EXPLORING THE DIVERSITY OF SURVIVORS THROUGH PHOTOVOICE: BUILDING A CONTEXTUALLY INFORMED RESPONSE TO SEXUAL VIOLENCE By Katherine Cloutier A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Psychology 2012 ABSTRACT EXPLORING THE DIVERSITY OF SURVIVORS THROUGH PHOTOVOICE: BUILDING A CONTEXTUALLY INFORMED RESPONSE TO SEXUAL VIOLENCE By Katherine Cloutier Intersectionality theory suggests sexual violence is shaped by the interactions of social classifications such as race, class, and gender (Carraway, 1991; K. W. Crenshaw, 1991). This is supported by data that demonstrates differing prevalence rates and varying post-assault behavior across survivors (Tjaden & Thoennes, 2006). Pressure is put on service systems to meet the needs of a diversity of survivors. Given the prevalence of sexual violence on college campuses (Fisher, Cullen, & Turner, 2000), and the growing diversity of students (Snyder & Dillow, 2011) it is important to assess whether survivors’ needs are being met by the campus-community. A project was developed to assess the needs and experiences of the diversity of survivors on the Michigan State University (MSU) campus and to establish a more contextually relevant response system. Using the Photovoice methodology, six survivors of sexual violence created photos and narratives that explored how diverse student characteristics intersect with experiences. Key findings emerged that focused on the helpfulness of reclaiming a sense of normalcy and control, voice, one’s body post-assault, and the need for increased institutional support. Participants reported similarities in their post-assault experiences. However due to unique instances of intersectionality, reclaiming processes manifested in different ways for certain survivors. Copyright by KATHERINE CLOUTIER 2012 ACKNOWLEDGMENTS I would like to begin by acknowledging my parents who provided me with the opportunity to pursue many opportunities in this world, a gift that not everyone receives. I would also like to thank my partner, Maxwell, who is not only ambitious, but also crazy energetic. Max, you make me feel more alive every day. To my sisters, who I constantly hope find me as a role model, inspiring them the way they inspire me; and my brother Charlie, who I can always count on for a good argument. Thank you to Jenny Mortenson, Leah Elliot, and Violence Free Communities by Design for supporting this project. To my committee members Dr. William Davidson and Dr. Cris Sullivan for providing guidance, flexibility, and understanding throughout this past year, and to Dr. Pennie Foster-Fishman, my advisor. Thank you for not only the support to carry out my ideas and goals, but also for serving as a brilliant sounding board to challenge and guide me. Finally, I would like to honor the brave women who participated in this project. It is my hope that this thesis and the digital story demonstrate the beautiful courage that emanates from all of you. I am so lucky to have been able to witness that courage myself. iv TABLE OF CONTENTS LIST OF TABLES vii LIST OF FIGURES viii OVERVIEW 1 LITERATURE REVIEW Extent and Nature of Sexual Violence Intersectionality and Sexual Violence Elaborating on the Health Impact of Sexual Violence Sexual Violence on College Campuses College Campus Response Building a Contextually Informed Response to Sexual Violence Summary of the Literature Review Brief Project Introduction 7 7 9 19 20 22 25 28 29 THE PHOTOVOICE METHODOLOGY Rationale for the Photovoice Methodology Rationale for MSU as Research Site 31 34 35 METHODS Research Questions, Framing Questions, and Qualitative Methods Gaining Entry: Violence Free Communities by Design (VFC Setting Description Recruitment Procedures and Participants Procedures and Photovoice Sessions Public Dissemination Data Storage and Participant Confidentiality Ethical Considerations of the Photovoice Project Institutional Review Board (IRB) Process Data Analysis Procedures Bracketing 37 37 39 41 42 45 49 50 51 51 52 56 RESULTS Cross-Case Analysis Cross-Case Analysis: Research Question 1 58 58 59 v Cross-Case Analysis: Research Question 2 Within-Case Analysis Within-Case Analysis: Case Study 1 Within-Case Analysis: Case Study2 Trustworthiness of Data 86 98 102 106 111 DISCUSSION Overview Building Upon the Research Base Implications for Practitioners and Researchers Study Limitations Dissemination of Findings 113 113 119 121 123 126 CONCLUSION 128 APPENDICES Appendix A Project Calendar Appendix B, Table 1 Lifetime Prevalence of Sexual Violence by Race/Ethnicity According to Black et al. 2011 Appendix C , Table 2 Impact of Sexual Violence as Reported by the National Sexual Violence Resource Center (2010a) Appendix D, Table 3 Research Questions, Framing Questions, and Facilitation Questions Appendix E Informed Consent Form Appendix F Participation Agreement Appendix G Recruitment Flier Appendix H Photovoice Project Development Survey Recruitment Email Appendix I Photovoice Project Development Survey Appendix J Photovoice Project Participation Recruitment Email Appendix K Photovoice Project Recruitment Survey Appendix L Recruitment and Sampling Flow Chart Appendix M Photovoice Curriculum Sessions Appendix N Participant Resources – Service Information Appendix O Participant Resources – Project Timeline Appendix P Participatory Data Analysis Email Appendix Q Ethical Considerations for Photovoice Projects Appendix R Community Allies for Photovoice Project Appendix S, Table 4 Participant Demographic Table Appendix T, Table 5 Data Summary Table Appendix U, Table 6 Case Study Comparison Table Appendix V, Table 7 Emergent Themes and Photovoice 129 130 REFERENCES 227 vi 131 132 133 134 142 143 144 145 150 151 154 156 196 197 198 199 204 205 208 223 225 LIST OF TABLES Table 1: Lifetime Prevalence of Sexual Violence by Race/Ethnicity According to Black et al. 2011 131 Table 2: Impact of Sexual Violence as Reported by the National Sexual Violence Resource Center (2010a) 132 Table 3: Research Questions Framing Questions, and Facilitation Questions 133 Table 4: Participant Demographic Table 205 Table 5: Data Summary Table 208 Table 6: Case Study Comparison Table 223 Table 7: Emergent Themes and Photovoice Photos 225 vii LIST OF FIGURES Figure 1. Wordle for Case Study 1. This figure presents the second-order themes most pertinent to this Participant 100 Figure 2. Wordle for Case Study 2. This figure presents the second-order themes most pertinent to this Participant 101 Figure 3. Wordle for Case Study 1. This figure presents the first-order themes most pertinent to this Participant 101 Figure 4. Wordle for Case Study 2. This figure presents the first-order themes most pertinent to this Participant 102 Figure 5. Photovoice photographs. The figure displays the three photos created by this participant throughout the Photovoice project 103 Figure 6. Photovoice photographs. The figure displays the three photos created by this participant throughout the Photovoice project 107 viii OVERVIEW Sexual violence is a human rights issue that affects not only women, but also children and men. According to the National Institute of Justice (2010), it involves “a specific constellation of crimes including sexual harassment, sexual assault, and rape. The perpetrator may be a stranger, acquaintance, friend, family member, or intimate partner” (para. 1). The National Sexual Violence Resource Center (2010b) emphasized that in any instance, consent is not provided by the victim, and ultimately the impact of sexual violence spreads widely from the survivors through their family, friends, and community. To understand the extent of sexual violence as a societal issue Black, Basile, Breiding, Walter, Merrick, Chen, and Stevens (2011), through The National Intimate Partner and Sexual Violence Survey from the CDC, used self-report survey instrumentation and estimated that “Nearly 1 in 5 women (18.3%) and 1 in 71 men (1.4%) in the United States have been raped at some time in their lives” (p. 1). Furthermore, many of these female victims had experienced rape prior to the age of 25; “…and almost half experienced their first completed rape before age 18” (p. 25). Within these estimates, the prevalence of rape among racial minority women varies considerably (see Appendix B, Table 1). The ethnic breakdown of lifetime victimization is as follows:: 18.8% among Whites, 22.0% among African-Americans, 26.9% among American Indian/Alaska Natives, and 33.5% among Multiracial individuals (Black, et al., 2011). As can be seen from these basic statistics, rates of rape are high yet not equivalent across all populations. However, prevalence rates alone are not the only ways that violence manifests differently across populations. 1 Arguably, the way in which the violence is experienced differs as well. Sokoloff and DuPont (2005) explored the intersections of race, class, and gender as they relate to violence. They argued that individuals exist in multiple social hierarchies which promote oppression and marginalization, and therefore no single social classification (e.g. gender) can be used as an explanation for violence (Sokoloff & Dupont, 2005). One illustration of this is the fact that lesbian women may experience violence as a response to a hetero-normative culture, whereas African American women experience violence within sexist and racist systems. These are systemic experiences of oppression that are not shared across all individuals or incidences of violence (Carraway, 1991; Collins, 1998; K. W. Crenshaw, 1991; Sokoloff & Dupont, 2005). The intersections of race, class, gender, sexual orientation, and all other types of social classifications create an amalgamation of factors that shape the experience of violence (physical, sexual, emotional, or other forms). These differing factors also influence the impact violence can have on an individual (Bograd, 2005; Carraway, 1991; K. W. Crenshaw, 1991; Sokoloff & Dupont, 2005), and the response exhibited by that individual (Fine, 1992; Sokoloff & Dupont, 2005). To demonstrate this phenomenon further, Renzetti (1997) explored the impact of sexual orientation on experience of violence. She reported multiple instances in which homosexual survivors experienced distinct forms of violence. In her work with battered lesbians, participants explained forms of violence such as abusers forcing familial and friendship ties to be severed, stealing property, engaging in self-induced violence, and abusing partners in other tailored ways that exacerbate individual weaknesses. Another example of the differing ways in which violence is manifested within gay or lesbian partnerships is the act of an individual threatening to out their partner (Renzetti, 1997; Sokoloff & Dupont, 2005). Furthermore, Allen and Leventhal (1999) 2 explained that “GLBT batterers have at their disposal the weapons of their own and their partners’ internalized oppression to help erase their partner’s sense of pride in being Queer” (p. 78). Therefore, it is suggested that such violence is rooted in misogynistic, and heterosexist foundations (Renzetti, 1997). The above paragraphs provide more of a theoretical understanding of cross-population differences; however there is also empirical support that demonstrates variations in sexually violent experiences. For example, Gross, Winslett, Roberts, and Gohm (2006) reported varying experiences of violence across racial groups, such that more African American women (compared to Whites) engaged in nonconsensual sexual intercourse because they felt it was useless to try to stop their partners (Gross, et al., 2006). Furthermore, African American women had reported significantly higher instances of their partner using physical strength, leading to vaginal intercourse (Gross, et al., 2006). The response system to sexual violence needs to acknowledge the different ways sexual violence is experienced by individuals in order to build services that effectively meet survivors’ needs post-assault. Specifically, if individuals are experiencing assault as a result of finding it useless to try to stop their partners, then tailoring prevention groups to address this perception would be essential. Moving from the experience of violence to help-seeking behavior, divergence across populations are also found; help-seeking behavior and disclosure of violence does not happen consistently (Heise, Ellsberg, & Gottemoeller, 1999; Ward, Chapman, Cohn, White, & Williams, 1992). This may be related to cultural norms of disclosing such personal and sensitive information. It may also vary as a function of the available options to the survivor. The extent to which a survivor identifies available options in terms of services and resources may be related to the community in which the survivor lives or economic constraints in the survivor’s life (Heise, 3 et al., 1999). If subgroups of survivors are systematically absent from traditional help-seeking venues, researchers and practitioners must question whether these survivors’ needs are being met. Have existing services been rendered useless to certain subgroups of survivors? While every survivor of sexual violence has a unique narrative (Sokoloff & Dupont, 2005) regarding where the violence happened, what may have lead up to the violence, the immediate health impact of the violence, and the survivor’s needs post-assault, they may also uniquely experience the relevant service systems. In order to assess services in terms of meeting the needs of the diversity of survivors, it is necessary to access these unique narratives. One setting that seems pertinent for such an investigation is a college campus. College campuses are deemed “hot spots” (p. 1) for sexual violence to occur (Fisher, et al., 2000). According to the Department of Justice (2000), “The victimization rate was 27.7 rapes per 1,000 female students” (p.10). This issue is being looked at from the perspective of social and cultural norms or influences, an approach that has been supported by feminist scholars such as Lottes and Weinberg (1997) who emphasize “a sociocultural etiology of sexual coercion” (p. 1). The high prevalence of sexual violence occurring on college campuses, compounded with the increasing diversity found throughout institutions of higher education (Snyder & Dillow, 2011), needs to be explored. It is important to acknowledge and honor these varying experiences and narratives of survivors in campus communities in order to improve the response to sexual violence. As stated previously, some survivors (or maybe even entire groups of survivors) may not interact with service systems (Heise, et al., 1999).Therefore, researchers need to assess whether all survivors’ needs are being met, and how service systems on college campuses may be improved to encourage this interaction. This is essential as there is some research to suggest that survivors who work with rape crisis centers and rape advocates 4 experience less distress, and may even have more successful experiences with other services systems (R. Campbell, 1998, 2006; R. Campbell & Bybee, 1997; R. Campbell & Martin, 2000). These concerns are particularly true for individuals representing historically disenfranchised groups who have been traditionally underserved on college campuses (Gross, et al., 2006). Exploring narratives from marginalized groups will provide an opportunity to build upon current campus efforts, first by understanding survivors’ unique narratives, and second by examining the extent to which the current service system is reflective of the diversity of survivors. Campus wide conversations about the experience of survivors from disenfranchised groups will offer service providers and program staff the opportunity to evaluate the current services on campus, and to create a more supportive and empowering environment for survivors and students. As supported by Crenshaw (1991), campus-community efforts based on the experiences of a single group will be “of limited help to women who because of race and class face different obstacles” (p. 1246). This is also true for women who do not identity as heterosexual. In order to prevent the further marginalization of survivors through the multiple contexts within which their identities exist, space needs to be created for the unique narratives to be shared and heard. This is the only way a more responsive community can be created; it is necessary to understand the intersection of contextual factors, and how that intersection produces a distinct experience, unique narrative, and specific set of needs (Carraway, 1991; K. W. Crenshaw, 1991; Sokoloff & Dupont, 2005). Currently we do not know if the services offered on the Michigan State University (MSU) campus, where the current study was implemented, support the diversity of survivor narratives and experiences. Therefore, the purpose of the current study is to explore the degree to 5 which not only MSU, but college campuses in general, can become more contextually informed in terms of the service and response system to sexual violence. The current study did not intend to establish such a system, but embraced an exploratory approach to understanding how one might become established in the future. To accomplish this, a diverse group of survivors was recruited to understand the range of their experiences and post-assault needs in order to inform a service system that is accurately reflective. Photovoice, a form of participatory action research (C. C. Wang, 1999), was utilized to do so. In order to shift, or improve, the campus-community response to sexual violence, decisions need to be made not by those who are traditionally given power, but by those whose lives have been most affected by this social issue. One method that has been suggested for addressing this issue is Photovoice (C. C. Wang, 1999). Wang (1999) states “community people ought to participate in creating and defining the images that shape healthful public policy” (p. 186) 6 LITERATURE REVIEW Moving into a more in-depth look at the literature, the author will begin by exploring the extent and nature of sexual violence (in general and across populations), offering a clearer understanding of intersectionality theory and how it applies to sexual violence, demonstrating the health impact related to sexual violence, addressing a comprehensive understanding of the issue of sexual violence across college campuses, and finally the author will tie this all together creating a clear justification for the current study. An introduction to the project specifics is provided at the end of the literature review. The author will begin by defining sexual violence, and demonstrating the magnitude of the issue. Extent and Nature of Sexual Violence Sexual violence exists in multiple forms, and is described across the literature with several terms; these terms include sexual coercion, rape, sexual assault, sexual molestation, incest, child sexual assault, intimate partner sexual assault, unwanted sexual contact or touching, sexual harassment, and sexual exploitation (Heise, et al., 1999). However, the National Institute of Justice (2010) highlights three specific aspects when defining sexual violence. These include sexual harassment, sexual assault, and/or rape. The focus of this project will be on sexual assault and rape. According to the National Institute of Justice (2010) sexual harassment includes unwanted touching or grabbing, as well as unwanted demeaning remarks or sexual comments. Sexual assault refers to the experience of unwanted sexual interaction, “up to but not including penetration” (para. 3). Additionally, these acts may be completed or attempted, but are always 7 against the will of the victim. It is also considered sexual assault when the victim is unable to provide consent, regardless of the reason. Examples of sexual assault provided by the National Institute of Justice (2010) are (1) intentional touching of the victim’s genitals, anus, groin, or breasts; (2) voyeurism; (3) exposure to exhibitionism; (4) undesired exposure to pornography; and (5) public display of images that were taken in a private context, or when the victim was unaware. Rape is defined as ”nonconsensual oral, anal, or vaginal penetration of the victim by body parts or objects using force, threats of bodily harm, or by taking advantage of a victim who is incapacitated or otherwise incapable of giving consent” (para. 4). Sexual assault is a significant public health issue for women and men; however, according to Black and colleagues (2011), a national self-report survey discovered that lifetime rates differ across genders. To reiterate the differing prevalence rates presented above, “Nearly 1 in 5 women” (p. 18) in the United States have been raped in her lifetime (18.3%). For men, lifetime prevalence was about 1 in 71 (1.4%). In terms of other forms of sexual violence (including forcing – or attempting to force - the victim to penetrate someone else, sexual coercion, unwanted sexual contact, and non-contact unwanted sexual experiences), lifetimes rates for women outweighed those for men as well (44.6% and 22.2% respectively). Across the globe, many women have reported their first sexual experience as forced. In 10 of the 15 sites included in a World Health Organization study (García-Moreno, Jansen, Watts, Ellsberg, & Heise, 2005) over 5% of sexually active women reported that their first sexual encounter was forced. Similar results have emerged from South Africa and New Zealand where pregnant teenagers reported force having been used during their first sexual interaction (Dickson, Paul, Herbison, & Silva, 1998; Wood & Jewkes, 1997). A similar South African study identified violence as a central part of participants’ sexual life, not simply existing within the first sexual 8 experience. According to Wood and colleagues (1998) “Violence was not limited to the first sexual act or to be the first relationship, but was also reported to be a feature of all subsequent sexual relationships” (p. 236). In the United States it was found that 24% of young women (aged 13 or younger) described their first sexual encounter as nonvoluntary, and 10% of women aged 19-24 described the same experience (Abma, Driscoll, & Moore, 1998). While it is obvious from the literature that sexual violence is a prevalent and widely spread problem across the globe, it is important to recognize that rates of sexual violence are not equivalent across all groups (Black, et al., 2011; Tjaden & Thoennes, 2006). Researchers and practitioners need to ask why this is the case. In addition to asking why some groups experience more or less sexual violence, the nature of that violence also needs to be explored. Specifically, how does one’s social identity influence the experience of sexual violence? Intersectionality and Sexual Violence Intersectionality theory is one approach to understand the way in which survivors experience violence relative to their identity and life, and may also serve as a framework to conceptualize the phenomenon of unequal rates of sexual violence across individuals and communities. As will be seen below, intersectionality differs from a purely feminist approach to addressing the issue of sexual violence, as a feminist approach focuses solely on gender as the blaming factor. Sokoloff and Dupont (2005) explained that the traditional feminist perspective connects violence against women solely to gender inequality. “However, scholars, survivors, advocates, and activists, particularly women of color and lesbians, are challenging the traditional feminist view that gender inequality is the primary factor…” (p. 43). Viewing sexual violence from an intersectionality perspective will allow researchers and practitioners to contextualize violence at an individual and community level, and may also provide the opportunity to develop prevention 9 and intervention strategies for specific groups of survivors. As was demonstrated in the overview, sexual violence is occurring at different frequencies among White, African-American, American Indian/Alaska Natives, and Multiracial individuals (Black, et al., 2011). Additionally, as can be seen immediately above, there are unequal rates of sexual violence across males and females (Black, et al., 2011; Tjaden & Thoennes, 2006). And finally, data also suggests that same-sex cohabitants (individuals who reported having lived with a same-sex intimate partner at least once in their lifetime) may experience even higher rates of sexual violence than oppositesex cohabitants (individuals who reported as having lived with an opposite-sex intimate partner, and never with a same-sex partner) (Tjaden & Thoennes, 2000a). While this further emphasizes the differing rates across groups, intersectionality, as will be described below, should not be thought of as a demographic approach to understanding rates of sexual violence. Rather, intersectionality is a framework that demonstrates the web of patterns that occur in survivors’ lives. The following studies supporting the illustration of intersectionality theory through rates of sexual violence and defining factors of sexual violence are published by National Institute of Justice (2000a, 2000b, 2006) and the National Center for Injury Prevention and Control (2011). These are the most current studies utilizing population samples to examine the rates of sexual violence within the United States. Below, differing rates of sexual violence across populations and the influence of social factors such as gender, race, and sexual orientation on sexual violence will be (1) demonstrated through the findings of the aforementioned population studies, and (2) explained from an intersectionality perspective. Differing rates of sexual violence and intersectionality. As stated previously, the racial/ethnic breakdown of lifetime victimizations (based on self-report data) is as follows: 18.8% among Whites, 22.0% among African-Americans, 26.9% among American Indian/Alaska 10 Natives, and 33.5% among Multiracial individuals (Black, et al., 2011). Sexual violence is experienced at different rates across racial/ethnic groups. Furthermore, data demonstrates that sexual violence takes on different forms across survivors, and has differential impact on individuals (Tjaden & Thoennes, 2006). As such, many feminist scholars discuss the necessity of recognizing the multiple systems of oppression within individuals’ lives and how this intersectionality influences the experience and impact of sexual violence and post-assault actions (Carraway, 1991; K. W. Crenshaw, 1991; Sorenson, 1996). In terms of sexual violence, or gender based violence more broadly, this topic of conversation has only recently entered the picture (Sokoloff & Dupont, 2005). Crenshaw (1991) explained that “the violence that many women experience is often shaped by other dimensions of their identities, such as race and class” (p. 1242). This perspective embodies the idea of intersectionality, and how it relates to sexual violence (Bograd, 2005; Carraway, 1991; K. W. Crenshaw, 1991; Sokoloff & Dupont, 2005). Intersectionality theory represents the conceptual foundation for the proposed study: That sexual violence is influenced by the intersections of societal classifications within which survivors exist (Carraway, 1991; K. W. Crenshaw, 1991). Using an intersectionality framework to understand differing rates, experiences, and impact, researchers and practitioners may begin to understand how survivors experience violence differently, and their needs in relation to these differences. Overall, these differences place significant challenges on settings structured to support survivors, as they must be equipped to effectively deal with this diversity. This is where the utility of intersectionality comes in. An intersectionality framework is useful for understanding differences across gender, race/ethnicity, and sexual orientation, and will be elaborated upon in relation to each of these factors. For each dimension mentioned above (gender, race/ethnicity, and sexual orientation), sexual violence will be examined in terms of rates, forms, and impact. The 11 following paragraphs do not intend to simply demonstrate differing frequencies of sexual violence, rather the way in which violence works its way uniquely into different social classification systems, while exposing the way in which these systems privilege some, and marginalize others through sexism, racism, and heterosexism. Gender, sexual violence, and intersectionality. Gender is one factor that illustrates the intersectionality perspective and influences the experience of sexual violence. For instance, defining factors of rape vary based on gender (according to self-report data). More specifically, different forms of penetration have been experienced at different rates between males and females: penetration of the mouth (23.9% of female survivors and 52.7% of male survivors); penetration of the anus by penis (13.4% of female survivors and 23.8% of male survivors); penetration of vagina or anus by objects or fingers (31.3% of female survivors, 20.1% of male survivors) (Tjaden & Thoennes, 2006). Additionally, it has been found that men and women experience rape in different locations. Private settings account for 84.5% of female victimizations, and 64.4% of male victimizations, whereas public settings account for 15.5% of female victimizations, and 35.6% of male victimizations (Tjaden & Thoennes, 2006). These differences are statistically significant. Statistically significant differences across gender have also been found in regards to the victim using drugs and/or alcohol (reported by 19.8% of female victims and 38.3% of male victims). While the following differences are not statistically significant, they may still be considered when understanding different patterns that exist across the ways in which males and females experience sexual violence. To begin, perpetrator drug and/or alcohol use was reported by 66.6% of female victims and 58.5% of male victims. Also, 31.9% of female victims, and 21.3% of male victims reported the perpetrator as threatening to kill or cause harm. Again, while 12 not statistically significant, the experience of physical assault during rape was reported differently across female and male victims (37.8% and 33.9% respectively); however, a statistically significant difference does exist across male and female survivors when it comes to being hit with an object (14.5% of male victims and 6.6% of female victims) (Tjaden & Thoennes, 2006). Acknowledging the differing ways sexual violence is experienced across gender is essential if researchers and practitioners intend to develop informed services for survivors postassault (i.e. providing hospital services that involve protocols for addressing physical assault for male victims). Additionally, further investigation of the differences explored above may allow prevention programs to better understand important areas of focus (i.e. male oriented prevention program addressing alcohol consumption). In terms of impact on health, gender differences illustrate that 31.5% of female victims experience physical injury, whereas only 16.1% of male victims report physical injury (Tjaden & Thoennes, 2006). Additionally, 3.1% of female victims contract sexually transmitted diseases (STD’s); this statistic was non-existent for men because only five or fewer male survivors reported post-assault STD’s (in such occurrences estimates were not calculated) (Tjaden & Thoennes, 2006). These numbers represent that sexual violence happens in different environments, takes on different forms, and manifests in varying ways across males and females (Tjaden & Thoennes, 2006). Recognizing this phenomenon through an intersectionality framework can lead researchers to explore the ways in which differences may lead to a variance in post-assault needs across men and women. 13 Race/ethnicity, sexual violence, and intersectionality. As will be described in the methods section, survivor voices from racial minority groups were not present in the current study due to recruitment challenges. However, the importance of accessing these voices is described below. While this exploratory study was unsuccessful in recruiting racial minority survivors, providing support for the importance of this is still necessary as it will be discussed further in the discussion section and suggests a significant implication for future research. Race and ethnicity also influence the experience of sexual violence (Tjaden & Thoennes, 2006). It is argued by many scholars that the violence experienced by women of color happens at the intersection of patriarchy and racism; violence experienced by racial minority individuals is usually the result of the indirect subordination they experience on a daily basis (Carraway, 1991; K. W. Crenshaw, 1991). Carraway (1991) argued that marginalized women may also be less apt to consider their experience as rape or sexual assault because the issue is frequently represented in the media as something that only happens to White, wealthy women. Could this also suggest reluctance to seeking services or reporting incidences if survivors are internalizing the violence as something other than a crime or an assault? When society fails to recognize both systems in action, women, or survivors, of color are in a position of further marginalization; placed on the periphery by other women, and by other people of color (Carraway, 1991; K. W. Crenshaw, 1991). When comparing lifetime prevalence rates of rape among women across race/ethnicity, the group with the highest rate is Multiracial individuals. This group also represents that with the highest lifetime prevalence rate of other forms of sexual violence as well (e.g. sexual coercion, unwanted sexual contact) (Black, et al., 2011). When comparing lifetime prevalence rates of other forms of sexual violence outside of rape among men across race/ethnicity (estimated 14 lifetime prevalence of rape among men across race/ethnicity was not disseminated in this report as there was not enough information to do so) Multiracial individuals are also represented as the group with the highest rate. A complete table listing the rates of male and female survivors of sexual violence throughout a lifetime by their race/ethnicity can be found in Appendix B, Table 1. This table can be thought of as representing the intersections of gender and race/ethnicity in terms of sexual violence. Crenshaw (1991) also described the ways in which women of color experience additional burdens that not are necessarily a part of White women’s lives, and how these burdens intersect with the experience of violence; for example, employment and poverty. According to the United States Department of Labor and the United States Bureau of Labor Statistics (2011), unemployment rates for White women were recently recorded at 8.7%, compared to 16% and 12.5% for African-American and Hispanic women respectively. Furthermore, weekly earnings were higher among professionally employed White women compared to African-American and Hispanic women. The rates of women living in poverty (which are higher than rates among men) also differ according to race, and these rates continue to grow. Poverty levels for Hispanic women grew from 23.8% in 2009 to 25% in 2010, while rates among African-American women rose from 24.6% in 2009, to 25.6% in 2010. These rates compared to those among White women (10.4%) illustrate the additional burdens placed on minority women (DeNavas-Walt, Proctor, & Smith, 2011). How does recovery and service seeking differ for survivors who are also dealing with such issues? Finally, in terms of service support and legal service environments, there is evidence that women of color are experiencing further subordination. This has mainly been seen through a lack of cultural or racial awareness within service settings and among service providers (Carraway, 1991), throughout requirements enforced by funding agencies, and lacking rates of 15 perpetrator persecution within the legal domain (K. W. Crenshaw, 1991). Similar to gender, recognizing the differences across racial/ethnic groups in terms of sexual violence may provide researchers and practitioners with a better understanding of how post-assault needs may differ based on the differing experiences of sexual violence. Sexual orientation, sexual violence, and intersectionality. Other examples of intersectionality and sexual violence can be seen among lesbian survivors. As stated previously, violence within intimate gay or lesbian partnerships may be a result of a hetero-normative society (Bograd, 2005; Renzetti, 1997; Sokoloff & Dupont, 2005); providing the perpetrator of violence with the ability to out the victim in terms of their sexual orientation (Renzetti, 1997). Violence experienced among gay or lesbian survivors is situated at the cross roads of patriarchy and heterosexism (Renzetti, 1997). According to Tjaden and Thoennes (2000a), a national survey found that among females, “39.2 percent of the same-sex cohabitants and 21.7 percent of the opposite-sex cohabitants reported being raped, physically assaulted, and/or stalked by a marital/cohabiting partner at some time in their lifetime” (p. 30). This phenomenon was illustrated similarly for men (Tjaden & Thoennes, 2000a), such that 23.1% of same-sex cohabitants and 7.4% of opposite sex cohabitants reported being raped, physically assaulted, and/or stalked by a cohabiting partner at some point in their lifetime (keeping in mind that this is not sexual violence alone, rather it also includes physical assault and stalking). These statistics seem to suggest that same-sex couples are experiencing higher rates of intimate partner violence victimization; however, a different conclusion is exposed when these comparisons are broken down by perpetrator gender across same-sex and opposite-sex cohabitants. Specifically, Tjaden and Thoennes (2000a) reported that “30.4 percent of same-sex cohabiting women reported being victimized by a male partner, whereas 11.4 percent reported 16 being victimized by a female partner. Thus, same-sex cohabiting women were nearly three times as likely to report being victimized by a male partner than by a female partner” (p. 30). For same-sex cohabiting men, victimization was also more frequently perpetrated by males (Tjaden & Thoennes, 2000a). However, it cannot be overlooked that women with a history of same-sex cohabiting partnerships have higher lifetime victimization rates of intimate partner violence than women with a history of opposite-sex cohabiting partnerships (regardless of perpetrator gender) (Tjaden & Thoennes, 2000a). In her work with lesbian survivors of intimate partner sexual violence, Girshick (2002) explained that the impact on health includes feelings of weakness, stupidity, disrespect, and depressive/suicidal thoughts. More importantly, Girshick (2002) explained that these “short-term and long-term emotional impacts on sexual violence are severe” (p. 1504), and the lack of acknowledgment of this form of abuse has led to a denial of services that lesbian survivors may be looking for. Additional aspects of intersectionality. And finally, other cultural factors such as religion or immigration status have been found to be influential on the experience of sexual violence. In terms of managing one’s experience of violence, many women have been found to utilize religious participation, or turn to religious leaders, for support. However, these authority figures have been found to impede the survivor from leaving an abusive partner in some instances, emphasizing the importance of fulfilling marital obligations (Sorenson, 1996). In terms of immigration status, fear of deportation for the victim, the perpetrator, or the family shapes the way in which violence is experienced and mitigated; this worry, in fact, may even prevent many survivors from ever contacting justice authorities (Sorenson, 1996). Additionally, federal immigration laws may require women to stay with their partners to complete the 17 citizenship process, regardless of violence that may be happening (Sorenson, 1996). There are also instances in which language barriers are enforced as eligibility criteria when survivors are entering shelters (K. W. Crenshaw, 1991). Language exclusiveness not only restricts the amount of information available to survivors whose first language is not English, but also the ability to seek shelter within certain programs (K. W. Crenshaw, 1991). Concluding support for intersectionality theory. The context in which survivors’ lives are situated needs to be considered when exploring the issue of sexual violence. Incorporating this perspective into sexual violence prevention and resources will inform a system that is reflective of survivors’ lived realities. Resources and programs that have such a framework are better situated to attend to the needs of survivors in a contextualized and specialized way. Services that are intended to help individuals (such as sexual violence services) may end up doing harm when they are not reflective of the lived experiences and needs of service seekers. Such an occurrence may result in pushing survivors further out on the periphery, resulting in a lack of knowledge held by service providers and the general community about contextualized experiences of sexual violence and survivor needs post-assault. Furthermore, this may create a system in which minority survivors do not seek services at all (Carraway, 1991; K. W. Crenshaw, 1991). While the current exploratory study does not represent all of the voices described above that are considered to be missing from service development (e.g. racial minority survivors, male survivors), the aforementioned support is necessary as it not only demonstrates the overall importance of breaking the silence for such communities, and suggests further implications for future research needed regarding the experience of such voices that are not captured here. Aside from the National Institute of Justice (2000a, 2000b, 2006) and the National Center for Injury 18 Prevention and Control (2011) reports, all other studies mentioned above fall under the category of theoretical literature or a meta-analysis of the literature for intersectionality theory and how it applies to sexual violence. Given the dearth of research that engages survivors to learn more about intersectionality and survivor diversity, the current study can begin to close this gap. Elaborating on the Health Impact of Sexual Violence As described above, the impacts on health vary in forms and severity. The National Sexual Violence Resource Center (2010a) outlined the impact of sexual violence and suggested emotional, psychological, and physical reactions. Emotional reactions in response to sexual violence included guilt, shame, isolation, anger, denial, self blame, and confusion. Psychological impact included nightmares, depression, difficulty concentrating, post traumatic stress disorder, substance use or abuse, and low self esteem. And finally, Campbell (2002) reported that physical reactions to sexual violence include changes in eating or sleeping behaviors, concerns about physical safety, concerns about pregnancy or sexually transmitted infection/human immunodeficiency virus, and physical injuries including gynecological problems, genital bleeding/infection, fibroids, genital pain, and painful intercourse. Additionally, the National Sexual Violence Resource Center (2010a) reported that “Some health outcomes can be fatal such as suicide, homicide, maternal mortality, and AIDS related deaths” (p. 1). A complete table illustrating the impact of sexual violence as reported by the National Sexual Violence Resource Center (2010a) can be found in Appendix C, Table 2. The existing literature suggests a significant number of impacts, some even lifelong, as a result of experiencing sexual violence (Black, et al., 2011; J. C. Campbell, 2002; Tjaden & Thoennes, 2000a, 2000b, 2006); however there is scarce literature on how these impacts may emerge from the amalgamation of factors such as gender, sexual orientation, or religion. This 19 phenomenon is a challenge to document as it is hard to isolate aspects of an individual’s identity and directly link it to specific impacts post-assault. However, understanding the impact sexual violence has on the diversity of survivors allows for services to be better tailored to counteract this impact in a positive way; a way that is reflective of the “converging systems” (p. 1265) in one’s life (K. W. Crenshaw, 1991). Ignoring the intersections of oppressive systems presents harm to survivors by prioritizing the needs of majority populations. Service development based on this prioritization is irrelevant to survivors whose realities exist within multiple, converging systems. When service providers do not alter their fight against violence accordingly, they run the risk of maintaining the very oppression that they are intending to eliminate (Carraway, 1991; K. W. Crenshaw, 1991). In addition, For example, providing services to lesbian survivors about how to break cycles of sexual violence within intimate heterosexual relationships denies the existence of a sexual orientation outside of heterosexuality, and provides the survivor with no tools for how to address the violence they are experiencing. If communities do not offer services and supports that attend to this diversity, survivors may fall into a fissure of oppression based on multiple systems at work. Sexual Violence on College Campuses Men on college campuses have been found to present significant danger, especially for women. According to the U.S. Department of Education Office for Civil Rights (2011) , “When young women get to college, nearly 20% of them will be victims of attempted or actual sexual assault, as will about 6% of undergraduate men” (p. 1). In a report put out by the U.S. Department of Justice (2000), it was estimated that “1 in 36 college women (2.8%) will experience a completed rape or attempted rape in an academic year” (p. 10). However, it is 20 important to remember that these figures only measure victimization for 6.91 months. When these figures are projected for an increased time period of 1-year, the rates jump up to nearly 5% of college women experiencing victimization (Fisher, et al., 2000). Gay, lesbian, and bisexual students have been significantly impacted by this issue at the college campus level; some studies have found gay, lesbian, and bisexual students may actually experience higher rates of sexual violence than their heterosexual counterparts (Duncan, 1990; Porter & Williams, 2011). To understand this phenomenon, many feminist scholars have examined the social context of college campuses that promotes the sexual victimization of college women. As described earlier by Lottes and Weinberg (1997), as possessing “a sociocultural etiology of sexual coercion” (p. 1), researchers should explore the story that many college campuses are telling about sexual violence. For instance, who is committing these violent acts? Where are these acts occurring? What are other contextual factors contributing to sexual victimization on college campuses? How are these acts being perceived by female students and survivors? And what are male students’ perceptions of their involvement? In a randomly selected national sample of women attending two and four year universities, it was reported that high levels of completed and attempted rapes were committed by people known to the victim. Specifically, 35.5% of completed rapes and 43.5% of attempted rapes were committed by classmates of the victim, and 34.2% of completed rapes and 24.2% of attempted rapes were committed by boyfriends/ex-boyfriends (Fisher, et al., 2000). The majority of completed rapes (66.3%) were found to take place off-campus in locations such as bars, nightclubs, or student residences close to campus (Fisher, et al., 2000). One factor that may be contributing to this issue that is not present in the general community is the culture of alcohol consumption and Greek life (Abbey, 2002; Fisher, et al., 21 2000; Gross, et al., 2006; Martin & Hummer, 1989; Minow & Einolf, 2009; Ward, et al., 1992). Such a culture illustrates environments in which women are frequently victimized (Martin & Hummer, 1989), and where hyper masculinity, power over women, violence, competition, alcohol consumption, and sexual expertise are central to fraternity life (Martin & Hummer, 1989). While the literature has demonstrated the importance of social context of sexual victimization on college campuses, it is also important to remember that some survivors may come to campus having already experienced sexual violence. According to The National Institute of Justice (2000) among women entering college 10.1% have experienced rape and 10.9% have experienced attempted rape. How does the college campus environment support or neglect such survivors, especially in the instance of experiencing assault again as an adult? Furthermore, how might the experience of childhood sexual assault influence the post-assault experience of adult sexual violence? College Campus Response The U. S. Department of Education (2011) Title IX of the Education Amendments of 1972 “prohibits discrimination on the basis of sex in any federally funded education program or activity” (p. 1). Recently, the Dear Colleague Letter was issued by the U.S. Department of Education Office for Civil Rights (2011) to “explain that the requirements of Title IX cover sexual violence and to remind schools of their responsibilities to take immediate and effective steps to respond to sexual violence in accordance with the requirements of Title IX” (p. 1). More specifically, this letter intends to provide institutional guidance for (1) the occurrence of unique sexual violence cases, (2) the independent responsibility to address such issues separately from criminal investigations, (3) Title IX requirements, (4) prevention efforts college campuses should consider, and (5) other factors contributing to the issue of sexual violence on college campuses. 