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Health Care Providers > Sexual Assault > Psychological First Aid

Supporting a survivor

Providing psychological first aid is a key responsibility of the health care provider. Emotional support must be offered to the survivor at all stages during the entire process of seeking history, examination and evidence collection. Below we provide some pointers to the messages that you can convey to the survivor, in order to support her.

- Be considerate and non-judgmental while talking to the survivor. Survivors may understandably be traumatized by the assault, and handling the situation with calm, by not expressing any kind of shock or disbelief would help provide a much needed sense of control.  Do not using victim-blaming questions like:

-What did you think would happen?
-What were you doing out alone?
-What were you wearing?
-You should have known better

- Go according to the survivor's pace and do not hurry. Maintain eye contact while speaking. Provide a listening ear for her experiences. Validate the experiences of the survivor at every stage and remind her that the violence she has faced is not her fault.

- Be sensitive about what the girl/woman has been through. In a majority of sexual assault cases the perpetrator is someone who the survivor knows. Keep in mind that this makes it even more difficult for the survivor to talk about the assault. Several survivors have feelings of self-blame and these must also be dispelled. It is important to convey to the survivor that she has done everything in her power to resist the assault. Highlight her strengths and the efforts that she has made to save herself.

- She may feel overwhelmed with all that is happening at the hospital/health centre, the police station, within her family and the community at large. Explain to her that some friends and family members may be more supportive, while others may blame her or may distance themselves from her. She may also receive threats from the abuser or may be pressurised to withdraw the case.

- It is important to explain to her that such an assault can have both physical and psychological health consequences. She may feel fearful, disoriented, guilty, embarrassed, or shameful. She may also have trouble sleeping and may get nightmares and flashbacks. These feelings may be experienced immediately after the episode or a few weeks later.

- Encourage her to speak to a close and trusted person about these feelings or seek support from a health provider or counsellor. Emphasize that disclosing these feelings would enable her to deal with the trauma and take steps towards the healing process.

- Convey to her that sexual assault is not an act of passion but an abuse of power. She has not done anything wrong so there is no need to feel ashamed or embarrassed. Sexual assault in fact must be understood as a severe form of physical assault causing physical and emotional trauma.

- Emphasize the need to seek counseling and support from friends and family. You may refer her to Dilaasa if she is located in Mumbai. Inform her that the center provides both emotional as well as social and legal support. It is crucial that she remain in contact with her health care provider and seek both medical and psychological support when required.

- Given the stigma that is associated with being sexually assaulted, many survivors may feel a sense of despair and may also think about suicide. Suicidal ideation must hence be assessed and appropriate measures taken. Refer the survivor to appropriate counseling services for further help.

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