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SEXUAL VIOLENCE IN THE LIVES OF WOMEN: AN
EXPLORATION OF HELP-SEEKING, EMOTIONAL SOCIAL
SUPPORT, RACE, AND CULTURE

presented by

SARAH PHILLIPS RAYMOND

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SEXUAL VIOLENCE IN THE LIVES OF WOMEN: AN EXPLORATION OF
HELP-SEEKING, EMOTIONAL SOCIAL SUPPORT, RACE, AND CULTURE
By

Sarah Phillips Raymond

A DISSERTATION
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
DOCTOR OF PHILOSOPHY
Department of Counseling, Educational Psychology, and Special Education

2005

ABSTRACT
SEXUAL VIOLENCE IN THE LIVES OF WOMEN: AN EXPLORATION OF
HELP-SEEKING, EMOTIONAL SOCIAL SUPPORT, RACE, AND CULTURE
BY
Sarah Phillips Raymond
Incident rates of sexual violence among women vary with estimates ranging from

1 out of 6 to as many as 1 in 3 women experiencing some form of SV in their lifetime
(Koss & Harvey, 1992; Tjaden'& Thoennes, 2000, 1998; Ullman & Knight, 1992). The
following studies extend the help-seeking literature exploring survivors of SV. The first
study used grounded theory and phenomenological qualitative methodology to analyze
open-ended interviews with eight ethnically-diverse female SV survivors in order to
assess their attitudes toward help-seeking and their perceptions of the social support they
received. Emerging themes promoting help-seeking included: willing to listen, believing,
and shared connection. Themes inhibiting help-seeking included: shame and blame, not
believing/ignoring, protecting others, and cultural themes. The second study examined
the survey reSponses of 108 female African American survivors of SV in attempt to
explore the interrelationships among emotional social support, racial identity
development, and psychological help-seeking attitudes. The findings reveal that racial
identity is significantly linked with help-seeking attitudes among African American
survivors of SV. Greater identification with Caucasian ideals and racial stereotypes was
associated with greater perceived need of psychological help, and greater tolerance of
stigma associated with receiving such help. Additionally, the findings suggest that as

women endorse less “Pro-Black” attitudes, and endure more severe or more frequent

instances OfSV; they are more likely to disclose personal problems. Implications for

clinicians, community outreach, training, research are discussed

This dissertation is dedicated to my family who provided unending love and support
during my graduate years, and always.

iv

ACKNOWLEDGEMENTS

First and foremost, I would like to express my sincere gratitude to the women
who participated in these two studies for their courage to share such personal
experiences. I would also like to express my gratitude to Dr. NiCole Buchanan, for her
mentorship, support, and guidance. As my dissertation chairperson, she not only inspired
me, but imparted much wisdom. I would also like to thank my other committee members:
Dr. Gloria Smith, Dr. Sonya Gunnings-Moton, and Dr. John Kosciulek. I am indebted to
these committee members for their support, motivation, and general interest in my
research.

I would also like to acknowledge my cohort members, who provided much
needed strength and support over several years of graduate work. Their loyalty,
friendship, and caring will always be one of the most memorable and significant parts of
this journey. Finally, I am equally appreciative of the support and mentorship provided

by the University of Notre Dame’s University Counseling Center staff.

