Rape and sexual assaults are highly prevalent problems globally, and a common pernicious myth about rape is that only strangers commit the act. However, according to a recent study conducted in the United States, approximately 50% of women asserted that at least one of their rape perpetrators was an intimate partner (Du Mont et al., 2017). Even though rape is a society-wide issue, the rape victim often suffers a blunt, personal violation (Murray et al., 2016). Du Mont et al. (2017) further asserts that a serious and common misconception is that a rape perpetrated by an intimate partner is less severe as compared to rape committed by a stranger. However, this notion is not true as the psychological, emotional, and physical trauma caused by rape from either party is detrimental. Care for rape survivors should be designed in such a way that the acute needs of each individual are addressed sensitively. This analysis provides the different treatment approaches for an individual raped by an intimate partner and a person raped by a stranger.
Difference between Client Needs
Whether an intimate partner or a stranger perpetrated the rape, the victim experiences a direct and personal violation. However, each client has different needs, and the primary client needs for an intimate partner rape victim is physical safety. As such, a counselor should devise strategies to help the client protect themselves and their children and prepare them to leave the abusive relationship. Assisting the client in achieving economic independence is essential. The client's need for an individual raped by a stranger is recovery from victimization. Therefore, a counselor should be sensitive and provide support for the survivors by enabling them to receive medical attention in addition to reporting the assault. Ensuring that the victim understands that they are not to blame for the incident will help reduce feelings of guilt and help them express their feelings (Huff & Rappleyea, 2019).
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Issues Faced by each Client
Stranger rape victims also experience PTSD a few weeks after the incident. Additionally, the thought of being raped by a stranger often contemplate suicide since they live with severe distress and depression. Emotional issues are common in stranger rape victims. Reducing the risk of being raped, especially by a stranger, can be achieved by implementing a variety of strategies such as being cautious, avoiding drug or alcohol intoxication, and avoiding teasing behaviors (Murray et al., 2016). For individuals raped by an intimate partner, feelings of shock and terror are common, and psychological consequences are severe. Such incidences of rape are associated with feelings of a profound violation of personal trust. An individual raped by an intimate partner often experience severe psychological stress, including anxiety, fear, anger and helplessness, fear, anger, and anxiety, in addition to intrusive thoughts and nightmares, which are often symptoms of post-traumatic stress disorder (PTSD). This is associated with the client’s inability to escape the painful situation, and the result is continued co-existence with the perpetrator. Moreover, intimate partner rape is often associated with domestic violence, which has negative impacts on the entire family, including the children.
Treatment Goals for each Client
Rape, whether by an intimate partner or a stranger, causes PTSD; hence treatment goals should focus on reducing symptoms associated with PTSD. For the client raped by her husband, treatment goals include decreasing the adverse effects of abuse including depression and PTSD, enhancing stress management, improving assertive communication, improving knowledge of how to solve conflicts and widening the knowledge of available resources within the community (Condino et al., 2016). Treatment goals for stranger rape victims include prevention or reduction of PTSD, psychopathology, anxiety, and depression, improving self-esteem, and improving social adjustment.
Treatment Approaches for Rape Victims
Vickerman & Margolin (2009) have described three treatment approaches for rape victims: stress inoculation training, prolonged exposure therapy, and cognitive processing therapy. Stress inoculation training (SIT) is ideal for individuals who have elevated fear and anxiety and the expression of specific avoidance behaviors. Treatment often targets rape-related phobias, including strange men and darkness. SIT also includes six behavioral and cognitive-behavioral coping strategies, including role-playing, covert modeling, muscle relaxation, controlled breathing, thought-stopping, and guided self-dialogue (Regehr et al., 2013). Prolonged exposure (PE) therapy is a treatment approach that focuses on assisting patients in reducing the anxiety associated with rape memories, thereby helping patients construct a more organized trauma story. Continued exposure to the incident by a repeated explanation of the incident in detail and repeated listening to the audio-recorded accounts helps the patient deal with depression, guilt, anxiety, rape-and related fears. Cognitive processing therapy (CPT) involves psychoeducation exposure and cognitive techniques. CPT involves recounting the rape incident by writing and reading the account to understand trauma-related areas of conflicting beliefs, logic, or assumptions. The aim is to create new understanding and the reevaluation of the incident to decrease avoidance and interruptions of unconsolidated aspects of the trauma (Regehr et al., 2013).
Appropriate Treatment Approach for each Client
Stress inoculation training (SIT) is best for a client who has been raped by a stranger, as it assists patients exhibiting fear, anxiety, and avoidance. SIT has been previously used to treat fear and anxiety symptoms in such patients. The patient will be taught to identify any environment that triggers fear, and in most cases, these are areas that resemble the location of the rape. The patient will also be taught to be alone and to relax their muscles. The patient will also be taught to reduce fearful thoughts and physiological sensations. Finally, the patient will be taught to engage in fearful behavior and manage avoidance behavior. For the client raped by her husband (intimate partner rape), the best treatment approach is PE therapy, which will help the patient confront traumatic memories and hence confront fear. Continued repetition of the experience as one records themselves is a way of making the scary memories less scary. This will reduce PTSD, which is common in such patients and improve adjustment, especially for married rape victims.
Conclusion
Intimate partner rape and stranger rape are equally dangerous. Intimate partner rape is often underreported, and most women suffer in silence, rape is a chronic problem, and it is associated with psychological and physical outcomes. It is of utmost importance for a counselor to recognize the damage related to all rape types ensures that client needs are addressed appropriately. While an individual raped by an intimate partner lives with a rapist, an individual raped by a stranger lives with a memory. Therefore, establishing the issues faced by each individual and their health and psychological needs assists in the development of appropriate treatment strategies. Accepting that rape is a common social problem helps the victimized individuals adopt the strategies that can reduce the risk of being raped.
References
Condino, V., Tanzilli, A., Speranza, A. M., & Lingiardi, V. (2016). Therapeutic interventions in intimate partner violence: An overview. Research in Psychotherapy: Psychopathology, Process, and Outcome , 19 (2). https://doi.org/10.4081/ripppo.2016.241
Du Mont, J., Woldeyohannes, M., Macdonald, S., Kosa, D., & Turner, L. (2017). A comparison of intimate partner and other sexual assault survivors’ use of different types of specialized hospital-based violence services. BMC Women's Health , 17 (1). https://doi.org/10.1186/s12905-017-0408-9
Huff, S., & Rappleyea, D. L. (2019). Understanding and responding to victims of interpersonal sexual violence and sexual assault within committed relationships. The American Journal of Family Therapy , 48 (1), 107-125. https://doi.org/10.1080/01926187.2019.1684217
Murray, C., Pope, A., & Willis, B. (2016). Sexuality and mental health. In Sexuality counseling: Theory, research, and practice (pp. 163-190). SAGE Publications. https://doi.org/10.4135/9781071801116.n9
Regehr, C., Alaggia, R., Dennis, J., Pitts, A., & Saini, M. (2013). Interventions to reduce distress in adult victims of sexual violence and rape: A systematic review. Campbell Systematic Reviews , 9 (1), 1-133. https://doi.org/10.4073/csr.2013.3
Vickerman, K. A., & Margolin, G. (2009). Rape treatment outcome research: Empirical findings and state of the literature. Clinical Psychology Review , 29 (5), 431-448. https://doi.org/10.1016/j.cpr.2009.04.004
