Discussion Week 2

A R T I C L E

WHAT IS AN EMPOWERMENT APPROACH TO WORKING WITH SEXUAL ASSAULT SURVIVORS?

Sarah E. Ullman Department of Criminal Justice, University of Illinois at Chicago

Stephanie M. Townsend Department of Psychology, Dominican University

This exploratory study sought to better understand what constitutes the empowerment approach used by rape crisis advocates working with sexual assault survivors. A grounded theory, qualitative, semistructured inter- view study was conducted of rape victim advocates (N 5 25) working in rape crisis centers in a large metropolitan area. Several characteristics were described as reflecting an empowerment orientation or approach to work with survivors, some of which were specifically described as a ‘‘feminist’’ empowerment approach. Implications for research and practice are drawn. & 2008 Wiley Periodicals, Inc.

Rape crisis center advocates provide a variety of services to victims of sexual assault, including crisis counseling, medical and legal advocacy, and 24-hour support on hotlines (Campbell & Martin, 2001). The importance of these services is underscored by research that suggests that survivors who worked with a rape crisis center advocate experienced significantly less distress than those who did not (Campbell et al., 1999). Additionally, in community studies when victims have been asked to rate the helpfulness of a variety of support sources, rape crisis centers are rated as most helpful after an assault (Filipas & Ullman, 2001; Golding, Siegel, Sorenson, Burnam, & Stein, 1989), even though only about one in five victims report seeking such services following sexual assault.

This article is based on research conducted while the first author was a faculty scholar at the University of Illinois at Chicago Great Cities Institute. Correspondence to: Sarah E. Ullman Department of Criminal Justice, 1007 West Harrison Street, University of Illinois at Chicago, Chicago, IL 60607-7140. E-mail: [email protected]

JOURNAL OF COMMUNITY PSYCHOLOGY, Vol. 36, No. 3, 299–312 (2008)

Published online in Wiley InterScience (www.interscience.wiley.com).

& 2008 Wiley Periodicals, Inc. DOI: 10.1002/jcop.20198

Reports from victims are an important source of information about what type of support they need and feel is helpful. However, it is also important to seek the perspectives of advocates whose role it is to provide direct support and help victims to access resources from other systems. According to the Illinois Coalition Against Sexual Assault (2002), sexual assault services provided by rape crisis centers are unique community services due to the following reasons:

* The primary goal is to create an environment in which the client feels safe and empowered.

* Services are client-centered and trauma-based. The client leads the process and discloses information she feels is pertinent. This may be different from the traditional medical model, in which the purpose is to complete a diagnostic assessment or direct the victim’s decisions.

* The client and sexual assault crisis worker work in a partnership to assess strengths and areas of concern as well as to develop and evaluate services goals in order to empower the client. This may be different from the traditional medical model in which the provider may be considered the expert who will direct, treat, or cure the client.

One of the unique features of rape crisis centers and their workers may be their approach to working with survivors, which is often labeled as a ‘‘feminist’’ or sometimes simply an ‘‘empowerment’’ approach. Riger (1984) examined feminist organizations, including those addressing violence against women, and described how grassroots organizations that enable people to obtain access to resources and develop skills and self-esteem can be important vehicles for empowerment. In other words, empowerment can occur at multiple levels as reflected in Rappaport’s (1984) definition: ‘‘Empowerment is viewed as a process: the mechanism by which people, organizations, and communities gain mastery over their lives (p. 3).’’

Rappaport’s definition introduced the idea that empowerment can occur at multiple levels. This idea is explained in more detail in Zimmerman’s (1995) theorizing that psychological empowerment can occur at intrapersonal, interactional, and behavioral levels. This conceptualization of empowerment at the individual level is described by Mechanic (1991) who stated, ‘‘Empowerment may be seen as a process by which individuals begin to see a closer correspondence between their goals and a sense of how to achieve them, and a relationship between their efforts and life outcomes (p. 800).’’ This definition may reflect how survivors of sexual assault navigate their recovery individually and in relationship to supportive others such as advocates and counselors who may help to facilitate adaptive behavioral coping strategies. In fact, some research suggests that women in particular experience empowerment when they can control their thoughts, feelings, and behaviors (Yoder & Kahn, 1992).

