Who Helps the Helpers? Social Support for Rape Crisis Advocates

Abstract

Secondary exposure to trauma may have negative effects on rape victim advocates’ well-being. Self-care can help to mitigate these negative effects on advocates’ well-being, and prior research suggests that social support is an especially important aspect of advocates’ self-care. However, there is a lack of research on how rape crisis advocates access and receive social support in relationship to their advocacy work. Therefore, semistructured qualitative interviews were conducted with 15 rape crisis advocates who volunteered for a rape crisis center in Chicago to understand how they accessed social support from informal and formal support providers, and when they did receive support, what was helpful versus unhelpful. Data were analyzed using thematic content analysis. Results revealed that many advocates were able to seek out and receive positive instrumental and emotional social support that nurtured them and their work. However, advocates also experienced a variety of barriers to obtaining positive support from informal support providers, including fear of burdening providers and a reluctance or lack of preparedness of their support providers to speak about the issue. Advocates emphasized the need for rape crisis centers to provide resources for their informal social support systems in order to encourage helpful responses. In addition, advocates praised the rape crisis center for its built-in formal support structures, but also encouraged the organization to seek broader representation of persons from minority backgrounds among their advocates and mentors. Implications and future directions for research and rape crisis centers are also discussed. The present study highlights the importance of social support systems for advocates and potential barriers that may be addressed to reduce service provider burnout and vicarious trauma.

Keywords

rape crisis centers advocates social support self-care vicarious trauma

Rape crisis advocates play a critical role in responding to and meeting the needs of sexual assault survivors. In doing so, they are exposed to trauma on a regular basis. Research has consistently found that such vicarious experiences of trauma have negative effects on mental health care providers’ well-being and may also contribute to service provider burnout and organizational turnover (Baird & Jenkins, 2003; Canfield, 2005; Williams, Helm, & Clemens, 2012). Thus, the research literature has made a strong push to encourage self-care and organizational support for mental health care practitioners who are exposed to secondary traumas. Prior research specific to the context of advocacy has established social support is an important aspect of advocates’ self-care (Iliffe & Steed, 2000; Schauben & Frazier, 1995; Wasco, Campbell, & Clark, 2002). However, accessing helpful social support in the unique context of rape victim advocacy may be challenging due to barriers such as stigma and rape myths. Thus far, there is a lack of research on how advocates seek out and receive social support from their networks in relationship to the secondary trauma they experience. Therefore, this article presents a qualitative case study of 15 volunteer advocates from a rape crisis center in Chicago, Illinois. The purpose of the present study was to explore how volunteer rape crisis advocates utilized social supports and understand how these support systems responded in both helpful and unhelpful ways. Before describing the current study, we first define and describe the concepts of vicarious trauma, wellness, self-care (with an emphasis on the social support aspects of self-care), and the challenges specific to rape crisis advocates.

Self-Care, Wellness, and Social Support

Providers working with trauma survivors can experience a range of negative mental health concerns, which the concept of vicarious trauma describes as the “transformation in the inner experience of the provider that comes about as a result of empathic engagement with client’s trauma material” (McCann & Pearlman, 1990; Saakvitne & Pearlman, 1996, p. 40). Symptoms of vicarious trauma are similar to those of posttraumatic stress disorder (PTSD), including loss of energy, difficulty in maintaining interpersonal relationships, nightmares, cynicism, feelings of hopelessness and despair, a disrupted frame of reference (change in worldview), disrupted psychological functioning, increased emotionality, emotional numbness, and even dissociation (Pearlman & Saakvitne, 1995). A disruption in providers’ worldviews, such as difficulty trusting others and struggle with feeling unsafe in situations and contexts that previously felt safe can leave them feeling stressed, fatigued, sad, and disillusioned (Williams et al., 2012).

The prevalence of burnout and vicarious trauma among service providers highlighted the need for wellness and self-care among caregivers (O’Halloran & Linton, 2000). Indeed, research has found that practicing self-care is the most important act mental health care providers can do to prevent or treat vicarious trauma and burnout (Barnett & Cooper, 2009; Killian, 2008). Self-care is a broad term used to describe caring for oneself through meeting one’s own needs in multiple domains. Self-care is the means in which personal wellness is achieved and maintained. Wellness reaches beyond the goal of being absent from disease to achieving more overall positive functioning and fulfillment. The Centers for Disease Control and Prevention (CDC; 2016) describes wellness as, at a minimum, the presence of positive emotions, absence of negative emotions (such as depression), satisfaction with life, a sense of fulfillment, and positive functioning.

There are different models of wellness, usually consisting of between six and eight domains; however, most include a social or interpersonal component (CDC, 2016; Prilleltensky, 2011). Prilleltensky (2011) described the subjective indicators of well-being in the interpersonal domain as “feeling supported heard, valued, appreciated, treated with respect and dignity.” In fact, having supportive interpersonal relationships is one of the strongest predictors of well-being (Myers, 2003). Social support plays an important role in physical and emotional well-being, and having a strong support network is shown to improve health in a number of areas, including reducing mortality rates and improving recovery from serious physical and mental illnesses (Corrigan & Phelan, 2004; Hurdle, 2001). Research emphasizes the importance of establishing and utilizing social supports early on because vicarious trauma affects one’s ability to trust others and experience intimacy in relationships (Pearlman & Saakvitne, 1995; Trippany, Kress, & Wilcoxon, 2004), which can increase isolation and negatively affect well-being.

