Current Trends in Psychological Assessment and Treatment Approaches for Survivors of Sexual Trauma

This document provides a review and critique of current trends in mental health assessment and treatment for sexual trauma survivors with an emphasis on early intervention. Treatment approaches are restricted to psychotherapy.

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VAWnet Summary:

Current Trends in Psychological Assessment and Treatment Approaches for Survivors of Sexual Trauma by Nicole P. Yuan, Mary P. Koss, and Mirto Stone (April 2006).

In Brief:

Female survivors of sexual trauma are vulnerable to a wide range of psychological consequences. Because some psychological symptoms may be long lasting and severe, treating them at the earliest point in time may reduce the duration and severity of distress.Ideal approaches for assessment and treatment for sexual trauma survivors are comprehensive, multi-faceted theoretical frameworks and techniques that are individualized to the needs of each survivor. Although trained professionals must administer most of the techniques, all individuals working with or for survivors may utilize knowledge in this area to improve the overall quality and accessibility of mental health services for women.

Psychological assessments contribute to referrals for specialized therapeutic services and the development of treatment plans. Important areas for exploration include some aspects of the assault, psychological distress and symptoms, and pre-trauma and post-trauma experiences. Although certain assault characteristics may shed light on the likelihood of mental health outcomes, extensive information gathering about the event should be generally avoided. Forced recollection of specific details has been shown to trigger or exacerbate emotional distress among some survivors. Brief screening tools and trauma-specific instruments are frequently used to obtain an objective assessment of specific groups of symptoms (e.g., depression, anxiety, alcohol problems, and posttraumatic stress). Pre-trauma experiences that may shape how the distress of sexual victimization is experienced and expressed include previous victimization, history of mental health difficulties, and stressful life events. Post-trauma experiences of interest include negative interactions with family and peers, medical professionals, law enforcement, and prosecutors.

A one-size fits all treatment approach does not exist. Ideally, the selection of treatment strategies is dependent on the primary areas of difficulty, the survivor's willingness to engage in a particular type of treatment, and strength of the clinician-client relationship. Current trends in psychological treatments include early interventions, targeted strategies, and multimodal approaches. Early interventions have produced mixed findings, but potential benefits may include the mobilization of a positive support network and reduced exposure to negative interactions early in the recovery process. Targeted therapies consisting of cognitive-behavioral interventions for PTSD have been shown to be effective in individual and group formats. Multimodal approaches are recommended for survivors with a multiple psychological issues, such as women who also experience depression or problem alcohol use.

Implementation of these recommended assessment and treatment approaches largely rests on greater opportunities for open dialogue and cross training among researchers, practitioners, advocates, and policymakers. This includes enhanced integration of violence against women and health promotion fields. By strengthening collaborations and addressing the stigma associated with sexual violence and mental health problems, more survivors may have access to services at their most critical point of need.

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