However, in a now classic paper, Riger (1993) critiqued empowerment theory’s individualistic, cognitive focus on autonomy, separateness, and control over one’s own behavior and circumstances. She argued that this notion of empowerment ignores actual power and the social structural and situational factors that limit individual empowerment, as well as community connection and relationship-based forms of empowerment. Researchers and theorists have shown how community, organizational, and societal contexts can constrain or facilitate individual behavior and thus the degree

300 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop

of their empowerment (Martin, 2005; Zimmerman, 2000), whether they are sexual assault survivors or persons attempting to assist survivors in their recovery.

Despite these theoretical discussions of empowerment, in the past 20 years there has been almost no empirical research examining how advocates actually empower victims of sexual assault or looking at whether survivors do end up empowered from seeking rape crisis services. Although much has been written about empowerment and its importance for working with female victims (Campbell et al., 2004), little research has identified what defines this approach from the perspective of victim advocates. In summary, although some research has documented the importance of an empower- ment approach to working with victims (Campbell et al., 2004), further work is needed to understand service providers’ perspectives on what this approach looks like and how those endorsing this approach differ from other advocates. Therefore, a qualitative interview study was conducted of victim advocates from various rape crisis centers in a large urban area. This was a grounded theory, exploratory study that aimed to (a) identify what constitutes an empowerment approach of advocates and (b) elucidate any unique characteristics of those endorsing a ‘‘feminist’’ approach. This study is important because it may yield insights into best practices for helping sexual assault survivors for both informal and formal support providers, including mental health professionals, who frequently encounter this population. This study may also help to clarify whether advocates who self-label as feminists are unique in how they describe their use of an empowerment approach when working with survivors.

METHOD

Sample

The sample was comprised of 25 women who were current or former rape victim advocates, working at rape crisis centers in a large Midwestern metropolitan area. This sample is part of a larger study of both clinicians and advocates working at a variety of social service agencies, including rape crisis centers (see Ullman, 2005, for a description of the first author’s experience doing these interviews). Participants were recruited using multiple methods. Letters were sent to 60 people working in agencies in the metropolitan area who were listed as participants at the most recent national conference on sexual violence prevention. All persons who called the researcher or responded to the researcher’s phone calls did participate in the study. In response to these letters, 14 interviews were conducted (a 23% response rate). Although the sexual violence conference is a selective source to sample, many eligible participants could be easily identified from that list, including contact information for many metropolitan area rape crisis workers who attended the conference. It should be noted that the first author, who made all the contact with participants and conducted all interviews, did not know any of the advocates interviewed and did not attend the conference. Additionally, 10 interviewees were identified by participants referring the interviewer to other people who have worked in the rape crisis field in the area, and one person was located by a chance meeting at a professional function.

This sampling strategy resulted in a total sample of 25 advocates, representing 10 distinct agency locations, with an average of 2.80 persons interviewed per location. Nineteen participants were currently working as advocates doing advocacy, referral, or crisis counseling at rape crisis centers. Six were former advocates who had worked at rape crisis centers, generally, within the past year. Most advocates had done medical

Empowerment Approach to Working with Survivors � 301

Journal of Community Psychology DOI: 10.1002/jcop

advocacy or crisis counseling. Two had done primarily legal advocacy, one had done health education, and six had also done administrative work (e.g., volunteer coordinator, director, supervisor etc.) in addition to advocacy. All women had experience working with sexual assault survivors ranging from 1.5 to 16 years of experience with an average of 5.14 years of experience (s 5 3.83). Eleven workers also had mental health experience doing crisis counseling or other types of therapy with sexual assault survivors with an average of 3.64 years of experience (s 5 6.00). Participants were asked to indicate if they had any or all of four types of training (sexual assault, domestic violence, child abuse, violence against women). Thirteen had all four types of training and 12 had from one to three types of training. All had training on sexual assault. No further detail was specifically asked about the nature and extent of participants’ training. In terms of practice location, 4 worked in suburban locations, 19 worked in the city, and 2 worked in both city and suburban settings. Women were asked to check off all applicable items in a checklist that characterized their treatment orientation. Seventeen endorsed a feminist orientation in their approach to working with survivors, whereas 12 endorsed various other treatment orientations such as client-centered and cognitive behavioral. All partici- pants were women. In terms of education, one had a PhD, seven had master’s degrees, 14 had bachelor’s degrees, and three had some college or an associate’s degree. Most women were White (n 5 12), followed by Hispanic (n 5 6), Black (n 5 5), Asian (n 5 1), and multiracial (n 5 1). Women’s average age was 33.04 years (s 5 9.20 years). Most women (n 5 12) were in their 20 s with a range of 25 to 58 years. Two had incomes of $10–20,000, 11 had incomes from $20–30,000 per year, eight earned $30–40,000 per year, three had incomes of $60,000 or more, and one refused to provide her income.