22 As stated by the U. S. Department of Education under Title IX (2011) , a school’s obligations include the following: (1) Once a school knows or reasonably should know of possible sexual violence, it must take immediate and appropriate action to investigate or otherwise determine what occurred; (2) If sexual violence has occurred, a school must take prompt and effective steps to end the sexual violence, prevent its recurrence, and address its effects, whether or not the sexual violence is the subject of a criminal investigation; (3) A school must take steps to protect the complainant as necessary, including interim steps taken prior to the final outcome of the investigation; (4) A school must provide a grievance procedure for students to file complaints of sex discrimination, including complaints of sexual violence. These procedures must include an equal opportunity for both parties to present witnesses and other evidence and the same appeal rights; (5) A school’s grievance procedures must use the preponderance of the evidence standard to resolve complaints of sex discrimination; (6) A school must notify both parties of the outcome of the complaint. However, college campuses cannot count on Title IX alone to create an environment that is supportive and helpful towards survivors. Furthermore, throughout the development of the current study it became clear that there are some significant controversies embedded within the Title IX requirements; for instance, a mandatory investigation once sexual assault is thought to have occurred. Not all survivors will want an investigation, and such investigations may in fact present further danger to a survivor. As such, it is essential to consider how the campus environment is assisting survivors in a path to recovery and healing; specifically in terms of services offered. The Department of Justice assessed 2,500 American colleges/universities to better understand their experience with and response to sexual assault. Approximately four in 10 schools offer sexual assault response training (Karjane, Fisher, & Cullen, 2005), and only half of 23 the surveyed schools had explicit goals for their sexual assault policy (Karjane, et al., 2005). Mental health services were classified as the most available resource to students who had experienced sexual violence (Karjane, et al., 2005). However, while mental health services are considered to be the most available service to student survivors, there exists a difference in how this service is utilized; 33.0% of female survivors received counseling from a mental health professional, whereas only 24.2% of male survivors received this same service (Tjaden & Thoennes, 2006). At MSU, the research site for the current study, there are numerous services that are provided to survivors of sexual assault. This is namely through the MSU Sexual Assault Program (2010) which offers crises intervention, advocacy, therapy, support groups, and prevention education. Additionally, the MSU Sexual Assault Program collaborates with the MSU SelfDefense Club, Residence Life, the Sexual Assault and Relationship Violence program, the administration and the MSU Sexual Harassment Policy, the LBGT Resource Center, the MSU Women’s Resource Center, Olin Health Center, the Office for Inclusion and Intercultural Initiatives, the MSU Police Department, MSU Student Life, and MSU Safe Place. Furthermore, the Sexual Assault Program also works with community services such as local shelters, sexual assault response teams, and hospital services. This study does not intend to focus solely on the service system at MSU, rather it intends to contribute to the development of a contextually informed response to sexual violence for college campuses more generally. While on paper there seems to be a significant amount of resources available to survivors across college campuses, what we do not know is how well these services are set up to respond to the diversity of survivor experiences. This lack of data was identified as an area of inquiry and/or improvement for campus services through the collaboration process for the current study. 24 The project was developed with a campus coalition that brings together members from different programs throughout campus (some are mentioned above), to target the issue of violence. The various members of this coalition have expressed an interest in better understanding the unique experiences and needs of survivors in order to assess the current response to sexual violence on a college campus. Building a Contextually Informed Response to Sexual Violence Due to the diversity of survivors on college campuses, a strain is put on the service system to understand and respond to these diverse experiences. This assertion is based on conversations with individuals within the service system on the college campus setting for the current study, and is supported by literature examining current issues among domestic and sexual violence service development. In a statewide study Macy, Giattina, Parish, and Crosby (2010) discovered that service staff expressed concern “that survivors of all racial, ethnic, and cultural backgrounds, sexual orientations, disabilities, and immigration statuses feel welcome to access services…” (p. 23). In terms of sexual violence, the intersections of social systems mold the experience, impact, and post-assault behavior (Carraway, 1991; Collins, 1998; K. W. Crenshaw, 1991). Therefore, researchers and practitioners need to consider the needs and help-seeking behavior post-assault across this diversity. In doing so, a contextually informed response system may emerge. A contextually informed response system to sexual violence refers to a network of services in the campus-community that (1) accurately reflects the lived realities of the diversity of survivors of sexual violence; (2) engages the voices of a diverse set of survivors to inform and develop the specific services that are offered; (3) operates in a respectable and supportive way across cultural variability among survivors. Carraway (1991) emphasizes “We must envision and 25 develop programs that include and are controlled by women of color, lesbians, women with disabilities, poor women, undocumented women, non-English speaking women, women who are not traditionally trained, incarcerated women, and unemployed women” (p. 1308). Rationale for a contextually informed response system comes from data that illustrates the different patterns of service utilization across survivors. For instance, survivors of sexual violence that identify as non-Hispanic Whites have been found to seek service from psychotherapists more often than Hispanic survivors, and, while not statistically significant, Hispanic survivors were more likely to speak with an authority figure in their Church (Sorenson & Siegel, 1992). While this pattern may be due to chance difference it is still important to recognize that some survivors seek services to address sexual violence through their place of worship (a space that many might not think of when assessing service options for survivors). Male survivors have been found to be less inclined to speak with mental health professionals or physicians, as well as individuals within the legal/law enforcement realm (Sorenson & Siegel, 1992). Men are also significantly less likely to seek support from rape crisis centers (Sorenson & Siegel, 1992). While this trend may not be unique to sexual violence, it still needs to be recognized in order to develop outreach services that are tailored towards such patterns. Acknowledging these patterns, and improving the different non-traditional service seeking (for instance, within religious settings), or alternate routes of seeking services, is one way of building a contextually informed response to sexual violence. In taking this approach, the contextually informed response system would incorporate non-traditional services into their regular service programming to reach a wider group of survivors whose needs may not be reflected as frequently in the literature. 26 Additionally, acknowledging the different conditions under which sexual violence is experienced will help to inform a contextually informed response system. For instance, some populations experience sexual violence in occurrence with alcohol use more often than others. Therefore, services that focus on alcohol as a common factor of sexual violence may simply be of limited utility for some individuals or groups (Gross, et al., 2006). Prevention efforts that focus on the elimination of alcohol use, or that teach skills on how to monitor alcohol intake, would be providing certain individuals with skills that they may never end up using as a prevention tool (Gross, et al., 2006). On the other hand, services that do not focus on alcohol use or intake monitoring would be limiting to some other populations as well. The final rationale for the need to build a contextually informed response system is supported by the literature that has examined the differing experiences of survivor interaction with traditional service systems. Scholars have argued that minorities are often mistreated by social services and suggest the need to rid the service seeking realm of racist undertones (Mama, 1989). Additionally, researchers have called upon service providers to acknowledge the differing needs and experiences of male survivors, in order to develop a language, as well as competent services, when working with this group of survivors (Davies, 2002). In general, the call to service systems to consider the contextual factors that contribute to the experience of sexual violence (such as gender and race mentioned above) is supported by empirical evidence that demonstrates differences across such factors (Black, et al., 2011; Tjaden & Thoennes, 2000a, 2000b, 2006). Service system interaction. Campbell (1998, 2005) examined the experience of service system interaction among survivors, specifically when seeking out the legal, medical, or mental health services. In her research, Campbell (2005) has demonstrated that many survivors 27 experience distressed feelings after their interaction with certain systems, and that distinctive factors related to the assault may influence specific interactions. For instance, victims’ cases were more likely to be dropped within the legal system if they experienced rape by a nonstranger, and/or rape when a weapon was not used. Victims were more likely to experience this same phenomenon if they were drinking alcohol at the time the rape occurred. Better experiences with service systems were found among women whose communities had more services to offer (and services that were more coordinated), and women who were injured as a result of the assault. Finally, race seemed to influence the experience with the legal system such that women raped by someone of the same race as themselves were more likely to have their case pursued, whereas women raped by men of a different race were more likely to have their case dropped (R. Campbell, 1998).The above mentioned factors of sexual violence (such as nonstranger versus stranger rape, weapon use, alcohol use) occur in varying degrees across groups of survivors (Tjaden & Thoennes, 2006) and seem to influence interactions with certain service systems. If some of these defining factors of assault are leading to, for instance, a lack of legal prosecution, these implications may be wiping out entire groups of survivors whose experiences of sexual violence fall under certain umbrellas. Acknowledging such patterns across survivors at the system level then becomes even more pertinent. Summary of the Literature Review Sexual violence is a human rights issue that is occurring at high rates on college campuses (Fisher, et al., 2000). Rape and sexual assault occur at different rates across survivors (Black, et al., 2011; Tjaden & Thoennes, 2000a, 2000b, 2006), and scholars have examined such patterns in rates, as well as service interaction and post-assault behavior, through an 28 intersectionality framework (Carraway, 1991; K. W. Crenshaw, 1991; K. W. Crenshaw, 1992; Sokoloff & Dupont, 2005). Understanding sexual violence through an intersectionality framework acknowledges the systems of oppression in women’s lives, and addresses the fact that specific systems present specific obstacles to survivors (Carraway, 1991; K. W. Crenshaw, 1991; K. W. Crenshaw, 1992; Sokoloff & Dupont, 2005), and that gender cannot be blamed alone for sexual violence that many women experience. Survivors’ lives exist across many systems; therefore their needs may vary considerably. Understanding whether these needs are being met is essential to better support the diversity of survivors. Currently, support for an intersectionality perspective on sexual violence is demonstrated by differing patterns of assault across groups and communities as illustrated through population based self-report studies (Black, et al., 2011; Tjaden & Thoennes, 2000a, 2000b, 2006). Such patterns are explained through theoretical standpoints and literature reviews (Sokoloff & Dupont, 2005), however few studies exist that are looking at empirical evidence for intersectionality and sexual violence. Brief Project Introduction The current project intended to understand the varying experiences among survivors on campus in order to better assess the level of support provided by the campus-community to the diversity of survivors. The purpose of this study was not to make generalizations about a specific group of survivors, but rather to honor and acknowledge a group of diverse perspectives, and to integrate their experiences, needs, and voices into the development of a contextually informed response to sexual violence on a college campus. While the sample for the current study involved only six women who were relatively similar and did not represent diversity in terms of gender, racial/ethnic identity, age, or educational background, their unique social locations were important to recognize. As such, the current study does not comprehensively address all of the 29 aspects of intersectionality and survivor diversity. This project was not an evaluation of campus services, nor was it necessarily a needs-assessment of survivors. Rather, this project intended to demonstrate the disparate experiences and impacts of sexual violence, and extended into the realm of service accessibility and development from the participants’ perspectives. Finally, it should be noted that while this study assumed participation in campus-community services will benefit survivors, there is also an acknowledgment that this may not be the case. The possibility of services harming rather than benefitting survivors is something the author was aware of and such experiences were addressed when they arose during group meetings. The second research question addressed ways in which the campus-community can be improved; therefore discussions around positive and negative interactions with the service system occurred. In order to engage survivors’ voices to the maximum extent, the Photovoice methodology was chosen. Photovoice is a research and action method that, according to Wang (1999) “enables people to identify, represent, and enhance their community through a specific photographic technique” (p. 1). Using this method, the project explored the following research questions: 1. How can a college campus create a contextually informed response to sexual violence? a. What is perceived as helpful to a diverse group of college students who have experienced sexual violence? b. What is needed in the campus-community to better support the diversity of survivors? 30 THE PHOTOVOICE METHODOLOGY The Photovoice methodology, created by Caroline Wang and Mary Burris (1997), allows researchers and practitioners to access the voices of historically silenced populations, and has three main goals; “to enable people to record and reflect their community’s strengths and concerns, to promote critical dialogue and knowledge about important community issues through large and small group discussion of photographs, and to reach policymakers” (p. 370). Wang and Burris explained that Photovoice is a participatory process based on contributions from empowerment theory, Freire’s theory of education for critical consciousness, feminist theory, and photography (1994). Wang (1999) outlined the following steps for the traditional Photovoice method: (1) selecting and recruiting a target audience of policymakers or community leaders; (2) recruiting a group of Photovoice participants; (3) introducing the Photovoice methodology to participants and facilitating a group discussion; (4) obtaining informed consent; (5) posing an initial theme for taking pictures (in the form of framing questions); (6) distributing cameras to participants and reviewing how to use them; (7) providing time for participants to take pictures; (8) meeting to discuss the photographs; and (9) planning with participants a format to share photographs and stories with policymakers or community leaders. In reference to the literature provided by Wang (1999), the Photovoice process is broken down below to demonstrate the dynamic nature of this methodology. Photovoice projects begin with the creation of research questions, which are broken down into more concise questions, referred to as framing questions. These framing questions are simple questions related to the 31 larger research theme, and are phrased in a way where participants are able to respond to them through photos and text. Once the participants complete the Photovoice training and project orientation (which is covered in the first meeting for Photovoice projects), the framing questions are presented. Each participant takes a photograph and writes a personal narrative for each of the framing questions presented. The photos and narratives (written, and later orally expanded on during the group meetings) serve as data for the research study. Wang (1999) suggested the acronym SHOWeD as a guide for participants when they are writing or orally sharing their narrative in order to be sure that their personal story behind their photograph is expressed. This acronym stands for: What do you SEE here? What is really HAPPENING here? How does this relate to OUR lives? WHY does this situation, concern, or strength exist? What can we DO about it? During the group meetings, minimal probing by the group facilitators takes place after each individual shares their photo and narrative to be sure their story is understood clearly. This information is analyzed to understand each individual’s unique story related to the project theme, and to also examine patterns across participants as well. Typically, each Photovoice meeting covers only one framing question. During each Photovoice meeting, a voting process also takes place. This occurs after all participants have shared their photos individually. The voting process narrows down two photos that are discussed at length by the entire group. During the group discussion, facilitators have pre-developed probes that are used to guide the conversations and to gain deeper insight into the participants’ experiences with the project theme. These run similarly to a focus group, and often the facilitation questions are constructed in a way that bridges the gap between the research questions and the framing questions to encourage a critical discourse around deeper meanings 32 and themes. This group discourse also contributes to the research data in that group conversations are recorded and included in the data analysis. A table illustrating the link between the research questions and framing questions for this study can be found in Appendix D, Table 3. A final step in Photovoice projects includes a public outreach component in order to share what was learned with community leaders or some targeted audience. Suggested by Wang (1999), by connecting the voices of individuals to the people who have decision making power, researchers can help establish social change, and the engagement of community members’ voices in conversation regarding the policies that are affecting their everyday lives. This step generally occurs in the form of public art exhibits or digital stories that compile the narratives, photos, and themes from the project. The Photovoice method is innovative for several reasons. Research participants are cocreating photos which are physical sites for learning and sharing information. It is from these creations that policy influence can happen; directly linking the photos and text to the realities of individuals, and using these photos and texts as a way to demand or elicit change establishes a clear path for community members to become actively engaged in influencing policy. Wang (1999) also suggests that allowing participants to have control over the meaning that is ascribed to the realities of their lives also prevents the implementation of misinformed policies; or in this case, ineffective services for survivors of sexual violence. Furthermore, co-creating the dissemination tool allows for a participatory preliminary analysis of the data as some of the themes found across the participants are often shared through the exhibit or digital story at this point in the study. This step too prevents researchers from ascribing misinformed meaning to participants’ voices. 33 The current Photovoice project followed the traditional structure. Three framing questions were explored through Photovoice sessions with the group. After these three Photovoice sessions the group members came together to co-create a digital story representing what was learned; the specifics of this dissemination tool are described in the methods section. A viewing event was also planned by the participants. The audience for this event was decided upon by the participants, and took place on campus at the MSU Museum. The Framing Safety Project (Frohmann, 2005) helped shape the design of the current study. This project used the Photovoice methodology to better understand battered women’s perceptions and experiences of safety within consistently violent settings. This project engaged a different population (survivors of sexual violence), but took a similar approach to understanding survivors’ experiences. Similar to The Framing Safety Project (Frohmann, 2005), rather than focusing on the violence that was experienced, the current project focused on the post-assault process and how systems can better support this process. Rationale for the Photovoice Methodology Community Psychology is interested in studying people in context, and doing so in an empowering and participatory way (Kelly, 1971; Rappaport, 1977). The research is expected to belong to the community, and also done with the community as co-researchers (Kelly, 2003). The current Photovoice project incorporated these values by establishing a project with intended empowering outcomes, and also eliminating traditional barriers between the researcher and participants. This project acknowledged that individuals exist in multiple social systems, and that these contextual factors shape lived realities. This perspective is aligned with a critical feminist paradigm (Creswell, 2007; Marshall & Rossman, 2011), as well as the foundational thinking of Community Psychology (Kelly, 1971). 34 Rationale for MSU as Research Site According to the U.S. Department of Education’s Campus Safety and Security Data Analysis Cutting Tool (2010), forcible sex offenses are defined as “any sexual act directed against another person, forcibly and/or against that person’s will; or not forcibly or against the person’s will where the victim is incapable of giving consent” (para. 2). The total number of on campus forcible sex offenses reported to campus security authorities on the MSU campus in 2007, 2008, and 2009 were 18, 8, and 16, respectively. The total number of on campus student housing facilities forcible sex offenses reported to campus security authorities on the MSU campus in 2007, 2008, and 2009 were 10, 6, and 10 respectively. However, these numbers only represent crimes that were reported to campus safety officials and therefore only illustrate a fraction of the sexual violence that occurred at MSU during those three years. As supported by Heise and colleagues (1999), many survivors progress through life without ever telling another person about the violence they have experienced. Therefore, reported crime statistics need to be considered accordingly. These statistics can be compared to the number of students who seek services at Michigan State University’s Sexual Assault Program. These numbers do not necessarily demonstrate the rate of sexual violence on campus either, considering many survivors do not seek services for years after the victimization has occurred, or maybe never at all. Nonetheless, according to the MSU Sexual Assault Program (2010), services were provided “to 300-400 survivors of sexual assault and other community members during the 2009/2010 academic year” (About Us section, para. 2). Information regarding the diversity of the survivors who have sought services at the MSU Sexual Assault Program is unavailable. The contrast between the number of reported cases of sexual assault and the number of survivors who seek services at the MSU 35 Sexual Assault Program demonstrates that many instances may be unreported, and that there is a large community of survivors on the MSU campus. Due to this large community of survivors on campus it is necessary to assess whether these survivors’ needs are being met by the services provided in the campus-community. 36 METHODS This qualitative study attempted to understand the phenomenon of sexual violence and post-assault experiences among the diversity of survivors on campus. As such, a phenomenological approach was chosen. A phenomenological approach to research aims to understand the lived experiences of a group of individuals who have experienced a similar phenomenon (sexual violence) (Creswell, 2007). To ensure Photovoice participants reflected some degree of diversity, a recruitment survey was used (see Appendix K) to understand student survivors in terms of race, ethnicity, age, sexual orientation, and service utilization experience. Information from this survey was used to recruit a diverse group; a diverse set of participants was needed to allow for the exploration of the research questions. Research Questions, Framing Questions, and Qualitative Methods This study aimed to address the following research questions: 1. How can a college campus create a contextually informed response to sexual violence? a. What is perceived as helpful to a diverse group of college students who have experienced sexual violence? b. What is needed in the campus-community to better support the diversity of survivors? In order to examine these research questions, the Photovoice project presented the following framing questions to the participants, who responded by taking photographs and writing narratives. Participants wanted to complete an additional round of Photovoice, for which they suggested the third framing question. This question was created by the participants, and 37 each individual responded by creating a four photo collage, rather than just producing one photograph as they did for the first two framing questions. 1. What is most helpful to someone after they have experienced assault? 2. What should the campus-community offer survivors like you? 3. Thinking about an aspect of your identity or experience with sexual violence that captures your diversity: (1) What has been an outlet for you based on this aspect of diversity? (2) What has been a barrier to seeking services or healing based on this aspect of diversity? (3) What should change about the service system to better reflect your diversity? (4) At a more abstract level, in general, how has your diversity interacted with your experience of sexual violence? The framing questions were directly linked back to the research questions through the facilitation probes that were used during the group conversations of the photos and narratives. See Appendix D, Table 3 which illustrates the link between the framing questions, facilitation questions, and research questions. The qualitative data collected from the project was analyzed using an inductive content analysis approach (Patton, 1990); results will be used to provide the campus-community with a better understanding of the lived experiences of a diversity of survivors, specifically related to post-assault needs and experiences. The Photovoice project collected data through multiple methods. This included data from an online Photovoice development survey (described below), the online Photovoice demographic recruitment survey, photos and narratives created and shared by the participants, group dialogue processes during the Photovoice meetings, and a personal written epoché (Creswell, 2007). The recruitment survey, photos, narratives, and group discourse data were analyzed to address the research questions for the current project. Each in-person Photovoice session was audio recorded 38 and transcribed. The transcriptions were stored on a password protected computer, and the audio files were destroyed upon the creation of each final transcription. All other data was stored in the case that future projects may build on the current one, and for participants to use in future exhibits or presentations. Gaining Entry: Violence Free Communities by Design (VFC) This current project was designed in collaboration with Violence Free Communities by Design (VFC), a campus coalition invested in eliminating violence in the Michigan State University campus-community. The author, a graduate student in Ecological-Community Psychology, was allotted time to develop a project with a community partner as part of the first year curriculum (practicum). Guided by theories of ecological inquiry (Ryerson Espino & Trickett, 2008), building university/community partnerships (Suarez-Balcazar, Harper, & Lewis, 2005), and establishing relationships with community coalitions (Wolff, 2001), the practicum experience consisted of the process of gaining entry, establishing relationships, and collaboratively developing a project that would benefit survivors on campus, as well as VFC. The initial project conceptualization began by exploring options for innovative studies. Photovoice was a possibility that had been presented to VFC in the past, although the method was never implemented. As such, this approach was pursued further. The author’s role in the conceptualization process consisted of attending coalition meetings, forming a Photovoice sub-committee, sending out questionnaires to the entire coalition to incorporate as much perspective as possible during project conceptualization, holding subcommittee meetings to make decisions about the Photovoice project, outlining ethical considerations when working with survivors of sexual violence, attending a portion of the sexual assault response training offered by one of the programs affiliated with VFC, and drafting a list 39 of community allies on campus to assist with the project (see list of community allies in Appendix R). The Photovoice sub-committee consisted of members from a range of programs and departments on campus, and these sub-committee meetings significantly shaped the purpose of the current project through discussions about the current state of sexual violence on campus, and going through questionnaire responses from the entire committee. The sexual assault response training focused on communication styles for speaking with survivors, empowerment based approaches to building relationships with survivors, and providing necessary resources to survivors on campus. One of the final steps during the collaborative development involved creating an online survey to send out to survivors on campus in order to access their perspectives during the development of the Photovoice project. The survey was created on surveymonkey.com, and was sent out through list-serves associated with VFC (academic department listserves for students; program listserves for staff, volunteers, and students who sign up if they are interested in learning more about the program). The survey was sent out to a large number of students on campus with the hopes of reaching a significant number of survivors. The purpose of this survey was to access the community of survivors on campus as co-creators of the project, and also aimed to create an ethically sound study. It included questions such as: What would make you not want to become involved in the Photovoice project? What concerns would you have as a participant? What types of framing questions would you be interested in responding to? Results from this survey influenced the focus of the framing questions and overall project plans (see Appendices J and K for recruitment email and survey protocol). With the assistance of VFC members, the survey was sent out through listserves multiple times for six weeks. These listserves were linked to programs within VFC. Therefore, students 40 who were subscribed to listserves with the Sexual Assault Program, The Center for Gender in Global Context, MSU Safe Place, the Women’s Resource Center, the Sexual Assault and Relationship Violence workshops, and the LBGT Resource Center received an email with a link to the survey. Data was stored in a Microsoft Excel spreadsheet on a password protected computer. It is hard to know how representative of a sample this is as records as to diversity among survivors do not seem to exist with the Sexual Assault Program. Twenty-two survivors participated in the survey. While structured demographic information was not directly asked about, some participants mentioned certain aspects of their identity and their responses illustrate some of the diversity found among survivors at Michigan State University. For example, one participant self-identified as male, pansexual, and a follower of Pagan religions; another survivor self-identified as a bisexual female, but someone who does not ascribe to either male or female gender constructions. Some respondents were White, others were Hispanic. No other ethnic or racial diversity was disclosed. While this sample may not be representative of the entire survivor population on campus, or the diversity of survivors on campus, the goal was simply to include survivor voice in parts of the project development in order to create a project that was supportive of the survivor experience. Survey responses informed the development of the first framing question presented to study participants, and also the overall structure of the project; at the time, the author was considering using an online adaptation of Photovoice given the sensitive nature of the topic of sexual violence. Survey respondents supported the in-person Photovoice process rather than the online one. Setting Description The current project took place on the Michigan State University campus. The in-person Photovoice sessions where the participants shared their photos and narratives and engaged in 41 group discussions also took place on the MSU campus in a reserved room. These meetings were facilitated by the author who was assisted by two other individuals: A therapist from the Sexual Assault Program on campus and a fellow graduate student from the Ecological-Community Psychology graduate program. Each of the additional supporters mentioned played a specific role in the project: The therapist established a safe space for participants to access during each meeting (in a small office room immediately next to the meeting room), and the fellow student assisted with meeting facilitation. Recruitment Procedures and Participants The sample for the project was MSU students (18 years of age or older) who have experienced sexual violence while a student at the university or no more than two years prior to coming to campus (if a student had experienced multiple instances of sexual violence, only one of those experiences had to meet this criteria to be considered). There was no restriction on gender; rather it was assumed that male survivors were not likely to volunteer given the record of male survivors participating in other survivor-oriented efforts or programs on campus. According to the literature demonstrating the frequency of sexual violence towards women across college campuses, among 1,000 female students there is likely to be 16.6 victims of completed rape, 11 victims of attempted rape, 16.6 victims of completed sexual coercion (including unwanted penetration, as well as contact of mouth on genitals or mouth on someone else’s genitals with the threat of non-physical punishment), and 19.1 victims of completed sexual contact with force or threat of force (including unwanted completed sexual contact not including penetration such as touching, fondling, kissing, licking, sucking, or some other form) (Fisher, et al., 2000). According to MSU Facts (2011) in the fall of 2011, there were 36,675 undergraduate and 11, 279 graduate or professional students; 52% of these students were women. Therefore, there were 42 over 24,000 female students to sample from, with the assumption that for every 1,000 of these students there were likely 16.6 students who were victims of completed rape alone; recruitment also included victims of sexual assault. The sample was recruited with the assistance of VFC. Campus organizations, programs, and events that were affiliated with VFC and provided access to diverse survivor populations were identified. These organizations can be found in Appendix R. Fliers describing the project and how to participate (see Appendix G) were distributed throughout campus. Over 500 fliers were posted in buildings including every residence hall, libraries, academic department buildings, gyms/physical recreation facilities, coffee shops and restaurants on the periphery of campus, the Student Services building, and the Student Union. Additionally, these fliers were sent out electronically through academic department student listserves, VFC program listserves (including the LBGT Resource Center, The Sexual Assault Program, The Center for Gender in Global Context, MSU Safe Place, and The Women’s Resource Center), as well as listserves with other programs such as Greek Life and The Vagina Monologues. Recruitment was open for four weeks. Once a prospective participant inquired about participating they were sent a response email with a link to an online recruitment survey (see Appendices J and K for the recruitment email and recruitment survey). This survey was created to better assess the diversity of the prospective participants, and to recruit a group that represented a diversity of survivors. The survey inquired about race, ethnicity, sexual orientation, gender, age, as well as survivors’ experience utilizing services on campus. The goal was to invite a group of survivors to participate that represented as much diversity as possible. 