The Role of Rape Crisis Advocates

Rape crisis advocates are particularly vulnerable to vicarious trauma (Campbell, Ahrens, Sefl, Wasco, & Barnes, 2001). Rape crisis advocates are trained individuals who provide immediate crisis counseling in hospitals to survivors of rape and connect survivors to future counseling and legal resources (Carlyle & Roberto, 2007; Preston, 2003). Oftentimes, these individuals are volunteers who are on call to provide crisis counseling a few times a month. Crisis counseling may include validating survivors’ stories, re-instilling feelings of power through educating survivors about options in their postassault health care choices, or advocating for the rights of survivors to be maintained and respected (Preston, 2003). In this role, rape crisis advocates help to facilitate quality services and also work to prevent further trauma to survivors that may occur as a result of insensitive or victim-blaming responses from other sexual assault responders (e.g., police, hospital staff; Campbell, 2006).

Well-Being and Rape Crisis Advocacy

Rape crisis advocates are exposed to survivors’ trauma through hearing detailed accounts of the assault, processing the trauma with the survivor, or witnessing the impact of the assault on survivors (Carlyle & Roberto, 2007). Working with sexual assault victims can have a meaningful negative impact on service providers’ psychological well-being (Dworkin, Sorrel, & Allen, 2014; McCann & Pearlman, 1990; Schauben & Frazier, 1995). Some research suggests that advocates may experience inadequate supervision or support from their advocacy organizations and that this lack of support contributes to burnout and vicarious trauma (Ullman & Townsend, 2007).

Self-Care and Social Support for Advocates

Despite compelling evidence that rape crisis advocates are at high risk for vicarious trauma and burnout, little research has been done to understand and promote advocates’ self-care. The research that has been done suggests that advocates engage in varied self-care practices that address different aspects of their well-being, including physical health activities, spiritual activities, leisure activities, debriefing, and seeking emotional and instrumental social support (Schauben & Frazier, 1995). Existing research underscores the importance of self-care via social support. One study on domestic violence survivor advocates found that debriefing and peer support were listed as the most important resources for handling difficult content from their work (Iliffe & Steed, 2000). In another study, advocates listed social support from friends or family and the opportunity to verbalize their intense feelings and experiences to others as important parts of their self-care (Wasco et al., 2002).

Yet, advocates may also experience unique barriers to obtaining social support with respect to their work. Rape is stigmatized and many people may not be comfortable discussing it. Research has shown that fear of stigma has prevented survivors from seeking social support with respect to the rape (Miller, Canales, Amacker, Backstrom, & Gidyz, 2011). This may also prevent advocates from seeking support in relationship to their vicarious trauma. Furthermore, people often respond in negative ways when rape survivors disclose their experiences, such as disbelieving the survivor’s story, blaming the victim, distancing themselves or acting in a cold manner, minimizing the issue, or simply failing to provide positive support (e.g., Ahrens, Cabral, & Abeling, 2009; Relyea & Ullman, 2015; Ullman, 2010). Such reactions have a negative impact on survivors and may also cause deterioration in the relationship between the survivor and the person they sought support from (Ahrens & Aldana, 2012). Advocates may also be vulnerable to such negative experiences when seeking help in response to their vicarious trauma. However, research has yet to conduct an in-depth examination of how advocates seek out and perceive social support in relationship to their vicarious trauma.

Current Study

The purpose of the present study was to explore how volunteer rape crisis advocates utilized social supports and understand how these support systems responded in both helpful and unhelpful ways. The present study was a part of a larger capacity building project between the researchers and the rape crisis center to explore how volunteer advocates engaged in self-care, received support, and utilized their training in responding to rape crisis calls. The rape crisis center was also interested in the extent to which advocates utilized formal supports that the organization provided to promote advocates’ self-care. We focus on rape crisis advocates because these advocates are at particularly high risk of vicarious trauma and the unique context of their work warrants specific attention. As is common in rape crisis centers, the center staff were mindful of burnout and turnover among advocates and the larger project sought to explore how advocates were supported by informal and formal systems. A better understanding of advocates’ self-care can be used to promote advocates’ well-being and prevent burnout, potentially improving care for survivors. Therefore, the current study used qualitative methodology to obtain an in-depth understanding of how volunteer advocates utilize and perceive social support as one particular strategy for self-care. Findings were used to help the rape crisis center think about how to effectively support advocates.

The focal research questions were as follows:

Research Question 1: What do advocates perceive to be helpful versus unhelpful when seeking social support from informal and formal support providers? Informal support providers are defined as people whom the advocate connected to outside of their formal role as an advocate (such as friends and family) while formal support providers are defined as people the advocate connected to within the rape crisis center they volunteered for.

Research Question 2: What do advocates perceive as barriers to seeking social support from informal and formal support providers?

