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This is to certify that the

dissertation entitled

THE COMMUNITY RESPONSE TO RAPE:
AN ECOLOGICAL CONCEPTION OF VICTIMS' EXPERIENCES

presented by

Rebecca Moira Campbell

has been accepted towards fulﬁllment
of the requirements for

 

 

 

 

 

Ph.D. degree in Psychology
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Major professor
it. LL/AM DAV/DSON
2 4,3 '9
Date é

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TlllI
IV ECOLi )Gli

 

 

 

THE COMMUNITY RESPONSE TO RAPE:
AN ECOLOGICAL CONCEPTION OF VICTIMS' EXPERIENCES

By

Rebecca Moira Campbell

A DISSERTATION

Submitted to
Michigan State University
in partial fulﬁllment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Psychology

1996

 

Tll
AXECOLOGW

 

This research examii
respiiind to the nu-ds
the legal system is in
ﬁltered out of the crii
misidering not only
Ihernali'cal and men
senlCE‘S that Were (ii

Other dimensions in:

ABSTRACT

THE COMNIUNITY RESPONSE TO RAPE:
AN ECOLOGICAL CONCEPTION OF VICTIMS' EXPERIENCES

By

Rebecca Moira Campbell

This research examined how the legal, medical, and mental health systems
respond to the needs of rape victims. Previous research has suggested that
the legal system is largely unresponsive to victims' needs as most cases are
ﬁltered out of the criminal justice system. This study extended this work by
considering not only the legal response to rape, but also the services offered by
the medical and mental health communities. In addition to examining the
services that were offered to victims by these three community systems, two
other dimensions were considered: whether the services offered were consistent
with the victims' needs and wishes, and the degree of advocacy needed to bring
about those outcomes. A national random sample of rape victim advocates
(N=168) participated in a phone interview that assessed the resources
available to victims in their communities, as well as the speciﬁc experiences of
the most recent rape victim with which they had completed work. Results
from hierarchical and iterative cluster analysis revealed three patterns in
victims' experiences with the legal, medical, and mental health systems.
Multinominal logistic regression was then used to evaluate an ecological model
predicting cluster membership. In the ﬁrst cluster ("Approaching J ustice")
victims had positive experiences with all three systems (i.e., they received the

services they wanted, and little advocacy was needed to bring about those

outcomes). These \\

 

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outcomes). These women were more likely to live in communities where
services to rape victims were organized in a more coordinated fashion, to have
been raped by a stranger with the use of a weapon, to be injured (trend), and to
be perceived as "good victims" by system personnel (e.g., crying, receptive to
help). In the second cluster ("One Saving Grace"), victims did not have
positive experiences with either the legal system or the mental health
community, but the medical system was responsive to their needs. These
women were more likely to have been raped by someone they knew without the
use of a weapon, and were more likely to have been under the inﬂuence of
alcohol at the time of the assault. Finally, in the third cluster ("Exercises in
Futility"), victims did not receive many of the services they wanted from all
three systems despite intensive efforts by the advocates. This third cluster
also had a higher proportion of women raped by someone they knew without
the use of a weapon, and women of color raped by white men were somewhat
more likely to be in this cluster. Implications for ecological theory and
interventions to improve the community response to rape victims' needs are

discussed.

To my family--Dave and Jody Campbell, and Julie Ahern

For their guidance and support

iv

ACKNOWLEDGEMENTS

I am very happy ﬁnally to be writing these acknowledgments. First, and
foremost, thanks to my Chair, Bill Davidson, who saw the potential of my half-
baked ideas long before I did and taught me to believe in them. I am grateful
that you let me try something different, guided me through it, and tolerated my
stubbornness. I appreciate the conceptual/theoretical help of Debby Salem
and Merry Morash, who taught me how to see the forest for my statistical
trees. I am grateful to my statistical role models Neal Schmitt and Deb
Bybee, who always had time for my questions, even the ridiculous ones. Many
thanks to my unofﬁcial committee member, Cris Sullivan, for her assistance in
the details of data collection.

This project could not have been completed without the dedication,
intelligence, and warmth often wonderful women. Thanks to Charlene Baker,
Robyn Frantz, Melanie Hill, Jeanne J eziorski, Mykel Johnson, Terri Mazurek,
Colleen Peake, Kate Schumacher, N amita Sharma, and Jennifer Walton for
their help creating and conducting these interviews.

I appreciate the early support ﬁ‘om Anna Marie Gire, Diane
Windischman, Kris Koetje-Wilson, and all the rape victim advocates I have had
the pleasure of working with for helping me formulate my ideas.

Many kudos to my ﬁ'iends for keeping me relatively sane. To Julie
Ahern for seeing me through from start to ﬁnish. To Holly Angelique for humor
and balance—these five years would have been very hard without you. Thanks

 

to my sounding b‘ ..
Guzman. Ruth Flt
Zumbahlen. and ti
special thanks to S
their hard work by TI
to me.

lam quite Si.
“Dim 0f m y pdl‘t'F

Finally. I am

. l
their work to parti c1

gamed from listenin

ihN pages. Must 1
Rib me: I hope I cut

silencui again

 

 

to my sounding boards for honest feedback: Cheryl Sutherland, Bianca
Guzman, Ruth Fleury, Christina Reid, Stan Gully, Karla Fischer, Zane
Zumbahlen, and the members of my dissertation support group. I also owe
special thanks to Shelley Smithson, Kristi Breen, and Candy Kokinakis for
their hard work behind the scenes that helped to make this process meaningful
to me.

I am quite sure that I could not have done this without the love and
support of my parents, and the many sacriﬁces they have made for me.

Finally, I am grateful to the rape victim advocates who took time out of
their work to participate in this study. The knowledge and insight I have
gained from listening to these women far exceeds what can be captured on
these pages. Most of all, to the rape victims who have shared their stories
with me: I hope I can use what I have learned so that we may never be

silenced again.

vi

 

LIST or TABLES
LIST or FIGIRE;

”LIFTER 1
MRODL'CTiox_

X'lenenct.

CHiPTER 2
METHOD

 

\

Sam p1e

‘ lemurs \

TABLE OF CONTENTS

LIST OF TABLES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ix
LIST OF FIGURES xi
CHAPTER 1
INTRODUCTION 1
An Overview of the Problem of Rape 3
Rape Victims' Experiences With Community Systems 8
A Theoretical Framework For Examining Rape Victims'
Experiences With Community Systems 3 1
The Current Study 40
CHAPTER 2
METHOD 43
Sample 43
Procedure 53
Measures 54
CHAPTER 3
RESULTS 7 7
Rape Victims' Experiences With Community Systems 7 7
An Ecological Model Predicting Victims' Experiences 9 7
Summary of Results and Qualitative Case Studies 1 1 1
CHAPTER 4
DISCUSSION 122
Summary of Major Findings 1 22
Conceptual Contributions of this Study to the Literature 127
Limitations of This Study 129
Implications for Research and Intervention 135
Conclusion 137

 

vii

APPENDICES

|
Appendix A:
Appendix B:
Appendix C:
Appendix D:
Appendix E:

LIST OF REFERE

 

APPENDICES
Appendix A: Power Analysis

 

Appendix B: Director Interview

 

Appendix C: Advocate Screening
Appendix D: Interviewer Training Manual
Appendix E: Advocate Interview

 

 

LIST OF REFERENCES

 

viii

138
140
145
147
160

212

Table l - Rape Vii"
Table 2 - AdVHC‘dIt'
Table 3 - Ad ViK‘dIt‘

Table 4 - DemUETa;
Worked \V

Table 5 - Character

 

~ychnmci
Table 9 - Psi chomct :I
Table-10 Psychomel
Table 11 - Psychomwl
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ablel4 sychornctsl
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able 10- sychomct‘l
Table} . .. I
chometi
Table
(homer;
Tablel
sych . .
Scale Wm ti l
\

 

LIST OF TABLES

Table 1 - Rape Victims' Experiences With Community Systems

Table 2 - Advocate Demographics

11

47

 

Table 3 - Advocate Work Histories

 

Table 4 - Demographics of the Most Recent Victim Advocate Had
Worked With

 

Table 5 - Characteristics of the Victims' Assaults

48

50
51

 

Table 6 - Psychometric Properties of Legal Resources Scale

55

 

Table 7 - Psychometric Properties of Medical Resources Scale

56

 

Table 8 - Psychometric Properties of Mental Health Resources Scalem

58

Table 9 - Psychometric Properties of Community Coordination Scalem59

Table 10 - Psychometric Properties of Legal-Action Scale

 

Table 11 - Psychometric Properties of Legal-Fit Scale

 

Table 12 - Psychometric Properties of Legal-Advocacy Scale

 

64
65
66
68

 

Table 13 - Psychometric Properties of Medical-Action Scale

Table 14 - Psychometric Properties of Medical-Fit Scale

69

 

Table 15 - Psychometric Properties of Medical-Advocacy Scale

Table 16 - Psychometric Properties of Mental Health-Action Scale

Table 17 - Psychometric Properties of Mental Health-Fit Scale

Table 18 - Psychometric Properties of Mental Health-Advocacy
Scale

70
73
74

75

 

ix

 

Table 19 - Scale In
Health

Table 20 - Scale M
Table 21 - Clusit‘i‘
Table 22 - Cluster
Table 2.3 - Cluster
Table 24 - Cluster 2
Table 25 - Cluster 2
Table 26 - Cluster 2
Table 27 - Cluster 3

Table 28 - Cluster 3

 

 

 

Table 19 - Scale Intercorrelations for Legal, Medical, and Mental

 

 

Health Action, Fit, and Advocacy Scales 76
Table 20 - Scale Means by Cluster Membership 80
Table 21 - Cluster 1 (Approaching Justice): Legal Experienceswmwwmﬁ3
Table 22 - Cluster 1 (Approaching Justice): Medical ExperiencesW84

Table 23 - Cluster 1 (Approaching Justice): Mental Health Experiencesw85
Table 24 - Cluster 2 (One Saving Grace): Legal Experiences 89
Table 25 - Cluster 2 (One Saving Grace): Medical Experiences 90
Table 26 - Cluster 2 (One Saving Grace): Mental Health ExperiencesWQ 1
Table 27 - Cluster 3 (Exercises in Futility): Legal Experiences 94
Table 28 - Cluster 3 (Exercises in Futility): Medical Experiences 95
Table 29 - Cluster 3 (Exercises in Futility): Mental Health Experiencesm96

Table 30 - Intercorrelations of Predictor Variables in Logistic
Regression Model 98

Table 31 - Original Logistic Regression Model Predicting Cluster
Membership 100

Table 32 - Reduced Logistic Regression Model Predicting Cluster
Membership 104

Table 33 - Derivative Values for Reduced Logistic Regression Model 107
Table 34 - Likelihood Ratio Tests for an Ecological Model 1 10

Table 35 - Summary of Results 121

Figure 1 ° OVenievx

IWEQ-Cluster l

 

“31393 - Cluster 2

Fare 4 - Cluster 3

LIST OF FIGURES

Figure 1 - Overview of Sampling Design

 

Figure 2 - Cluster 1 Proﬁle

 

Figure 3 - Cluster 2 Proﬁle

 

Figure 4 - Cluster 3 Proﬁle

 

xi

44
82
88
93

 

 

What
Now
Give'.
Tell e
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The a
Ifﬁze"

From

The ancient l

characterizes the pi

 

AfterTereus rapes I

anytime of the assaul

Tereus fears comm u

Public with her stun

This story highlight;

believe them? will t}

CHAPTER 1
INTRODUCTION

What punishment you will pay me, late or soon!
Now that I have no shame, I will proclaim it.
Given the chance, I will go where people are,
Tell everybody; if you shut me here,

I will move the very woods and rocks to pity.
The air of Heaven will hear, and any god,

If there is any god in Heaven, will hear me.

From Ovid's Metamorphoses, Book VI, The Rape of Philomela

The ancient Roman tale of the rape of Philomela by Tereus
characterizes the promise and problems of the community response to rape.
After Tereus rapes Philomela, he kidnaps her to try to prevent her from telling
anyone of the assault, but she vows to tell her story to anyone who will listen.
Tereus fears community retribution so he hides her. Although she plans to go
public with her story, Philomela is aware that only the gods may believe her.
This story highlights a critical concern for rape victims: will their communities
believe them? will they help?

When women go public with their stories of rape, they place a great deal
of trust in our social systems as they risk disbelief, scorn, shame, punishment,
and refusals of help (Madigan & Gamble, 1991). How these interactions with
system personnel unfold can have profound implications for victims' recovery
(Kerstetter, 1990). Ifwomen are able to receive the services they need, and
are treated in an empathic and supportive manner, then our social systems
can work as effective catalysts for healing (Estrich, 1987; Fairstein, 1993;
Golding et al., 1989; MacKinnon, 1987 ; Madigan & Gamble, 1991; Parrot, 1991;
Russell, 1990; Warshaw, 1988; Wyatt, Newcomb, & Notgrass, 1990).

Conversely, if victims do not receive the services they want and are treated in

1

2

an insensitive manner, then community personnel can magnify feelings of
powerlessness, shame, and guilt for rape victims (Feldman-Summers &
Palmer, 1980; Flynn, 197 4; Madigan & Gamble, 1991; Medea & Thompson,
1974; Peters, 1973; Russell, 1974). These negative experiences and outcomes
have been termed "the second rape" (Madigan & Gamble, 1991). Analysis of
these interactions between victims and social systems may uncover ways to
promote a community response to rape that is psychologically beneﬁcial to
victimized women.

Where in the community could a rape victim turn for help? Several
different, separate places may be available. Victims go to the hospital for the
rape exam and evidence collection; to the police station to meet with a
detective; to the state's attorney to discuss prosecution; to a primary care
physician or gynecologist for follow-up care; to the county board of health for
follow-up HIV testing; to the rape crisis center for information and crisis
counseling; to a different counselor for follow-up support. Community
resources for rape victims are piecemeal and uncoordinated-different systems
perform different functions. Not surprisingly, research in this area is likewise
diffused among disciplines and methodologies. Typically, each system--legal,
medical, mental health, rape crisis centerSuis studied in isolation. From the
perspective of the victims, however, these lines of demarcation may not be as
distinct, meaningful, or useful. This ﬂurry of activity is about one event in their
lives, one trauma that is then parceled out among many for attention. To
thoroughly understand victims' experiences with community systems, the
totality of this task must be addressed head-on: victims' experiences with
multiple community systems should be the focus. How does the legal, medical,
and mental health systems respond to victims' needs? By taking this more

holistic view of how communities respond, we can see where research and

3

intervention is lacking and where further work is needed. We can begin to see
what victims experience and evaluate how well our social services are
responding to this problem.

The purpose of this research, therefore, is to examine the problem of
rape and victims' experiences with multiple community systems including the
legal, medical, and mental health systems. Four substantive areas are
covered. First, an overview of rape and its prevalence, and psychological and
physical health impact is provided. Second, previous research on victims'
experiences with community systems is examined, probing for conceptual and
methodological limitations of this literature. Third, an ecological theoretical
model is proposed as a conceptual heuristic for researching victim-system
interactions. Finally, a research study that addressed some of the theoretical
and methodological limitations of existing research is presented. A national
random sample of rape victim advocates were interviewed to document
victims' experiences with multiple community systems. The individual-level
and environmental-level factors that impacted those experiences were also

examined.

An Overview of the Problem of Rape
Deﬁningﬁaps
The legal deﬁnition of rape varies across states, but generally for an
incident to be considered rape or sexual assault two conditions must be
present: 1) some degree of force or the threat of force must be applied; and 2)
penile/vaginal penetration must occur (Bechhofer & Parrot, 1991; Berger,
Searles, & Neuman, 1988; Estrich, 1987). 1 Whereas rape statutes appear to

 

1 Recently, many states have included anal and/or oral penetration as well as penetration
by an object in their rape/criminal sexual conduct statutes (Berger, Searles, & N euman,

 

4

focus on the act committed and ignore the relationship between the victim and
assailant, it is useful for both research and interventions to classify rape into
two broad categories: stranger rape and non-stranger rape (acquaintance,
date, and marital rape). 2 The act committed in both types of rape is the same,
but there are several features that differentiate non-stranger rapes. First,
non-stranger rape victims are assaulted by someone they know and implicitly
trust, making the violation they experience more than just an intrusion of their
bodies (Gidycz & Koss, 1991). Second, non-stranger rapes are often less
physically violent than stranger rapes. Most do not involve a weapon or injury
beyond minor bruises and scratches (Amir, 1971; Burgess & Holmstrom,
1979; Burt, 1991; Macdonald, 197 9; Russell, 1984; Warshaw, 1988). But,
Koss et a1. (1988) found that stranger rape and date rape victims were equally
likely to have been held down, beaten, and/or choked in the assault. Finally,
alcohol use is more prevalent in non-stranger rapes. A number of studies
indicate that one-third to two-thirds of date rapists and many date rape
victims were drinking alcohol prior to the assault (Koss et al., 1987 ; Lott,
Reilly, & Howard, 1982; Polonko, Parcell, & Teachman, 1986; Richardson &
Hammock, 1991; Wilson & Durrenberger, 1982).
Prevalence

Based on an extensive review of epidemiological data, Koss (1993a)
concluded that approximately 25% of adult women in this country have been
raped. Although popular conception of the typical rape is the crazed-man-in—

 

1988). For example, Michigan's Criminal Sexual Conduct Law (1974) has served as a model
for many states and it includes ﬂ forms of penetration, no matter how slight (Berger,
Searles, & Neuman, 1988). It is also important to note that many state's criminal sexual
conduct statutes have several "degrees" of sexual assault. Such laws deﬁne fondling and
other non-penetration coerced sexual activity as criminal offenses.

2 See Campbell and Johnson (1994) for a discussion of how the legal system is indeed not
"blind" to who commits a rape. The issue of stranger versus non-stranger rape is very
salient in the minds of criminal justice workers as well as lay people (e.g., Burt, 1980;
Campbell, 1998; Feild, 1978; Feldman-Summers & Palmer, 1980; Krahe, 1991).

S

the-bushes-with-a-weapon assaulting a woman a night (Burt, 1980;
MacKinnon, 1987), sexual assault is more likely to be perpetrated by the
acquaintance, friend, date, or husband of the victim (Belknap, 1989; Kanin,
1957; Kirkpatrick & Kanin, 1957 ; Kanin & Parcell, 1977; Koss et al., 1987 ;
Miller & Marshall, 1987 ; Russell, 1982, 1984). For example, in a national
survey of college women, Koss et al. (1987) found that in 84% of the rapes, the
offender and victim knew each other, and 57% of them were speciﬁcally
"dates." Russell (1982, 1984) reported that 24% of a probability sample of
adult community women described experiences that involved forced
intercourse or intercourse completed when the woman was drugged,
unconscious, asleep, or otherwise totally helpless and unable to consent.
Another 31% reported at least one attempted rape. Approximately 72% of the
rape/attempted rape victims in her sample were victimized by an
acquaintance, 58% of which were dating partners (Russell, 1984). Similarly, of
the 4,866 sexual assaults reported to rape crisis centers in Michigan in 1993,
33.1% were acquaintance/date rapes and 8.2% were martial rapes, compared
to 15.6% stranger rapes (Sexual Assault Information Network, 1994). 3
Although many people view stranger rape as the "typical" rape, both national
and local data suggest non-stranger rape is far more common.
Psychological Impact

The psychological impact of rape is devastating (Katz, 1991; Katz &
Mazur, 1979; Koss et al., 1988; Warshaw, 1988). It comes as a shock,
destroying an individual's ability to maintain the important illusion of personal
safety and invulnerability, and threatens many assumptions and beliefs a
woman may have about herself and the world around her (Katz, 1991). Not

 

3 The remaining 43.1% were either child sexual assault, incest, or ritual abuse.

6

surprisingly, most victims exhibit high levels of psychological distress in the
ﬁrst week after the rape. This distress peaks in severity three weeks post-
assault, continues at high levels for one to two more months before ﬁnally
abating two to three months post-assault (Davidson & Foa, 1991; Koss,
1993b; Rothbaum, Foa, Riggs, Murdock, & Walsh, 1992). Throughout this
process of recovery, victims experience guilt, shame, fear, anxiety, tension,
crying spells, an exaggerated startle response, depression, anger (both
generalized and speciﬁcally toward men), discomfort in social situations,
impaired memory and concentration, and/or rapid mood swings (Burgess &
Holmstrom, 1974, 1979, 1988; Burkhart, 1983; Frieze, Hymer, & Greenberg,
1987; Goodman, Koss, & Russo, 1993; Hanson, 1990; Katz, 1991; Katz &
Mazur, 1979; Koss et al., 1988; Resick, 1987, 1990; Warshaw, 1988). Even
when evaluated several years after the assault, survivors are more likely to
have a serious psychiatric diagnosis, including major depression, alcohol abuse
and dependence, drug abuse and dependence, generalized amdety, obsessive-
compulsive disorder, and post-traumatic stress disorder (Burnam et al., 1988;
Kilpatrick et al., 1985; Koss, 1993b; Winﬁeld et al., 1990).

Some authors have argued that the overall trauma is worse for victims
of non-stranger rapes (Katz, 1991; Katz & Mazur, 197 9; Shore, Baum, &
Sales, 1980). Katz (1991) compared the psychological functioning of stranger
and non-stranger rape victims, and found that stranger rape victims blamed
themselves less for the rape, saw themselves in a more positive light, and felt
more completely recovered from the rape than those raped by intimate
partners. Rape by someone familiar can be an even more personal attack
than rape by a stranger because it occurred within a context that was
otherwise associated with safety and privacy (Katz, 1991; Katz & Mazur,

7

1979). The violation of trust inherent in non-stranger rape can exacerbate
victims' psychological distress.
Physical Health Impact
In addition to causing severe emotional trauma, rape has both short-
term and long-term physical health consequences (Koss, 1993b). Immediate
health concerns include: physical injuries ﬁ'om the assault, soreness, bruising,
vaginal and pelvic pain, vaginal and/or rectal lacerations, and sometimes
additional injuries ﬁ'om the use of a weapon (Beebe, 1991; Koss, Woodruff, &
Koss, 1991; Parrot, 1991). 4 In 4% to 30% of rape cases, victims contract
sexually transmitted diseases (STDs) as a result of rape (Murphy, 1990), and
pregnancy results ﬁom rape approximately 5% of the time (Beebe, 1991; Koss,
Woodruff, & Koss, 1991). The long-term health effects of rape can persist for
years following the assault (Koss, Woodruff, & Koss, 1991). Survivors of
sexual assault have signiﬁcantly more somatic health problems than non-
victimized women including. gastrointestinal problems; abdominal pain;
diarrhea; pain during urination; pelvic pain; cardiopulmonary symptoms;
fainting or loss of consciousness; pain during sexual intercourse; irregular
menstrual periods; excessive menstrual bleeding; frequent urinary, colon,
bladder, and yeast infections; weight problems; and eating disorders including
both anorexia nervosa and bulimia (Felitti, 1991; Golding, 1994; Golding et al.,
1988; Kimerling & Calhoun, 1994; Koss, 1993b; Koss & Heslet, 1992; Koss,
Koss, & Woodruff, 1991; Koss, Woodruff, & Koss, 1991; Parrot, 1991;
Waigandt et al., 1990). It is not the case that victimized women had more
health problems even before the assault, as some research has followed

women longitudinally and concluded that these health problems appeared after

 

4 It is important to note that these injuries (with the exception of weapon injuries) are
common for both stranger and non-stranger rape victims.

 

the rape (
health in

Gi
sittims 0

experien.

rape \ictim:

Systems.
Where
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8

the rape (Koss, Koss, & Woodruff, 1991). Both the psychological and physical

health impact of rape is wide-spread, persistent, and severe.

Rape Victims' Experiences With Community Systems

Given the psychological and physical trauma associated with rape,
victims often need support and information to begin to cope with this
experience, and desire a sympathetic and helpful response ﬁom their
communities (Golding et al., 1988; Golding, et al., 1989; Madigan & Gamble,
1991). Bowker (1983) distinguished between two types of social helping
systems--informal and formal. Victims may chose informal resources (e.g.,
talking to friends), or may evoke the assistance of formal help sources (e.g., the
legal system), or may utilize a combination of both informal and formal help
sources. In this review, the focus will be on three formal systems from which
rape victims may seek assistance: the legal, medical, and mental health
systems.
Dimensions of Li_terpture Review

Whereas there are several ways to deﬁne and measure victims'
experiences with community systems, an approach that has been commonly
used in the literature, and will be adopted in this review as well, is to examine
what services are offered to rape victims. Several traditions of research-
analysis of archival records, qualitative reports of victims experiences, and
case studies-are united to form the picture of if, when, and how community
resources are offered to rape victims.

The studies that have examined the help offered to rape victims are
summarized in Table 1 (N =25 studies). To further our understanding of this
issue, four dimensions must be explored when reviewing this literature: who
was sampled, which systems have been investigated, which theoretical

9

perspectives have been utilized, and how the services that were offered to
victims' were measured.

First, although it is a logical ﬁrst choice to study rape victims, it is often
prohibitively difﬁcult to recruit this sample (see Lee, 1993), so systems
personnel are often studied instead of, or in addition to victim samples. This is
not necessarily a problem provided that personnel from multiple systems are
studied so that a more complete picture of victims' experiences with social
systems can emerge. Consequently, the body of literature summarized in
Table 1 must be evaluated on whether diverse samples of people who have
interactions with victims and community systems have been tapped.
Examining personnel from only one system (e.g, police) cannot capture the
complexity of victims' exchanges with multiple systems.

A second issue, which is closely related to the ﬁrst, is which systems have
been investigated. As discussed previously, the psychological and physical
health trauma of rape often creates a need for assistance from multiple help
sources in victims' communities. Over-sampling one system provides a
fragmented view of victims' experiences with community system personnel.

Third, the theoretical frameworks-speciﬁed or implied--must be
examined when reviewing this literature. Adapting Rappaport's (1977)
discussion of the relations between traditional psychological theories and
community psychology, it is possible to delineate four "meta-theories" utilized
to explain human behavior and interactions with social systems. Each meta-
theory makes varying assumptions as to the role of individuals and/or their

environments to explain behavior.

10

Individual diﬁerences models--These theoretical frameworks adopt an
individual level of analysis, proposing that individual differences are the
root explanation of human behavior (e.g., Bem [1970] and Bem & Allen's
[197 4] work on attitudes and beliefs; Rotter's [1954] concept of internal
and external locus of control). With respect to the community response
to rape, research working within this meta-perspective attempts to
understand social system service delivery by looking for psychological
differences in victims (e.g., their assertiveness) and/or system personnel
(e.g., level of awareness).

For the literature in Table 1, a study was designated as an individual
differences model if systematic differences in the response to rape were
explained as a function of characteristics of victims or system
personnel.

Micro-interpersonal models--This meta-theory incorporates some
aspects of individuals' environments to explain behavior through
analysis of the dynamics of small groups (usually dyads) (e.g., social
learning theory and the works of Bandura [1969], Mischel [1968],
Peterson [1968], and Ullman & Krasner [1969]). For example, research
steeped in this tradition would examine the interpersonal dynamics of
victims' interactions with individual system personnel.

Studies in Table 2 were labelled as micro-interpersonal models if they
examined victims' exchanges with system personnel: for example, the
content of their discussions, and/or to what extent victims and system
workers altered their behavior in response to the behavior of the other.

Macro-interpersonal / micro-structuraluDrawing in still more
environmental inﬂuences, these models probe individuals' larger
interpersonal networks to understand behavior (e.g., Carson's [1969]
and Tannenbaum's [1938] explication of labelling theory; Sarbin's [1970]
description of role theory). For the study of rape, studies in this
framework might focus on the role of victims' social support networks
and other interpersonal resources in the victim-system exchange.

11

The reviewed literature was labelled as a macro-interpersonal model if it
explained the differences in service delivery to victims in terms of the
roles victims and system personnel play and how those roles dictate
behavior.

Social structural-Social structural meta-theories explore human
behavior by examining interrelationships among social systems and how
resources are exchanged within individuals' communities (e.g., Merton's
[1938, 1949, 1957] social systems theory of anti-social behavior). For
example, the resources available in victims' communities and/or the
policies and procedures of the Social systems they seek help from are
focal points for research rooted in this theoretical tradition.

A study in Table 1 was designated as a social structural model if it
explained differences in service delivery in terms of resources available
and/or programs and policies in victims' communities to address rape.

Examining the services that are provided to rape victims can be approached
from several theoretical perspectives that make differing assumptions as to
the importance of social environments. Identifying the meta-theoretical
perspective of existing studies can be helpful in determining conceptual gaps in
our understanding of victim-systems exchanges.

A ﬁnal issue to examine when reviewing this literature is how services
that were provided to victims' were measured. Some research has relied on
ofﬁcial system records (e.g., police and court records), whereas other studies
have asked victims directly what services they were offered by system

personnel.

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17

The IﬁggProcessing of Rape: Services Offered, Services Denied

The process of reporting and prosecuting a rape can be a very long and
complicated affair. Victims' ﬁrst contact with the criminal justice system is
usually with the police when they ﬁle a report of the assault. This initial report
may be given to a detective to investigate the rape and collect a more detailed
statement. At this stage it varies across jurisdictions whether this
report/investigation will automatically be forwarded to the prosecutor, or if the
police are allowed to decide whether to forward the report. The prosecutor then
chooses whether to authorize an arrest and press charges. Not all cases are
charged as rapes or sexual assaults, as some are charged at lesser offenses
(e.g., simple assault, reckless endangerment). Ifthe charges are not dropped
at some point, the accused rapist has the choice of pleading guilty to the
original offense, or, if a bargain has been struck, to a lesser offense, or going to
trial. If he is convicted at the trial, the judge must decide whether probation or
jail time will sufﬁce as punishment.

