Victims' Response to Trauma and Implications for Interventions: A Selected Review and Synthesis of the Literature

3. IMPLICATIONS FOR VICTIMS

3. IMPLICATIONS FOR VICTIMS

The main focus of research in victimization is to improve victim services and, thereby, reduce the trauma associated with victimization. Given the above discussion, one can note much research that tracks how victimization and subsequent coping affect the individual. Borrowing the model of Casarez-Levison (1992), I am going to organize this section developmentally and locate important cognitive, emotional, coping and intervention issues within each stage. This approach should help integrate the above literature and help service-deliverers identify salient issues for clinical interest.

Previctimzation/Organization.

Recall that this stage focused on the previctimization adaptation level of the person (Casarez-Levison, 1992). Here clinicians will want to gather a relatively comprehensive history. The following elements should be included:

Victimization/Disorganization.

Recall that this stage focuses on the crime, and the first few hours or days following the crime (Casarez-Levison, 1992). Victims and their caregivers need to be aware of the following:

Transition/Protection

Recall that this stage focused on how the person begins to adjust to the victimization and its implications (Casarez-Levison, 1992). Clinicians are more likely to be actively involved with victims as they move through this stage.

Reorganization/Resolution

Recall that this stage focused on a reintegration of the person into a stable functioning individual (Casarez-Levison, 1992). Victims need to understand the following:

In trying to gain increased understanding of victim subjective experience, it is useful to examine victimization as a process. In a sense, victimization is a developmental process where an individual must adjust to an external stressor. As the victim moves from the criminal event to subsequent recovery and reintegration, they are faced with different challenges. Their cognitive skills will be challenged and changed as part of this process and the preceding review has discussed some of these changes. However, one must remain mindful of the fact that each victim is an individual and the specific challenges will change because of these differences.

3.1 Heterogeneity of Victims: Need for a Services Continuum

In examining workplace violence, Barling, Rogers & Kelloway (2000) noted that people experience the same events differently. In their research, they found that the fear of reoccurrence of traumatic event could affect the person's mood. The above review covered issues such as severity of crime, severity of response, use of threat, use of weapon, as elements of the process of victimization that can affect outcome. This finding among workplace violence can be generalized into understanding that all crime victims will have very unique responses to the crime event. Thus, interventions need to be adaptive to these individual differences.

Individual differences may be seen as the major reason for individual intervention. The unique experience of some individuals makes individual focus an integral part of treatment. However, there are also commonalities in the victim experiences that all victims will experience to a greater or lesser degree. These may include feelings of fear or anger or psychological/behavioural avoidance. However, victims should not be lumped together as the effects could be harmful. For example, social comparison would mean that mixing severity levels would likely be harmful to victims of more severe crime (Greenberg & Ruback, 1992). These victims may get caught in a cycle of depression, victim-stance or self-blame when comparing their experience with less traumatized victims. This argues for some form of continuum of services that might help move victims closer to a state of health.

Many victims may benefit from minimal services such as information sharing, written literature, knowledge of available supports, and education regarding possible signs and symptoms of deeper problems. In fact, it is this group that may benefit from CISM interventions, with its focus on information-sharing and resource linking (Everly et al., 2000). These victims likely rely on natural supports or their own unique coping strategies to cope with their victimization. In other words, they are able to cope with their new status as victim. This group is likely made up of those who experienced relative non-traumatic victimization or who have particular resiliency in coping with situational and chronic stressors.

A second group could be labelled moderately traumatized. These victims may experience some symptoms, such as fear or anger, but learn to deal with it with minimal professional support. They may benefit from the same interventions as the lower traumatized group, but may also benefit from support groups, individual intervention or other group intervention. This may be relatively short-term intervention focused on specific negative symptom and targeting specific skills training. This group may also rely on natural supports, but may require the support of paraprofessionals and professionals.

The highly traumatized group could also benefit from all the above services, but will often need more intensive intervention. This may include long term therapy to deal with symptoms and building coping skills. Treatment would likely need to address previous trauma and long-term effects of victimization. The focus on symptoms would also need more time to generalize to other aspects of life. It is likely that the severely traumatized victim will be at increased risk of very negative symptoms. Furthermore, if these victims have multiple problem areas and pre-victim problems, it is sensible to place professional resources at the disposal of this group. Professionals should be better equipped to deal with idiosyncratic reactions and act as a resource to paraprofessionals and volunteers.

One final group that needs to have specific interventions are those that we might call precontemplators: those who have experienced a trauma, are experiencing negative reactions but refuse to acknowledge either the reaction as related to the trauma or minimize the scope of the reaction. These clients need specific intervention to help them understand victimization and how to recognize when to ask for help. Often with precontemplators, consciousness-raising techniques through written materials (pamphlets), opportunity for self-reevaluation or dramatic relief through information sessions, or other less confrontational means should be helpful in allowing this group to make an informed assessment of their present functioning and possible choices (Rosen, 2000). However, it is important to recall the warning of Nelson et al. (2002) that clinicians should not assume that people who have experienced a potentially traumatic event would automatically be traumatized. Thus, service-deliverers need to handle these situations in a sensitive manner to prevent further distress.