Method

Recruitment and Sample

The present study interviewed 15 rape crisis advocates who were volunteers for a rape crisis center in Metropolitan Chicago to better understand their self-care strategies and the impact of their advocacy work on their social support systems. Volunteer advocates were chosen as the focus of this research because the majority of advocates in this setting who provided rape crisis support were volunteers and the focus of the present study was on the support systems, self-care strategies, and training of the advocates within the organization. In their role as advocates, volunteers partnered with the rape crisis center to provide medical advocacy, such as information about options or serving as an advocate to the needs of a survivor of rape in the emergency room. To facilitate the recruitment of volunteer advocates, the volunteer manager of the rape crisis center utilized the volunteer advocate listserv and social networking page to send out a recruitment letter to all advocates from the researchers. All volunteer advocates from the focal organization were eligible to participate. To determine the number of interviews to complete, we looked for theoretical saturation, or when common themes and patterns began to repeat themselves and new observations were limited (Glaser & Strauss, 1967). We continued to interview advocates until new interviews did not add substantially different information, which occurred around the 15th interview.

The 15 advocates who participated had a wide range of experience with an average length of volunteer advocacy of 2.84 years (SD = 3.64). Thirteen women and two men were interviewed, with an age range of 23 to 61 years (average age = 35, SD = 13.08). Advocates were from a variety of racial and ethnic backgrounds, with 47% White, 20% mixed, 7% Jewish, 13% African American, and 7% African. The majority of participants (67%) were married or currently partnered. Three advocates in the present study had children, often who were older in age (average age of children = 26 years, SD = 3.21).

Data Collection and Procedures

This study was part of an organizational capacity building project to better understand how to equip, train, and support rape crisis volunteers. Researchers discussed potential research questions with the rape crisis center and drafted the outline of the interview protocol incorporating research questions the organization wanted to ask related to organizational support systems. Participants who were interested contacted the researchers to coordinate an interview time. Individual interviews were conducted at a mutually agreed upon time and location with either the first or second author. Before the start of the interview, the research purpose was discussed and written informed consent was obtained. Individual interviews were then conducted using a semistructured interview guide that assessed advocate’s self-care strategies (e.g., Tell me about some ways you care for yourself?) and social support systems (e.g., Tell me about a time when someone supported you well in your role as an advocate. What about that experience made it feel supportive?). Throughout the interview, researchers utilized probing questions to gain a deeper understanding of participants’ experiences. Audio-recorded interviews lasted anywhere from 30 min to 120 min. Interviews were audio recorded with the consent of the participant and then transcribed. Transcripts were then reviewed for accuracy before analysis.

Data Analysis

The purpose of the present study was to explore how volunteer rape crisis advocates utilized social supports and how these support systems responded. In approaching the research process, researchers adopted an interpretivist/constructivist paradigm where meaning is understood as hidden and uncovered through intentional, deep engagement with the transcript (Ponterotto, 2005). Furthermore, meaning is considered to be co-constructed between researcher and participant first in the interview itself and second as the researcher reflects on the text of the interview to identify reoccurring themes and patterns (Guba & Lincoln, 1994; Ponterotto, 2005). Thus, data were analyzed using qualitative thematic content analysis allowing researchers to abstract codes and themes to describe the experiences of participants (Graneheim & Lundman, 2004).

Following the structure of thematic content analysis (Burnard, 1991), researchers began their analysis through thoughtful reflection by taking recorded notes called “memos,” which begin identifying emerging themes and categories. The transcripts were read by the first and second author and coded to identify emerging themes and categories. The first and second author both independently coded two thirds of the interviews, and the last third was coded by one of the two coders. The first and second author identified categories and themes independently of one another, and each created a category system that grouped together themes into meaningful headings and subheadings. The first and second author worked to combine their independent category systems into one structure that captured the meaning and content of the interviews and reduced repetition among the categories. This resulted in one category structure that captured the main themes and subthemes from the interviews. This category system was presented to the third author and a team of research assistants who reviewed a subset of interviews and checked the heading or category structure for clarity, consistency, and validity. After the combined category system was finalized, researchers returned to the transcripts of the interview to identify quotes to support or counter the category system. This forms the backbone of the “Results” section.

Results

Overview

While many advocates received positive social support, they also described several ways in which the support that they looked for was denied to them. Interactions with informal support providers (defined as people whom the advocate connected to outside of their formal role as an advocate, such as friends and family) were mixed. Due to the traumatic nature of rape, at times, advocates felt unable to reach out for support to protect others’ emotions. In addition, many support providers were too uncomfortable or too unprepared to respond to the topic of rape, and thus were unable to provide advocates with the emotional support they desired. On the contrary, many family and friends understood the issue of rape and/or valued the advocate’s role and subsequently provided excellent emotional and tangible support. Formal sources of support (defined as people the advocate connected to within the rape crisis center they volunteered for) tended to be seen more positively because they understood the issue and the nature of the work. However, these were not perceived to be accessible by all advocates. We first present themes related to social support from informal providers followed by themes related to social support from formal providers highlighting both helpful and unhelpful responses.

Informal Support Providers

Advocates turned to a variety of sources of support within their personal lives. Common examples included friends, family, and intimate partners. Some advocates also discussed receiving support from counselors and coworkers. Generally, experiences of seeking and receiving support from these informal sources were mixed, with many advocates describing both positive and limited support experiences from different people.

Positive experiences of seeking and receiving informal social support

When asked about their social support systems, advocates expressed positive experiences in seeking and receiving informal social support. This support included being emotionally supportive and providing tangible help.

