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  1. Practical Strategies for Working with Victims Across the Lifespan Dr. Lilli Perez Rosemarie Camacho, IMFT Dr. Patricia Taimanglo November 16, 2011

  2. ADULT VICTIMS OF SEXUAL ASSAULT • Sexual Symptoms • Major Long Term Medical Symptoms • Major Long Term Psychological Symptoms

  3. Major Sexual Symptoms of Sexual Assault • Difficulty with becoming aroused and feeling sensations; • Sex feels like an obligation; • Sexual thoughts and images are disturbing; • Inappropriate sexual behaviors or sexual compulsivity; • Vaginal pain; • Inability to achieve orgasm or other orgasmic difficulties;

  4. Major Sexual Symptoms of Sexual Assault • Erection problems or ejaculatory difficulty; • Feeling dissociated while having sex; • Detachment or emotional distance while having sex; • Being afraid of sex or avoiding sex; and • Guilt, fear, anger, disgust or other negative feelings when being sexual.

  5. Major Long-Term Medical Symptoms • Insomnia; • Vaginal or pelvic pain; • Eating disorders; • Headaches; • Lower back pain, chest pressure;

  6. Major Long-Term Medical Symptoms • Erection problems or ejaculatory difficulty; • Asthma; • Dizziness / fainting; • Self-harming / self-mutilation; and • Chronic physical complaints.

  7. Major Long-Term Psychological Symptoms • Anxiety; • Panic Attacks; • Low self-esteem; • Stress Disorders / PTSD; • Personality Disorder; • Substance abuse; and • Self-Abused behaviors.

  8. Activity • Reader / Reporter • Read the victim profile. • Others draw pictures, signs & symbols to represent what is read. • After 10 minutes, a reporter will give general description of the victim.

  9. Assessment Should Inform Treatment • Presentation • Age • Affect / mood • Cognitive ability • Adaptive function – communication, self-care, social skills, working/school, family, leisure activities, academic function or education, etc.

  10. Assessment Should Inform Treatment Community Support/Activities • Family (family of origin, nuclear, extended); • Friendships • Co-workers; • Sports; • Work; • Spiritual; etc.

  11. Assessment Should Inform Treatment • Development – Early life (1st 3-4 years) • Medical concerns • Relationships • Family of origin – attachment • Current family • Extended family

  12. Assessment Should Inform Treatment • Socio-Economic Status • History of mental illness; • History of sexual abuse/trauma; • History of substance abuse;

  13. Assessment Should Inform Treatment • History of legal concerns • Charges filed • Preparing client for court involvement;

  14. Treatment • Advocacy • Supportive Therapy • Powerful short-term therapy • Art Therapy • Narrative Therapy • Medication Therapy • EMDR • Evidenced Based Therapy for Anxiety, Depression, and Trauma

  15. Narrative Therapy • Recording memory of event; • Journaling

  16. Art Therapy • Art pulls out your feelings and makes them tangible or real so you can see them and deal with them. • When a person paints something, one can get an overall feeling of the painting and the person doing it. • Colors convey much about the experience and where the individual is in their healing.

  17. Art Therapy • Self-portraits • Eventually some paint their abuser, body parts or critical elements of the assault. • Recovery Rituals