. Directions for future research focusing on larger scale populations are addressed.     

A multiple case study of rape victim advocates' self-care routines: the influence of organizational context

This study assumes that rape victim advocates who provide community outreach services to victimized women must adjust to a heightened awareness of sexual violence to do their jobs. Using qualitative methodology, this multiple case study explored rape victim advocates' strategies for incorporating repeated exposure to sexual assault into their daily lives as well as ways that organizations can support such endeavors. Findings suggest that advocates' self-care routines draw upon various personal resources (i.e., cognitive, physical, social, spiritual, verbal), and serve 2 roles for coping with rape-related pain: (a) cathartic releasing of traumatic material, and (b) improving capacity to integrate the traumatic material into one's life. Additionally, over 20 organizational characteristics that workers perceive to be supportive (e.g., weekly meetings, flexible hours) were identified. Nonparametric and categorical statistical analyses were used to analyze the relationship between organizational support and self-care routines, finding that advocates working in organizations with higher levels of support utilize more strategies that are integrative in nature. Implications of these findings are discussed.     

An Integrative Model for Ethnocultural Counseling and Psychotherapy of Victims of Organized Violence

The author researched sociocultural factors related to psychotherapy with victims of organized violence from different perspectives: a refugee counseling center in a metropolis (Frankfurt, 1991–95) and refugee camps in neighboring countries (Uganda, 1994–96). At first the psychopathology of victims of organized violence is described. Then a review of treatment approaches follows and a conceptual model for integrative psychotherapy is developed. On the basis of qualitative analysis of client–therapist interactions, case discussions, supervision, evaluation of treatment, and literature review, an eclectic model for ethnocultural counseling and psychotherapy was developed. This eclectic model can be divided into (1) therapeutic relationship and transference, (2) modeling techniques, (3) extrapsychic techniques, (4) somatic techniques,(5) working through traumatic/grief/repressive experiences, and (6) reeducative and supportive techniques.     

抽动症儿童的箱庭治疗个案研究

探讨箱庭治疗对抽动症儿童的有效性和作用机制。对一名抽动症儿童进行15次箱庭治疗,综合使用作品分析、访谈法和问卷法对治疗的过程及效果进行评估,结果发现个案的变化经过问题呈现、转变和自性三个阶段,箱庭治疗所提供的自由受保护的空间、矫正性的情绪体验以及良好的咨访关系等能够帮助个案减少抽动症状,提高情绪调节能力和人际交往能力。     

The Reality and Myth of Rape: Implications for theCriminal Justice System

This article sets out to evaluate the researchevidence for rape myths and the extent to which theyare causally related to rape proclivity; negativeattitudes towards rape victims; and the reporting ofsexual assault incidents to the police. In reviewingthis literature, we provide an evaluation of theimpact of this research on the criminal justice systemand possible future developments. We argue that thisresearch, while failing to provide conclusive evidenceof a causal relationship, has nevertheless played animportant part in shaping more sympathetic approachestowards rape victims in the criminal justice system.However, we also argue that the current research fallsshort of the level of proof required for it to beadmitted as evidence in criminal trials. We considera number of alternative uses including AmicusCuriae briefs, and the training of juries and judgesprior to hearing rape cases.     

An Occupational Therapist's Interdisciplinary Approach to a Geriatric Psychiatry Activity Group: A Case Study

Occupational therapy has long recognized the usefulness of activity groups to promote functional outcomes for clients in mental-health settings. An occupational therapist used an interdisciplinary approach (working with a psychiatric nurse practitioner and a manual arts therapist) to conduct a biweekly geriatric psychiatry activity group. A case study is presented to demonstrate the success and longevity of the interdisciplinary activity group. Each clinician contributed unique skills to provide occupation which provided positive outcomes for the clients. Practically, the employing of different disciplines allowed group coverage for each other in times of cost-containment and limited resources.     

案例教学的医学伦理学再造

我国医学伦理学采用案例教学法已经有二十余年的历史了。在此期间,案例教学得到了一定的发展,却也受到了诸多因素的限制。当前,中国医学伦理学的案例教学朝哪里去、怎么去等一系列新的问题摆在我们面前,这些问题必须依赖于加强我国医学伦理学软件环境的建设并对案例教学进行医学伦理学的再造方能加以解决。     

案例研究与决疑法：当代医学伦理学的经验主义方法论反思

当代医学伦理学至今没有形成较为成熟稳定的研究方法,方法论的“革命”往往意味着科学的革命、学科范式的转型和知识谱系的变革。案例研究与决疑法是医学伦理学常见的两种经验主义方法。这两种方法的广泛运用,是当代医学伦理学对于规范伦理学中“原则主义”的一种实践“反叛”与深度批评。对这两种方法的基本逻辑、实践特征、优点和弊端进行详细分析,深入探讨医学伦理学的学科方法论,通过对方法学的反思,表明当代医学伦理学的方法论在原则与例外、普遍与特殊之间“徘徊”不定,进一步推进对医学伦理学学科建设的理解与反思。

     

From Survivor to Thriver: A Pilot Study of an Online Program for Rape Victims

Approximately 15% to 20% of women have been victims of rape and close to a third report current rape-related PTSD or clinically significant depression or anxiety. Unfortunately, very few distressed rape victims seek formal help. This suggests a need to develop alternative ways to assist the many distressed victims of sexual violence. Online treatment programs represent a potentially important alternative strategy for reaching such individuals. The current paper describes a pilot evaluation of an online, therapist-facilitated, self-paced cognitive behavioral program for rape victims. Five college women with current rape-related PTSD were recruited to complete the From Survivor to Thriver (S to T) program in a lab setting over the course of 7 weeks. After completing the program, 4 participants reported clinically significant reductions in PTSD symptoms and no longer met criteria for PTSD. All participants reported clinically significant reductions in vulnerability fears and 4 reported significant reductions in negative trauma-related cognitions. Implications of the results for further development of the S to T program and how clinicians could utilize this program in treating rape-related PTSD are discussed.     

Emotional Reactions of Rape Victim Advocates: A Multiple Case Study of Anger and Fear

This research explores the emotional reactions of a rarely studied group of women who work closely with survivors of sexual violence: rape victim advocates. Women who assist rape victims in obtaining medical, criminal justice, and mental health services were interviewed about their experiences, and qualitative analysis was used to delineate the situational context of the advocates' emotional reactions. Results indicate that respondents experienced anger and fear in response to both individual (e.g., a perpetrator's menacing glare) and environmental (e.g., community denial of a problem) cues. Additionally, some experienced rape victim advocates perceived their emotional reactions to be an important part of their work with rape victims. These findings suggest that intense emotional reactions, previously conceptualized within a vicarious trauma framework, may at times serve as resources for women working with rape survivors.     

Reconceptualizing Quantitative and Qualitative Methods: A Case Study Dealing with Place as an Exemplar

A useful framework for understanding methods is to think of them as being on a continuum of holistic and pattern focused to particularistic and specific. This paper argues for this conceptualization rather than thinking of quantitative and qualitative methods as oppositional and potentially contradictory. A case study provides an example of using both quantitative and qualitative methods in a holistic and pattern-focused study, while also attending to the values and goals of community psychology. The substantive research goal is to understand a child's experience of places related to school. Methods include ethnographic long-term participation and observation, interviews, multidimensional scaling, and social network analysis. Most quantitative method variables are generated from study participants; no outside structure is imposed. The quantitative methods extend and inform the qualitative methods, just as the qualitative methods extend and inform the quantitative methods. The quantitative and qualitative methods work reciprocally to extend and inform each other.