Advocates discussed how their informal support systems were emotionally supportive through listening or providing comfort after difficult calls. For one advocate, emotional support meant her friends provided encouragement and told her they were praying for her:

I have a really great group of friends and family . . . In general whenever I signed up for shifts before, I’ve been surprised to find my friends were very supportive and they’re like, “Oh we will be praying for you” and “you’re going to be great.” (W15)

For this advocate and others, the thoughtfulness of their social support systems was helpful whether through text messages offering encouragement, prayer, or checking in before or after a time on call to see how the advocate was feeling. Advocates appeared to appreciate when their friends and family were actively aware of and interested in their advocacy activities.

Interestingly, advocates who were survivors expressed how discussing their advocacy experiences with fellow survivor advocates was particularly helpful. Survivor advocates discussed how their own experiences came up in relation to their advocacy. Discussing their advocacy experiences with other survivors was particularly important during times when elements of their own experience were reflected in their advocacy work. One advocate shared how her friend who is also a survivor was a key resource for her because they have a shared experience and knowledge of what the other had experienced:

I have another friend who’s a survivor . . . who . . . is also a social worker and she’s done work on a rape crisis line before, so we get it. Like she can offer support that no one else can, just because she gets it, like in a way that few other people can’t unless they’ve been there themselves. (W05)

For survivor advocates, social support from fellow survivors was a positive and crucial support system as they engaged in the trauma and experiences of other survivors in the emergency room.

Informal support systems also provided tangible help to advocates. Tangible support took the form of meeting direct needs such as driving advocates to and from calls, giving hugs, offering to stay with the advocate after taking a call, or being flexible and accommodating when advocates needed to change social plans. This form of support was provided most often by partners and at times, by friends. One advocate shared how her husband always dropped her off and picked her up from calls: “My husband took a great amount of pride in driving me to all my calls because he felt that that was his way in participating—was to make sure I got there quickly” (W11). She linked his assistance as benefitting both her advocacy (i.e., getting to the call quickly) and her husband because he felt he could support his wife in her advocacy through driving her to and from her calls. Others similarly reflected on how tangible help (e.g., meals, hugs, being present so the advocate would not be alone, being accommodating about social plans) met their needs and improved their ability to advocate and care for themselves.

Other advocates talked about how members of their support systems had not responded well in the past, but were working to educate themselves to respond in more helpful, sensitive ways. One advocate, whose husband had previously not understood why she wanted to be a rape crisis advocate, shared how over time her husband has grown to understand why she is an advocate and started helping her with her advocacy:

He’s becoming more in tuned to like, now he’s starting to talk about it when a report comes on TV or the news about survivors. He is into it now. And I did a community fair for [name of organization] recently at [location of community fair]. He went with me. When I had a bathroom break, he was passin’ out pamphlets and things and talkin’ with people. So, he’s being drawn into the work. (W04)

This level of support and partnership that some social supports provided was particularly encouraging to advocates. Despite poor responses in the past, advocates appreciated the intentional actions of support systems to learn about the advocate’s work and passion. It seems that having others, especially one’s social support system, directly helping the advocate in their advocacy work motivated and uplifted advocates.

Limitations of informal social support

Although advocates discussed positive aspects of informal social support in relationship, they also noted many ways in which informal social supports were less helpful or limited in the support they provided to advocates.

In particular, advocates shared barriers to processing their experiences with informal supports because they were concerned about the impact of their sharing on others. Advocates were worried their experiences would trigger others or prompt disclosures for which they were unprepared. One advocate shared how she chose to talk about a survivor’s experience in broad terms for confidentiality, but also because her boyfriend’s family had a history of abuse:

I kinda felt like it [discussing details of the survivor] was almost a breach . . . [of confidentiality] in giving all these details. I guess I would rather just like not share [the details] because if I’m gonna tell a story then I’m gonna tell the full story as opposed to just these broad strokes . . . Also for him, he had some abuse in his family as well, so I also didn’t wanna like kind of bring up those feeling for him necessarily. (W3)

At times, advocates feared sharing with others because of a past history of abuse or because they feared others may disclose their experiences of abuse. Generally, advocates struggled with which details to share and with whom they shared for fear of traumatizing or triggering others.

Participants also shared how some people in their informal support systems provided limited support. Some social support systems did not know how to care for survivors beyond basic support, which while well intentioned, was often lacking. For one advocate in particular, she shared wanting to talk with her husband about her advocacy, but he did not understand her advocacy work or how to support her well in it. Although more recently her husband was reading a book to learn how to better support her, she described throughout her interview that she struggled with the level of support her husband was currently providing:

I love my husband but he, like I said . . . he’s super supportive, and it’s like “That’s so great you did that” and like “I want to hear about it” and the roots like “I support you.” And I’m like “That’s great,” but he also doesn’t like really get it . . . sometimes I’m like, I’ll talk to you but I’m not, not gonna really talk to you . . . I just don’t think he knows . . . the questions to ask, or he’s not, he’s actually working on it since I expressed that like I want you to be more interested in sexual oppression and all this stuff, so he’s like reading a book. He’s funny, sends me articles to read. So I think it’ll get better . . . (W01)

Other advocates reflected these sentiments, expressing how their support systems were often unsure of what questions they could ask, perhaps unsure given the sensitive nature of sexual assault and confidentiality. Advocates expressed a desire for a resource packet or short training for their support systems to inform them about how to best respond to and support advocates.