Agencies

Eight rape crisis centers were freestanding organizations, two programs were housed within a larger social service agency or community mental health center, and one participant worked both on a rape crisis hotline and in a university counseling/ advocacy setting. Services for rape victims in the area from which participants were sampled include a 24-hour hotline for the entire metropolitan area that is run out of the largest rape crisis center in the city. The hotline is coordinated by full-time employees and staffed by trained volunteers 24 hours a day. Other services provided by the area’s rape crisis centers include medical and legal advocacy, crisis counseling and referral to other social and mental health services, prevention education, and training for other agencies including the police and the State’s Attorney’s office. Agencies where workers were employed included two large rape crisis centers, one of which had satellite offices in both city and suburban locations. Both of these rape crisis centers had administrative/supervisory staff, advocates, and counselors, with a smaller core of paid full-time staff and a larger core of volunteer victim advocates, who typically went on emergency room calls when rape victims were taken there by police following an assault (see Wasco et al., 2004 for more information about services in this region).

Some workers mainly did crisis counseling and gave referrals to survivors of sexual assault, while others did longer term therapy with survivors or administrative work and supervision of other employees in their agencies. Most advocates did crisis counseling and medical advocacy, with two advocates primarily doing legal advocacy and prevention education to area schools and colleges. Typically those doing mostly

302 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop

counseling also worked on advocacy needs with clients, some of whom were also receiving therapy from mental health professionals outside of the rape crisis center. Smaller agencies were typically more mental health focused and were often a part of community mental health centers, although they still identified as rape crisis centers. They provided the same advocacy and counseling services, but the larger organizations where they were housed also served other populations, such as child victims or clients with general mental health needs. Agencies varied in geographic location and both provider and client demographic characteristics, partially reflecting the agency, its philosophy, and the client population of the specific agency location. For example, agencies in predominantly Black or Hispanic neighborhoods had more staff with similar ethnic backgrounds, whereas agencies located in the downtown central city had a greater proportion of White staff.

Procedure

Participants completed in-person interviews at a time and location convenient for them. Most interviews were conducted at their work offices (20) at a convenient time for the women, but five preferred to be interviewed at other locations. Interviews were conducted from November 2002 through May 2003 by the first author. Interviews ranged from 45 minutes to 1 hour 20 minutes, with the average interview length of 65.36 minutes (s 5 13.36 minutes), and a modal interview of 1 hour. Semistructured interviews asked about women’s training and work experience with survivors of sexual assault as well as other relevant work experience, how disclosures of sexual assault tended to occur, how interviewees typically respond to disclosures, difficult and rewarding aspects of working with survivors, barriers to working with survivors and to survivors’ obtaining services, and solutions that might improve services to this population. Participants were also asked about their views about the role of mental health professionals in working with sexual assault survivors. Only the data on the advocates’ treatment orientation or role were analyzed in the current study. In the section of the interview about treatment orientation, participants were asked to indicate which approach from a list of treatment approaches characterized their approach to working with survivors, with multiple responses possible.

Analysis Strategy

A grounded theory approach was used for data analysis. Four stages of analysis were used. The first stage consisted of open and axial coding (Strauss & Corbin, 1998). Open codes emerged from the text to break the data into discrete parts. Axial coding extended the analysis from the textual level to the conceptual level. The second stage of analysis involved construction of a meta-matrix, which is a master chart that compiles descriptive data from each case into a standard format (Miles & Huberman, 1994). Column headings identified key variables and each row represented a program. This process allowed for the identification of themes that were common to many programs and those that were unique to a small number of programs. The third stage of analysis was the manipulation of the meta-matrix to create submatrices that were ordered conceptually according to key variables (Miles & Huberman, 1994). This process allowed for identification of patterns between variables. The final stage was the creation of analysis forms that summarized the submatrices. In completing these forms, both within-case and cross-case analyses were done in which the content of codes within and then across cases were compared. The goal was to identify and

Empowerment Approach to Working with Survivors � 303

Journal of Community Psychology DOI: 10.1002/jcop

interpret any themes or patterns that could answer the research question of what constitutes an empowerment approach and a feminist empowerment approach to working with survivors following a sexual assault. The results as described in the following section were based on the final stage of analysis.

