Rape Crisis Victim Advocacy: A Systematic Review

Abstract

While rape crisis center (RCC) advocacy is generally regarded as valuable, there are no prior systematic reviews of the advocacy literature. This review examined RCC advocacy service provision, perceptions and impact of advocacy, and challenges and facilitators to effective service provision. Databases related to health and social sciences were searched including Academic Search Complete, PsychINFO, PubMed, CINAHL, ProQuest, Science Direct, OAlster, WorldCat, and MEDLINE. Empirical articles written in English that examined RCC advocacy service provision and/or impact in the US were included. The researchers reviewed abstracts and titles, and then full texts. Forty-five articles met criteria, were summarized, and double checked. Findings demonstrate advocacy is multi-faceted, beneficial, and challenging. Advocates work directly with survivors and interact with other responders on behalf of survivors. Specifically, advocates provide emotional support, safety plan, support survivors in making decisions, and assist them in navigating other systems. While advocates are generally regarded positively by survivors and responders, some responders have concerns about advocates. In addition, advocates sometimes report victim-blaming and being ill-equipped to meet survivors’ needs. Finally, advocates face specific challenges in their work with survivors and responders. Future research using diverse methodological approaches is needed to understand advocacy utilization and reach; survivors’ perceptions of advocacy; marginalized survivors’ experiences; connections between specific services, implementation, and outcomes; and effective strategies for advocates’ interactions with other responders. Additional resources to help advocates serve all survivors effectively and equitably; to support evaluator-practitioner partnerships; and to share unpublished data on advocacy may help contribute to improvements in advocacy practice.

Adolescents and sexual assault: A critical integrative review

“…Following an SA, survivors of all ages may choose to engage several different formal systems for support or services. This includes the (1) the medical system, most often accessed to attend to physical and psychological healthcare needs (Du Mont et al, 2009), while also providing forensic evidence collection (see Office on Violence Against Women, 2013); (2) the criminal legal system, which survivors may choose to access due to safety concerns or for a means of holding accountable the person who harmed them (see Spohn & Tellis, 2012); and (3) rape crisis centers, which often provide crisis intervention, counseling services, and personal, medical, and legal advocacy as survivors attempt to navigate complex systems (see Shaw & Campbell, 2011; Wegrzyn et al, 2023). Survivors may also be offered advocacy services through the criminal legal system with police‐based or prosecutor‐based victim advocacy services.…”

Reasons for Not Reporting Among Sexual Assault Survivors Who Seek Medical Forensic Exams: A Qualitative Analysis

“…Survivors referenced ways that reporting could negatively impact their employment, housing, custody, and close relationships. These are not short-term problems with easy solutions, and advocacy agencies are often the only response system able to provide the type of long-term support it would take to navigate them ( Macy et al, 2009 ; Wegrzyn et al, 2023 ). Because community-based advocates are not affiliated with police agencies, they can also provide a neutral space to talk through the advantages and disadvantages of reporting and be there to support survivors regardless of what they decide ( Patterson & Tringali, 2015 ).…”

The Working Relationship Between Emergency Room Nurses and Medical Rape Victim Advocates: A Qualitative Examination of Nurses’ Perceptions of the Influence of Nurse Training and Experience on Nurse–Advocate Interactions

“…Participants in this study connected nurse training and experience with their perceptions of the quality of their working relationships with medical advocates (i.e., advocates who assist survivors in obtaining medical and forensic services through the medical system) (Wegrzyn et al, 2022). Specifically, training and experience were associated with nurse-medical advocate collaboration (i.e., rapport, respect, trust, and appreciation), role understanding, and perceptions of SA expertise.…”

“…Rape crisis medical advocates assist and accompany survivors who seek medical and forensic services to mitigate their potential negative experiences with the medical system (Moylan et al, 2017; Payne, 2007). In doing so, medical advocates provide emotional support to the survivor, advocate for the rights of the survivor, offer information and referrals, and attempt to certify that the survivor's medical needs are sufficiently met (Moylan et al, 2017; Payne, 2007; Wegrzyn et al, 2022). Survivors who work with advocates in medical settings report more comprehensive treatment, fewer negative interactions with ER staff, and less overall distress from their experiences with the medical system than survivors who do not receive the services of medical advocates (Campbell, 2006).…”