In addition, advocates shared how the topic of sexual assault was sometimes not seen as socially acceptable to talk about and people’s reactions discouraged them from sharing. Participants shared stories where they were told to talk about it less or were labeled as the “rape girl.” For this advocate and others, it seemed that as advocates sought social support, they became more aware of a social prohibition about talking about sexual violence. This may be particularly challenging for advocates because they engage the topic and reality of rape regularly. One advocate discussed how she felt she had to edit her experiences because it is not talked about socially and makes some of her friends uncomfortable:

It’s not something that’s okay to talk about socially, and that makes it hard sometimes . . . the whole mood changes as if like me daring to say this unspoken elephant in the room that everybody knows is a problem but everybody’s not comfortable with limits my ability to interact with people, or just creates tension. And I’ve had friends and partners of friends essentially tell me that I should talk about it less and it makes people uncomfortable . . . There’s people that I talk about it less with because I know their partners aren’t comfortable . . . so . . . having to edit my experiences and my processing because of other people’s discomfort can be very hard. (W08)

While advocates expressed an awareness that some people were not able to hear or discuss the topic of sexual assault, it continued to be a barrier to advocates as they were unsure how to share their experiences with others in ways that respected their support system’s boundaries and limits, yet also remained true to their advocacy, experiences, and passions.

For the two male advocates in the present study, they discussed difficulty seeking help from informal supports as a result of personal barriers including their pride or the expectations of society. In particular, male advocates discussed how the expectation for men to be stoic restricted them from seeking support. One male advocate was asked about his barriers to social support and he noted his own pride and struggle with vulnerability as challenges to accessing social support:

Pride and honesty. [Laughter] It’s a personal thing that goes back to a lot of the ways of being both self-aware and dealing with others. And if you’re reserved about things, you may or may not feel shame about things. And if you feel shame about things it, it will cause anxiety when you try and address them with yourself or especially when you’re trying to address them with other people. So there’s that . . . And in addition to that just being able to be honest is, it’s a barrier for a lot of people . . . [when asked about how these barriers are for men] . . . There’s a huge expectation of stoicism. (M7)

This advocate and the other male advocate in the study both experienced barriers to seeking support because of gender-based expectations and norms. One male advocate noted how in his experience, men in his social support system were avoidant of talking about or discussing his work as a rape crisis advocate: “Men are more likely to avoid it . . . Men are so used to that not being a factor they have to think about that it’s very visibly uncomfortable for men” (M7). Due to social norms and added stigma of male survivors of sexual assault, these advocates did not feel they could openly talk about their experiences or readily access forms of social support.

Formal Support Providers

Participants also discussed their experiences of seeking and receiving support from sources within the rape crisis center itself. In the present study, formal support was defined as support that came as a result of the advocates’ work with the organization. Advocates were encouraged during training to connect with and build relationships with other advocates, which we conceptualize as a type of coworker relationship. The rape crisis center also had a formal role structure in place in which new advocates were connected to senior advocates designated to be available to as a mentor and source of postcall support. In addition, some advocates called staff members whom they had relationships with instead of other advocates or their assigned senior advocate. So while the agency had formal structures in place, they also encourage their advocates to seek support from one another and thus, we consider these supports as formal supports. Generally, when used, these sources of support were characterized as extremely positive. However, these forms of support were often less likely to be utilized than more informal forms of support discussed previously, and some advocates did not feel that they had an experience where they needed to access these forms of support.

Positive experiences of seeking and receiving formal social support

Advocates shared a variety of helpful responses provided by formal support systems. In particular, participants named staff members and organizational supports such as mentors and senior advocates as encouraging and supportive to the advocates in the present study. Advocates noted how it was helpful to hear positive feedback from staff. One advocate shared how she was able to talk with her mentor and get the support she needed following a call:

I had a really good time to debrief right away with my mentor . . . and [a staff member] . . . I was able to talk to them and kind of get feedback from them they were like, “it seems like [you] . . . handled it well.” That immediately put me at ease. (W15)

Throughout, advocates shared how the affirmations of a job well done from more seasoned advocates and staff were key in feeling supported and assisted them in processing their advocacy.

Within the organization recruited for this study, almost every advocate mentioned a particular key staff member, the volunteer manager, as helpful and caring. This staff member assists volunteer advocates with scheduling and also serves as a major source of support. Advocates described this staff member as nurturing, nonjudgmental, and always available to listen and provide support. One advocate shared how this staff member was a key support to her especially because the staff member’s personality allowed her to connect well:

And so its personality, and [name of person at organization] has it. Whatever it is she has it. She just has this mothering type thing about her . . . It’s, she just, she’s like everybody’s auntie in a way . . . She’s relatable. She’s not old, she’s young but she has this seasoned, kind of thing going for her. And I like, I connect with that. (W04)

Other advocates shared similar sentiments about this staff member who they saw as a key person from whom they could seek support. This staff member was in a highly visible role for advocates, interacting with them throughout their training, which may have also aided in the majority of advocates naming this staff as a key form of formal support.

