User:Kaitlin Snyder/sandbox

Disclosure Behaviors
Extensive research findings suggest that talking about traumatic experiences with a supportive other is crucial to positive health outcomes post-trauma.1 Many sexual assault survivors across cultures do not self-disclose or report the assault experience, with fear of being blamed for the assault cited as one of the most common reasons for non-disclosure1. Although it can be challenging to accurately measure and understand disclosure behaviors post-assault due to the stigma surrounding sexual assault1, research suggests the majority of survivors do not tell someone what has happened to them immediately after the sexual assault occurs.2 When survivors do choose to talk to others about the assault, they tend to talk to informal supports first (e.g., family, friends) and may wait up to weeks, months, and years rather than telling someone immediately.3 4 Moreover, research suggests that less than a quarter (i.e., approximately 5-20%) of survivors of rape report the rape incident to law enforcement.5

Impact of Disclosure & Non-Disclosure on Well-being
Survivors who experience support and care from informal and formal supports following disclosure about [sexual] assault are more likely to have positive outcomes compared to those who experience unsupportive or stigmatizing responses following disclosure1. Negative responses following disclosure are linked to greater mental and physical health symptoms, including greater severity of post-traumatic stress symptoms.6 Survivors who experience blame and stigmatization following a sexual assault are also more likely to adopt harmful coping strategies.7 Moreover, research suggests that receiving less informational and emotional support and more blame-related responses to sexual assault disclosures are associated with experiencing sexual assault revictimization.8

Factors Related to the Discussion to Disclose
The decision to disclose or not disclose one’s sexual assault experience may depend on several factors. Factors that facilitate disclosure of sexual assault and violence include labeling the sexual assault as a criminal behavior, receiving supportive responses to initial disclosures, and receiving encouragement from informal supports to disclose to formal supports services (e.g., law enforcement, health service providers, legal services).9 With child survivors of sexual abuse, important themes regarding need and opportunity to disclose experiences of sexual abuse are central to their decision to disclose.10 These themes include access to a trusted person, comprehension of abuse as not normal, difficulties regulating distressing emotions, desire to change the circumstances of the abuse, expectation that their disclosure will be believed, and being asked about their well-being.10 Findings amongst adolescent and adult female-identifying survivors of sexual assault suggest that healthcare providers can better support survivors through asking questions that provide an opportunity for disclosure, awareness of indicators that a sexual assault may have occurred, communication of safety to disclose through supportive environment, inclusion of client-centered and culturally competent response in care provided, and further training in how to respond to disclosures.11

Findings suggest that feelings of self-blame and shame and expectations of stigmatization get in the way of survivor disclosure and decisions to ask for help following sexual assault.6  Survivors may decide against disclosing the assault to formal support services (e.g., law enforcement, service providers) due to a number of barriers, including: lack of knowledge or belief in the seriousness or criminality of the assault, fear of lacking evidence to corroborate the assault, fear of lack of confidentiality and retaliation by the perpetrator, disinterest in interacting with law enforcement, fear of being labeled as a victim, self-blame related to the assault, denial of the assault, and lack of access to resources.1 Barriers to disclosure may also be culturally relevant (e.g., fear of being outed) in that they are related to one’s social identities and history, or more adhere to social roles and expectations according to an individual’s current sociopolitical environment.12 13 Research with children and adolescents in forensic settings suggests minors that identify as female, are older in age, and who have already disclosed are more likely to disclose sexual abuse in interviews.14 Identified unique barriers to disclosure for older survivors of sexual assault, perhaps especially older women, involve the discrepancy between previous and current definitions of sexual assault (i.e., legal definitions of sexual assault have generally expanded over time) and social acceptability in discussing sex and sexual violence openly.15 A unique barrier to disclosure for adult survivors of child sexual abuse is the belief that disclosure is either unnecessary, as the abuse may be far removed from their present-day lives, or otherwise remain unsure about how disclosure could improve their current life, well-being, or relationships.16

Formal Supports: Facilitating Disclosure
First responders such as law enforcement and healthcare providers have a large impact on survivors after a sexual assault occurs. Physical health providers are expected to be a front-line support to survivors by providing numerous resources following an assault, including not only physical care but also information about mental health and legal care and assistance related to safety of the survivor and family members if necessary. 17 The World Health Organization (WHO) also recommends that healthcare workers provide care in a supportive, judgement-free, validating manner when working with survivors of sexual assault and abuse.17 18

Findings across multiple studies suggest that providing emotional support (e.g., nurturing statements, communication that the survivor is not at fault for their experience) and tangible support (e.g., medical care, mental health resources, safety assessments, information on sexual assault) are considered helpful responses from providers following disclosure of sexual assault.11 Moreover, providing resources without a validating and empathetic response may be perceived negatively by sexual assault survivors.11 Unhelpful responses from providers reported by survivors are being blamed for the sexual assault, diminishing or dismissing the negative impact of the assault on the survivor, being treated differently post-disclosure, responses that lack emotional support, and doubting the survivor’s disclosure.11

Informal Supports: Facilitating Disclosure
RAINN’s National Suicide Sexual Assault Hotline staff provide the following phrases for guidance on how to be supportive in response to someone who has disclosed that they have experienced a sexual assault:

“It’s not your fault./You didn’t do anything to deserve this.”

“You are not alone./I care about you and am here to listen or help in any way I can.”

“I’m sorry this happened./This shouldn’t have happened to you.”19

RAINN staff suggest continued support to survivors should involve avoiding judgment of any symptoms the survivor experiences following a sexual assault or the length of time their recovery process takes, follow-up checking-in regarding the survivor’s well-being, and knowledge about resources for survivors when a higher level of care may be indicated. 19