Practical Strategies for Working with Victims Across the Lifespan

1. Practical Strategies for Working with Victims Across the Lifespan Dr. Lilli Perez Rosemarie Camacho, IMFT Dr. Patricia Taimanglo November 16, 2011

2. ADULT VICTIMS OF SEXUAL ASSAULT • Sexual Symptoms • Major Long Term Medical Symptoms • Major Long Term Psychological Symptoms

3. Major Sexual Symptoms of Sexual Assault • Difficulty with becoming aroused and feeling sensations; • Sex feels like an obligation; • Sexual thoughts and images are disturbing; • Inappropriate sexual behaviors or sexual compulsivity; • Vaginal pain; • Inability to achieve orgasm or other orgasmic difficulties;

4. Major Sexual Symptoms of Sexual Assault • Erection problems or ejaculatory difficulty; • Feeling dissociated while having sex; • Detachment or emotional distance while having sex; • Being afraid of sex or avoiding sex; and • Guilt, fear, anger, disgust or other negative feelings when being sexual.

5. Major Long-Term Medical Symptoms • Insomnia; • Vaginal or pelvic pain; • Eating disorders; • Headaches; • Lower back pain, chest pressure;

6. Major Long-Term Medical Symptoms • Erection problems or ejaculatory difficulty; • Asthma; • Dizziness / fainting; • Self-harming / self-mutilation; and • Chronic physical complaints.

7. Major Long-Term Psychological Symptoms • Anxiety; • Panic Attacks; • Low self-esteem; • Stress Disorders / PTSD; • Personality Disorder; • Substance abuse; and • Self-Abused behaviors.

8. Activity • Reader / Reporter • Read the victim profile. • Others draw pictures, signs & symbols to represent what is read. • After 10 minutes, a reporter will give general description of the victim.

9. Assessment Should Inform Treatment • Presentation • Age • Affect / mood • Cognitive ability • Adaptive function – communication, self-care, social skills, working/school, family, leisure activities, academic function or education, etc.

10. Assessment Should Inform Treatment Community Support/Activities • Family (family of origin, nuclear, extended); • Friendships • Co-workers; • Sports; • Work; • Spiritual; etc.

11. Assessment Should Inform Treatment • Development – Early life (1st 3-4 years) • Medical concerns • Relationships • Family of origin – attachment • Current family • Extended family

12. Assessment Should Inform Treatment • Socio-Economic Status • History of mental illness; • History of sexual abuse/trauma; • History of substance abuse;

13. Assessment Should Inform Treatment • History of legal concerns • Charges filed • Preparing client for court involvement;

14. Treatment • Advocacy • Supportive Therapy • Powerful short-term therapy • Art Therapy • Narrative Therapy • Medication Therapy • EMDR • Evidenced Based Therapy for Anxiety, Depression, and Trauma

15. Narrative Therapy • Recording memory of event; • Journaling

16. Art Therapy • Art pulls out your feelings and makes them tangible or real so you can see them and deal with them. • When a person paints something, one can get an overall feeling of the painting and the person doing it. • Colors convey much about the experience and where the individual is in their healing.

17. Art Therapy • Self-portraits • Eventually some paint their abuser, body parts or critical elements of the assault. • Recovery Rituals