TABLE OF CONTENTS

LIST OF TABLES .................................................................................. ix
INTRODUCTION .................................................................................. 1
CHAPTER 1
STUDY ONE INTRODUCTION AND LITERATURE REVIEW ........................... 6
Help-Seeking and Identified Sources of Help ........................................... 7
Emotional Social Support .................................................................. 9
Statement of Purpose ...................................................................... 10
CHAPTER 2
METHODOLOGY .................................................................................. 11
Participants .................................................................................. 11
Method of Recruitment .................................................................... 12
Prescreening Participants .................................................................. 12
Interviews .................................................................................... 13
Debriefing and Completion of Interview ................................................ 14
Data Analysis ............................................................................... 15
Validating Findings ........................................................................ 15
CHAPTER 3
RESULTS ............................................................................................ 16
Two Overarching Themes ................................................................ 18
Emerging Themes Promoting Help-Seeking ........................................... 19
Willing to Listen and Believing ................................................ 19
Shared Connection ................................................................ 20
Emerging Themes Inhibiting Help-Seeking ............................................ 21
Shame and Blame ................................................................. 21
Not Believing or Ignoring/Acting Like It Did Not Happen ................. 23
Negative Interactions with Medical Support .................................. 24
Protecting Others .................................................................. 25
Cultural Themes ................................................................... 25
Readiness for Counseling ........................................................ 26
CHAPTER 4
DISCUSSION ....................................................................................... 27
Sources Most Helpful to Survivors ...................................................... 27
Emerging Themes Related to Why Persons Were Helpful ........................... 28
Cultural Factors and Help-Seeking ...................................................... 31
Significance of Study ...................................................................... 37
Limitations .................................................................................. 39
CHAPTER 5
STUDY TWO INRODUCTION AND LITERATURE REVEW ........................... 43

vi

Historical Context of Sexual Violence and African American Women ............ 45

Historical Context of Sexual Violence ......................................... 46
Stereotypes and Assumptions about African American Women. . . . . . . . ....47
Incidence of Sexual Violence ............................................................ 49
Sexual Harassment and Racialized Sexual Harassment .............................. 51
Sexual Harassment ................................................................ 5 1
Racialized Sexual Harassment ................................................... 54
Help-Seeking and Identified Sources of Help .......................................... 55
Afiican American Help-Seeking Behaviors and Theoretical Considerations. . ....57
African American Female Attitudes towards Sexual Violence ............. 57
African American Male Attitudes towards Sexual Violence ............... 60
African American Help-Seeking Attitudes .................................... 62
Coping and Non-Traditional Forms of Help-Seeking ........................ 64
Other Theoretical Considerations ............................................... 66
Racial Identity Development ............................................................. 67
Emotional Social Support ................................................................. 69
Summary .................................................................................... 73
Statement of Purpose and Research Questions ......................................... 74
CHAPTER 6
METHODOLOGY ................................................................................. 77
Participants .................................................................................. 77
Procedure and Method of Recruitment .................................................. 77
Psychology Subject Pool ......................................................... 78
Website Subject Pool ............................................................. 78
Measures .................................................................................... 79
Help-Seeking Attitudes ........................................................... 79
Sexual Violence and Trauma Assessment ..................................... 80
Perceived Emotional Social Support ........................................... 81
Attitudinal Scale ................................................................... 82
Racial Identity Development .................................................... 82
Confounds and Covariates ....................................................... 83
CHAPTER 7
RESULTS ............................................................................................ 85
Multiple Regression ........................................................................ 86
Openness ........................................................................... 88
Need ................................................................................. 89
Stigma and Confidence ........................................................... 89
Emotional Social Support x Racial Identity Development .................. 89
Trauma Responses ......................................................................... 89
Reported Help-Seeking ................................................................... 90
Who Was Not Helpful ..................................................................... 91

vii

CHAPTER 8

DISSCUSSION ...................................................................................... 93
Factors Facilitating and Inhibiting labeling ............................................. 96
Reported Help-Seeking .................................................................... 98
General Implications of Findings ....................................................... 103

Applied Implications ............................................................ 103
Research Implications ........................................................... 105
Limitations ................................................................................. 106
Design and Internal Validity ................................................... 106
External Validity and Generalizability ....................................... 106
Measurement Limitations ............................................. 108

Conclusion ................................................................................. 109

APPENDICES ..................................................................................... 111
A: Study 1 Informed Consent ........................................................... 111
B: Debriefing and Local Resources .................................................... 113
C: Informed Consent Subject Pool ..................................................... 115
D: Informed Consent Website Subject Pool .......................................... 117
E: Debriefing and Resources ............................................................ 119
F. Demographic Information ............................................................ 121
G: Study 2 Measures ..................................................................... 122

Attitudes towards Seeking Processional Psychological Help Scale ...... 122

Trauma History .................................................................. 125

The Social Support Questionnaire ............................................. 128

Feminism and the Women’s Movement Scale, FWM ..................... 132

Black Racial Identity Attitude Scale (Form RIAS-B) ...................... 133

H: Tables .................................................................................. 137

