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Types of Sexual Trauma
James and Gilliland (2013) explained date and acquaintance rape on college campuses has become a significant problem. Often drugs and alcohol are linked to this type of rape. A report issued by the U.S. Department of Justice indicated rape represents the most common violent crime at U.S. universities.
Sexual abuse of children is known to cause lasting emotional trauma well into adulthood. Re-victimization can occur among survivors who neglect to get treatment. Putman (2009) noted PTSD may appear in the lives of children at any time when they have been victimized sexually.
Putman (2009) explained cognitive-behavioral approaches provide empirical evidence in the resolution of PTSD in children. For adults and children, many therapeutic approaches to PTSD integrate reviewing and reprocessing traumatic events.
James and Gilliland (2013) noted Cognitive restructuring and prolonged exposure can be a beneficial intervention as it allows the client to reframe his or her thinking and possible distorted beliefs about him or herself. It is a way to separate fact and fiction concerning the sexual assault.
This intervention includes using imagery from the abusive events so the negative stimuli builds to a crescendo in as much as the client can tolerate, and hence loses its grip on the client. Hunter (2009) pointed out narrative therapy in which clients can tell stories of transcendence whereby they refuse to identify as victims, can provide empowerment.
The idea inherent in narrative theory seems to be that it focuses on strengthening autonomy in that it teaches as Erford (2014) pointed out, "in essence narrative counseling holds that we are the authors of our own lives." (p. 142). Narrative theory is also a creative, and non-judgmental approach that is effective across cultures particularly among ethnic groups that emphasize storytelling in their culture. (Erford, 2014).
It also involves a collaborative process. Richert (2003) noted, "The therapist is active in asking those questions, making those reflections, and suggesting those experiential exercises… will help the client to greater new meanings and open new possibilities." (p. 197). The narrative therapist asks investigative questions to gain an understanding of an individual's story and how the individual perceives him or herself.
Further, as Rambo and Boyd (2015) noted, the therapist makes attempts at deconstructing problems and externalizing or separating them from the individuals hoping to help avoid blame. This would be important for a survivor of sexual abuse as they often experience self-blame.
Further, externalizing is used to move away from pathologizing clients. Narrative theory also demands active listening and creating an empathic connection which are two important elements of effective therapy. Narrative therapy (developed by Michael White in Australia and New Zealand) is supportive, affirming, and non-judgmental.
Erford, B.T.(2014) Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations(2nd ed.). Upper Saddle River, N.J.: Pearson Inc.
Hunter, S. V. (2009). Beyond surviving: Gender differences in response to early sexual experiences with adults. Journal of Family Issues, 30(3), 391-412. doi: 10.1177/0192513X08321493
James, R. K. & Gilliland, B. E. (2013). Crisis intervention strategies (7th ed.). Belmont, CA: Thomson Brooks/Cole
Kress, V. E. W., Trippany, R. L., & Nolan, J. M. (2003). Responding to sexual assault victims: Considerations for college counselors. Journal of College Counseling, 6(2), 124-133. doi: 10.1002/j.2161-1882.2003.tb00233.x
Putman, S. E. (2009). The monsters in my head: Posttraumatic stress disorder and the child survivor of sexual abuse. Journal of Counseling & Development, 87(1), 80-89. doi: 10.1002/j.1556-6678.2009.tb00552.x
Richert, A. J. (2003). Living stories, telling stories, changing stories: Experiential use of the relationship in narrative therapy. Journal Of Psychotherapy Integration, 13(2), 188-210. doi:10.1037/1053-0422.214.171.124
Ricks, L., Kitchens, S., Goodrich, T., & Hancock, E. (2014). My Story: The Use of Narrative Therapy in Individual and Group Counseling. Journal Of Creativity In Mental Health, 9(1), 99-110. doi:10.1080/15401383.2013.870947