RESULTS AND DISCUSSION

Several approaches to working with survivors were described by advocates most frequently. These included feminist, empowerment, client-centered, problem-or- iented, and crisis intervention. In this sample, 72% of participants said they had a ‘‘feminist’’ orientation or approach to working with survivors. Of this 72%, just under half (44%) mentioned this as the only approach they used to work with survivors. Almost one-third (28%) of advocates said they used client-centered approaches, 16% used cognitive-behavioral approaches, and 8% mentioned empowerment approaches generally to working with survivors. In addition, 36% of advocates mentioned also using some ‘‘other’’ form of treatment including: psychodynamic, crisis counseling, trauma treatment, systems, and no specific treatment model.

Definitions of Feminist/Empowerment Approaches

All advocates interviewed mentioned ‘‘empowerment’’ at some point in their narratives, even if they did not describe this as their treatment orientation. This approach was used by a majority (over two-thirds) of advocates in this sample with or without other approaches. It was explained and distinguished from other approaches as follows.

We use what’s called an empowerment approach; it’s really not just like what people would think of as client-centered because we don’t use the medical model. We don’t make diagnoses, although we do treatment plans. We discuss the case history, do progress notes every week, each time we see a client or refer a client. The goal is really to see the person get their power back or to see them get some type of control back in their life, where they can function day to day. (Advocate 1).

[Agency X] is very strict about using the empowerment model approach, very client-centered, meet the person where they are at. Don’t pressure them into making any sort of decision. We lay out the options on the table and we support their decision. If it’s a decision that may harm them like suicide or homicide, we don’t support those. (Advocate 3).

Really the philosophy is very client-centered—follow the survivor’s agenda is sort of your mantra. (Advocate 10).

These three advocates all appear to describe a client-centered approach as actually constituting the empowerment approach, yet the first advocate states that empower- ment is distinct from client-centered approaches in that it does not rely on the medical model or on diagnoses. The other two advocates’ descriptions use the term client- centered but do not seem to describe an approach that differs from the first advocate. Given that the term ‘‘client-centered’’ comes from the psychological treatment field, it may be that the first advocate was trying to distinguish rape crisis center’s

304 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop

empowerment approach from a traditional, client-centered approach used in the mental health field. These quotes also differ in that the first advocate identifies the elements that constitute the ‘‘goal or outcome’’ of an empowerment approach, which is characterized as one who gets power/control back in their life. The other two advocates speak about the ‘‘method(s)’’ used to effect the goal of an ‘‘empowered survivor’’ describing this as ‘‘meeting the survivor where she is’’ and ‘‘following the survivor’s agenda.’’

Importance of Control

The rationale for the empowerment approach as explained by one advocate was typical. She explained the use of an empowerment approach by advocates as being a contrast to the ways in which informal network members often respond to survivors that may be experienced as having control taken away from them, just as it was during the assault:

A lot of times, people want to take over—they look at a sexual assault victim and they may even feel helpless themselves. A lot of people such as significant others and parents want to take over because they want to make it better. But really the survivor has to make it better for themselves is how I look at it. So you need to work with them and to let them take control back into their own lives. Help them when they ask for it, but let them make the major decisions, let them know what their options are, but don’t make those decisions for them. I let the survivors control the conversation, so it goes where they want it to go and to bring out issues. I might guide them to decide what they want to focus on in the conversation, but really it’s their call. (Advocate 7).

A major characteristic of the empowerment approach described here is who takes control. Because the act of rape constitutes having someone take away control from the victim, it is crucial that survivors regain control in any and all ways possible to facilitate their empowerment. Implicit in this idea is that no one can really make things better for the survivor or fix the problem, which is likely a common well-intentioned, yet ultimately negative reaction of those around the survivor. These reactions may emerge from egocentric needs (Ullman, 2000) of support providers trying to cope with their feelings of anger, violation, and distress at the perpetrator and the traumatized survivor. It may be that support providers really want to help survivors they care about from truly altruistic motivations, but they may also have a personal need to help in order to empower themselves to cope with the harmful ripple effect of victimization or ‘‘vicarious trauma’’ affecting those around the victim (Davis, Taylor, & Bench, 1995; Salston & Figley, 2003; Schauben & Frazier, 1995).

Techniques for Empowerment

Several specific techniques like mirroring and empathy were described as part of the empowerment approach. For instance, one advocate described what this approach should help to achieve for survivors:

My explanation particularly to other people who are in training about what the role of the advocate is in the process is that we are a kind of a mirror. That is, we hold up a mirror and say, ok, this is what you have, these are the options

Empowerment Approach to Working with Survivors � 305

Journal of Community Psychology DOI: 10.1002/jcop

you have, this is your situation, this is where you can go, these are your paths that you could possibly take. Now you need to look at yourself and say okay, what do I want to do with that? (Advocate 8).

