Fundamental premises arising from this values-based orientation to sexual violence and supported by knowledge of trauma, are client-centred and empowering practise:

• Begin from a place of respect for victims/survivors and their personal strengths and needs
• Develop relationship and rapport
• Sensitively ascertain what this victims/survivor’s needs are, with regard to who they are as an individual and how they are responding to what they are experiencing. Assist victims/survivors through their decision-making process if need be.
• Assist victims/survivors through in getting their needs met.
• Advocate for respectful and informed treatment by others

The nature of sexual assault is that it is the imposition of the penultimate power of one person over another. Empowerment, or the restoration of power over self, is a counter to this significant, though often not complete, loss of power. Client-centred practice, whereby the client’s needs are the most important determinant of what happens,[1] is a counter to the objectification and human dis-connection of the sexual assault. What victims/survivors feel, want, and need is of primary importance to this human working alongside and for them.

Client-centred practice is a long held foundation to work in this sector, and can seem straightforward. However, due to the impact of the assault and the demands of some of the ways that we respond to assault, it can be more complex to achieve than simply asking what victims/survivors want and helping them to get it.

For example, many women who are physiologically and emotionally in a state of traumatisation are not able to answer direct questions about their needs, as they are not necessarily able to access those parts of themselves that know what they need. They might more easily be able to identify what they don’t want.

This approach to the work is further supported by what we are coming to know about the relationship between attachment patterns and PTSD,[2] that those with less secure patterns of attachment, whether that be avoidant or anxious, are more vulnerable to the development of PTSD. Being able to meet attachment needs arising from the event, that is, to be able to provide an appropriate and available human response, can mitigate the development of later trauma impacts.

What constitutes client-centred and empowering practice:

• Begin from a place of respect for the survivor’s feelings and needs,[3] such as, respect for their resilience, vulnerability, sense of shame, need to re-establish privacy and personal boundaries, need to regain control, need to believe that they are not vulnerable, need for dignity…whatever their individual needs are. Sexual violence can impact any aspect of self, so a survivor’s needs can relate to any aspect of self. Working from an English based New Zealand culture, there are often not words or concepts to articulate all of the impacts that survivors experience from sexual violence so we recognise the need for holistic responses. [4]
• Develop relationship and rapport utilising verbal and non-verbal communications by which you let the survivor know that you are attuned to them and you are there for them. Attuning to a person who is traumatised requires one to “tune into” what the survivor is feeling and the depth of it, without being destabilised by this. In this you help the survivor to feel better, and are able to advocate effectively for them in the “world”. Such attunement and presence alongside and for the victim/survivor can also assist them to move to feeling safe. While feeling safe can be a fundamental need and desire, it can also be a long journey. The sooner started, the less negative impact the experience of feeling unsafe will have.
• Sensitively ascertain what the survivor’s needs are, with regard to who they are as an individual and how they are responding to what they have and are experiencing. Assist the survivor through their decision-making process if need be. In the aftermath of sexual violence, a survivor may not have the capacity to make all decisions unassisted. They may be feeling destabilised and unable to think or feel clearly if they experienced the assault as overwhelming.
• The context for this decision-making can be the midst of a legal system which has its own requirements, being mandated to protect the rights of the alleged offender and make a case. Therefore, our role is to create space around the survivor in this whereby they have the chance to exert some power for themself. The art of the work is to form good relationship with the survivor so they know their well-being is our number one concern, offer the survivor as much information as they are able to process, facilitate their decision-making capacities (e.g. slowing down the process, arranging privacy for them, reducing stress on them by making sure their physical needs are met as much as possible, and moving forward to take care of them when they need us to), with their consent.
• Advocate for respectful and informed treatment from other services – including victim/survivor rights to accurate information, informed consent and decision-making, choices and control, and to being treated with courtesy and compassion and with respect for their dignity and privacy – and from other groups, such as family and community.

Studies show that specialist sexual assault advocates increase victim’s/survivor’s information and knowledge and help them to understand options and make decisions. [5]

Many of the other services or people involved in responding to sexual violence have agendas other than, or in addition to, the welfare and well-being of the victim/survivor.   Family and friends can themselves be secondarily traumatised by the event, or triggered into their own traumas. They may also be holding cultural beliefs and practices which lead to victim blaming or an inability to tolerate high levels of emotion or talk about sexual matters. Some families, friendships and/or communities are strong enough to hold this kind of event happening to one of their members, others not. Others fragment in the face of the impact of the trauma, and leave the survivor alone. Having a dedicated support worker means there is one person focused on the needs of victim/survivor, who doesn’t have another agenda, is not personally involved and has support and supervision to deal with impacts on themselves .

The issue of whether there is a greater psychological benefit in reporting the sexual assault to the police remains unclear.

