Treatment and Therapy After Rape - Research Paper Example

? Interview with rape therapist with support of literature Intimate Partner Violence (IPV) through rape and other forms of assaultis rampant in California. These incidences of IPV rape are either fatal or nonfatal, but all are damaging to the victims both physically and psychologically (Myers, 2011). Research into this type of rape was conducted by interviewing Dr. Khalil Rahmany of The Hume Center Concord, CA. The doctor acknowledges that IPR (Intimate Partner Rape) has some of the most damaging consequences on victims as it is perpetrated by a loved one, either a husband or boyfriend. Even though IPR is banned across the United States, some states still have poor response mechanisms to this type of rape. Lenient attitudes towards IPR sometimes justified by lawmakers, individuals or the victims themselves; such lenience towards IPR stems from stereotypical mindsets regarding the roles of both genders which suppress the rights of women. IPR is nonconsensual sexual relations between the victim and their spouse (Simon, 2001). According to Dr. Khalil, Battered Women Shelters (BWS), are the right places to house victims of IPR; this is because referring the patient back home will lead to more psychological trauma as she will have to face the perpetrator on a regular basis so reliving the rape ordeal. This will, in turn, result in loss of headway gained through treatment. It is paramount to ascertain both the patients’ safety by ensuring they are not subjected to any more gender based violence. Once the hospital receives a victim of IPR, the initial course of action is to undertake extensive clinical examination to repair and treat any injuries. Routine clinical examination entails treatment of any tears in the victims’ sexual organs and dressing of any exterior wounds. As most rapes are brutal in nature, we note that in most cases, the victims’ sexual organs are often damaged through vigorous friction; some are as dangerous as to require surgical repairing of the torn tissues (Myers, 2011). Medical examination is then carried out on the patients to determine whether any diseases have been transmitted to them through the act of rape. Dr. Khalil asserts that in some occasions, IPR results in transmission of HIV/AIDS by the perpetrator. In such instances, the victim may be HIV negative while the spouse has the disease, the partner will then transmit the virus to the victim. On the other hand, in cases where both spouses have the AIDS virus, transmission of the perpetrator’s virus group to the victim may result in serious complications in managing the virus. Medical examination entails the provision of the proper medical assistance, such as offering the right type of IRV drugs to mitigate effects of the virus. For most IPR victims, family and community support is present while in others it is not. A proper support system from both the family and community is key towards the treatment of IPR victims. Such support is initiated by the medical professional who takes the family through the proper course of action in handling the victim. Brief training is done to the family, which helps them in dealing with the brutal act and helping the victim overcome the trauma imposed (Myers, 2011). However, as the doctor notes, in some instances support is not available as the idea of spousal rape is sometimes viewed as non-existent. While the community and family may consider IPR an unimportant issue, the rape victims is bound to undergo various degrees of self loathing as they blame themselves for the rape. It is apparent that rape victims are concerned about the society’s perception towards them changing than their mental and physical state as a result of the rape. It is the clinician’s task to enable the patient to view these faulty and self-defeating cognations by employing therapeutic measures in the course of treatment. Patient self denial has in the past been encouraged by discriminatory gender ideals and some religious teachings. Most patients believe that it is their wifely duty to engage in sex with their husbands, whether or not they are willing to or not. These stereotypes impede the healing process and in some instances deter the patient from reporting the crime to relevant authorities (Russell, 1998). Societal denial also undermines the patient’s healing process; the society might be implying that the act of rape did not occur, or it was the patient’s fault. These stereotypes subsequently increase the likelihood of patients being raped multiple times, the clinician is tasked with ensuring that the patient acknowledges IPR as a crime and institute measures to mitigate its effects. Through counseling, the clinician explains that IPR may be compounded by financial dependency on the perpetrator. The patient is encouraged to find ways of ensuring their individual financial stability which will reduce the notion of being trapped in the abusive relationship thereby the patient will be able to leave the abusive spouse. The clinician also instills on the patient the need to report any abusive tendencies by the spouse. Most rape victims fail to report rape cases for fear of physical harm either on them or their loved ones should they report the crime or leave. Ensuring that the patient’s self confidence is restored is key in the healing process (Myers, 2011). Dr. Khalil explained that he had come across multiple cases of IPR in his many years of practice, but it is only in the recent times that patients seek treatment or report these rape incidences to the authorities. Although the degrees of brutality in the rape incidences vary, the effects are mostly similar. However, the more sudden, forceful and life threatening the ordeal, the more clinically challenging it is. Some rape cases are quite challenging that we have to seek assistance from the police, this is especially in extremely brutal rape cases. The doctor tells of one case where the woman was so severely beaten up by the spouse they had to call on the police to arrest the perpetrator. Cases of fatal IPR are on