Another advocate when discussing her counseling work with survivors explained the client-centered approach in more interpersonal terms saying,

I treat them from the heart and I think that’s what I’ve noticed they respond to. It’s just about really being there with them, allowing yourself to feel someone else’s pain and when you share that, that’s when the growth seems to come. (Advocate 14).

She went on to describe this process further and her role in helping her clients find their own path to recovery.

I firmly believe that change only comes if the client is the one who figures it out. My supervisor at the center said you know we are not the tour guides. It’s almost like you are on a path with the client, they got the map, you’re just there to make sure they don’t necessarily get off the road. You’re not leading them or anything. The way I work is to trust that they are going to get to the point that they need to and it’s not going to help if I sit here and bombard them with advice. (Advocate 14).

This description sounds very akin to ‘‘non-directive’’ counseling practices that may also facilitate empowerment of therapy clients, and clearly highlights the role of empathy in facilitating empowerment of survivors. Another advocate described the lack of taking an active role to empower survivors saying,

Part of empowering survivors is letting them know, I’m not going to be on your back and I’m not going to hassle you to get these services, but if you want them, they’re there. And it doesn’t matter when you decide that you want them. (Advocate 25).

This lack of taking an active role described here contrasts with the role of many other professionals and informal social network members’ responses who often taken control of what happens after assault and thereby disempower survivors (Campbell et al., 1999; Martin, 2005; Ullman et al., 2007). Others talked about skills and responses to survivors reflected in this approach:

I’ll just support them and be like yeah, that makes sense you’re pissed off about it, they shouldn’t have done that to you. So it’s really about active listening and giving them back what they’re telling me. I never doubt them, I never question them, I’m there to empower them, to support them. (Advocate 29).

One advocate expressed the contrast between what she termed the feminist empowerment model with more traditional counseling.

306 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop

You know this approach has been talked about a lot lately. We’re reviewing all of our policies and procedures. I think as a feminist and believer in the empowerment model, as an advocate I don’t have to be completely detached, don’t have to have flat affect. Initially, when you see a counselor, they’re practiced in being somewhat detached, not completely, you know, they’re engaged with the client, but flat affect, but we’re allowed to react to what victims say and to be empathic and reach out to them. (Advocate 33).

She proceeded to describe her approach to working with survivors in more detail:

I very clearly explain this to all of my survivors. I say to them there will be times when you want me to make a choice for you, but I can’t. If there’s a way I could just fix it and wave a wand I would, but I can’t. So we talk about their options so they can take back their life and I offer them nonjudgmental support and just give them a chance to tell their story. The first thing I do with all my clients is just let them sit and tell their story for as long as they want. (Advocate 33).

Finally, an advocate described ‘‘feminist’’ counseling as:

Strengths-based counseling where I try to figure out what resources exist, what they have a handle on already and find ways to expand that as opposed to trying to introduce totally new strategies. I also try to really think about the situation they are in, because there may be things that would be great for them to do, but they’re not realistic. Financial constraints can be problematic and for underage girls it’s hard, because you can tell a woman to get away from her abusive partner, but you can’t tell a child to get away from an abusive parent. You really have to think about that, when you’re thinking about how to structure counseling—what is available to them. (Advocate 35).

Advocate Versus Agency Orientations

In considering experiences survivors have when seeking services from rape crisis agencies and the impact of those agencies on survivors’ recovery, it is important to consider not only the individual advocate with whom the survivor may interact but also the agency as a whole. While the hope is that all interactions the survivor has with the agency are empowering, this may not be true. Survivors may interact with multiple agency staff (e.g., advocates, hotline volunteers, receptionists, etc.). Additionally, their experiences may be affected by the climate in the agency when they are seeking services onsite, the information and tone of literature the agency distributes, etc. Therefore, it is important to examine the consistencies and inconsistencies in orientation throughout the agency. Because this study relied only on data from advocates, findings about inconsistencies is limited. However, comments by advocates do provide evidence that the consistency or fit between advocates and the larger agency should be considered.

One ex-advocate who had burnt out and left her job after feeling mistreated by her agency said that although a feminist empowerment approach was her

Empowerment Approach to Working with Survivors � 307

Journal of Community Psychology DOI: 10.1002/jcop

approach, it was not that of her agency, even though they claimed to have this philosophy.