Table l ........................................................................... 137

Table 2 ........................................................................... 138

Table 3 ........................................................................... 139
REFERENCES .................................................................................... 140

viii

LIST OF TABLES

Table 1
Correlation Matrix of Outcome Predictor Variables in Regression Analysis ............ 137

Table 2
Summary of Hierarchical Regression Analyses for ATPHSS Openness and Need
Subcales ........................................................................................... 138

Table 3

Summary of Hierarchical Regression Analyses for ATPHSS Stigma and Confidence
Subscales .......................................................................................... 139

ix

Introduction

Alarming statistics concerning the prevalence of sexual violence (SV) among
women underscores the need for continued research in this area. Sexual violence is
defined as any unwanted sexual activity forced by one person on another, including, but
not limited to: stranger rape, forced sodomy, acquaintance rape, date rape, marital rape,
gang rape, child sexual abuse, and incest. Incident rates of SV against women vary with
estimates ranging from 1 out of 6 to as many as 1 in 3 women will experience some form
of SV in their lifetime (Koss & Harvey, 1992; Tjaden & Thoennes, 2000, 1998; Ullman
& Knight, 1992). It is estimated that as many as 1 in 4 college women will experience
SV during their college years (Fisher, Cullen, & Turner, 2000). More alarming is the fact
that many sexually violent incidents go unreported, suggesting that the available statistics
underestimate the actual number of women who have experienced SV (Mahoney, 1999).
Researchers estimate that as much as 60% to 84% of SV goes unreported to police
(NCVS, 2003; Kilpatrick, Edmunds, & Seymour, 1992.)

An examination of the short-term and long-term afiereffects experienced by
survivors provides initial insight in to the psychotherapy needs of this population.
Common aftereffects include: shame, isolation, sexual inhibition, sleep disturbances,
substance abuse, sexual dysfunction, mistrust, intrusive thoughts, denial, dissociation,
helplessness, feeling overwhelmed, feeling loss of power and autonomy, fear, guilt,
depression, anxiety, impairment of concentration, exaggerated startle responses, and post-
traumatic stress disorder (PTSD), (Delahunta & Baram, 1997; Foa, Rothbaum, &

Steketee, 1993; Resick, 1993). It is estimated that only 30% of survivors enter

psychotherapy, a fraction of the women directly impacted by SV (George, Winfield &
Blazer, 1992; Miller & Cohen, 1995).

Help-seeking is generally conceptualized as a sharing of problems with others in
an attempt to receive aid, guidance, or assistance for problems causing distress (Gourash,
1978). When these behaviors are psychological in nature (i.e. anxiety, depression, and
PTSD) it is termed mental health help-seeking (N cal-Barnett & Crowther, 2000).
Terminology related to mental health help-seeking is confusing; psychotherapy and
counseling have been used in describing such behaviors. Some researchers view
counseling, also termed professional counseling, as a more brief intervention (up to 12-15
sessions), and infer that psychotherapy is more long-term (more than 12 sessions), with
the term therapy often used interchangeable with psychotherapy (Gelso & Fretz, 2001 ).
Wolf (1977) has defined psychotherapy as the treatment of problems of an emotional
nature where a relationship is established between the professional and client with the
intent of elirninating/changing/decreasing problems, reconciling disturbed patterns of
behavior, and encouraging healthy development. Psychotherapy has also been described
as work with more distressed individuals that attempts to restructure personality, features
in-depth examination, and focuses on analytic processes (Gelso & Fretz, 2001). An
emphasis on situational events and conscious process that is supportive defines the
process of counseling (Brarnmer, Abrego, & Shostrom, 1993). A combination of these
events, which is more common, suggests that the terms counseling and psychotherapy
can be used interchangeable (Gelso & F retz, 2001).