43 Recruitment survey data was entered and stored in a Microsoft Excel spreadsheet. The first step in determining participant eligibility based on survey responses included the following criteria: Participants must (1) identify as a survivor of sexual violence; the violence of which had to have occurred since they have been an MSU student (18 years of age or older), or no more than two years prior to coming to campus; and (2) have access to a digital camera of 12 megapixels or higher, connection cords or another mechanism to download the photos from a camera to a computer, and the internet; and (3) not have any past experience with Photovoice projects. While limiting recruitment to individuals who have access to a digital camera restricted certain individuals from participating, a camera is essential to participate in a Photovoice project. Despite significant efforts to recruit a large group of participants, only 12 individuals filled out the survey. Considering the high rates of sexual violence on campus, the response rate for recruitment was low. However, similar experiences of barriers to recruitment have been expressed by other staff members among the survivor services on campus. Of these, 11 individuals were eligible based on the criteria described above. With the intention of conducting two Photovoice groups simultaneously, all 11 respondents were invited to attend the first Photovoice meeting; however only seven individuals attended. The four respondents who did not attend were lost at this point during recruitment due to various reasons, most of which were related to an inability to commit to the time that was required of the project. After the orientation meeting, only six individuals decided to participate after learning more about the project. The seventh prospective participant dropped out after this meeting due to illness. See Appendix L for a flow chart demonstrating the recruitment process. Table 4 (in Appendix S) describes the initial 11 survey respondents and the final sample for this study (complete with demographic information). As this table illustrates, while this 44 sample did not include racial diversity, the participants did represent diversity in terms of religious identity, sexual orientation, and service utilization in the campus-community. Of these six young women, four identified as either bisexual, Queer, or Questioning or Exploring in terms of their sexual orientation; two of these four women identified strongly with a religious identity; one of these two young women identified with her Native American background; one participant identified as an atheist; three participants sought services and received services related to sexual violence; one participant tried to seek services but did not receive any; one participant identified as not wanting to seek services; and one participant wanted to seek services but did not do so. Because sexual violence experiences can vary significantly for lesbian and heterosexual women (Tjaden & Thoennes, 2006) and religion has been described as having both positive and negative impacts on survivors of sexual violence (Sorenson, 1996), it was decided that this sample provided an important opportunity to explore the intersectionalities of gender, sexual orientation, and religion. These factors will be considered in terms of how they intersect with the experience of sexual violence, and the manifestation of that violence post-assault. Furthermore, participants varied on the level of service interaction they had with MSU, a characteristic that was also considered in relation to an intersectionality framework. Each participant received a $40 gift certificate to compensate them for their time at the completion of the Photovoice project. Procedures and Photovoice Sessions A project calendar can be found in Appendix A, and an outline of the Photovoice session procedures can be found in Appendix M. Overall the process included: (1) training participants on the Photovoice methodology, (2) engaging the participants in multiple group meetings to 45 discuss their photos and narratives, and (3) engaging participants in co-creating dissemination material including a digital story to share what was learned from the project with community leaders. This dissemination tool took the form of a digital story, a specific media tool that innovatively disseminates information to community leaders and decision makers. There were five structured meetings (from the introductory session to a participatory data analysis process) with the participants throughout the project. A participation agreement contract (See Appendix F) was used to ensure that participants understood project requirements (in terms of what they needed to create prior to each meeting and how often they would gather with the other participants) in order to receive their incentive. Additionally, if participants had to miss a meeting the author scheduled an additional time to meet with them so they could share their photo orally with the author, making their data available for transcription and analysis. If a participant became overwhelmed by the project at any time, they were encouraged to re-evaluate their participation, and if they decided to come back, they were welcomed. Finally, if there were instances in which certain components of each Photovoice round (e.g. an oral narrative) were not completed by a participant, the author contacted the participant, and set up additional meetings in order for missed components to be completed. Maintaining participant safety. A sexual assault therapist was stationed outside the meeting room to serve as a resource to the participants. Specifically, the therapist maintained a safe space in a room adjacent to the meeting room where participants could spend time if they decided to leave the meeting for any reason. Participants were welcome to speak with the therapist or visit the safe space at any point during the Photovoice meetings. The therapist also had materials to give to participants if they were interested in seeking services in the campus46 community. These materials outlined services offered, as well as a Student Survival Guide created by MSU Safe Place. To view a portion of these resources, see Appendix N. The sexual assault therapist joined the Photovoice group at several points primarily during training to discuss ethical issues, emotional and physical safety, and diversity. See Appendix M for more details on her role for each meeting. The Photovoice Sessions. The Photovoice process consisted of four meetings, of which all participants were strongly encouraged to attend. Two participants missed the final meeting, and one of them made up this missed attendance by sharing an audio recorded oral narrative with the author at a separately scheduled time. The first meeting focused on the consent process, and also covered the project timeline, ethics, and purpose. The Photovoice process was presented and participants were trained on how to use this specific methodology. Resources outlining campus services were available for participants (again, see Appendix N), and a timeline for the project was given out (see Appendix O). This meeting also covered camera tricks and usage, how to send in photographs prior to the next meeting, and an introduction to the first framing question. Participants were asked to take photos in response to the first framing question prior to the next session. The second meeting was used to discuss the first framing question: What is most helpful to someone after they have experienced assault? Photos and written narratives were emailed to the author (to an address set up specifically for the project), three days prior to the meeting, and were compiled into a Microsoft PowerPoint presentation to view during the meeting. Instructions for the written narratives were open-ended. Some participants described what they took a picture of and why, while some responded directly to the framing question. Additionally, participants were guided by the SHOWeD structure proposed by the traditional Photovoice methodology (C. 47 C. Wang, 1999) in order to get them thinking about the deeper meanings behind their photographs. Each participant selected only one photograph to share with the group per framing question. The PowerPoint presentation was shown at the group meeting where each participant was invited to share their photo, narrative, and oral story behind their picture. After each participant shared, minimal probing questions were presented to be sure that the story behind their photo was understood. After all participants shared their work, a voting process took place to decide on two photographs to guide the group discussion. To complete this step, participants were given two circle stickers. Numbered index cards were passed around to all participants, each card representing a photograph that was shared. The final slide in the PowerPoint contained numbered thumbnails of all of the photographs shared. Participants put their stickers on the card that represented the numbered photograph they wanted to vote for. Once the voting process was complete a group level discussion about the selected photos was facilitated using probes that intended to connect the framing questions to the research questions. The framing question and selected participant photos and narratives served as entry points into the deeper conversation. Facilitation questions are listed in Appendix D, Table 3. At the end of this meeting, participants were assigned the second framing question. The third and fourth meetings were used to discuss the second framing question, as well as the additional framing question that was decided upon by the participants: (2nd Framing Question) What should the campus-community offer survivors like you? (3rd Framing Question) Thinking about an aspect of your identity or experience with sexual violence that captures your diversity: (1) What has been an outlet for you based on this aspect of diversity? (2) What has been a barrier to seeking services or healing based on this aspect of diversity? (3) What should 48 change about the service system to better reflect your diversity? (4) At a more abstract level, in general, how has your diversity interacted with your experience of sexual violence? This final, multi-layered four photo collage framing question was not an original part of the study. Rather, participants were interested in completing one more round of Photovoice and constructed this last framing question. Participants had collaboratively come up with these four questions, after which one participant suggested that instead of narrowing it down to a single question, a multiple photo collage should be completed so as to cover as all of the suggested ideas. The third and fourth meetings ran similar to the first with the addition of a participatory data analysis stage. Prior to the participatory data analysis, participants were emailed a text document that included their written and oral narratives from the first two framing questions (see Appendix P for the email template for the participatory data analysis). Participants were asked to underline the important sections in their narratives, which later served as the foundation for a participatory coding framework. Participants were encouraged to delete these files from their computers after they finished underlining the important themes and sent it back to the author. During the following meeting participants finalized their underlined sections and copied them onto notecards. The next step involved the participants posting all of the notecards on a blank wall in order to identify first- and second-order themes that were emerging across their narratives. Participants were then able to rearrange notecards together to create a preliminary coding framework for the data. Use of this framework is described in detail later. Public Dissemination As suggested by Wang (1999), Photovoice projects culminate in a public outreach dissemination tool; for this project a digital story has been created. Marshall and Rossman (2011) described digital stories as short movies that are created with photo, text, video, or music, and 49 have “an empowering and/or emancipatory ideology, seeking to encourage people to give voice (and image and sound) to their life experiences” (p. 154). Digital stories intend to reach out to community leaders in a way that directly engages community members’ voices in conversation regarding programs or policies. Photos and narratives from the Photovoice sessions have been used to create the digital story and key audience members throughout the campus-community were selected by the participants to view the digital story through two events that were held at the Student Services Building and the MSU Museum. Plans to keep the digital story as a sustainable tool and/or resource on campus have been made collaboratively with VFC, as well as other programs at MSU (e.g. the Residential Assistant training program and the Counseling Center). Participants actively created the digital story with minimal help from the author (e.g. the author was responsible for preparing the materials to be used for the digital story, facilitating the process of creating the digital story, reserving space for digital story viewing events, and sharing the results of the study in order for the participants to make specific references as to where campus efforts need to be focused). Participants constructed the digital story and utilized the photos and narratives to make specific recommendations as to how the campus-community can better support the diversity of survivors. Data Storage and Participant Confidentiality The three Photovoice sessions where photos and narratives were shared were audio recorded, which participants consented to at the beginning of the project. After each audio recorded meeting, the files were uploaded to a personal, password protected computer. Transcriptions (containing the individual sharing and the group dialogue processes) were created for each audio file, and once these transcriptions were complete, checked, and cleaned, the audio 50 file was deleted. For each round of Photovoice, a case summary was created for each participant that contained their photo, written narrative, and the oral narrative they provided during the group meeting. Transcriptions and case summaries were imported into NVivo Qualitative Software 9.0 (QSR NUD*IST Vivo Software, Qualitative Solutions and Research) for storage and analysis, and were also saved as Microsoft Word documents for additional analyses. Any hard copies of transcripts or data were kept in a locked filing cabinet. Participants were assigned an identification (ID) number upon completing the consent process. This ID number is referenced in place of participant names throughout the results and in all research reports. Other identifying information has also been removed. For example, when a participant disclosed specifics related to experiences of sexual violence (e.g. perpetrator name), such details were eliminated from the transcripts/narratives. Consent forms were kept in a locked filing cabinet, and a master list that connects the participants’ names to their ID was kept separate from the consent forms, on a password protected computer. This list will be destroyed when all aspects of the project are complete. Ethical Considerations of the Photovoice Project Due to the sensitive nature of the current project, ethical considerations were explicitly discussed multiple times during project development. Two steps were involved in setting up the ethical considerations for the current project. To begin, the ethical overview of Photovoice projects, created by Wang and Redwood-Jones (2001) was consulted. This helped to establish basic guidelines and protocols for the project. Additionally, in collaboration with VFC, ethical issues were outlined specific to the current project. An overview of these factors is included in Appendix Q, along with a table that lists how the project addressed each ethical issue outlined. Institutional Review Board (IRB) Process 51 Institutional review board approval from MSU was received for the Photovoice project. The consent form for participating in the Photovoice project was two-fold: (1) Consent to be involved as a participant; (2) Consent to display photographs and narratives in the Photovoice digital story. The full consent form approved by IRB is included in Appendix E. The ability for participants to photograph other people was removed from the project as a result of the IRB approval process. As such, participants were encouraged to photograph things that represented people they may have wanted to include in a photograph, or to photograph large groups of people in which individual identities could not be determined. Participants did, however, choose to do some self-portraiture. Hard copies of data will be kept for five years after the project is complete, and electronic data will be kept for seven years after the project is complete. Data Analysis Procedures Demographic survey data, participant generated photos, individual narratives (written and oral), and group level conversations have been analyzed for the current study. The photos and narratives were analyzed from all three framing questions. The group conversation for the third framing question was not analyzed as not all participants were able to make it to an additional group meeting. Both within-case and cross-case analyses were conducted (Patton, 1990). It should be noted that the focus of the analysis was on the text generated throughout the study (e.g. written narratives, oral narrative, and transcribed group meetings), rather than the photographs. However, Table 7 in Appendix V illustrates one photo that contributed to the development of each of the major themes that emerged from the study. All of the photos generated throughout the study allowed for access to deeper meaning behind the data that emerged, however Photovoice studies have a more significant focus on the text during the analysis and 52 interpretation stage. Researchers may consider thematically analyzing the photos in future Photovoice studies. Using an inductive content analysis approach (Patton, 1990), the within-case analysis contextualized survivor experience of sexual violence in terms of perceived helpfulness and postassault experience, while the cross-case analysis searched for patterns across participants. To begin the analyses all audio files were transcribed, quality checked, and cleaned (to remove identifying information). Additionally, case summaries for each framing question for each participant were created, quality checked, and cleaned (to remove identifying information). These case summaries included the photograph, written narrative, and oral narrative for each round of Photovoice. Data were stored and analyzed using NVivo 9.0 (QSR NUD*IST Vivo Software, Qualitative Solutions and Research). Within- and cross-case thematic summaries were created in Microsoft Word documents and Microsoft Excel spreadsheets. All data was read over multiple times, and organized by research question before analysis began. Inductive content analysis of all data: Constructing the coding framework. All data (group transcripts and case summaries) were analyzed using an inductive content analysis approach. As suggested by Patton (1990), the author organized the data by research question, and then sought “sensitizing concepts” (p. 391). Sensitizing concepts served as flags as the author worked through the data, alerting her to certain content identified as areas of interest by the author and VFC. Examples of sensitizing concepts for the first research question included helpful, unhelpful, and needs; examples of sensitizing concepts for the second research question included service accessibility, service inaccessibility, needs, meeting needs, responding to needs, supporting survivors, and campus-community. These concepts were used to further organize the 53 data into bins prior to the creation of first- and second-order themes. Because of the way in which the framing questions were worded, all of the data fit into these sensitizing concepts. Emergent coding began with the author identifying first-order themes within each of the sensitizing concept bins. The author then merged this set of codes with the themes identified by the participants to create an exhaustive set of first-order themes. When possible, the participants’ language was used when drafting the final list of these first-level codes. Some of the author’s codes were dropped if they did not appear to be important in the participatory framework, and similarly, some participant generated codes were dropped if they were not represented across multiple survivors. Usually, codes were refined to capture ideas that both the author and participants shared. This first-order coding framework was sent out to the participants for feedback. Next, the author re-grouped the first-order themes into second-order themes at a meta level. The purpose of this coding level was to comprehensively summarize the story inside the data: What was perceived as helpful post-assault, and what can be done in the campuscommunity to better support survivors? For example, the first-order themes for the first research question emerged as descriptions of certain behaviors that were helpful post-assault (e.g. swimming), and were re-grouped into second-order themes based on the meaning or utility identified by participants (e.g. reclaiming normalcy and control in life). The first- and secondorder themes were then merged to create the final coding framework. This framework was then used to conduct the within- and cross-case analyses. The coding process was iterative, and the author visited the data multiple times before the final coding was complete. This stage of data analysis used Microsoft Word documents to filter through the data and identify themes, and Microsoft Excel spreadsheets were used to re-group and organize data by theme in order to 54 refine the framework before creating the final list of themes. The final framework was then saved in a Microsoft Word document, and imported into NVivo 9.0 (QSR NUD*IST Vivo Software, Qualitative Solutions and Research), and participants completed a member check on this final coding framework as well. Cross-case analysis. Using the first- and second-order themes described above, a crosscase thematic analysis was conducted across all participant data. Data, organized by research question, was coded with first- and second-order codes and these codes were entered into a data matrix to illustrate the themes across participants and to visualize patterns. Particular attention was paid to the core characteristics across participants, and how these were related to the themes found across individuals (Miles & Huberman, 1994). Within-case analysis. The second aspect of the multiple case studies approach (Patton, 1990) consisted of conducting a within-case study for two participants. These case studies provide a thick and detailed description (Patton, 1990) of each participant’s holistic story, and include the demographic information, photos, narratives, and first- and second-order themes for each of the two participants. Furthermore, the within-case analysis highlights the intersectionalities of the different participant characteristics. These two participant case studies were selected as they are best situated to demonstrate the main findings from the research, and illustrate the cross-case analysis themes. Each case study represents diverse perspectives and intersectionalities among the levels of diversity represented in the sample. Namely, the first case study presented illustrates the experience of a heterosexual survivor who identified as an atheist and had tried to seek services at MSU, but did not receive any. The second case study illustrates the experience of a survivor who identified as Queer with a strong United Methodist religious 55 background and fluid gender identity. The within-case analysis and participant case studies are included below, after the cross-case analysis is presented. Bracketing Throughout the data collection process, and prior to the analysis, the author engaged in a process of bracketing her own experiences, beliefs, perceptions, and positionality (Creswell, 2007; Marshall & Rossman, 2011) in order to separate any biases from the data gathering and interpretation. This process was an essential step in the research process in order to acknowledge her relationship to the phenomenon, and to minimize any impact it may have had on the data (Patton, 2002). The author is a 25 year old White woman who identifies as heterosexual. She has had past experiences with sexual violence, and has been drawn to this particular social issue since the start of her graduate school studies. The author also identifies as a participatory action researcher, which is reflected in this project. The author has two younger sisters with whom she is very close, and their presence in her life has driven her towards research related to women’s experiences, violence against women, and women’s empowerment. The author has been pursuing research and community work related to these topics for the past five years. This project grew out of the author’s first year practicum experience which focused on developing the Photovoice project and manual with a coalition on campus. This coalition is a group of people across the university who are focusing on the issue of sexual violence on the MSU campus. The practicum project was very engaging, challenging, and also rewarding. As project implementation neared, the author assumed recruitment would happen with ease, and that accessing a diverse group of survivors would not be a challenge. Furthermore, the author assumed that most interested survivors would be at a particular moment in the healing process 56 during which they were ready to share their stories and implement change in the campuscommunity. The author also wanted to be able to report not only beneficial research back to the coalition, but also data that supported the existing resources on campus. However, the author also had to be sure that she was reporting what she was hearing, and if there was unfavorable information shared regarding the services, this too would have to be shared with the campuscommunity. Upon recruiting the final group of participants for the study the author began to consider different aspects of her own identity that may interact with the data collection and interpretation. These included her sexual orientation and religious identity. To begin, the majority of the participants identified their sexual orientation as Queer, bisexual, or Questioning or Exploring. As a heterosexual individual the author is an outsider to this specific community. As such, she familiarized herself with literature on violence within and against these communities. The author also focused on establishing relationships with the LBGT Resource Center on campus which is where the meetings were held. Furthermore, half of the participants identified rather strongly with a particular religion. Being that the author is someone who identifies as spiritual, but not religious, this may have interacted with those individuals’ stories. Finally, as a young woman who is not much older than the participants in the project, the author was careful not to establish any roles with the participants that would manipulate them into over-disclosure of feelings or experiences that they would only share within friendly relationships. These facets of the author’s identity, research interests, and relationships with the coalition on campus may have impacted the study. However, by bracketing these aspects and acknowledging their existence the author hoped to minimize any affect they may have had. 57 RESULTS Cross-Case Analysis It is necessary to understand the intersection of contextual factors and how that intersection produces a distinct experience, unique narrative, and specific set of needs among survivors. The intersectionalities across participants are apparent in the cross-case analysis as core characteristics are mentioned at times to demonstrate unique intersectionalities. These intersectionalities emerge more clearly, however, throughout the within-case analysis. Overall, the data provides support for the intersectionality approach to understanding survivors’ experiences of sexual violence. While participants had some similar experiences, they reported very unique approaches of healing, coping, and accessing services after assault. Often these ways of coping were connected to their unique constellation of gender identity, sexual orientation, and religion. Across these unique intersections among the participants, three healing venues were identified: reclaiming normalcy and control, reclaiming voice, and reclaiming body. Participants also agreed that an institution that creates a proactive environment and recognizes and acts on the complexity of sexual violence is both needed in order for the MSU campus-community to better support the diversity of survivors of sexual violence. Differing opinions regarding what the institution should offer were directly linked to the core demographics that illustrate the diversity among the participants. For example, those participants that identified with a strong religious background felt as though services needed to address the intersection of sexual violence and religion better, whereas participants who identified as bisexual felt as though services needed to address the intersection of sexual violence and sexual orientation better. A data summary table 58 can be found in Appendix T, Table 5. This table also demonstrates the ways in which intersectionality emerged through the data. Cross-Case Analysis: Research Question 1 The first research question asked: What is perceived as helpful to a diverse group of college students who have experienced sexual violence? Overall, the participants described a story of reclaiming where they progressed from victim to survivor and moved out of crisis and into healthy living apart from the assault by reclaiming their lives in a variety of ways. Three venues for reclaiming emerged: reclaiming normalcy and control, voice, and body. Each helped the participants post-assault to move into a life that was not shaped by the assault experience, but one that was reflective of the survival of the violence. This process of reclaiming contributed to the progression of redefining oneself as something more than solely an individual who had experienced sexual violence. Reclaiming normalcy and control, voice, and body contributed to each participant’s status change from victim to survivor, and to some extent this process of reclaiming extended beyond that as well. These processes of reclaiming were spoken about in a transitional sense, emphasizing that reclaiming was not static, nor were these processes complete at any given moment. The following elaboration demonstrates the different mechanisms and strategies that participants used to reclaim normalcy and control, voice, and body. This process of reclaiming, though shared through meaning and purpose, took many different forms for the women depending on their unique constellation of characteristics. Reclaiming normalcy and control. First and foremost, participants spoke of the helpfulness of reclaiming normalcy and control post-assault. Normalcy is not referred to in a way to suggest a general idea of being normal, rather, here, normalcy is defined by the participant, being whatever it is they claim as their normal; a process of returning back to the life they were 59 living pre-assault, while taking ownership of how it may be different post-assault. Reclaiming normalcy was an establishment of balance in one’s life through mechanisms that were resilient throughout the post-assault process. The process of reclaiming normalcy embodied the act of participants reclaiming control over certain remnants of the sexual violence they experienced. This control often contributed to a process in which the survivor was reclaiming this normalcy or balance by the grace of their own action, in order for their life to resemble consistency, steadiness, and resilience to the assault they experienced. The process of reclaiming normalcy and control manifested in five ways, including traditional services for healing (e.g. counseling/therapy, group counseling, and prescribed medication), unconditional social support (e.g. familial support), goal setting, immersing oneself into life’s routines (e.g. schoolwork, sports, increased responsibility in leadership positions), and keeping tabs on the perpetrator. In some instances, these strategies for reclaiming normalcy and control were things actively pursued by the survivor, but not always (e.g. social support was not sought out by all participants, but at times it was readily provided by people in their social networks). Mechanisms for reclaiming normalcy and control varied across participants, but the meaning and purpose for engaging in such strategies was shared. Traditional services for healing. The most common mechanism for reclaiming normalcy and control came in the form of traditional services for healing. These services included counseling/therapy, group counseling, health service, the use of prescribed medication, and many participants spoke about positive experiences of seeking these services on the MSU campus. All participants mentioned at least one of these traditional services for healing to reclaim normalcy and control post-assault. For instance, many participants spoke about the benefits of counseling post-assault, and how individual and group therapy were instrumental in reclaiming normalcy 60 and controlling the post-assault healing process. There was overwhelmingly positive feedback related to the Sexual Assault Program and the Counseling Center on campus. Often these services were described as outlets that truly saved the participants, and counselors in these programs were described as having provided support that participants were unable to locate elsewhere. For example, one participant was faced with a reaction post-assault that she did not know how to deal with. This involved her continued interest in the perpetrator, and she said that out of all the services she sought, her counselor in the Sexual Assault Program was the only person that helped her address this feeling. Other staff members in the Sexual Assault Program were described as bringing “light to the dark.” Counseling and group counseling often provided participants not only with services that targeted mental health and well-being, but made them feel like they were not alone, made them feel closer to reclaiming normalcy and control. One participant shared: …services like through the school I found helpful because they made me feel like I wasn’t a complete idiot. Participants also spoke about seeking health services, for instance at Olin student health center, to make sure they were initially okay in terms of pregnancy or sexually transmitted infection; again, this act helped them to maintain a sense of control and normalcy in their lives. Finally, participants spoke about the use of medication, and motivators for using medication post-assault. While medication (e.g. antidepressants or anxiety medication) often led to an inability to reclaim normalcy and control in one’s life, participants spoke about their reasoning behind obtaining medication as hopefulness to regain balance and normalcy in regards to their emotional state. To highlight the presence of intersectionality, across the four women who identified as Queer, bisexual, or Questioning or Exploring, each identified the use of 61 medication as part of their post-assault process to try and reclaim normalcy and control in their lives. Unconditional social support. The next most common mechanism for reclaiming normalcy and control was in the form of unconditional social support, specifically through family and friends. Unconditional social support, specifically nonjudgmental support and acceptance from others, was described as helpful post-assault by all participants because it facilitated the feeling of normalcy and control. According to participants, this type of support was most helpful when it reflected the idea that the sexual violence they experienced was unacceptable, and that it should never have happened. Having allies engage with them around this perspective helped participants reclaim their lives because it re-engaged them in a process of maintaining intimate relationships in their lives. More often than not, these relationships were ones that had been a part of survivors lives long before the violence occurred. At times, unconditional social support was something that participants actively sought out in order to reclaim normalcy and control in their lives, while at other times it was something available within their environment. Sometimes when it was needed it was not available, other times it was: I do think that it’s really important to have that kind of community available to you because that was the thing that I was able to fall back on and those are the people that I know love me no matter what and they just wanna do something for me. They want me to be okay. Unconditional social support from friends was one mechanism that was shared across multiple participants. Many participants differentiated between friends who requested to know the details of the assault, versus friends who were more concerned about what they could do to 62 help. The latter offered that unconditional social support that facilitated the process of reclaiming normalcy and control, while the former did not. One participant explained: I guess I’m really relating to all of the people whose friends didn’t, didn’t ask what they could do to help. Um, because I did have friends who did ask that and that’s why I’m still friends with them…I’ve completely cut off relations with a lot of people who did say ‘Well, what happened?’ Unconditional social support from family members was also an integral part of participants’ ability to reclaim normalcy and control when it was received. Unfortunately this was not the case for all participants. One participant explained: And I still needed I still needed warmth and love, I needed my family, I needed support. Participants spoke about the helpfulness of receiving such support from their mothers and sisters, and emphasized the positive role their family members played in the post-assault process. As stated previously, this support was not received by all participants, which created a significant barrier to reclaiming normalcy and control. Specifically, some participants discovered they were not able to be open with their family members about their assault and the impact it was having on their lives. As a result, these participants felt they had to fragment their lives, compartmentalizing certain aspects of their identity depending on the environment they were in. For instance, one participant spoke about her exploration of sexual orientation postassault, and her inability to share this with her family. Due to their strong religious background, any sexual exploration outside of heterosexuality was unacceptable to her family. As such, this participant was unable to reclaim sexuality as part of her normal life, constantly feeling as though she needed to hide her identity. She explained a situation in which she told her mom 63 about a “friend” who was raped, and how that “friend” began dating women afterwards. She was speaking about herself, and used this as a way to gauge what her mother’s reaction might be: And my mom looked at me and she was like ‘Please don’t tell me, you’re trying to like, tell me that you’re gay or something.’ And I was just like ‘No, no it’s not me, it’s someone else.’ But very unaccepting of the idea…I’m not even saying that I’m a lesbian, I’m just saying that I have a sexual draw towards females. But with my religion and my family it complicated my healing because it made me ashamed to ever talk about it. Another participant was also strongly impacted by the social support she received from her family, in multiple (and conflicting) ways. For this participant, her sisters, who are also survivors, played a very positive role in her life, and their support allowed her to reclaim normalcy and control. She explained the connection she has to her younger sister, who had previously saved her life. When this participant was younger she had made plans to end her life, much in relation to the assault she had experienced at a young age. Moments before doing so her younger sister entered the room. This participant explained: …about five minutes before I planned on like pushing forward with this, she walks in our room and she goes, ‘You know what sis, I don’t know where I’d be without you’…she knew how broken I was, and regardless of how broken I was, she was like ‘You know what, you’re pushing through, I’m really proud of you. Having such a strong connection allowed this participant to reclaim normalcy and control by embracing the fact that she was not only living for herself, but also for her sister. After this happened, she explained that she then focused a great deal of her life to being a better sister, and fulfilling that role in every way she could. Again, allowing for normalcy and control to be regained through familial connection. 