With a system this complex, it is to be expected that some cases will slip
through the cracks. Empirical data suggest that many cases are ﬁltered out
and attrition for rape cases is quite high. Many victims are offered very few
services. Analysis of national police and court data by LaFree (1980) and
Galvin and Polk (1983) indicated that over half of reported rapes are ﬁltered
out of the criminal justice system. LaFree's (1980) analysis of official police
and court records in the 19703 revealed that 37% of reported rapes resulted in
arrest; of those arrests, 47% were felony charged; of those felony charges, 59%
ended in guilty pleas by the assailant; of those who went to trial, 60% were
convicted. Galvin and Polk's (1983) examination of records in the late 19703
and early 19808 paints an almost identical picture. Forty percent of reported

rapes resulted in arrest, but, a lower percentage of arrests were felony charged

18

(24% compared to 47 %). Of those cases charged, 71% ended in a guilty plea,
and 7 2% of those that went to trial were convicted. Although these conviction
rates are quite high, it is important to remember how many cases never make
it to trial. Galvin and Polk's (1983) results suggest that for every 100 rapes
reported to the police, only 17 are reviewed by prosecutors and charged with
felonies, only four of which are convicted at trial. More recent data collected by
the Campus Violence Prevention Center (1990) in a survey of college
campuses indicated that only 19% of reported rapes on college campuses ended
in some type of criminal prosecution.

These data do not appear to tell a ﬂattering tale for the criminal justice
response to rape. But, is this response unique to the crime of rape? LaFree's
(1980) and Galvin and Polk's (1983) data suggested that the attrition rate for
rape cases, although high, is comparable to other serious felonies, such as
robbery, burglary, and assault. They argued that rape cases are not being
unfairly denied or dismissed--all serious felonies had a less-than-ideal response
ﬁ‘om the criminal justice system. Other data have suggested rape cases are
actually handled more efﬁciently than other crimes. Caringella-MacDonald
(1985) examined the processing of sexual assault cases and non-sexual assault
cases in a jurisdiction in Michigan. She found that a higher percentage of non-
sexual assaults were denied for prosecution by the district attorneys than
sexual assaults (46% and 33%, respectively). Once cases had been accepted
for prosecution, there was no difference in their later dismissal or acquittal
rates. Contradictory results were obtained by McCahill, Meyer, and Fischman
(1979) in their study of ofﬁcial police and court records in Philadelphia. They
found that 46% of reported rape cases were unfounded/dismissed, which was
signiﬁcantly higher compared to other crimes.

19

To interpret these contradictory ﬁndings and understand how the legal
system responds to rape, four additional pieces of information may be
necessary. First, the type of rape studied--stranger rape or non-stranger rape
(i.e., acquaintance, date, marital)--may color the results. Second, the speciﬁc
sexual assault laws in practice at the time of the study would be expected to
impact the legal response. Third, the level of community resources dedicated
to addressing rape may be relevant. Finally, the reasons behind the attrition
rate for rape cases must be examined and compared to other crimes.

First, how the legal system responds to stranger rape and non-stranger
rape may be radically different. Based on her reading of case law, Estrich
(1987) asserted that the legal system distinguishes between "real" rapes and
"simple" rapes. "Real" rapes are committed by someone unknown to the
victim (i.e., stranger rape), often involve the use of a weapon, and result in
some physical injuries to the victim. "Simple" rapes are committed by
someone known to the victim (e.g., acquaintance rape). In practice, however, it
is primarily the "real" rapes that receive attention by the criminal justice
system. "Simple" rapes are dropped out of the system.

Estrich cited four elements implicit in legal doctrine that work together
to maintain a system that is suspicious of (at best) or erases (at worst) non-
stranger rapes. First, prior relationship cases are viewed as "private"
disputes, which removes them from the business of the public prosecution
system. Second, these cases are seen as less serious and the defendants less
blameworthy because they often involve a "claim of right, " whereas attacks by
strangers do not. The "claim of right" philosophy stipulates that if a woman
has consented to sex in the past, then the man has a continuing right to sexual
satisfaction from her. Third, prior relationship cases are thought to involve
contributory fault by the victim, but stranger offenses do not. Simple rapes

20

are "victim precipitated" -- she agreed to dates, drinks, rides, or failed to
strongly resist sexual overtures. These acts precipitate sex, and "she should
have known better." Finally, attacks by non-strangers are thought to be less
terrifying to victims, and therefore less serious.

Estrich's arguments suggest that the type of rape must be considered
when examining how cases are processed through the criminal justice system.
LaFree (1980) and Galvin and Polk ( 1983) did not report the type of rape
studied when they concluded that rape cases were handled similarly to other
felonies. Ifmost of these cases were stranger rapes ("real" rapes), there may
be some support for Estrich's position because they received as much
institutional attention as other felonies receive in our system. If, however,
many of these cases were non-stranger rapes, then the legal system may not
distinguish sexual assaults by the relationship between the assailant and the
victim. McCahill et al. (197 9) did consider the type of assault, and found that
stranger rape cases were investigated more thoroughly and were less likely to
be dropped out of the system than non-stranger rape cases. Kerstetter's
(1990) study of police and prosecutor decisions in rape cases also found that
stranger rape cases were more likely to be accepted for prosecution and be
more rigorously pursued. Qualitative accounts of victims' experiences further
support these ﬁndings. Stories collected by Fairstein (1992), Finkelhor and Y110
(1983), Madigan and Gamble (1991), Russell (1990), and Warshaw ( 1988)
suggest that victims of acquaintance, date, and marital rape are told more
frequently that their cases are not prosecutable, and they are dropped before a
trial can take place.

A different picture is presented by Caringella-MacDonald's (1985) data.
Most of the sexual assault cases she examined in one county in Michigan were

non-stranger attacks, and rape cases still had a better prosecution record than

21

other assaults. Yet, one important backdrop feature of this study is the
Michigan sexual assault law. Thus, the second key piece of information needed
to solve this puzzle is the state law guiding prosecution. At the time
Caringella-MacDonald's study was conducted, the Michigan Criminal Sexual
Conduct law was considered one of the most progressive and stringent laws in
the country (see Spohn & Horney, 1992). It deﬁnes rape as an act of
penetration, however slight, by the use of force or the threat of force. The
emphasis is on the behaviors of the assailant (the use of force or the threat of
force), rather than on the state of mind and behavior of the victim (victim's
consent). This deemphasis on consent has been noted to be the critical factor
in bringing more cases through the criminal justice system (Spohn & Horney,
1992). Caringella-MacDonald's ﬁndings must be interpreted in light of the
reformed sexual assault law that guided the prosecution of rape cases in the
state of her research.

Third, the level of community resources devoted to pursuing rape
prosecution may impact how cases are processed. Very little research has
addressed this component, but what is available suggests that more
community resources aid prosecution efforts. For example, Vito, Longmire,
and Kenney (1983) evaluated the impact of an intervention that paired police
officers with rape victim specialists (advocates). These advocates
accompanied the police on rape calls and worked as a liaison between the
victim and the criminal justice system. Vito et a1. ( 1983) found that this
program increased the rape conviction rate in that community. They
attributed this increase to the efforts of the victim specialist in coordinating
the steps of prosecution—victim specialists who were supported by and paid for
by county monies. A survey conducted by the US. Department of Justice

( 1994) revealed similar results. In communities where there was more

22

coordination and integration of services for victims, conviction rates and victim
satisfaction were higher. Community resources may have also played a role in
success of the New York City Sex Crimes Prosecution Unit (Fairstein, 1992).
Fairstein, the chief prosecutor in this unit, noted that New York City had
dedicated signiﬁcant resources to law enforcement and prosecutors to learn
how to successfully investigate and prosecute rape cases. Not surprisingly,
the conviction rates for both stranger and non-stranger rape increased
substantially, with stranger rape cases still more successful. These case
studies indicate that community resources allocated for sexual assault
prosecution may be another factor impacting how rape cases are processed
through the criminal justice system.

A ﬁnal consideration for the legal literature is why some cases are
ﬁltered out of the criminal justice system. It has already been suggested that
the type of rape and the level of community resources for prosecution may be
inﬂuential, but there are other factors that work independently and together
with these other components to impact prosecution. Several studies have
found that rape victims' willingness to prosecute is a primary factor affecting
whether a case will be ﬁltered out (LaFree, 1981; Kerstetter, 1990; Rose &
Randall, 1982; Williams, 1981). This is consistent with most other crimes, as
the district attorney will have a very difﬁcult time prosecuting any case
without the support and testimony of the victim (see Kerstetter, 1990). For
rape cases in particular, assaults that involved the use of a weapon and
resulted in physical injuries to the victim are more likely to be pursued
(LaFree, 1981; Kerstetter, 1990; Rose & Randall, 1982). Other research has
indicated that these features--use of a weapon and physical injuries--are far
less common in non-stranger assaults (Amir, 1971; Burgess & Holmstrom,
1979; Burt, 1991; MacDonald, 1979; Russell, 1984; Warshaw, 1988). Whether

23

report was dropped because it was a non-stranger rape, or because it did not
volve the use of a weapon or result in injuries may be difficult to ascertain
cause the two often go hand-in-hand. The victim's perceived credibility also
ﬂuences disposition. Rose and Randall (1982) conducted a qualitative

ntent analysis of police reports in a large metropolitan area and found that
ses perceived as legitimate were pursued more thoroughly. Legitimacy, they
gued, is really a code word for victim's credibility. Ifthe victim had previous
cial and/or sexual contact with the assailant, if she had previous sexual
lationships, if she were dressed in a way to reveal parts of her body, if she

are under the inﬂuence of alcohol or drugs, then she was seen as less credible
1d her report less legitimate. Williams' (1981) analysis of police reports in one
rge urban city provided almost identical results: high attrition was related to
ctims' credibility. Attrition for other types of crimes was not as strongly
ﬂuenced by the characteristics of the victim.

The criminal justice system services that are available to rape victims,
Lerefore, appear to be quite sparse. There are data to support both the
)sition that attrition rates are worse for rape, and that they are no worse for
Lpe. It has been suggested that this legal literature described in Table 1 can
a better understood by examining the larger context of the assault--what type
'rape was it? what state law was in effect? how much community resources
1d been devoted to addressing this crime? what aspects of the assault or the
.ctim inﬂuenced the decisions of the police and prosecutors? Integrating this
formation from the studies in Table 1 suggests that when there is a strong
ipe law in effect and when there is community support and resources for
rosecution of sexual assaults, the processing of rape cases may be more

)mplete.

 

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24

Medical Care for Rape Victims
Immediately following a rape, a woman may need medical attention for

four reasons. First, the forensic evidence needs to be collected from the

victim's body (e.g., semen samples, blood samples, hair/ﬁber/skin samples).
Second, since it is not uncommon for victims to be physically injured in the
assault (e.g., vaginal lacerations), a medical exam is helpful to detect and treat
these problems. Third, information and testing for sexually transmitted
diseases is common as is the administration of a preventative dose of
antibiotics to treat any diseases that might have been contracted in the
assault Finally, although pregnancy from rape is rare (5% of the time [Beebe,
[991; Koss, Woodruff, & Koss, 1991]), it is a concern for many victims, and
:ome hospitals can administer the Morning After Pill to prevent pregnancy.

Surprisingly, there is very little research examining whether hospitals

re indeed offering all of these services (e.g., pregnancy counseling, Morning
ﬁer Pill, STD treatment) to victims in the exam. The National Victim
enter's (1992) national survey of female survivors of sexual assault indicated
at many of these recommended practices and policies are not followed in the
edical exam. For instance, 60% of the victims were not advised about
egnancy testing or how to prevent pregnancy. Although 43% of the women
[0 had been raped within the last ﬁve years were very concerned about
itactn'ng HIV ﬁ‘om the assault, 73% were not given information about

ting for exposure to HIV. Another 40% were not given information about

risk of contracting other sexually transmitted diseases. These ﬁndings
gest that there is some inconsistency in what information and services are
red to victims during the medical exam.
An intervention described by Evans and Sperekas (1976) provides some

s as to how to improve emergency medical service for victims. This

 

25

program introduced trained volunteers into the emergency room to assist with
the rape exam, and to ensure that victims received all the information and
services they were entitled to. The volunteers were in the emergency room
From 10:00pm to 4:00am seven days a week. Evans and Sperekas reported
hat this program was well received by the medical staff who welcomed the
Lssistance of the volunteers. As a result of this intervention, follow-up
iservice trainings were conducted with both medical staff and law
nforcement personnel, who were also pleased with the program. With respect
» services for victims, the authors concluded that this program was effective
. helping victims obtain the services and information they wanted in their
rams.

Another factor to consider in the medical response to rape is how doctors
d other health care providers address the long—term health effects of rape.
addition to the emergency medical attention that victims need, many
vivors also require follow-up care. A growing body of research has linked
ual victimization with both chronic and acute health problems, as well as
h increased medical service utilization (Felitti, 1991; Golding, 1994; Golding
l., 1988; Kimerling & Calhoun, 1994; Koss, 1993; Koss & Heslet, 1992;
s, Koss, & Woodruff, 1991; Koss, Woodruff, & Koss, 1991; Parrot, 1991;
gandt et al., 1990). Despite these health problems, it does not appear that
: doctors are screening for a history of sexual trauma. Two studies of
en in a primary care clinic HMO program revealed that doctors rarely
211 for sexual assault. Although most of the women in the study believed it
ippropriate for doctors to ask about previous victimizations, only 4% were
11y asked (Koss, Koss, & Woodruff, 1991; Walker, Torkelson, Katon, &

1993). This lack of screening may be related to the fact that most

d States and Canadian medical schools do not teach how to inquire about

0f

the

H

DYE

 

 

26

sexual violence; the only instruction doctors often receive is how to collect the
forensic evidence following an attack by a stranger (Freund, 1991). Goodman,
Koss, Fitzgerald, Russo, and Keita (1993) argued that because medical
)rofessionals are not inquiring about current or past experiences of
ictimization, many survivors of sexual assault are not receiving appropriate
ervices.
Both the short-term and long-term medical care of rape victims appear

. be marked by inconsistencies in service. Whether these gaps in service are
as of omission or commission has not been addressed in the literature; but
gardless, many victims are not receiving complete medical information and
sistance relating to sexual assault. To improve service to rape victims, the
dim] literature reviewed in Table 1 suggests a picture similar to legal
earch: rape victim advocates who work together with system personnel can
ilitate service delivery.
lgssing the Emotional Needs of Rape Victims

Mental health workers may be called upon to help both the victim and
:e close to her who are also traumatized by the rape, including her family,
[(18, husband, and/or signiﬁcant other. This assistance could be limited to
iding information about rape and its effects, or could extend to short-term
rig-term counseling or support groups. Most of the research on the
iological services for rape victims has sought to identify effective forms of
:py (e.g, Frank et al., 1988; Frank & Stewart, 1984; Foa et al., 1991; Koss
rvey, 1991; Resick et al., 1989; Resick & Schnicke, 1992) and assess the
lence of post-traumatic stress disorder (PTSD) in rape victim
ations (e.g., Foa, Steketee, & Olasov, 1989; Norris, 1992; Rothbaum et
92) rather than documenting whether these services are in fact provided

[ms and their families. Some light was shed on this issue by Forman and

27

Wadsworth's (1983) study of community mental health centers (CMHC).

I‘hey found that over 75% of CMHCS in their sample did provide these services
'or victims and their families. Other work by Gornick et a1. (1985) and Harvey
1982a, 1982b, 1985, 1988) revealed that rape crisis centers now offer these
lental health services to victims and their families/friends. King and Webb's
-981) survey of N224 rape crisis centers found that all victims who requested
.unseling received it, and 62% of the victims had at least one follow-up

ntact by center staff several months later to check in and address any
curring concerns. In a pattern of results very similar to both the legal and
edical research, mental health centers and rape crisis programs that are

:re connected to other services in the community have been found to more
active in addressing victims' needs (Harvey, 1982a, 1982b, 1985; Smith &
rcus, 1984).

Research on the mental health response to rape, therefore, has been
ren by other questions than service delivery for victims. The few studies
unarized in Table 1 that have addressed this issue indicate that many of
e resources are available to victims at both community mental health
ers and rape crisis centers. The rise in the number of rape crisis centers in
country (Matthews, 1994; Webster, 1989) and the expansion of their
ces may indicate that the mental health needs of rape victims may be
r addressed than their legal and medical ones.

Tusions

Several conclusions can be drawn from the literature reviewed in Table
'st, the services offered by each of these three systems are not uniform.
ears that victims may have different experiences with each system,
ome more responsive to their needs than others. The literature to date
:ts that most rape cases are ﬁltered out of the criminal justice system,

28

and few victims have their day in court. Whether this attrition rate is unique
for rape remains an unresolved issue in this ﬁeld. Although there have been far
fewer studies examining the medial and mental health response to rape, the
available research indicates that victims often do not receive all the
recommended medical services, but that mental health services may be more
widely and easily available.

Second, community coordination of services appears to enhance service
delivery. Several case studies indicated that programs that unite rape victim
advocates and system personnel are quite effective in increasing the number of
:ervices offered to victims, as well as improving victim satisfaction. Other
irograms and policies that work to bring together these three systems to
treamline their services to victims are similarly effective. These
iterventions also produced beneﬁcial outcomes for the agencies involved,
[eluding heightened awareness about rape and stronger working relationships
i th other agencies in their communities.

A ﬁnal conclusion that can be drawn is that a social structural model
LS been the primary theoretical perspective guiding this research (N=18 of 25
1dies (7 2%) in Table 1). The differences in service delivery for victims tend to
explained in terms of the resources available in the community or in the
icies and practices of our social systems. Research in the legal system,
vever, has included some individual-level work, as some studies have
ntiﬁed aspects of victims that affect legal processing (e.g., their credibility).
3 literature suggests that service delivery is primarily affected by

munity resources and policies, but individual characteristics of the victims

' also be factors.

 

29

Limitations

There are several problem with the studies summarized in Table 1 and
lescribed above that limit our understanding of victims' experiences with social
systems. The scope of this literature has been methodologically and
;heoretically too narrow, which as they are often interrelated, further clouds
:onceptual clarity. Evidence for this claim of narrowness stems from four
ssues. First, these three systems tend to be studied in isolation, with the legal
system being the primary focus in the literature. As mentioned previously,
_'rom the perspective of the victims who have contact with multiple systems,
;hese lines of demarcation may not be as meaningful. Madigan and Gamble
1991) argued that victims may perceive these "different" systems as simply
lifferent places they must ﬁnd and seek out to address one problem in their
,ives. Studying a single system over the others, therefore, obscures this more
:omplete picture of victims' experiences. Their interactions with multiple
systems should be the focus future work.

A second limitation with this literature is how victims' experiences with
social systems have been conceptualized and measured. As discussed earlier,
1 common approach in the literature has been to understand victims'
experiences by examining what services were offered to them. But, there may
)e other dimensions to consider. For example, were the services offered what
be victims wanted? Did a case never make it to trial because the vi_c_tim_
lecided not to go through with it, or because system personnel decided to drop
be case. Depending on this contextual information, we would reach very
lifferent conclusions about how well our social systems are addressing rape.

It may also be important to consider the accessibility of these services.
No scenarios highlight this issue. In the ﬁrst, a victim was told about the
Morning After Pill to prevent pregnancy in the hospital and given the

3O

medication right away to take while she was there. In the second, a victim was
not told about the Pill by the hospital staff. A volunteer from her local rape
crisis center spoke up and asked the staff about the Pill, who explained it was
not hospital policy to administer the Pill, but ﬁnally agreed to give the victim a
prescription for it that could be ﬁlled after she left the hospital. Both women
may have "received the Morning After Pill," but this contextual information
about the advocacy needed to bring about this service tells a more complete
picture these victims' experiences. Therefore, in addition to examining the
services that are offered to victims, it may be useful to examine the larger
:ontext of those services: were they consistent with victims' needs? were they
'eadily and easily available?

Third, the M in which these services have been offered has often
een overlooked for study. Under what circumstances do victims receive what
ervices? The literature suggests that victims of stranger rape receive
‘fferential treatment than victims of non-stranger rape. Additionally, women
ho were injured in the assault and/or had a weapon used against them receive
are help. Yet, there may be other characteristics about victims, the rape,

d their communities that could impact service delivery.

Finally, the theoretical models guiding this research have been largely
Lited to a single level of analysis, most often a social structural perspective.
nmunity psychologists have long noted that the prevalence and complexity
ocial problems can be better explained and understood by examining the
ironmental context of the problem (e.g., the policies of a community
em) rather than looking at the individual characteristics of person involved
.ly, 1966, 1968; Levine & Perkins, 1987; Rappaport, 1977 ; Seidman, 1983;
.man & Rappaport, 1986). But, it is also often the case that individual and
ctural characteristics are interrelated. A single theoretical perspective for

 

 

 

 

31

'estigating rape may be too limiting. Features of the community, the rape,
:l the victim may work in combination with each other to produce different
tcomes. A conceptual framework is needed that can span the individual and

uctural components at play in this issue.

A Theoretical Framework For Examining Rape Victim s'
Experiences With Commum’ty Systems

:ological Theory

 

Ecological theory with its attention to person-environment ﬁt and
ological settings can provide one ﬁamework through which to theorize and
search victim-system interactions that spans individual and systemic
.ctors (Bronfenbrenner, 1979; French, Rodgers, & Cobb, 197 4; Kelly, 1966,
368, 1971; Pargament, 1986; Trickett, Kelly, & Vincent, 1985). Ecological
ieorists have generally asserted that individual-system ﬁt is beneﬁcial to the
erson, and misﬁt can have negative consequences for a person's psychological
'ell-being (Jahoda, 1961; Pargament, 1986; Pervin, 1968). Applying this view
) rape, a "ﬁt" between the victim and the social systems she encounters is
esirable. But, what exactly is meant by "ﬁt" between individuals and
ystems? Harrison (1978) outlined different conceptualizations of ﬁt, such as
be ﬁt between abilities and demands (e.g., skills possessed [abilities] and the
lemands in a job for a particular skill [demands]). A second instance, one more
'elevant to thinking about rape, is the ﬁt between needs and
supplies/resources. In the case of rape, this view of ﬁt would examine how the
needs of rape victims are met by services provided by community systems.

Developing ideas about ﬁt between systems and individuals requires
delving further into ecological theory, and drawing on Kelly‘s work articulating

32

an ecological analogy for understanding behavior (Kelly, 1966, 1968, 1971).
The basic premise of Kelly's work is that the functions of individuals and
community organizations are interdependent, and the structure and function of
social units differ with corresponding variation in behavior of individuals (Kelly,
1966, 1968). Consequently, the experiences of an individual in one setting,
nurtured in one manner, and competing for certain resources may be quite
different ﬁ'om the experiences of another individual situated in a different
setting, nurtured differently, and/or competing for other resources. Individuals
will consequently have different patterns of experiences given different
ecological settings. In other words, the ﬁt between individuals and systems will
vary based on the ecological setting within which this ﬁt is trying to take root.
To understand the ﬁt of individuals and systems necessitates examining
ecological settings, which are constructed of environments, events, and
)ersons (Harvey, 1990; Kelly, 1966, 1968; Koss & Harvey, 1991).
fnvironmental constructs refer to structural features of a community, such as
esources available, functional features, such as procedures followed for
3rvice delivery, and attitudes and values of the community as a whole. Event
instructs refer to the speciﬁc problem(s) that prompts an individual to need
:sistance and/or seek help, and instigates a community help-system network
respond. Person constructs are the characteristics of individuals which they
ing to the person-system interface, such as race/ethnicity, gender, and
liefs and attitudes. These three components are interdependent and to
scribe an ecological setting necessitates examining the interrelationships
ong relevant environmental, event, and person-centered variables. Kelly
71) argued that this requires the study of natural settings--to examine the
ural ecology of a setting with respect to uncovering these interrelationships.
advantage, and ultimate goal of such an ecological analysis, is that it can

33

{est ways to redeﬁne the context surrounding a social problem so that a
if'ic community problem is altered as the host environments are changed.
i_gation of Ecological Theory to the Study of Rape

Applying this theory to the study of rape suggests that victims will have
rent patterns of experiences with social systems depending on the
.gical setting they are located within. To deﬁne and describe these
)gical settings necessitates examination of the interrelationships between
.ronmental, event, and person-centered constructs that may be related to
e victims' experiences with social systems (Koss & Harvey, 1991).
:ause ecological theory has not yet been applied to the study of rape (Koss
1 Harvey [1991] noted its utility, but they did not expand to hypothesize
llCh aspects of environments, events, and persons might be relevant),
search from rape, domestic violence, and community psychology must be
.tegrated to ﬂesh out this theoretical model.

Environmental constructs. Two environmental factors that may

nPact victims' interactions with social systems are the resources available in
ictims‘ communities, and the Coordination of services in the social systems in
heir communities. First, Kelly (1966, 1968, 1971) and other ecological
heorists have suggested that the resources available to address a social
)roblem will affect person-environment ﬁt (a community level variable
Rappaport, 1977]). For example, if the hospitals in a city do not have doctors
:rained to Perform the rape medical exam and evidence collection kit, this is
me 3911409 Victims will likely not receive. On the other hand, if a community's
police department has a special sex crimes unit that has specially trained staff
in rape Prosecution, a victims' experiences may be markedly different than

victims in other communities with no such crime unit. Therefore, the legal,

lite

 

34

medical, and mental health resources available in each community may be
inﬂuential.

A second environmental construct is the amount/degree of coordination
among community systems which may impact how victims are responded to
(a community level variable [Rappaport, 1977]). Research from sociology and
organizational psychology suggests that interorganizational coordination can
improve service delivery (Agranoff & Pattakos, 197 9; Baker & O'Brien, 1971;
Tausig, 1987 ; Turner & TenHoor, 1978). Most applications of
interorganizational analysis have involved examining corporate business
'unctioning (e.g., Van de Ven, 1976; Van de Ven & Ferry, 1980; Van de Ven,
Walker, & Liston, 1979) and mental health service delivery (e.g., Tausig, 1987;
‘urner & TenHoor, 1978), but some communities have adopted this approach
)r servicing victims of intimate male violence. For instance, some
)mmunities have a more integrated and coordinated response to sexual
ssault, via coordinated response teams, community task forces of system
:rsonnel from different agencies and systems, cross-system training
minars, and/or hospital rape programs that have mental health workers on
iff. Research on both domestic violence and sexual assault suggests that
agrams that coordinate efforts to help victims affect service delivery
'ygger & Edleson, 1987 ; Edleson, 1991; Evans & Sperekas, 197 6; Gamache,
leson, & Schock, 1988; Harvey, 1982a, 1982b, 1985, 1988; Syers &

.eson, 1992; U.S. Department of Justice, 1994). How a system may

pond to victims may be a function not only of what resources are available,

also how embedded that system is within a network of social agencies. The

rconnectedness between environments may impact victim-system ﬁt.
Event constructs. Event factors can be thought of as those features

ted to the rape/assault itself. Three such features may be the type of rape

35

(stranger or non-stranger), speciﬁc features of the assault (e.g., use of a

weapon, presence of physical injuries), and the context of the rape (e.g., an
"isolated" incident or part of an abusive relationship, whether rape occurred
while the victim was under the inﬂuence of alcohol). First, whether the victim
was raped by a stranger or by a date (or otherwise "known" person) may have
some relation to how community systems respond (a "group" or dyadic
variable [Rappaport, 197 7]). It has been widely suggested (with growing
empirical support) that acquaintance/date rape cases are not viewed as
serious, real crimes, and therefore are not responded to in an appropriate and
expeditious manner (Campbell, 1993; Campbell & Johnson, 1994; Fairstein,
.993; Kerstetter, 1990; Krahe, 1991; MacKinnon, 1987; Rose & Randall, 1982;
lmart, 1989). Although many have argued that who a woman is raped by
hould have no bearing on how she is treated (e.g., MacKinnon, 1987 ), it

smains a potential systemic bias to investigate.

Speciﬁc features of the assault itself, such as whether the assailant

:ed a weapon (e.g., knife or gun) and whether the victim sustained additional
lysical injuries, may inﬂuence how a system will respond (a "group" or dyadic
riable [Rappaport, 1977]). There is some documentation that if a weapon

.8 used in the assault and if the victim sustained physical injuries, the

dical and legal systems will take the case more seriously and be more
ponsive (LaFree, 1981; Rose & Randall, 1982; Warshaw, 1988).

Finally, for women who are raped by non-strangers (i.e., dates,

bands, etc.), sometimes the sexual assault is the only form of violence they

subjected to, but for others, rape occurs in addition to physical and

tional battering (see Pirog-Good & Stets, 1989). Previous research has

rested that the legal, medical, and mental health systems are reluctant to

'vene in battering relationships (see Sullivan, in press, for a review), so it is

36

possible that victims who are experiencing multiple forms of violence may
receive different systemic treatment than those for whom the rape is the only
issault they have been subjected to. Research by Rose and Randall (1982)
also suggested that alcohol use by victims decreases the likelihood of an
effective system response. Additionally, social psychological attitude research
ias indicated that when victims are under the inﬂuence of alcohol, people are
nore likely to assume a rape did not happen, or if it did, it was the victims' fault
ILott, Reilly, & Howard, 1982; Polonko, Parcell, & Teachman, 1986;
Richardson & Hammock, 1991; Wilson & Durrenberger, 1982)

Person-centered constructs. Whereas there are likely dozens of

 

individual characteristics of victims that inﬂuence how systems respond, three
more broad-based characteristics are considered: race/ethnicity, social class,
and victims' demeanor when interacting with system personnel ( individual-
level variables [Rappaport, 197 7]). Literature from both rape studies and
beyond suggest that members of disadvantaged or stigmatized groups (i.e.,
non-white, lower socio-economic status) receive differentially worse treatment
)y social systems (Collins, 1991; Davis & Proctor, 1989; De Jongh, 1991;
3ordon-Bradshaw, 1988; Mama, 1989a, 1989b; Pinderhughes, 1989; Sue &
Sue, 197 7 ; Wilson, 1993; Wyatt, Newcomb, & Notgrass, 1990). Consequently,
;he race/ethnicity of the victim and the assailant may affect service delivery,
[8 may the match between the victim's and assailant's race. Moreover,
rictims' socio-economic status may affect what services are offered. Finally,
rictims' demeanor when interacting with system personnel may be inﬂuential.
VIadigan and Gamble (1991) suggested that some victims exhibit "good victim"
)ehavior: they cry or show some other obvious expressive signs of distress and
are receptive to help and suggestions ﬁom system personnel. In other words,

they was clearly traumatized, and therefore more credible. Women who

37

behaved in this manner may receive differential treatment ﬁom system

personnel than those who did not.