One of the other main forms of support advocates identified was other advocates. When asked about their support systems, advocates often mentioned how the relationships they had with other advocates from the organization were one of the main forms of social support that they accessed. Advocates were seen as particularly supportive because they could relate to the experiences of being on call and responded in more informed, sensitive ways. One advocate shared how her advocate friend was supportive through checking in when she was on call, providing a listening ear, and even meeting up to connect in person:

When it comes to this particularly, I would say [friend who is also an advocate] . . . because every time she is on a shift, she writes me and says, “Are you, are you on?” We will talk all about it and then when I’m on, she’ll like remember. And be like “Oh you are on shift today? Right?” Which is like what! How do you even remember that? I like her a lot. And we have very similar value systems and beliefs and stuff so that we really were very supportive of each other, so that has been really, really cool to have her. And it took us forever, but we finally actually met in person and talked. (W15)

It seems that advocates knew how to support each other well because of their shared experience. Thus, advocates may play a particularly crucial role in supporting one another.

Limitations of formal social support

Despite extremely positive experiences with formal social support systems, advocates made suggestions for improving supports provided by the organization. One such area was the formal social support groups for volunteer advocates. Advocates felt these groups were often held at inconvenient times which limited attendance (as evidenced by only one of the 15 advocates in the present study having attended the support groups). One advocate shared how her work hours were in direct conflict with the meeting times:

There’s been all these support groups that they have that literally since the first one post my training, I wanted to go to. But basically having a day job [laughs] is a real barrier. It just turns out that all of the support meetings are literally in conflict with [her job]. (W15)

While these meetings were perceived as potentially helpful, scheduling conflicts and other commitments made it difficult for advocates to access these supports.

In addition, advocates from minority groups noted how the organization as a whole could work to be more inclusive of different backgrounds (i.e., gender, racial/ethnic, and age). Advocates from minority groups highlighted how they felt that the systems within the organization were not representative of themselves, their experiences, or their culture, as many of the advocates were young, White, privileged, female college students. These advocates discussed difficulty connecting with others within the organization. This was reflected by one advocate who was from a racial/ethnic minority group:

I reached out to [my mentor] once. She listened to me, supported me, and I told her basically what I told you, but I haven’t felt the need to reach out to her again. Um, [long pause to think] and I think it’s because [long pause to think] I don’t think it’s really been necessary, but then again she’s young and she’s in [the younger] age bracket, and so I’m wondering, is that once again a barrier that I, a self-erected barrier that I don’t, are resistant to talking to her because she is this college-educated, white girl. (W04)

While this advocate recognized the potential of a self-erected barrier to support, other advocates resonated with this frustration as they looked for greater diversity within the organization to access support from people who more closely represented themselves.

Discussion

The current study examined rape crisis advocates’ utilization and perceptions of social support from both informal and formal support providers. Consistent with prior research, findings show that advocates believed being able to emotionally process through their experiences with peers or friends was beneficial to their well-being (Iliffe & Steed, 2000; Wasco et al., 2002). The present study extends beyond prior research by documenting specific ways support providers were helpful such as asking about advocates’ work, understanding how their advocacy affected their relationships, and providing tangible help. In these ways, support providers emotionally supported and facilitated the work of the rape crisis advocates.

While prior research has largely emphasized the positive role of social support for advocates, the current study’s findings illustrate that social support from friends and family is not always available or even very helpful. Advocates noted their own reluctance to share with others because they did not want to burden them, and likewise, advocates also noted that many potential support providers were clearly uncomfortable hearing about their work. This issue was also salient for the two male advocates in the sample who noted that rape advocacy was particularly difficult for them to discuss with other men. When advocates did seek social support, they also noted it sometimes was not very helpful and people seemed unsure of how to respond well. Notably, however, advocates did not note outright hurtful responses to their work (such as dismissing or minimizing the issue or their work). Victim blaming and disbelieving responses to rape are common in our culture, and advocates did not seem to receive those; it may be that advocates intentionally seek support from people who they believe are unlikely to engage in such hurtful responses.

The mixed findings on informal social support providers may explain why advocates emphasized obtaining support from other advocates and rape crisis center staff. Through their shared experiences, many advocates generally felt they could trust one another to be willing to hear about their experiences, to “get it,” and to respond in ways that were helpful. However, this was not a universally effective strategy: Advocates from marginalized and minority groups (e.g., women of color, older women) often felt estranged from these formal sources of support. Prior research on the role of the rape crisis organization in fostering social support for advocates is extremely limited, although researchers have noted that lack of supervision contributes to advocates’ vicarious trauma (Ullman & Townsend, 2007). In this study, the focal organization seemed to place an unusually high emphasis on helping advocates obtain support, which may explain why advocates as a source of support was such a salient theme.

Limitations and Implications for Future Research

The current study provides valuable insight into what advocates found more or less beneficial when seeking out and receiving social support from both informal and formal sources. However, the study was only limited to the perspectives of the advocates themselves. Future work that examines the point of view of both the advocate and the person they sought support from would be particularly beneficial in understanding these types of interactions as transactional. How and why do they unfold the way they do? How do support providers understand and navigate their responses? How, if at all, do support providers feel informed or prepared to be able to respond? How do their interactions affect the advocate/support provider relationship? How can these types of interactions be improved to enhance advocates’ well-being?

In addition, the current study focused on the experiences of 15 volunteer advocates who worked with one rape crisis center in Chicago. The advocates who did choose to participate in the study may not be representative of all of the advocates within the organization. For example, advocates who did respond to the advertisement may have had particularly strong beliefs about the importance of self-care and support for advocates. In addition, some subgroups of advocates discussed ways in which they believed their experiences were connected to their unique identities (specifically as male advocates, advocates of color and/or older advocates, and survivor advocates). However, given the small size of these groups in our sample, future research is needed to fully understand their unique experiences with respect to their utilization and perceptions of informal and formal social support.