64 This participant, however, experienced a lack of unconditional social support from her parents, specifically when she came out to her father as a bisexual woman. This lack of support prevented her, in a similar way as the participant mentioned above, from reclaiming normalcy and control in her sexual life. She shared: I came out to my father and I told him that I was seeing a girl, and then like this ‘Is this cause of what happened to you? This participant explained that this perspective held by her parents significantly impacted her healing as they were not able to offer acceptance of her sexuality, specifically as they attributed it only to the assault she experienced. For this participant, identifying as a bisexual woman was not a result of her assault, but was only given meaning by others because of her assault; again, leading to an inability for her to reclaim normalcy and control in terms of a sexual life because it was misunderstood by others as a fleeting reaction rather than an aspect of her identity. Reclaiming normalcy and control was achievable when unconditional social support was available post-assault. In instances in which unconditional support was not received, it was a significant hindrance on participants’ ability to regain and re-engage in a normal life. Goal setting. The third most common mechanism for reclaiming normalcy and control involved goal setting post-assault. Five participants spoke about the act of goal setting as a helpful part of the post-assault process that allowed them to reclaim normalcy and control, to have specific things to accomplish and live for each day. One participant explained that: …having like, specific reasons to live, and um, kind of like I have my, my weekly calendar and I go ‘Oh, well I have one thing to accomplish each day. So I have to accomplish those things, like otherwise I’m letting other people down, I’m letting myself 65 down, I’m, I’m not accomplishing all of the things that I know I can and, um, that like really helps me kind of push forward through all of these things… Goals varied significantly across participants, but they all contributed to the act of reclaiming the normal rhythm of one’s life and moving forward in the healing process. Immersing oneself into life’s routines. The fourth most common mechanism for reclaiming normalcy and control came in the form of immersing oneself into life’s routines. This included engaging in schoolwork and sports, increased responsibility in leadership positions, and indulgence in things that provided happiness; five participants identified these strategies as part of their post-assault process. Schoolwork, sports, and increased responsibility in leadership positions were also strategies for reclaiming normalcy and control as these mechanisms allowed participants to commit themselves to something that was seemingly detached from their assault. For instance, one participant explained: One of my greatest outlets was schoolwork. It almost became an unhealthy obsession, but it was one thing that brought consistency in a world breaking into a million pieces. Another participant spoke about swimming in a similar way, and shared that when she finally returned to the pool after a long period of not wanting to be in a bathing suit: Everything was just like it used to be, and the world like melted away, and he went away, and all the nasty things my mom said went away. And yet another participant spoke about her ability to reclaim normalcy and control by indulging in things that brought her happiness. This was something she had not allowed herself for awhile after she was assaulted: I like food, I like clothes, I like books. Um, and I think that kind of, um, almost like consciously letting myself enjoy things is really helpful to me, and kind of, um, like letting 66 myself be okay, is um, really important because there was awhile where, like, I wanted to just like close up into myself, there wasn’t going to be anything that I liked, I was just going to you know, go to school, and sleep, and maybe eat if I felt like it. Again, indulgence in such things provided this participant with the opportunity to reclaim normalcy and control in her life again. Keeping tabs on the perpetrator. And finally, the fifth most common mechanism for reclaiming normalcy and control was keepings tabs on the perpetrator. This was endorsed by four participants. Keeping tabs on this person allowed participants to take preventative actions to support balance and a sense of normalcy and control in their lives. Participants did this by assessing the likelihood of the perpetrator attending specific parties, avoiding bars or restaurants where the perpetrator usually hangs out, and keeping up with certain aspects of a perpetrator’s life (e.g. whether they were transferring schools or not). One participant spoke about how keeping tabs allowed her to feel as though she were in control of the perpetrator and the effect her had on her: Cause I wanted to know where he was, I wanted to be able to keep him in my box…it’s like a control thing, be able like control what he’s doing in my life. Continuing, she explained that when she did not know a general idea of where the perpetrator was, she felt like: …it was all happening again because I couldn’t tell where he was. Another participant shared: …knowing where he was and what he was doing I think was really healthy for me so that I didn’t have to, like, fall to pieces about it. 67 Reclaiming voice. The next most helpful aspect of the post-assault healing process, according to participants, was reclaiming voice. Reclaiming voice usually was a two-layered process for most mechanisms identified by the participants including (1) constructing feelings about the experience of assault that were in line with each participant’s constellation of gender, sexual orientation, and religion (e.g. embracing the fact that contrary to some religious thought, sexual violence is never something that is deserved), while (2) actively pursuing a post-assault process that supported these feelings (e.g. finding healing through religion that refuted this victim blaming thought and support survivors through the healing process). This participant spoke about her process of incorporating her religious background into her post-assault healing process, even though there were barriers to practicing her religion after she was assaulted (not only because she was assaulted, but also because she began exploring her sexual identity postassault). Her process of reclaiming voice involved her seeking out religious support that directly addressed and overcame these barriers; finding religious support that was tailored to her intersectionalities. The process of reclaiming voice manifested in seven different ways, including artistic outlets for healing (e.g. photography, writing), negotiating religion post-assault (e.g. tension between religion and sexual identity), advocacy and legal pursuits, activist outlets for healing (e.g. the Vagina Monologues), embracing a comprehensive understanding of the experience (e.g. understanding it was not my fault), reclaiming the environment the assault took place in, and open communication of feelings about the assault. Each of these mechanisms is described further below. The pursuance of reclaiming voice may be unique to individuals, but the process of reclaiming voice is a shared experience. Some of the strategies for reclaiming voice were emotional/cognitive (e.g. reclaiming the environment the assault took place in), and some were behavioral (e.g. advocacy). 68 Artistic outlets for healing. The most common mechanism for reclaiming voice involved artistic outlets for healing. These outlets covered a range of activities, and each participant identified at least one of these activities as a means to reclaim voice. All but one participant spoke of at least one of these outlets for reclaiming voice, and explained the helpfulness this brought to the post-assault process. To begin, writing was a common outlet for reclaiming voice post-assault: I think poetry is one of the greatest outlets I’ve ever had… Whatever I felt, I have to write about it first cause it’s a safe place. And then I can talk about, so… Writing poetry, songs, journal entries, blogging, and short stories were discussed by participants as helpful mechanisms for reclaiming voice. Writing, similar to other outlets, was described as an opportunity to gain new perspectives on the assault. One participant shared an experience of writing a poem about how she had been sexual with a woman after she had been raped by a man. Writing this poem helped her gain a new understanding of why she had done so, and helped her clarify her feelings towards the act. Writing was also described as cathartic and expressive, and the fact that it could be private or public was of great utility to participants; some participants spoke about sharing their writing at support groups. Photography was another artistic outlet that was used by one participant to reclaim voice, and gain a new perspective on the assault she had experienced: …for my situation, uh, the, being able to look at things in a different way helped not only think ‘Wow, what happened was scary and wrong,’ but ‘Why did it happen? Does it matter why it happened? Um, wha-, what do you think, what do I think he was thinking? Um, how can I deal with this? How else can I deal with this? How ca-, does somebody else deal with it?’ Um, and, so I guess it was, picture taking is an escape for me, and is a 69 way for me to see beautiful things, and not always have to worry about the dark, scary things. A final artistic outlet was jewelry making, which was described by one participant as an opportunity she found for healing: …healing came for me in beading necklaces, and making jewelry, and making dream catchers .I found peace in that, and I also found peace in, I’m part Native American, um, Chippewa Tribe, I’m from the Sault Ste. Marie. And touching back with like that part of my past, and thinking about nature, and wanting to learn about that and the culture has also really helped me to realize how much my people are still suffering. Um, rape is really high in Native American tribes, and it actually has inspired me I think to now go and work, um, up in the Sault for a little while after I graduate. Negotiating religion post-assault. The next most common mechanism for reclaiming voice was manifested within the process of negotiating religion post-assault. Five participants mentioned the negotiation of religion post-assault. This process of negotiation involved religion intersecting with aspects of participants’ identity (such as tension created between religion and the act of engaging in sexual activity, and tension created between religion and one’s sexual identity), as well as the general process of using religion as an outlet post-assault. All three aspects of negotiating religion post-assault brought challenges to participants’ healing process, and were presented as barriers to healing which were often overcome only with participants’ active and consistent efforts. As such, this process of reclaiming voice was very complex for each participant who negotiated the presence of religion in their lives post-assault. In terms of religion intersecting with participants’ engagement in sexual activities, one participant, whose religious background had a very strong presence in her life, explained that she 70 was afraid to talk to her priest about her increased sexual activity post-assault. She felt shame about having responded to her assault in this way, however, upon speaking with one priest in particular she explained: …he completely got it. He was just like, ‘I’m not gonna judge you, you did what you needed to cope and to live,’ when I told him about like my sexual interactions afterwards. However, this positive support from religious leaders was not a common experience. One participant explained that the church she attended growing up was really supportive and loving, however her current church near campus was not so: …growing up in the Methodist church I was never made to feel shame about sexuality, homosexuality, bisexuality, or, um, just having sex in general, until I came to college…we got a new minister in my [current] church. And, uh, he’s very, um, restrictive, and repressive towards sexuality in general, and has made comments about homosexuality that make me feel uncomfortable and make it feel like my place of worship isn’t safe for me. Two participants who engaged in religion as an outlet post-assault seemed to internalize general oppressive tenets of religious thought specifically related to sexual interactions and sexual orientation. Both of these participants identified as bisexual or Queer, and religion had always had a strong presence in their lives. However, it was overcoming these obstacles presented by religion that created an opportunity for participants to reclaim voice. For instance, one participant explained: I won’t say this outside of this room, but I am a bisexual. Um, you’ll never get me to repeat that. And it’s because of my faith and my identity… Continuing, this participant explained: 71 It was because of God, and I, once again, that makes it tough because I owe my life to him, and yet I still feel that I’m restricted in some ways to healing fully for it…I feel like this amazing being saved me, and loves me so much and that I’m gonna turn my back on him and do something that I’m not supposed to do. This participant also spoke about a great deal of oppression and denial of her identity that came from her family and their strong religious beliefs. However, through the process reclaiming voice, this participant embraced a perspective that God still loved her, and that, despite the oppression she experienced from religion: I know my faith was…one of the greatest parts of my healing. I know that finding God again and going to church, and finding that love and light in my life was, it’s the reason why I’m still here and I didn’t take my own life. Another participant spoke about this process of identifying barriers presented by her religious identity, internalizing this oppression, and then reconstructing her association with religion in a way that provided her the support and religious connection she was looking for. To begin, she explained that: I don’t really feel comfortable or safe to share a lot about my sexuality within the church until it can live its mission of radical love for all people. This participant also explained that: As a Queer, feminist United Methodist woman who was assaulted by a heterosexual man, I feel like I’ve got a dessert plate of identities. It’s tough to pick which one to tackle first, and they don’t all seem to go together. Which do I reconcile, and which do I set aside to deal with later? 72 Despite these challenges, this participant later explained her reconstruction of religion in her life, which suggested that in order to engage in religion in a positive way, she had to embrace those positive aspects that religion presented: You gotta be the church…it’s something we say all the time in campus ministry and it’s something that I feel very strongly about. Furthermore, this participant spoke about the helpfulness provided by her church community, post-assault, despite the barriers to healing that were presented along the way. For both participants, acknowledging the barriers imposed by religion, reconstructing these barriers (and the presence/meaning of religion in their lives), and re-engaging with religion as an outlet was a helpful process of reclaiming voice post-assault. Advocacy and legal pursuits. The third most common mechanism for reclaiming voice involved advocacy and legal pursuits. Two participants spoke about pursuing the legal system post-assault, and both participants explained this process as one in pursuit of reclaiming voice over the assault. Undertaking the legal system was described more in a negative light than a positive light, and as such was mainly described as a significant barrier to reclaiming voice postassault. In reflecting on her engagement with the legal system, one participant explained: I’m happy I did it, but I don’t think it helped me heal. Participants’ experiences with the legal system were described as being full of judgment and humiliation; one participant had photographs of her vagina displayed around the courtroom. Participants explained the unfair aspects of the process, for instance having consistent postponements of court dates with little communication about this to the survivor, completely stopping contact with the survivor during the investigation period of the assault, and providing 73 confusing language that created an unclear understanding of what was actually happening with the case. One participant explained: The court process was awful, it was scary, you get…judged. One participant who had pursued the initial steps of the legal system commented that when she had finally heard back about her case after a long period of no communication: …it was very hypocritical, very bias…I understood the conclusion they came to, but I don’t understand how they came to the conclusion. There was…not even like a violation of sexual harassment. Pursuing the legal system was an effort to reclaim voice, however more so than not, it ended up impeding on participants’ efforts to do so. Nonetheless, bringing the perpetrator to justice through the legal system was motivated by a desire to reclaim voice post-assault. Advocacy was also discussed as an opportunity to reclaim voice over the assault. Advocacy was multifaceted in that it included aspects of participants advocating for themselves, as well as for other survivors. This was often spoken of in a transitional sense, and one that participants moved back and forth on continuously. Three participants spoke about the helpfulness of advocating for themselves and others, and commented on their overwhelmingly positive experiences with SACI, the sexual assault advocacy program on campus. One participant explained: …some of the greatest healing came in helping others through advocacy…I also do SACI, which is um, sexual assault advocacy, which has really helped me heal and allowed me to experience emotions. The SACI program had a positive effect on participants, and demonstrated the helpfulness of advocacy in relation to reclaiming voice post-assault at an individual and 74 collective level. Traditional services, specifically the legal system and advocacy efforts, were part of the process of reclaiming voice for participants Activist outlets for healing. Activist oriented behavior and fostering a survivor community were pursued by all but one participant in an effort to reclaim voice. Such activist behavior included participating in The Vagina Monologues, Take Back the Night, and the Slutwalk, which were described as freeing aspects of the post-assault process. These opportunities for activism created environments where participants were able to be open and active about the issue of sexual violence with other survivors as their allies. This too was described as a process of reclaiming voice, and the connection to the benefits of fostering a survivor community was strong. Activist oriented behavior and fostering a survivor community were really important to participants at an individual and collective level. The benefit of connecting to the survivor community was something that all participants spoke of, even though making this connection happened at different times, and in different ways across participants. Embracing a comprehensive understanding of the experience. The fourth most common mechanism for reclaiming voice involved embracing a comprehensive understanding of the experience. This comprehensive understanding was described in two distinct ways: Understanding fault, and accepting that it was rape. Two participants spoke in depth about how reaching a point of understanding it was not their fault was a pivotal moment in their post-assault process. This aspect of healing is connected to reclaiming voice because these participants expressed feelings of silence and internalized shame prior to coming to understand that the assault they experienced was not their fault. Reaching this point illustrated their process of solidifying their feelings about the assault, and seeking out a healing process that allowed them 75 to embrace this feeling. For one young woman, reaching this point allowed her to genuinely begin the healing process. Understanding she was not at fault held great weight due to her religious background and the religious tenet that you essentially get what you deserve in life. Upon realizing this was not the case and she was not at fault, this participant was able to reclaim her voice, and connect in a new way with her religion throughout her healing process. This was only possible because she came to believe that this barrier to healing imposed by religion was not indicative of the God she believed in. And I needed faith to get through; I thought God had left me. Um, abandoned me that I had deserved it, and it was through going to church and talking to a priest that I realized that I didn’t deserve it… Another participant shared a similar moment of helpfulness when she came to embrace the fact that: No matter what my relationship to the perpetrator looked like, what I said or was wearing, or the fact that it happened right in my own front yard; nothing I did placed the blame on me for being violated. These experiences were often supplemented with the process of accepting that the incident was rape. Upon reaching this point in the post-assault process, participants were better equipped to seek help and pursue healing opportunities. To illustrate the intersectionalities of two women who identified strongly with a religious background, the acceptance that what happened to them was not their fault was noted as an integral aspect of the post-assault healing process. These two women identified as bisexual and Queer. This theme was not shared across the other participants. Reclaiming the environment the assault took place in. The fifth most common mechanism for reclaiming voice was the act of reclaiming the environment in which the assault 76 took place. Reclaiming the environment the assault took place in was a combination of a physical act (e.g. revisiting the house where the assault occurred), and an emotional domination of the assault (e.g. saying out loud that the assault no longer has any power). Four participants spoke about this strategy for reclaiming voice, and explained the helpfulness this brought to the postassault process. This strategy was emotional/cognitive for some, and behavioral for others. For instance, one participant spoke about a ritual she had established for when she finds herself back in the assault setting. This ritual involves her entering the room, verbally proclaiming her anger associated with the assault, taking a few moments to recollect her feelings, and then exiting the room to move on with her day: But I walk back and I’m like ‘Fuck you!’ And then I sit down and I carry on with my day. And like that was really hard the first time, but it helps now. Another participant, who had experienced assault just outside her family home in which she spent her childhood, essentially reclaimed the environment by re-telling the story of this specific setting. This re-telling is something she does privately, to herself, during which she refocuses her attention on positive associations with the setting. This is a physical area that also tied to familial memories and relationships. As such, this participant has re-told the story of that space by focusing on those positive relationships that enter in the space with her, post-assault: Often time I’ll be driving up with my mom or my sister, and um, focusing on the positive, and focusing on the relationship in that immediate vicinity there really helps. Many times, this reclaiming of environment involved the construction of a new narrative for the setting. This new narrative allowed for a purposeful forward motion away from the assault. For example, one participant spoke about her experience of going back to the perpetrator’s house and reclaiming the environment by personally stating her separation from the 77 assault, and again, a leaving behind of the experience of assault associated with a specific environment. There was not a new narrative told in this instance, but rather stating a farewell to the assault setting. And, I was able to kind of, I did go back to his house after it had happened. And been like ‘Ya know what, I’m done with this place, like this place doesn’t matter anymore.’ This participant further explained this action, stating: I did have to go back and be like ‘You don’t have power.’ And like after I let that power go I didn’t really give a shit if he was alive or not. Reclaiming the environment in which the assault took place provided participants with the opportunity to redefine these settings in relation to their own personal narrative, allowing them to regain power over these structures, as well as their post-assault process. This mechanism allowed participants to reclaim voice over the assault. Open communication of feelings about the assault. The final mechanism for reclaiming voice was open communication of feelings about the experience of assault. Open communication was at a private level (open writing about emotions that one was experiencing), as well as a public level (having open conversations with people about the assault; openly expressing feelings at events such as open mic nights). Four participants spoke about this strategy for reclaiming voice, and explained the helpfulness this brought to the post-assault process. This strategy was multifaceted such that it referred to not only the structure of communication (mutually engaged dialogues, active listening), but also the quality of what was shared. Specifically, participants spoke of the need to be open and raw about the feelings they were having, no matter how awful. This was often referred to as a “nakedness of emotions”: 78 I don’t think it’s just nakedness of bodies, but nakedness of emotions. Uh, it was really liberating for me to do this open mic this weekend… Furthermore, this participant explained that at the open mic event: …it felt really good to be raw and real and not sensor myself which is part of why I find profanity is such a nice coping mechanism… I was able to be completely uncovered in terms of my feelings about the issue which is so difficult to do. Open communication as an act of reclaiming voice was important to multiple participants. This communication was between family and friends, as well as with oneself through more private modalities. Whatever the structure, this communication always involved the same qualities, which were open, raw, and honest. Being open about their feelings, and also engaging in open communication with others about their experience, allowed them to reclaim voice by declaring ownership of the impact it has had on their life. Furthermore, participants described such acts as freeing and liberating; a helpful aspect of the post-assault process. Reclaiming voice was a helpful part of the post-assault process for participants. The different strategies elaborated above were used by participants to rebuild a personal narrative that told their story of assault in a new way; in a way that exposed the assault (privately or publicly) as something that made them a survivor and not just a victim. Reclaiming Body. And finally, participants spoke of the helpfulness of reclaiming their bodies post-assault. This manifested in three different ways, including negotiating intimate relationships post-assault (e.g. exploring fluidity of sexual identity, achieving orgasm/being sexual), changing one’s appearance (e.g. tattoos, piercings), and dark coping (e.g. cutting). Reclaiming body involved exercising control over one’s physical body and allowed for manipulation of all things related to the body. Reclaiming one’s body was an experience that at 79 times conflicted with what is generally thought of as healthy aspects of healing. However, even the mechanisms that are described as “dark” provided an essential sense of helpfulness to participants. Mechanisms for reclaiming body varied across participants, but share similarities in meaning and purpose. Reclaiming body was a shared experience across participants. Negotiating intimate relationships post-assault. The most common mechanism for reclaiming body included negotiating intimate relationships post-assault. Specifically, this negotiation of relationships post-assault varied across participants, and involved a lack of intimate relationships, exploring the fluidity of sexual identity, achieving orgasm/being sexual, negotiating the relationship with the perpetrator, and embracing post-assault partners’ response to the assault. These forms of negotiation were identified by four participants and contributed to the process of reclaiming body through intimate relationships post-assault. Exploring the fluidity of sexual identity, and achieving orgasm are described further below. Three participants spoke of their intersection of sexual identity, and exploring the fluidity of sexual orientation post-assault. For one participant in particular, she had embraced the possibility of intimate relationships with women post-assault, and began to accept her identity as a bisexual woman. However, this was not something she publicly defined herself as. Reclaiming her body post-assault involved an increase in sexual activity, and some of these activities were with women. She explained: I was already ashamed of my rape, and these feelings, these uncertainties in sexuality, scared me. This shame was perpetuated by her family’s strong religious background, which very much refused acceptance of homo- or bisexuality. She further explained lesbian…whore…unfaithful. I was just trying to heal but being judged all along. 80 Later, accepting her process of exploring sexual identity post-assault, this participant explained: I wrote a poem about how I had been with a girl after my assault…it was good finally to be able to write that down on a piece of paper that I was with a girl…I know why I did it, and it helped me cope with those feelings cause I had a lot of shame…So, to me, it made complete sense after my assault. That if I was going to be intimate, sometimes I would want that to be with a woman. Because they’re tender, and they understand me, and they would never be able to stick themselves into me the way he was able to, or, they, women don’t have a penis as a weapon. Another participant explained that while she identified as Queer before the assault occurred: I think that my assault also forced me to realize that my sexuality and libido are not constant: they are fluid and fluctuate with my environment and my experiences, and I am much more comfortable and accepting of that now. Achieving orgasm and being sexual was another significant aspect of negotiating intimate relationships and reclaiming body for participants. This included finding comfort with being naked, loving one’s body again, achieving orgasm with another person, and for one participant, putting on her swimsuit and returning to the pool again. In terms of reaching orgasm with another person, one participant explained: …often times it just feels like this unreachable ideal. Like, I just feel so close, and be like, recall my experience, or just, just feel weighted or feel heavy or just unable to, and it feels like I’ll always be unable to. Gaining an acceptance of the impact this had on her body and ability to engage in sexual experiences was helpful for this participant post-assault, who later explained that: 81 I was, um, having sex with the current person I’m seeing and I just had an incident where I just couldn’t deal with it and after that we’ve been taking sort of a sex sabbatical. Reclaiming her body by taking a break from sexual interactions was one way in which this participant negotiated intimate relationships post-assault. Another participant spoke about the challenges imposed by having an orgasm with another person, and explained: I can’t orgasm with someone else, and that’s really frustrating. This participant also spoke about her experience of being forced into giving someone oral sex. She was also able to reclaim her body in the following way: …for a long time I wouldn’t do that, and guys would get upset with me, and they’d be like ‘Why not? It’s like, it’s not a big deal.’ And, um, then I always felt like I had to explain to them, ‘Well I was forced into doing this and it terrified me and it’s traumatized me.’… then, I kind of realized like, I can use this as a means of feeling empowered and important. Um, like…I have someone’s dick in my mouth. Like, I could murder them…that’s just fantastic to me and I’m just like, yes, I am in control of this and I can do this; and screw you! Reclaiming body through the negotiation of intimate relationships was one spoken of in detail, specifically regarding the fluidity of sexual identity, and negotiating ways of accepting the challenges of achieving orgasm and being sexual post-assault. Other participants spoke about the importance of communicating barriers to being sexual with current partners, and shared different strategies for achieving orgasm with others while avoiding situations where they felt they had to engage in sexual activities just to provide pleasure for someone else. Changing one’s appearance. The second most common mechanism of reclaiming body involved changing one’s appearance, specifically through tattoos, piercings, changing one’s hair, 82 and dressing differently. This mechanism for reclaiming body was identified by all participants. Changing one’s appearance was an act of reclaiming one’s body as: …a means of helping me move onto a new part of my life. It was good for me to move past what had happened because I spent a long time dwelling and feeling guilty...[it was] so liberating in so many ways to completely change my appearance. Some participants spoke about the act of getting a tattoo post-assault, and how that was helpful in reclaiming their body, and commemorating the assault they experienced. One participant shared: It was almost like taking it out of what was inside of me, and putting it on the exterior where I could look at it and say like ‘Okay, that happened, um, now what am I gonna do?’ Like I want to take this, and make, and have it, um, make me a better person for it, and help others. Another participant explained: What was most helpful after my sexual assault was my tattoo, a way of making healing my own work of art...in loving myself, I became strong enough to reclaim my body, my life, and my tattoo. The act of getting piercings was described in similar ways related to reclaiming one’s body. Additionally, two participants spoke about the act of cutting all of their hair off postassault, and how this act of reclaiming their body was incredibly helpful, and relieved them of the physical burden of not only the weight of their long hair, but the burden of the assault. One participant explained: 83 …since I cut my hair I personally have been feeling, um, like stronger and freer…I said it was like having this physical burden on myself cause my hair was damn long..I had been carrying it around like as a physical weight. Specifically addressing her act of reclaiming, this participant continued to say: And when I cut my hair it was sort of like I can change who I am, I can change the way that I view things, I can be someone different than I was, and that’s okay for me because that’s the way I needed to be able to cope. At times the act of cutting off one’s hair extended further into gender identity. One participant explained: Post-assault I cut off all of my hair…taking a more masculine role on relationships and cutting off all of my hair but also wearing dresses, and, and performing a more feminine gender identity. Participants also spoke about dressing differently as a way to reclaim their own body. One participant explained: Like I used to wear like t-shirts all the time…but I started wearing more feminine clothes just to kind of be like, ‘I’m going to show that I have feminine features, and you’re gonna like it!’ Changing one’s appearance through tattoos, piercings, and changing one’s hair and dress, all contributed to the act of reclaiming one’s body, and provided participants with a liberating, and helpful, opportunity post-assault. Dark coping. Dark coping was the final strategy for reclaiming body, post-assault, specifically cutting and drinking. Three participants spoke about the act of cutting, and the specific type of helpfulness this act provided. Motivators for cutting included the desire to 84 experience feelings again, after periods of numbness; self punishment for being too emotional; and as one participant explained: For a constant reminder that I’d never let myself put myself in that situation again. The act of cutting gave participants immediate control over their bodies; something that had been taken away from them from the assault. According to one participant, cutting allowed for her to take care of and nurture something back to health. For three participants, cutting was a tangible method of coping. One participant explained: I needed something that I could feel, that was like an int-, and intense something, um, as opposed to just sort of all these surface things. Furthermore, one participant explained that: …cutting is a way of living, it’s a way of allowing yourself to release the pain, and its more so saying I’m trying to get through this. And finally, one participant disclosed: I continued to cut because people would ask me why I do it, and it was very visible when you swim. And, I was like, this is my body. I am going to do with it whatever I please. While the dangers of cutting were recognized by participants, the purpose of the act was still promoted, and explained as a helpful part of the post-assault process in terms of reclaiming one’s body. Drinking was also discussed in the same way by one participant who explained: …last year after the assault happened with my ex-boyfriend I got on this real like binge drinking, like my grades when down the crapper, I was drunk four nights a week. Both acts (cutting and drinking) were described as mechanisms for dark coping by the participants themselves, however both were still acknowledged for the coping purpose they provided. Both acts were defined by the process of reclaiming one’s body post-assault. 85 Reclaiming body was an integral, and helpful, aspect of the post-assault experience. The different mechanisms described above varied across individuals, but all shared the aspect of reclaiming ownership over their body, reclaiming their body’s engagement in sexual activities, and reclaiming their pride, comfort, and love with their own bodies. Reclaiming body provided participants the opportunity to have complete control over their bodies, a power that was perceived as having been taken from them as a result of their assault. Cross-Case Analysis: Research Question 2 The second research question asked: What is needed in the campus-community to better support the diversity of survivors? For this research question participants described a story of institutional support that creates a culture in which sexual violence is viewed as something to be condemned, and establishes a system in which survivors are supported. Two venues for increased institutional support emerged from the data: institutional support creating a proactive environment and institutional support recognizing and acting on the complexity of sexual violence. Participants’ intersectionalities of gender, sexual orientation, and religion often influenced their opinions on how the institution should recognize and act on the complexity of sexual violence; however, regardless of participants’ identities, all agreed on how the institution should be more proactive. The following elaboration demonstrates the different strategies that MSU as an institution needs to focus on in order to achieve increased institutional support in these two areas. Institutional support (IS) creating a proactive environment. Participants spoke most frequently about the need for institutional support in the campus-community, specifically around creating a proactive environment. This included creating a setting that provided consistent environmental support (e.g. validation that the experience was real, widespread understanding of 86 sexual assault) and raising awareness (e.g. through advocacy and activism). Participants spoke of the lack of support within their campus-community, which results in survivors needing to be proactive in order to locate and receive support Consistent environmental support. Most frequently discussed by all participants were the survivor services on campus and the significantly beneficial benefit these provided for healing; however there was much discussion about how outside of these services, survivors were faced with an environment that was not supportive. According to participants, a campuscommunity environment that is consistently supportive (from services, to administration, to student perceptions, to campus policies) is needed to better support the diversity of survivors. Participants reported that the current campus-community does not offer this consistency but rather has pockets of fragmented support. As a result, survivors may utilize certain services and feel supported, but upon exiting these services, survivors are faced with a campus-community that does not validate their experience; instead participants noted that a rape culture is still a dominant aspect of the campus-community. For example, participants spoke about the prevalence of rape jokes that are told in social settings, and how this introduces an added burden to survivors who are not only subjected to hearing these jokes, but are expected to bear the weight of having to take action against such jokes (e.g. calling someone out for telling a rape joke). This was often related to the fact that there still lacks widespread understanding of sexual assault: …people make rape jokes all the time...If I can make it quite clear that it happened to me without saying anything so then they all, so they feel like guilty assholes, I’ll do that. Other times…I’ll ask them what they hope to accomplish for the statement….And so it’s this acceptable thing and like rape culture is such a big deal. 87 Furthermore, according to the participants, the campus-community needs to do a better job of creating safe spaces for survivors, and should consider focusing their efforts beyond campus boundaries (e.g. reaching out to local high schools to support violence prevention programs and establish a reputation of condemning sexual violence on campus). Transforming these aspects of the campus-community would help to create a more proactive environment in which survivors felt supported. According to the participants, addressing the topic of rape culture needs to be supplemented by institutional system support from MSU. Institutional system support from MSU needs improvement in four major areas, including: training for Residential Assistants, service visibility/accessibility, the Sexual Assault and Relationship Violence program, and the Study Abroad program. Training for Residential Assistants. Multiple participants interacted directly with their Residential Assistant (RA) during their reporting of sexual violence, or navigating through the post-assault process. Participants described these interactions as unsupportive, and often quite negative. For instance, one participant explained that she began cutting as a way to cope with her experience of rape. Her roommates reported this to their Residential Assistant, who then requested meetings with this participant to address the issue: And then I had to go to these meetings about how I was a disease and how to fix it. And I don’t think it was intentional, either. I really don’t. She was doing what she thought was best, and that’s why we need education… One participant who was also an RA agreed with other participants’ sentiment that the RA’s could use increased training, especially around sensitivity. She commented mainly on the lack of quality of the minimal sexual assault training that the RA program engages in: 88 I am an RA, and…we actually do training for fellow RA’s um, on sexual assault and how to work with residents and things like that. Um, and it was kind of sad that the people who are to help you, we don’t get training on how to help survivors…so a lot of mentors who haven’t ever heard of SACI, or haven’t gone through any of that were like ‘Oh my God, like how, how do you talk to them? I want to help but I, I don’t know how. Regarding the process that RA’s follow when a sexual assault is reported, this participant commented: Our training is…you have to contact your supervisor and go through a protocol. There is absolutely nothing of, okay, here is how to talk to someone… Service visibility/accessibility. The next area of institutional system support acknowledged by participants as needing improvement related to service visibility and accessibility. This emerged from a discussion about whether the current services on campus supported the diversity of survivors. To this question one participant responded by saying: I don’t know because it’s [services] not talked about enough...I still don’t know about anything else [other services] really. You have to be willing to take the time to do the research [about offered services], and I guess I’ve been okay with what I have, but I don’t know if MSU offers that [a set of services that supports all survivors] or not cause I’ve never seen anything about it...I think that first step is if they do offer that, they need to get it out there more. And if they don’t offer it, then they need to get it... Another participant explained: I didn’t know about anything on campus. One more participant suggested: 89 …visibility of the programs needs to be improved…someone who isn’t involved with so many progressive causes like I am, would have no idea that there’s you know such a wealth of resources… Participants seemed to agree that improving program visibility and accessibility would contribute to a proactive environment where the institution made service seeking a process that did not require so much effort on the survivors’ end. Participants agreed that the lack of program visibility and accessibility was not a fault they ascribed to the services on campus, rather this was the fault of an institutional system that did not fully support these programs, or deem them important to students in the campus-community. The Sexual Assault and Relationship Violence program. The third form of institutional system support that needed improvement was the Sexual Assault and Relationship Violence program. Many participants commented on the fact that the workshop is not mandatory, and many students have figured that out. Making this workshop a mandatory requirement of all students at MSU was strongly supported by the participants. One participant stated: I don’t know anyone who’s been to one of those programs. Another participant explained that the SARV workshops: …are required, that’s how they’re marketed, it’s just people figure out, like ‘Nothing happens to me if I don’t go…There’s no actual bite so perhaps a better, um, goal, would be to actually make it have a bite. Another participant commented that the SARV workshops split attendees up into males and females, and while they allow you to choose which gender identity you feel most comfortable with, there is no conversation about bisexuality. She asked: But if you’re, you’re bisexual, you know, what, what do you do? 90 The Study Abroad program. The final form of institutional system support focuses on the Study Abroad program and one survivor’s narrative in particular: I was sexually assaulted during my Study Abroad experience. My diversity comes from my attack by a stranger in a foreign land, my non-religious identity, and my prior trauma that played into how I responded while abroad. Upon reporting the assault during her Study Abroad experience, the program leader dismissed it completely. She was assaulted again the next day, and not only did she not receive support from the program leader again, both the program leader and her peers assessed the assault as being hilarious, rather than traumatic, responding in the following way: But then when I told the group members I was with…and my…program director, it was ‘Oh you got grabbed? That’s hilarious!’ And like, very much, like ‘Oh, you, you just need to man up, like that’s not a big deal.’ Furthermore, after breaking that barrier and reporting her assault only to have it denied by the program leader, this participant experienced further disservice when she returned home. She shared: …when you come back you do like an exit survey kind of thing to talk about your experience. And they never ask ‘Did you undergo anything? Do you need additional help or services from being there?’…there was absolutely no mention of sexual assault or rape. She was left constantly wondering: What recourse do you have when the program director doesn’t deem it important? 91 As a result, she said that MSU as an institution needs to start asking about sexual violence, specifically through the Study Abroad exit survey. Furthermore, increased training for the Study Abroad program is absolutely necessary: MSU did a major failure in the, the return survey, um, without asking about…any type of trauma so I feel failed by that…because they didn’t have a check…system...MSU, um, did a serious disservice to me, and I don’t know how many other individuals… She continued: …when you have an institution that actually asks…I think a lot can be gained from it. And a lot of people, if asked, will self disclose. Will say ‘I am a survivor,’ or ‘I do need services.’…One of the things I am most excited about with Photovoice is having MSU finally start to ask. Lastly, this participant, after not having received immediate support when the violence occurred, nor having been provided (or assisted with seeking) resources when she returned home, received absolutely no services in relation to the sexual assault she experienced while abroad. Raising awareness. In addition to providing consistent environmental support, all participants explained that creating a proactive environment on campus required raising awareness about the prevalence of sexual violence on college campuses, specifically through advocacy and activism. Participants spoke about advocacy and activism as efforts in which survivors and non-survivors embraced a mission that regularly promoted survivor rights and disseminated information about the survivor experience through two roles: advocates and activists. Participants spoke about possible ways to achieve this, such as a media campaign, working with campus magazines of publications, and incorporating sexual assault into 92 Residential Life programs. Raising awareness was thought to be necessary in order for other people to understand what survivors have experienced, to disseminate accurate information about things like consent and impact, to improve knowledge and communication around issues of sexual violence, to start conversations about issues related to gender and assault (e.g. the impact on the transgendered community), to reduce stigma and eliminate myths about rape, and to demonstrate the reality of this issue to people on campus. Participants noted that one way to raise awareness was through increased efforts to support advocacy and activism. Participants spoke about the benefit of advocacy, and survivors advocating for each other, and how this contributes to raising awareness on campus. They also spoke about the benefit of activism on behalf of survivors, and how activism may encourage non-survivors to become involved, which also would help raise awareness on campus. Infiltrating the campus-community in such a way would help to establish a proactive environment where survivors were supported and not denied when telling their stories or seeking services. This campus should offer more acknowledgment that sexual violence occurs on this campus. Institution support (IS) recognizing and acting on the complexity of sexual violence. Finally, participants also spoke about the need for the institution to recognize and act on the complexity of sexual violence. This included the need for a diversity of outlets for healing for survivors, as well as specialized service development (e.g. addressing the intersection of sexual orientation and sexual assault) in the campus-community. Overall, participants were asking for a more holistic approach to supporting the diversity of survivors in the campus-community. Specialized service development. In terms of recognizing and acting on the complexity of sexual violence, five participants felt it was most important that the institution develop 93 specialized services; these services were thought to be non-existent in the campus-community. According to participants, specialized service development should incorporate how sexual violence intersects with the following facets of survivor identity: sexual orientation, ethnic/racial/cultural identity, gender identity, and religious background. Participants’ whose lives were most influenced by these factors tended to support the need for such service development. For example, participants highlighted the importance of having services that attended to the role of bisexuality in their healing process. One participant, who identified as a bisexual woman, spoke about the perspective held by one of her family members that: …lesbians are lesbians because they have been assaulted. She shared the oppression she felt from this, and how it became a barrier to her healing. However, another participant shared her experience of wanting to be sexually intimate with women only after she had been assaulted. Given the vast range of reactions, sexual identities, and expressions of sexuality, specialized service development addressing these complexities are needed. Another participant, who identifies as Queer, supported such specialized service development, stating that: …the pain that people feel you know relative to their experience, and relative to their…sexuality, and what’s happened to them prior to an assault can make, can make the impact differ. Some participants also spoke about the need for specialized service development addressing the intersection of sexual violence and ethnic/racial/cultural identity. While all participants identified as White, participants acknowledged that survivors from varying racial/ethnic/cultural groups would likely face different barriers to healing than they were facing 94 themselves. Participants acknowledged that language ability and culturally specific norms of communication may present as barriers to survivors from different communities. One participant suggested the creation of a 24/7 chat room for survivors to access in order to disclose assault and engage in the post-assault healing process. Participants agreed that a 24/7 anonymous chat room may reach survivors from communities that are less likely to disclose. Participants also spoke about specialized service development that focused on gender identity, and the need to increase service and supports for male survivors. And finally, specialized service development addressing the intersection of sexual violence and religion was desperately needed. This often coincided with intersection of sexual orientation, as the two participants who identified with a strong religious background identified as Queer and bisexual. One participant shared: …so I think, that while faith, um, should go hand in hand with, with recovery and support, unfortunately so often it does not…clergy, um, in the Methodist church which is my denomination, receives some training on, um, not assault, but awareness of sexual harassment in the workplace, which doesn’t even begin to touch uh, on things that myself and other survivors have felt. She continued to explain: …so a program, um, an informational program, or maybe a panel for the religious advisors association could be beneficial...as well as programs targeted at particular denominations. I think there are definitely ways to integrate faith into healing. Another participant, who had experienced a significant deal of oppression as a result of her sexual orientation and religious background (but who also identified her greatest outlet as religion), stated: 95 I completely agree, and I think we should give resources to church groups on campus about ways that, um, victims usually tend to cope…I needed a place to health through God and religion but a safe place where I wouldn’t be judged either. I needed a place to find the light of God again and to realize that He never stopped carrying me. I found many places that fed my anger towards religion when I ultimately needed it to heal. Continuing, she explained: I guess what I needed from campus that I didn’t get was a place where I could go and have someone who really, could understand God, and talk about God, and not be judgmental at the same time, and not tell me I’d gotten what I deserved, or things along that nature. Another participant also spoke about the benefit that a church community provided for her after she was assaulted, and also spoke about her involvement with the Reconciling Ministries Network, which is: …an initiative that aims to make the church more inclusive for LGBT people. I’ve been volunteering for them for two years, because I don’t feel comfortable or safe to be my authentic self in my faith community until they live out their mission of God’s love for all people, of all walks of life and experiences. This participant spoke about how she tried to speak with one of her ministers about her experiences of assault and sexuality, and she explained: Cause my home church is excellent, then when I’ve explained my experiences to my minister here, um, I mean he said ‘Oh, that’s, that’s awful.’ Um, but really, doesn’t offer support, and when I talk to him about other sexual issues, he’s um, pretty, um, pretty unprogressive and actually a bit oppressive. 96 According to the participants, acknowledging and acting on the complexity of sexual violence through specialized service development in these four areas is needed in the campuscommunity to better support the diversity of survivors. Diversity of outlets. And finally, every participant mentioned the necessity of a diversity of outlets for healing provided by the campus-community. Providing a wide range of services and outlets for survivors was thought to increase the ability for survivors to find their voice. According to the participants, MSU needs to continue to offer the diversity of services that are already provided, but expanding upon this diversity is still needed. Furthermore, offering a diversity of outlets to survivors would allow participants the ability to make choices throughout their post-assault process that are more in line with their specific needs. This approach would acknowledge the diversity of experiences of sexual violence, and the uniqueness of survivors in general. Furthermore, these outlets should not only supply a range of content (e.g. groups that utilized swimming, water skiing, hiking, music, and free settings for survivors to be expressive), but should also offer a range of anonymity. Many participants spoke about the benefit of having services that were anonymous, as well as services that were more public. Some survivors were more connected to anonymous services, while others were more suited for activist oriented ones. Offering this range ensures that all survivors can find their voice in whatever form is best for them. For instance, one participant spoke about how she was well suited for opportunities like the Slut Walk or Vagina Monologues because such settings were more in line with her process of finding voice. This participant explained that many of her survivor friends do not feel connected to those outlets, and prefer to utilize individual therapy instead. One participant explained: ...voice can vary from person to person, but with the right resources and support, every survivor can find their voice. 97 Within-Case Analysis A within-case analysis is provided below to present a thick description of the experience of two participants and to highlight how the intersectionality of sexual orientation, gender, religion, and service utilization at MSU influences these experiences (Patton, 1990). Extreme case sampling was used as these two case studies are best situated to demonstrate these similarities and differences, and also represent two cases that exist on the extreme ends of the responses to both research questions (Bernard, 2006). The first case study represents the experience of a heterosexual survivor who identified as an atheist and had tried to seek services at MSU, but did not receive any. The second case study illustrates the experience of a survivor who identified as Queer with a strong United Methodist religious background and fluid gender identity. See Table 6 below (also in Appendix U) which illustrates the intersectionalities of the participants for each case study. Table 6 Case Study Comparison Table Case Study #1 Case Study #2 Demographics • White • White • Female • Female • Age 21 • Age 20 Intersectionalities • Heterosexual Intersectionalities • Queer • Raised in a Roman • United Methodist Catholic family but religious background identified as an atheist • Was not interested in • Tried to seek services seeking services at MSU at MSU but did not receive any Demographics 98 Table 6 (cont’d) Strategies to Reclaim Normalcy and Control • • Unconditional social support Traditional services Strategies to Reclaim Normalcy and Control • • • • • Strategies to Reclaim Voice • • • Advocacy and legal pursuits Artistic and activist outlets for healing Open communication of feelings about the assault Strategies to Reclaim Voice • • • • • Strategies to Reclaim Body • Change in appearance Strategies to Reclaim Body • • What Is Needed to Create A Proactive Environment What is Needed to Recognize and Act on the Complexity of Sexual Violence • Consistent environmental support Raising awareness Specialized service development Diversity of outlets What Is Needed to Create A Proactive Environment What is Needed to Recognize and Act on the Complexity of Sexual Violence • • • • • • • Unconditional social support Immersing oneself into life’s routines Traditional services Goal setting Keeping tabs on the perpetrator Reclaiming the environment the assault took place in Negotiating religion post-assault Embracing a comprehensive understanding of the assault Artistic and activist outlets for healing Open communication of feelings about the assault Change in appearance Negotiating intimate relationships postassault Consistent environmental support Raising awareness Specialized service development Diversity of outlets A Wordle was created to visually represent the differences and similarities across these two participants. A Wordle is a basic text display tool created by inputting words or phrases into a text box. The words or phrases are then displayed with a creative layout, and the words or 99 phrases that appear in the text box with a higher frequency appear larger. Four Wordles are presented below as two Wordles were created for each of the two participant case studies. One Wordle represents the first-order themes central to the participant (See Figures 3 and 4), while the other Wordle represents the second-order themes central to the participant (See Figures 1 and 2). They are presented next to one another to effectively display some of the similarities and differences across these two survivors. The themes, as well as the similarities and differences that are apparent, in each Wordle will be emphasized below in the written case studies. When examining each Wordle, it is important to pay attention to the text size of the second-order themes presented. Wordles are created by analyzing the frequency with which a word or phrase is used during the creation. Therefore, the themes that were more frequently used for each participant will appear larger. Figure 1. Wordle for Case Study 1. All of the text in this figure is not meant to be read. This figure presents the second-order themes most pertinent to this participant. For interpretation of the references to color in this and all other figures, the reader is referred to the electronic version of this thesis. 100 Figure 2. Wordle for Case Study 2. All of the text in this figure is not meant to be read. This figure presents the second-order themes most pertinent to this participant. Figure 3. Wordle for Case Study 1. All of the text in this figure is not meant to be read. This figure presents the first-order themes most pertinent to this participant. 101 Figure 4. Wordle for Case Study 2. All of the text in this figure is not meant to be read. This figure presents the first-order themes most pertinent to this participant. Within-Case Analysis: Case Study 1 This participant is a 21 year old White, heterosexual female who was raised in a Roman Catholic family but identified as an atheist. She has experienced sexual violence multiple times throughout her life, one of which occurred during her time as a student at MSU. This participant identified as having tried to seek services, but did not receive any. Furthermore, this participant experienced assault during her time on a Study Abroad program. Being in a geographical and cultural location outside of her own had a significant impact on the post-assault process. Below (Figure 5) are the three photographs created by this participant in response to each of the framing questions. 102 Photograph Framing Question FQ1: What is most helpful to someone after they have experienced assault? FQ2: What should the campus-community offer survivors like you? Extra FQ: Thinking about an aspect of your identity or experiences with sexual violence that captures your diversity: (1) What has been an outlet for you based on this aspect of this diversity? (2) What has been a barrier to seeking services or healing based on this aspect of diversity? (3) What should change about the service system to better reflect your diversity? (4) At a more abstract level, in general, how has your diversity interacted with your experience of sexual violence? Figure 5. Photovoice photographs. The figure displays the three photos created by this participant throughout the Photovoice project As Figure 1 illustrates above, reclaiming normalcy and control was most helpful postassault for this participant. She also strongly believes that a proactive environment is needed in the campus-community to support the diversity of survivors of sexual violence (See Figure 1). Reclaiming normalcy and control. For this participant, reclaiming normalcy and control was focused around the theme of unconditional social support, and how a lack of this support created a barrier to her reclaiming normalcy and control post-assault. When assault occurred 103 during this woman’s study abroad, the immediate unsupportive response she received significantly impacted her healing, her post-assault process, and her return to the states. Her program director dismissed the assault when she disclosed her experience, and her peers showed no empathy or support either. Unconditional social support that was non-judgmental and more concerned about helping and less concerned about knowing the details of the assault was very important for this participant. Immediately following the assault that took place while this woman was a student at MSU, she shared that her study abroad peers did not assess it as anything serious, and suggested she was being a “downer” on the trip after it occurred. She described the reaction of her peers and program director as “demeaning, just, nullifying,” specifically because this experience was brining up feelings related to her previous assault. Upon returning to the states it was hard to know what to seek services for due to the lack of support from the program director. And finally, unconditional social support from her community of friends was a very beneficial part of this woman’s post-assault healing process, specifically upon returning home to the states. Reclaiming voice. Reclaiming voice was helpful for this participant post-assault, and took the form of writing and blogging about her experiences, and fostering and engaging in the survivor community. This participant spoke about the helpfulness of blogging post-assault, and described it as a way of “breaking the silence” for her. This was especially helpful for this participant as she did not have access to immediate resources because the assault occurred while she was overseas. Another mechanism to reclaim voice for this participant was fostering and engaging in the survivor community when she returned back to MSU; for instance, joining SACI. The assault this woman experienced while abroad was not addressed whatsoever by her program director, and she was in a position in which she did not receive any support from her 104 mentor or peers, which resulted in a lack of service/tangible support immediately following the assault. Therefore, fostering this community upon returning home was very helpful as she was not sure what was appropriate to ask for at that time in terms of services or help: Whereas coming back from India it’s like the, that weird negotiation of what I felt was acceptable to ask for help for. Reclaiming body. This participant also spoke of the helpfulness of reclaiming her body post-assault through physical change; specifically a tattoo she has on her foot to commemorate the first assault she experienced when she was much younger. Getting this tattoo, she said, “was liberating.” She also spoke of the tattoo as a reminder of what happened, and a motivator for what is to be done about it. IS Creating a proactive environment. This participant spoke of the need for more consistent environmental support throughout the campus-community. This involved eliminating rape culture on campus, promoting greater understanding of sexual assault, and most important for this participant, increasing institutional system support from MSU. The latter included increased training for RA’s around sexual assault and the provision that SARV workshops become mandatory for incoming students. In terms of making these workshops mandatory, she suggested: saying like, ‘Okay, we’re gonna charge you if you don’t go because we pay money to these people so maybe saying like if you don’t go your charged X amount of money, or you can’t enroll until you attend a session unless you have a viable reason. Most importantly, this participant spoke of the need for improvement within the Study Abroad program at MSU. including increasing sensitivity of program directors to assault charges and an inclusion of questions about assault in the re-entry survey. 105 IS Recognizing and acting on the complexity of sexual violence. According to this participant, specialized service development that acknowledges survivors racial, cultural, and ethnic identities was needed in the campus-community, as well as services that support male survivors. This participant highlighted the importance of campus-community services incorporating a holistic approach to better understand the way assault is being interpreted by each individual within the context of their own lives. Within-Case Analysis: Case Study 2 This participant is a 20 year old White female who identifies as Queer, but does not like to compartmentalize her sexual identity. She strongly identifies with her United Methodist background, and at the beginning of the study, this participant had experienced sexual violence once during her time as an MSU student or no more than two years prior to enrolling. This participant was not interested in seeking services at MSU. Below (Figure 6) are the three photographs created by this participant in response to each of the framing questions. 106 Photograph Framing Question FQ1: What is most helpful to someone after they have experienced assault? FQ2: What should the campus-community offer survivors like you? Extra FQ: Thinking about an aspect of your identity or experiences with sexual violence that captures your diversity: (1) What has been an outlet for you based on this aspect of this diversity? (2) What has been a barrier to seeking services or healing based on this aspect of diversity? (3) What should change about the service system to better reflect your diversity? (4) At a more abstract level, in general, how has your diversity interacted with your experience of sexual violence? Figure 6. Photovoice photographs. The figure displays the three photos created by this participant throughout the Photovoice project As Figure 2 illustrates above, reclaiming voice was most helpful post-assault for this participant. She, like the participant described in the first case study, also strongly believes that a 107 proactive environment is needed in the campus-community to support the diversity of survivors of sexual violence (See Figure 2). Reclaiming normalcy and control. For this participant, the use of medication was an aspect of her process of reclaiming normalcy and control post-assault. She spoke about the helpfulness of medication, however, she also acknowledged the “love-hate affair” she has with it. For this participant, medication was perceived as a necessary component to her post-assault healing process: I need to reach equilibrium again and then someday, I guess that is a goal, to get, to get off the meds at some point when I feel that I’ve, I’ve made peace and I’m strong enough to deal with, with my anxiety, and with my compulsive goal setting. The use of medication was shared across all four participants who identified as Queer, bisexual, or Questioning or Exploring. For this participant, reclaiming normalcy and control was also focused around her increased involvement and commitment to school, and other positions of leadership. Reclaiming voice. Activist oriented behavior (e.g. open mic events for survivors, Take back the Night, and the Vagina Monologues) and fostering the survivor community were helpful in reclaiming voice for this participant; although such mechanisms for reclaiming voice were not pursued until a couple years after the assault. Reclaiming voice for this woman also involved reaching a point where she understood that this experience of sexual violence was not her fault. This participant noted this as a significant part of the post-assault healing process. She shared: No matter what my relationship to the perpetrator looked liked, what I said or was wearing, or the fact that it happened right in my own front yard: nothing I did placed the blame on me for being violated. 108 Accepting the fact that the violence she experienced was not her fault was something shared only by the other participant in the study who identified as bisexual with a strong religious identity. For this participant, religion was a central part of her life. Negotiating her religious identity played a role in reclaiming voice post-assault. She shared: Growing up in the Methodist church I was never made to feel shame about sexuality, homosexuality, bisexuality, or, um, just having sex in general, until I came to college. Upon coming to college and joining a new church, this participant began to feel the impact of faith on her sexuality, and her identity as a survivor. Her minister was described as oppressive and restrictive towards sexuality and made her feel as though her “worship was not a safe place.” Prior to coming to joining her new church, religion had always been a positive outlet for this woman, however she shared that she did not feel comfortable to be open about her sexuality until “the Church can live its mission of radical love for all people.” Religion, however, did play an integral part in the healing process, specifically engaging and utilizing her church community. She explained “You gotta be the Church,” meaning you have to get out of it what you want. This participant also spoke about her conflicting identities and their impact on the postassault healing process. This quote illustrates her intersectionalities well, specifically in relation to the assault she experienced. She shared that she is: …uniquely situated in that I have kind of conflicting identities in that I work for the church, and I’m, I’m like a legacy member of the United Methodist Church, my family’s been going to the same Church since Calvin Coolidge was president. Um, but I, also, um, I don’t compartmentalize my sexual identity. Uh, and I’ve been with women before. So, these two identities in relation to my assault conflict, and, and problemtatize it and make 109 it more complicated and made, um, coping with it and talking with people that surround me and all their various identities, um, really, really provide different perspectives, but also, also make it difficult to, to reconcile. Um, and, and difficult to find, fund a place and find a spot for me as survivor. And, and as a Christ follower. Reclaiming body. For this participant, changing her appearance post-assault was helpful. This involved performing a more feminine gender role in terms of her dress, but also cutting her hair off in “self-deprecatory rage.” These changes were also supplemented by taking on a more “masculine role in relationships.” This participant noted that post-assault she “shifted some of her sexual focus to women.” This helped her realize that “sexuality and libido are not constant.” However, achieving orgasm and being sexual presented a challenge for this woman, post-assault. She explained that: Often times it just feels like this unreachable ideal. Like, I’m just feel so close, and be like, recall my experience, or just, just feel weighted or feel heavy or just unable to, and it feels like I’ll always be unable to….that can be really, um, distressing…really weigh heavy on you…The feeling this one experience you’ve had is, you know, has left an indelible impact on your sexual life. IS Creating a proactive environment. This participant spoke about the need for more consistent environmental support throughout the campus-community. This involved eliminating rape culture on campus, and promoting greater understanding of sexual assault. This participant also spoke about the need for increased system support from MSU as an institution, beginning with efforts to increase the visibility of available resources on campus. 110 IS Recognizing and acting on the complexity of sexual violence. This woman spoke about the need to offer survivors a diversity of outlets for healing, as well as specialized services. According to this participant: …the pain people feel you know relative to their experience, and relative to their, to their sexuality, and what’s happened to them prior to an assault can make, can make the impact of it differ. In terms of services and sexual identity, this participant brought up the fact that the SARV workshops provided participants with the ability to choose the gender they most closely identify with before splitting the group for the seminar. While she found this to be a good idea, she also pointed out “But if you’re, you’re bisexual, you know, what do you do?” Improvement in the SARV workshops around sexual orientation needs to be focused on. Finally, this participant focused on bringing religion into service development, suggesting that faith and recovery/support should go hand in hand. She suggested panels for religious leaders on campus to attend for sexual assault training, training of clergy members, public lectures for which religious leaders could attend, and simply establishing religious settings in which recovery and faith do go hand in hand, and individuals can establish a community where it is acceptable to share openly about assault and/or sexual identity. Trustworthiness of Data To increase the trustworthiness of the data, multiple member checks were completed by the participants throughout the study (Creswell, 2007). This took place during the participatory data analysis stage when participants were establishing the first set of themes to represent the data. Additionally, participants examined the final codes and verified that the final coding framework (first- and second-order themes) represented their stories, as well as the other stories 111 that emerged from the study. Lastly, the results were iteratively visited by the author’s committee chair who provided feedback on data interpretation. 112 DISCUSSION Overview The current study was interested in two main questions related to the diversity of survivors of sexual violence in the MSU campus-community. The first question focused on what was most helpful post-assault to a diverse group of students on the MSU campus who identified as survivors of sexual violence. Findings suggested that processes of reclaiming normalcy and control, voice, and body were most helpful for survivors post-assault. In order for the service system to better support the diversity of survivors it is important that these helpful post-assault processes be incorporated into regular service development and delivery. Not only should specific mechanisms for reclaiming normalcy and control, voice, and body be included in service delivery, but the acknowledgment of these three healing venues also needs to be brought to the forefront of resource development and the post-assault healing process. Many of the findings from this study are consistent with what is found in the literature concerning sexual violence (Connors, 1996a; Postmus, Severson, Berry, & Ah Yoo, 2009); however, some unique contributions were made through this Photovoice project. Specifically, the barriers and facilitators to healing that were provided simultaneously by specific mechanisms for healing. For example, prescribed medication was identified as such for survivors who identified as Queer, bisexual, or Questioning or Exploring as well as religion for two participants who identified as Queer or bisexual with a strong religious background. Both prescribed medication and religion presented concurrent barriers and facilitators to healing. Furthermore, these same participants spoke about the experience of self-blame early on in the 113 healing process, and how reaching a point of embracing that the assault was not their fault was an integral point in their healing processes. While this is a process that is noted in the literature, the author believes it was uniquely presented to these participants as both were also negotiating similar feelings of discomfort or guilt in terms of their sexual orientation and religion. Using the Photovoice method to explore the experience of sexual violence in this project allowed for increased opportunities to understand the participants’ post-assault healing processes. For example, as can be seen throughout the data, participants all identified aspects of reclaiming normalcy and control. These mechanisms for reclaiming often appeared different (e.g. swimming versus prescribed medication), but provided similar utility for participants. Being that there was this disconnect across some of the participants, the Photovoice process allowed for survivors to share their mechanisms for reclaiming in multifaceted ways (e.g. through photos, written narratives, oral narratives, and group conversation). Having this approach to data collection allowed for not only a deeper understanding for these reclaiming process, but also shed light on similarities and differences across participants. If the data collection process was more static, for instance a one-shot focus group, similarities in the utility of these seemingly different processes may not have emerged. Mechanisms to reclaim normalcy and control that could be incorporated into the service system for survivors of sexual violence include the continued traditional services such as therapy, counseling, and, when necessary, recommendations for medical treatment such as prescribed medications; support groups that discuss the reaction of survivors wanting to keep tabs on their perpetrator, how to negotiate this process safely, and why it is important for some survivors to engage in this behavior; support groups that discuss the helpfulness of unconditional social support and how to seek this out if it is not already provided in one’s life; study groups for 114 survivors; and support groups that focus on the benefits of re-immersing oneself into regular life patterns post-assault. Mechanisms to reclaim voice that could be incorporated into the service system for survivors of sexual violence include outlets that allow more for the release of raw and honest feelings about the assault that one has experienced (anonymously, publicly, in an activist oriented way); continued efforts to increase advocacy and legal support for survivors; support groups or survivor led interest groups for those survivors who are incorporating religion into their post-assault healing process (this could also be done through partnerships with religious leaders in the campus-community); increased services that incorporate artistic or activist outlets, for example, a writing or photography group; and support groups that directly address the process of reclaiming the environment in which the assault took place and understanding that rape is never the fault of the survivor. And finally, mechanisms to reclaim body that could be incorporated into the service system for survivors of sexual violence include support groups, or even workshops, that focus on how to negotiate intimate relationships after one has experienced sexual violence; support groups that are focused on the motivators for and processes of dark coping; and groups that focus on, and maybe even encourage, the process of changing one’s appearance post-assault. While this may be a challenge, given the endorsement of tattoos and piercing post-assault, it could be possible to set up funds (or partnerships with local tattoo artists) for survivors who want to get a tattoo post-assault as financial cost was identified as a barrier to doing so. While previous research has identified the importance of reclaiming (Connors, 1996a), this study adds to the field by identifying three routes for reclaiming post-assault, and highlighting how different female survivors sought different venues of and mechanisms for 115 reclaiming. One form of reclaiming that emerged in this study was the importance of religion as a healing venue. Prior researchers have also found that religion and/or spirituality is an important component to incorporate into the healing process (Frazier, Tashiro, Berman, Steger, & Long, 2004; Postmus, et al., 2009) Additionally, the need for survivor allies to address, and accept, instances of dark coping emerged from the current study, and is supported throughout the literature as well. It is suggested in the literature that therapists who are working with survivors who are engaging in self injurious behaviors embrace open communication about such dark mechanisms for coping. Furthermore, therapists are encouraged to recommend art or other expressive modalities as alternative outlets for harmful behaviors (Connors, 1996b). Offering outlets for survivors to obtain tattoos or piercings, however, has not been found in the literature. The second question focused on what was needed in the campus-community to better support the diversity of survivors of sexual violence. Findings suggested that institutional support was most needed in the campus-community; specifically the MSU institution needs to create a more proactive environment, as well as one that recognizes and acts on the complexity of sexual violence. Creating a more proactive environment is an especially large endeavor that entails an entirely transformative approach to which sexual violence is currently addressed among college campuses. Survivors are expected to be proactive in reporting, seeking services, seeking justice and judicial processes, and navigating these systems relatively on their own. Establishing a system that is proactive in how it addresses sexual violence would be an drastically different approach. Opportunities to close both of these gaps in institutional support are outlined below; however, overall, the institution needs to begin responding to sexual violence in a way that demonstrates that it is a punishable act, while at the same time providing individuals with the services and supports they need to progress from victim to survivor. 