University of Southern Denmark, Odense, Denmark.
Odense University Hospital, Odense, Denmark.
J Interpers Violence. 2022 Aug;37(15-16):NP14140-NP14165. doi: 10.1177/08862605211006358. Epub 2021 Apr 18.
Although research indicates that specialized sexual assault (SA) services are effective in terms of promoting postassault recovery and improving legal outcomes, little is known about how to best support survivors facing co-occurring difficulties and inequalities (e.g., preexisting mental health issues, substance abuse, poverty). This deficiency in knowledge was also expressed by service providers at Danish SA centers (SACs), who described this using the term "vulnerable survivors." Therefore, the present study aims to address this knowledge gap by exploring (a) how service providers understand vulnerability in the context of SA and (b) how service provision is currently approached for these survivors. Interviews were conducted with 18 service providers representing five professional groups (psychologists, social workers, forensic doctors, nurses, police) and analyzed using Interpretative Phenomenological Analysis. A total of eight themes emerged from the analysis, including service providers' descriptions of what characterizes vulnerability in survivors and broader perspectives on service provision for these survivors. Survivors considered least likely to attain desired supports were also those perceived to be most vulnerable with regards to risk and experiences surrounding sexual victimization (e.g., individuals with preexisting mental health issues). Service providers also believed that a large proportion of those served experience ongoing vulnerabilities that are difficult to manage within existing support models. The results thus suggest that survivors' needs cannot be met if vulnerabilities are overlooked or ignored. At the same time, the concept of vulnerability warrants caution since vulnerabilities are often placed within individual survivors, but the formal support system also appears vulnerable in its ability to meet the diverse needs and priorities of those served. The implications for SA services across the globe are discussed, including a need for more individually tailored and trauma-informed responses to SA that simultaneously address co-occurring difficulties and inequalities in survivors.
尽管研究表明，专门的性侵犯（SA）服务在促进性侵后恢复和改善法律结果方面是有效的，但对于如何最好地支持同时面临困难和不平等（例如，先前存在的心理健康问题、药物滥用、贫困）的幸存者知之甚少。丹麦性侵犯中心（SAC）的服务提供者也表达了这种知识上的不足，他们用“弱势幸存者”一词来描述这一点。因此，本研究旨在通过探索（a）服务提供者如何理解性侵犯背景下的脆弱性，以及（b）目前如何为这些幸存者提供服务，来解决这一知识空白。对来自五个专业群体（心理学家、社会工作者、法医、护士、警察）的 18 名服务提供者进行了访谈，并使用解释现象学分析进行了分析。从分析中得出了八个主题，包括服务提供者对幸存者脆弱性特征的描述以及对这些幸存者提供服务的更广泛观点。那些被认为最不可能获得所需支持的幸存者也是那些在性受害方面风险和经历最脆弱的幸存者（例如，有先前心理健康问题的个体）。服务提供者还认为，很大一部分服务对象都存在持续的脆弱性，这使得他们很难在现有的支持模式下管理这些脆弱性。因此，结果表明，如果忽视或忽略脆弱性，就无法满足幸存者的需求。同时，脆弱性的概念需要谨慎对待，因为脆弱性通常存在于个别幸存者身上，但正规的支持系统在满足服务对象的多样化需求和优先事项方面似乎也很脆弱。讨论了全球范围内的性侵犯服务的影响，包括需要更个性化和以创伤为中心的性侵犯应对措施，同时解决幸存者同时面临的困难和不平等。
