The terms “therapy” and “counseling” can be used in many different ways, but in our work, we use them to mean different and specific things. To distinguish between the two, it may be helpful to refer to the latter as “crisis counseling” or “crisis intervention.”
Crisis intervention is a brief service conducted by trained professionals that focuses on offering stability and support during an episode of crisis or period of specific need. The advocate provides emotional support, assesses the client’s needs, brainstorms and explains options, and assists the client in connecting with helpful resources. Depending on what’s needed at the time, the session may aim to resolve an emotional or mental health crisis, or it may aim to answer specific questions or connect to specific resources. Crisis intervention is intended to be a short-term intervention rather than an ongoing source of support: Most OCRCC clients talk to an advocate anywhere from one to five times. When someone is in an immediate crisis, crisis intervention works to resolve the current episode so that the client is able to focus on their long-term healing process. Often one of the helpful resources that advocates connect clients to is therapy.
Therapy goes beyond immediate stabilization to help clients begin the journey of healing from trauma and other major life stressors. In the process of healing, therapy aims to manage and resolve trauma symptoms in the long term. Therapy is an intervention delivered by licensed mental health professionals who are required to document and justify their treatment strategies. Therapy is a longer-term service designed to move past stabilization and delve into the causes of stressors. The Center’s Bilingual Therapy Program provides up to 16 sessions of trauma-focused therapy to aid survivors in processing their trauma and alleviating their triggers and symptoms.
Sexual assault victim advocates and trauma therapists often work together to meet all of the survivors’ needs so that they can move from surviving to thriving. Advocates – like our expert staff and trained volunteer Companions – help to stabilize clients during episodes of crisis, whether prior to beginning therapy or in between therapy sessions. Our therapists provide a safe space for survivors to dig deeper into painful experiences and resolve emotional and somatic reactions so that they can live a full life.
Trauma-informed care is a perspective that takes into consideration the impact of trauma and the myriad trauma responses when providing services. We have seen increasing attention to providing trauma-informed care in the fields of medical and mental health services, but we have also received requests for trauma-informed dental check-ups, moving companies, and many other services. That makes sense because trauma impacts all areas of life. I recently discovered that this also applies to marathon training.
I am a runner. My running journey began almost 10 years ago when the rape crisis center at which I volunteered held an annual 5k fundraiser race. 5ks led to 10ks, which led to half marathons, and eventually marathons. My dream was to one day make it to the Boston Marathon, and through dedication and hard work, I got there. I ran the 2016 Boston Marathon, using the race as a way to turn my passion into a fundraiser in support of OCRCC, again uniting my interest in running and interest in working to end sexual violence.
I am also a social worker. In my role at the Center, I regularly work with clients who have experienced sexual violence. I bear witness to stories of personal healing, tumultuous relationships, bureaucratic response systems, and social norms that allocate blame and judgment where they don’t belong. I love what I do, but sometimes this work can be hard.
Although I had run marathons before, and although I was beyond ecstatic about running the Boston Marathon, I found it nearly impossible to train for the race. Based on what I know of marathon training and what I know of trauma, it seems to me that the physical demand of training was more difficult because of the emotional toll of my work.
Survivors of sexual violence often struggle with anxiety, depression, symptoms of PTSD, or sleep disorders, which are sometimes dismissed as being “all in your head.” Based on decades of practice and research, Bessel van der Kolk shows how traumatic experiences leave a physical imprint in his book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Despite the somewhat intimidating small print and large number of pages, this book is an invaluable resource for anyone working through trauma or supporting survivors of trauma.
Kolk begins by explaining how the brain processes traumatic incidents. The threat of danger triggers the fight, flight, or freeze response, which changes how somebody interprets, processes, and remembers a traumatic experience. Due to the different ways people interpret trauma, survivors exhibit a range of responses when dealing with the aftermath of an assault. Some may express intense emotions, like rage or hopelessness, while others may seem shut down or disconnected. Many survivors experience all of these responses at different times during their healing process.
In honor of International Forensic Nurse’s Week, we acknowledge the effort and dedication of the highly trained cadre of SANE nurses that provide sensitive and skillful medical attention to survivors of sexual assault. SANE stands for Sexual Assault Nurse Examiner, a specialization that is necessary, beneficial, and valuable. SANE nurses receive extensive training to fulfill two equally important roles: collecting forensic evidence and providing trauma-informed medical care to survivors.