116 In order to create a more proactive environment, the institution needs to focus on raising awareness, possibly through effective media campaigns or by supporting activist efforts that address the issue of sexual violence; as well as providing consistent environmental support throughout the campus-community. In other words, support services such as the Sexual Assault Program, while endorsed as beneficial post-assault, are not enough as survivors are then expected to leave the Sexual Assault Program only to be faced with rape culture, a lack of understanding/knowledge about sexual violence throughout campus, and an institution that does not provide a consistent message that supports survivors. Specifically, increased training within the Study Abroad program and the Residential Assistant program is needed. Furthermore, the institution needs to better support those existing services that have a positive impact on survivors (e.g. the Counseling Center and the Sexual Assault Program), and the Sexual Assault and Relationship Violence (SARV) workshops need to be mandatory, with a punishment when students do not attend. While these aspects of increasing institutional support are included in the requirements laid out by Title IX, specifically through the Dear Colleague Letter (2010), they have not been fully adopted by the campus-community. Furthermore, advocates, counselors, and survivors have expressed a great deal of dissatisfaction with the Title IX requirements as they may present danger to the survivor and could significantly impede upon an empowering healing process postassault. Little research exists on how institutions need to begin truly adopting these requirements to better support survivors of sexual violence at an institutional level. In terms of recognizing and acting on the complexity of sexual violence, the institution needs to prioritize the importance of offering a diversity of outlets for survivors so as to reach more individuals, and provide more students with opportunities to find their voice and their 117 unique route to healing. Additionally, MSU needs to incorporate religious outlets into the service system for survivors of sexual violence, as well as services that are tailored to address the influence that sexual orientation may have on the experience of assault, or the influence the experience of assault may have on one’s sexual orientation. In addition to answering these two research question, this project intended to understand the varying experiences among survivors on campus in order to better assess the level of support already provided by the campus-community to the diversity of survivors. Findings suggest a few things related to this question. To begin, many participants said they really did not know whether MSU supports the diversity of survivors. One woman in particular explained that because of her intersectionalities as a Queer, United Methodist woman who was sexually assaulted, she often times feels quite alone and is unsure of how MSU could even begin to address her unique location as a survivor of sexual violence. Many other participants said that the support for the diversity of survivors might exist in the campus-community, but that it is such a challenge to learn about the services because it often requires a lot of work from the survivor herself. However, services such as the Sexual Assault Program and Counseling Center received significantly positive feedback from those participants who utilized these resources. Other aspects of the campus-community that received positive feedback included the Vagina Monologues, Take Back the Night, and the Slut Walk. As of recently, however, the Sexual Assault Program has been experiencing many barriers to providing services to survivors, which has resulted in a wait list for many individuals who are trying to seek services there. In response to this, participants were adamant that MSU as an institution is at fault for not provided further support to this essential program. Overall, it was clear that these services (e.g. the Sexual Assault 118 Program on campus), were beneficial, and that the problems with the service system did not exist within such programs. Rather, the problems were identified at the institutional level. In taking an intersectionality approach, the contextually informed response system would incorporate non-traditional services (such as those mentioned above) into their regular service programming to reach a wider group of survivors whose needs may not be reflected as frequently in the literature or the current system. Building Upon the Research Base The current study expands upon what is found in the literature, and provides a few unique contributions to the research on intersectionality and sexual violence. To begin, the results of the current study are reflected in the literature, specifically in the way of support for the helpfulness of open communication and expression about sexual violence. One study worth referencing looked at post-assault behavior and how this behavior was related to reported positive life changes. Frazier, Tashiro, Berman, Steger, and Long (2004) found that social support and “approach-oriented coping strategies...such as…expressing emotions” (p. 27) resulted in survivors reporting more positive life changes post-assault. Both of these findings were reflected in the current study, as according to participants, unconditional social support and open communication of feelings were both helpful aspects that allowed for the processes of reclaiming normalcy and control and reclaiming voice, respectively. Furthermore, Frazier and colleagues (2004) reported that participants who “rely on their religious faith to cope also report more positive life changes…” (p. 27). Again, this is in line with the processes of negotiating religion post-assault that were found within the current study. The process of reclaiming normalcy and control was identified as most helpful postassault, according to participants in the current study. Similarly, Postmus and colleagues (2009) 119 demonstrated in a separate study that “tangible supports” (p. 865) were found to be most helpful to survivors. These tangible supports included food, housing, and financial assistance, and seem to present similarly to the process of reclaiming normalcy and control in one’s life. While mechanisms for the process of reclaiming normalcy and control differ across the two studies (food, housing, financial assistance; versus schoolwork, therapy, and taking on leadership positions), they seem to contribute to the same post-assault healing process of reclaiming a sense of normalcy and control throughout one’s daily life. The current study may reflect the nuances of what it means to reclaim normalcy and normalcy among survivors from a younger, far more privileged, cohort, rather than survivors from the older, less privileged cohort represented in the comparison study. Postmus and colleagues (2009) also described the importance of religious or spiritual counseling as a theme that emerged in their study, such that religious or spiritual counseling was one of the “top 10 services reported as being most helpful” (p. 861). Again, this finding was congruent with the current study. However, the current study also contributes to this theme such that participants who identified closely with this outlet for coping and healing experienced a unique process of pursuing religious outlets due to their sexual orientation. Further research is needed to explore the distinctive ways that religion may present simultaneously as a barrier and a facilitator to healing for survivors of sexual violence. Finally, Postmus and colleages (2009) explained that emotional support from family members and/or friends was reported by survivors as among the top ten most readily available services. This was not necessarily reflected in the current study, as many participants reported genuine, non-judgmental support was often quite hard to come by. Furthermore, according to Postmus (2009) and colleagues emotional support, though it was identified as easily obtained, 120 was not identified among the more helpful sources of support post-assault; nor was legal support. This was similarly reflected in the current study such that familial/friend support often presented barriers to healing as it tended to be laden with judgment, and the legal process was identified as a direct barrier to healing. Finally, the current study discussed the influence that social reactions in the campuscommunity had on their experience of sexual violence. Rape culture was discussed throughout the data, and was said to be a hindrance on healing. This is reflected in the literature, specifically in one study that assessed the impact that social reactions have on the post-assault healing process. This study found that negative social reactions such as blaming the victim or invalidating the experience were found to significantly impede upon the healing process (R. Campbell, Ahrens, Sefl, Wasco, & Barnes, 2001). While much of the results that emerged from the current study are reflected in the literature, some unique contributions are made. To begin, the helpfulness of tattoos and piercings for survivors of sexual violence is not discussed in the existing literature. This unique aspect of healing should be considered more seriously as a positive aspect of the healing process. Furthermore, the current study contributes to the intersectionality literature in that it demonstrates the way in which survivor narratives and post-assault experiences vary, and how these variations may be related to the constellation of different aspects of survivors’ identities. Specifically, the use of prescribed medication was only integrated into the post-assault healing processes of survivors who identified as bisexual, Queer, or Questioning or Exploring, and religion was unique situated for bisexual and Queer participants who identified the co-existence of barriers and facilitators to healing linked to their religious identity. Implications for Practitioners and Researchers 121 Survivor diversity in terms of the intersectionalities of sexual orientation, and religion is represented in the current study and the findings that emerged. The data represents the unique influences that these factors may have on the survivor experience in terms of manifestation of the assault, post-assault healing processes, and post-assault needs. Future researchers should consider replicating this study to gain a more in-depth understanding of the post-assault needs of distinct groups of survivors, such as those who identify as lesbian, bisexual, Queer, or Questioning or Exploring. Conducting a study with such a sample would expand on the findings of the current study as it would provide a more detailed exploration of the experience of survivors from sexual orientation minority groups. This same replication could occur with survivors representing different religious backgrounds (e.g. recruiting the same group as mentioned above, but limiting it to lesbian, bisexual, Queer, or Questioning or Exploring survivors who identify with a strong religious background). Such a study would provide an even further expansion on the current findings, and would contribute significantly to the intersectionality literature. Some questions still need to be asked, however. To begin, only one survivor from a racial minority group responded to the recruitment fliers. Additionally, when working with the services on campus to try and increase the sample diversity to be more inclusive of racial minorities, many program staff explained that this was a problem they too were often challenged by. The question still remains, then, are the needs of survivors from racial minority groups being met? It seems as though they clearly are not. How can we better address these needs within the college campus-community/experience? Is the current service system ill-equipped to address such needs, resulting in a lack of representation from such communities? 122 Researchers and practitioners must continue to pursue the issue of sexual violence on college campuses as it can no longer be pushed aside when it is happening at such profound rates. As mentioned previously, the Sexual Assault Program on campus is currently facing challenges in terms of providing services to survivors. Due to a lack of support from the institution and decreased capacity, there is currently a wait list to receive services from the Sexual Assault Program. This wait list is not short, and individuals have been placed on the wait list for one to four weeks. Given the high rates of sexual violence on college campuses (Fisher, et al., 2000), such issues need to receive continued and consistent attention. Furthermore, findings suggest systematic transformations at the systems level, similar to what is needed in the Sexual Assault Program mentioned above. For instance, increased training for Residential Assistants and Study Abroad program staff emerged from the data as a need in the campus-community. Such training opportunities have begun to be explored as a result of the preliminary dissemination of findings through the digital story viewing event. However, are training programs of sufficient potency? In terms of the Study Abroad program, it may be the case that increased training happens alongside the creation of international partnerships that are created by MSU in order for students to access service systems during their time abroad, if they so choose. While increased training seems necessary for these two programs, there is also the underlying need for this to happen in conjunction with an overhaul of the current way in which survivors are treated in the campus-community; establishing a more proactive environment. Study Limitations A few limitations were apparent in the current study. To begin, a small sample was recruited to learn about the diversity of survivors on campus, specifically when considering the potential size of the survivor community on campus. A larger, more diverse sample would 123 provide more insight into what it means to build a contextually informed response system to sexual violence. Such a sample should focus on recruiting specified groups, for instance, racial minority survivors (possibly breaking these down further into specific racial minority groups). For each group, recruiting approximately 6-8 participants would be appropriate. Having multiple groups that focus on diversity from different perspectives (racial/ethnic identity, sexual orientation) could help provide a better understanding of the diversity of survivors and survivor experiences by capturing multiple voices from these communities, and providing a safe and homogenous environment for participants to share their experiences. The diversity among survivors on campus may not actually be represented in this current study due to the fact that a small subset of survivors voluntarily agreed to participate; this sample was essentially a convenience sample. Increasing diversity through recruitment methods posed challenges to the current study. Future studies may focus on increasing diversity in the following ways. As mentioned above, it may be important to explore survivor diversity through homogenous groups that represent the diverse communities of interest; for example, recruiting a group of survivors all from the same racial/ethnic community (e.g African-American), recruiting a group of survivors who all identify as lesbian women, recruiting a group of all male survivors, or recruiting a group of racial minority male survivors. Not only would the homogeneity provide a better sense of safety to participants, it would also provide a more in-depth look into the community narratives unique to such groups. Having a mixed group with one representative from each of the communities listed above would cause an over reliance on each individual to accurately reflect that community’s experience. 124 When recruiting such survivor groups, it would be important to partner with one or two individuals who are a part of each community. Not only would they be able to offer insight into specific recruitment methods that would be most appropriate (the use of fliers, the use of social media), they would also be able to access these communities as an insider. Furthermore, the presence of such partners could possibly be perceived as increased safety and support by those individuals who were thinking about volunteering. Another limitation to the current study involves the uniqueness of the Photovoice method, and how that may be better suited for some survivors and not others. This may present a selection bias in the sample such that those who volunteered for the study may be more adept at sharing their experiences through the specifics of the Photovoice method. Furthermore, participants discussed that they each were in very specific stages of healing that enabled them to participate in such an intimate study. For some, their participation could not have been possible if the study had taken place six months prior, for example. As such, a Photovoice project regarding sexual violence seems to target survivors who are at a certain step in the post-assault process, thereby limiting the number of individuals who are available to engage in this project. While it is important to find ways to reach out to the survivors who avoided this project, it is also important to speak with survivors who are at this place in healing, and who may feel comfortable making specific recommendations regarding the campus-community and its efforts towards sexual violence. To examine these possible biases further, the author has referenced the literature to assess similarities and differences found across other studies. Linking the findings back to the literature may help to understand if the findings are (1) similar to what is supported by other scholarly 125 work, (2) a truly unique contribution to the literature, or (3) are the result of a biased sample that is not reflective of the community of survivors of sexual violence. Dissemination of Findings The results of the study will be shared with the collaborating coalition, Violence Free Communities by Design (VFC), as well as various programs throughout campus that have been identified as needing increased training around the issue of sexual violence. Efforts will be made to share the results with the MSU Administration, University President, and other policy makers on campus in order to work towards building a contextually informed response system to sexual violence. Increased training related to sexual violence with the Study Abroad program and Residential Assistant program will be pursued and specialized service development focusing on religion, racial/ethnic/cultural identity, sexual orientation, and gender identity will also be shared with program developers in the campus-community. The author and participants have already coordinated two viewing events on campus for the digital story. Both events were emotionally charged, powerful, and successful in recruiting audience members. Across both events, audience members included students, faculty, service staff, program volunteers, and campus administration. All responses to the digital story were positive not only from the audience members, but from the participants as well. Additionally, some participants spoke at these events about how beneficial this project was to their healing process. To better assess this impact, interviews with the participants may be planned. Given the benefit that participants’ expressed as a result of participating in the current project, researchers should consider using the Photovoice method and the use of digital stories in future studies. Such 126 an approach to the research process may have empowering impacts on participants and communities. The digital story was requested by some programs to use for increased staff training, and the Sexual Assault Program plans to use the digital story as part of their service delivery as well. Other programs in the surrounding community have also requested the use of the digital story in for their service development and outreach initiatives. 127 CONCLUSION Reclaiming normalcy and control, voice, and body were identified by a diverse group of survivors of sexual violence in the MSU campus-community. Furthermore, these survivors addressed the need for increased institutional support that creates a proactive environment and acknowledges the complexity of sexual violence. These survivors represented the unique intersectionalities of gender, sexual orientation, and religion, and how such intersectionalities influence the experience of sexual violence. Future studies should expand on the topic of survivor diversity, specifically in terms of racial and ethnic diversity among survivors. Furthermore, it is important to learn more about the unique narratives of survivors from the community represented here. Specifically, the experience of female survivors who embrace a religious background, and identify as lesbian, bisexual, Queer, or Questioning or Exploring. Increased interest in using the Photovoice method with the survivor community on campus has been expressed by the participants, as well as staff from various programs that are connected to the survivor community. Specifically, future Photovoice projects on the MSU campus may focus on accessing an even deeper understanding of survivor diversity, and may be entirely survivor driven. Conversations about how to implement this project as part of annual campus programming have occurred. Using such an innovative and intimate method to learn about the experience of sexual violence is challenging, but rewarding, and may continue to provide not only an in-depth understanding of the survivor experience, but also a first-hand evaluation of the current services and initiatives that are striving to end sexual violence in campus-communities. 128 APPENDICES 129 Appendix A: Project Calendar Project Step IRB Approval Recruitment Meeting#1:PhotovoiceTraining and Consent Process Meeting #2: Photovoice Session (Framing Question #1) Meeting #3: Photovoice Session (Framing Question #2) Meeting #4: Photovoice Session (Framing Question #3 – Created by Participants) & Participatory Data Analysis Digital Story Creation Digital Story Viewing Events Time Duration N/A 4 weeks N/A Date Week of 2/20/2012 2/29-3/28 4/2/2012 N/A 4/9/2012 N/A 4/16/2012 N/A 4/30/2012 N/A N/A Summer/Fall Summer/Fall 130 Appendix B Table 1 Lifetime Prevalence of Sexual Violence by Race/Ethnicity According to Black et al. 2011 Hispanic Hispanic (%) Non-Hispanic Black (%) White (%) Asian or Pacific Islander (%) American Indian or Alaska Native (%) Multiracial (%) Women Rape 14.6 22.0 18.8 * 26.9 33.5 Other sexual 36.1 violence Men 41.0 47.6 29.5 49.0 58.0 * 1.7 * * * 22.6 21.5 15.7 20.1 31.6 Rape * Other sexual 26.2 violence *Estimate is not reported; relative standard error > 30% of cell size ≤ 20. 131 Appendix C Table 2 Impact of Sexual Violence as Reported by the National Sexual Violence Resource Center (2010a) Impact Domain Emotional reactions Psychological reactions Physical reactions Examples • Guilt, shame, self blame • Embarrassment • Fear, distrust • Sadness • Vulnerability • Isolation • Lack of control • Anger • Numbness • Confusion • Shock, disbelief • Denial • Nightmares • Flashbacks • Depression • Difficulty concentrating • Post Traumatic Stress Disorder • Anxiety • Eating disorders • Substance use or abuse • Phobias • Low self esteem • Changes in eating or sleeping patterns • Increased startle response • Concerns about physical safety • Physical injury • Concerns about pregnancy or contracting an STI or HIV 132 Appendix D Table 3 Research Questions, Framing Questions, and Facilitation Questions Research Questions 1. How can a college campus create a contextually informed response to sexual violence? a. What is perceived as helpful to a diverse group of college students who have experienced sexual violence? b. What is needed in the campuscommunity to better support the diversity of survivors? Framing Questions Facilitation Questions What is most helpful to someone after they have experienced assault? Were these services/supports helpful to anyone else here? Why or why not? Do people think that different survivors have different ideas about what is most helpful? Why or why not? Are there some things that were not helpful? What were they? Why were they not helpful? Do you think that is reflective of all survivors’ needs? Why or why not? What should the campus-community offer survivors like you? Is this service currently available here on campus? Would you say MSU does a good job of meeting the needs of the diversity of survivors here on campus? Why or why not? What does MSU need to do to better meet these needs? How can the campus become more responsive to the diversity of needs? 133 Appendix E: Informed Consent Form Consent Form for Participation of Human Subjects in Research Michigan State University Project Title: Exploring the Diversity of Survivors through Photovoice: Building a Contextually Informed Response to Sexual Violence Primary Investigator: Dr. Pennie Foster-Fishman (fosterfi@msu.edu) Secondary Investigator: Katherine Cloutier (clouti25@msu.edu) Investigator Contact: clouti25@msu.edu or msuPhotovoice@gmail.com What is this project about? You are being asked to participate in a research study. The purpose is to learn more about the narratives of survivors of sexual violence, how these narratives represent a diverse group of survivors on campus, and how we can improve the campus response to the issue of sexual violence that reflects the needs of the diversity of survivors. Therefore, it is possible that there will be survivors in the group who may differ from yourself in terms of gender identity, sexual orientation, race, ethnicity, or many other factors. You are being invited to participate based on your experience as a survivor of sexual violence. Your experiences and knowledge may help spread awareness about the issue of sexual violence, and may contribute to an improved response to the issue of sexual violence on campus and in the community This research is being performed by a graduate student at Michigan State University, whose contact information can be found above. 134 What is involved if you participate in this Project? If you volunteer for this research study, you will be asked to participate in the Photovoice process. This process will include taking pictures and writing narratives that reflect your experience, sharing these photos and narratives in group meetings with other individuals who have experienced sexual violence, participating in group conversations during these meetings about how the response system at MSU can be improved, and co-constructing a digital story with the other group participants. This digital story will include the photos and narratives created throughout the project, as well as additional visual displays of disseminating what was learned. This digital story will be shown to an audience that is entirely decided on by the participants. This step intends to facilitate change in the campus community based on your perspective as a survivor, to increase campus community awareness about sexual violence, as well as to illustrate to policymakers on campus the need for a response system that is reflective of the diversity of needs. There will be 2-3 viewing events planned; after each viewing of the digital story a facilitated discussion with the audience will take place. You will be asked to attend these events. No identifying information will be included in the digital stories so as to promote the continued use of the digital story in various venues and opportunities. Having access to a digital camera and the internet access are required to participate. The Photovoice process of photo taking, narrative writing, and group meetings will take place twice throughout the project. Prior to the group meetings you will email me your photo and narrative so they can be displayed and shared with the group during the meeting. The meetings will be recorded to be sure I do not miss important information that is shared. Overall, the project will last approximately 5 months, but will only require your participation for 6 meetings throughout the entire time. Your participation in this study is completely voluntary. In other words, it is up to you if you want to participate; you have the right to say no. If you decide you want to participate, you can decide not to take pictures in response to certain questions, may opt out of any group discussions, or may chose to not participate in specific aspects of the project. Additionally, you can terminate 135 your involvement in the project at any point in time during the entire process. For any of the mentioned decisions, there will be no negative consequence. Your participation will not affect your relationship with Michigan State University, or campus community services. At the end of your participation in the Photovoice session procedures you will receive a $40 gift certificate. You will still receive this gift certificate if you opt out of certain project aspects or decide not to participate in certain group discussions. What Are the Potential Risks and Benefits of Participating? The potential risks for participating in the study include being identified as a survivor of sexual violence, and experiencing discomfort as a result of discussing the violence that was experienced. Being exposed as a survivor could pose risk in terms of experiencing further assault from a perpetrator, as well as experiencing the social stigma of being a survivor of sexual violence. An additional risk may be posed for homosexual/bisexual survivors who participate as it may also be a risk to be identified as a homosexual or bisexual individual. The likelihood of risk is minimal considering the measures taken to reduce the risk of participants' identities being exposed, and the availability of service resources that will be presented. The topic of violence is very sensitive, and it may be upsetting or traumatic for you to share these stories and experiences with the group participants and larger community. The main group facilitator has attended training for sexual assault response, and will be assisted by a therapist from the Sexual Assault Program as well as a colleague from the Community Psychology graduate program. You may experience some loss of privacy and discomfort when taking, sharing, discussing, and displaying your photos, as well as during the digital story viewing event. When the group decides to put together the digital story at the end of the project, you have the right decide whether or not your pictures and stories will be shared, as well as if you would like to be present at the viewing. 136 Remember, if there is any part of the project that you do not want to participate in, you can end your involvement, or opt out of certain aspects. There will be no negative consequences for doing so. Nor will the availability of resources or services be jeopardized. While there are no direct benefits to participating, there is the potential benefit of having the opportunity to share your experiences. The valuable information that you share may help us learn about ways in which we may be able to spread awareness throughout the campus community, and improve the services for survivors of sexual violence. How Will Confidentiality Be Protected? The primary and secondary investigators, a therapist from the Sexual Assault Program, a cofacilitator on the project and the MSU Institutional Review Board are the only people who will have access to the photos, narratives, and any data related to the research project. All data will be stored on a password protected computer for seven years and hard copy materials for five years after the project closes. The group meetings will be transcribed, and the audio recordings will then be deleted. If you choose to sign the consent form a participant number will be assigned to you. Your participant number will keep track of any single documents should they be separated from project data, and will be the only link to your name and participation in the project. This number will be used in the transcriptions, publications, and reports that are produced from the project. But your identity or individual responses will not be shared. All information that you give us will be kept confidential and private. When the results of the research are published or discussed at conferences/during outreach activities, identifying information will be removed. Your identity will be protected to the maximum extent allowable by law. In order to contact you about the project, I will need to collect some private identifying information. The consent form and identifying information will be kept entirely secure. This information will be stored in a file separate from the information that is shared during the project. 137 Again, only study team members and MSU’s Institutional Review Board (IRB) will have access to the data. Who Can Be Contacted With Questions? If you have any questions as we proceed through the Photovoice project, please ask Katherine Cloutier (contact information below). If you have any questions or concerns regarding your rights as a study participant, or are dissatisfied at any time with any aspect of this study, you may contact – anonymously if you wish –MSU’s Human Research Protection Programs, at 517-3552180, FAX 517-432-4503, or e-mail irb@msu.edu, or regular mail at: 202 Olds Hall, MSU, East Lansing, MI 48824. You will receive a copy of this form to keep for your records. If you would not like a copy, you can keep it on file with one of the investigators: Katherine Cloutier clouti25@msu.edu kcloutier28@gmail.com msuphotvoice@gmail.com 630.674.9221 PLEASE CONTINUE ON TO THE NEXT PAGE 138 Permission to Participate: 1. I have read the consent form, given a copy of this form, and I voluntarily agree to participate in this research study. _______________________________________ __________________ Participant signature Date _______________________________________ __________________ Printed Name Date _______________________________________ __________________ E-mail address Date _______________________________________ __________________ Researcher Signature Date ________________________________________________________________________ 2. I voluntarily agree for my photos and narratives to be used in research and reports. _______________________________________ __________________ Participant signature Date _________________________________________________________________________ 3. I voluntarily agree for the group meetings to be audio recorded. _______________________________________ ___________________ Participant signature Date 139 Consent Form to Display Photographs in the Photovoice Digital Story & Viewing Event One of the goals of this project is to illustrate the diverse narratives among student survivors. Sharing the photographs and narratives with the greater community is an opportunity to spread awareness and education related to the issue of violence on campus, and may also provide policymakers a better understanding of the unique experiences of students. This may inform program and service development in a way that is more reflective of survivor needs and desires. I voluntarily agree to have my photographs and/or narratives used in publications, presentations, or public display (for example, the digital story) for the project, and voluntarily agree for the study team to use them. If not, there will be no negative consequence. _______ Yes _______ No Do you plan to be in attendance during the MSU campus events when the digital story is shared with a selected audience? _______ Yes _______ No I voluntarily agree for the continued use of the digital story in outreach activities, conference presentations, or other reports that may come from this study. _______ Yes _______ No If you have any concerns or thoughts you would like to share, or if you are undecided about any of these aspects, please feel free to mention them below: _________________________________________________________ _________________________________________________________ 140 If you change your mind regarding these decisions, please contact: Katherine Cloutier clouti25@msu.edu kcloutier28@gmail.com msuPhotovoice@gmail.com 630.674.9221 _____________________________________ Name of Photographer ____________________________________ Signature of Photographer ____________________________________ Date 141 Appendix F: Participation Agreement Participation Agreement For the project Exploring the Diversity of Survivors through Photovoice: Building a Contextually Informed Response to Sexual Violence, I will attend the following meetings (check next to each date if you plan to be in attendance: Monday, March 26th _____ Monday, April 2nd _____ Monday, April 9th _____ Monday, April 16th _____ Monday April 30th _____ Prior to the two Photovoice session meetings (April 2nd & 9th) I plan to take a photo, send it into the research team, and write a brief narrative about the photo Yes _____ No _____ I plan to participate in the participatory data analysis stage during the fourth meeting for the project (April 16th). If I do not complete the data analysis during that meeting I plan to do so outside of the meeting. Yes _____ No _____ I am aware that I will receive my $40 gift certificate after the participatory data analysis stage. Yes _____ No _____ Signature _______________________ Name (printed) ____________________ Date: ____________________________ 142 Appendix G: Recruitment Flier Exploring the Diversity of Survivors through Photovoice: Building a Contextually Informed Response to Sexual Violence Dr. Pennie Foster-Fishman and student researcher Katherine Cloutier, are implementing a Photovoice research study with survivors of sexual violence on the MSU campus. We are interested in learning about the diversity of survivors on campus, and their experiences seeking services. The intention is to learn about these experiences in order to build a more supportive response system to sexual violence in the campus-community. Have you ever experienced sexual violence since you began attending classes at MSU? Are you at least 18 years of age or older? If so, keep reading to learn more about the project. What is involved if I participate? • Participate in an online eligibility survey • If you meet the eligibility criteria: Participate in a Photovoice training meeting during which you will be asked to complete an informed consent process • Participate in approximately 6 in-person Photovoice meetings • Take photographs and write narratives in relation to your experience as a survivor of sexual violence, and share these photos and narratives with the group\ • Co-create and share a public outreach video that compiles some of the photos and narratives that were created throughout the project • At the end of the Photovoice session procedures you will receive a $40 gift certificate to compensate you for your time. Who should I contact to inquire about participating? If you are a student who is a survivor of sexual violence and are interested in joining, please contact: msuPhotovoice@gmail.com 143 Appendix H: Photovoice Project Development Survey Recruitment Email Hello, Currently on the MSU campus a Photovoice project is being developed by a graduate student and a campus-community partner. Photovoice is a community action/research process that uses cameras, photos, and written narrative to better understand the lived experiences of individuals. For the project being developed, survivors of sexual violence are being asked to participate in the photo-taking, narrative writing, and photo/narrative sharing process. If you are a survivor of sexual violence please consider taking this survey! This survey intends to inform the development of the Photovoice project; it is not the actual Photovoice project. The link below will direct you to a survey regarding your thoughts about this project. Your feedback and input is greatly appreciated. http://www.surveymonkey.com/s/YMB3JRW This is completely voluntary, and there are absolutely no penalties if you decide not to take the survey. Thank you! -Katherine A. Cloutier Ecological-Community Psychology Doctoral Program Michigan State University kcloutier28@gmail.com 144 Appendix I: Photovoice Project Development Survey 1. Photovoice Overview… The present survey is collecting research regarding a Photovoice project that is currently being developed on the MSU campus with Violence Free Communities by Design, and a graduate student (contact information will be provided). The Photovoice project is intended for survivors of sexual violence, and this current survey is seeking feedback from survivors to inform the development of the Photovoice project. Below we provide information about the Photovoice process and this survey. Thanks for checking it out! WHAT IS PHOTOVOICE? Photovoice is a community action/research process that utilizes cameras, photos, group discussions, and stories as a way to better understand the lived experiences of individuals. Below is a VERY brief overview of the Photovoice process. 1. Taking Photos in Response to Framing Questions: Framing questions are posed to the group of individuals participating in the project. Participants use photos and written or oral stories to respond to the framing questions. Framing questions are guided by the purpose of the project, and are usually tied to the issue being explored. Examples may be: What are you proud about in your community? What problems do college students face daily? What was your experience locating resources on campus? There are an infinite number of possibilities here. 2. Individual and Group Photo & Story Sharing: In group meetings participants share their photos and stories. The meeting creates space for participants to discuss the important messages that the photographer shared. This process of sharing photos and stories happens multiple times throughout the project. 3. Photovoice Exhibit: Photovoice projects culminate in a public display of the photos and narratives that were created and shared by the participants. The goal of this exhibit is to spread awareness and increase community education about a specific issue, while also influencing policies by connecting with community members who possess decision making power. WHO DO WE WANT TO INCLUDE IN THIS PHOTOVOICE PROJECT? For this project, the intended participants are student survivors of sexual violence. In other words, these photos, group discussions, and narratives will be created and shared by survivors. As a survivor of sexual violence, you received this survey because we value your thoughts on this project. This survey is looking for feedback and input regarding the Photovoice project being developed. YOUR RIGHTS AS A VOLUNTARY, ANONYMOUS PARTICIPANT IN THIS SURVEY: Please feel free to share as little or as much as you would like. The results are completely 145 anonymous. The answer boxes appear small, but there is no text limit, so please do not feel restricted to the small area displayed. THIS IS COMPLETELY VOLUNTARY AND THERE IS ABSOLUTELY NO PENALTY IF YOU DECIDE NOT TO PARTICIPATE IN THE SURVEY. IF AT ANY TIME YOU WOULD LIKE TO EXIT THE SURVEY, CLICK THE LINK ON THE TOP RIGHT OF THE PAGE TO DO SO. YOU MAY ALSO SKIP ANY QUESTIONS YOU WOULD NOT LIKE TO ANSWER. By moving on to the next page you are voluntarily agreeing to participate in the survey. Thanks! Contact Info: kcloutier28@gmail.com (Graduate Student Katherine Cloutier) fosterfi@msu.edu (Faculty Adviser Dr. Pennie Foster-Fishman) 146 2. Thoughts about the Photovoice process… The following questions are about your general feelings towards the Photovoice process, specifically thinking about the experience of participating as a survivor of sexual violence. The response boxes look small, but there is no limit to how much you can write. Please feel free to write as much as you would like. 1. What would make you not want to become involved in the Photovoice project? What concerns would you have as a participant? 2. What aspects of the Photovoice process do you like? 3. Specifics about the current Photovoice project… The following questions are related to specifics for the current Photovoice project. Again, thinking about the participation of survivors of sexual violence, what do you think about the following components? The response boxes look small, but there is no limit to how much you can write. Please feel free to write as much as you would like. 1. One of the goals of the current project is to understand the different survivor narratives that exist. Survivors may differ significantly in terms of gender, sexual orientation, sexual identity, and in many other ways. Would you feel comfortable sharing your photos and stories with survivors who have significantly different identities than yourself? For example, would you feel comfortable sharing photos and narratives with survivors of a different... race or ethnicity than yourself? sexual orientation than yourself? gender than yourself? 147 2. Participants in this project will take pictures in response to some broad questions - called framing questions. These questions are meant to create a shared context for the stories and photos across all of the participants. For example, “What resources, if any, were most helpful to you?" In thinking about the purpose of this project, do you have any suggested framing questions that you might like to respond to through photos and narratives if you were involved in a Photovoice project? What stories do you think people might want to highlight in their photos? 3. The following are some of the framing questions that have been developed for the project thus far. Please indicate which ones you believe should be incorporated into the project. Check as many as you would like. How has your identity been shaped by the violence you experienced? What is a survivor? What does it mean to be a survivor? How do you define safety? Where do you feel safe? Where did you feel safe before the violence occurred? Where do you feel safe now? How does being a survivor influence your sense of safety? What has been helpful during your own experience? What has been unhelpful during your own experience? 4. The Photovoice process can also happen through an online environment which would entail the same process of responding to framing questions through photos and text, but sharing occurs through a secure, private, and protected online setting. Photovoice has been used this way in the past, and may be used for this current project as well. As a survivor of sexual violence, would you prefer to use the online method of photo sharing and text based discussions as opposed to in-person group sharing and discussions? Yes No Maybe (please elaborate below) 148 5. Do you have any thoughts you would like to share regarding the online Photovoice process, versus the in-person Photovoice process? Are there any feelings you have towards sharing your photos and narratives through an online environment as opposed to sharing photos and narratives through in-person group discussions? 6. Near the end of the Photovoice project the photos and narratives are displayed in a community show. The purpose of this step is to spread community awareness, reach people who may have decision making power, and inform the development of current and future resources in the community. As a survivor of sexual violence, what are your feelings about... the exhibit, in general? your name being displayed at the exhibit? 7. One of the goals of this project is understanding the diverse range of stories from survivors. Therefore, you may use this box to indicate anything related to your identity that you would like to share. This may be gender, race, ethnicity, sexual orientation, sexual identity, or absolutely anything at all. Please feel free. Again, this too is completely voluntary. 8. Thank you very much for your participation in this survey. Feel free to add anything else in this box that you would like to share. 