Although research suggests that psychotherapy (counseling) contributes to

positive post-SV adjustment among survivors (Neville & Pugh, 1997), there is limited

empirical research on this topic. Neville and Pugh (1997) reported that counseling was
associated with increased long-term self-esteem among rape survivors. Moreover, Cohen
and Roth (1987, cited in Neville & Pugh, 1997) observed that survivors who sought
counseling reported a decrease in intrusive thoughts regarding SV as compared to
survivors that did not seek counseling. Furthermore, the timeframe within which services
are received influences outcomes; survivors who sought counseling immediately
following SV experienced less anxiety and depression as compared to those survivors
who delayed seeking treatment (Stewart, Hughes, Anderson, Kendall, & West, 1987).
These studies demonstrate that psychotherapy interventions may reduce symptomology
related to sexual violence among women survivors. Possible psychotherapy inventions
include group counseling and/or individual counseling which are either trauma-based and
specific to SV or more general. As such, these findings encourage the need for continued
research on help-seeking practices of SV survivors.

Gaps in the literature reflect the need for additional inquiry. The literature is
inconclusive regarding how help-sources are utilized (e. g. police, emergency rooms,
crisis centers, family, friends, and professional sources of counseling). Additionally, this
research often fails to delineate between types of mental health services utilized by
survivors. As a result of these gaps, it is difficult to determine help-seeking rates of
survivors in conjunction with these sources of help.

Future research must further address what types of psychotherapy interventions
are most appropriate, accessible, and beneficial for survivors. Given that up to 30% of
survivors do seek psychotherapy, practicing psychologists will encountering survivors of

SV experiencing some combination of these afiereffects. There is a critical need for

greater understanding of these processes to inform evidence-based interventions in this
area.

Demonstrated differences concerning race and ethnicity’s impact on help-seeking
suggest the need for research addressing these differences among women seeking
psychological treatment related to SV. Although findings are inconsistent regarding
ethnic differences in prevalence rates of SV (N eville& Heppner, 2004, Wyatt, 1992), it is
clear that non-Caucasian women experience SV (Tj aden & Thoennes, 1998) and that
many experience psychological trauma requiring psychotherapy. The research reveals
that African American (Wyatt, 1992), Asian and Latina women are less likely to seek
professional help as compared to Caucasian women (Akustsu, Snowden & Organista,
1996, as cited in VanHook, 1999) and prefer culturally approved alternatives like prayer
and community elders (Mattis, 2002; Chiang, 2004). These variations in help-seeking
generate questions about sources of support that non-Caucasian survivors find helpful.

Methodological limitations plague the findings related to diversity and help-
seeking among survivors of SV. Inconsistent definitions of SV across studies may have
affected detection of racial differences in prevalence rates (George, & Winfield, &
Blazer, 1992). Non-white women may label SV behavior differently (Holzman, 1997;
Neville & Pugh, 1997; and Wyatt, 1992) which may impact reporting and help-seeking
rates. Non-diverse samples have also made it difficult to speculate how help-seeking
rates vary among non-white survivors of SV. Additionally, gaps exist in the social
support research, specifically regarding specificity of emotional social support, and who

African American survivors find as helpful informal sources of support.

To address these limitations, the following studies examined help-seeking
attitudes of survivors of SV. The first study used grounded theory and phenomenological
qualitative methodology to analyze open-ended interviews with eight ethnically-diverse
female SV survivors in order to assess their attitudes toward help-seeking and their
perceptions of the social support they received related to their SV experience. The
second study examined the survey responses of 108 female African American survivors
of SV in attempt to explore the interrelationships among emotional social support, racial
identity development, and psychological help-seeking attitudes. Together, these studies
provide valuable insight regarding the help-seeking attitudes of women survivors of SV,
while attending to the importance of the cultural contexts within which participants

develop help-seeking attitudes and enact related behaviors.