S_1mea1:y of ecological theoretical model. An ecological perspective of

victims' experiences with social systems suggests that environmental, event,

and person-centered variables may all affect victim-system interactions. With

respect to rape, variables to examine within each of these three domains are:

Environment:

Event:

Person:

Level of resources available within the victims'
communities

Degree of coordination of community systems in
their communities

Type of rape (stranger or date)

Features of the assault (weapon use, injuries)

Context of the assault (battering relationship,
alcohol use)

Race/ethnicity of the victim
Race/ethnicity of the assailant

Match in race/ethnicity between the victim and the
assailant

Social class of the victim

Victim's demeanor

unlikely that a single study could investigate the inﬂuence of all of these

ables on victims' experiences. Rather, aspects of this model can be

uated in several studies, using both victim and system personnel

lations, that together form a web of evidence evaluating this theoretical

el.

 

38

Feminist Standpoint Theory
Applying ecological theory to the study of rape identiﬁes constructs and
interrelationships among constructs for study, but it is not as helpful in sorting
out the relative advantages of different samples and approaches that could be
used to test such ideas. Consequently, integrating feminist standpoint theory
nto this model can suggest who should be studied to provide insight into both
he individual-level and environmental-level constructs speciﬁed by ecological
heory. Standpoint theory places emphasis on the locations of informant
roups relative to the social institutions and individuals involved in a social
roblem (Hartsock, 1983). This phenomenological approach is rooted in Marx's
ew that social being determines consciousness (Hawkesworth, 1989). This
eory claims that class, race, gender, and sexual orientation structure a
rson's understanding of reality. To survive, less powerful groups must be
:uned to the culture of the dominant group. Additionally, these individuals
ve the potential for a more complete and less distorted view of social reality
ecisely because of their disadvantaged position (Nielsen, 1990). By living out
ir lives in both the dominant culture and in their own culture, members of
matized groups can develop a type of double vision, and hence, a more
prehensive understanding of social reality (Hartsock, 1983; Westkott,
9).
This standpoint, however, must be develoﬂ through appropriating
s experiences through intellectual and political struggles against gender,
class, and sexual orientation inequalities (Allen & Baber, 1992; Collins,
, 1991; Harding, 1987; Harstock, 1983). The location of oppressed groups
via their oppressors creates the potential for critical social analysis, but
»ut consciousness raising experiences of this location, such a standpoint

ot emerge. Hence, standpoint theorists issue a challenge to ﬁnd groups on

39

the margins of social structures and actively engage them in describing their
experiences and perceptions (Allen & Baber, 1992).
Application of Feminist Standpoint Them to the Study of Rape
Integrating standpoint theory and an ecological conception of rape
suggests that rape victim advocates may be an informative sample for
understanding the community response to rape. Most communities in the
United States have a rape crisis center with staff members who work as
:ommunity-based advocates, helping victims access the services they need
Webster, 1989). Advocates accompany women to the hospital and police
tation, and often continue their involvement in a case through the stages of
)urt processing. They also help women ﬁnd the counseling or support services
1ey may need for themselves or their families. The primary role for an
lvocate throughout this process is to work on behalf of the victim. To that
.d, they must determine what it is the victim wants ﬁ'om each system, and
en work to bring about those actions by either prompting community
rsonnel to offer those services or by stepping in to prevent outcomes that
: inconsistent with the victims' needs.
The advocate's location relative to victims and social systems is ripe for
lysis. They work with victims in community systems, standing with one
in the world of the rape victim and with one foot in the world of community
1 systems, and carry the responsibility of mutual translation. In the
uage of standpoint theory, they live their professional lives in the dominant
we (in community systems) and in the margins (the world of victimized
en), creating the potential for a more complete view of the systemic
inse to rape. To develop and maximize the potential of this standpoint,
g advocates to describe their experiences working on behalf of victims can

 

40

provide information on both individual-level and environmental-level constructs

speciﬁed by ecological theory.

The Current Study

 

goals of the Study and Research Questions

 

There are multiple conceptual and methodological gaps in the existing
terature on the experiences of rape victims with community systems, and
'hereas a single study cannot knit all the holes together, the current research
.ms to address two major goals. First, this research seeks to describe victims'
:periences with multiple community system through an analysis of not only
hat services were offered, but also whether those services offered were
nsistent with victims' needs and if this help was readily available. Second,

e context in which these services were offered is examined. Under what
'cumstances are victims having what kind of experience? Ecological theory,
th its attention to multiple levels of analysis, guides this exploration. This
rspective suggests that victims will have different patterns of experiences
:11 social systems depending on environment, event, and person constructs
play in their case. Therefore, the questions posed in this research are two-
1: (1) What services are offered to rape victims by multiple community
incies? and (2) Do environmental, event, and person-centered variables
heated by ecological theory predict unique variance in those experiences?
.ther words, are all three levels speciﬁed by ecological theory needed to
lerstand victims' experiences?

Working within feminist standpoint ideology, rape victim advocates were
rviewed to learn about their communities and the experiences of the most
nt victim they had completed work with. Adopting the advocate's

,pective requires that assessment of the victims' experiences focus on

41

aspects directly observed by the advocate or those directly told to the
advocate. Similarly, features of the environment, event, and person (i.e.,
victim) must likewise be objectively-grounded.

Two primary advantages of this approach make it a fruitful method for
examining these theoretical and methodological issues. First, the standpoint of
he advocate relative to victims and social systems can provide insight into
0th individual-level and environmental-level phenomenon. Second, examining
re impact of several community-level variables, as is proposed in this
reoretical model, requires documenting victims' experiences in several
pmmunities. Accessing advocates from several communities is a more
ﬁcient and feasible method for addressing these systemic questions.
oreover, advocates, rather than victims, are better able to describe the
sources available in their communities and degree of coordination and
egration of their systems (again, an advantage of their standpoint).
@cation of Independent and Dependent Variables

The aims of this study are to describe victims' experiences with social
tems, and then to determine if environmental, event, and person-centered
iables predict those experiences. Three groups of independent variables are
sidered: (1) Environmental variables-resources available in the victim's
.munity and coordination among community systems in that community;
Event variables-type of rape (stranger rape or non-stranger rape),
'acteristics of the rape (use of a weapon, presence of physical injuries),
ext of the assault (battering relationship, alcohol use); and (3) Person-
ered variables--race/ethnicity (of victim, of assailant, match between
m and assailant), socioeconomic status of victim, and victim's demeanor

r interacting with system personnel.

42

The dependent variable is victims' experiences with community
systems, as reported by rape victim advocates. The advocates were asked to
iescribe in detail what happened in the most recent adult sexual assault case
;hey had completed. Three key dimensions are considered: (1) what actions
vere taken by each system; (2) did those actions taken (or those actions not
aken) ﬁt with what the victim wanted from the system (i.e., did the system do
vhat the victim wanted it to); and (3) what involvement did the advocate have
n bringing about those actions.
lypotheses

Two hypotheses are evaluated in this study: (1) Rape victims will have
ifferent patterns of experiences with the legal, medical, and mental health
ystems; and (2) Those patterns of experiences can be successfully predicted
V the proposed ecological model. Speciﬁcally, the selected variables, such as
smmunity coordination, will successfully predict victims' experiences, ar_1c_l_ the
tree levels speciﬁed by ecological theory will predict unique variance in the
itcome variable (victims' experiences). Ecological theory stipulates that
formation about the environment, the event, and the person is necessary to
iderstand social phenomena; this assumption is explicitly tested in this
:ond hypothesis.

CHAPTER 2
METHOD

Sample

A two-step process was used to identify the rape victim advocates.
I‘igure 1 provides an overview of the sampling design. First, agencies that
irovide community-based advocacy to victims of sexual assault were
lentiﬁed. The most recent and comprehensive national directory of services
)r sexual assault victims is by Webster (1989): Sexual assault anghild
sxual abuse: A national directory of victim/survivor services and preventions
rogpams. This directory describes 2,387 programs that offer services to rape
ctims, including rape crisis centers, combined rape crisis-domestic violence
'ograms, domestic violence shelters, legal system victim-witness programs,
unseling programs, special hospital treatment centers, and information
*twork groups. The two types of agencies relevant for selecting the target
rticipants for this study were rape crisis centers and combined rape crisis-
mestic violence programs. Compared to the other services, Webster (1989)
bed that these programs are more likely to provide direct advocacy, and work
:h victims in multiple community systems. The other types of agencies
ier do not provide advocacy (e.g., counseling programs) or are focused on
ving victims only within one community system (e.g., legal system victim-
ness programs). Rape crisis centers and combined rape crisis-domestic

ence programs have advocates who work with victims in multiple

Lmumty settings.

43

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44

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45

A total of N =7 59 agencies were listed as providing advocacy for rape
ms: N=390 ﬂee-standing rape crisis centers, and N=369 combined rape
ts-domestic violence programs. A random sample of agencies was selected,
Ltifying for agency type. A power analysis indicated that at least N=165
'ocates would be needed to have a power of .80 (alpha=.05), so N=84
:ncies were randomly selected from the ﬂee-standing rape crisis center list

1N=390 free-standing rape crisis centers is 51% of the total advocacy
rvice pool of N=7 59, N=84 is 51% of N =165), and N=81 agencies were
lected from the combined rape crisis-domestic violence program list (as
=369 is 49% of total pool of N=7 59, N=81 is 49% of N=165) (see Appendix A
.r logic and computations of the power analysis).

In the second step of sample selection, the directors ﬁ'om the randomly-
elected N=165 agencies were contacted by phone (see Appendix B for
screening procedures used). An overview of the study and its purpose was
srovided and they were asked if they have paid or volunteer staff who provide
community-based advocacy services to adult rape victims. The directors were
then asked to provide the name of the advocate who provides the ﬂit direct
advocacy work at that agency. If the director stated that no one provides
these services, this agency was removed ﬁ'om the list of N=165 target
agencies and a randomly-selected replacement from the same type of agency
was drawn.

Once a list of N=165 target advocates was compiled, each one was
contacted by phone and asked if they would be willing to participate in the
study (see Appendix C for the screening procedures used). A detailed screening
was conducted to ensure that the advocate had recently worked with an adult
female rape victim who had contact with at least one community system. If

the advocate had not had such an experience, a new agency was randomly-

 

46

ted (from the same agency type) and the director screening procedures
ribed above were repeated to ﬁnd a new target advocate. If the advocate
worked with such a rape victim, but refused to participate in the study,
ther randomly-selected agency was selected and procedures described
viously were employed. This process was repeated until at least N=165
rocates agreed to be interviewed.

Over two-hundred agencies were contacted (N =2 13), of which N=17 7
are eligible for participation in the study. Of the N=36 centers that were not
igible for the study, N=8 were no longer in existence, N = 19 had changed their
srvices since the publication of the directory and now provided only therapy
10 advocacy) for victims, N=2 did not have a recent sexual assault case in the
sast three years, N=5 now worked only with domestic assault victims (i.e., the
rad no sexual assault program), and N=1 now worked only with victims of child
sexual abuse. From this pool of N =17 7 eligible centers, N =168 advocates were
interviewed (95% response rate). All of the N=9 centers who refused to
participate were interested in being interviewed, but had to refuse because
they were too short-staffed to allow the time to complete the interview.

Table 2 summarizes the advocates' demographics. The mean age was
37.25 years with a range of 22 years to 65 years old. The majority of the
sample was White (88%) and most had obtained a bachelors degree (44%). A
sizable number of the advocates reported that they were also survivors of
sexual assault (43%). Table 3 presents the advocates' work histories. They
had worked as rape victim advocates for an average of 5.28 years, with a
range from 5 months to 20 years. They had worked with 400 victims in their
career (on average), with a range of 1 victim to 5,721 victims. The advocates
reported that they worked mostly in the legal system (57 %) on behalf of
victims of acquaintance rape (85%). The reasons they decided to become

 

 

47

 

 

 

Table 2
Advocate Demographics
Percentage or Mean
GENDER (Female) 100%
AGE 37.25 (9.69) (22-65)
RACE
White 88%
African-American 5%
Latina 4%
Native American Indian 2%
Asian-American 1%
Arabic-American 1%
EDUCATION
Some high school 1%
High school graduate 6%
Some college 17%
Associates degree 6%
Bachelors degree 44%
Some graduate school 8%
Graduate degree 1 8%
SURVIVOR OF SEXUAL ASSAULT 43%

 

Note: First parentheses is standard deviation; second parentheses is range

48

 

 

 

Table 3
Advocate Work Histories
Percentage or Mean
HOW LONG AS ADVOCATE 5.28 years (4.22) (5 mo-20 yrs.)
NUMBER OF VICTIMS IN CAREER 400 (808.58) (1-5,721)

SYSTEM WORK THE MOST WITH

Legal 57 %
Medical 24 %
Mental Health 1 7 %
Other 2%

TYPES OF CASES WORK THE MOST WITH

Stranger rape 3%
Acquaintance rape 85%
Date rape 12%
Marital rape 1 %

REASONS FOR BECOMING AN ADVOCATE

Being a survivor of sexual assault 25%
School practicum or class 24%
Interest/concern for women's issues 35%
Interest/concern ﬁrst for domestic violence 14%
Needed employment 25%

 

Note: First parentheses is standard deviation; second parentheses is range

49

advocates were varied. For some, a concern for women's issues initiated their
involvement (35%), another 25% stated that their experiences as a survivor
led them to this work, some simply needed employment (25%), 24% became
involved through a class or school practicum experience, and for 14% of the
advocates, an initial concern for domestic violence issues branched out into
concern about sexual assault.

As mentioned previously, the advocates were asked to describe the most
recent adult sexual assault case they had completed. Table 4 presents these
victims' demographic characteristics. The victims were, on average, 10 years
younger than the advocates (mean age 28.35 years, range 17 years to 78
years old). Most of them had obtained a high school degree (45%), and only
12% had some type of college degree. Over a third of the victims were
described by the advocates as working class (35%), with 25% described as
lower class and 26% as middle class. Only 14% were described as above middle
class.

The characteristics of the assaults against these women are reported in
Table 5. Most women in this sample were raped by someone they knew (76%),
and most were raped by a single assailant (90%). Whereas almost all of the
women were subjected to forced vaginal penetration (95%), some experienced
anal rape (20%), oral rape (23%), and/or rape by a physical object (14%). Thus,
some women experienced multiple forms of rape. In this sample of victims,
women were raped on average 1.89 times by the assailant in the assault with
a range of one time to twenty times. Forty-one percent experienced no
physical injuries from the attack, but 48% experienced some bruising, 23%
were cut during the assault, and 19% experienced some type of head injury
including a blow to the head and/or broken blood vessels in the eyes and face
ﬁom being choked. Most of the women did not have a weapon used against

50

Table 4
Demogpaphics of the Most Recent Victim Advocate Had Worked With

 

Percentage or Mean

 

GENDER (Female) 100%
AGE 28.35 (10.07) (17-78)
RACE
White 7 1 %
African-American 14%
Latina 9%
Native American Indian 4%
Asian-American 2%
EDUCATION
Some high school 15%
High school graduate 45%
Some college 28%
Associates degree 3%
Bachelors degree 6%
Some graduate school 1%
Graduate degree 2%
SOCIOECONOMIC STATUS
Lower class 25%
Working class 35%
Middle class 26%
Upper middle class 10%
Upper class 4%

 

Note: First parentheses is standard deviation; second parentheses is range

 

Table 5

“fl

5 1
Table 5

Characteristics of the Victims' Assaults

 

Percentage or Mean

 

TYPE OF RAPE
Stranger rape 22%
Acquaintance rape 46%
Date rape 16%
Marital rape 6%
Gang rape-stranger 2%
Gang rape-acquaintance 8%

TYPE OF FORCED PENETRATION

Vaginal rape 95%
Anal rape 20%
Oral rape 23%
Rape by object 14%
NUMBER OF FORCED PENETRATIONS 1.89 (1.97 (1-20)

INJURIES SUSTAINED

None 41%
Cuts 23%
Vaginal or anal lacerations 8%
Bruises 48%
Broken bones 3%
Head injuries 19%
WEAPON
No weapon 7 1%
Knife 19%
Gun 5%

Object 6%

 

 

Tab!

ALC

ASS
C0.)
REL

HOV-

52

 

 

Table 5 (cont)
Percentage or Mean
ALCOHOL USE BY VICTIM

N 0 alcohol 66%

Some alcohol 10%

Tipsy/drunk 18%

Blacked out or passed out 5%
ASSAULT OCCURRED WITHIN THE 23%
CONTEXT OF A BATTERING
RELATIONSHIP

HOW LONG AGO ASSAULT OCCURRED 10.07 mos. (9.82) (14 dys-4 yrs)

 

S3

them in the assault (71%), and most were not under the inﬂuence of alcohol
(66%). For almost one-quarter of the women (23%), this assault occurred
within the context of an abusive relationship. At the time the interview with

the advocate was conducted, the rape had occurred on average 10 months ago.

Procedure

The interviews with the advocates were conducted over the phone with a
mean duration of 1.34 hours (SD=26.69 minutes), with a range of 40 minutes
to 3.25 hours. Ten trained interviewers, who received course credit for their
participation in the project, completed N=109 interviews (65% of the sample).
Each interviewer completed an average of 10.9 interviews, with a range of 3
interviews to 26 interviews. The remaining N=59 (35%) were conducted by the
primary investigator. The training manual used to prepare the interviewers
for data collection can be found in Appendix D. These research assistants were
allowed to start phoning advocates only after they could complete and code an
interview with over a 95% accuracy rate.

These phone interviews were not tape recorded, so the interviewers were
instructed to write the advocates' accounts verbatim. Twenty-ﬁve percent of
the completed interviews were randomly selected and the advocates were re-
contacted to double check their responses for accuracy. Again, the
interviewers had successfully coded the information over 95% of the time. For
the qualitative data reported in this study, the speciﬁc advocates who are
quoted were re-contacted and read their transcription. Corrections in their

narratives were made as necessary.

 

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54

Measures
Variables in the ecol<gical model (independent variables)

The measures used to asses the constructs in the ecological model were
created for this study by the primary investigator as there are no established
instruments in the literature to work ﬁom. Several sources of information
were drawn upon to create this interview. Rape victim advocates' training
manuals ﬁom several rape crisis centers were reviewed; literature on
community resources for rape victims was examined (e.g., Koss & Harvey,
1991); two focus group with ten advocates in each were also conducted to
explore the exact wording in the interview and to pilot the measure (see
Appendix E for the interview protocol).

For the environmental constructs, four scales were created to measure
resources available in the community to address rape and the coordination of
those services. The event and person-centered constructs were assessed with
single items in the interview protocol.

Environmental variables. To measure the Legal Resources available in
the community, the advocates were asked if a number of programs or services
existed in their area (e.g., did the police department have a rape unit or sex
crimes unit? did the prosecutors' office have a rape unit or sex crimes unit?)
To create the Legal Resources Scale, the number of such programs or services
were summed so that higher scores reﬂect a larger number of legal resources
available for the problem of rape. The psychometric properties of the ﬁve-item
Legal Resources Scale can be found in Table 6. This scale had acceptable
internal consistency with alpha=.60 with corrected item-total correlations
ranging from .26 to .55. 5

 

5 Many of these scales assessing the environmental constructs were based on items that
were dichotomously coded, so it is to be expected that the alphas will be somewhat low.

55

Table 6

Psychometric Properties of Legal Resources Scale

 

 

Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Police sex crimes unit .35 .48 .43
Police sexual assault protocol .69 .47 .26
Prosecutor sex crimes unit .3 1 .46 .47
Prosecutor victim witness program .84 .36 .55
Prosecutor court accompaniment .63 .48 .29
Alpha = .60 Scale Mean = 2.82 Scale SD = 1.41

 

To assess the MedicalResources available in the community, the
advocates were asked if a number of medical services were offered at the
hospitals in their area (e.g., do the hospitals perform the rape exam and
evidence collection kit? do the hospitals offer victims the Morning After Pill to
prevent pregnancy?). To create the Medical Resources Scale, the number of
services were summed so that higher scores reﬂect a larger number of medical
services available to victims at the hospital. The psychometric properties of
the Medical Resources Scale can be found in Table 7. One item, rape exam and
evidence collection kit, was dropped due to lack of variance as all communities
offered this service. The internal consistency for this ﬁve-item scale was

somewhat low (alpha=.31) with corrected item-total correlations ranging from

56

Table 7

Psychometric Properties of Medical Resources Scale

 

 

Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Information on risk of pregnancy .98 .1 1 .07
Information on risk of STD .97 .1 7 .16
Morning afterpill .89 .32 .27
STD preventive treatment .91 .29 .30
Schedule follow-up visit .26 .44 .09
Alpha = .31 Scale Mean = 4.01 Scale SD = .75

 

Note: One item, Rape Exam and Evidence Collection, was dropped due to lack
of variance as all communities offered this service.

.07 to .30. The items with lower corrected item-total correlations were retained
to preserve the conceptual meaning of the scale (i.e., the scale reﬂects all of the
services that could be offered to victims in the medical exam as opposed to just
some services that exhibited stronger psychometric properties).

Mental Health Resources were assessed by asking the advocates if three
types of counseling services were available in their area (e.g., are there places
that offer short-term [10 sessions or less] rape-related therapy? are there
places that offer long-term [more than 10 sessions] rape-related therapy? are
there places that offer rape-related counseling services for women with special

needs, such as women of color, lesbians, and women who are diﬂ'erently-abled?).

To create the Men
mmwwmmh
resources availabf
properties of the l
internal consister
with corrected ite
lower conected it
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57

To create the Mental Health Resources Scale, the number of services were
summed so that higher scores reﬂect a larger number of mental health
resources available to rape victims in that community. The psychometric
properties of the Mental Health Resources Scale can be found in Table 8. The
internal consistency for this three-item scale was somewhat low (alpha=.26)
with corrected item-total correlations ranging from .15 to .21. The items with
lower corrected item-total correlations were retained to preserve the
conceptual meaning of the scale (i.e., the scale reﬂects Q of the services that
could be available to victims as opposed to just some services that exhibited
stronger psychometric properties).

The Community Coordination of resources was assessed by asking the
advocates what types of programs or policies existed in their area that brought
together the various agencies that serve rape victims to streamline their
services. For example, advocates were asked if they had programs such as
Sexual Assault Response Teams (SARTs) at the hospital in their community,
which brought legal, medical, and mental health personnel to one location to
work with victims. Similarly, they were asked if their communities had a
multi-agency sexual assault task force, which worked to oversee services to
victims. The advocates were also asked about training programs that existed
between the rape crisis center and other agencies that aim to increase
familiarity between services providers, increase knowledge about the services
provided by each agency, as well as promote working together on each rape
case. The psychometric properties of the Community Coordination Scale can
be found in Table 9. The internal consistency for this ten-item scale was .64
with corrected item-total correlations ranging from .15 to .41. Again, the items
with lower corrected item-total correlations were retained to preserve the

conceptual meaning of the scale.

58

Psychometric Properties of Mental Health Resources Scale

 

 

Sc ale Items Item Item Corrected
Means SDs Item-Total
Correlation
S hort—term counseling .97 . 1 7 . l6
I4ong-term counseling .92 .27 .2 1
Counseling for women .4 1 .49 . 15

with special needs

Alpha 2 .26 Scale Mean = 2.30 Scale SD = .41

 

Table 9

Pstchometric Pro

 

Scale Items

 

Inter-agency servic
Sexual assault tasl
Rape crisis center t
Rape crisis center 1
Rape crisis center 1
Rape crisis center 1
POM“? train rape cr
PTOSECutor train rz
Medical train rape
Mental health trai

Alpha : 64

\

59

 

 

 

Table 9
Eychomgic Properties of Community Coordination Scale
/
Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Inter-agency service programs .30 .46 .32
Sexual assault task force .33 .47 .15
Rape crisis center trains police .82 .38 .34
Rape crisis center trains prosecutor .31 .46 .26
Rape crisis center trains medical .76 .43 .29
Rape crisis center trains mental h. .58 .50 .36
Police train rape crisis center .78 .42 .33
Prosecutor train rape crisis center .67 .47 .41
Medical train rape crisis center .74 .44 .27
Mental health train rape crisis center .61 .49 .32
Alpha = .64 Scale Mean = 6.08 Scale SD = 2.30

\

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60

Event variables. The event variables in the ecological model were
assessed with individual items in the interview protocol. For the analyses,
Type of Rape was recoded to distinguish stranger rape and non-stranger rape

( acquaintance, date, and marital). Likewise, Injuries from the Assault and Use
ofa Weapon were recoded to reﬂect presence/absence of physical injuries to the
victim and the presence/absence of a weapon. Whether the rape occurred

Within the Context of a Battering Relationship was assessed by asking

advocate (to the best of her knowledge) whether the relationship between the
victim and assailant had been characterized by other physical violence prior to
this rape (dichotomously coded). Finally, Victims' Use of Alcohol at the time of

assault was recoded to reﬂect use of alcohol/no use of alcohol.

Person-centered ga_ri;ab_l_e_s_; The person centered variables in the
ecological model were assessed with individual items in the interview protocol.
For the analyses, Victim'Race and Assailants' Race were recoded to reﬂect
WrSOns who were described as white/caucasian and those that were described
as peOPIe of color. Victims' SES was similarly recoded to distinguish between
those described as lower class from those described as working, middle, or
upper class. Victims' Demeanor was assessed by a single item that asked if
the Victim exhibited "good victim" behavior in her interactions with system
I"31‘s()1111el. Using a deﬁnition of "good victim" behavior suggested by Madigan
and G‘fllrnble (1991), the advocates were asked if the victim was crying or
silo -

wlhg some other obvious expressive signs of distress and was receptive to
help and suggestions from syStem personnel. This variable was dichotomously

coded
for the analyses.
V‘alidity assessment for the va_ri_ables in t_he ecological model. To

e
[Katha-Elle the validity of the advocates' reports, data were also collected from
95m

and medical personnel. The validity of the Legal Resources Scales was

¥

 

 

61

assessed by interviewing law enforcement personnel in a smaller group of
communities in this study. Fifty rape crisis centers were randomly selected
ﬁ'om the total sample of N: 168, and the primary police department (and
hospital, see below) in these communities were contacted. The ofﬁcers,
detectives, or chief of police were asked the same questions about police legal
resources as were the advocates (do the police department have a rape unit or
sex crimes unit? do the police oﬂicers follow a protocol in rape cases?) Kappas
were computed to assess the degree of agreement between the advocates and
l aw enforcement personnel. Although the kappas indicated that the rate of
agreement was better than chance (both kappas were positive), they were
somewhat low: police rape or sex crimes unit, kappa=.60; police protocol for
rape cases, kappa=.32. These discrepancies were due to the law enforcement

personnel stating that they did have such a resource whereas the advocates

reported the police did not have that service.
The validity of the Medical Resources Scales was assessed by

interviewing hospital staff in N =50 communities in this study. 6 The nurses or
doctors were asked the same questions about medical services as were the
adecates. Kappas were computed to assess the degree of agreement between
the advocates and hospital staff: information on pregnancy, kappa =32;
it‘11-‘(31'lililation on risk of sexually transmitted diseases, kappa =.88; Morning
%r Pill, kappa =.36; STD preventive treatment, kappa =.7 5; follow-up care
“sit, kappa =.24. Overall, these discrepancies were due to the hospital staff
181::3 that they did have such a service whereas the advocates reported the
1“-8.19. did not have that resource. For one item, whether the hospital

 

61h.\
ﬁfty communities were the same as those selected for the police interviews. In other

wo s
a communities were randomly selected and both the police departments and

has ~ ‘ ﬁﬁy
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oﬁered Victims
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Due to t
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advocate have
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were gathered

62

oﬁ‘ered victims the Morning After Pill to prevent pregnancy, the discrepancy
W as in the opposite direction: the advocates reported more often that the
hospital did offer the Pill than did the hospital staff. Given that several of the
hospitals in this sample were afﬁliated with the Catholic Church and had
Stated policies against administering the Morning After Pill, it is not surprising
that the hospital staff may have not reported such violations in policies by
individual doctors.

Due to the limited resources of the research team, the validity of the

Mental Health Resom‘ces Scale, the Community Coordination Scale, and the
other variables in the ecological model were not assessed.
Victims' experiences with community systems (dependent vaﬂﬂ)

To describe victims' experiences with the legal, medical, and mental
health systems, three dimensions of information were collected: (1) what
actions were taken by each system; (2) did those actions taken (or those

actions not taken) ﬁt with what the victim wanted from the system (i.e., did
the System do what the victim wanted it to); and (3) what involvement did the
adVOcate have in bringing about those actions. Thus, for each action that

co uld have been taken by each community system, three pieces of information
Pele gathered: Was the action taken? (scale: 1=yes; O=no) Did that outcome
at with what the victim wanted? (scale: 1=yes; O=no) How much, if any,
advocacy was needed to bring about that outcome (scale: O=none; 1: a little;
2: SO~‘ule; 3= quite a bit; 4: a great deal). For each system (legal, medical, and
mental health), three scales were constructed: Action, Fit, and Advocacy.

Legal egmriences. Previous research and advocate manuals have
0111:1311
ed the legal services could be available to victims for sexual assault (see

p0. ‘ 83 Harvey, 1991). In this study, seven such actions were examined: (1)
Q report taken; (2) investigation conducted about the rape; (3) police

¥

 

reports forwarde
by prosecutor; (16
and outcome of t
three scales wen
Advocacy Scale.
actions that wer
The psychometr
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63

reports forwarded to prosecutor; (4) arrest of the assailant; (5) charge issued
by prosecutor; (6) guilty plea, to original charge or other charge; and (7) trial
and outcome of trial. To describe victims' experiences with the legal system,
three scales were constructed: Legal Action Scale, Legal Fit Scale, and Legal
Advocacy Scale. For the Legal Action Scale, the number of these seven
actions that were taken in each case were summed to create the scale score.
The psychometric properties of this scale can be found in Table 10. This scale
had acceptable internal consistency with alpha = .77 and corrected item-total
correlations ranging from .34 to .81. 7 A similar procedure was used to create
the IJegal Fit Scale as the number of outcomes that ﬁt with what the victim
wanted were summed. A higher score on this scale indicated that the response
ﬁ-om the legal system was a better ﬁt with what the victim wanted. It is
important to note that this measure is independent of actions taken, so it is
possible to have a low score on the Legal Action Scale, but a high score on the
Leg a1 Fit Scale, which would indicate that few actions were taken, but that
Was consistent with what the victim wanted. Table 11 summarizes the
psychometric properties of the Legal Fit Scale. Internal consistency for this
scale was .76, and the range of corrected item-total correlations was .03-.78.
The i1:811:18 with the low corrected item-total correlations were retained to
provide consistency in items across all the action, ﬁt, and advocacy scales.
Finally, the Legal Advocacy Scale was created by summing the rating of how
much advocacy was needed to bring about each outcome. The scale had an
alpha ‘ . . . .
‘.73 With corrected item-total correlations ranging ﬁom .36 to .62 (see
Telb]_,e 12).