149 Appendix J: Photovoice Project Participation Recruitment Email Hello, And thank you for your interest in joining the Photovoice Project! As you may have read, Photovoice is a community action/research process that uses cameras, photos, and written narrative to better understand the lived experiences of individuals. For the current project, survivors of sexual violence are being asked to participate in the photo-taking, narrative writing, and the photo/narrative sharing process. The photos and narratives are then shared with specific communities on campus, for instance service providers, in order to better learn from survivors. If you have experienced sexual violence, and are interested in participating in the Photovoice project, please click on the link below to take a short survey. This survey intends to assist in recruiting a diverse group of survivors for the project, in order to better understand the experience of many different survivors. Taking this survey is completely voluntary, and there are no penalties if you decide not to take it, or if you exit the survey at any point. http://www.surveymonkey.com/s/BCQRR5T Thank you for your interest, and I will be in touch soon! Katherine Cloutier The Photovoice Project 150 Appendix K: Photovoice Project Recruitment Survey Thank you for inquiring about the Photovoice Project: Exploring the Diversity of Survivors through Photovoice: Building a Contextually Informed Response to Sexual Violence. The current research project aims to understand the diversity of survivors of sexual violence on the MSU campus, and their unique experiences. To get a better understanding of who you are we are going to ask you a few questions related to your identity and the violence you have experienced. The information from this survey will only be used in the event that you participate in the project. At that point, the information you provide will be combined with the information provided by the other participants as a way to demonstrate the diversity of the participating group. Personal identifying data will not be linked to your name in the future use of the information you provide. The potential risk for participating in this survey is being identified as a survivor of sexual violence by someone who may witness you filling out the survey. If at any point throughout the survey you would like to exit, please see the top right corner of your screen (an exit button will be located there). While there is no direct benefit to filling out this survey, participating in this process helps this project move forward. This project intends to benefit the population of survivors on campus by learning about the ways that campus community services may be improved to support diversity. If you meet the criteria for the current study, you will be contacted through email and invited to participate in the Photovoice project. At that point, the first meeting for the Photovoice project will happen, during which the informed consent process for the study will take place. Please feel free to share as little or as much as you would like. The answer boxes may appear small, but there is no text limit, so please do not feel restricted to the small area displayed. THIS IS COMPLETELY VOLUNTARY AND THERE IS ABSOLUTELY NO PENALTY IF YOU DECIDE NOT TO PARTICIPATE IN THE SURVEY. IF AT ANY TIME YOU WOULD LIKE TO EXIT THE SURVEY, CLICK THE LINK ON THE TOP RIGHT OF THE PAGE TO DO SO. YOU MAY ALSO SKIP ANY QUESTIONS YOU WOULD NOT LIKE TO ANSWER. By moving on to the next page you are voluntarily agreeing to participate in the survey. Thanks! Contact Info: Katherine Cloutier: kcloutier28@gmail.com (Secondary Investigator) Dr. Pennie Foster-Fishman: fosterfi@msu.edu (Primary Investigator) The Photovoice Project: msuPhotovoice@gmail.com 151 1. Do you identify as someone who has experienced sexual violence? o Yes o No 2. How do you identify in terms of your gender? o o o o Female Male Transgender Other (feel free to elaborate below) 3. How do you identify in terms of your race/ethnicity? o o o o o o o o White Black or African-American Hispanic, Latino, or Spanish Origin American Indian or Alaska Native Asian Native Hawaiian or Pacific Islander Multi-Racial Other (feel free to elaborate) 4. What is your age? 5. How do you identify in terms of your sexual orientation? o Heterosexual o Homosexual o Bisexual o Questioning or Exploring o Other (feel free to elaborate) 6. Is there anything else about your culture or identity you would like to share? 7. Did the sexual violence occur during your time as a student at MSU or no more than 1 year prior to coming to MSU? 152 o Yes o No o Unsure how to answer this (please elaborate below) 8. In terms of accessing services for survivors of sexual violence on the MSU campus, how would you categorize yourself? o Wanted to seek services, but did not do so o Tried to seek services, but did not receive any o Was not interested in seeking services at MSU o Sought services, and received them o Unsure how to answer this (please elaborate below) 9. Have you participated in Photovoice projects in the past? o Yes o No 10. Just some logistics: Do you have access to a digital camera? _______________ If yes, how many mega-pixels does it have? ______________ Do you have access to the cords that connect the camera to a computer, or another way of downloading the pictures to a computer? ________________ Do you have access to the internet? _______________ Are you available to meet on Monday nights throughout some of March and April? __________ If you would like to be contacted to participate in the study (if you meet the eligibility criteria), please leave your name and email address here: ________________ 153 Appendix L: Recruitment and Sampling Flow Chart Fliers • Fliers distributed through listserves and posted throughout campus (4 weeks) • Prospective participants emailed project email address from flier Contact • Prospective participants sent survey link survey completion required to participate Survey • Participant diversity and eligibility analzyed based on survey results Analysis Invite • Final group invited to participate in the project 154 Participants who responded to survey (12) Filter based on inclusion/exclusion criteria: • Survivor of sexual violence • Student at MSU • Violence occurred at MSU or no more than 2 years prior • Has access to digital camera, connecting device, and internet • 18 years of age or older • Have not participated in Photovoice projects in the past Eligible Participants Invited to Project/First Meeting (11) Final Group: 6 Female Participants SEXUAL ORIENTATION x SERVICE UTILIZATION • 2 Identified as heterosexual o 1 Sought and received services at MSU o 1 Tried to seek services at MSU but did not receive them • 4 identified as bisexual, questioning or exploring, or queer o 2 Sought and received services at MSU o 1 Wanted to seek services at MSU but did not do so o 1 Was not interested in seeking services at MSU 155 Appendix M: Photovoice Curriculum Sessions Meeting #1: Training, Project Overview, Consent Process 6:00-9:00 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • • Katherine: Lead facilitator/note taker Jenny: Co-facilitator/note taker; help me stayed focused on theme (training, safety, introduction to project, consent process), follow me through schedule Leah: Presenter during meeting: Safety, diversity, resources, etc. 6:00-7:00 Overall guidelines for Project o Introduce myself, Jenny, Leah, and their roles  Introduce myself • Hello, my name is Katherine Cloutier. I am really excited to have everyone here for this project; I think it will be a wonderful and rewarding journey. I am a student in the Ecological-Community Psychology program, and for this project I am really interested in learning about all of you, and your unique and powerful stories. I want you to feel comfortable to talk to me throughout this process, and also to come to me with any questions, problems, or concerns.  Introduce Jenny 156 • Jenny will be co-facilitating the meetings with me. She is a colleague of mine in graduate school, and has used Photovoice for some past projects. •  Jenny may introduce herself as well Introduce Leah • Leah is a sexual assault therapist from the MSU Sexual Assault Program. Leah is going to present some information and lead some conversations today, but for the majority of the time across the next meetings Leah will remain outside the room. So, if during any of the meetings you feel like you want to step out for a bit, or you need someone to speak with, please feel comfortable seeking out Leah. She will always be in a safe space that she will set up right over in the lobby area, and will be present during some of the later stages of the project as well. If there is any discomfort regarding Leah’s presence please come and let us know; we understand that this could cause some challenges for participants. And like I have already said, please feel free to speak with any of us throughout the project. We also hope that this space here is found to be safe too. We want everyone to feel comfortable sharing their photos and narratives with each other here. To help with this we also have soft noise makers to drone out any noise circulating throughout this center. So, if you say something in here, it is unlikely to be heard in the lobby area, or in the side office where 157 Leah will be. There will also be a noise maker in those areas to help with this as well. o Describe purpose of project  The purpose of this project is to learn about you all as survivors of sexual violence. Specifically, we are interested in understanding the diversity of survivors on the MSU campus, how experiences may differ across individuals, and most importantly the extent to which MSU effectively supports the diversity of survivors on campus. As we continue to move through the meeting today you will learn more about the purpose of the project; please feel free to ask any questions. o Introduce Leah who will then present  Now, Leah is going to take over for a bit. She is going to talk about safety, services, and things to consider throughout the project. • Topics for Leah to cover, and to what extent o Emotional safety during the project  Discuss what emotional safety is, specifically in relation to sexual violence  Discuss how the process of taking pictures, writing narratives, and talking to other group members may cause emotional discomfort at times  Discuss implication of identifying oneself as a survivor (What does that mean throughout daily life, and in 158 terms of your relationships with others in your life – how might your family members be impacted? Your partners? Your friends?) Remember these things when taking your photographs o Briefly mention services, but not too in-depth as to not impact what is learned from the project o Briefly mention that printed out materials will be available if sought out from Leah (leave those with Leah in her binder and to put out in safe space); these will list campus-community resources for survivors to seek out o Discuss priorities and making sure project involvement does not infringe on academics or other things within participants’ lives o Discuss diversity  Specifically talk about how it may feel to share your experiences with participants who are quite different from you (race/ethnicity, gender, sexual orientation, etc.)  Discuss the importance of making all participants feel welcome, and how it may be challenging for individuals who are different from the rest of the group or different from yourself 159  Discuss how it may be challenging to collaborate with survivors who may even share characteristics with violent people in your lives; mention that it is important to remember that all group members are survivors  Key aspect: Respecting, honoring, and acknowledging diversity throughout the project o Have Leah discuss her connection to the service system  Participants should feel free to voice discomfort in terms of Leah’s participation in the project due to the fact that she is connected to the service system, and much of what we will talk about will relate to that system  To protect against this discomfort, Leah will remain in an adjacent room for the majority of the remaining meetings for the project o Discuss safe space that Leah will set up for the 2 rounds of Photovoice  Leah will be setting up a safe space in an adjacent room for participants to use if they feel they need to step out of the Photovoice session at any moment  The safe space may be used to simply sit and recollect oneself, or participants can feel free to talk with Leah 160 and seek information/services from her in the private office that is connected to the safe space  Participants should feel free to leave the room at any point they decide to; can let facilitators know, or can simply get up and go to Leah/safe space o Introduce Jenny who will then present on the following: Physical safety during the project  Discuss how to remain physically safe while taking pictures and while attending/traveling to and from the meetings  Discuss safety implications of photographing anything directly related to the violence experienced (what may happen if you return to where it happened, bumped into someone you were not expecting to see, etc.)  Discuss the implications of including people in the photographs taken by participants (emphasize the importance of being creative when photographing people so as not to disclose their identity; PEOPLE’S FACES/BODIES CANNOT BE INCLUDED IN ANY PHOTOGRAPHS)  Discuss the fact that the perpetrator must not be included in the photographs taken, or disclosed of in the narratives  Discuss ability to take self-portraits, but that the consequence of this would be publicly identifying as a survivor as their picture may be used in publications or shown during events on campus 161  Discuss how participants should be mindful of their relationship with any legal system, and if their participation will have any influence on that process o Back to Katherine presenting: Facilitate a conversation for participants to get to know each other and to establish a community  Participants may go around and introduce themselves so we can get to know one another •  Share your name, and one thing you are proud of about yourself Discuss how the group wants to identify • Many times throughout the project we will be using the terms ‘survivor or ‘survivors.’ This may not be a term that some of us are used to using, or referring to ourselves as, and I want to be sure that people feel comfortable with this, before we continue on to use it for the entire project. Does anyone have suggestions for a term they would prefer? Or, is the term ‘survivor’ one that everyone feels comfortable with? o Facilitate conversation regarding ethics for the current project  Because of the sensitive nature of the current project, there are also some ethical guidelines we want to discuss. First of all, this space is supportive of all of the photos, narratives, and experiences that will be shared. We want to be sensitive and respectful of what people share, and how we all may express ourselves. This will require a lot of trust among you all, as well as with the facilitators. Because we also want to keep each other safe when we come together to meet and that definitely includes one another’s emotional safety. 162 As Leah spoke about before, we also want to make sure we are honoring and respecting each other’s diversity; at times this may cause discomfort, but we all need to remember how our words and actions may make others feel. We also want to establish an environment where people are comfortable discussing their own diversity.  There is also the issue of confidentiality. There will be more information about this at the end of the meeting, but as researchers we will be taking all precautions necessary to keep your participation in this project confidential. In order to help promote that, we ask that you be mindful of the way you handle your photos and narratives. It may be good practice for you all to delete your photos and narratives after they have been sent to me. The issue of confidentiality also goes back to trust. Because we all have responsibilities to the other participants in terms of keeping their identity confidential and protected as well. So, the information we all learn here will not be something we can leave here and talk about with friends. While there will be an outreach component to this project, we want to be sure that everyone’s identities are protected to the maximum extent possible.  And finally, our next 2 meetings will be audio recorded. The purpose for this is simply to make sure I do not miss anything when I am analyzing the valuable information you all share with me. As such, I will ask you to say your name before you speak each time, that way I can better understand the 163 differing experiences and perspectives. Your names will be removed, however, from all written reports or analyses. • 7:00-7:30 Project Introduction/Photovoice Overview o Introduce Photovoice process  The Photovoice process consists mainly of presenting you all with a framing question to which you respond to through taking a photograph, and writing a narrative about that photograph in relation to the framing question. The framing questions will be fairly basic, and intend to learn about your unique perspective.  Prior to the next 2 meetings, you will be emailing me your photo and your written narrative. You can only submit one photograph per framing question. The email address is msuPhotovoice@gmail.com. I will also email you from this address so you have it on file for the remainder of the project. Please use this for any questions or concerns you may have.  You can write your narrative before or after you take your picture, whichever works best for you. When you are writing your narrative, imagine that someone is looking at your photograph, but you are not there to explain it to them. What would you want them to take away from the photo in relation to the framing question? You may consider thinking about the SHOWeD approach which was proposed by the creators of Photovoice. 164 • What do we SEE here? What is HAPPENING here? How does this affect OUR lives? WHY does this strength, concern, challenge exist? What can we DO about it?  In-person meeting • The next part of the Photovoice process includes the in-person meeting. We will have 2 of these meetings; one for each of the framing questions. The first part of the meetings will consist of individual sharing. Each of you will have about 5 minutes to share your photo with us (I will be putting this into a PowerPoint so you will not have to worry about bringing them), and tell us about the personal story or meaning of the photograph to you. As facilitators we may ask a couple questions to be sure we understand your photo and story. You can use this as an opportunity to share additional information about your photograph beyond the written narrative that you will also email me. • After everyone has shared their photograph for the meeting, we will go through a voting process. I will set up note cards that correspond to each of the photos that we shared, and each person will take two circular stickers and put them on two of the note cards. The 2 photos that receive the most votes will be chosen to be discussed further by the group. This process allows us to discuss issues together, and does not intend to make anyone feel poorly about their photos or narratives. 165 • Once the 2 photos have been chosen, we will discuss them as a group. Remember that you are all talking to each other during this discussion, rather than simply speaking to myself or Jenny. Jenny and I will pop in at times to ask some questions for clarification when needed, and we will also be tying it to some of the themes of the project in terms of diversity and services at MSU. •  There will be 2 of these in-person meetings throughout the project. Digital story creation and viewing event – bring up digital story example and start by showing it • After the 2 Photovoice sessions, we will collaboratively develop a digital story. This means we will be taking the photos and narratives that you all create, and will be creating a short movie with Windows Movie Maker. Your names will not be included in the story, and not everyone has to help create the digital story. When it comes time to create this, we will decide who wants to be involved. Hopefully everyone will want to do so! • This digital story can incorporate photos, text, video, and music. So if there are other ideas we have to create this, please feel welcome to share and get involved. • All of the decisions regarding the digital story will be decided by you all. 166 • Following this creation of the digital story, a viewing event on campus will be planned. The goal is to have a few of these events, and you all will decide who to invite. You are also welcome to decide whether you would like to attend the event. Sharing this digital story with people on campus intends to have your voices heard regarding how the MSU campus-community may be improved upon to better support survivors of sexual violence. o Introduce project timeline and resources – hand out to participants  Meeting #2 - Framing question #1 – presented at the end of the meeting today • Photos and narratives completed individually and emailed to msuPhotovoice@gmail.com • Group meeting to follow; individual sharing, voting, group conversations  Meeting #3 - Framing question #2 – presented at the end of the 2nd meeting • Photos and narratives completed individually and emailed to msuPhotovoice@gmail.com • Group meeting to follow; individual sharing, voting, group conversations •  Recruit those who will help with the digital story creation Meeting #4 – Participatory data analysis • More details on this to come later 167 • You will be underlining the important themes throughout the narratives you share, and will also be participating in a analysis activity with the group participants  Meeting #5 – Digital story introduction/creation • Digital story will be created with the participants post participatory data analysis • •  Audience and viewing event will be set-up If additional meetings are needed we will schedule them then Meeting #6 – Digital story viewing event on campus • Audience will be decided upon by participants • Digital story will be shown, and a facilitated discussion will take place afterwards o Re-orient to project purpose  Now that we have gone through the overview of the project, I just want to reorient us to the purpose of the project so we can all keep it in mind throughout. So, again, we are hoping to learn about the experience of survivors of sexual violence to improve the response system in the campuscommunity. We are interested in learning about the diversity of survivors on campus, and therefore we want to establish a supportive environment for us all to explore this diversity. o Establishing group norms 168  The last thing I was hoping to talk about regarding these meetings is whether or not you all have preferences on how these meetings should be structured at the beginning or end? For instance, is there a specific way you all would prefer the meetings to begin or end? Music? Quiet time? • If participants have thoughts on this, facilitate the discussion, and finalize these norms (if any are even suggested). • 7:30-8:00 Camera Usage and Photovoice Opportunities o Individual Photovoice process  When you are completing the individual Photovoice process of taking a picture and writing your narrative, it is important to find a process that works for you. You may like writing the narrative, and then finding a picture to fit it, or the other way around. If you take multiple photographs you will have to choose one to bring to the meeting. When you are trying to decide on which one to bring think about the main idea you want people to take away from your story. Also, remember, that these pictures have to be taken by you, not found on the internet, or created through photo software programs. o Camera usage  Camera ethics for Photovoice • When you are taking your photos, always remember to keep yourself and others safe; do not take photos or participate in the project in a way that may put you, or someone else in danger. If you feel comfortable asking a friend to come with you as you take photos, 169 please feel free to do so, but you will also want to remember that you now have 2 people to keep safe. • As I have said before, this relates to where you are taking your photos, as well as where you are storing your photos. If they are on your camera or computer you may want to consider deleting them after you send them to me. • Every photo for this project should be taken by you – remember that photos from the internet, google, or facebook are not allowed.  Camera ethics for this specific project: Recap on safety issues • There may be serious ramifications for certain individuals showing up in photographs. As such, no one, especially perpetrators, can be in the photos; we need to be creative when photographing others - think about photographing them in a way that does not show their face, or photographing something that represents this person. • It is also important to remember the consequences of having your own face/body in the photographs as this may put you at risk for being identified as a survivor through publications or events on campus. • In fact, you should be cautious when including any subjects in photos. If you are taking a picture of a large mass of people in which no one can really be identified, then it is okay. However, if you are able to distinguish a person in any of the photos then you will need to refrain from using that photo. 170 • Final thoughts o As the project moves forward, also keep in mind the ramifications of exposing yourself as a survivor of sexual violence; how may this impact your life, your relationships, or even your academics?  Camera Tricks • Features on most cameras o Zoom o Portrait, landscape, macro mode o Flash – when and how to use • Camera tricks PowerPoint – bring up presentation o These photos were taken by a student who created a Photovoice manual guide and are being used to illustrate ways to play around with your cameras. o Framing can be used to create an interesting composition in the photograph. o Angles can be used as well to provide the viewer with an interesting perspective. o Lighting and lighting zones may also be explored. o You can see here how the photographer incorporated lines into the frame. o Patterns are also an interesting way to create your photos 171 o And the last 2 demonstrate the rule of thirds. For those of you who do not know, the rule of thirds suggests you use 2 horizontal and 2 vertical lines, to make an imaginary grid in your viewfinder, and to place the object you are photographing at one of the intersections of these lines. • How to communicate ideas through photos and narratives o Share Photovoice example from WV training with youth  The last thing I wanted to share was a personal example from a past Photovoice project Jenny and I both worked on. The framing question was: What is something you are proud of in your community? • Read response on PowerPoint o Next Steps for Project  Announce Framing Question #1 • The first framing question for the following meeting is: What is helpful to someone after they have experienced assault? • I will also email you regular updates as well as the framing questions through the Photovoice email address. • Remember to use this email address with concerns or questions throughout the project. • Email me your photo and narrative at least 3 days before the next meeting. Receiving your photo and narrative 3 days before the 172 meetings is an ideal situation. If you need flexibility with this, please just let me know. • When writing your narrative, remember to imagine that someone is viewing your photo but you are not there to explain it to them. What would you want the viewer to take away in relation to the framing question? In the handout I gave you earlier there are tips on the last page for what to think about when writing your narrative. Specifically refer to the SHOWeD methodology.  The next meeting will consist of each participant sharing their photo and narrative, a voting process to decide which photographs will be discussed indepth, followed by a group discussion about what was shared. Remember that the photos and narratives will all be viewed through PowerPoint so be sure to get me your materials at least 3 days before the next meeting.  • Announce next meeting date, time, and location 8:00-9:00 Jenny: Consent process with all participants: Ask preference for reading line by line or an oral summary o Complete group oral consent process with all participants o Encourage participants to read consent form line by line when they get home  Group reading of Consent Form and Participant Agreement  Have all participants sign Consent Forms and Participant Agreements; bring up front to submit  Participants can take a copy of the consent forms upon leaving if they desire 173  If participant decides not to participate, they can print their name, but do not sign it; submit with everyone else to minimize discomfort for that individual  Whether you have decided to participate or not, please feel free to come and speak with us after the meeting for anything. o Just one last final message: The materials handed out today such as the consent form and timeline, indicate that this project is about sexual violence. Please keep this in mind as you leave tonight and go throughout your daily life. You may decide to leave any materials here with us, tonight and throughout the project, or you may leave with them. It is up to you, but please be aware of how this may impact safety of yourself or other participants. 174 Meeting #2: Framing Question #1 What is most helpful to someone after they have experienced assault? 6:00-9:00 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • Katherine: Lead facilitator/note taker Jenny: Co-facilitator/note taker; help me stayed focused on theme (COVER ALL FACILITATION QUESTIONS), follow me through schedule Leah: Safe space coordinator • 6:00-6:15 Start with established group norm • 6:15-6:30 Facilitators, reflection, and agenda o Re-introduce all project facilitators and their roles  Hello everyone! I just want to take the time once more to introduce myself, Jenny, and Leah. Leah will be in the next room over so if at any point you would like to step out and take a break or speak with Leah, please feel free to do so (Leah will leave at this point). o Quick debrief about how the first round of Photovoice went  What did everyone think of the first Photovoice round?  What did people like? What did people not like?  Is there anything you need for the next round of Photovoice that you did not have for this one? o Go over agenda 175  Audio recording will begin after this. Please remember to state your name before you speak.  We will start with the individual sharing process. When your picture comes up, please take a few minutes to say your name, and tell us the story behind your photo. What does it mean to you? What would you want someone to take away from it? Jenny and I may ask some questions about your photo and narrative just to be sure we understand your story correctly.  After everyone shares their photo we will go through the voting process to see which 2 photos we will talk about at length.  The next part will be the group discussion about the 2 photos, and then we will end with some debriefing. • 6:30-7:15 Individual sharing (begin audio recording) o PowerPoint set up and displayed o Re-introduce framing question: What is most helpful to someone after they have experienced assault?  Each participant has 5 minutes to share with the group their photo and narrative • Alright, so when your photo comes up, please tell us the story behind it. What is the personal meaning behind the photograph? Why did you choose this photo to share?  Katherine and Jenny: When participants are sharing, remember to ask facilitation questions to gain further clarification 176 • Examples: Can you tell me more about that? So why was this photo the one you choose to share? So what I am hearing you say is… • 7:15-7:30 Voting process o Thank you to all of you for sharing your photos with all of us. The next part of the process will be the voting. Remember, this is only to allow us all to come together and talk about 2 of the photos as a group, and is not intended to make anyone feel poorly about their photos. o Pass out 2 stickers to each participant o Pull up last slide with all photos numbered on it o Lay out numbered index cards that correspond to the photos o Now if you can all decide on two of the photos you would like to discuss with the group and place your stickers on the index cards that correspond with those photos. o Two photos will be chosen. In the event of a tie, one of the facilitators will randomly select two from the group of photos with the highest votes • 7:30-8:45 Group level process o Go backwards in the PowerPoint to pull up the 2 winning photos.  These are the two photos and narratives that will be discussed more in-depth through a facilitated conversation among everyone here. We can talk about them together, or one by one depending on how you all feel. Remember, do not talk to me, talk to each other. And again, please say your name before you speak. Jenny and I will be popping in and out of the conversation to pose 177 some questions for everyone to think about. How about we begin by the photographer re-explaining their photo to us? o Katherine and Jenny: Facilitation questions  Were these services/supports helpful to anyone else here? Why or why not?  Do people think that different survivors have different ideas about what is most helpful? Why or why not?  Are there some things that were not helpful? What were they? Why were they not helpful? • 8:45-9:00 o End with established group norm o Thank you all for participating today! I hope everyone enjoyed our first round of Photovoice, and again, please be in contact with us if there is anything you would like to talk about. o Debriefing  Is there anything else people would like to talk about?  Please remember the things we discussed at the first meeting: Safety, confidentiality, ethics, and seeking support if needed.  Is there anything that people would like to talk about before the 2nd and final round of Photovoice? o Next Steps for Project  Announce Framing Question #2 178 • The next framing question is: What should the campus-community offer survivors like you? • I will email this to you again, as well as any updates before the next meeting. • Email me your next photo and narrative to the Photovoice address at least 3 days prior to the meeting. • When writing your narrative, remember to imagine that someone is viewing your photo but you are not there to explain it to them. What would you want the viewer to take away in relation to the framing question? In the handout I gave you earlier there are tips on the last page for what to think about when writing your narrative. Specifically refer to the SHOWeD methodology.  The next meeting will consist of each participant sharing their photo and narrative, a voting process to decide which photographs will be discussed indepth, followed by a group discussion about what was learned. Remember that the photos and narratives will all be viewed through PowerPoint so be sure to get me your materials at least 3 days before the next meeting. We will also decide who is going to help create the digital story at the end of the next meeting, so come prepared to talk about your ideas for this.  Announce next meeting date, time, and location  Feel free to come and speak with us otherwise we will see you next time! 179 Meeting #3: Framing Question #2 What should the campus-community offer survivors like you? 6:00-9:00 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • Katherine: Lead facilitator/note taker Jenny: Co-facilitator/note taker; help me stayed focused on theme (COVER ALL FACILITATION QUESTIONS), follow me through schedule Leah: Safe space coordinator • 6:00-6:15 Start with established group norm • 6:15-6:30 Facilitators, reflection, and agenda o Re-introduce all project facilitators and their roles  Hello everyone! I just want to take the time once more to introduce myself, Jenny, and Leah. Leah will be in the next room over so if at any point you would like to step out and take a break or speak with Leah, please feel free to do so (Leah will leave at this point). o Quick debrief about how the second round of Photovoice went  What did everyone think of the second Photovoice round?  What did people like? What did people not like?  How did it differ from the first round? o Go over agenda 180  Audio recording will begin after this. Please remember to state your name before you speak.  We will start with the individual sharing process. When your picture comes up, please take a few minutes to say your name, and tell us the story behind your photo. What does it mean to you? What would you want someone to take away from it? Jenny and I may ask some questions about your photo and narrative just to be sure we understand your story correctly.  After everyone shares their photo we will go through the voting process to see which 2 photos we will talk about at length.  The next part will be the group discussion about the 2 photos, and then we will end with some debriefing, and planning for the participatory data analysis and digital story creation. • 6:30-7:15 Individual sharing (begin audio recording) o PowerPoint set up and displayed o Re-introduce framing question: What should the campus-community offer survivors like you?  Each participant has 5 minutes to share with the group their photo and narrative • Alright, so when your photo comes up, please tell us the story behind it. What is the personal meaning behind the photograph? Why did you choose this photo to share? 181  Katherine and Jenny: When participants are sharing, remember to ask facilitation questions to gain further clarification • Examples: Can you tell me more about that? So why was this photo the one you choose to share? So what I am hearing you say is… • 7:15-7:30 Voting process o Thank you to all of you for sharing your photos with all of us. The next part of the process will be the voting. Remember, this is only to allow us all to come together and talk about 2 of the photos as a group, and is not intended to make anyone feel poorly about their photos. o Pass out two stickers to each participant o Pull up last slide with all photos numbered on it o Lay out numbered index cards that correspond to the photos o Now if you can all decide on two of the photos you would like to discuss with the group and place your stickers on the index cards that correspond with those photos. o Two photos will be chosen. In the event of a tie, one of the facilitators will randomly select two from the group of photos with the highest votes • 7:30-8:45 Group level process o Go backwards in the PowerPoint to pull up the 2 winning photos.  These are the two photos and narratives that will be discussed more in-depth through a facilitated conversation among everyone here. We can talk about them together, or one by one depending on how you all feel. Remember, do not talk to me, talk to each other. And again, please say your name before you 182 speak. Jenny and I will be popping in and out of the conversation to pose some questions for everyone to think about. Why don’t we begin by the photographer re-explaining their photo to us? o Katherine and Jenny: Facilitation questions  Do you think that is reflective of all survivors’ needs? Why or why not?  Is this service currently available here on campus?  Would you say MSU does a good job of meeting the needs of the diversity of survivors here on campus? Why or why not?  What does MSU need to do to better meet these needs?  How can the campus-community become more responsive to the diversity of needs? • 8:45-9:00 o End with established group norm o Thank you all for participating today! I hope everyone enjoyed our second round of Photovoice, and again, please be in contact with us if there is anything you would like to talk about. o Debriefing  Is there anything else people would like to talk about?  Please remember the things we discussed at the first meeting: Safety, confidentiality, ethics, and seeking support if needed. o Next Steps for Project 183  Two more things before we leave for the night. We need to decide who would like to help create the digital story for the outreach part of the project. • Pass out note cards o If you would like to actively participate in the creation of the digital story, please write your name on this card. Or, if you have ideas about how the digital story or viewing event should happen, please write them on here and give this card to us as well. Just be sure to clearly indicate your preference for participating in the creation of the digital story since I will be contacting those who leave their name for the next meeting. I would encourage everyone to be involved in this part of the project! This digital story can incorporate other things as well such as video, music, and other art forms.  Announce that those who are interested in creating the digital story will be contacting through email  Announce that the digital story viewing event will take place when the story is created  Date, time, and location for that event will be sent out as well  Announce the participatory data analysis • Also! I will be sending each of you through email a typed up account of your narratives that were constructed throughout the project – your written and orally shared narratives. To be sure that I am highlighting 184 the important aspects of your stories when we disseminate the information learned I want to ask each of you to be a part of preliminary data analysis. As such, I am going to ask you to underline the ideas/themes that are most important to you throughout the narratives I send you. These underlined sections will essentially make up the beginning of the data analysis for the project. Please read the email carefully as I will include instructions on how to complete this step, and also safety considerations. After you have underlined the important themes in your narratives, saved it, and re-sent it back to me, I would like to ask you all to delete the information from your emails and computers in order to continue to protect confidentiality, privacy, and safety. • Our next meeting will focus on how this part of the project goes, and we will do an additional data analysis activity during the meeting. I will be in touch soon regarding time, location, etc.  Announce meeting date, time, and location for the participatory data analysis meeting  Ask participants where they want their gift certificate for  Track this, and purchase gift certificates prior to next meeting 185 Meeting #4: Participatory Data Analysis, Data Analysis Notecard Activity, Sharing of the Preliminary Data Analysis 6:00-9:00 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • • Katherine: Lead facilitator/note taker, facilitating participatory data analysis activity Jenny: Co-facilitator/note taker; help me stayed focused on theme (completing participatory data analysis/activity), follow me through schedule Leah: Safe space coordinator 6:00-6:45 Check to see that all participants have underlined themes in their written and orally transcribed narratives • 6:45-8:00 Facilitate notecard activity (pass out materials) o Transferring underlined ‘headlines’ to notecards o Participants find common ‘headlines’ across others (micro-level) o Participants create bigger ‘headlines’ to group together smaller ‘headlines’(macro-level) o All of these are taped up on the wall o Copy down final completion of the notecard activity • 8:00-8:30 Present preliminary data analysis that I completed prior to the meeting • Next Steps for Project o Announce meeting date, time, and location for the digital story introduction meeting 186 o Announce that those who did not complete the data analysis stages need to do so before the next meeting o Announce that those who are interested in creating the digital story will be contacting through email o Announce that the digital story viewing event will take place when the story is created o Date, time, and location for that event will be sent out as well o For those who are not involved in the digital story creation, we will also be in touch with you so you can view it prior to the showing of the story • Distribute gift certificates if all participants have complete data analysis process o Have participants sign incentive tracking list upon receiving incentive  Check that all participants have received incentive (make sure those not in attendance receive gift certificate) • Debrief o Thank participants for their honesty, openness, and effort o Be sure to explain the meaning this project has for women, survivors, and all people who are victims of violence o Encourage them to continue on to do things such as this o Pass out additional gift if it applies (crystals to bring to digital story viewing events?) 