I can’t buy that RCC’s have an empowerment model, because that’s not how the infrastructure of the agency works and that’s not how the staff are. I agree that’s what is said and that’s what is encouraged with clients, but it’s definitely not how the agency works. (Advocate 30).

After hearing this, I sought elaboration, and in future interviews, I asked advocates how supportive the agency was of survivors and got the following responses from an ex-advocate and from a current supervisor, respectively, regarding the same agency.

The agency is not overall supportive, I mean I kind of had to think about it and decide whether I thought it was supportive or not (laughs). So I mean yes, but I mean with this huge disregard for the staff going on also. So yes, but indirectly no, kind of, does that make sense? I just feel like how much can they care about survivors when the staff is being, the staff who’s working directly, the frontline people working directly with survivors, it’s like this blatant disregard for their well-being so, it just kind of makes me wonder how, I don’t know, I mean that’s sort of my cynical perspective at this point. (Advocate 30).

I would say here, it’s really extraordinarily supportive. We all have our bad days but I think that overall this agency strives to really try and support and acknowledge the difficulty in doing this work. I think our agency does that on some level, whether or not they’re able to achieve it is a different story (Advocate 8).

These advocates describe the dilemma of an organization whose goal is to empower victims that in fact may disempower female workers, by tapping into traditional female gender-role socialization of advocates that leads to female workers’ sacrificing of their own needs and self-care in order to take care and advocate for the needs of survivors (Wasco & Campbell, 2002). In fact, barriers to the empowerment of survivors may occur at societal, organizational, and individual levels (Ullman & Townsend, 2007).

Data from advocates interviewed in this study suggest that although empower- ment can occur at the interpersonal level (e.g., between advocate and client), it also may or may not characterize organizations, which fits Zimmerman’s (2000) theory of levels of empowerment. From a sociological perspective, it is hard to imagine that advocates’ ability to empower survivors would not be facilitated or constrained by how empowering their organizations’ practices are, as suggested by this advocate. In fact, advocates argue that rescuing does not really help clients, as they need to make their own choices and be supported in that process. Zimmerman (2000) states that ‘‘organizations that provide opportunities for people to gain control over their lives are empowering organizations’’ (p. 51). Of course, rape crisis centers should be empowering and have that as a goal for survivors, but it is important that they do the same for their workers as lack of support/empowerment for advocates may harm them and limit their ability to empower clients. Empowerment should be viewed as being not only a dynamic between advocate and client but also a guiding principle that should permeate the functioning of the entire agency.

308 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop

Safety Planning as Empowerment

Several advocates talked about discussing ideas about safety as empowering survivors. For example:

I talk about futuristic type goals. If you go out with your friends to a party or bar, what steps will you take for safety? We advise them to pair up with a friend, make sure you have a ride home, don’t go with a friend you don’t knowythings like that, so they can feel they have a strategy for the next time and are better equipped, so that they can try to be social again. (Advocate 1).

We support their decisions, but we also make sure to give them as many safety options and opportunities as possible as well as resources and referrals. (Advocate 3).

The link that advocates are making between safety planning and empowerment is an example of Zimmerman’s (1995) concept of behavioral empowerment, which occurs when actions are taken to regain a sense of control over life. Actions associated with behavioral empowerment vary with the goals and opportunities available but could include problem-focused coping, stress-management activities, and resource utilization. Other forms of behavioral empowerment include active responses aimed at averting or dealing with potential violence such as taking self-defense classes or engaging in safety planning. However, it should be noted that the idea of safety planning as empowerment is not universally accepted out of concern that it is dangerously close to victim blaming. The importance of not blaming victims is a recurring theme in the training of advocates (c.f. Bay Area Women Against Rape [BAWAR], 1993; Brighter Tomorrows, 1996; Sexual Assault Prevention and Awareness Center [SAPAC], 1991 for examples). It is debatable whether safety planning as empowerment is an example of Ryan’s (1976) definition of victim blaming as a process in which a social problem is identified (sexual violence), those who are affected (female victims) are studied to discover how they differ from the rest of the population, the differences (vulnerability to sexual violence, including behaviors) are defined as the cause of the problem itself, and a bureaucrat (agency) invents a program to correct the differences. Because safety planning was not specifically raised as a question for all advocates, it is not clear if the idea of safety planning as empowerment was uniformly endorsed in this sample. Given the emphasis in the field on not blaming victims, this is an important question for future inquiry.

Social Support as Empowerment

Finally, several advocates described empowerment as encouraging support seeking and/or community involvement in their work with survivors.