 

(uh-Qt 3' 0f the scales assessing victims' experiences were based on items that were
niously coded, so it is to be expected that the alphas will be somewhat low.

Table 10

W

Scale Items

 

Police report
Investigation
Report forward
Arrest

Cbarge issued I
OUtCOme of cha

.lesailant sente

Alpha : 7']

\

64

 

 

 

Table 10
Echometric Properties of Legal-Action Scale
Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Police report .93 .25 .34
Illvestigation .85 .36 .47
Report forwarded to prosecutor .73 .45 .62
Arte st .55 . 50 .7 8
Charge issued by prosecutor .52 .50 .81
Outcome of charge 1.13 1.58 .70
As sailant sentenced to jail .27 .44 .69

Alpha = .77 Scale Mean = 4.98 Scale so = 3.24

 

Table 11

Psvchometri

 

Scale Items

 

Police repor
Investigatio
Report forw
Arrest

Cbarge i551

Outcome 01

Alpha = .7t

\

Table 11

65

P svchometric Properties of Legal-Fit Scale

 

/

 

Scale Items Item Item Corrected

Means SDs Item-Total

Correlation
Police report .97 .17 .03
Investigation .96 .19 .34
Report forwarded to prosecutor .85 .35 .55
Arr-rest .70 .46 .7 8
Charge issued by prosecutor .64 .48 .77
Outcome of charge .37 .48 .52

Alpha = .76

Scale Mean = 4.50

Scale SD = 1.54

 

Table 12

Psvchometric Pr

Scale Items

 

Police report
Investigation
REPOrt forw ardet
Arrest

Charge issued b3

OUTCOme of char

Alpha = .73

\

66
Table 12

Psychometric Properties of Legal-Advocacy Scale

 

 

Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Police report .19 .82 .36
Investigation .90 1.56 .46
Report forwarded to prosecutor .43 1.17 .61
Arrest .36 1.09 .62
Charge issued by prosecutor .64 1.41 .49
Outcome of charge .82 1.54 .37
Alpha = .73 Scale Mean = 3.33 Scale SD = 5.06

 

medical 53mm ‘
(2) information ‘
effects of rape gl
of rape given to ‘
llomingATter P
initiated. To cre
were taken in ez
properties). lntr
total correlation.
outcomes that ii
of this scale indi
ﬁt with what the
properties of the
and the range of
Advocacy Scale t

67

Medical experiences. Seven services that could have been offered by the
medical system were examined: ( 1) information on pregnancy given to victim;
(2) information on STDs given to victim; (3) information on the physical health
effects of rape given to victim; (4) information about the psychological effects
of rape given to victim; (5) rape exam and evidence collection kit performed; (6)
Morning After Pill administered; and (7 ) STD preventive antibiotic treatment
initiated. To create the Medical Action Scale, the number of these actions that
were taken in each case were summed (see Table 13 for psychometric
properties). Internal consistency for this scale was .68, with corrected item-
total correlations from .26 to .55. For the Medical Fit Scale, the number of
outcomes that ﬁt with what the victim wanted were summed. A higher score
of this scale indicated that the response ﬁom the medical system was a better
ﬁt with what the victim wanted. Table 14 summarizes the psychometric
properties of the Medical Fit Scale. Internal consistency for this scale was .57 ,
and the range of corrected item-total correlations was .02-.55. The Medical
Advocacy Scale was created by summing the ratings of how much advocacy
was needed to bring about each outcome. The scale had an alpha =.65 with
corrected item-total correlations ranging ﬁ'om .08 to .52 (see Table 15). In all
three of these scales, items with the low corrected item-total correlations were
retained to preserve the conceptual meaning of the scale (i.e., the scale reﬂects
Q of the services that could be offered to victims in the medical exam as
opposed to just some services that exhibited stronger psychometric properties)
as well as to provide consistency in items across all the Action, Fit, and

Advocacy scales.

Table 13

Psvchometric Pr

Scale Items

 

Information on r
Information on r
Information on p
Information on p
Rape Exam and g
MPWWr pil.

STD Preventive

Alpha : .68

\

68

Table 13

Psychometric Properties of Medical-Action Scale

 

 

Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Information on risk of pregnancy .68 .47 .31
Information on risk of STD .67 .47 .40
Information on physical health .15 .36 .26
Information on psychological health .15 .36 .29
Rape exam and evidence collection .84 .37 .49
Morning afterle .37 .49 .34
STD preventive treatment .7 7 .43 .55

Alpha = .68 Scale Mean = 4.19 Scale SD = 1.82

 

 

Table 14

Psvchometri

 

Scale Items

 

Information (
Information (1
Information 0
Information or
Rape exam an

Morning after
STD preventi

Alpha : {ﬂ

\

69

Table 14

Psychometric Properties of Medical-Fit Scale

 

 

Scale Items Item Item Corrected
Means SDs Item-Total
Correlation
Information on risk of pregnancy .84 .36 .45
Information on risk of STD .7 8 .42 .55
Information on physical health .72 .45 .20
Information on psychological health .45 .50 .27
Rape exam and evidence collection .92 .27 .02
Morning aﬁerpill .90 .30 .35
STD preventive treatment .91 .29 .23

Alpha = .57 Scale Mean = 5.53 Scale SD = 1.40

 

Table 15

Psxchometric Pr

Scale Items

 

Information on r
Information on r
Information on I
Information on ;
Rape exam and (
Morning after pil

STD Pml’entive

AlIlha : .55

\

W

70
Table 15

Psychometric Properties of Medical-Advocacy Scale

 

 

Scale Items Item Item Corrected

Means SDs Item-Total

Correlation

Information on risk of pregnancy .95 1.96 .51
Information on risk of STD 1.33 2. 19 .50
Information on physical health 2.21 .2.47 .54
Information on psychological health 3.30 2.37 .48
Rape exam and evidence collection .37 1. 14 .08
Morning aﬁerpill .21 .81 .30
STD preventive treatment .16 .7 6 .25
Alpha = .65 Scale Mean = 8.52 Scale SD = 7.23

 

Meng health experiences. To examine victims' experiences with the
mental health system, ﬁve services were considered: (1) information on the
impact of rape given to victim; (2) short-term counseling for victim; (3) long-
term counseling for victim; (4) information given to family/friends about rape
and its effects; and (5) counseling with family and/or friends. For the Mental
Health Action Scale the number of these actions that were taken in each case
were summed. Internal consistency for this scale was .57, with corrected item-
total correlations ﬁ‘om .24 to .47 (see Table 16). The Mental Health Fit Scale
was created by summing the the number of outcomes that ﬁt with what the
victim wanted. Table 17 summarizes the psychometric properties of this

 

scale: intei
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71

scale: internal consistency was .38, and the range of corrected item-total
correlations was .04-.49. Finally, the Mental Health Advocacy Scale was
created by summing the ratings of how much advocacy was needed to bring
about each outcome. The scale had an alpha =.61 with corrected item-total
correlations ranging from .31 to .50 (see Table 18). In a manner similar to the
medical scales, items with low corrected item-total correlations were retained
to preserve the conceptual meaning and consistency of these scales.

Scale intercorrelations. The intercorrelations (corrected for attenuation)
among these nine scales that assessed victims' experiences with the legal,
medical, and mental health systems can be found in Table 19. The correlation
between the Mental Health Action and Mental Health Advocacy scales was
quite high (uncorrected _1_‘=.7 2, corrected for attenuation g >1.00). To address
this potential problem of multicolinearity, the Mental Health Advocacy Scale
was dropped for the analyses and only the Mental Health Action and Mental
Health Fit scales were used. This high correlation suggested that to receive
mental health services, some advocacy was necessary.

Mmﬁve case studﬁ

Several qualitative case studies were selected and described to illustrate
the relationships between the independent and dependent variables (Steckler,
McLeroy, Goodman, Bird, & McCormick, 1992). Denzin ( 1994) recommended a
process called negative case analysis for selecting qualitative case studies to
highlight quantitative ﬁndings. In this process, cases that are quite typical of
the phenomena being described, as well as those that deviate somewhat from
that norm are selected. The use of less typical examples is necessary to

demonstrate the diversity or variability in the quantitative data.

 

 

Tose
ﬁndings 1' i.e
were asked
”atypical” cc
8091. The N
that had 10'

72

To select these cases, three coders read a summary of the quantitative
ﬁndings (i.e., Chapter 3, Results), and all of the completed interviews. They
were asked to label each interview as a "typical" case for its cluster or as an
"atypical" case. The average percent agreement for the N=168 interviews was
80%. The N=9 cases that were selected for description/illustration were those

that had 100% agreement among the three coders.

 

 

 

lﬂlormati

Counselir

Alpha : "

73

Table 16

Psychometric Properties of Mental Health-Action Scale

 

 

Scale Items Item Item Corrected

Means SDs Item-Total

Correlation

Information on rape and effects .90 .30 .30
Short-term counseling .67 .48 .46
Long-term counseling .36 .48 .34
Information to family/friends .47 .50 .24
Counseling to family/friends .22 .43 .33
Alpha = .7 5 Scale Mean = 3.42 Scale SD = 2.06

 

 

Table 17

74

Egghometric Properties of Mental Hgajth-Fit Scale

 

i

 

Scale Items Item Item Corrected

Means SDs Item-Total

Correlation
mformation on rape and effects 99 . 10 .04
Short-term counseling .98 .14 .33
Ipng-term counseling .95 .22 .49
Information to family/friends .9 1 .29 .03
Counseling to family/ﬁ'iends .90 .30 .25

Alpha = .38 Scale Mean = 4.73 Scale SD = .60

Table 18

Psvchometri

 

Scale Items

 

Information
Short-term t
ling-term c
Information

Counseling '

AInna = .61

\

75
Table 18
Psychometric Properties of Mental Health-Advocacy Scale

 

f

 

Scale Items Item Item Corrected

Means SDs Item-Total

Correlation
Information on rape and effects 4.19 1.81 .31
Short-term counseling 1.67 1.82 .50
Ipng—term counseling .61 1.37 .3 1
Information to family/friends 2.17 2.46 .41
Counseling to family/friends .45 1.22 .35

Alpha = .61 Scale Mean = 9.10 Scale SD = 5.59

 

 

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CHAPTER 3
RESULTS

Two hypotheses were examined in this research. First, it was expected

that rape victims would have different patterns of experiences with the legal,
medical, and mental health systems. To evaluate this hypothesis, a
combination of hierarchical and iterative cluster analysis was performed. The
second hypothesis was that these patterns of experiences could be
successfully predicted by the proposed ecological model. Furthermore, the
three domains speciﬁed in this model—environmental, event, and individual
characteristics, were expected to predict unique variance in the outcome
variable. Multinomial logistic regression was used to test how well the data ﬁt
this proposed model. Qualitative case studies were used to summarize the

ﬁndings from these two hypotheses.
Rape Victims' Experiences With Community Systems

Cluster analysis is a quantitative taxonomic classiﬁcation system
whereby individuals within a heterogeneous population can be grouped based
on SiInilar characteristics (Aldenderfer & Blashﬁeld, 1984; Rapkin & Luke,
1 993 ). These subgroups are formed based on multivariate proﬁles. Groupings
% formed where persons belonging to the same cluster are more similar to
each other than persons belonging to a separate cluster (Anderberg, 1973;
Rapkin & Luke, 1993). Cluster analysis was performed on the eight remaining
S(:ales assessing victims’ experiences with community systems: Legal Action,
1“di Fit, Legal Advocacy, Medical Action, Medical Fit, Medical Advocacy,
Mental Health Action, and Mental Health Fit. The scale scores were
SIZEludardized prior to clustering to account for their widely differing variances

(Ndenderfer & Blashﬁeld, 1984).
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The clustering was performed in two stages. First, initial groupings were
derived through hierarchical clustering using Ward's Method and squared
Euclidean distances as the measure of proximity. Ward's Method was chosen
because it maximizes cluster homogeneity by minimizing the within-cluster
error sum of squares (Rapkin & Luke, 1993). In other words, it maximizes
intra-cluster similarity and maximizes inter-cluster difference. Squared
Euclidean distances was chosen because this approach reﬂects not only inter-
individual proﬁle similarities (relative magnitude), but also similarities in
absolute magnitude. Second, the centroids of these initial clusters were then
submitted to an iterative clustering procedure (K-means) to reﬁne ﬁnal cluster
membership and reduce the incidence of cluster misassigment that is common
with agglomerative methods (Blashﬁeld & Aldenderfer, 1988; Mowbray, Bybee,
& Cohen, 1993). When using an agglomerative approach, cases that were
j Oined early on stay together throughout the solution, which may keep them in
a Cluster other than the one they are "closest" to. The iterative procedure uses
the initial centroids to maximize within group similarity and between group
diﬂ‘erence. Although missing data were not a problem overall in this study,
some women did not have contact with all three community systems (N=31).
For the cluster analysis, missing data were handled as such: these N=31 cases
were not included in the hierarchical clustering and the creation of the initial
cluster centroids. For the iterative clustering, they were added back into the
analysis and the iterative procedures placed them into the clusters based on
their pattern of experiences in the two systems with which they did have

t:
ohtact.
Whereas there is no generally accepted rule for choosing the correct

‘h “Illber of clusters, a combination of empirical procedures and overall
111‘Zerpretabilityis used (Anderberg, 197 3; Luke, Rappaport, & Seidman, 1991;

Rapkin i
deciding
dmdﬁ
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79

Rapkin & Luke, 1993; Romesburg, 1984). Four factors were considered when
deciding on the number of clusters in the solution. First, an inspection of the
plot of fusion coefﬁcients revealed that the most marked ﬂattening of the scree
curve occurred between a three and four cluster solution. Second, the sizes of
the clusters should be fairly similar, which aids interpretation. The three
cluster solution produced the most even distribution of the sample (32%, 39%,
29%). Third, examination of the dendogram revealed that the partitions
containing the four- and ﬁve-cluster solution were created by forming a cluster
based on a single location that split-off from one of the three larger clusters.
These single split-offs appeared aftﬂ the three-cluster solution. Finally, the
three cluster solution suggested a conceptually meaningful organization of the
data. In the four cluster solution, there was a small group characterized
almost exclusively by high advocacy. There were no other distinguishable
features about the actions taken or the ﬁt of those actions in the cluster, and
they appeared to be together because high advocacy was employed. In the
trtll‘ee cluster solution, this small fourth cluster was divided among the three
r eIlilajning clusters based on the actions taken, the ﬁt with the victims' wishes,
as Well as the advocacy needed. The means for the three cluster solution can .
be found in Table 20.
The reliability/stability of this three-cluster solution was examined using
a SII>lit-half test (Luke, Rappaport, & Seidman, 1991). Half of the victims' data
were randomly selected and the cluster procedures described above were
attlI>loyed. The same three-cluster solution emerged from this split-half test,

s
uggesting that the clusters represented a stable organization of the data.
Ql‘eover, the women were in the same clusters as in the total sample solution.

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Figure 2 presents the proﬁle of scores found in the ﬁrst cluster. This
cluster contained N =53 (32%) women and was characterized by a high number
of actions, high ﬁt, but with low advocacy across the three systems. In other
words, these victims received a relatively large number of services, which was
what they wanted, and the advocate did not intervene to bring about those
actions. For example, most of the cases in this cluster moved all the way
through the criminal justice system and were not ﬁltered out (see Table 21 for
breakdown of the individual services provided by the legal system). In 89% of
the cases in this cluster, the prosecutor issued some type of charge against the
assailant, and 39% of the cases ended in a plea bargain and 28% were
convicted at trial. The outcomes of the trials and plea bargains were not
always desirable and not exactly what the victim wanted (only 66% of the time

was the outcome consistent with the victims' wishes), but these assailants
were most likely to receive some jail time for their crime (53%).
In the medical system, these women also received many of the services
they wanted (see Table 22). Most of the women received information about
Pregnancy and STDs (86% and 92%, respectively), and 54% were able to
Obtain the Morning After Pill. Almost all of them received a preventive does of
antibiotics to treat any STDs that might have been contracted in the assault

( 9 4 %).
The women in this cluster also received many of the counseling services

they wanted for themselves and those close to them who were also affected by
the rape: over half received either short-term or long term counseling (89% and
65%, respectiveIY), and almost halfof the victims' family or friends received

Q911nseling(40%) (see Table 23).

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Table 21

Cluster 1 (Approaching Justice): Legal Experiences

 

 

LEGAL
Action Fit Advocacy
Police report 100% 100% 4%
Investigation 96% 100% 19%
Report forwarded to prosecutor 94% 98% 6%
Arrest 89% 98% 7%
Charge issued by prosecutor 89% 96% 13%
Outcome of charge 66% 8%

Charges that had been issued 6%
were dropped

Plead guilty-reduced charge 22 %
Plead guilty--original charge 1 7 %
Trial—guilty of reduced charge 9%

Trial--guilty of original charge 28%

Trail—acquittal 8%
Eligible for jail time 76%
Actually received jail time 53%

\

% Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes
Numbers in the Advocacy column represent the percent of time the
outcome for that action required intervention by the advocate

Infon
Infon
1an

L;

Table 22

Cluster 1 (Approaching Justice): Medical Experiences

 

 

MEDICAL
Action Fit Advocacy
Information on risk of pregnancy 86% 62 % 6%
Information on risk of STD 92% 70% 12%
Information on physical health 23% 36% 51%
Information on psychological health 19% 7 1 % 7 6%
Rape exam and evidence collection 98% 100% 2%
Morning aﬁer pill 54% 54% 2%
STD preventive treatment 94% 7 6% 4%

 

Note: Numbers in the Action column represent the percent of the time that

service was delivered

Numbers in the Fit column represent the percent of time the outcome

for that action ﬁt with the victims' wishes

Numbers in the Advocacy column represent the percent of time the
outcome for that action required intervention by the advocate

Ta

85
Table 23

Cluster 1 (ApproachingJustice): Mental Health Experiences

 

 

MENTAL HEALTH
Action Fit
Information on rape and effects 98% 87%
Short-term counseling 89% 98%
Long-term counseling 65% 98%
Information to family/friends 67% 63%
Counseling to family/friends 40% 87%

 

Note: Numbers in the Action column represent the percent of the time that

service was delivered
Numbers in the Fit column represent the percent of time the outcome

for that action ﬁt with the victims' wishes

 

86

In light of this pattern of relatively high services, relatively high ﬁt, and
low advocacy, this cluster was named "Approaching Justice"--these women
had as good an outcome as was possible. It is important to note that these
cases were not "cake-walk." Many of the women in this cluster had difﬁcult
interactions with system personnel, and had outcomes that were inconsistent

with their needs. Thus, this is not a "smooth sailing" cluster. This is the

cluster with the least turbulence.
The second cluster contained the largest portion of the sample with

N =65 (39% of the sample). Figure 3 shows the proﬁles in this cluster. The
women in this group did not have uniform experiences across the three
systems. First, their legal involvement was characterized by low actions, low
ﬁt, and fairly low advocacy. In other words, these cases did not go very far in
the system, but the victim @ want to purse prosecution. There was a marked
misﬁt between what the system did and what the victim wanted. Most often,
these cases were ﬁltered out in the very early stages of processing, usually by
the police deciding not to forward their reports to the prosecutors. For
example, as can be seen in Table 24, only 43% of the police reports were
forwarded to the prosecutor (with only 43% of the women reported that this
Outcome was consistent with their wishes) and only 8% of these cases in this
Cluster were charged by the prosecutors (32% of the women reported this
outcome ﬁt with their needs). None of the rapists in this cluster received jail
time. The advocates usually did not step in and try to push these cases
forward though. One advocate summed up an explanation that many

adVocates oﬁ‘ered for why that was:

87

"You could tell it (the case) was going to go no where and nothing I could
do would change that. The police were adamant. I would have had
better luck banging my head against a brick wall. Besides, you have to
think of the next victim you'll be working with. You don't want to anger
the police so badly on one case that it may hurt the next victim who

comes throug ."

The victims in this cluster had better experiences with the medical
system. Although they received fewer services than the women in the ﬁrst
cluster, what they received was what they wanted. Again, the advocates did
not feel they had to intervene to see that the victims' needs were being met.
For example, as can be seen in Table 25, most of the women received
information about pregnancy and STDs (7 3% and 7 3%, respectively), but 39%

were able to obtain the Morning Alter Pill. Most of them received a preventive
does of antibiotics to treat any STDs that might have been contracted in the
assault (77%).

The experiences with the mental health system were mixed for the
women in this group (see Table 26). Most of the women did not receive short-
term or long-term counseling (which was consistent with what they wanted),

but their family or friends often did not receive information about rape and its
631Tects (which was inconsistent with what they wanted) (32% received
information, which only 25% of the victims stated was consistent with what

they wanted).
For this pattern of experiences--negative with legal, positive with

n1Edical, mixed with mental health—this cluster was named "One Saving

Q“race." The legal and mental health experiences were less than what these

Victims wanted, but the medical system came through for them. They had one
Q'Ommunity system experience that was beneﬁcial and addressed their needs,

“he saving grace.

 

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Table 24

Cluster 2 (One Saving Grace): Legal Experiences

 

 

LEGAL
Action Fit Advocacy

Police report 97% 80% 4%

Investigation 71% 78% 19%
Report forwarded to prosecutor 43% 43% 6%
Arrest 1 5% 3 7% 7 %
Charge issued by prosecutor 8% 32% 13%
Outcome of charge 0% 8%

Charges that had been issued 6%
were dropped

Plead guilty--reduced charge 1 %
Plead guilty--original charge 0%
Trial—guilty of reduced charge 0%
Trial--guilty of original charge 0%

Trail—acquittal 1%
Eligible for jail time 2%
Actually received jail time 0 %

\

N\'ote;: Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes
Numbers in the Advocacy column represent the percent of time the
outcome for that action required intervention by the advocate

90
Table 25

Cluster 2 (One Saving Grace): Medical Experiences

 

—_——

 

MEDICAL
Action Fit Advocacy

Information on risk of pregnancy 7 3% 64% 14%
Information on risk of STD 7 3% 65% 21%
Information on physical health 2 1 % 29% 37 %
Information on psychological health 21% 54% 64%
Rape exam and evidence collection 86% 88% 19%

Morning aﬁerpill 39% 46% 8%

STD preventive treatment 7 7% 64% 2%

 

m Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes
Numbers in the Advocacy column represent the percent of time the
outcome for that action required intervention by the advocate

9 1
Table 26

Cluster 2 (One Saving Grace): Mental Health Experiences

 

 

MENTAL HEALTH
Action Fit
Information on rape and effects 97% 7 5%
Short-term counseling 47 % 98%
Long-term counseling 18% 98%
Information to family/friends 32% 25%
Counseling to family/friends 6% 97%

 

Note: Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes

92

Finally, the third cluster was characterized by very high levels of
advocacy (see Figure 4 for proﬁles of this cluster). Their involvement with the
legal system had fairly high action, fairly high ﬁt, and very high advocacy.
These cases went quite far in the criminal justice system (i.e., they were not
dropped early on as in the second cluster). But, these cases did not go as far or
as well as the cases in the ﬁrst cluster. At every step along the way, the
advocate had to encourage these case along. But, an "11th hour" catastrophe
marked many of these cases. For example, as can be seen in Table 27, 70% of
these cases were charged by the prosecutor, but only 39% of the women
reported that the outcome of that charge was consistent with what they
wanted. The cases were moving along (with the help of the advocate), but in
the ﬁnal stages, something went wrong: a case was dismissed a few weeks
before it was set to go to trial, a plea was struck that reduced the charges to
misdemeanors such as simple assault, reckless endangerment, or "terroristic
tendencies." Thirty-four percent of the assailants pled guilty (28% were to a
reduced charge), 12% were convicted of the original charge, and 34% received
jail time.

A somewhat similar pattern of results was found in the medical system:
very low number of services, even lower ﬁt, and very high advocacy (see Table
28). These women wanted far more services than they received, and the
advocates were largely unsuccessful in obtaining these services for the
victims. Only 48% of the women received information about pregnancy, and
34% received information about STDs. Most of the women were not able to
obtain the Morning After Pill (11%), and only 34% of the women stated that
this was consistent with what they wanted. Over half of the women, however,
did receive preventive antibiotic treatment for STDs (66%).

93

 

 

 

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Table 27
Cluster 3 (Exercises in Futility): Legal Experiences

 

 

LEGAL
Action Fit Advocacy
Police report 98% 94% 13%
Investigation 92% 94% 28%
Report forwarded to prosecutor 88% 94% 19%
Arrest 70% 78% 24%
Charge issued by prosecutor 7 0% 7 8% 21%
Outcome of charge 39% 41%

Charges that had been issued 12%
were dropped

Plead guilty--reduced charge 28 %
Plead guilty-«original charge 6%
Trial—guilty of reduced charge 4%
Trial--guilty of original charge 12%

Trailnacquittal 8%
Eligible for j ail time 50%
Actually received jail time 34%

 

Note: Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes
Numbers in the Advocacy column represent the percent of time the
outcome for that action required intervention by the advocate

Table 28

Cluster 3 (Exercises in Futilityx Medical Eépeﬁences

 

 

MEDICAL
Action Fit Advocacy

Information on risk of pregnancy 48% 4 1% 47 %
Information on risk of STD 34% 22% 64%
Information on physical health 5% 47 % 68%
Information on psychological health 4% 42% 91%
Rape exam and evidence collection 68% 91% 13%
Morning aﬁerpill 11% 34% 14%
STD preventive treatment 66% 7 6% 9%

 

Note: Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes
Numbers in the Advocacy column represent the percent of time the
outcome for that action required intervention by the advocate

96
Table 29

Cluster 3 (Exercises in Futility): Mental Health Experiences

 

 

MENTAL HEALTH

Action Fit
Information on rape and effects 98% 82%
Short-term counseling 84% 96%
Long-term counseling 37 % 87%
Information to family/ﬁ'iends 51% 51%
Counseling to family/friends 22 % 87 %

 

Note: Numbers in the Action column represent the percent of the time that
service was delivered
Numbers in the Fit column represent the percent of time the outcome
for that action ﬁt with the victims' wishes

97

In mental health system, many of these women received some
counseling (84% short-term; 37 % long term), but only about half of the time did
their family or friends receive information about rape and its effects (51%). It
appeared that the women in this cluster did want their family or friends to
learn more about rape as 51% stated that this outcome was consistent with
their needs (see Table 29).

Due to this pattern of high levels of advocacy with relatively little payoff
for the victims, this cluster was named "Exercises in Futility." The advocates
worked very hard in these cases, but were largely unsuccessful in obtaining the
legal, medical, and mental health services the victim desired.

An Ecolgical Model Predicting Victims' Elmeriences

 

The second hypothesis to be evaluated was whether these patterns of
experiences could be successfully and uniquely predicted by the proposed
ecological model. Given that the dependent variable was cluster membership,
a categorical variable with three levels, multinominal logistic regression was
used to evaluate the model (Hosmer & Lemshow, 1991). Table 30 presents
the intercorrelations (corrected for attenuation) among the predictor variables.
Table 31 presents the ﬁrst analysis of this model that included all of the
variables expected to predict cluster membership. From this ﬁrst set of
analyses, two problems became apparent. First, several variables were not
signiﬁcant predictors: legal resources, medical resources, mental health
resources, whether the rape occurred within the context of a battering
relationship, victims' race, victims' SES, and assailants' race. The second
problem was that a suppressor effect emerged. Although the correlation
between type of rape and use of a weapon was only 9:41, it was sufﬁcient to
cause a problem of multicolinearity. As can be seen in Table 30,

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this intercorrelation created an odds ratio that was not interpretable and
contradicted the univariate ﬁndings. In the contrast between cluster 1 and
cluster 2 ("Approaching Justice" and "One Saving Grace"), the odds ratio
suggested that women who were raped by strangers were 4.28 times as likely
to be in the "One Saving Grace" cluster as in the "Approaching Justice"
cluster. By contrast, the univariate ﬁndings suggested that women who were
raped by strangers were more likely to be in the "Approaching Justice" cluster:
x 2 (2, N=168) = 17.69, Q<.001.

To address these problems, two modiﬁcations were made for the second
set of analyses. First, Hosmer and Lemshow (1991) recommended dropping
variables from the model that have no predictive value and re-running a
smaller, better ﬁtting model. Retaining the variables that make no signiﬁcant
contribution to the outcome variable can artiﬁcially inﬂate the goodness of ﬁt
indices. Therefore, following Hosmer and Lemshow's (1991) suggestions, only
the variables that had exhibited a signiﬁcant relationship with cluster
membership and any variables that had exhibited a trend were selected
(community coordination, type of rape/use of weapon, injuries, use of alcohol,
victims' demeanor, and match between victim and assailants' race). To
address the second problem (the suppressor effect), three dummy-coded
variables were created to capture four relationships that could exist between
type of rape (stranger or non-stranger) and weapon use (weapon or no
weapon). These dummy-coded variables were entered into the model to
represent the relationship between type of rape and weapon use.

To evaluate this reduced model, four sets of analyses are needed. First,
the overall ﬁt of the model must be considered with the likelihood ratio statistic
and McFadden's rho squared. Second, the signiﬁcance of the individual
predictors to differentiate cluster membership must be considered using odds

103

ratios for individual contrasts, the global wald test, and the derivative values
for each variable. Third, the degree to which the model can successfully
classify the cases into their correct cluster must be examined with the
prediction success index and the percent correctly classiﬁed. Finally, because
this is a multi-level model (environment, event, and person-centered), the
utility of each 13311 must be examined (i.e., are all three 3% necessary to
predict cluster membership). A series of likelihood ratio statistics testing for
the signiﬁcant effect of each level to predict unique variance in the outcome
variable must be computed.

The likelihood ratio statistic for the test of goodness of ﬁt for the overall
model was signiﬁcant, indicating that the model provided a reasonably good ﬁt
of the data: LR x 2 (16, N=168) = 59.56, p<.001. (The null hypothesis for this
test is that the model coefﬁcients would be zero.) McFadden's rho squared is
multinominal logistic regression analog to R-squared in linear regression, which
was .17 in this model. Hensher and Johnson (1981) noted that values for
McFadden's rho squared between .20 and .40 are considered acceptable, which
places the value for this model outside this range. Hosmer and Lemshow
(1991) offered a different interpretation of this statistic. They argued that
since McFadden's rho squared is simply a mathematical variation of the
likelihood ratio test chi square, its utility is questionable as it does not add new
information as to the variance accounted for by the model. Therefore, they
suggest that less emphasis should be placed on this statistic and its range of
values.

