Secondary Victimization of Rape Victims: Insights from Mental Health Professionals Who Treat Survivors of Violence

Reviewed by
Priscilla Schulz, LCSW

from an article of the same title by:

Rebecca Campbell, and Sheela Raja, University of Illinois at Chicago

Published:
Violence and Victims, V. 14 (3), 1999

What is the scope of this study?
This study surveys Illinois mental health professionals to get their opinions about the extent and impact of secondary victimization of rape victims who seek help from social service providers after the assault. The study also looks at the backgrounds of survey respondents to see how differences in mental health training, orientation and experience affect respondents' perception of secondary victimization. Researchers hypothesized that training and experience serving rape survivors, as well as experience treating minority and poor women would strongly influence clinicians' perceptions and opinions about secondary victimization.

What is secondary victimization?
Secondary victimization refers to behaviors and attitudes of social service providers that are "victim-blaming" and insensitive, and which traumatize victims of violence who are being served by these agencies. Institutional practices and values that place the needs of the organization above the needs of clients or patients are implicated in the problem. When providers subjugate the needs and psychological boundaries of rape victims to agencies' needs, victims feel violated.

The disregard of victims' needs by providers can so closely mimic victims' experiences at the hands of their assailants that secondary victimization is sometimes called "the second rape" or "the second assault." The personal beliefs and behaviors of social service workers are also sources of secondary victimization:

• Belief in rape myths that blame the victim for the assault and which result in providers voicing doubt about the veracity of victims' accounts
• Neglecting to offer or outright denial of important services such as pregnancy testing, informing rape survivors about HIV-AIDS and other sexually transmitted diseases, and legal prosecution of the sexual assault
• The performance of services in ways that leave victims feeling "violated and re-raped" or which otherwise damage victims' psychological well being.
  

How was the study conducted?
The integrity of sampling methods in this study was essential to rule out bias among study participants. Researchers solicited study participation from a representative sample of Illinois licensed mental health professionals (i.e., clinical/counseling psychologists, clinical social workers, social workers and professional counselors), and mailed to them a questionnaire designed specifically for the study. Consisting of 15 questions and 4 subscales, the questionnaire rated study participants' perception of the problem of secondary victimization using a forced-choice, 5-point Likert scale. It asked such questions as what did providers do that caused secondary victimization, and how did contact with social service providers affect the psychological well being of rape victims, positively or negatively. Besides completing the questionnaire, study participants were asked to give relevant personal and professional information about their therapeutic orientation, training, experience and to characterize their caseloads by sex, race and income level.

Forty-four percent of clinicians surveyed returned completed questionnaires. Only responses of clinicians with experience treating rape survivors were eligible to be included in the study, other responses were discarded. Eligible responses were then compiled and statistically evaluated along with characteristics of the respondent and his/her mental health practice.

What were the study's findings?

Is secondary victimization a problem?

1) Only 48% of study participants believed that contact with the social service system as a whole (i.e., legal, medical and mental health services considered together) can benefit rape survivors psychologically, and that those service providers are doing a good job of helping this population of clients.

2) The majority of mental health professionals surveyed (84%) agreed that contact with social service providers re-traumatizes rape victims.

a) Eighty-one percent of study participants believed that the legal system's treatment of rape victims is psychologically detrimental.

b) Eighty-nine percent of study participants agreed that the medical, post-rape exam was traumatizing for rape survivors.

c) Fifty-eight percent of study participants implicated mental health professionals in contributing to secondary victimization of rape survivors through harmful practices.

Did the background training and experience of clinicians affect their perception of the problem of secondary victimization?

Yes. Clinicians with specific training about sexual assault, who endorsed a feminist treatment orientation and who had experience treating rape survivors were significantly more likely to agree that contact with social service providers caused secondary victimization of rape survivors.

How did race and income levels of rape victims affect clinicians' perceptions of the problem of secondary victimization?

1. Clinicians who worked primarily with minority and/or low income rape survivors in their practices were significantly more likely to express the opinion that social service providers treated rape victims in a detrimental and re-traumatizing manner.
2. Clinicians whose practices consisted primarily of well to do, white women (incomes above $50,000) were more likely to report that contact with social service agencies was beneficial for victims in the aftermath of a rape.
   

What are the study's implications?

1. All mental health providers should be made aware of issues of violence against women, including secondary victimization.
2. Social service personnel (legal, medical and mental health) should all be trained about how to work with victims of violence to prevent secondary victimization. The instructional video Restoring Dignity: Frontline Response to Rape (1998) by the Long Island College Hospital and Junior League of Brooklyn is recommended.
3. Mental health professionals can play an important role in preventing secondary victimization by advocating for change in social service systems that treat rape survivors.
   

Reviewed by Priscilla Schulz, January 2000