It’s important to go back to society and connect with people, to not fear socializing and engaging in a dialogue or having a good time with people. I think that’s important for normalization. (Advocate 1).

When we talk about support systems, we talk to survivors about who is going to support you, how are you going to find support after this? A lot of times people will say, I’m gonna talk to my cat or my dog, because that’s somebody

Empowerment Approach to Working with Survivors � 309

Journal of Community Psychology DOI: 10.1002/jcop

that’s not going to be judgmental of me. I hear that so often that I try to normalize that feeling. (Advocate 8).

We find it interesting that the need for both safety and social support were raised by advocates as issues that they had also faced personally in their organizations and that compromised their work as advocates on behalf of survivors (Ullman & Townsend, 2007).

Summary

In summary, the empowerment approach taken by advocates was client-centered and emphasized survivors making their own choices and taking control by taking a lead in the therapeutic process, which allowed for a personal level of engagement between advocate and client and included connecting the client with outside resources. Descriptions of how this approach was enacted did not actually appear different whether labeled as feminist specifically or not. As reported elsewhere, however, self-labeled ‘‘feminist’’ advocates did differ from those not endorsing the feminist label in some of their personal characteristics, perceptions of their agencies and difficulties in doing their work, and perceptions of barriers survivors face in getting help (see Ullman & Townsend, in press).

CONCLUSIONS AND STUDY IMPLICATIONS

This study explored what constitutes an empowerment approach to working with rape survivors as described by advocates and counselors in rape crisis centers. Obviously our study is limited by a small sample from a subset of centers in one metropolitan area, some of whom were former advocates with negative experiences that may have motivated them to participate. No rural advocates were included in this study, which is a limitation because rape crisis services are much more limited in rural areas (Martin, 2005) and both advocates’ and victims’ experiences may differ in rural areas (Logan, Evans, Stevenson, & Jordan, 2005). Clearly the small convenience sample of advocates studied presents biases that may not reflect what a random sampling of rape crisis center employees and former employees might report. Although some participants were drawn from a sexual violence conference list because this was a conference in the same metropolitan area as this study it was heavily attended by rape crisis center personnel from the region’s rape crisis centers, actually making it a fairly dense local source of advocates from which to draw a sample.

Because only the first author conducted these interviews, age and race matching with advocates was not possible. The first author is a White, middle-aged female, which may have led to fewer or poorer quality data from advocates with different age/ethnic characteristics. (See Ullman, 2005 for a discussion of her perceptions of how this may have affected interviews with older, ethnic minority women in particular.)

One issue we did not ask about was what participants believed the meaning was of the treatment orientation terms used to identify their strategy of working with survivors. For example, some advocates described client-centered and empowerment approaches as quite similar, whereas others felt they were distinct. Research must examine not only philosophy and training practices employed by organizations but also what these labels mean to workers who use them as part of their identities and how those labels actually relate to their work with survivors. Clearly, the self-labeled

310 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop

treatment orientation did mean something to those interviewed in this study, but it is not clear that these labels relate to differences in how advocates work with survivors, perhaps due to relative homogeneity in the rape crisis organizations’ philosophies and training of advocates.

On the other hand, assessing empowerment at the level of the organization and the individual advocate is important as well as assessing organizational practices and advocates’ behaviors with their clients. Such data are needed to clarify how these labels relate to actual practices at organizational and individual levels, and more importantly how organizations varying in the degree of empowering practices they employ affect the ability of their advocates to empower survivors. Martin (2005) has argued that organizational constraints and goals often result in secondary victimization of rape victims because workers follow rules required to do their jobs, which entails practices that often conflict with the needs of rape victims. The term ‘‘empowerment’’ is widely used but not clearly defined in terms of how it translates into practice, which highlights the need for more research to understand what rape crisis centers mean by empowerment and how they enact it. Enacting empowerment needs to be examined in terms of interpersonal relationships between advocates and survivors, intervention strategies when working with survivors, other work done by the agencies, and the climate within the agencies for both survivors and staff.

REFERENCES

Bay Area Women Against Rape. (1993). Advocate training manual. Oakland, CA: Bay Area Women Against Rape.

Brighter Tomorrows. (1996). Advocate training manual. Grand Prairie, TX: Brighter Tomorrows.

Campbell, R., Dorey, H., Naegeli, M., Grubstein, L.K., Bennett, K.K., Bonter, F., et al. (2004). An empowerment evaluation model for sexual assault programs: Empirical evidence of effectiveness. American Journal of Community Psychology, 34, 251–262.