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tests, which address the signiﬁcance of each predictor in the model. For an
outcome variable with three levels, two sets of contrasts will be performed, as
well an overall test for each predictor. In the ﬁrst contrast, the women in

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105

cluster 1 ("Approaching Justice") were compared with the women in cluster 2
("One Saving Grace"). The women who had the best possible outcomes were
compared to the women who had a positive outcome with only the medical
system. The results of the odds ratio tests indicated that women who were
raped by a stranger without the use of a weapon were 15.66 times as likely as
those raped by strangers with a weapon to be in the "One Saving Grace"
cluster, which was the group whose cases were dropped out early in the stages
of legal processing. Similarly, women who were raped by someone they knew
without the use of a weapon were 6.22 times as likely to be in the "One Saving
Grace" cluster. Victims who were drinking at the time of the assault were also
4.01 times as likely to be in this cluster where their involvement with the legal
system was cut short.

This contrast between cluster 1 and 2 ("Approaching Justice" and "One
Saving Grace") also indicated that women who lived in communities with a
higher coordination of resources for sexual assault were more likley to be in the
cluster of women who had relatively positive experiences across all three
systems ("Approaching Justice"). Women who were injured in the assault
were somewhat more likely to be in this positive experiences cluster. Finally,
women who exhibited "good" victim behavior were also more likely to be in the
"Approaching Justice" cluster.

In the second contrast, cluster 1 ("Approaching Justice") and cluster 3
("Exercises in Futility") were compared. Fewer variables differentiated these
two clusters. Women in the Exercises in Futility cluster were more likely to
have been raped by a someone known to them without the use of a weapon
(4.05 times as likely). There was also a trend for the match between the
victims' and assailants' race. Intro-racial rapes were somewhat more likely to

be in the cluster "Approaching Justice," whereas inter-racial rapes appeared

106

more in the cluster "Exercises in Futility." Speciﬁcally, women of color who
were raped by white men were somewhat more likely to have been in the
"Exercises in Futility" cluster.

The wald test provides an overall test of the predictive value of each
variable in the equation by averaging across the contrasts. So as expected,
the variables signiﬁcant in the individual contrasts were signiﬁcant, but the
trends in the contrasts were not. Overall effects were found for: community
coordination, stranger rape without a weapon, non-stranger rape without a
weapon, alcohol use by victim, and whether the victim exhibited "good" victim
behavior.

Table 33 presents the derivative values for each predictor. The
derivatives (Steinberg & Colla, 1991) show the absolute change in probability
of each category of the dependent variable that is associated with a one unit
change in each independent variable. These results indicate that living in a
community with higher coordination of community resources increased the
probability of being in the ﬁrst cluster ("Approaching J ustice') by .04,
decreased the probability of being in the second cluster ("One Saving Grace")
by .04, and had virtually no effect (.001) on the third cluster ("Exercises in
Futility"). In other words, there was slightly more community coordination in
the cluster where women had the most positive experiences across all three
systems. Being raped by a stranger with the use of a weapon increased the
probability of being the ﬁrst cluster by .20, decreased the probability of being in
the second by .29 and slightly increased the probability of being in the third
cluster by .08. This suggests that there were more stranger rapes with
weapons in the cluster with the most positive outcomes ("Approaching
Justice"). The derivatives for the remaining variables indicate that non-

stranger rapes without the use of a weapon were more likely in clusters 2

107

Table 33

Derivative Values for Reduced Log’stic Regression Model

 

Individual Variable Derivatives

 

(Averaged)

Predictors Cluster 1 Cluster 2 Cluster 3
Community coordination .04 -.O4 .00 1
Stranger rape w/weapon .20 -.29 .09
Stranger rape w/out weapon -.36 .57 -.22
Nonstranger rape w/out weapon -.35 .26 .09
Injuries from assault .15 -.12 -.03
Alcohol use by victim -.15 .33 -.18
"Good" victim .21 -.30 .09
Match between victim & .13 -.03 -.11

assailant race

 

108

and 3--the clusters with fairly negative outcomes ("One Saving Grace" and
"Exercises in Futility"). There were more injuries in the ﬁrst cluster (the group
with the most positive outcome-"Approaching Justice"). There was more
alcohol use by women in the second cluster (the cluster with cases that were
dropped out in the early stages of legal processing-"One Saving Grace").
"Good" victim behavior was more common in the ﬁrst cluster, which had the
most positive outcomes ("Approaching J ustice"). Finally, women of color raped
by white men were slightly more likely to be in cluster 3 ("Exercises in
Futility"), who had an uphill battle with all three systems.

The prediction success indices revealed that this model could
successfully classify 54% of the cases: 53% for cluster 1 ("Approaching
Justice"), 62% for cluster 2 ("One Saving Grace"), and 46% for cluster 3
("Exercises in Futility). For purposes of comparison, chance prediction for this
model was only 34%. The prediction success index, which measures the gain
the model exhibits in the number it correctly predicts versus a purely random
model, was .21 for cluster 1, .23 for cluster 2, and .16 for cluster 3. The larger
the success index, the better the model did in successfully classifying cases.
This index can be negative if the classiﬁcation was worse than chance. Both
the percent correctly classiﬁed and the prediction success index for cluster 3
("Exercises in Futility") were somewhat low, but given that fewer variables
distinguished the third cluster, it is not surprising that these values pulled the
overall rate for the model down a bit.

In the ﬁnal set of analyses, the utility of each l_ev_el in the model was
considered. It had been argued that the advantage of an ecological perspective
is that it can help us understand this phenomena from a multiple-level
perspective. As opposed to many other psychological and sociological theories,
ecological theory examines both the environmental and individual level. At

109

issue for this ﬁnal set of analyses is whether all three levels of ecological theory
predict unique variance in cluster membership. Do we really need information
about the environment, about the event, and about the person to predict
experience? A series of likelihood ratio tests were performed to examine the
unique variance explained by each level. In this test, the LR for the full model
is compared to the LR for a model with a block of variables removed. The full
model is compared to this nested model. The LR from the nested model is
subtracted from the LR of the full model. This difference is a chi square that is
then evaluated for signiﬁcance (with the difference degrees of' freedom). This
chi square should be signiﬁcant, indicating that the model with this block is
signiﬁcantly different from a model without this block of variables. 3

As can be seen in Table 34, with the variance accounted for by the
event and individual levels already established, the environmental level
explained additional unique variance. Moreover, after taking into account the
effects of the environmental and individual levels, the event level could still
explain unique variance. Finally, the variance accounted for by the
environmental and event levels still left unexplained variance that could be
successfully predicted by the individual level. Thus, each level speciﬁed by
ecological theory explained unique variance in the victims' experiences with
community systems. These results suggest that all three levels of variables
speciﬁed by ecological theory were necessary to predict victims' experiences
with the legal, medical, and mental health systems.

 

8 The logic of these procedures was suggested by Darlington (1968) for ordinary least
squares regression, and is adapted here for logistic regression.

110

Table 34
Likelihood Ratio Tests for an Ecological Model

 

Predictors Difference in LR x 2

 

Environmental Constructs 6.17 *

Community coordination

Event Constructs 38.70 ***
Type of rape/weapon

Injuries
Alcohol use by victim

Person Constructs 10.84 *

"Good" victim
Match in race/ethnicity

 

Note: *** p <.001 * p <.05

111

Summary of Results and Qualitative Case Studies

To summarize the ﬁndings from the cluster analysis and logistic
regression model evaluation, several cases studies highlight the key results of
this research (see Table 35 for a summary of the major ﬁndings). In this study
a three cluster solution was obtained. Women in ﬁrst cluster, "Approaching
Justice," had the most positive experiences across all three systems. They
were also more likely to live in communities with higher coordination of services
to victims. Additionally, they were more likely to have been raped by strangers
with weapons, and were slightly more likely to have been injured in the assault.
These women were "good" victims-they showed emotional distress and they
were receptive to help. For many of the cases in this cluster the evidence of
rape was overwhelming, and it would have been very difficult for the case to
ngt go well.

C_luster 1: Case Study #1

A stranger broke into a woman's house and raped her a knife-point. He
told her that he was going to use a condom so there would be no evidence
of rape. But, when the rapist ﬂed the scene, he leﬂ: the used condom at
the woman's home. After he was gone, the victim called the police. The
assailant apparently realized a short time later that he had left the
condom there, and decided to return to her house to retrieve it. He
arrived in time to be apprehended by the police. He was later convicted
of aggravated criminal sexual conduct (ﬁrst-degree rape) and sentenced
to 25 years in prison with no possibility for parole. This woman's
experience with the medical system was also quite positive. The police
took her to the emergency room where she was examined right away.
She received information about pregnancy, STDs, as well as the
psychological and physical health problems she might experience later
on. The Morning After Pill and STD preventive treatment were also

112

administered. This woman received short-term and long-term
therapy, and her father and ﬁance were able to ﬁnd a support group for
the signiﬁcant others of rape victims.

This case study represents the best case scenario for a traumatic experience.
Several of the key ingredients to activate the legal system were in place (e.g.,
stranger rape with the use of a weapon). The evidence left behind by the
assailant was undoubtedly of help as well. This victim also had support from
the medical and mental health system. As her advocate described this case,

"There was no question this was rape--it was a textbook rape, well, except for
the idiot rapist, but that helped too."

Cluster 1: Case Study #2

A woman was driving home from work when a stranger walked up to her
car at a red light and forced his way into her car at gun-point. He forced
her to drive to a deserted area outside the city, and then he raped her
twice vaginally and once orally. He then made her drive back into the
city and drop him off near his home. The woman went immediately to
the police to report the assaults, even though she was crying and almost
hysterical. The police responded very quickly and did a thorough search
of his neighborhood with police dogs. They found the assailant and
arrested him. He was convicted of two counts of aggravated criminal
sexual assault (for the two vaginal rapes; he was not convicted for the
oral rape) and sentenced to 60 years in prison. At the trial, nine police
ofﬁcers attended to support the victim. They did not have to testify, but
they chose to appear to demonstrate their belief in the victim. This
community has a Sexual Assault Response Team (SART), so the police
took to woman to the hospital where a specially trained Sexual Assault
Nurse performed the rape exam and provided all the medication and
information the victim wanted. An on-site counselor talked to this
woman and her husband and set up follow-up appointments for further

counseling.

113

This case also included several elements that appear to be necessary for legal
prosecution (e.g., rape by a stranger with the use of a weapon). This victim
was so believable that police ofﬁcers not required to be at the trial came
anyway to show their support. A key factor in this story is the role of
community coordination and how it may have impacted this victim's
experiences. This community had a well established SART team, and the
police, medical staff, and hospital counselors had worked together before and
established a good working relationship. These three systems came together

and worked as a unit, which appears to have had a positive impact.

Cluster 1: Case Study#3

The victim and assailant had been in a long-term relationship for several
years and had one child together. The woman had ended the relationship
several weeks before the assault, which angered her former partner. He
came into her apartment one night when she was sleeping, and ripped
her nightgown off and used it to tie her to the bed. He beat her severely:
he punched her in the stomach and the face, and choked her with his
hands repeatedly. While he was raping her, he tried to strangle her with
the cord ﬁ'om her curling iron. When he ﬁnally released her and left her
apartment, she called the police. They took her initial report and took
her to the hospital, but did not arrest the rapist until almost a month
later. The woman was too frightened to testify against him in a trial, so
the prosecutor accepted a guilty plea to the original charge of one count
of aggravated rape. At the hospital, this woman received all the
treatment she desired, and the hospital social worker met with her after
the exam to talk about the rape and provided her with a resource list of
places in the community she could turn to for support.

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This case was a little different from the others in this cluster in that it was a
non-stranger rape. But, it was very brutal. Law enforcement was a little
sluggish in its response (waiting a month to arrest him), but the prosecutor
moved swiftly after that and was responsive to the victim's wishes to avoid a
trial. The systems in this community worked in a somewhat coordinated
fashion as the hospitals involved mental health social workers in rape cases.

The second cluster, "One Saving Grace," did not have uniform, positive
experiences across all three community systems. The cases in this cluster
were dismissed from the legal system, and many women did not have positive
experiences with the mental health system. But, they did receive the medical
services they wanted. One system came through for them, one system was
their saving grace. The women in this cluster were more likely to have been
raped by someone they knew who did not use a weapon against them. They
were also more likely to have been using alcohol at the time of the assault.
Many of these cases are what we often think of as the typical acquaintance or
date rape.

_Cl_uster 2: Case StugL#l

A woman was out one evening at a bar with several of her male and
female friends. She was drinking-probably to the point of legal
intoxication, but was still conscious and aware of what was happening.
One of her male friends offered to walk her home that eveningnhe said to
protect her from the rapists, muggers, and junkies. On the way home,
he pushed her down into some bushes and raped her vaginally, orally,
and with some of the branches from the bush. Her case was never
forwarded to the prosecutor because the police felt that because alcohol
was involved, it was unwinnable. They also told the advocate that
because she had ﬂirted with this ﬁ'iend, it was questionable if this was
rape. However, the hospital staff worked well with this victim, providing
her with ample information about pregnancy and STD's. The advocate

115

also reported that they were very sensitive in addressing the fact that
she had been raped several times. This woman was able to ﬁnd short-
term counseling, but was on a two-year waiting list for the long-term
work she desired.

The advocate who worked with this woman described this case as "unwinnable,
a dead end if there ever was one." She was referring to the combination of
circumstances that plagued this case--a rape between friends, drinking,
possible ﬂirting--which the brutality of the actual assault could not overcome.
As the advocate described it, "no one could forget the branches, but they
couldn't forget the drinking either." As with most of the cases in this cluster,
there was, in essence, no legal response. The medical system looked past these
factors to focus on the assault and the care of the victim. The mental health

system was helpful for a short time, but longer-term help was unavailable.

Cluster 2: Case Study #2

A woman was out one evening at a bar with her friends and a man
approached her and asked her to dance. She refused, but he continued
to pester her all evening. When she left, he followed her home and forced
his way into her house. He was very physically violent and raped her
twice vaginally and then forced his ﬁst up her vagina and her rectum.
She was very traumatized and called her therapist for advice, who told
her to take an extra dose of Valium and Ritalin. Three nights later, the
assailant returned and broke into her house a second time, and raped
again two more times. After he ﬂed, the woman called the police. The
police did not arrest him because they said she had had prior sexual
relations with this man, so therefore, this incident could not have been
rape. At the hospital, the doctor who performed the rape exam stated
that he thought there was no evidence of "forcible rape," only evidence of
consensual sex. The nurses, however, spent a great deal of time talking
to the woman about the assaults and the importance of pregnancy,
STD, and HIV testing. One of the nurses volunteered to go with the

116

woman to the county board of health for a baseline HIV test (which was
negative). The nurses also referred her to the local community mental
health center, but the victim was still on a waiting list to be seen. Six
months later, the assailant tracked her down again and raped her a third
time. She did not call the police. When she was tested again for HIV six
months after this third assault, her test came back positive. It is not
known if she contacted HIV ﬁ'om the assailant because she was unable
to convince a judge to order him to be tested as there was no report of
the rapes.

This case highlights how much previous contact with the assailant can sway
the judicial system. Even though the previous encounter was a rape, it was
redeﬁned as consensual sex, therefore negating the subsequent rapes. There
were no injuries, no weapon, no tell-tale momentos of rape. Although at ﬁrst
the medical response appeared to be following the road of no response, the
nurses came forward to help this victim. They went above and beyond the call
of duty to ensure that someone was listening to and helping this woman.

Mr 2: Case Study #3

A woman was at a bar one evening and got very drunk. Two men she
met that night offered to take her home. At her apartment they both
raped her two times-~vaginally and anally. The next morning she went
to the police to ﬁle a report. The detective did ﬁle a report, and did
forward it to the prosecutor, but when the advocate and victim ﬁnally
obtained a copy of his report, they understood why the case had been
dropped. The detective stated that she volunteered to gang-bang and
then felt "slutty" the next morning and called rape. The prosecutor was
not receptive to meeting with her so she could try to tell her side of the
story, and he kept telling her "these things happen," "there was no crime
here." The woman went to the hospital too long after the assault
happened to conduct the rape exam, but the nurses talked to her about
the risk of pregnancy and STDs, and offered her the Morning After Pill

117

and antibiotics to prevent STDs. The woman was billed for her visit to
the emergency room (over $500), and ﬁled for Victims of Crime
Compensation. She was refused reimbursement because the
prosecutor had no record of her assault, and she had to pay the bill
herself. At the time this interview was conducted, the woman was still
on a waiting list for the long-term counseling she desired.

This case also involved drinking and assailants known to the victim, but more
interestingly, it shows some of the negative consequences of un-coordinated
community response. This victim was caught between the rules of the legal
system and the medical system. She was billed for her exam, and the legal
system would not work with her or the medical community to resolve payment.
It also demonstrates how a negative response from one system can
occasionally set off a chain reaction of difﬁth circumstances for the victim.
The advocate for this case stated that she thought the woman waited to go to
the ER because she was still so traumatized by the police: "the wait meant no
exam, no exam is seen as more proof of no rape."

Finally, the third cluster, "Exercises in Futility," were characterized by a
great deal of work with little payoff. These cases often had some sort of "11th
hour" catastrophe that ended them with a less than desirable outcome for the
victim. Likewise, despite efforts by the advocates, these women did not receive
much medical or mental health assistance. These victims were also more
likely to have been raped by someone they knew without the use of the
weapon, and there was a trend that women of color who were raped by white
men were more likely to be in this cluster. The cases in this group were very
difﬁcult. One advocate offered an explanation for what happened in a case in

this cluster that summarizes the stories of many women in this group:

118

"Most everything we needed was there. It was clear it was rape. It was
clear there was force. She wasn't drinking. So it really looked like this
case was winnable. But it wasn't. I think the police, and prosecutors,
and the doctors just didn't know what to do with this woman. It wasn't a
stranger rape, but she didn't lead him on and she wasn‘t drinking, but
she wasn't crying. There was no neat category for this, no clear
explanation, no one thing to point to and say 'ah ha, this is it, this is why
it happened.‘ So with no other explanation, it must be her fault."

gym 3: Case Study #1

The case the advocate in the above quote was referring to involved a
couple that had been dating for over a year. The relationship had been
non-violent until one night when the man forced sexual activity on his
girlfriend that he had seen in pornographic movies. He physically
restrained her and raped her vaginally, and then continued to rape her
repeatedly with various household objects. She struggled, she called for
help, and when he ﬁnally let her go, she ran out of the apartment to call
the police. With lots of prodding by the advocate, the case went to trial
and he was acquitted on all counts. When the woman was at the
hospital, the staff there dismissed her fears about pregnancy and STDs
by stating that because she had been with him for a year, it was
unlikely these issues were going to be a problem for her. This woman
has not received the long-term counseling she wants because she does
not have the ﬁnancial means to pay for it.

As with many of the cases in this cluster, this rape occurred between people

who knew each other without the use of a weapon. And, it lacked many of the

other features that elicit a system response (positive or negative). The

services this victim did receive were the result of the advocate's efforts.

C_lr_ister 3: Case Study #2
An African-American woman agreed to give her White male co—worker a
ride home one evening. He pulled a knife on her and raped her in the car.

119

In the struggle, she was out several times by the knife. When he left
and started walking home by himself, she drove to the closest hospital,
which was just over the county line. At that hospital, they refused to
treat her because she was in the "wrong" hospital because the assault
actually occurred in the other county. The woman had to drive herself
almost 30 miles to the hospital in the county where the rape occurred.
She waited over 10 hours in the emergency room before a doctor came
on staff who could do the rape exam. She was not given information
about pregnancy or STDs despite her voiced concern about HIV. The
police met with her at the second hospital and took her report. The
advocate worked with the police for over a year pushing this case along
to trial. At the trial he was convicted of aggravated sexual assault, but
the judge did not sentence him to jail as he did not see him to be a serious
threat to the community. The trauma of the trial interfered with the
victim's daily life to the extent that she lost her job. She was able to ﬁnd
a support group for survivors of sexual assault, and was on a waiting list
for long-term counseling.

When examining the rape itself, it would be tempting to predict that this case
belongs in another cluster. There was a weapon and injuries, but the rape was
committed by someone known to the victim. Perhaps even more importantly,
the victim was a woman of color and the assailant was a white man. The
implicit rules in our culture about the value of men and women, of whites and
blacks may have been related to thoroughness with which this woman was
deniedhelp.

Cluster 3: Case StLdyj-‘3

A woman went to visit one of her male friends at his college dorm. While
he went out to pick up some dinner, another man on his ﬂoor came into
the room. He talked to her for a while, and then dragged her across the
hall to his room where his two other roommates were waiting. The three
men raped her--vaginally, orally, and anally. Other men on the dorm

120

ﬂoor dropped in during the assault to see if she was willing to do a "freak
show" (a group sex show for the ﬂoor). Two other men raped her and a
line of men formed waiting for their turn. The woman's friend returned
and pulled her out of the room before anyone else could rape her. Aﬁer a
year of constant work by the advocate, two of the assailants pled

guilty to a reduced charge, and received one year in jail and a $1,000 ﬁne.
The ﬁrst three assailants were never charged because they were
prominent athletes at the university. The hospital staff were not very
supportive of the victim. The victim explained to the staff that she was
very concerned about pregnancy because she had been raped before and
got pregnant from the assault. The staff dismissed her fears, and
despite the efforts of the advocate, they did not give her the Morning
After Pill because it was against hospital policy. (The advocate found a
doctor in a nearby county who would prescribe the Pill for the victim.)
The counseling center at this woman's university was able to offer her
10 sessions of therapy, but were not able to extend the work. This
woman withdrew from the university one month later.

In this rape, once again there no weapon, no injury, no drinking, no response.
The advocate worked steadily on this case, but to no avail. Gang rapes by
their very nature are quite brutal, and are often redeﬁned as a "group sex
show." There were not many acquaintance gang rapes in this study, and all
but one of them were in this cluster. All were denied legal and medical help.

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CHAPTER 4
DISCUSSION

The goal of this research was to examine rape victims' experiences with
multiple community systems including the legal, medical, and mental health
systems. In previous research, the focus has been on delineating what
services were offered to victims by these systems. This study expanded the
literature by exploring not only what services were offered, but whether the
services offered (or not offered) ﬁt with victims' needs as well as the degree of
advocacy needed to bring about those outcomes. A related aim for this study
was to describe the context in which these services were offered: under what
circumstances are victims offered which services? An ecological model that
included environmental, event, and individual-level predictors was evaluated for

its efﬁcacy in explaining victims' experiences.

Summary of Ma'pr Findings

Two hypotheses were tested in this research. First, it was expected that
victims' would have different patterns of experiences with community
systems. There was support for this hypothesis as a meaningful three cluster
solution was obtained. Second, it was hypothesized that the proposed
ecological model would successfully predict these patterns of experience.
Whereas not all of the variables speciﬁed in the original model were signiﬁcant
predictors, several constructs did differentiate the clusters. Additionally, there
was support that these three levels of variables explained unique variance in

victims' experiences. In other words, to understand victims' interactions with

122

123

social systems, information about the environment, the rape itself, and
characteristics of the victims was needed.

The ﬁrst cluster was characterized by relatively high services, high ﬁt,
and low advocacy across all three systems. These women received as positive
an outcome as was possible. They were able to obtain the services they
wanted with little intervention and advocacy. The model evaluation results
suggested that these women were more likely to have been raped by strangers
with the use of a weapon and were somewhat more likely to have been injured
in the assault. These ﬁndings are consistent with previous research by Estrich
(1987 ), Kerstetter (1990), LaFree (1981), Madigan and Gamble (1991),
McCahill et al. (1979), and Rose and Randall (1982), which indicated that the
legal system responds differentially when weapons and injuries are involved.
These are "real" crimes, and as such, will be prosecuted. Furthermore,
Madigan and Gamble (1991) described from their qualitative work with rape
victims the "good victim" phenomena: women who are clearly distressed and
receptive to help may be treated preferentially. The results of this
quantitative, larger scale study indicate that such demeanor may have
consequences for victims' outcomes. Women who exhibited "good victim"
behavior were more likely to be in this ﬁrst cluster who had the most favorable
outcomes. For many of the cases in this cluster, several of the key ingredients
that appear to prompt social systems to respond were present. One advocate
summed up her case, as well as this cluster, rather succinctly: "Everything
that anyone could have possibly needed was there. There was no way they
couldn‘t help her without looking like total assholes."

In the second cluster, women did not have uniform patterns of
experiences across these three systems. Their interactions with the legal and

mental health systems were mixed at best, and quite negative at worst. The

124

advocates usually did not intervene in these cases to try to alter their
outcomes. Most of these cases were quickly ﬁltered out of the criminal justice
system, which was ’grconsistent with what the victims wanted. They wanted
to pursue prosecution, but system did not respond to that desire. Several
advocates reported that although this outcome was not what the victims
wanted, any efforts to try to change matters would have been in vain, so it was
best not to expend the effort. As one advocate described it, "there was no point
in trying to do anything, everyone had made up their minds long before she (the
victim) really had a chance to tell her story." By contrast, the medical system
was more responsive to these women's needs. Although they received fewer
medical services than the women in the ﬁrst cluster, what they obtained was
what they wanted, and the advocate did not have to intervene to bring about
these outcomes. In the mental health system, victims in this cluster received
only some of the services they wanted.

Results from the evaluation of the model indicated that women in this
second cluster were more likely to have been raped by someone they knew
without the use of a weapon and were more likely to have been drinking at the
time of the assault. These ﬁndings provide some quantitative support to the
qualitative stories collected by Fairstein (1992), Finkelhor & Yllo (1983),
Russell (1990), and Warshaw (1988), which indicated that rapes between
known parties are often met with skepticism. Very little research has
examined how alcohol affects service delivery, and these ﬁndings support
attitudinal research that suggested that alcohol use "negates" the rape
(Richardson & Hammock, 1991). This proﬁle of ﬁndings is consistent with
what is often thought of as the typical date rape: rape between known parties,
under the inﬂuence of alcohol. These ﬁndings imply that although the medical

125

system may not respond differentially to these cases, the legal and mental
health systems may have implicit rules for service delivery in date rapes.

The third cluster deﬁes simple explanation. As one advocate who
worked with a woman in this cluster described it, "this case was very
complicated and took a lot of work, which really didn't do much for her (the
victim) in the end." Due to the advocates' efforts, many cases did proceed past
some of the initial steps of criminal prosecution, but were irrevocably stalled in
the ﬁnal stages. Cases ready to go to trial were inexplicably dropped weeks or
days or even hours before court. Other cases were pled to misdemeanors.
Until this ﬁnal twist of events, the outcomes were consistent with the victims'
needs. The advocates were largely unsuccessful in reversing these "11th hour
catastrophes." In the medical system, this pattern of ﬁ'ustration repeated
itself. The victims received very few services, which was inconsistent with
their needs. They wanted far more services than they were able to receive,
despite the efforts of the advocates. In the mental health system, once again,
these victims did not receive all of the services they desired.

Only two of the variables in the model differentiated this third cluster:
rape by a nonstranger without the use of a weapon, and a mismatch between
the victims' and assailants' races. In some respects, one could argue that this
cluster was deﬁned as much by what it lacked as what it included. These cases
did 953 involve strangers; they did r_ro_t involve weapons; they did not involve
injuries; they did 9L1? involve alcohol use; they did not have victims who
exhibited "good victim" behavior. In other words, these cases lacked many of
the factors that our social systems may use to decide how to respond. What
these cases did involve was rape between known parties, and for the women of
color in this cluster, a rape often committed by a white man. This result is
consistent with the arguments proposed by social historians such as Berhard

126

et al. (1992), Davis (1981), Gordon (1987 ), hooks (1981), and White (1985).
Throughout history, violence against women of color has not been seen as
violence if it is committed by white men. As such, our social systems are
replete with checks and balances to maintain these oppressions (White, 1985).
This study provides some partial empirical support for this analysis.

In summary, the ﬁndings from this research suggest that for rape
victims to receive many of the services they want, their cases may need to ﬁt
a rather constricted mold. When certain characteristics of the victim, the
assault, and the community are in careful alignment, the likelihood of an
outcome that is consistent with victims' needs is most probable. As these
factors start to deviate from this narrow path, the number of services may
drop off, the ﬁt with victims' wishes may be compromised, and the advocacy
needed to bring about beneﬁcial outcomes may rise. Furthermore, it could be
argued from these results that the legal system may be the least forgiving of
such deviations. Cases that do not conform neatly were often ﬁltered out of
the system or were dropped later on despite extensive work by the advocates.
The medical system may not work under such stringent implicit rules. Even in
the stereotypical date rapes, the doctors and nurses in this study often
responded in a manner consistent with victims' needs. The implicit rules of
mental health system, however, did not emerge as clearly. Many women
received the short-term help they desired, but longer-term help was not as
readily available, creating relatively negative experiences for women in two of
three the clusters. The assumption that mental health services are readily

available to victims may therefore need reexamination.

127

Conceptual Contributions of this Stgdy to the Literature

This study raises several conceptual issues for research that seeks to
understand rape victims' experiences with social systems. First, previous
research has often studied each of these three primary social systems in
isolation, with the legal system being the dominant focus. In this study, rape
victim advocates helped us see beyond the walls of individual systems as they
function as a link between community systems. Feminist standpoint theory
suggested that advocates could be an informed source as they work in the
dominant culture (our social systems) and in the margins (the world of the
victim). This interview may have provided an opportunity for advocates to
appropriate their experiences and develop this standpoint. From this
perspective, it was discovered that victims do not have uniform experiences
across all three systems. How the legal system responds to rape is not always
the same as the medical or mental health systems. The cases in the second
cluster ("One Saving Grace") in particular underscore the importance of
examining all three systems simultaneously. The legal system was largely
unresponsive to these cases, but the medical system was the "saving grace"
for these women. Rape victims' experiences with social systems, therefore,
may not be all good, or all bad. When we expand the horizon to consider
multiple systems, we can begin to see the uniqueness of each system, as well
as the totality of victims' experiences.

