A Person-Centered Approach to Understanding Service Needs Following Sexual Assault

It is well-known that survivors of sexual assault can have extensive post-assault service needs (e.g., legal, medical, and mental health-related). The existence of effective formal support systems for survivors is thus of vital societal importance. To meet survivors’ needs, specialized sexual assault services have been developed internationally and in Denmark. Research suggests
that specialized sexual assault services have promising effects in relation to survivor recovery. Unfortunately, sexual assault services are not equally attainable for all survivors, and not all
survivors experience them as helpful. The success of existing service models has thus been increasingly questioned. Therefore, the goal of the present PhD study was to gain a deeper understanding of the mechanisms that account for disparities in service utilization and identify ways that service delivery can be improved for marginalized and underserved survivors. The present PhD study was conducted at the research group THRIVE, the Department of Psychology, University of Southern Denmark, in collaboration with Danish Sexual Assault Centers (SACs). SACs offer specialized psychological treatment and acute forensic medical examination to survivors 12+. The PhD study consists of three studies. The first paper is a systematic scoping review that sought to identify which survivors are most underserved by formal support systems in Western countries and why they are underserved. The findings of Paper 1 suggest that survivors with the following characteristics face additional or unique barriers to service utilization: ethnic minorities, disabilities, financial vulnerability, sexual and gender minorities, mental health conditions, problematic substance use, and older age. The second paper used qualitative interviews to investigate multidisciplinary SAC providers’ (N = 18) perspectives on vulnerability in the context of sexual assault. Participants consisted of forensic doctors, nurses, psychologists, social workers, and police investigators. Survivors perceived to be least likely to obtain and benefit from services by SAC providers were also those considered most vulnerable 8 regarding experiences surrounding victimization. Qualitative interviews were also used in the third and final paper, but this study sought to explore the issue of underserved survivors from the perspective of survivors (N = 5). Paper 3 shows that the experience of sexual assault and its aftermath is subjective and that it is shaped by multiple factors. Paper 3 also demonstrated the complex needs experienced by some survivors (e.g., pre-existing mental health problems, prior interpersonal victimization). The combined findings of the PhD study are discussed using multiple frameworks, including intersectional theory. Taken together, the present research underscores the need for more person-centered (i.e., individually tailored) responses to survivors of sexual assault, internationally and in Denmark.