Campbell, R., & Martin, P.Y. (2001). Services for sexual assault survivors: The role of rape crisis centers. In C.M. Renzetti, J.L. Edelson, & Bergen, R.K. Sourcebook on Violence Against Women. (pp. 227–241). Thousand Oaks, CA: Sage.

Campbell, R., Sefl, T., Barnes, H.E., Ahrens, C.E., Wasco, S.M., & Zaragoza-Diesfeld, Y. (1999). Community services for rape survivors: Enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67, 847–858.

Davis, R., Taylor, B., & Bench, S. (1995). Impact of sexual and nonsexual assault on secondary victims. Violence and Victims, 10, 73–84.

Filipas, H.H., & Ullman, S.E. (2001). Social reactions to sexual assault victims from various support sources. Violence & Victims, 16, 673–692.

Golding, J.M., Siegel, J.M., Sorenson, S.B., Burnam, M.A., & Stein, J.A. (1989). Social support sources following sexual assault. Journal of Community Psychology, 17, 92–107.

Illinois Coalition Against Sexual Assault (2002, October). Service standards. ICASA Policies and Procedures Manual. Springfield, IL.

Logan, T.K., Evans, L., Stevenson, E., & Jordan, C. (2005). Barriers to services for rural and urban rape survivors. Journal of Interpersonal Violence 20, 591–616.

Martin, P.Y. (2005). Rape work: Victims, gender, and emotions in organization and community context. New York: Routledge.

Mechanic, D. (1991). Strategies for integrating public mental health services. Hospital and Community Psychiatry, 42, 797–801.

Empowerment Approach to Working with Survivors � 311

Journal of Community Psychology DOI: 10.1002/jcop

Miles, M.B., & Huberman, A.M. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage Publications.

Rappaport, J. (1984). Studies in empowerment: Introduction to the issue. Prevention in Human Services, 3, 1–7.

Riger, S. (1984). Vehicles for empowerment: The case of feminist organizations. Prevention in human services, 3, 99–117.

Riger, S. (1993). What’s wrong with empowerment? American Journal of Community Psychology, 21, 279–292.

Ryan, W. (1976). Blaming the victim. New York: Vintage Books.

Salston, M., & Figley, C.R. (2003). Secondary traumatic stress effects of working with survivors of criminal victimization. Journal of Traumatic Stress, 16, 167–174.

Sexual Assault Prevention and Awareness Center. (1991). Hotline training manual. Ann Arbor, MI: Author.

Schauben, L. J., & Frazier, P. A. (1995). Vicarious trauma: The effects on female counselors of working with sexual violence survivors. Psychology of Women Quarterly, 19, 49–64.

Strauss, A.L., & Corbin, J.M. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Newbury Park, CA: Sage.

Ullman, S.E. (2000). Psychometric characteristics of the social reactions questionnaire: A measure of reactions to sexual assault victims. Psychology of Women Quarterly, 24, 257–271.

Ullman, S.E. (2005). Interviewing clinicians and advocates who work with sexual assault survivors: A personal perspective on moving from quantitative to qualitative methods. Violence Against Women, 11, 1–27.

Ullman, S.E., Filipas, H.H., Townsend, S.M., & Starzynski, L.L. (2007). Psychosocial correlates of PTSD symptom severity in sexual assault survivors. Journal of Traumatic Stress, 20, 821–831.

Ullman, S.E., & Townsend, S.M. (2007). Barriers to working with sexual assault survivors: A qualitative study of rape crisis center workers. Violence Against Women, 13, 412–443.

Wasco, S.M., Campbell, R., Howard, A., Mason, G., Staggs, S., Schewe, P., et al. (2004). A statewide evaluation of services provided to rape survivors. Journal of Interpersonal Violence, 19, 252–263.

Wasco, S.M., & Campbell, R. (2002). Emotional reactions of rape victim advocates: A multiple case study of anger and fear. Psychology of Women Quarterly, 26, 120–130.

Yoder, J., & Kahn, A. (1992). Toward a feminist understanding of women and power. Psychology Women Quarterly, 16, 381–388.

Zimmerman, M.A. (2000). Empowerment theory: Psychological, organizational, and community levels of analysis. In J. Rappaport & E. Seidman (Eds.). Handbook of community psychology. (pp. 43–63). New York: Plenum.

Zimmerman, M.A. (1995). Psychological empowerment: Issues and illustrations. American Journal of Community Psychology, 73, 581–599.

312 � Journal of Community Psychology, April 2008

Journal of Community Psychology DOI: 10.1002/jcop