Second, this research re-considered the assessment of victims'
experiences with social systems. A primary focus in the literature has been to
identify which services are offered to victims. In this study, two other
dimensions were examined: the ﬁt of such services with victims' needs and the
availability of such help. These two new dimensions appeared to help
distinguish and contextualize victims' experiences. For example, many of the

128

cases in the second cluster ("One Saving Grace") had limited involvement with
the legal system. Without assessing this issue of ﬁt, an erroneous conclusion
may have been reached: the victims did not want to prosecute and voluntarily
withdrew. Additionally, by asking the advocates how much, if any, advocacy
was needed to bring about different outcomes, it became apparent that some
cases required little intervention whereas other required a great deal. In the
third cluster ("Exercises in Futility"), the legal steps that were taken were
often done so because of the efforts of the advocates. This is a rather different
scenario from the cases in the ﬁrst cluster ("Approaching Justice"), which
often moved through to the ﬁnal stages with no intervention at all. The
services that are offered to victims tell part of the story. The ﬁt and the
advocacy required to bring about different outcomes ﬁll in details of the plot.
They begin to describe the context of victims' experiences, context which is
necessary to evaluate how well our social systems are addressing this problem.
Finally, an ecological model was examined in this study with three levels
of variables-environmental, event, and individual. All three of these levels
explained unique variance in the outcome variable (cluster membership/
victims' experiences). Whereas the individual predictors in this model may or
may not have been successful predictors, the levels appeared to be
instrumental. In other words, drawing on information from the environment,
the rape itself, and some characteristics of the victims were necessary to
predict victims' outcomes. For instance, race and victims' demeanor explain
only part of the pattern. With additional information about the type of rape,
the use of a weapon, injuries sustained, and alcohol use at the time of the
assault, more variance can be accounted for. Furthermore, an even more
distant variable, such as the coordination of the services available to victims in

these communities, had an aﬂ'ect. The programs and policies in a community

129

that work to streamline services to victims may trickle down to affect the
speciﬁc experiences of individual victims. These ﬁndings provide some
empirical support for Kelly's (1966, 1968, 1971) theoretical arguments that
environmental structures and practices may impact individual outcomes. The
individual level is a necessary, but not sufﬁcient approach to understand

victim-system interactions such as these.

Limitations of this Study

Several methodological limitations of this study may temper the
strength of the conclusions that can be drawn from this work. First, it is
important understand the tradeoffs of studying rape victims advocates to
learn about victims' experiences. This standpoint holds a wealth of
information, but it also raises issues of accuracy and representativeness.
Because the advocates did not directly experience these interactions, their
reports may contain inaccurate information. To address this potential
problem, three measures were taken. First, as discussed previously, the
questions in the interview were largely limited to factual information-was this
service offered, yes or no. By steering away from more perceptually-based
issues, the advocates' biases may not have had as much opportunity to
surface in the interview. Second, the advocates were asked to review the
victims' ﬁles and their notes prior to the interview to prevent memory
problems or distortion. This cannot, however, ﬁx any inaccuracies already in
the report.

Therefore, as a third check of the accuracy of the advocates' reports,
validity data were gathered from personnel from two other social systems (see
Method section). Police ofﬁcers and hospital staff were asked what services
they provided to rape victims, and their responses were compared with

130

advocates' answers to these same items. The police and advocates only had
fair agreement on these two items (kappas were .60 or lower) as the officers
stated they had services, which the advocates reported were not available.
The agreement between the hospital staff and advocates was higher (most of
the kappas were .60 or higher), but again, disagreement was in the usually in
the direction of medical staff stating they had services that the advocate did
not think were available.

It is possible that advocates and the system had different
interpretations of the questions, creating the relatively low kappas. For
example, several ofﬁcers stated that their department did indeed have a sex
crimes unit because they had one or two detectives who worked "quite a bit" on
sexual assault cases. In other words, some officers may have been considering
more informal case assignment policies such as this as constituting a sex
crimes unit. The advocates were likely reporting as to whether a formal unit
existed. Likewise, some hospital staff described what services are supmsed to
be offered to victims whereas the advocates may have been reporting what is
typical administered. Such differing implicit deﬁnitions of these services may
have contributed to lower agreement. Additionally, social desirability bias may
have been a factor. Some police oﬂicers and hospital staff may have biased
their answers (i.e., stated that they had services available which in actuality
are not typically offered) to present their organizations in a more favorable
light.

But, if the advocates, police, and hospital staﬁ' did have uniform
understanding of the questions, then it appears that advocates tended to
underreport. Given that both the presence of a service and the absence of one
are of interest in this study, this limitation in accuracy must be kept in mind
when evaluating these results. Unfortunately, validity data were not collected

131

from most of the victims, so the accuracy of the advocates' reports of their
experiences is difﬁcult to determine.9 In future work, it may be more fruitful
to have advocates and system personnel report on how a speciﬁc case was
processed rather than on these general questions about availability of services.
The agreement between advocates and system personnel on what happened in
speciﬁc cases may provide a better index of the accuracy of advocates' reports.

The representativeness of the advocates' reports must also be
considered. The advocates had been working in their jobs for ﬁve years on
average, which raises questions as to how typical their last case was relative
to their experiences. To address this issue, the advocates were asked to rate
how typical this case was relative to their experiences as advocates. A four
point scale was used (1=not typical at all to 4=very typical). The mean rating
was 3.89, which suggests that many of these cases were representative of the
type of work these advocates were doing in their jobs.

A larger issue to explore, though, is how representative these victims'
experiences were relative to all rape victims. Not all victims work with rape
victim advocates, which questions the generalizability of these ﬁndings. To
investigate this issue, a random sample of N =50 communities in this study
were selected. 10 The police department and primary hospital in each
community was contacted and asked what percentage of the rape victims they
work have an advocate with them. The hospital staff reported that they call
their rape crisis center and request an advocate to come to the ER to work

with the victim 93% of the time. The police reported that they contact the

 

9 For a supplemental project, some of the victims who had worked with these advocates
were contacted to participate in qualitative interviews. For the N=20 victims who
participated in these interviews, there was 100% agreement with the advocates as to what
services were offered in that case and whether each outcome was consistent with the victims'
needs.

10 These were the same N =50 communities selected for the validity assessment described
in the Method section.

132

rape crisis center less often, but that is because the hospital has already called
the advocate. For the cases where the victim has not been to the hospital
and/or does not have an advocate, the police stated they contact an advocate
62% of the time. Therefore, the approach used in this study appears to have
captured the majority of the rape victims who had legal or medical contact, but
has a margin of error from 7 %—38%. This error rate must be remembered
when considering the generalizbility of these ﬁndings.

Another issue of representativeness is much harder to address.

Because not all victims live in communities with rape crisis centers and have
access to advocates, how does this sample compare to such victims?
Unfortunately, because there are no national data available that indicate what
proportion of rape victims have access to rape crisis centers, this issue
remains unresolved. Combining data from Webster's (1989) national directory
of rape crisis centers and the 1990 Census reveals that there are 759 rape
crisis centers in the United States, which is one center per 125,000 women
aged 18-64. Every state has at least one rape crisis center, and the National
Coalition Against Sexual Assault (1995) reported that even women who live in
very rural areas have a rape crisis center within a two-hour drive from their
homes. Whether women actually utilize these centers is unknown.

When evaluating the representativeness of this sample, it is important
to remember that the victims in this study had considerable help and support
due to working with advocates. Thus, the bias of this sample is probably in the
direction of painting a more favorable picture of rape victims' experiences with
community systems. Given that many victims in this study still had negative
experiences, then we have more than ample reason to be concerned for the

victims who do not have such help.

'rr

 

133

These issues of accuracy and representativeness must be considered
when utilizing a rape victim advocate sample. Through their work and its
standpoint, advocates are privy to a great deal of information--information
that could be ﬁltered through their biases. Moreover, because advocates are
rarely the focus of study, the representativeness of their caseloads is difﬁcult
to determine. These drawbacks must be weighed against the potential gains.
The literature to date has lacked a nation-wide examination of victims'
experiences with these three community systems that considered both
individual and environmental factors affecting outcomes. Rape victim
advocates helped illuminate some of these issues.

A second limitation of this study is that several of the variables in the
proposed ecological model were not signiﬁcant predictors. The legal, medical,
and mental health resources were not related to victims' experiences, which
may have occurred because of two problems. First, most of the advocates
reported that their communities had almost all of these resources, which
restricted the range on these variables. Second, how these questions were
asked may have been problematic. The advocates reported whether their
communities had a particular resource (yes or no), but they were not asked
about the utilization of such services. A variety of community resources may
not be as helpful if victims do not know about them and use them. A resource
that exists in theory, but not in practice, may not affect victims' experiences.
Future research should reexamine these variables paying attention to this
issue of utilization.

Only one of the event-level variables was not a signiﬁcant predictor--
whether the rape occurred within the context of a battering relationship.
Unfortunately, many of the advocates did not know this information (60%),
and for those who were privy to this level of detail, only 23% of the time was

134

the rape one part of an abusive relationship. With this much missing data and
the restriction of range for those who could complete this item, it is not
surprising this variable had no effect. Another important issue that should
have been examined is whether the service providers the victim interacted
with knew about these other forms of violence. Sullivan (in press) provided a
thorough analysis of how our social systems discriminate against battered
women, but in this instance, they would have to know this was a violent
relationship for there to be any expected effect on outcomes. Other research
should examine these issues.

Among the individual-level predictors, race exhibited a curious effect.
The race of the victim and the race of the assailant were not predictive in
themselves, but the match between their races was signiﬁcant. This result is
consistent with what some social historians, such as Berhard et al. (1992) and
White (1985) have concluded about violence and race. What happens within
race is not of as much societal concern, but there are many more implicit rules
in our culture about violence between races. Namely, violence against women
of color by white men is not viewed as a crime deserving social attention. This
suggests that race itself may not be as important as the context of race.

The victims' socio-economic status also did not predict outcomes. The
measurement of SES in this study was rather crude as the advocates were
asked to describe the victims as lower class, working class, middle class, or
upper middle class. Social class is a complex construct in our culture, and this
method of assessment may not have been sensitive enough to capture this
complexity. It could also be the case, however, that SES, measured even as
simply as was done in this study, may not affect victims' outcomes. With the
other factors at play in each case, such as the rape itself and the victims'

demeanor, social class may not be of as much importance.

135

A ﬁnal limitation of this study is that only a small group of all the
possible factors that could affect victims' experiences were studied. There may
be other variables that were not examined in this model that may impact how
social systems respond to victims. For example, some advocates suspected
that victims' history of drug use may have affected their treatment. Some of
the women in this sample had serious drug problems, which was known to the
police and hospitals. Their rapes were often not considered to be real rapes,
but simply the exchange of sex for drugs. Likewise, some advocates noted that
the women they worked with who were homeless and/or worked as prostitutes
received differentially negative treatment. In other words, there may be many
other features of the victim, the rape, or the environment that were not

explored that could also be signiﬁcant factors.

Implications for Research and Intervention

This study can serve as a springboard into several research projects.
As described previously, several of the variables examined in this study need
reﬁnement and reanalysis (e.g., community resources, the role of domestic
violence, race/ethnicity, social class). Another key research issue raised by
these results is why community coordination of services appears to have
beneﬁcial effects for victims. Are these programs and policies effective
because, for example, medical personnel now have a better idea of what is
needed for legal prosecution, so more attention is paid to the forensic evidence?
Or, is community coordination a tangible, identiﬁable by-product of heightened
community awareness about sexual assault and violence against women? In
this study several different types of programs and policies were combined to
create a single scale of community coordination, but it would be useful to
understand the differential effects of Sexual Assault Response Teams (SARTs)

136

from multi-agency training programs. A qualitative approach may be useful
for teasing out these issues. In-depth case study work with the communities in
this sample that exhibited high coordination of services may reveal details of
why such coordination appears to be effective.

A second line of research would examine how the speciﬁc rape laws of
each state may impact victims' experiences. As discussed previously, the rape
legal literature has suggested that state statutes affect case processing (e.g.,
Caringella-MacDonald, 1985; Estrich, 1987). The rape laws of each state could
be coded to reﬂect their deﬁnitions and procedural guidelines. These state-level
variables could then be tested to see if they predict victims' experiences.

A third line of research that stems from these ﬁndings would involve
accessing the victims' themselves and examining how these different patterns
of experiences affected their recovery from the rape. Advocates can provide
proxy information for some issues, but not for others. For example, to what
extent do victims feel revictimized in these different patterns of interactions?
How did the advocate facilitate (or possibly impede) their healing process? It
may also be interesting to sample victims from communities that do not have
access to a rape crisis center so as to understand how the involvement of
advocates affects outcomes.

Intervention and evaluation research is also suggested by this work. If
other research continues to indicate that coordination of services for rape
victims is beneﬁcial, then programs that bring the legal, medical, and mental
health systems together to help rape victims could be implemented and
evaluated. Research by Evans and Sperekas ( 1976) and Vito et al. (1982)
provide some models for structuring interventions as does Edleson's (1991)
work on domestic violence. Research from domestic violence has suggested

that community-level interventions that coordinate services to victims can

137

have positive short-term and long-term beneﬁts (e.g., Edleson, 1991). Future
evaluation work may also delve into training programs for system personnel
who work with victims of violence. The results of this study indicated that
community workers may need more information about non-stranger rape and
about the role of alcohol in sexual assault. Evaluation efforts should seek
information not only from system personnel, but also ﬁom rape victim

advocates and the victims themselves.

Conclusion

This study provided an initial view into rape victims' experiences with
the legal, medical, and mental health systems. When women go public with
their stories of rape, they do not all have negative experiences, nor do they all
have positive outcomes. The response from these social systems appears to
be function of several variables. Characteristics of the victim affect these
interactions as do features of the rape itself. Even more distant variables,
such as the community coordination of resources for victims, can have
tangible effects for victims' experiences. This is a complex interaction, and as
such, it requires a theoretical analysis that examines multiple levels. The
utility of such an ecological framework such as this that spans multiple levels
of analysis is that helps identify the pressure points, such as these, to create
social change. It suggests how our social systems can be reorganized to create
settings that are more receptive to victims' needs. Improving victims'
experiences with the legal, medical, and mental health systems may require
both individual and structural changes.

APPENDICES

APPENDIX A
Power Analysis

A sample size of N=165 advocates was chosen based on a priori power
analysis of the study design and proposed statistical procedures. Seven
independent variables and a ﬁve-cluster solution were assumed for these
computations; in fact, fourteen independent variables were examined and only
a three-cluster solution was obtained. Hosmer and Lemeshow (1989) noted
the difﬁculty of estimating power for logistic regression. Instead, they
suggested that if one stipulates that multivariate assumptions of normality
will be met, a power test for discriminant function analysis can provide
accurate power estimates. Thus, following Cohen's (1988) procedures for
discriminant function analysis/MAN OVA, a power test for the overall model
was computed: alpha was set at .05, power at .80, and f2 (standardized effect
size) at .15 (equivalent to a multivariate R2=.40 and multiple R2=.13) (i.e., a
medium effect size was assumed). This analysis indicated that N=55
participants would be needed for this study. But, this sample size was likely
too small for an interpretable cluster solution to emerge. More importantly,
this test of the overall model did not suggest how many participants would be
needed for individual contrasts of interest. For example, the contribution of an
single independent variable (e. g., coordination of community resources) to
predict cluster membership was of interest in this study (i.e., does community
coordination add signiﬁcant predictive power [variance] after the other
independent variables have been accounted for?). Therefore, a second power
analysis was computed. F2 was set at .05 (equivalent to multiple R2=.05),
which was smaller than for the overall model, but one would expect a smaller

138

139

eﬁ'ect for an individual variable versus an entire model. The power test for
such contrasts was computed with alpha was set at .05, power at .80, and f‘2 at
.05. This analysis indicated that N: 165 participants would be needed for this
study.

APPENDD( B

Director Interview

Agency Name

 

 

Agency Phone

 

THIS IS THE PROTOCOL TO FOLLOW WHEN FIRST CONTACTING EACH RAPE
CRISIS CENTER. FOLLOW THE STEPS BELOW, BUT TRY TO MAKE IT SOUND
CONVERSATIONAL AND INFORMAL.

"May I speak with the Director of your rape crisis services program?"

"Are you the Director of ? (insert
name of the rape crisis center you are calling) My name is and I'm
calling from the Community Response to Rape Project at Michigan State University. We
are a small research project that is surveying rape victim advocates across the country to
learn about how rape victims are being treated by the legal, medical, and mental health
systems. We're trying to locate advocates who would be willing to talk to us about their

experiences working on behalf of rape victims in their communities."

"As the Director of a rape crisis center, we are asking for your help to ﬁnd advocates. Do
you have anyone on your staff--paid staff or volunteer staff—-who works in the community

providing advocacy services to rape victims?"
(ifno). "Well, thank you for your time today. We really appreciate your help."

(if yes) "I would like to contact some of your advocates to ask them if they would be
interested in participating in our project. May I have the name of two advocate who
provide a great deal of advocacy work with rape victims?" (record information on Advocate

Recruitment Sheet)

"1 would also like to ask you a couple of questions about your agency. Do you have about
15 minutes now to talk?" (If no, ask when would be a good time to call back; schedule
interview and record on Director Interview Scheduling Sheet).

140

141

(If yes) "Great. First, I need to get your formal consent to allow me to ask you some

questions.

Has the purpose of this research project been fully explained to you?

 

You may discontinue participation at any time without penalty. You do not have to answer
all of the questions in the interview. The information you provide will be held in the
strictest conﬁdence. Your name will not appear on the interview. You will be identiﬁed
only by an ID number. You can obtain a copy of the results of this project after its

completion.

Do you understand these rights and conditions?

 

Do you freely consent to participate?

 

Would you like a copy of the results when they are ﬁnished?

 

(If yes, put her name and address on the "Send Results To" labels)

1. How would you describe your organization's philosophy on rape and violence
against women?

(PROBE: what does your organization see as the role of women in causing and
preventing rape? what does your organization see as the role of men in causing rape

and preventing rape?)
2. What are the primary goals of your organization?
3 . Would you characterize your rape crisis center as being a more service-delivery

agency or a social action and social change organization? (CLARIFY ONLY IF
N EEDEDnsocial action refers to community education, prevention efforts,
empowerment agendas).

% of efforts that are direct service

 

% of efforts that are social action and social change

4. What services does your organization provide? Do you have/do . . .
Hotline 1=YES O=NO
Medical advocacy 1=YES 0=NO

142

 

 

 

 

 

 

Police advocacy 1=YES O=NO
Other Legal advocacy leES O=NO
Crisis counseling 1=YES O=NO
Short-term counseling 1=YES O=NO
Long-term counseling 1=YES O=NO
Political lobbying 1=YES O=NO
(state level lobbying for legislative changes on rape)
Political action work 1=YES O=NO

 

(sponsoring demonstrations, media campaigns, marches, protests)

 

 

Community education in secondary schoolsmleES O=NO

Com. education in colleges 1=YES O=NO

Com. education with men's groups (frats)ml:YES O=NO

Com. education with professional groups/mleES O=NO
civic groups

Training with other agencies 1=YES 0:NO

Rape avoidance programs for women 1=YES O=NO
(safety hints for women)

Self defense programs for women 1=YES O=NO
(rape prevention)

Any other services? ( ) 1=YES O=NO

 

Do you see your organization's role as more to collaborate and cooperate with other
agencies in your community or to try to change them? (PROBE: how so?)

In your agency, who is involved in making decisions regarding programs and
policies?

(PROBES: What is the role of paid staff? role of volunteer staff? role of executive
director? role of board of directors? how are these decisions made?)

How would you characterize your organization's structure?

(PROBES: Do you have an executive director; Do you have a board of directors;
Who is on the board of directors; Who has the "ﬁnal" say about decisions; Would
you characterize your organization as a collective or as a more traditional
organizational structure? Why?)

143

 

 

 

 

 

 

8. What are your organization's sources of funding?
FEDERAL FUNDING % (from 0%-100%)
STATE FUNDING % (from 0%-100%)
COUNTY FUNDING % (from O%-100%)
CIT Y/T OWNSHIP FUNDING % (from 0%-100%)
FOUNDATION FUNDING % (from O%-IOO%)
PRIVATE CONTRIBUTIONS % (from O%-100%)
FUNDRAISING % (from O%-100%)

 

 

9. What is your operating budget?

10. How many staff do you have?

 

 

 

 

 

PAID STAFF
VOLUNTEER STAFF
l 1. How long has your organization been in existence?
(in months)
12. In the past year, how many clients did your rape crisis center serve?
13 . What is the population of the community you serve?

 

13a. Would you describe the community you work in as . . .

1=VERY RURAL
2=SOMEWHAT RURAL
3=URBAN, SMALL
4::URBAN, MEDIUM-SIZED
5=URBAN, LARGE

14. How would you describe the political climate of the community you work in

1=VERY PROGRESSIVE

2=SOMEWHAT PROGRESSIVE

3=MIXED (BOTH PROGRESSIVE AND CONSERVATIVE POCKETS)
4=SOMEWHAT CONSERVATIVE

5=VERY CONSERVATIVE

 

'nni

 

 

144

5 . To what extent is rape viewed as a serious problem by your community as a whole?
(PROBES: do they view other forms of violence against women, such as domestic
assault, as a more serious problem?)

6.

How pervasive are victim-blamin g attitudes about sexual assault in your community
as a whole?

Those are all of the questions] have for you. Thanks so much for your time today. I
really appreciate your help.

 

 

APPENDD( C
Advocate Screening

Advocate Name

 

Advocate Phone

 

THIS IS THE PROTOCOL TO FOLLOW WHEN CONTACTING THE ADVOCATES

TO RECRUIT THEM FOR THE STUDY. FOLLOW THE STEPS BELOW, BUT TRY
TO MAKE IT SOUND CONVERSATIONAL AND INFORMAL.

"May I speak with

 

(insert name of advocate)
"My name is

 

and I'm calling from the Community Response to Rape
Project at Michigan State University. I got your name from

 

 

(insert name ofDirector) because we are looking to talk to rape victims
advocates who work in the community on behalf of rape victims.

 

 

(insert name ofDirector) said you might be interested in hearing more about
our project.

"Do you have a few minutes for me to tell you a little bit more about it?
(If no, ask when would be a good time to call back)

"We are a small research project that is surveying rape victim advocates across the country
to learn about how rape victims are being treated by the legal, medical, and mental health
systems. We're trying to locate advocates who would be willing to talk to us about their
experiences working on behalf of rape victims in their communities. It is our hope that we

can use this study as a way to hook up advocates across the country so we can all learn
what is happening, what's working, and what needs improvement."

"If you decide to participate, I would like to interview you over the phone, at your

convenience. The interview will take about an hour to an hour-and-a-half.

"In the interview, I will ask you about the resources that are available to rape victims in
your community. A large section of the interview is about the speciﬁc experiences of the

last rape victim you worked with who had at least some contact with the legal, medical, or

145

 

 

146

mental health systems. I do not want the name of the victim and we do not want to

jeopardize her conﬁdentiality. I just want to know how she was treated by the community
agencies she had contact with."

"I‘m would also ask you about what you would like to see done differently to improve how

rape victims are treated. Your recommendations are very important to us since you're the
one who's actually out there doing the work."

"Would you be willing to participate in this study and be interviewed?"
(If no) "Well, thank you for your time today. We appreciate your help."

(If yes) "Great. Now to do the interview, I would need you to think back to the most
recent adult rape victim you had contact with. It's really important that it be an adult,

female, rape victim, not an adolescent victim, or a child sexual abuse victim, or an incest
survivor."

"It's also really important that this victim had at least some contact with either the legal
system, and/or the medical community, and/or the mental health system. If the last adult

female rape victim you worked with did not have any such contact, I will need you to think
back to the most recent one that did."

"It may be helpful for both of us if you can review what happened in this case before we
talk again, so it will be fresh in your mind for the interview."

"Do you have any questions about the interview ?"

 

"Let's set up a time and date that would be convenient for you to do the interview"
(record information on sheet)

(after you ‘ve scheduled the interview) "Let me give you my name and phone number in
case you need to get in touch with me. My name again is

and
my phone number is

 

 

. Let me also give you the name of the Project

Coordinator in case you would like to talk to her. Her name is Rebecca Campbell and she
can be reached at (517) 353-5015.

 

 

APPENDD( D

Interviewer Training Manual

PREFACE

Welcome to the Community Response to Rape Project. I hope that you
wih ﬁnd this experience to be an exciting and rewarding one. In the next

semester, you will be learning about ﬁeld research methods and data collection
techniques. The training you will be going through was designed to teach you
about. rape and violence against women, quantitative and qualitative

interviewing, and methods of coding data. You will be responsible for various
facets of the data collection process including maintaining conﬁdentiality,

contacting rape crisis centers, conducting interviews with the directors of rape
crisis centers and victim advocates, coding the interviews, and reporting case
proceedings to the rest of the group.

Your role in this project is critical to its success. The way in which we
conduct these interviews will affect how each participant views our project and

researchers in general. It it my hope that this project will be beneﬁcial not only
to the women we interview, but to you, the interviewer, as well. Welcome
aboard!

OVERVIEW OF TRAINING

This schedule is based on Michigan State University's semester system
because the interviewers are undergraduate juniors and seniors majoring in
psychology. The interviewers receive course credit in exchange for their
participation.

Week 1-Overview of the Project
I. Introductions of all staff members
ll. Overview of the project

0 WhatI wanted to examine in my dissertation
0 How I chose this approach to those questions
0 Developed ideas ﬁ‘om my experience as a victim advocate

0 We will be interviewing directors of rape crisis centers and advocates
0 What is an advocate?

147

 

 

1 48
III. Overview of the timeline

' Goal is to ﬁnish data collection by end of Summer 1995
0 Each will be assigned 20 interviews to complete

0 Training will last next three weeks

0 You will be expected to complete 2 interviews per week

IV. Overview of rape
0 What is rape
Penetration by threat of force or use of force
Types of penetration: vaginal, anal, oral, by object
Committed by: stranger, friend, co-worker, date, husband, anyone
Most often committed by someone known to victim
0 Why does rape happen
Theory 1: Individual-level explanations
Aggression of individual men
Miscommunication
Women as provokers
Theory 2: Social-level explanations
Feminist analysis of oppression
0 Psychological reactions to rape
Immediate reactions

Expressive reactions
Controlled reactions

Long-term reactions

Trust
Fear

Guilt
0 Physical health reactions to rape

Sleeping problems
Eating/digestive problems
Headaches

Changes in sexual relations
Sexually transmitted diseases
Pregnancy

149

0 Rape as a community issue

Rape crisis centers
Legal system
Medical system
Mental health system

V. Conﬁdentiality

0 Cases to be discussed only among project staff
0 Protecting case assignments and interviews
0 Self-care

Assignment Week 1: Readings on rape

Goodman, L.A., Koss, M.P., Fitzgerald, L.F., Russo, N.F., & Keita, GP.
(1993). Male violence against women: Current research and
future directions. American Psychologi_st_:, 18, 1054- 1058.

Koss, M.P. (1993). Rape: Scope, impact, interventions, and public
policy responses. American Psychologist, _4_8_, 1062- 1069.

Koss, M.P., & Harvey, MR. (1991). The rape victim: Clinical and
community interventions. Newbury Park, CA: Sage.

Chapter 1--The Crime of Rape

Chapter 2-—The Trauma of Rape
Chapter 3-Rape as a Community Issue
Chapter 4--The Rape Crisis Center

1 S 0
Week 2--Discuss Ream monstration of Advocate Interview

I. Discuss readings from last week

0 Questions and clariﬁcations
O Socio-political meaning of violence against women

Mechanism of oppression?
Mechanism of patriarchy?
Violence against women as a feminist issue

0 Rape as an act of violence, act of sex, act of both
0 Community response to rape

Grass roots?
Top-down?
Consciousness raising groups?

H. Demonstrate advocate interview

III. Collect addresses, phone numbers, and interviewing availability

Assignment Week 2:

Practice advocate interview with me and other grad students ﬁ'om
prepared script; prepare list of questions you have about the interview

Week 3—Discuss Practice Advocate Interview/Demonstration of
ﬁght Interview

I. Discuss practice interview from last week

0 Overall organization of interview

0 Clarify meaning of questions

0 Additional probes

0 Clarify coding of answers

0 Writing in qualitative answers

0 Double checking your coding

0 Turn in interview for reliability check

II. Demonstration of director interview and advocate screening
III. Distribute addresses and interviewing schedule

 

151

Assignment Week 3:

Practice complete interview sequence with me and other grad students
from prepared script; prepare list of questions you have about the
interview

Week 4-Discuss Practice Interviews/Trouble Shoom Q. tribution of
Case

I. Discuss practice interviews

0 Discuss reliability check from last week on advocate interview

0 Handout on coding reminders (see end of training manual)

0 Clarify questions about director interview and advocate screening
0 Turn in practice interviews for reliability check

11. Trouble shooting
0 Role plays for trouble with directors

No time

What is this project again?
Need conﬁrmation about project
Conﬁdentiality

Why should her center do this

0 Role plays for trouble with advocates

No time

What is this project again?

Need conﬁrmation about project
Conﬁdentiality

Determining an eligible case for the interview

0 Accessing phones and schedule conﬂicts
0 Finding me for emergencies
III. Distribution of case loads

0 List of agencies to contact
0 Distribution of materials

 

 

1 5 2
Assignment Week 4:

Final mock interview with me with same script
Organize materials for data collection

Week 5--Sta_r__trng° Data Collection

1. Review ﬁnal practice interview

0 Discuss ﬁnal reliability check
0 Discuss who must do another practice interview

II. Starting data collection

0 Review phone and interviewing schedule

0 Calling your ﬁrst rape crisis center
Assignment Week 5:

For those with green light—complete 2 interviews

Otherwise, one more practice interview, then if reliability improves,
contact ﬁrst rape crisis center

Weeks 6-13--Data Collection
Format of meetings for data collection period:

I. Take turns discussing cases (2 per week)

0 Re-tell victim's story and the response from each community system
0 Coding questions

11. Trouble shooting
0 Iffalling behind schedule, ways to complete 2 interviews per week
0 Director/advocate concerns
0 Access to phones

III. Feedback sheets ﬁom prior week's interviews

IV. Emotional check-in

1 5 3
Special Project: Speaking Out Against Violence Against Women

I. Magazine writing project

0 Letters of protest to magazines that promote VAW
0 Letters of protest to companies that promote VAW

H. Volunteer training at our rape crisis center

Assignment Weeks 6-13:

Complete 2 interviews per week
Work on magazine writing project

Week 14: Wranggg’ Up
I. Final interviews
II. Final paper

0 Reﬂections on what you have learned about rape

0 Reﬂections on what you have learned about our society

0 Reﬂections on what you have learned about women's status
0 Impact project has had on you

154

The Community Response to Rape Project
REMINDERS ABOUT CODING

BEFORE YOU TURN IN A PACKET OF INTERVIEWS, MAKE SURE YOU
CHECK OVER THE FOLLOWING THINGS:

I.

