Communication Tips for Caring for Survivors of Sexual Assault
You can support your patients' recovery from sexual assault by interacting with them in an empowering, compassionate manner.
Fam Pract Manag. 2019 Jul-Aug;26(4):19-23.
Author disclosures: no relevant financial affiliations disclosed.
The past few years have witnessed unprecedented disclosures of sexual assault, spanning public figures from business, politics, pop culture, and the media. The #MeToo movement has sparked tremendous interest, involving people openly sharing their sexual trauma experiences privately in health care settings and in public venues such as social media.
Physicians should be prepared for patient disclosures of sexual trauma to occur in the exam room and be ready to respond in an empowering and compassionate manner. This article focuses on effective communication methods for addressing sexual trauma with patients who have experienced sexual assault in adulthood. The recommendations apply both to the immediate aftermath of the trauma and to working with survivors in the subsequent days, months, and years after the assault. The medical and legal issues around working with survivors of sexual assault are beyond the scope of this article, but excellent resources are available (see “Resources”).
Physicians need to be prepared for patients to disclose a history of sexual assault and respond to patients in an empowering, compassionate manner.
How physicians respond to disclosure of sexual assault matters. You can be most helpful by providing emotional support, offering resources, and reassuring patients the assault wasn't their fault.
Avoid using physical touch to comfort, as it's impossible to know how survivors will experience touch. Use your words, tone of voice, and body language to convey support.
DEFINING THE IMPACT ON SURVIVOR HEALTH
According to the Centers for Disease Control and Prevention, the lifetime prevalence of contact sexual violence (defined as rape, being made to penetrate someone else, sexual coercion, or unwanted sexual contact) is 36 percent for women and 17 percent for men.1 Among female survivors, nearly half of their perpetrators are current or former intimate partners.1 Furthermore, more than half of women report being re-victimized sexually.2
Sexual assault has a clear impact on survivors' physical and mental health. Women and men who have experienced sexual assault have a higher risk of health conditions such as asthma, irritable bowel syndrome, headaches, chronic pain, poor sleep, and overall poor physical health.1 Mental health problems are also more common among sexual assault survivors, including post-traumatic stress disorder (PTSD), depression, anxiety, substance abuse, excessive feelings of shame and guilt, sexual problems, and others.1,3
Referencesshow all references
1. Smith SG, Chen J, Basile KC, et al. The National Intimate Partner and Sexual Violence Survey (NISVS): 2010–2012 State Report. Atlanta: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2017....
2. Walsh K, Danielson CK, McCauley JL, Saunders BE, Kilpatrick DG, Resnick HS. National prevalence of posttraumatic stress disorder among sexually revictimized adolescent, college, and adult household-residing women. Arch Gen Psychiatry. 2012;69(9):935–942.
3. Thurston RC, Chang Y, Matthews KA, von Kanel R, Koenen K. Association of sexual harassment and sexual assault with midlife women's mental and physical health. JAMA Intern Med. 2019;179(1):48–53.
4. Peter-Hagene LC, Ullman SE. Social reactions to sexual assault disclosure and problem drinking: mediating effects of perceived control and PTSD. J Interpers Violence. 2014;29(8):1418–1437.
5. Ullman SE, Peter-Hagene LC. Longitudinal relationships of social reactions, PTSD, and revictimization in sexual assault survivors. J Interpers Violence. 2016;31(6):1074–1094.
6. Hakimi D, Bryant-Davis T, Ullman SE, Gobin RL. Relationship between negative social reactions to sexual assault disclosure and mental health outcomes of black and white female survivors. Psychol Trauma. 2018;10(3):270–275.
7. Berry KM, Rutledge CM. Factors that influence women to disclose sexual assault history to health care providers. J Obstet Gynecol Neonatal Nurs. 2016;45(4):553–564.
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