Personal reactions to sexual assault disclosures made by female clients diagnosed with serious mental illness
| DOI | https://doi.org/10.1108/JMHTEP-10-2017-0057 |
| Date | 09 July 2018 |
| Pages | 248-256 |
| Published date | 09 July 2018 |
| Author | Charlotte Strauss Swanson,Tracy Schroepfer |
| Subject Matter | Health & social care,Mental health,Mental health education |
Personal reactions to sexual assault
disclosures made by female clients
diagnosed with serious mental illness
Charlotte Strauss Swanson and Tracy Schroepfer
Abstract
Purpose –Mental health practitioners working with female clients diagnosed with a serious mental
illness (SMI) often face client disclosures of sexual assault. Research has shown that practitioners’
responses can be complicated by the diagnosis and lack of professional training; however, less is known
about the role their person al factors may play. The purp ose of this paper is twofold : to further
understanding of practitioners’personal reactions and investigate how these reactions affect their
professional respons e.
Design/methodology/approach –Nine mental health practitioners participated in face-to-face interviews,
in which they were asked to describe their personal reactions when faced with a disclosure and to discuss
how these reactions influence client assessment, treatment and referral.
Findings –The study results show that lacking training, practitioners expressed feelings of uncertainty, fear
and worry about how best to respond without causing further harm. Findings serve to inform future training to
support practitioners and, as a result, improve care and treatment for this population.
Originality/value –This study is unique because it explores the personal reactions mental health
practitioners’experience when responding to disclosures of sexual assault among women diagnosed with an
SMI and how these reactions may impact their professional response.
Keywords Violence against women, Disclosure, Sexual assault, Serious mental illness
Paper type Research paper
Mental health practitioners working with female clients diagnosed with a serious mental illness
(SMI) often face client disclosures of sexual assault (Khalifeh et al., 2015). When such disclosures
occur, practitioners find that responding can be complicated by the diagnosis, which may impact
the client’s presentation, history and symptomology (Ashmore et al., 2015; Bengtsson-Tops
et al., 2009; Rice, 2008). Practitioners report feeling unprepared on how to professionally
respond, assess and determine the most effective treatment (Bengtsson-Tops et al., 2009;
Rice, 2008). In addition, these feelings of unpreparedness have also been found with
practitioners’actual assessment and treatment plans for these clients (Chessen et al., 2011;
Agar and Read, 2002). Such research findings are concerning since the likelihood of a disclosure
is high for this client population and experiencing a sexual assault increases the risk for
adverse psychological and social effects, as well as suicide attempts (Khalifeh et al., 2015).
These potential risks have led researchers to seek a deeper understanding of the challenges
reported by mental health practitioners working with this population.
Mental health professionals responding to disclosures of sexual assault among the general
population report both rewarding and challenging aspects of their work supporting victims.
Professionals doing trauma work have indicated feeling anger, fear, frustration with systems intended
to help victims, and secondary traumatic stress reactions (Ullman, 2010). Researchers have
studied the implications of such reactions, specifically in regards to secondary traumatic stress, and
have found they can have both negative personal implications for the worker and professional
impacts (Ullman, 2010). Research suggests that more formal and informal support is needed
Received 9 October 2017
Revised 6 February 2018
Accepted 30 April 2018
Charlotte Strauss Swanson
is based at the School of
Social Work, University of
Wisconsin-Madison, Madison,
Wisconsin, USA.
Tracy Schroepfer is Professor
at the School of Social Work,
University of Wisconsin-Madison,
Madison, Wisconsin, USA.
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THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
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VOL. 13 NO. 4 2018, pp.248-256, © Emerald Publishing Limited, ISSN 1755-6228 DOI 10.1108/JMHTEP-10-2017-0057
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