Furthermore, the focal rape crisis center may represent a unique organizational context with respect to advocates’ social support. The rape crisis center had several formal processes in place to connect advocates to support including mentor advocates and advocate support groups. Such supports may not be available at all rape crisis centers. Thus, the advocates in the sample may be more likely to view other advocates as a source of support than in other organizations in which these formal processes do not exist. In addition, the volunteer pool of advocates is quite large, and like the context of Chicago, extremely diverse. This may diminish advocates’ sense of belonging to the entire group of advocates at this organization, particularly for advocates who are less privileged or underrepresented within the broader pool of advocates. Therefore, future research could expand upon the current study by examining other diverse organizational and community contexts in which rape crisis advocacy is conducted.

Implications

The current study highlights the need to help rape crisis advocates access positive social support. Advocates noted difficulties in accessing support from people within their social networks. Training or mentoring from senior advocates could prepare new advocates for potential issues with obtaining support from friends and family and provide strategies for navigating these challenges. In addition, advocates generally seemed to think that their support providers were well intentioned, but were uncomfortable with the topic or unsure of how to be helpful. The present study highlights the need for rape crisis centers to educate support providers to understand the issue and why the advocates want to talk about it, overcome the stigma of talking about it, and be prepared to respond in ways that are helpful.

Findings also suggest that like the focal rape crisis center, rape crisis centers can utilize formal structures to help advocates obtain support from one another. Rape crisis centers can help advocates to form these types of supportive relationships with other advocate peers for example, via in person meetings and debriefing/support groups for advocates. Unlike many rape crisis centers, the focal organization in this study also had a formal role structure in which senior advocates were designated to be available to provide support to other advocates. Findings suggest that for some advocates, this is an extremely beneficial resource. Rather than having to form their own connections to obtain support, they knew who within the organization was expected to be available to them when they needed support. In addition, volunteer managers who provide consistent support and supervision may be key for volunteer advocates as this was one of the main sources of support that was noted by almost every advocate in the present study.

However, some advocates felt designated mentor advocates were not a helpful resource to them because they did not feel that they had enough in common with the mentor advocate. Often this was cited due to differences in age, race/ethnicity, and class. This highlights the need for attending to diversity in selecting mentor advocates. That said, while the availability of diverse mentor advocates is highly desirable, this may not always be possible in some contexts. Furthermore, attempts to create a diverse mentor advocate pool may inadvertently create a disproportionate burden on some groups who are marginalized and underrepresented among rape crisis advocates (e.g., women of color and older women). Therefore, with the understanding that all mentor/mentee relationships may not involve shared backgrounds, training for mentor advocates could also focus on effectively supporting diverse advocates and helping to establish nodes of connection with mentee advocates who have different backgrounds from themselves. This is particularly important as many subgroups, particularly women of color, already experience marginalization within the antirape movement and should not also experience a disproportionate burden of vicarious trauma due to lack of support.

Conclusion

Prior research has shown that rape crisis advocates are routinely exposed to traumatic material that may negatively affect their well-being, and social supports can be particularly important for advocates. In an extension of this research, the current study illustrated that many advocates are able to seek out and receive positive social support that nurtures them and their work. However, advocates also experienced a variety of barriers to obtaining positive support, including fear of burdening others, others’ reluctance and lack of preparation to provide support around the issue, and not being able to connect to formal support providers with dissimilar backgrounds. Researchers and rape crisis centers can continue to support advocates through research and interventions that help promote positive, supportive relationships.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Jaclyn D. Houston-Kolnik is victimologist and manager of the Center for Victim Studies in the Research and Analysis unit of the Illinois Criminal Justice Authority. She works to lead the unit’s efforts in developing a statewide research agenda that will help inform policy, practice, and funding as it relates to victimization and victim services. She received her PhD in community psychology from DePaul University with a focus on violence against women. She has research and evaluation experience on such topics as sexual assault, human trafficking, and intimate partner violence.

Charlynn A. Odahl-Ruan, PhD, is a clinical psychologist with a doctorate from DePaul University in Chicago. Her research focuses on the empowerment and well-being of women, including the impact of gender role ideology, the effect of spirituality and gender norms upon women’s identity formation, and gender-based economic disparities. She also studies the impact of self-care strategies on vicarious trauma of advocates and therapists working with trauma survivors.

Megan R. Greeson received her PhD in community psychology from Michigan State University and is an assistant professor of clinical and community psychology at DePaul University. Her program of research focuses on improving the response to gendered violence. Her current work examines multilevel, multidisciplinary community interventions for sexual assault survivors including Sexual Assault Response Teams.

References

Ahrens

C. E.

Aldana

(2012). The ties that bind: Understanding the impact of sexual assault disclosure on survivors’ relationships with friends, family, and partners. Journal of Trauma & Dissociation, 13, 226-243.

Ahrens

C. E.

Cabral

Abeling

(2009). Healing or hurtful: Sexual assault survivors’ interpretations of social reactions from support providers. Psychology of Women Quarterly, 33, 81-94.