the rise, however, most of these instances result from assault over time without the victim reporting the crime (Campbell and Soeken, 1999). Because of shame and guilt associated with rape, most victims do not report the crime; cooperation with law enforcement is mostly coerced by family members who encourage the patient to report the crime. During counseling, clinicians empower victims to report the perpetrators and seek legal redress to prevent future incidences. However, there are some notable cases where the patients report the crime to law enforcement agents. Following the outlawing of marital or spousal rape, law enforcers and the court systems have no tolerance towards rape perpetrators. Once reported, the police perform thorough investigations and later assist in the prosecution of the criminals. Clinicians are involved in the investigation process and are sometimes called upon to offer their testimonies in courts of law. Confidentiality in rape cases is crucial and should be introduced at the onset of clinical work. Clinical practitioners handling a rape victim is advised to practice caution in disseminating information pertaining the patient’s treatment. Clinicians sometimes use code numbers in place of the patient’s name to ensure patient anonymity during the course of the treatment and subsequent treatments trauma (Basile and Saltzman, 2002). This is, however, done under request, and approval is received from the patient. Even when law enforcement agents are involved, patient confidentiality is upheld. Law enforcers ensure the patient is assisted by a trained agent in matters relating to IPV, in particular IPR. Law enforcers and clinicians who divulge confidential patient information are liable for prosecution and could lose their professional licenses (Bauer, 2002). The court system allows for strict adherence to patient confidentiality where court proceedings involving rape cases are held in the judges’ private chambers, away from public scrutiny and judgment. This ensures that the patient feels confident to divulge all necessary information to the relevant officers. The patient is also assured of confidentiality when all persons involved in the treatment process and law enforcement sign a release of information pledge, which legally binds them to uphold the confidentiality at all levels and stages in the process of treatment and prosecution of the perpetrator (Bergen, 1999). Spousal or marital rape profoundly affects the victim’s relationship with friends and family. Fundamental variables such as cultural perceptions, world view and education influence the relationship between rape victims and their families and friends. Majority of the time, the issues of IPR are not taken well by family members and friends; cultural ideals insist that it is not possible for spousal rape to occur as both parties have a duty to have sex with each other trauma (Basile and Saltzman, 2002). Following this cultural thesis, it is often impossible for the family to reconcile themselves to the occurrence of IPR, which in turn leads to the relationship deterioration between the victim and family members. In addition, levels of education on matters relating to gender based violence plays a crucial role in the relations between the victim and family and friends (Simon, 2001). Persons who are well versed in the knowledge of this type of violence are more likely to be sympathetic towards the rape victim than those ignorant of IPR (Rathus and Feindler, 2004). Educating the victims’ friends and family on IPR should be incorporated in the treatment of IPR victims as it will determine their subsequent relationship. In previous times, the world overview towards IPR was non committal in ascertaining the possibility of spousal rape. However, as a result of IPR prevalence and increased information on the vice, the world view has changed with some nations outlawing the vice and others in the process of outlawing it (Ghiselli, Campbell and Zedeck, 1991). Victims, their families and friends respond differently to the traumatic event. Patients also respond differently to treatment; this is mainly based on their levels of knowledge relating to IPR and the course of action taken against the perpetrators. The nature of the trauma significantly affects such response. In cases where a patient receives multiple traumas, both physical and psychological, the patient is more likely to respond negatively to treatment as she will feel disheartened by the ordeal and lose hope. Guilt and shame play a crucial role in the patient’s response to treatment. Patients who feel like they are to blame for the crime respond may refuse treatment and insist on not reporting the crime (Chamberlain, 2005). The level of education regarding gender rights also influences patient’s response to treatment; those who are well versed with information of these rights are more likely to appreciate the course of treatment and participate in it wholeheartedly than those ignorant of their rights. They are also more likely to initiate legal proceedings against the perpetrators than those who lack the relevant information. In my clinical profession, I have never come across any witness coming forth in rape cases. This may be attributed to the fact that most people perceive IPR as a domestic family issue thus they do not intervene. In some cases, patients’ families watch in silence as the victim is raped by the spouse repeatedly. The fact that no witnessed come forth compounds the problem of IPR as more and more victims continue to suffer in silence (Hasday, 2000). The intake process for rape victims into the clinic involves an initial assessment of the patient by myself to ascertain the emotional and mental state of the patient. Dr. Khalil explains that his intake process involves attentiveness to the patient’s overall health and in particular the mental state. He undertakes a mini-mental exam to attest to the patient’s emotional mindset and employ measures to mitigate the effects of trauma on the patient’s mental state. 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