On the director interview, make sure that page 7 «Advocate
Recruitment Sheetuis COMPLETELY ﬁlled out (except the sections to
be ﬁlled out by me!).

On the advocate screening make sure that page 3--Advocate Interview
Scheduling Sheet--is COMPLETELY ﬁlled out (except the sections to be
ﬁlled out by me!)

 

Be sure to ﬁll in your interviewer ID number

Be sure to ﬁll in the date the interview was conducted AND the le_ng_tl; of
the interview (how long it took)

Make sure EVERYTHING is circled/ﬁlled out in the ENTIRE interview

0 double check that you have ﬁlled in all answers; on your practice
interviews many items were inadvertently left blank

0 if you have to just re-copy information that was given in a
previous question, make sure you do it! DO NOT write "see
above" or put an arrow up. RE-COPY the information

0 if a woman had no contact with a social system, then every
single item for that system must be circled 9

0 in the beginning section of the interview (resources available), if
the service is not available, you circle O=NO, but be sure to circle
9 for the three followup items (9=service not available)

Convert all numbers (e.g., years into months). Fill in the converted
numbers in the spaces below the items. Make sure you appropriately
convert ALL the numbers in the ENTIRE interview (both director and

advocate)

Go back through the interview and ﬂesh out ALL the answers
IMMEDIATELY after you get oﬁ‘ the phone. Use a DIFFERENT
colored ink.

10.

155

0 really ﬂesh out the details; in your practice interviews you were
not getting the whole story down on paper

0 if need be, write on the back of the page, but really try to get
down EVERYTHING that the advocate said

Pay particular attention to the questions that ask about what actions
the advocate took in each matter (e.g., police report, rape exam). Make
sure these are as DETAILED as possible. Really ﬂesh these out. They
are CRITICAL to my dissertation!

Please write NEATLY. I know that when you're doing the interview it's
hard to be neat, but when you go back through to ﬂesh out the details,
please write neatly and clearly. I could not read some of your
handwriting in the practice interviews.

Keep up-to-date on your paperwork. Keep your turquoise phone log
updated after each round of phone calls. Please keep DETAILED notes
on your lavender contact sheets for each contact you have trying to
complete the director interview, the advocate screening, and the
advocate interview.

REMINDERS ABOUT THE DIRECTOR INTERVIEW

It is not necessary to ask the PROBES for question 1; use the probe
questions only if the director seems to be having trouble answering the
question. Also you can use the probe

Would you say that your center has a feminist philosophy or
orientation?

An alternative wording you can use is:

Ifyou had to characterize how much time you and your staff
spend doing direct service work with survivors, and how much
time you spend doing community education, percentage-wise how
would this breakdown? What percentage of your time is spent
doing each?

Political lobbying would be circled YES if they are members of their
state coalition and their state coalition is involved in this kind of work

Political action work would be circled YES if they work on or participate
in things like the Take Back the Night March or the Clothesline Project

 

11.

12.

13a.

10.

11.

13.

156

m avoidance means that when they speak to groups of women, they
give safety tips such as not walking alone at night, being careful how
much you drink when you go out, etc.

Self defense would be circled YES only if the self defense classes are
provided by the rape crisis center.

Make sure you ask the following PROBES for this question (highlight
them to remind yourself.)

Who is on your Board of Directors

Who has ﬁnal say about a decision
Whether their structure is collective or more traditional

VOCA (Victims of Crime Act) money is FEDERAL money

Write in how long the center has been in existence. YOU convert that
time into months and write in on the line below. DO NOT ask the
director to make this conversion. You can do it after you get off the
phone with her. IN GENERAL, do all math calculations and
conversions after you get off the phone with the director/advocate.

For the number of clients served, write in the breakdown exactly as
provided to you by the director (e.g., "we had 600 crisis calls and spoke to
1,000 people in our community education programs"; write in 600 for
crisis call and 1,000 for community education)

For the size/type of the community they work in (rural to urban),
CIRCLE ALL that apply

REMINDERS ABOUT THE ADVOCATE INTERVIEW

Question about treatment for STD's, please read question EXACTLY as
worded

Follow-up care visit should only be circled YES if the hospital actually
schedules the appointment for the woman. Ifthey tell her she should go
see her doctor, circle NO

Circle YES for if they have a police sex crimes unit only if they have a
gaggp of ofﬁcers who work only on rape/sexual assault cases (and child
abuse cases)

Circle YES for if they have a prosecutor sex crimes unit only if they
have a M of prosecutors who work only on rape/sexual assault cases
(and child abuse cases)

14.

16.

17.

21.

22.

24.

30.

39.

42.

47.

49.

157

Victim advocacy programs are also sometimes known as victim witness
programs or victim assistance programs

If the rape crisis center provides short-term therapy circle YESaALL
OF THEM. Ifthe rape crisis center does mt provide short-term
therapy, circle YES-SOME OF THEM

Ifthe rape crisis center provides long-term therapy circle YES—ALL OF
THEM. If the rape crisis center does {ﬂ provide long-term therapy,
circle YES--SOME OF THEM

For the other groups who work on improving community awareness
about rape, circle YES only if it is a group outside of the rape crisis
center. It must be a separate group not afﬁliated with the rape crisis
center

Training for police oﬂicers--if they do training with police academy
students go ahead and circle YES and ask the subsequent questions

Training for medical personnel-if they do training with nﬂical residents
or interns go ahead and circle YES and ask the subsequent questions

Training of the volunteers at the rape crisis center by mental health
staff—circle YES only if the training is done by someone outside of the
agency. The mental health worker must not be afﬁliated with the

center; she/he must be an outside person to circle YES
Section II, right above question 39, new wording:

For this next set of questions, I'd like you to think back to the
most recent sexual assault case that you have COMPLETED.
This needs to be an adult, female rape survivor.

By 'COMPLETED' I mean that no further action is being taken in
this case by the legal system or the medical system. It is OK if
she is still receiving counseling.

Ifthe advocate met the woman at the hospital right after the assault
happened, code as ZERO days for time between when assaulted and
when started working with her

Code what is the highest educational level attained for the victim right
now (e.g., for a woman who was raped while in college, but has graduated
by the time we do the interview, code as graduated and circle
appropriate degree)

Please write in the number of times she was raped and whether the rape
was mam. oral, and/or by object

51.

57.

59.

59.

60.

61.

62.

67.

69.-

75.

69.

70.

158

Ifshe had NO CONTACT with the lgggl system (but, make sure there
really was no contact, no police report, no contact with detectives, no
contact with the prosecutors), then skip this whole section and go to the
medical system section (question 59)

Ifthe advocate provided the referral, circle NO and for 57b. circle 5
(advocate gave referral herself)--DON'T have her rate her involvement

If she had NO CONTACT with the medical system (but, make sure
there really was no contact, no emergency room contact, no contact

with regular doctor or health center), then skip this whole section and go
to the mental health system section (question 69).

Ifthe advocate provided the info about pregnancy circle NO to 59

Ask 59a same as always

For 59b. circle 5 (advocate gave info herself)—DON'T have her rate her
involvement

Ifthe advocate provided the info about STD circle NO to 60

Ask 60a same as always

For 60b. circle 5 (advocate gave info herselD—DONT have her rate her
involvement

Ifthe advocate provided the info about physical health circle NO to 61
Ask 61a same as always

For 61b. circle 5 (advocate gave info herselD—DON'T have her rate her
involvement

Ifthe advocate provided the info about psychological health circle NO to
62. Ask 62a same as always

For 62b. circle 5 (advocate gave info herself)—DON'T have her rate her
involvement

If the advocate provided the referral, circle NO and for 67b. circle 5
(advocate gave referral herself)--DON'T have her rate her involvement

The section of questions about the mental health system includes any
services provided

by the advocate and/or the rape crisis center; the mental health system
includes the rape crisis center

If the advocate provided the info about psychological health circle YES
to 69. Ask 69a same as always

For 69b circle 5 (advocate gave info herself)--DON'T have her rate her
involvement

If advocate provided short term therapy, just write that in and have her
rate her involvement

71.

72.

73.

75.

80.

87.
90.

94.

1043.

105.
105a.

106.

159

If advocate provided long term therapy, just write that in and have her
rate her involvement

Ifthe advocate provided the info to family and friends circle YES to 72
Ask 72a same as always

For 72b circle 5 (advocate gave info herself)--DON'T have her rate her
involvement

If advocate provided therapy to friends and family, just write that in and
have her rate her involvement

Ifthe advocate provided the referral, circle YES and for 7 5b. circle 5
(advocate gave referral herself)--DON'T have her rate her involvement

New wording

These next few questions might sound a little strange, but we've
been hearing ﬁom some advocates that sometimes women don't
get quite as much help if they are very confrontational or have a
very assertive stance about them. Would you say this was an
issue for this woman's involvement with the

legal system
medical system
mental health system
Do n_o§ read the probe questions underneath

It might be a good idea to read back to the advocate the suggestions for
improvement she told you about

New wording
What is your educational background?
Skip this question (name of police department and hospital)
Go ahead and ask 105a no matter what answer they give to 105

For the women they work with who have been raped, have them rank
order the types of rape

If 106 is NO, go to 107 quickly without skipping a beat

APPENDDi E

Advocate Interview

Section I
Resources and Coordination of Rape-Related Services in Their Community

Section instructions:

This ﬁrst set of questions are about the resources that are available to rape victims in
your community. Now what I mean by "your community" is the area that you work in as
an advocate. For some advocates that's only part of a large city, for others it's an entire
city, for others it's multiple cities. Think of "community" as the area for your work in.

l . First, do you have a rape crisis hotline in your community?
1=YES ----- > Go to Questions 1a. 1b. 1c.
O=NO ----- > Go to Question 2.

1a. How accessible is this rape crisis hotline to victims in your community?
Keep in mind issues of how accessible this service would be for victims of
different social-economic status, different races and ethnicities, whether

they lived in an urban or rural area.

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

lb. Are there a sufﬁcient number of rape crisis hotlines to meet the needs of
victims in your community? Would you say the number available is . . .

1=VERY MADEQUATE (POOR)
2=SOMEWHAT LEADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

1c. How would you describe the guality of this rape crisis hotline? How
well does it meet the needs of victims in your community? Is it . . .

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

160

161

Do you have places in your community that offer immediate, crisis intervention
counseling for rape victims?

1=YES ----- > Go to Question 2a. 2b. 2c.
O=NO ----- > Go to Question 3.

23. How accessible is this counseling to victims in your community?

1=POOR
=FAIR
3=AVERAGE
4=GOOD
5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

2b. Are there a sufﬁcient number of places offering this crisis counseling to
meet the needs of victims in your community? Would you say the number

available is . . .
1=VERY _I__N_ADEQUATE (POOR)
2=SOMEWHAT INADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
S=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

2c. How would you characterize the Quality of this crisis counseling? How
well does it meet the needs of victims in your community? Is it . . .

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

Do you have agencies in your community that will send someone to go with victims
to the hospital or to the doctor?

1=YES ----- > Go to Question 33. 3b. 3c.
O=NO ----- > Go to Question 4.

3a. How accessible is this service to victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

162

3b. Are there a sufﬁcient number of agencies that offer this service to meet
the needs of victims in your community? Would you say the number

available is . . .
1=VERY I_N_ADEQUATE (POOR)
2=SOMEWHAT MADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

3c. In your opinion, how well does this service meet the needs of victims in
your community? Is it . . .

lzPOOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

Do you have agencies in your community that will send someone to go with victims
to the police?

1=YES ----- > Go to Question 43. 4b. 4c.
O=NO ----- > Go to Question 5.

4a. How accessible is this service to victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

4b. Are there a sufﬁcient number of agencies that offer this service to meet
the needs of victims in your community? Would you say the number

available is . . .
1=VERY I_NADEQUATE (POOR)
2=SOMEWHAT INADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVEQAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

163

4c. How well does this service meet the needs of victims in your
community?
Is it . . .

1=POOR

2=FAI R

3=AVERAGE

4=GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

These next few questions are about the hospitals in your community and the
services they offer. First, do the hospitals in your community perform the rape
exam and evidence collection procedures?

l=YES--all of them ----- > Go to Question 5a. 5b. Sc.
2=YES--some of them ----- > Go to Question 5a. 5b. 5c.
O=NO ----- > Go to Question 6.

5a. How accessible are the hospitals that do perform this service? Again,
keep in mind the issues I asked about earlier, like the social class of the
victim, her race or ethnicity, whether she lived in an urban or rural area.

lzPOOR

2=FAIR

3=AVERAGE

4:GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

5b. Are there a sufﬁcient number of hospitals that perform the rape exam
and evidence collection procedures to meet the needs of victims in your
community? Would you say the number available is . . .

1=VERY MADEQUATE (POOR)
2=SOMEWHAT EADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVHIAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

5c. In your opinion, how skilled are the doctors and nurses in your
community at performing the rape exam and evidence collection? Are they

1=POOR

2=FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9:NOT APPLICABLE, SERVICE NOT AVAILABLE

164

6. Do the hospitals in your community give victims information about the possible risk
of pregnancy from the rape?

1=YES--all of them ----- > Go to Question 6a. 6b. 6c.
2=YES--some of them ----- > Go to Question 63. 6b. 6c.
O=NO ----- > Go to Question 7.

6a. How accessible are the hospitals that do offer this information to victims
in your community?

1=POOR

2=FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9:NOT APPLICABLE, SERVICE NOT AVAILABLE

6b. Are there a sufﬁcient number of hospitals that provide this information
to meet the needs of victims in your community? Would you say the
number available is . . .

1=VERY MADEQUATE (POOR)
2=SOMEWHAT mADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

6c. How good are the hospitals at remembering to give this information to
victims? Are they . . .

1=POOR

2=FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

7 . Do the hospitals in your community offer rape victims the Morning After Pill?
1=YES--all of them ----- > Go to Question 7a. 7b. 7c.
2=YES--some of them -----> Go to Question 7a. 7b. 7c.
O=NO ----- > Go to Question 8.

7a. How accessible are the hospitals that do offer the Morning After Pill to
victims in your community?

1=POOR

2=FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

165

7b. Are there a sufﬁcient number of hospitals that offer the Morning After
Pill to meet the needs of victims in your community? Would you say the

number available is . . .

1=VERY I_NADEQUATE (POOR)
2=SOMEWHAT INADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

7c. How good are the hospitals at remembering to offer the Morning After
Pill to rape victims? Are they . . .

l=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

8. Do the hospitals in your community give victims information about the possible risk
of contracting a sexually transmitted disease from the rape?

l=YES--all of them ----- > Go to Question 8a. 8b. 8c.

2=YES--some of them ----- > Go to Question 8a. 8b. 8c.
O=NO ----- > Go to Question 9.

8a. How accessible are the hospitals that do offer this information to victims
in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

8b. Are there a sufﬁcient number of hospitals that provide this information
to meet the needs of victims in your community? Would you say the

number available is . . .

1=VERY mADEQUATE (POOR)
2=SOMEWHAT I_N_ADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORETHAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

 

166

8c. How good are the hospitals at remembering to give this information to
victims? Are they . . .

1=POOR

2:FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9:NOT APPLICABLE, SERVICE NOT AVAILABLE

9. Do the hospitals in your community give victims a preventive dose of antibiotics to
treat any sexually transmitted diseases that may have been spread through the rape?

l=YES--all of them ----- > Go to Question 9a. 9b. 9c.
2=YES-—some of them ----- > Go to Question 9a. 9b. 9c.
O=NO ----- > Go to Question 10.

9a. How accessible are the hospitals that do offer this treatment?

l=POOR

2=FAIR

3=AVERAGE

lib-GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

9b. Are there a sufﬁcient number of hospitals that offer this treatment to
meet the needs of victims in your community? Would you say the number

available is . . .

1=VERY I_NADEQUATE (POOR)
2=SOMEWHAT I_NADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

9c. How good are the hospitals at remembering to offer this treatment to
rape victims? Are they . . .

1=POOR

2=FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

167

Do the hospitals in your community routinely schedule a follow-up care Visit for
victims?

10.

----- > Go to Question 10a. 10b. 10c.
----- > Go to Question 103. 10b. 10c.

----- > Go to Question 11.

l=YES--all of them
2=YES--some of them

O=NO

10a. How accessible are the hospitals that do offer a follow-up visit to
victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

10b. Are there a sufﬁcient number of hospitals that offer a follow-up visit to
meet the needs of victims in your community? Would you say the number

available is . . .
1=VERY I_NADEQUATE (POOR)
2=SOMEWHAT I_N_ADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

10c. How good are the hospitals at remembering to offer a follow-up visit
to rape victims? Are they . . .

1=POOR

2=FAIR

3=AVERAGE

4=GOOD

5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

The next couple of questions are about your police departments and prosecutors

l 1.
ofﬁce. Do the police departments in your community have a special rape unit or sex

crimes unit?

1=YES-all of them ----- > Go to Question 11a. 11b. 11c.

2=YES--some of them ----- > Go to Question 113. 11b. 11c.
----- > Go to Question llaa.

O=NO
THEN 12.

11a. Is there anyone in your police departments who has
had special training on rape, sort of a resident "rape expert?"

1=YES ----- > Go to Question 12
O=NO ----> Go to Question 12

168

11a. How accessible is this service to victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

1 1b. Are there a sufﬁcient number of departments that have this service to
meet the needs of victims in your community? Would you say the number

available is . . .

1=VERY INADEQUATE (POOR)
2=SOMEWHAT EADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

11c. How would you rate the overall quality of these rape units? How well
do they meet the needs of victims in your community Are they . . .

1 =POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

12. Do the police in your community have special procedures that they follow in rape

cases?
1=YES--all of them ----- > Go to Question 12a. 12b. 12c.
2=YES--some of them ----- > Go to Question 12a. 12b. 12c.
O=NO ----- > Go to Question 13.

123. How accessible are the departments that follow special procedures?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

12b. Are there a sufﬁcient number of departments that use special
procedures in rape cases? Would you say the number available is . . .

1=VERY LNADEQUATE (POOR)
2=SOMEWHAT I_NADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORETHANADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

169

12c. How well do these special procedures meet the needs of victims in
your community Are they . . .

lzPOOR
2=FAIR
3=AVERAGE
4=GOOD
5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE
13. Does the prosecutors ofﬁce in your community have a special rape unit or sex
crimes unit?
1=YES-~all of them ----- > Go to Question 13a. 13b. 13c.
2=YES--some of them ----- > Go to Question 13a. 13b. 13c.
O=NO ----- > Go to Question 14.

13a. How accessible is this service to victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9:NOT APPLICABLE, SERVICE NOT AVAILABLE

13b. Are there a sufﬁcient number of ofﬁces that have this service to meet
the needs of victims in your community? Would you say the number

available
1=VERY I_N_ADEQUATE (POOR)
2=SOMEWHAT INADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

13c. How would you characterize the quality of these rape units? How well
do they meet the needs of victims in your community Are they . . .

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

14. Does the prosecutors ofﬁce in your community have a victim advocacy program?

1=YES—all of them ----- > Go to Question 14a. 14b. 14c.

2=YES--some of them ----- > Go to Question 14a. 14b. 14c.
O=NO ----- > Go to Question 15.

170

14a. How accessible is this service to victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

14b. Are there a sufﬁcient number of ofﬁces that have this service to meet
the needs of victims in your community? Would you say the number

available is . . .
1:VERY MADEQUATE (POOR)
2=SOMEWHAT MADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
(EXCELLENT)

5:MORE THAN ADEQUATE
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

14c. How would you describe the quality of the victim advocacy program?
How well does it meet the needs of victims in your community Is it . . .

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

Does someone from your prosecutors ofﬁce offer to go with victims to court?

----- > Go to Question 15a. 15b. 15c.
----- > Go to Question 15a. 15b. 150.

----- > Go to Question 16.

15.

1=YES--all of them
2:YES--some of them

O=NO

15a. How accessible is this service to victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

171

15b. Are there a sufﬁcient number of ofﬁces that offer this service? Would
you say the number available is . . .

1=VERY I_NADEQUATE (POOR)
2=SOMEWHAT MADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

15c. How good is the prosecutors ofﬁce about remembering to offer this
service to rape victims. Are they . . .

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=N OT APPLICABLE, SERVICE NOT AVAILABLE

The next couple of questions are about the mental health services that are available
in your community. Do you have agencies or individuals in your community that

offer short-term, rape-related therapy?

16.

1=YES--all of them ----- > Go to Question 16a. 16b. 16c.
2=YES--some of them ----- > Go to Question 16a. 16b. 16c.
O=NO ----- > Go to Question 17.

16a. How accessible are the agencies or individuals that Offer this therapy?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

16b. Are there a sufﬁcient number of agencies or individuals that offer this
therapy to meet the needs of victims in your community? Would you say

the number available is . . .

1=VERY INADEQUATE (POOR)
2=SOMEWHAT1LIADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

172

16c. How would you characterize the Quality of this short-term, rape-related
therapy?

1 =POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

17. DO you have agencies or individuals in your community that Offer long-term, rape-
related therapy?

l=YES-—all of them ----- > GO to Question 17a. 17b. 17c.

2=YES--some of them ----- > Go to Question 17a. 17b. 17c.
O=NO ----- > Go to Question 18.

17a. How accessible are the agencies or individuals that Offer this therapy?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

17b. Are there a sufﬁcient number of agencies or individuals that offer this
therapy to meet the needs of victims in your community? Would you say

the number available is . . .

1=VERY [NADEQUATE (POOR)
2=SOMEWHAT ﬁADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORETHAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

17c. How would characterize the Quality of this long-term, rape-related
therapy?

1 =POOR
2=FAIR
3=AVERAGE
4=GOOD

5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE

173

Do you have agencies or individuals in your community that offer rape-related

18.
therapy speciﬁcally for women with special needs; for example, women of color,
lesbians, women who are differently-abled ?
l=YES--all of them ----- > Go to Question 18a. 18b. 18c.
2=YES--some of them ----- > Go to Question 18a. 18b. 18c.
O=NO ----- > Go to Question 19.
18a. How accessible are the agencies or individuals that offer this therapy to
victims in your community?
1=POOR
2=FAIR
3=AVERAGE
4=GOOD
5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE
18b. Are there a sufﬁcient number of agencies or individuals that offer this
therapy to meet the needs of victims in your community? Would you say
the number available is . . .
1=VERY EADEQUATE (POOR)
2=SOMEWHAT I_NADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)
9=NOT APPLICABLE, SERVICE NOT AVAILABLE
18c. How would you describe the overall Quality of this therapy?
1=POOR
2=FAIR
3=AVERAGE
4=GOOD
5=EXCELLENT
9=NOT APPLICABLE, SERVICE NOT AVAILABLE
19. Are there any other services available to rape victims in your community that we

haven’t already talked about? Any special programs for rape victims, any special
rape response teams?
1=YES ----- > GO to Question 19a. 19b. 19c. 19d.

Describe:
O=NO ----- > Go to Question 20.

174

19a. How accessible are the agencies or individuals that offer this service to

victims in your community?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD
5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

19b. Are there a sufﬁcient number of agencies or individuals that offer this
service to meet the needs Of victims in your community? Would you say the

number available is . . .

1:VERY MADEQUATE (POOR)
2=SOMEWHAT I_NADEQUATE (FAIR)
3=SOMEWHAT ADEQUATE (AVERAGE)
4=ADEQUATE (GOOD)
5=MORE THAN ADEQUATE (EXCELLENT)

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

19c. How would you describe the quality of this service?

1=POOR
2=FAIR
3=AVERAGE
4=GOOD
5=EXCELLENT

9=NOT APPLICABLE, SERVICE NOT AVAILABLE

19d. Are there multiple agencies involved in this service or program?

1=YES ----- > Go to Question 19dd.
O=NO ----- > Go to Question 20.

19dd. Who are these agencies involved in this service or program?

POLICE 1=YES
OF HER LEGAL 1=YES
EMERGENCY ROOM HOSPITAL 1=YES
OF HER MEDICAL 1=YES
MENTAL HEALTH 1=YES

OTHER (specify ) 1=YES

O=NO
O=NO
O=NO
O=NO
O=NO
O=NO

20.

175

These next couple of questions are about special groups you may have in your
community that deal with the problem of rape, but don't actually provide direct
service to victims.

For example, does your community have a sexual assault task force? And by that I
mean some sort of multi-agency group that gets together to create policies or make
recommendations to agencies in your community?

1=YES ----- > Go to Question 20a.
O=NO ----- > Go to Question 21.

20a. Who is on this task force?

 

 

 

 

 

 

POLICE 1=YES (number ) O=NO 9=NA
OTHER LEGAL 1=YES (number ) O=NO 9=NA
MEDICAL 1=YES (number ) O=NO 9=NA
MENTAL HEALTH 1=YES (number ) O=NO 9=NA
RAPE CENTER 1=YES (number ) O=NO 9=NA
VICTIMS 1=YES (number ) 0:NO 9=NA
OTHERS 1=YES (number ) O=NO 9=NA

 

20b. Who started this task force? How did this task force begin?
20c. What are the functions of this task force? What does it do?

20d. How long has this task force been in existence?

 

CODE: MONTHS

20e. In your Opinion how effective and helpful has this task force been to
your community as a whole? Would you say it has been . . .

1=N OT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL
%NOT APPLICABLE

20f. In your opinion, how effective and helpful has this task force been to
victims in your community? Would you say it has been . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL
9=NOT APPLICABLE

176

21. Do you have any women's groups or other special groups that work on improving
community awareness of the problem of rape?

1=YES ----- > Go to Question 21a.
O=NO ----- > Go to Question 22.

21a. How many of these groups are in your community?

FOR FIRST GROUP:
21b. Who is in this group?

 

 

 

 

 

 

POLICE 1=YES (number ) O=NO
OTHER LEGAL 1=YES (number ) O=NO
MEDICAL 1=YES (number ) O=NO
MENTALI-[EALTI-I 1=YES (number ) O=NO
RAPE CENTER 1=YES (number ) O=NO
VICTIMS 1=YES (number ) O=NO
OTHERS 1=YES (number ) O=NO

 

21c. Who started this group? How did it begin?
21d. What are the functions of this group? What does it do?

21e. How long has this group been in existence?

 

21f. In your opinion how effective and helpful has this group been to your
community as a whole? Would you say it has been . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL
9=NOT APPLICABLE

21 g. In your opinion, how effective and helpful has this group been to
victims in your community? Would you say it has been . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL
9=NOT APPLICABLE

22.

1 77
FOR SECOND GROUP:

21h. Who is in this group?

 

 

 

 

 

 

POLICE 1=YES (number ) O=NO
OTHER LEGAL 1=YES (number ) O=NO
MEDICAL 1=YES (number j O=NO
MENTAL HEALTH 1=YES (number ) O=NO
RAPE CENTER 1=YES (number ) O=NO
VICTIMS 1=YES (number ) O=NO
OTHERS 1:YES (number ) O=NO

 

21i. Who started this group? How did it begin?
21j. What are the functions of this group? What does it do?

21k. How long has this group been in existence?

 

211. In your opinion how effective and helpful has this group been to your
community as a whole? Would you say it has been . . .

 

lzNOT HELPFUL AT ALL
=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL
9=NOT APPLICABLE

21m. In your opinion, how effective and helpful has this group been to
victims in your community? Would you say it has been . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL
9=NOT APPLICABLE

These next questions are about the training professionals in your community receive
about sexual assault.

First of all, does anyone from your rape crisis center do trainings, programs,
workshops, or presentations about rape with the police in your community?

1=YES ----- > Go to Question 22a.
O=NO ----- > Go to Question 23

178

22a. How long has this training been in existence?
CODE MONTHS
22b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO I 1 TIMES A YEAR
7=MONTHLY

8=DON‘T KNOW

9=NOT APPLICABLE

22c. In your opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

22d. In your opinion, how helpful is this training for victims in your
community?

1=N OT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE
23 . Does anyone from your rape crisis center do any type of training or presentations
on rape with the prosecutors in your community?
1=YES ----- > Go to Question 233.
O=NO ----- > Go to Question 24
23a. How long has this training been in existence?
CODE MONTHS

179

23b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO 11 TIMES A YEAR
7=MONTHLY

8=DONT KNOW

9=NOT APPLICABLE

23c. In your opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

23d. In your Opinion, how helpful is this training for victims in your
community?

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

24. Does anyone from your rape crisis center do any trainings or presentations about
rape with doctors, nurses, or other health care professionals?

1=YES ----- > Go to Question 24a.
O=NO ----- > Go to Question 25

24a. How long has this training been in existence?
CODE MONTHS
24b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS
4=ONCE A YEAR

180

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO I 1 TIMES A YEAR
7=MONTHLY

8=DONT KNOW

9=NOT APPLICABLE

24c. In your opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
kA LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

24d. In your opinion, how helpful is this training for victims in your
community?

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

25. Does anyone from your rape crisis center do any type of training or presentations
on rape with any mental health professional in your community?

1=YES ----- > Go to Question 25a.
O=NO ----- > Go to Question 26

253. How long has this training been in existence?
CODE MONTHS
25. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANY WHERE FROM 3 TO 11 TIMES A YEAR
7=MONTHLY

8=DONT KNOW

9=NOT APPLICABLE

181

25c. In your Opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2:A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

25d. In your opinion, how helpful is this training for victims in your
community?

1=NOT HELPFUL AT ALL
=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

26. Does anyone from your rape crisis center do any trainings, presentations, or
workshops about rape with other rape crisis centers in your community?

1=YES ----- > Go to Question 26a.
O=NO ----- > Go to Question 27

26a. How long has this training been in existence?