187 Meeting #5: Introduction to the Digital Story Creation (Summer/Fall) 6:00-9:00 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • • Katherine: Lead facilitator/note taker Jenny: Co-facilitator/note taker; help me stayed focused on theme (creating a powerful, ethical, and informative digital story that may elicit change in the campus-community), follow me through schedule Leah: Safe space coordinator 6:00-6:45 Introduce purpose of the digital story o Thank you all for coming to help with the creation of the digital story and event planning. I have my laptop here with Windows Movie Maker, as well as some learning modules to help us start using the program. o Briefly cover what we want in the digital story o Link what we want in the story to the purpose of using this dissemination tool o Facilitate discussion about what people want in the story, and what they do not want in the story  Ethical issues for why participant’s names will not be included in the digital story • Because there will be further use of the digital story, we have decided it would be best to keep all of your names out of the actual final creation. 188  Ethical issues of being present at the viewing event • We also need to be aware of the ethical issues that arise as identifying as survivors at the digital story viewing event. Keeping in mind issues of safety, academics (since campus leaders may be present), and simply public identification as someone who has experienced sexual violence, please be in contact with Jenny, Leah, or I about accommodations you would like, or feelings about this. • •  How are people feeling about this aspect of the project? Facilitate discussion around this Ethics of disclosing oneself as a survivor – how might this affect your family, friends, and/or partner as well?  What is it that we want people to take away from the digital story and how can we do that in a way that keeps us all safe? o Who do we want to invite?  Next we need to decide who we are going to invite to the digital story viewing event. Remember we are going to try and have a few of these, so how about we brainstorm three different audiences that we can invite.  Facilitate this discussion and decide on the three different audiences  Remember to tie these audiences to a purpose for why we want them to view the digital story • 6:45-8:00 Digital story learning modules 189 o Next I have some learning modules/activities that we can go through to explore the different options we have with this program.  Complete learning modules  Draft a storyboard (or similar formatted plan) for digital story o Announce date, time, location for digital story creation meeting 190 Meeting #6: Digital Story Creation and Viewing Event Planning (Summer/Fall) 6:00-9:15 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • • Katherine: Lead facilitator/note taker Jenny: Co-facilitator/note taker; help me stayed focused on theme (creating a powerful, ethical, and informative digital story that may elicit change in the campus-community), follow me through schedule Leah: Safe space coordinator 6:00-6:15 Discuss ethics for what to include in the digital story (re-iteration of last meetings ethics discussions) o Thank you all for coming to help with the creation of the digital story and event planning. I have my laptop here with Windows Movie Maker, as well as the photos and narratives from the last 2 meetings. But before we start putting things together we should talk about ethical issues that may arise. o Facilitate discussion about what people want in the story, and what they do not want in the story  Ethical issues for why participant’s names will not be included in the digital story • Because there will be further use of the digital story, we have decided it would be best to keep all of your names out of the actual final creation. 191  Ethical issues of being present at the viewing event • We also need to be aware of the ethical issues that arise as identifying as survivor at the digital story viewing event. Keeping in mind issues of safety, academics (since campus leaders may be present), and simply public identification as someone who has experienced sexual violence, please be in contact with Jenny, Leah, or I about accommodations you would like, or feelings about this. • •  How are people feeling about this aspect of the project? Facilitate discussion around this Ethics of disclosing oneself as a survivor – how might this affect your family, friends, and/or partner as well?  What is it that we want people to take away from the digital story and how can we do that in a way that keeps us all safe? • 6:15-9:00 Discuss the digital story content o Windows Movie Maker refresher o Re-visit storyboard from last meeting o Bring up all materials:  Photos and written narratives  Poem from transcripts?  Preliminary analysis of themes (Katherine); receive feedback on accuracy of these themes from participants  Preliminary analysis form participants 192  Music, video, additional poetry, other forms of expression? o Creating the digital story  Remind group: Do not refer to us (facilitators) for decisions, talk to each other! • 9:00-9:15 Make final decisions o Finalize who to invite and where to hold the event; plan 2-3 viewing events o Check that no identifying information is included in the digital story (names, etc.) o Decide on what participants want to discuss with the audience after the digital story viewing  Draft facilitation questions for post-viewing conversation o Plan additional meetings if needed (to finish the digital story); debrief o Remind participants that they will be contacted through email with more information regarding the digital story viewing events o Disseminate digital story and plans for event(s) to all project participants for their approval (those in attendance, and those not) through email  Make sure participants can be in attendance  Explain details for the viewing event  Briefly discuss ethical issues of this in terms of identifying publicly as a survivor of sexual violence (re-cap from meeting discussion)  Announce time, date, location for digital story viewing event o Debrief 193 Digital Story Viewing Events (Summer/Fall) 7:00-9:00 PM Facilitators: Katherine, Jenny, Leah FACILITATOR ROLES: • • • • Katherine: Lead facilitator/note taker/presenter Jenny: Co-facilitator/note taker; help me stayed focused on theme (presenting digital story and facilitating a discussion among the participants and audience members), follow me through schedule Leah: Co-facilitator 6:00-6:30 Introduce project o Introduce participants o Introduce facilitators: Katherine, Jenny, Leah o Introduce project purpose  Thank you to everyone who came to the event. We are about to show you a digital story that was created by the participants of this project. This study utilized the Photovoice methodology with survivors of sexual violence in order to better learn about the diversity of survivors on campus and how MSU can promote a service system that is informed by this diversity.  The project asked participants to take photographs and write narratives about certain questions posed to them. These questions related to service accessibility, helpfulness, and survivor diversity. The participants for this 194 project reflect a diverse group of survivors from the MSU campus, and this digital story was created to share their stories with all of you. • 6:30-6:45 View digital story • 6:45-7:45 Facilitate discussion among participants and audience o What was learned from the project? o Consult facilitation questions drafted by participants o How can MSU build a more contextually informed response to sexual violence? o Remind group: Do not talk to us (facilitators), talk to each other! • 7:45-8:00 Debrief • 8:00-8:15 Debrief with participants only o Announce additional information for the future viewing events o Final good-bye 195 Appendix N: Participant Resources – Service Information Below is a brief list of resources that are in the immediate area, as well as a guide created by MSU SafePlace. Who to contact with questions regarding the project: • Katherine Cloutier: o clouti25@msu.edu • The Photovoice Project – msuPhotovoice@gmail.com Immediate Resources • The Sexual Assault Program Hotline (517)372-6666 • The Listening Ear (517)337-1717 CMH Crisis Services: Psychiatric emergencies including suicidality or psychosis (800)372-8460 or (517)346-8460 • • MSU Counseling Center is open for crisis walk-ins Monday, Tuesday 8am-7pm; Wednesday, Thursday, Friday 8am-5pm, phone number is (517)355-8270 • MSU Safe Place Crisis Line related to Domestic Violence (517)355-1100 Your participation in this project will by no means influence any services you may seek on campus or in the community. If at any time during the project you would like to end your participation please do so by contacting one of the project coordinators listed above. Please remember to always consider your safety during this project. 196 Appendix O: Participant Resources - Project Timeline Meeting 1 • • • • • • • Meeting 2 Introduction to the project Photovoice training Project timeline Ethical considerations Consent process What is next? Framing question for next meeting: What is most helpful to someone after they have experienced assault? • • • • • • • Meeting 3 • • • • • • • • • • • • • Framing Question #2: What should the campus-community offer survivors like you? Email your photo and narrative to msuPhotovoice@gmail.com 3 DAYS before Meeting #3 Meeting audio recorded Individually share photos and narratives (displayed through PowerPoint) Group discussion Recruit for digital story creation Katherine will be emailing you materials to underline for data analysis What is next? Introduction of the Digital Story Introduce digital story Discuss ethics for this part of the project Discuss who we want to invite as the audience Plan 2-3 viewing events Plan additional meetings to create the digital story • • • • • Framing Question #1: What is most helpful to someone after they have experienced assault? Email your photo and narrative to msuPhotovoice@gmail.com 3 DAYS before Meeting #2 Meeting audio recorded Individually share photos and narratives (displayed through PowerPoint) Group discussion What is next? Framing question for the next meeting: What should the community offer survivors like you? Meeting 4 Participatory data analysis Prior to the meeting Katherine will email you some of your own data to analyze Before the meeting read over the materials sent to you and begin analyzing the data Participatory data analysis activity during meeting Begin plans for digital story Digital Story Creation and Viewing Event with Campus-community (Summer/Fall) • Digital story created by group • Goal is to hold 2-3 viewing events • Provide food/drinks for event • View the digital story • Facilitate discussion among participants and audience after the viewing 197 Appendix P: Participatory Data Analysis Email Hello ___________, Attached you will find a file of your written and oral narratives from the past two Photovoice sessions. After you open the file and read through it, please do the following: 1. Underline the important points/themes of each narrative. Imagine that the narratives are turning into newspaper headlines (or something similar). What are the most important main ideas to be taken away? Please feel free to underline as many or as little as you would like. 2. Once you have underlined the important ideas, save the file, and re-send it back to me at msuPhotovoice@gmail.com. Please be sure to leave the file name as it is so I can keep track of whose is whose. 3. After you have sent the file, please delete it from your computer so as to protect confidentiality, safety, and privacy. These underlined excerpts will be pulled together to create the beginning of the data analysis framework for the project! Thank you for taking the time to participate in this step. Katherine Cloutier The Photovoice Project 198 Appendix Q: Ethical Considerations for Photovoice Projects Ethical Considerations for Photovoice Projects Developed from Wang & Redwood-Jones (2001) 1. Rights and safety of individual participants a. Administer consent forms to participate in the project b. Facilitators must constantly hold the safety of individuals above all else c. Hold an initial meeting that discusses safety concerns 2. Rights of individuals appearing in participant’s photographs; including intruding into another’s space, exposing information about an individual, distorting another’s character, reproduction of photographs for someone else’s benefit a. Provide consent forms for individuals who appear in photographs b. Include consent forms regarding the display or publication of photographs from the project (to meet project’s goals as decided by participants) c. Prior to the beginning of the project, letters may be written to teachers, employers, community organizations, or other individuals/groups who may witness the Photovoice process taking place around the community 3. Recruitment methods: Do participants know how and why they are being contacted? a. Be clear about the recruitment methods, and how that relates to the purpose of the project 4. While the potential of a marginalized group to elicit social change is significant, Photovoice projects should be careful not to place the entire burden of creating social change solely on a disenfranchised group a. Recruit additional participants for the social change aspect, who may have resources to elicit the change intended 5. Limiting the range of issues to be explored through the project based on who is recruited to participate a. Consider the representation of the sample of participants. Could this be restricting the issues to be explored? Whose voices are not being represented? 6. Is the community voice really being heard when decisions are being made by researchers or project staff? a. Facilitators need to adhere to the values of participatory research; decisions should be granted to the participants as much as possible 7. Facilitators finding a balance between encouraging critical thinking among the photographers, without interjecting their own opinion (maintaining the values of Photovoice throughout the project) 199 a. Consider options for how to train facilitators to achieve this 8. Facilitators refraining from suggesting ideas for picture taking a. Initiate conversations by asking additional questions, or rephrasing the framing questions, rather than suggesting themes to take pictures about 9. Supporting the status quo by turning to “higher ups” to influence decisions and policies a. Remember, deciding policies is not necessarily a goal of the Photovoice process, rather it is important to facilitate individuals in an empowering way that permits contact with policy makers Table 1. Photovoice Ethics: Minimum Best Practices from Wang & Redwood-Jones (2001) 1. Provide and review with participants a consent form, regardless of whether required by the facilitators’ sponsoring institution 2. Provide an “Acknowledgment and Release” consent form on which participants obtain the signatures of the people they photograph, regardless of whether required by the facilitators’ sponsoring institution 3. Frame the first training around a group discussion about the use of cameras, power, and ethics, emphasizing safety and the authority and responsibility that come with using a camera 4. Provide written material (such as a brochure that describes the goals of the Photovoice project, who will participate, how photographs will be used, and whom to contact for more information) that participants can give to subjects or interested community members 5. Provide a letter for youth or adult participants to give teachers and school principals or employers as applicable regarding the goal and duration of the project and establish whether and how cameras will be used at school or work 6. Provide participants with prints to give back to people they have photographed 7. Provide and review with participants a consent form indicating permission to publish any photographs, or only specified photographs, to promote project goals, regardless of whether required by the facilitators’ sponsoring institution 8. Mentor project staff and participants on the ethical principles and actions underlying Photovoice Ethical Considerations Unique to the Proposed Project Developed in Collaboration with Violence Free Communities by Design • • • • Confidentiality of survivors; this may be entirely up to the participants Creating a safe space to share narratives Respecting the individual process of healing and sharing Respecting the participants’ decisions in terms of displaying their photographs and stories 200 • • • • • • • • Providing the participants with sufficient resources outside of the Photovoice project Consider safety in terms of participants exposing themselves as survivors to partners, friends, family or community members Avoid the situation of participants having to relive the violence experienced Consider participants’ relationship with any legal systems, and how that may be jeopardized due to participating in the project Be clear about the implications of a survivor’s decision to disclose information Be clear about how this decision may affect a survivors’ friends or family Establish that perpetrators should not be photographed or disclosed of if they have not been convicted; legal implications Consider the implications of a mixed gender group and how this may influence the project 201 Ethical Issues and How They Are Addressed Ethical Issue Confidentiality of survivors; this may be entirely up to the participants. • • • Creating a safe space to share narratives. • • Respecting the individual process of healing and sharing. • Respecting the participants’ decisions in terms of displaying their photographs and stories. • Providing the participants with sufficient resources outside of the Photovoice project. • • How it is Addressed Identity will be protected to the maximum extent allowable by law. Data security procedures and informed consent processes. Participants have autonomy over whether their photos and narratives are included in the digital story, and whether they will be present at the viewing event. Meetings will take place at a safe campus location. Asexual assault therapist will be present throughout the project. Discussions regarding respect, diversity, and safety will happen regularly throughout the meetings. An additional consent form has been created for this purpose and allows for participants to make their own decision regarding the digital story and viewing event. A sexual assault therapist will be present throughout the project. The sexual assault therapist will also have printed out materials on hand to give to participants if they are interested. Discussions regarding disclosure of oneself as a survivor take place throughout the project. Framing questions have been created in order to focus on aspects not directly related to the violence experienced (a focus on postassault). Legal ramifications are discussed with participants. Consider safety in terms of participants exposing themselves as survivors to partners, friends, family, or community members. Avoid the situation of participants having to relive the violence experienced. • Consider participants’ relationship with any legal systems, and how that may be jeopardized due to participating in the project. Be clear about the implications of a survivor’s decision to disclose information. • Be clear about how this decision may affect survivors’ friends or family. Establish that perpetrators should not be • This issue is discussed with participants during the first meeting, and then again prior to the digital story viewing event. Issue also discussed with participants. • Issue discussed during Meeting #1. • • 202 photographed or disclosed of if they have not been convicted; legal implications. Consider the implications of a mixed gender group and how this may influence the project. • • 203 Diversity (in terms of gender, race/ethnicity, and sexual orientation) is discussed at length during Meeting #1, and future meetings. Participants will have met the group before they complete the informed consent process. Appendix R: Community Allies for Photovoice Project Community Partners Developed collaboratively with Violence Free Communities by Design, the following list of community allies intends to list out who the project may seek out for event assistance, service linkage for participants, opportunities to invite audience members to the Photovoice show, and other partners on campus to introduce to the Photovoice project and methodology. Those organizations with a star next to their name will be collaborators for Photovoice participant recruitment as they provide access to diverse survivor populations. • Violence Free Communities by Design* • Greek Life* • Coalition Against Sexual Violence • The Center for Gender in Global Context* • Sexual Assault Program* • MSU Safe Place • Women’s Resource Center* • Sexual Assault and Relationship Violence Prevention Program • LBGT Resource Center* • COMPASS Program • Self Defense Program • Women’s Center of Greater Lansing • The Vagina Monologues* • Take Back the Night 204 Appendix S Table 4 Participant Demographic Table In Study? Gender Race/ ethnicity Age Sexual Orientation Yes Female White 22 Heterosexual on survey; identified as bisexual in group Yes Female White 20 Yes Female White Yes Female White Time Violence Occurred PartAt MSU or Native no more American than 2 years prior to enrolling Level of Service Seeking Sought services and received them Heterosexual Not provided Sought services and received them 21 Heterosexual Raised in a Roman Catholic family but identified as an atheist 19 Questioning or Exploring Not provided 205 Cultural Factors Multiple experiences throughout highschool and one at MSU or no more than 2 years prior to enrolling Multiple experience throughout lifetime, at least one of which was at MSU or no more than 2 years prior to enrolling At MSU or no more than 2 years prior to enrolling Tried to seek services but did not receive any Wanted to seek services but did not do so Table 4 (cont’d) Yes Female White 19 Bisexual Not provided Yes Female White 20 Queer United Methodist No Female White 23 Homosexual Not provided No Female White 20 Heterosexual Not provided No Female White 18 Heterosexual Not provided 206 Multiple experience throughout lifetime, at least one of which was at MSU or no more than 2 years prior to enrolling At MSU or no more than 2 years prior to enrolling At MSU or no more than 2 years prior to enrolling At MSU or no more than 2 years prior to enrolling At MSU or no more than 2 years prior to enrolling Sought services and received them Was not interested in seeking services at MSU Sought services and received them Wanted to seek services but did not do so Sought services and received them Table 4 (cont’d) No Female No Female White 20 Black or 18 AfricanAmerican Queer Identified as a feminist Pansexual Not provided 207 Multiple experience s, one of which was at MSU or no more than 2 years prior to enrolling At MSU or no more than 2 years prior to enrolling Sought services and received them Wanted to seek services but did not do so Appendix T Table 5 Data Summary Table SecondOrder Theme Reclaiming normalcy and control First-Order Theme N/A Definition • • • • • Establishing and controlling a balance in one’s life through mechanisms that were resilient throughout the post-assault process. At times this normalcy and control looked as a return to the life prior to an assault, while at other times it was an active pursuit of a new normal for life post-assault. Normal is not used here to suggest a reflection of the status-quo; rather it is used to refer to a state of balance however it may be defined by the individual herself. Reclaiming normalcy and control manifested as five mechanisms listed below as first-order themes. Addressing intersectionality: Medication was a strategy for reclaiming normalcy and control that was only pursued by those participants who identified as bisexual, Queer, or Questioning or Exploring. 208 Quotes I like food, I like clothes, I like books. Um, and I think that kind of, um, almost like consciously letting myself enjoy things is really helpful to me, and kind of, um, like letting myself be okay, is um, really important because there was awhile where, like, I wanted to just like close up into myself, there wasn’t going to be anything that I liked, I was just going to you know, go to school, and sleep, and maybe eat if I felt like it. Table 5 (cont’d) Reclaiming Traditional normalcy and services control • • Reclaiming normalcy and control Unconditional social support • • • Traditional services were the most common mechanism that provided survivors with an opportunity to reclaim normalcy and control in their lives, post-assault. These services included counseling, health services, and the use of prescribed medication. Through, for example, counseling, survivors were able to maintain a balance in their lives that assisted in future progress in the post-assault healing process. Unconditional social support was the next most common mechanism that allowed survivors to reclaim and maintain normalcy and control post-assault. This allowed for a reclaiming of normalcy and control, to some extent, because it was a large part of their life preassault, and therefore needed to be (even more so) post-assault. This unconditional social support when helpful, involved nonjudgmental and resilient support. However, support from others that involved judgment or questioning was quite unhelpful postassault. 209 …services like through the school I found helpful because they made me feel like I wasn’t a complete idiot. And I still needed warmth and love, I needed my family, I needed support. Table 5 (cont’d) Reclaiming normalcy and control Goal setting • • Reclaiming normalcy and control Immersing oneself into life’s routines. • • • Goal setting post-assault was the next most common mechanism reported by survivors for reclaiming normalcy and control. In a sense, goal setting provided a checklist for things to accomplish and issues to overcome. This structure of intended progress provided survivors with a sense of normalcy and control for their everyday life. Immersing oneself into life’s routines also allowed for a reclaiming of normalcy and control. Such opportunities were centered around school work, increased responsibility in leadership positions, and sports. These opportunities allowed participants to reclaim normalcy and control through structured activity that reflected life without assault. 210 …having like, specific reasons to live, and um, kind of like I have my, my weekly calendar and I go ‘Oh, well I have one thing to accomplish each day. So I have to accomplish those things, like otherwise I’m letting other people down, I’m letting myself down, I’m, I’m not accomplishing all of the things that I know I can and, um, that like really helps me kind of push forward through all of these things… One of my greatest outlets was schoolwork. It almost became an unhealthy obsession, but it was one thing that brought consistency in a world breaking into a million pieces. Table 5 (cont’d) Reclaiming normalcy and control Keeping tabs on perpetrator • Keeping tabs on the perpetrator also provided participants with a sense of normalcy and control post-assault, as it prevented them from unintentionally running into the perpetrator, an act that derailed the healing process significantly. Keeping tabs on the perpetrator allowed for the direct control of this possibility. 211 Knowing where he was and what he was doing I think was really healthy for me so that I didn’t have to, like, fall to pieces about it. Table 5 (cont’d) Reclaiming N/A voice • • • • Reclaiming voice involved expressing emotions and exercising control over sexual violence at an individual and collective level, often including re-telling the story of assault as one of survival and not of victimization. Reclaiming voice was a process of making things happens (e.g. pursuing the legal system), rather than feeling forced to adapt to the things that were happening externally. Reclaiming voice manifested through seven mechanisms listed below as first-order themes Addressing intersectionality: For two participants who identified strongly with a religious background, reclaiming voice through negotiating religion played an interesting role that facilitated healing and was also a barrier to healing such that these two participants identified as bisexual and Queer. Furthermore, both of these participants identified the process of coming to understand that the violence they experienced was not their fault an integral part of the postassault healing process. 212 …some of the greatest healing came in helping others through advocacy…I also do SACI, which is um, sexual assault advocacy, which has really helped me heal and allowed me to experience emotions. Table 5 (cont’d) Reclaiming Artistic outlets voice for healing • • Reclaiming voice Negotiating religion postassault • • • • Writing, photography, and jewelry making were identified by participants as mechanism to reclaim their voice. These artistic outlets provided survivors with an opportunity to express their feelings about the assault in a unique way and retell their story of assault as one of survival. Negotiating religion postassault the next most common mechanism for reclaiming voice For some participants finding a voice to be open about their assault through religious outlets was an integral part of the healing process. These barriers were reflective of a general denial of survivors’ sexual orientation, as well as a lack of support from religious leaders or other religious followers. When this negotiation of religion led to a positive experience of finding voice post-assault, it provided survivors with a powerful and influential coping outlet. Unfortunately, this negotiation of religion tended to present barriers to healing, rather than facilitators. 213 I think poetry is one of the greatest outlets I’ve ever had…Whatever I felt, I have to write about it first cause it’s a safe place. And then I can talk about, so… …growing up in the Methodist church I was never made to feel shame about sexuality, homosexuality, bisexuality, or, um, just having sex in general, until I came to college…we got a new minister in my [current] church. And, uh, he’s very, um, restrictive, and repressive towards sexuality in general, and has made comments about homosexuality that make me feel uncomfortable and make it feel like my place of worship isn’t safe for me. Table 5 (cont’d) Reclaiming voice Advocacy and legal pursuits • • • • Reclaiming voice Activist outlets for healing • • Some traditional services also provided survivors with the opportunity to reclaim their voice. Specifically, these services included pursuing the legal system as well as advocacy efforts. The legal system provided survivors with many unique and painful challenges, however, the legal process was perceived by survivors to be an opportunity to take an active stance against the perpetrator, share their story of survival, and help to prevent sexual violence from happening to others. Advocacy outlets, for example SACI (sexual assault advocacy on campus), were also viewed as an opportunity for survivors to reclaim voice, speaking out and supporting themselves as well as other survivors. Activist oriented behavior and fostering the survivor community were the next most common strategies identified by participants to reclaim voice. Specific outlets included the Vagina Monologues, the Slut Walk, and Take Back the Night 214 The court process was awful, it was scary, you get…judged…I’m happy I did it, but I don’t think it helped me heal. I think I am lucky because I am a part of SACI, and I am a part of all these things, the Vagina Monologues. And I’ve surrounded myself by all these people, like this Photovoice project, it’s helped me heal so much… Table 5 (cont’d) Reclaiming voice Comprehensive understanding of the experience • • • Reclaiming voice Reclaiming the environment the assault took place in • • Reclaiming voice was also found through an attainment of a comprehensive understanding of the experience. Mainly, this was seen through survivors acknowledging that the experience of sexual violence was not their fault, and accepting that what they experienced was actually rape or sexual assault. Acceptance of both of these factors created an opportunity for survivors to reclaim their voice to tell a new story about their experience. This new story is one of violence followed by survival, rather than denial, selfblame, and confusion. Another mechanism for reclaiming voice involved reclaiming the environment the assault took place in. This reclaiming of environment was usually a combination of a physical act (e.g. re-visiting the house where the assault occurred) and an emotional domination of the assault (e.g. saying out loud that the assault no longer had any power). 215 No matter what my relationship to the perpetrator looked like, what I said or was wearing, or the fact that it happened right in my own front yard; nothing I did placed the blame on me for being violated. And I was able to kind of, I did go back to his house after it happened. And been like ‘Ya know what, I’m done with this place, like this place doesn’t matter anymore.’ Table 5 (cont’d) Reclaiming voice Open communication of feelings about the assault • • • Open communication of feelings about the assault was the final mechanism for reclaiming voice postassault. This open communication was at a private level (open writing about emotions that one was experiencing), as well as at a public level (having open conversations with people about the assault; openly expressing feelings at events such as open mic nights). Allowing oneself to be raw and uncensored was liberating for survivors, and allowed them to be honest about the assault, rather than having to keep certain emotions a secret. 216 I don’t think it’s just nakedness of bodies, but nakedness of emotions. Uh, it was really liberating for me to do this open mic this weekend…it felt really good to be raw and real and not sensor myself which is part of why I find profanity is such a nice coping mechanism. I was able to be completely uncovered in terms of my feelings about the issue which is so difficult to do. Table 5 (cont’d) Reclaiming body N/A • • • • • • Reclaiming body involved exercising control over one’s physical body. Reclaiming body manifested in positive ways (e.g. tattoos), as well as darker ways (e.g. cutting). Regardless of whether the action is perceived as positive or negative, reclaiming body included things that allowed for the control, and sometimes manipulation, of all things related to the body. This also involved sexual interactions, and the role of the body in such situations. Reclaiming body manifested as three mechanisms listed below as first-order themes. Addressing intersectionality: Reclaiming body through the negotiation of intimate relationships presented differently for participants who identified as bisexual, Queer, or Questioning or Exploring, post-assault. 217 I think that my assault also forced me to realize that my sexuality and libido are not constant: they are fluid and fluctuate with my environment and my experiences, and I am much more comfortable and accepting of that now. Table 5 (cont’d) Reclaiming body Negotiating intimate relationships post-assault • • • Reclaiming body Change in appearance • • • Negotiating intimate relationships post-assault was the most common mechanism through which survivors reclaimed their body. This negotiation involved issues of being able to orgasm with another person, exploring fluidity of sexual orientation, negotiating a relationship with the perpetrator, and confronting post-assault partners’ responses to the assault. Embracing and taking control of these factors created an opportunity for survivors to reclaim their body, becoming active in each aspect, rather than maintaining a sense of passivity. The next most common mechanism for reclaiming body involved change in appearance. Such changes involved dressing differently, changing one’s hair, and getting a tattoo or piercing. These methods were used to change one’s appearance not only to exercise complete control over one’s body, but also to embrace a new appearance on the outside as there was a new selfimage on the inside. 218 I wrote a poem about how I had been with a girl after my assault…it was good finally to be able to write that down on a piece of paper that I was with a girl…I know why I did it, and it helped me cope with those feelings cause I had a lot of shame…So, to me, it made complete sense after my assault. That if I was going to be intimate, sometimes I would want that to be with a woman. Because they’re tender, and they understand me, and they would never be able to stick themselves into me the way he was able to, or, they, women don’t have a penis as a weapon. …a means of helping me move onto a new part of my life. It was good for me to move past what had happened because I spent a long time dwelling and feeling guilty…[it was] so liberating in so many ways to completely change my appearance. Table 5 (cont’d) Reclaiming body Dark coping • • • Institutional support creating a proactive environment N/A • • • The final mechanism for reclaiming body involved methods of dark coping. This was more often seen through the act of cutting, post-assault. Cutting, for example, was used to take control over one’s body while being the sole decision maker regarding what would happen to one’s body. Constructing a campuscommunity in which survivors are actively provided with services and offered support, rather than having to exhaust themselves in seeking services and gaining support. Cultural norms in the campus-community need to be reshaped in order to provide survivors support outside of traditionally supportive settings. Institutional support creating a proactive environment was discussed in two different ways which are described below as first-order themes. Addressing intersectionality: All participants regardless of their intersectionalities endorsed the need for increased institutional support to create a more proactive environment. 219 I continued to cut because people would ask me why I do it, and it was very visible when you swim. And I was like, this is my body. I am going to do with it whatever I please. …visibility of the programs needs to be improved…someone who isn’t involved with so many progressive causes like I am, would have no idea that there’s you know such a wealth of resources. Table 5 (cont’d) Institutional Consistent support environmental creating a support proactive environment • • • Consistent environmental support was the most commonly endorsed aspect of institutional support creating a proactive environment. This mechanism encompassed many facets of institutional support in the campus-community, but overall focused on the need to make the campuscommunity consistently supportive, rather than having small pockets of support scattered throughout. Consistent environmental support took the form of a general validation throughout campus that the experience and issue of sexual violence is real, increased and widespread understanding of sexual assault, the elimination of rape culture, institutional support at a systems level, the need for MSU to extend beyond campus boundaries in term of their sexual violence initiatives, and the need to establish safe spaces for survivors. 220 MSU did a major failure in the, the [Study Abroad] return survey, um, without asking about…any type of trauma so I feel failed by that…because they didn’t have a check…system…MSU, um, did a serious disservice to me, and I don’t know how many other individuals… Table 5 (cont’d) Institutional Raising support awareness creating a proactive environment • • Institutional N/A support recognizing and acting on the complexity of sexual violence • • • Another mechanism to contribute to the creation of a proactive environment on campus involved raising awareness and advocacy. Such efforts were deemed important because with increased awareness throughout campus, specifically in the form of advocacy, then people would know the extent of the problem of sexual violence throughout the campus-community. Institutional recognition that sexual violence is not just a static life event that is marked by a clear beginning and end point. Institutional support recognizing and acting on the complexity of sexual violence was discussed in two different ways which are described below as first-order themes. Addressing intersectionality: Participants endorsed the need for increased support that recognizes and acts on the complexity of sexual violence. For participants whose experiences were shaped by religion or sexual orientation, increased service development in these areas were identified as needed. 221 This campus should offer more acknowledgment that sexual violence occurs on this campus. …so a program, um, an informational program, or maybe a panel for the religious advisors association could be beneficial…as well as programs targeted at particular denominations. I think there are definitely ways to integrate faith into healing. I guess what I needed from campus that I didn’t get was a place where I could go and have someone who really, could understand God, and talk about God, and not be judgmental at the same time, and not tell me I’d gotten what I deserved, or things along that nature. Table 5 (cont’d) Institutional Specialized support service recognizing development and acting on the complexity of sexual violence • • Institutional Diversity of support outlets recognizing and acting on the complexity of sexual violence • • • • Specialized service development was the most commonly endorsed mechanism that would contribute to institutional support that recognizes and acts on the complexity of sexual violence. Such specialized service development involved religion, gender, sexual orientation, and culture, and how these factors interact with the experience of sexual violence. Diversity of outlets was another mechanism that would contribute to institutional support that recognizes and acts on the complexity of sexual violence. The campus-community needs to offer a diversity of opportunities, services, and outlets for survivors of sexual violence in order for all survivors’ needs to be met. Since survivors experiences and needs vary, so should the outlets available to them. Having a diversity of outlets allows for all survivors to find their voice, as well as opportunities for healing. 222 …the pain that people feel you know relative to their experience, and relative to their…sexuality, and what’s happened to them prior to an assault can make, can make the impact differ. ...voice can vary from person to person, but with the right resources and support, every survivor can find their voice. Appendix U Table 6 Case Study Comparison Table Case Study #1 Demographics • White • Female • Age 21 Intersectionalities • Heterosexual • Raised in a Roman Catholic family but identified as an Atheist • Tried to seek services at MSU but did not receive any Strategies to • Unconditional social Reclaim support Normalcy and • Traditional services Control Case Study #2 Demographics • White • Female • Age 20 Intersectionalities • Queer • United Methodist religious background • Was not interested in seeking services at MSU Strategies to Reclaim Normalcy and Control • • • • • Strategies to Reclaim Voice • • • Advocacy and legal pursuits Artistic and activist outlets for healing Open communication of feelings about the assault Strategies to Reclaim Voice • • • • • Strategies to Reclaim Body • Change in appearance Strategies to Reclaim Body 223 • • Unconditional social support Immersing oneself into life’s routines Traditional services Goal setting Keeping tabs on the perpetrator Reclaiming the environment the assault took place in Negotiating religion post-assault Embracing a comprehensive understanding of the assault Artistic and activist outlets for healing Open communication of feelings about the assault Change in appearance Negotiating intimate relationships postassault Table 6 (cont’d) What Is Needed to Create A Proactive Environment What is Needed to Recognize and Act on the Complexity of Sexual Violence • • • • Consistent environmental support Raising awareness Specialized service development Diversity of outlets What Is Needed to Create A Proactive Environment What is Needed to Recognize and Act on the Complexity of Sexual Violence 224 • • • • Consistent environmental support Raising awareness Specialized service development Diversity of outlets Appendix V Table 7 Emergent Themes and Photovoice Photos Emergent Theme Reclaiming Normalcy and Control Contributing Photo Reclaiming Voice 225 Table 7 (cont’d) Reclaiming Body Institutional Support Creating a Proactive Environment Institutional Support Recognizing and Acting on the Complexity of Sexual Violence 226 REFERENCES 227 REFERENCES Abbey, A. 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