Few rape survivors seek help from formal social systems after their assault. The purpose of this study was to examine factors that prevent survivors from seeking help from the legal, medical, and mental health systems and rape crisis centers. In this study, 29 female rape survivors who did not seek any postassault formal help were interviewed about why they did not reach out to these systems for assistance. Using qualitative methodology, this study found that survivors believed that formal social systems would or could not help or would psychologically harm them. Specifically, survivors thought that systems would not help because survivors themselves believed that they were unworthy of services or that their rape experience did not match stereotypical conceptions of rape. Survivors did not see how the systems could help or protect them from their assailants. Finally, survivors anticipated that systems personnel would cause them further psychological harm by not believing they had been raped or not caring about them. Survivors feared that system assistance would have intensified their painful feelings beyond their coping skills. Therefore, survivors who do not seek help may be attempting to protect themselves from perceived psychological harm. Implications for social work practice are discussed.

After a rape, survivors may seek help from multiple community organizations including the criminal justice system (CJS). Research has found that few survivors report their assaults to the police and of those who do report, many withdraw their participation during the investigation. However, relatively little is known about the factors that lead survivors to participate in the CJS, and how other community services provided by forensic nurses or victim advocates may also help encourage survivor engagement. In the current study, 20 survivors who reported their victimizations to police within a large Midwest county were interviewed about the factors that influenced their involvement in the CJS. Further, we examined the role that the police, forensic nurses, and victim advocates played in their participation. Using qualitative analyses, our findings suggest that informal supports hold a strong role in the reporting process and formal supports are influential in survivors' engagement in the investigational process. © 2010 Wiley Periodicals, Inc.

In sexual assault nurse examiner (SANE) programs, specially trained forensic nurses provide 24-hour-a-day, first-response medical care and crisis intervention to rape survivors in either hospitals or clinic settings. This article reviews the empirical literature regarding the effectiveness of SANE programs in five domains:(a) promoting the psychological recovery of survivors, (b) providing comprehensive and consistent post-rape medical care (e.g., emergency contraception, sexually transmitted disease [STD] prophylaxis), (c) documenting the forensic evidence of the crime completely and accurately, (d) improving the prosecution of sexual assault cases by providing better forensics and expert testimony, and (e) creating community change by bringing multiple service providers together to provide comprehensive care to rape survivors. Preliminary evidence suggests that SANE programs are effective in all domains, but such conclusions are tentative because most published studies have not included adequate methodological controls to rigorously test the effectiveness of SANE programs. Implications for practice and future research are discussed.

Research has documented that few reported rapes are prosecuted by the legal system. The purpose of this study is to explain how the interactions between victims and detectives can strengthen or weaken the investigation itself. Twenty rape victims were interviewed to examine how law enforcement detectives' manner of questioning affects rape victims' level of disclosure. Using qualitative methodology, the results show that the detectives' manner of questioning can play a role in victims' disclosure. Detectives using a gentle manner of questioning with victims can help produce stronger victim statements and thus build stronger cases for prosecution.

Sexual assault survivors often feel traumatized by the care received in traditional hospital emergency departments. To address these problems, Sexual Assault Nurse Examiner (SANE) programs were created to provide comprehensive medical care, crisis intervention, and forensic services. However, there is limited research on the actual experiences and emotional impact of sexual assault survivors who seek treatment from SANEs. This qualitative study examined twenty rape survivors' experiences with forensic nurse examiners of a Midwestern SANE program. Findings suggest that SANEs provided survivors with care and compassion, clear explanations, and choices. Taken together, these positive experiences were perceived as "humanizing". However, some survivors perceived forensic nurses as hurtful when they were not provided with choices, explanation, and/or acted cold and distant. Implications for future research on SANE care and practice are discussed.