CODE MONTHS
26b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5:TWICE A YEAR

6=ANYWHERE FROM 3 TO 11 TIMES A YEAR
7:MONTHLY

8=DON'T KNOW

9=NOT APPLICABLE

26c. In your opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

27.

182

26d. In your opinion, how helpful is this training for victims in your
community?

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

These next questions are about your rape crisis center and how you train your
volunteers and staff.

First, do you have someone from the police department come in and talk at your
training sessions?

1=YES ----- > Go to Question 27a.
O=NO ----- > Go to Question 28

27a. How long have you had police come in to talk to your staff?
CODE MONTHS
27b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO 11 TIMES A YEAR
7=MONTHLY

8=DONT KNOW

9=NOT APPLICABLE

27c. In your opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

183

27d. In your opinion, how helpful is this training for victims in your
community?

1=N OT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE
28. Do you have someone from the prosecutors ofﬁce come in and talk at your training
sessions?
1=YES ----- > GO to Question 28a.
O=NO ----- > Go to Question 29

28a. How long have you had prosecutors come in to talk to your staff?
CODE MONTHS
28b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO 11 TIMES A YEAR
=MONTHLY

8=DONT KNOW

9=NOT APPLICABLE

28c. In your opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=N OT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

28d. In your opinion, how helpful is this training for victims in your
commlmity?

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

184

29. Do you have a doctor, nurse, or other health care professional come in and talk at
your training sessions?

1:YES ----- > Go to Question 29a.
O=NO ----- > Go to Question 30

29a. How long have you had medical professionals come in to talk to your
staff?

CODE MONTHS

29b. How often is this training conducted?

1=ONCE

2=SPORADICALLY

3=ONCE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO 11 TIMES A YEAR
7=MONTHLY

8=DON’T KNOW

9=NOT APPLICABLE

29c. In your Opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

29d. In your opinion, how helpful is this training for victims in your
community?

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE
30. Do you have someone from the mental health community, like a therapist or a
community mental health center worker, come in and talk at your training sessions?

1=YES ----- > Go to Question 30a.
O=NO ----- > Go to Question 31

185

30a. How long have you had mental health professionals come in to talk to
your staff?

CODE MONTHS
30b. How Often is this training conducted?

leNCE

2=SPORADICALLY

3=ON CE EVERY TWO YEARS

4=ONCE A YEAR

5=TWICE A YEAR

6=ANYWHERE FROM 3 TO 1 1 TIMES A YEAR
7=MONTHLY

8=DONT KNOW

9=NOT APPLICABLE

30c. In your Opinion, how helpful is this training for the agencies involved?
Would you say . . .

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

30d. In your opinion, how helpful is this training for victims in your
community?

1=NOT HELPFUL AT ALL
2=A LITTLE HELPFUL
3=SOMEWHAT HELPFUL
4=MOSTLY HELPFUL
5=VERY HELPFUL

9=NOT APPLICABLE

31 . The next few questions are about the relationship between your rape crisis center
and other agencies in the community. How good is the relationship between your
rape crisis center and the mlice in your community. Would you say . . .

1=VERY POOR
2=SOMEWHAT POOR
3=SATISFACTORY
4=VERY GOOD
5=EXCELLENT

1 86
How much mutual respect is there between your rape crisis center and the mlice in
your community. Would you say . . .

1=VIRTUALLY NONE
2=A LITTLE

3=SOME

4=QUITE A BIT

52A GREAT DEAL

How good is the relationship between your rape crisis center and the mosecutor's
Ofﬁce. Would you say . . .

leERY POOR
kSOMEWHAT POOR
3=SATISFACTORY
4=VERY GOOD
5=EXCELLENT

How much mutual respect is there between your rape crisis center and the
prosecutor's Ofﬁce. Would you say . . .

1=VIRTUALLY NONE
2=A LITTLE

3=SOME

4=QUITE A BIT

5=A GREAT DEAL

How good is the relationship between your rape crisis center and the hospitals in
your community. Would you say . . .

1=VERY POOR
2=SOMEWHAT POOR
3=SATISFACTORY
4=VERY GOOD
5=EXCELLENT

How much mutual respect is there between your rape crisis center and the hospitals
in your community. Would you say . . .

1=VIRTUALLY NONE
2=A LITTLE

3=SOME

4=QUI'TE A BIT

5=A GREAT DEAL

How good is the relationship between your rape crisis center and the mental health
uni (such as a community mental health center) in your area. Would you

32.

 

33.

34.

35.

36.

 

37.

com 51

say .
1=VERY POOR
2=SOMEWHAT POOR
3=SATISFACTORY
4=VERY GOOD
5=EXCELLENT

187

How much mutual respect is there between your rape crisis center and the mental
health community in your area. Would you say . . .

1=VI RTUALLY NONE
2=A LITTLE

3=SOME

4=QUITE A BIT

5=A GREAT DEAL

38.

188

Section II
Experiences of the Last Sexual Assault Victim Worked With

Section instructions:

For the next set of questions, I'd like you to think about the most recent adult,
female ram victim you worked with. As I mentioned on the phone when we set up this
interview, we would like to hear about the experiences Of the most recent adult, female rape
victim you worked with who had some contact with either the legal system, medical
community, or mental health system.

39. First, I'd like to get some background information about the victim and the assault
incident. How old was the victim at the time of the assault?

 

 

 

years
40. How old was the victim when you ﬁrst came into contact with her?
years
41. How long ago was it when you ﬁrst started working with this victim?
CODE' days

 

42. How long was it after she was assaulted before you started working with her? In
other words, how long was it between when she was assaulted and when you

 

 

starting working with her?
CODE: days
43 . How did you come into contact with the victim? How did you meet her and get

involved in her case?

‘44- What is the victim's race/ethnic group? Would you say . . .

1=WHITE
2=AFRICAN-AMERICAN/BLACK
3=LATTNA/CHICANA/HISPANIC ----- > Go to Question 443.

45.

47.

189

443. Is her primary language English or Spanish? In
other words, did she talk to the police or doctors or
whoever she had contact with in English or Spanish?

1=ENGLISH
2=SPANISH

4=NATIVE AMERICAN INDIAN
5=ASIAN-AMERICAN

6=ARABIC-AMERICAN

7=OTHER (specify )

Would you say that this victim came from a background?
l=LOWER CLASS
2=WORKING CLASS
3=MIDDLE CLASS
4=UPPER MIDDLE CLASS
5=UPPER CLASS
6=DON'T KNOW

What is/was the victim's occupation?

 

What is the victim's highest educational level attained?

l=SOME HIGH SCHOOL
2:HS GRADUATE

3=SOME COLLEGE
4=ASSOCIATES DEGREE
5=BACHELOR'S DEGREE
6=SOME GRADUATE WORK
7=GRADUATE DEGREE
8=DON'T KNOW

Was the victim 3 student at the time she was assaulted?

1=YES ----- > Go to Question 483.

O=NO ----—> Go to Question 49.

2=DON'T KNOW -----> Go to Question 49.
483. Was she a

1=HIGH SCHOOL STUDENT

2=TRADE SCHOOL STUDENT

3=COMMUNITY COLLEGE STUDENT
4=UNIVERS I'T Y COLLEGE STUDENT
5=GRADUATE OR PROFESSIONAL SCHOOL STUDENT

ﬁDON'T KNOW

1 9O
49. Could you briefly tell me her story? What happened in the assault?

CODES/PROBES:
493. Type of assault

l=STRANGER RAPE

2=ACQUAINTANCE RAPE

3=DATE RAPE

4=MARITAL RAPE

5=GANG RAPFJSTRANGER

6=GANG RAPEJACQUAINTANCE
7=OTHER (specify )

49b. Relationship with assailant(s) before the assault

1=NONE, WERE STRANGERS
2=KNEW EACH OTHER BY SIGHT
3=FRIENDS, CASUAL
4:FRIENDS, CLOSE

5=DATING

6=DATING, LIVING TOGETHER
7=MARRIED

8=DONT KNOW
49c. Race/ethnicity of assailant

1=WHITE

2=AFRICAN-AMERICAN/BLACK
32LATINO/CHICANO

4=NATIVE AMERICAN INDIAN
5=ASIAN-AMERICAN

6=ARABIC-AMERICAN

7=OTHER (specify )

8=DONT KNOW

49d. Would you say that the assailant came from a background?

l=LOWER CLASS
2=WORKING CLASS
3=MIDDLE CLASS
4=UPPER MIDDLE CLASS
5=UPPER CLASS

6=DON'T KNOW
49e. Did the victim sustain any physical injuries from the assault?

1=YES (specify )
— O

2=DON'T KNOW

191

49f. Was a weapon used in the assault

1=YES (specify )
O=NO
2=DON'T KNOW

49g. Was the victim under the inﬂuence of alcohol?

1=YES ----- > GO to Question 49gg.
O=NO ----- > Go to Question 49h.
2=DON'T KNOW

49gg. Victim was . . .

1=VICTIM HAD SOME ALCOHOL, NOT DRUNK
2=VICTIM TIPSY

3=VICTIM DRUNK, BUT CONSCIOUS
4=VICTIM DRUNK, BUT BLACKED OUT
5=VICTIM PASSED OUT

49h. Was the assailant under the inﬂuence of alcohol?

1=YES ----- > Go to Question 49hh.
O=NO ----- > Go to Question 49i.
=DON'T KNOW

49hh. Assailant was . . .

1=ASSAILANT HAD SOME ALCOHOL, NOT DRUNK
2=ASSAILANT TIPSY

3=ASSAILANT DRUNK

4=DON'T KNOW

49i. Was the victim using drugs at the time of the assault?

1=YES ----- > Go to Question 49ii.
O=NO ----- > Go to Question 49j.
2=DON'T KNOW

49ii. Victim was using . . .

 

MARUUANA 1=YES O=NO
TRANQUILIZERS 1=YES O=NO
AMPHETAMINES 1=YES O=NO
COCAINFJCRACK 1=YES O=NO
HEROIN 1=YES O=NO
HALLUCINOGENIC 1=YES O=NO
OTHER (specify J
1=YES O=NO

8=DONT KNOW

192

49j. Was the assailant using drugs at the time of the assault?

1=YES ----- > Go to Question 49jj.
O=NO ----- > GO to Question 49k.

2=DON'T KNOW

49jj. Assailant was using . . .

 

MARIJUANA 1=YES O=NO
TRANQUILIZERS 1=YES O=N O
AMPHETAMINES 1=YES O=NO
COCAINEJCRACK 1=YES O=NO
HEROI N 1=YES O=NO
HALLUCINOGENIC 1=YES O=NO
OTHER (specify )

1=YES O:NO
8=DONT KNOW

49k. ASK ONLY IF SHE WAS A VICTIM OF NON-STRANGER
RAPE. IF SHE WAS A VICTIM OF STRA
QUEsﬁON3’o

Was the assault an isolated incident or part of a battering relationship?

l=SINGLE ASSAULT ----- > Go to Question 50.
[PROBE: so he wasn't emotionally or physically abusive too?]

2=SINGLE ASSAULT, BUT EMOTIONALLY ABUSIVE TOO

----- > Go to Question 49kk.
3=SOME PHYSICAL VIOLENCE

----- > Go to Question 49kk.
4=REGULAR PHYSICAL VIOLENCE

----- > Go to Question 49kk.

8=DONT KNOW
9=NOT APPLICABLE

49kk. You mentioned that the rape occurred within an abusive
relationship, did the community service agencies the victim worked
with know that this was an abusive relationship?

1=YES, ALL
2=YES, BUT ONLY SOME (specify )
3=NONE

193

50. When you ﬁrst came into contact with the Victim, how was she handling being
assaulted? In other words, how was she adjusting to being assaulted?

51. Turning to the contacts she had with community agencies, I'm going to ask about a
series of actions that might have been taken by the legal, medical, or mental health
systems.

First, I have some questions about the legal system.
Was a police report taken?

1=YES ----- > Go to Question 513.
O=NO ----- > GO to Question 513.
9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

513. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 51b.
Or—NO ----- > Go to Question 51b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

51b. What actions, if any, did youtake in this matter? (Describe)

0=NONE

12A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

52. Was there an investigation conducted about the rape?
1=YES ----- > Go to Question 523.

O=NO ----- > GO to Question 523.
9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

523. Was that what the Victim wanted to happen?

1=YES ----- > Go to Question 52b.
O=NO ----- > Go to Question 52b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

52b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

1=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

194

53. Was the police report forwarded to the prosecutors ofﬁce?
(IF NO POLICE REPORT TAKEN) Did the prosecutors ofﬁce ﬁnd out about the

rape?

1=YES ----- > Go to Question 533.
O=NO ----- > Go to Question 533.
9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

$33. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 53b.
O=NO ----- > Go to Question 53b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

53b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITT LE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

54. Was an arrest made?

1=YES ----- > Go to Question 543.
O=NO ----- > Go to Question 543.
9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

$43. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 54b.
O=NO ----- > Go to Question 54b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL
54b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

19S

55. Was a formal charge issued by the prosecutor?

1=YES ----- > Go to Question 553.
O=NO ----- > Go to Question 553.
9:NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

553. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 55b.
O=NO ----- > Go to Question 55b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

55b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

56. ASK ONLY IF A CHARGE WAS ISSUED BY THE PROSECUTOR
What was the outcome of that charge?

1=CHARGES WERE LATER DROPPED
2=RAPIST PLEAD GUILTY TO LESSER NON—SEX CRIME

OFFENSE
3=RAPI ST PLEAD GUILTY TO LESSER SEX CRIME

OFFENSE
4=RAPIST PLEAD GUILTY TO ORIGINAL CHARGE

5:TRIAL (outcome )
9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

563. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 56b.
O=NO ----- > Go to Question 56b.
8=DONT KNOW

kNOT APPLICABLE, NO INVOLVEMENT IN LEGAL

56b. Did you do any advocating for the victim in this matter? (Describe)

0=N ONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

196

57. Did anyone from the legal system, say a police ofﬁcer or prosecutor, refer the
victim to a hospital or doctor or anyone from the medical community? Did they
refer her to a therapist or anyone afﬁliated with the mental health community?

1=YES ----- > Go to Question 57b.
O=NO ————— > Go to Question 58.
9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

57b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT
5=ADVOCATE MADE REFERRAL HERSELF

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

58. Were there any other actions taken by the legal system that I haven't asked about?
Any other contact with police, prosecutors, or judges that we haven't already talked

about?
1=YES ----- > Go to Question 583.
Describe:
O=NO ----- > "*Go to Question 593*"

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

583. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 58b.
O=NO ----- > Go to Question 58b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

58b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN LEGAL

59. These next questions are about her involvement with the medical system.
Was this woman given any information by 3 doctor, nurse, or other health care
professional about the possible risk of pregnancy ?

1=YES ----- > Go to Question 593.
O=NO ----- > Go to Question 593.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

60.

61.

197

593. Did She express any concern to you about pregnancy? Did she
mention that she was worried about getting pregnant?

1=YES ----- > Go to Question 59b.
O=NO ----- > Go to Question 59b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

59b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

5=ADVOCATE GAVE THE INFORMATION HERSELF
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

Was the victim given any information by a doctor, nurse, or other health care
professional about the possible risk of exposure to a sexually transmitted disease
from the assault?

1=YES ----- > Go to Question 603.
O=NO ----- > Go to Question 603.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

603. Did the victim express any concern to you about contracting an STD?
Did She mention that she was worried about getting an STD?

1=YES ----- > Go to Question 60b.
O=NO ----- > Go to Question 60b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

60b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

kA GREAT DEAL OF INVOLVEMENT

5=ADVOCATE GAVE THE INFORMATION HERS ELF
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

Was she given any information by a doctor, nurse, or other health care professional
about the physical health effects of rape or any information about some of the
physical health problems that are associated with rape? (examples: sleep problems,
eating problems)

1=YES ----- > Go to Question 613.
O=NO ----- > Go to Question 613.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

198

613. Did the victim express any concern to you about her physical health?
Did She mention that She was worried about the rape affecting her physical

health?
1=YES ----- > Go to Question 61b.
O=NO ----- > Go to Question 61b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL
61b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

5=ADVOCATE GAVE THE INFORMATION HERSELF
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

62. Was the Victim given any information by a doctor, nurse, or other health care
professional about the psychological effects of rape?

1=YES ----- > Go to Question 623.
O=NO ----- > Go to Question 623.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

623. Did the victim mention that she was worried about how the rape was
going to affect her life in general?

1=YES ----- > Go to Question 62b.
O=NO ----- > Go to Question 62b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL
62b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEME\IT

4=A GREAT DEAL OF INVOLVEMENT

5=ADVOCATE GAVE THE INFORMATION HERSELF
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

63 . Was a rape exam performed and an evidence collection kit done?
1=YES ----- > Go to Question 633.
O=NO --—--> Go to Question 633.

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

199

63a. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 63b.
O=NO ----- > Go to Question 63b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

63b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

64. Was the victim given the Morning After Pill to prevent pregnancy?

1=YES ----- > Go to Question 643.
O=NO ----- > Go to Question 643.
9=N OT APPLICABLE, NO INVOLVEMENT IN MEDICAL

643. Did the victim want the Morning After Pill?

1=YES ----- > Go to Question 64b.
O=NO ----- > Go to Question 64b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL
64b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

65. Was she given a preventive dose of antibiotics to treat any STDS she may have
contracted from the assault?

1=YES ----- > Go to Question 653.
O=NO ----- > Go to Question 653.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

200

653. Did the victim express any concern to you about contracting an STD?
Did she mention that she was worried about getting an STD?

1=YES ----- > Go to Question 65b.
O=NO ----- > Go to Question 65b.
8=DONT KNOW

9=NOT APPLICABLE. NO INVOLVEMENT IN MEDICAL

65b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LIIT LE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

66. Was the victim treated for any physical injuries she sustained (besides the rape)?

1=YES ----- > Go to Question 663.
O=NO ----- > GO to Question 663.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

66b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

67. Did anyone from the medical system, say a doctor or nurse, refer this woman to a
police ofﬁcer or prosecutor or anyone from the legal community? Did they refer her
to a therapist or anyone afﬁliated with the mental health community?

1=YES ----- > Go to Question 67b.
O=NO ----- > GO to Question 68.
9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

67b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4:A GREAT DEAL OF INVOLVEMENT

5=ADVOCATE MADE REFERRAL HERSE.F

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

201

68. Were there any other actions taken by the medical system that I haven't asked
about? Any other contact with doctors, nurses, or health care practitioners that was
related to the rape that we haven't already talked about?

1=YES ----- > GO to Question 683.
O=NO ----- > ***Go to Question 69.***
9:NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

683. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 68b.
O=NO ----- > Go to Question 68b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

68b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MEDICAL

69. These next questions are about her involvement with the mental health community.
Was the victim given any information by a mental health professional about the
psychological effects of rape ?

1=YES ----- > Go to Question 693.
O=NO -----> Go to Question 693.
9=NOT APPLICABLE, NO INVOLVEMENT IN lMH SYSTEM

693. Did the victim express any concern to you about her own emotional

wellbeing?
leES ----- > GO to Question 69b.
O=NO ----- > Go to Question 69b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN lMI-I SYSTEM

69b. Did you do any advocating for the Victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

kA GREAT DEAL OF INVOLVEMENT

5=ADVOCATE GAVE THE INFORMATION HERS EJF
9=NOT APPLICABLE, NO INVOLVEMENT IN MI-I SYSTEM

70.

71.

202

Did the victim receive any Short term therapy concerning the rape?
1=YES ----- > Go to Question 703.

O=NO ----- > Go to Question 703.
9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

703. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 70b.
O=NO ----- > Go to Question 70b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

70b. What actions, if any, did you take in this matter? (Describe)

0=N ONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

Did the victim receive long-term therapy concerning the rape?

1=YES -----> Go to Question 713.
O=NO ----- > Go to Question 713.
9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

713. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 71b.
O=NO -----> Go to Question 71b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM
71b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

kA GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN lMI-I SYSTEM

203

72. Was any information about rape given to the victims' family or friends by a mental
health professional?

1=YES ----- > Go to Question 723.
0:NO ----- > Go to Question 723.
9:NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

723. Did the victim mention that she wanted her family and friends to get
more information about rape? Did She seem concerned that her family or
friends didn't really understand rape and how it effects women?

1=YES ----- > Go to Question 72b.
O=NO ----- > Go to Question 72b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

72b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

kSOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

5=ADVOCATE GAVE THE INFORMATION HERSELF
9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

73 . To the best of your knowledge, did any of the victim's family or friends receive
counseling about this rape?

1=YES ----- > Go to Question 733.
O=NO ----- > Go to Question 733.
9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

733. Was that what the victim wanted to happen?

1=YES ---—-> Go to Question 73b.
O=NO ----- > Go to Question 73b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN ME SYSTEM
73b. What actions, if any, did you take in this matter? (Describe)

0:NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

204

74. Did anyone from the mental health community, say a therapist or mental health
worker, refer the victim to the police or prosecutors or anyone from the legal
community? Did they refer her to a doctor or therapist or anyone afﬁliated with the

medical community?
leES ----- > GO to Question 74b.
0:NO ----- > Go to Question 75.

9:NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM
74b. Did you do any advocating for the victim in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

5:ADVOCATE MADE REFERRAL HERSELF

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

75. Were there any other actions taken by the mental health system that I haven't asked
about? Any other contact with therapists, community mental health centers, or
other crisis lines that was related to the rape that we haven't already talked about?

1=YES ----- > Go to Question 753.
O=NO ----- > "*Go to Question 76!“
9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

753. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 75b.
O=NO ----- > Go to Question 75b.
8=DONT KNOW

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM
75b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO INVOLVEMENT IN MH SYSTEM

76. Were there any other contacts with other community agencies about the rape, like a
church or other organization?
1=YES ----- > Go to Question 763.
O=NO ----- > "'"Go to Question 77 .***

205
763. Was that what the victim wanted to happen?

1=YES ----- > GO to Question 76b.
O=NO ----- > Go to Question 76b.
&DONT KNOW

9=NOT APPLICABLE, NO OTHER INVOLVEMENT
76b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9:NOT APPLICABLE, NO OTHER INVOLVEMENT

77. ASK ONLY IF THE VICTIM WAS A COLLEGE STUDENT

Were there any other contacts with other campus ofﬁcials or the student judicial
system about the rape that we haven't already talked about?

1=YES ----- > Go to Question 773.
O=NO ----- > ***Go to Question 78.***

77a. Was that what the victim wanted to happen?

1=YES ----- > Go to Question 77b.
0:NO ----- > Go to Question 77b.
8=DONT KNOW

9=NOT APPLICABLE, NO OTHER INVOLVEMENT
77b. What actions, if any, did you take in this matter? (Describe)

0=NONE

l=A LITTLE INVOLVEMENT

2=SOME INVOLVEMENT

3=QUITE A BIT OF INVOLVEMENT

4=A GREAT DEAL OF INVOLVEMENT

9=NOT APPLICABLE, NO OTHER INVOLVEMENT

78. Given your experiences as an advocate how typical was this case you've just
described?

1=NOT AT ALL TYPICAL

-----> Go to Question 783 then to Question 79
2=A LITTLE TYPICAL (SEVERAL ASPECTS ATYPICAL)

----- > Go to Question 783. then to Question 79

3=FAIRLY TYPICAL (A FEW ASPECTS ATYPICAL)

----- > Go to Question 783. then to Question 79
4=va TYPICAL

----- > Go to Question 79

783. What was atypical about the case you just described?

79.

80.

81.

82.

206

How difﬁcult was it for you to help this woman get the services we've talked
about? (PROBES: What was difﬁcult about it? What made it not so difﬁcult?)

Sometime women have a hard time getting help if they are very confrontational with
people at community agencies.

[ASK ONLY IF HAD CONTACT WITH THE LEGAL SYSTEM]
Would you say this was an issue for this woman's interactions with the legal
system? How so?

[ASK ONLY IF HAD CONTACT WITH THE MEDICAL SYSTEM]
Was this an issue for her contact with the medical system? How so?

[ASK ONLY IF HAD CONTACT WITH THE MENTAL HEALTH SYSTEM]
Was this an issue for her contact with the mental health community? How so?

Likewise, some women have trouble getting help if they swear, use bad language,
or do other things that some people perceive as un-lady-like.

[ASK ONLY IF HAD CONTACT WITH THE LEGAL SYSTEM]
Would you say this was an issue for this woman's interactions with the legal
system? How so?

[ASK ONLY IF HAD CONTACT WITH THE MEDICAL SYSTEM]
Was this an issue for her contact with the medical system? How SO?

[ASK ONLY IF HAD CONTACT WITH THE MENTAL HEALTH SYSTEM]
Was this an issue for her contact with the mental health community? How so?

On the other hand, women sometimes get more help if they are crying or showing
other obvious signs of distress.

[ASK ONLY IF HAD CONTACT WITH THE LEGAL SYSTEM]
Would you say this was an issue for this woman's interactions with the legal
system? How so?

[ASK ONLY IF HAD CONTACT WITH THE MEDICAL SYSTEM]
Was this an issue for her contact with the medical system? How so?

[ASK ONLY IF HAD CONTACT WITH THE MENTAL HEALTH SYSTEM]
Was this an issue for her contact with the mental health community? How so?

83.

85.

86.

87.

88.

89.

207
Section III

General Beliefs About Community Systems and Recommendations

That's all the questions we have about your experiences with this particular victim.
These next questions are a little different. We want you to think about how well ir_I
general community agencies respond to the needs of rape victims. Overall, how
well do you think the mlice in your community respond to the needs of rape
victims. Would you say they are

1=NOT RESPONSIVE AT ALL
2=RARELY RESPONSIVE
3=OCCASIONALLY RESPONSIVE
4:FREQUENT LY RESPONSIVE
5=RESPONSIVE ALL OF THE TIME

Overall, how well do you think the prosecutor's ofﬁce in your community responds
to the needs of rape victims. Would you say they are . . .

 

1=NOT RESPONSIVE AT ALL
2=RAREY RESPONSIVE
3=OCCASIONALLY RESPONSIVE
4:FREQUENTLY RESPONSIVE
5=RESPONSIVE ALL OF THE TIME

Overall, how well do you think the hospitals in your community respond to the
needs of rape victims. Would you say they are . . .

1=NOT RESPONSIVE AT ALL
2=RARELY RESPONSIVE
3=OCCASIONALLY RESPONSIVE
4=FREQUENT LY RESPONSIVE
5=RESPONSIVE ALL OF THE TIME

Overall, how well do you think the mental heath system in your community
responds to the needs of rape victims. Would you say they are . . .

1=NOT RESPONSIVE AT ALL
2=RARELY RESPONSIVE
3=OCCASIONALLY RESPONSIVE
4=FREQUENT LY RESPONSIVE
5=RESPONSIVE ALL OF THE TIME

To what extent is rape viewed as a serious problem by your community as a whole?
(PROBES: do they view other forms of Violence against women, such as domestic
assault, as a more serious problem?)

How pervasive are victim-blaming attitudes about sexual assault in your community
as a whole?

How concerned does your community seem to be with violence against women in
9
general .

 

208

90. What do you feel should be done to improve how your community responds to the
needs of rape victims? PROBE: what Should police do? what Should prosecutor's
ofﬁce do? what Should hospitals do? what should mental health professionals do?

91.

92.
93.

94.

95.

96.

97.

98.

209
Section IV

Demographics and Personal History

I have some ﬁnal questions about you and your work history as a rape victim
advocate. (DON'T HAVE TO ASK, JUST RECORD GENDER)

l =FEMALE
2:MALE

How old are you?

 

Which best describes your racial/ethnic group?

1=WHIT E
2=AFRICAN-AMERICAN/BLACK
3=LATINA/CHICANA/HISPANIC

=NATIVE AMERICAN INDIAN
5=ASIAN-AMERICAN
6=ARABIC-AMERICAN
7=OTHER (specify Q

What is the highest level of education you have attained?

l=SOME HIGH SCHOOL
2=HS GRADUATE

3=SOME COLLEGE
4=ASSOCIATES DEGREE
5=BACHELOR'S DEGREE
6=SOME GRADUATE WORK
7=GRADUATE DEGREE

Are you currently a student?

1=YES (specify )
O=NO

What is your job title with this rape victim service organization you work for?

 

IS this a paid or volunteer position?

1=PAID
2=VOLUNTEER

What are your major activities and responsibilities are in this job?
PROBE: Do you work more as an advocate or as a crisis counselor

Do you see your job as more to collaborate and cooperate with other agencies in the
community or to try to change them? How so?

100.

101.

102.

103.

104.

210

Do you see the work you do as similar to or different from the other agencies that
help rape victims? (PROBES: How similar? How different?)

How long have you been a rape Victim advocate?

 

CODE' months

How long have you been afﬁliated with this agency?

 

CODE: months

 

Approximately how many sexual assault Victims have you worked with in your
career?

 

 

Which community system do you have the most contact with? In other words, ""
which system do you work the most with with victims?

 

 

RANK ORDER
LEGAL
MEDICAL
MENTAL HEALTH
OTHER (specify )

 

 

1043. We are also trying to talk to people who work in the legal system and
the medical community. Could you give me the name of the Police
Department you work with and the name of any contact person there I could
try to reach?

Police Department

 

Police Contact Person

 

Contact Phone (if known)

 

 

211

Could I also have the name of one of the hospitals you work with and the
name of a contact person there I could try to reach?

Hospital

 

Hospital Contact Person

 

Contact Phone (if known)

 

105. In yourjob, do you work mostly with . . .

1=ADULT SEXUAL ASSAULT VICTIMS ----- > GO to Question 1053.
2=ADULT INCEST SURVIVORS ----- > Go to Question 106.
3=CHILD SEXUAL ABUSE VICTIMS ----- > Go to Question 106.

1053. Are these victims most often victims of . . .
RANK ORDER

STRANGER RAPE
ACQUAINTANCE RAPE
DATE RAPE

MARITAL RAPE

106. Are you a survivor of sexual assault?

1=YES ----- > Go to Question 106a. and 106b.
O=NO ----- > Go to Question 107.

1063. Was having been victimized in your own life a factor that got you
involved in the current work you do?

106b. How do your own experiences as a survivor inﬂuence your work as
an advocate?

107. How did you decide to become involved in this kind of work?

Those are all the questions we have for you. IS there anything else you want to add
or think we should know about?

Thanks for all your time helping us with this project. If you have any questions
about the results or anything else, you can contact the project director, Rebecca Campbell,

at (517) 353-5015.

 

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