Baird

Jenkins

S. R.

(2003). Vicarious traumatization, secondary traumatic stress, and burnout in sexual assault and domestic violence agency staff. Violence and Victims, 18, 71-86.

Barnett

J. E.

Cooper

(2009). Creating a culture of self care. Clinical Psychology: Science and Practice, 16, 16-20.

Burnard

(1991). A method of analyzing interview transcripts in qualitative research. Nurse Education Today, 11, 461-466.

Campbell

(2006). Rape survivors’ experiences with the legal and medical system: Do rape victim advocates make a difference? Violence Against Women, 12, 30-45.

Campbell

Ahrens

C. E.

Sefl

Wasco

S. M.

Barnes

H. E.

(2001). Social reactions to rape victims: Healing and hurtful effects on psychological and physical health outcomes. Violence and Victims, 16, 287-302.

Canfield

(2005). Secondary traumatization, burnout, and vicarious traumatization: A review of the literature as it relates to therapists who treat trauma. Smith College Studies in Social Work, 75, 81-101.

Carlyle

K. E.

Roberto

A. J.

(2007). The relationship between counseling self-efficacy and communication skills of volunteer rape crisis advocates. Communication Research Reports, 24, 185-193.

10.

Centers for Disease Control and Prevention. (2016). Well-being concepts. Retrieved from http://www.cdc.gov/hrqol/wellbeing.htm#three

11.

Corrigan

P. W.

Phelan

S. M.

(2004). Social support and recovery in people with serious mental illnesses. Community Mental Health Journal, 40, 513-523.

12.

Dworkin

E. R.

Sorell

N. R.

Allen

N. E.

(2014). Individual-and setting-level correlates of secondary traumatic stress in rape crisis center staff. Journal of Interpersonal Violence, 31, 743-752.

13.

Glaser

Strauss

(1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine.

14.

Graneheim

U. H.

Lundman

(2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112.

15.

Guba

E. G.

Lincoln

Y. S.

(1994). Competing paradigms in qualitative research. In Denzin

N. K.

Lincoln

Y. S.

(Eds.), Handbook of qualitative research (pp. 105-117). Thousand Oaks, CA: Sage.

16.

Hurdle

D. E.

(2001). Social support: A critical factor in women’s health and health promotion. Health & Social Work, 26, 72-79.

17.

Iliffe

Steed

L. G.

(2000). Exploring the counselor’s experience of working with perpetrators and survivors of domestic violence. Journal of Interpersonal Violence, 15, 393-412.

18.

Killian

K. D.

(2008). Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self-care in clinicians working with trauma survivors. Traumatology, 14, 32-44.

19.

McCann

I. L.

Pearlman

L. A.

(1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131-149.

20.

Miller

A. K.

Canales

E. J.

Amacker

A. M.

Backstrom

T. L.

Gidyz

C. A.

(2011). Stigma-threat motivated nondisclosure of sexual assault and sexual revictimization: A prospective analysis. Psychology of Women Quarterly, 35, 119-128.

21.

Myers

D. G.

(2003). Close relationships and quality of life. In Kahneman

Diener

Schwarz

(Eds.), Well-being: Foundations of hedonic psychology (pp. 374-391). New York, NY: Russell Sage Foundation.

22.

O’Halloran

T. M.

Linton

J. M.

(2000). Stress on the job: Self-care resources for counselors. Journal of Mental Health Counseling, 22, 354-364.

23.

Pearlman

L. A.

Saakvitne

K. W.

(1995). Treating therapists with vicarious traumatization and secondary traumatic stress disorders. In Figley

C. R.

(Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 150-177). London, UK: Brunner-Routledge.

24.

Ponterotto

J. G.

(2005). Qualitative research in counseling psychology: A primer on research paradigms and philosophy of science. Journal of Counseling Psychology, 52, 126-136.

25.

Preston

L. D.

(2003). The sexual assault nurse examiner and the rape crisis center advocate: A necessary partnership. Topics in Emergency Medicine, 25, 242-246.

26.

Prilleltensky

(2011). Wellness as fairness. American Journal of Community Psychology, 49, 1-21.

27.

Relyea

Ullman

S. E.

(2015). Unsupported or turned against: Understanding how two types of negative social reactions to sexual assault relate to post-assault outcomes. Psychology of Women Quarterly, 39, 37-52.

28.

Saakvitne

K. W.

Pearlman

L. A.

(1996). Transforming the pain: A workbook on vicarious traumatization. New York, NY: W.W. Norton.

29.

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.

30.

Trippany

R. L.

Kress

V. E. W.

Wilcoxon

S. A.

(2004). Preventing vicarious trauma: What counselors should know when working with trauma survivors. Journal of Counseling & Development, 82, 31-37.

31.

Ullman

S. E.

(2010). Talking about sexual assault: Society’s response to survivors. Washington, DC: American Psychological Association.

32.

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.

33.

Wasco

S. M.

Campbell

Clark

(2002). A multiple case study of rape victim advocates’ self-care routines: The influence of organizational context. American Journal of Community Psychology, 30, 731-760.

34.

Williams

A. M.

Helm

H. M.

Clemens

E. V.

(2012). The effect of childhood trauma, personal wellness, supervisory working alliance, and organizational factors on vicarious traumatization. Journal of Mental Health Counseling, 34, 133-153.