“YOU CAN STAY IF YOU WANT” -- WOMEN’S EXPERIENCES PROVIDING RAPE CRISIS MEDICAL ADVOCACY

Many survivors of sexual trauma describe the forensic rape exam as a second rape (Campbell et al., 1999; Parrot, 1991). Rape crisis medical advocates (RCMAs) assist survivors through this process, a time of particular vulnerability to retraumatization (Resnick, Acierno, Holmes, Kilpatrick, & Jager, 1999), by providing emotional support, education, and advocacy for comprehensive and respectful services. Campbell (2006) stated that the primary role of the RCMA is to reduce victim-blame, or the tendency to blame the victim of a crime for the crime or the circumstances leading up to it. The literature has consistently shown that survivors who worked with RCMAs received more medical and legal services and were less likely to feel revictimized (Campbell, 2006; Resnick et al., 1999; Wasco et al., 2004), but the impact of the work on RCMAs has not been sufficiently examined. Previous research has shown that many advocates experienced anger and fear in relation to the work (Wasco & Campbell, 2002), that RCMAs who witnessed more victim-blame reported less satisfaction with the work and lower levels of affective commitment to the job (Hellman & House, 2006), and that professional counselors who worked with trauma survivors reported higher levels of vicarious trauma than those who did not (Schauben & Frazier, 1995). Other researchers have shown that counselors who worked with trauma survivors reported higher traumatic stress than those who did not, and counselors who worked with victims of sexual trauma endorsed more disruptive beliefs about self, others, and the world (Bober & Regehr, 2005). However, the appropriateness of generalizing results observed among counselors to RCMAs is unclear. The purpose of this study was to examine possible predictors of RCMAs’ experiences of vicarious trauma (VT) and vicarious post-traumatic growth (VPTG). Since a great deal of research examining the effects of trauma on care-providers focuses on individual-level contributing variables like personality style, coping skills, and history of victimization (Kelley, Schwerin, Farrar, & Lane, 2005; King, King, Fairbank, & Adams, 1998; Pearlman & Mac Ian, 1995), in this study I examined the predictive ability of several environmental/contextual/systemic variables on RCMAs ratings of VT and VPTG, including caseload, amount of formal individual and group supervision received, ratings of social community at work, meaning of the work, emotional demands of the work, and perceptions of witnessing VB by police and medical staff. One hundred and sixty-four RCMAs participated in this internet-based survey research. A series of hierarchical regression analyses demonstrated that higher ratings of VT were predicted by younger age, lower amounts of formal group supervision received, and lower ratings of the social community at work and the meaning of the work. Ratings of VPTG were significantly and positively predicted by amount of formal individual supervision received, and negatively predicted by age and educational achievement. Interpretations and recommendations are provided to assist rape crisis agencies in supporting RCMAs in their work