Understanding rape survivors' decisions not to seek help from formal social systems

Health and Social Work, May, 2009 by Debra Patterson, Megan Greeson, Rebecca Campbell

The current study also found that survivors did not seek help when they believed the formal social systems could not help them. Therefore, another aim of social marketing should build a positive image of the services offered by the formal social systems. The findings of the current study would suggest that a social marketing plan should address survivors' concerns about help seeking, such as loss of privacy and fear of services intensifying their emotions to an unmanageable level. Thus, the social marketing should include information regarding confidentiality and common emotions that emerge during the process and strategies to keep these temporary emotions at a manageable level. Overall, the social marketing message needs to communicate that services are available to all survivors, regardless of the type of rape (for example, acquaintance rape) and severity (for example, degree of violence and injury) thereof. Because survivors viewed help seeking as risky to their well-being, the message also should promote services as beneficial and safe for survivors.

Although social marketing has been found to increase help seeking, survivors will not seek help if they anticipate psychological harm. Survivors in this study anticipated that seeking help would cause them further psychological distress but did not actually seek help from any formal social system. Although the survivors were just anticipating further distress from seeking help, prior research suggests that these survivors may have accurate concerns about help seeking. For example, studies have found that rape survivors often do not receive needed services and are treated by system personnel in ways that they experience as upsetting and victim blaming. Survivors experienced being blamed, were told their cases were not serious enough, and were not believed by system personnel. These negative experiences with formal social systems are associated with higher levels of posttraumatic stress symptoms (Campbell & Raja, 2005; Campbell et al., 2001). Therefore, it is important to improve the systems' response so survivors are not revictimized (for example, blamed) when seeking help from formal social systems.

Social workers are often housed in these formal social systems (for example, police departments, hospitals, mental health agencies, rape crisis centers), providing opportunity for social workers to play an important role in improving survivors' experiences with formal social systems. In addition, many communities are forming multidisciplinary coordinated response initiatives to improve formal social systems' responses to rape survivors (Littel, 2001). Prior research has found that communities with higher coordinated responses were more successful in providing higher quality care consistent with survivors' needs (Campbell & Ahrens, 1998). Furthermore, these community initiatives are associated with law enforcement's improved treatment of rape survivors (Zweig & Burt, 2006). Ethical principles charge social workers with the responsibility of pursuing social change, particularly with and on behalf of vulnerable and oppressed individuals, leaving social workers with the task of preventing systemic harm to survivors (NASW, 2000). Therefore, the presence of social workers in these coordinated responses may have an important role in improving the treatment of rape survivors. Social workers can contribute to these initiatives by advocating for and training on survivor-centered empowerment approaches to working with survivors. However, the unique contributions of social workers in these community-coordinated responses have not been examined. Therefore, future research should explore whether and how social workers contribute to the improved response toward victims of rape within these multidisciplinary initiatives.