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

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

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;

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.

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

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

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

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.

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.

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

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

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

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

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

Narrative Therapy Recording memory of event; Journaling

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.

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