Some studies have suggested involvement with the criminal justice system increases levels of fear [6]  while others have suggested that those women who elected to proceed to prosecute their assailant reported higher self-esteem[7] “While clinically, it makes sense that attempting to take some kind of action towards increasing control over the event may be beneficial to the individual, the continued and not unfounded lack of faith in the criminal justice system to protect individuals remains high. It remains the task of the individual, and not the clinician, to decide whether or not to report their sexual assault to the police, proceed with examination, and legal proceedings”. [8]

Services would address a range of victim/survivor needs including physical and emotional safety, personal support needs (engaging with family), practical supports (access to money, transport, housing), forensic issues, medical needs, police reporting options, counselling options, and need to be delivered flexibly. [9]

1.  Campbell, L. (2016). Sexual Assault Support Service for Canterbury: Research to inform service design. Aviva
2.  Twaite, J., & Rodriguez-Srednicki, O. (2004). Childhood sexual and physical abuse and adult vulnerability to PTSD: The mediating effects of attachment and dissociation. Journal of Child Sexual Abuse, 13 (1), 17-38
3.  Campbell, L. (2016). Sexual Assault Support Service for Canterbury: Research to inform service design. Aviva
4.  Thomas, A. (2013). Multi sectoral services and responses for women and girls subject to violence. Interactive Expert Panel: Making the Difference. New York: United Nations Commission on the Status of Women, Fifty-seventh session. Campbell, L. (2016). Sexual Assault Support Service for Canterbury: Research to inform service design. Aviva
   Blanch, A. (2008). Transcending violence: Emerging models for trauma healing in refugee communities. SAMHSA National Centre for Trauma-Informed Care. Retrieved from: http://www.vawnet.org/summary.php?doc_id=3479&find_type=web_sum_GC
5. Critelli, F. M. (2012). Voices of resistance: Seeking shelter services in Pakistan. Violence Against Women, 18(4): 437-458. Retrieved from: http://vaw.sagepub.com/content/18/4/437.full.pdf+html
   Kulkarni, S., Bell, H., & McDaniel Rhodes, D. (2012). Back to basics: Essential qualities of services for survivors of intimate partner violence. Violence Against Women, 18(1): 85-101. Retrieved from: http://vaw.sagepub.com/content/18/1/85.full.pdf+html
   Wasco, S., Campbell, R., Howard, A., Mason, G., Staggs, S., Schewe, P., & Riger, S. (2004). A statewide evaluation of services provided to rape survivors. Journal of Interpersonal Violence, 19, 252-263.
6. Kilpatrick, D., Saunders, B., Veronen, L., Best, C., and Von, J. (1987) Criminal victimization: Lifetime prevalence, reporting to police, and psychological impact. Crime and Delinquency, 33, 479–489.
7. Cluss PA, Boughton J, Frank LE, Stewart BD, West D. (1983). The rape victims: Psychological correlates of participation in the legal process. Criminal Justice and Behavior 10, 342–357.
8. Petrak, J. (2002). The psychological impact of sexual assault. In Petrak, J., & Hedge, B. (Eds). The trauma of sexual assault: Treatment, prevention and practice (pp.19-44). UK: Wiley.
9. Quixley, S. (2010). The right to choose: Enhancing best practice in responding to sexual assault in Queensland. Queensland Sexual Assault Services. Retrieved from: http://apo.org.au/node/22924

PRACTICE EXAMPLES

1.  Client-centred practice and the concept of empowerment are cornerstones of the ways that sexual assault support services work due to our understanding that they are an effective response to sexual violence precisely because they undermine the dynamics of that violence.

The following excerpt from the Competency Guidelines of Whanau Ahuru Mowai/Rape Crisis demonstrates a commitment to client centred practice.

We see the counselling/support relationship being a partnership in which the Whanau Ahuru Mowai/Rape crisis worker facilitates a process of allowing the client to move at her own pace, and, in the counselling situation, to structure her own healing journey.  This differs from the traditional medical approach which sees the counsellor as the healthy expert who can fix or cure the client’s sickness.

2.  Arranging the service so that it meets the client’s capacity, for example, getting other services to come to Wellington HELP to meet a client who is anxious about the meeting, or negotiating with police to meet at HELP and send a female officer if that is what the client needs to be able to consider reporting.

There are certain words or actions that can trigger bad memories of a rape.  It was hugely beneficial to me when my counsellor asked if there was anything, words or actions that I didn’t want to hear or see. Too easy, just ask first.  It made the sessions easier to go through.
– Louise Nicholas (Survivor Advocate)

I don’t think he realises that he actually takes the inner you away from you, that you’re only a shell, someone that’s just fluffed the whole being out of you. Everyone struggles to get themselves back again.
– Connie (Jordan, 2008, p.163)

For victim/survivors to be able to walk their journey safely, I have found through not only my own experiences, but that of others I have supported, that having one person to walk with you and help guide you through the maze of processes was immensely helpful. It helps gives back some control, it gives a sense of trust and empowerment. So much is taken away from you when you are raped, it’s nice to know that people who are supporting you understand, realise your needs and are prepared to be patient allowing you to move through this journey at your own pace.
– Louise Nicholas (Survivor Advocate)