Chapter 1
Hearing Important Voices: An Exploration of Help-Seeking and Social
Support among Female Survivors of Sexual Violence

Study 1 Introduction and Literature Review

Underutilization of psychological services by SV survivors, coupled with the
many possible aftereffects associated with SV, raises important questions regarding the
help-seeking attitudes of SV survivors. Future research is needed addressing types of
social support that facilitate help-seeking among survivors. Conservative estimates
indicate that 1 in 6 women will experience some form of SV in their lifetime (Tjaden &
Thoennes, 2000). After such an event, survivors commonly experience sleep
disturbances, substance abuse, sexual dysfunction, mistrust, intrusive thoughts, denial,
dissociation, helplessness, feeling overwhelmed, fear, guilt, depression, anxiety,
impairment of concentration, depression (Delahunta & Baram, 1997; Foa, Rothbaum, &
Steketee, 1993; Resick, 1993) at levels severe enough to interfere with their
work/academic functioning and emotional well-being. Despite the high price these
events extract from victims, it is estimated that only 30% seek crisis therapeutic services,
despite the documented benefits of immediate and targeted post-assault counseling
services (Miller & Cohen, 1995; George, Winfield & Blazer, 1992).

Given the potentially devastating effects associated with SV and the
underutilization of services, it is essential that research investigate factors influencing the
help-seeking behaviors women do engage in as well as their effectiveness is reducing
harmful after-effects of SV. To address this need, the following study used grounded

theory and phenomenological qualitative methodology to analyze open-ended interviews

with eight ethnically-diverse female SV survivors in order to explore the types of social
support that facilitated effective help-seeking behaviors among SV survivors.
Help-seeking and Identified Sources of Help

Help-seeking is generally conceptualized as a sharing of problems with others in
an attempt to receive aid, guidance, or assistance for problems causing distress (Gourash,
1978). When these behaviors are psychological in nature (i.e. anxiety, depression, and
PTSD) it is termed mental health help-seeking (N cal-Barnett & Crowther, 2000).
Terminology related to mental health help-seeking is confiising; psychotherapy and
counseling have been used in describing such behaviors. Some researchers view
counseling, also termed professional counseling, as a more brief intervention (up to 12-15
sessions), and infer that psychotherapy as more long-tenn (more than 12 sessions), with
the term therapy often used interchangeable with psychotherapy (Gelso & F retz, 2001).
Wolf (1977) has defined psychotherapy as the treatment of problems of an emotional
nature where a relationship is established between the professional and client with the
intent of eliminating/changing/decreasing problems, reconciling disturbed patterns of
behavior, and encouraging healthy development. Psychotherapy has also been described
as work with more distressed individuals that: 1) attempts to restructure personality; 2)
features in—depth examination; and 3) focuses on analytic processes (Gelso & Fretz,
2001). A supportive environment with an emphasis on situational events, and conscious
process defines the process of counseling (Brammer, Abrego, & Shostrom, 1993). A
combination of these events, which is more common, suggests that the terms counseling

and psychotherapy can be used interchangeably (Gelso & Fretz, 2001).

The majority of help-seeking research regarding survivors of SV focuses on the
sources of help survivors use (i.e. police, emergency rooms, crisis centers, friends and/or
family, and professional sources of counseling). However, the literature is inconclusive
regarding how sources of help are utilized and often fails to delineate between the types
of mental health services utilized.

As a result of this gap in the current literature, it is difficult to determine the rates
at which survivors seek and utilize sources of help as well as variations in utilization due
to the type of SV. However, some studies have attempted to address these concerns. For
example, Koss, Koss, and Woodruff (1991) found that survivors are more likely to seek
help from medical doctors than from mental health care providers or victim assistance
organizations. Several studies have also found that the nature of the rape experience
influenced help-seeking behavior of survivors, such that survivors of stranger rape were
more likely to seek psychological help than survivors of acquaintance rape (Koss et al.,
1988; Mahoney, 1999; and Ullman & Siegel, 1993). For example, using a large
probability sample, Ullman and Siegel (1993) found that 55% of stranger rape survivors
sought help from a “professional helper” while only 30% of women assaulted by an
acquaintance sought professional help. Similarly, in a non-random university sample of
489 women, of the percentage of participants that told someone, 1.7 % of survivors raped
by an acquaintance and 19.2% of women raped by a stranger sought crisis counseling
(Koss et al., 1988). Finally, in a sample of over 100 female sexual assault survivors in
the Chicago area, only 39% utilized mental health care services (Campbell, Sefl, Barnes,
Ahrens, Wasco, & Zaragoza-Diesfield, 1999). Regardless of the relationship of the

assailant to the survivor, survivors underutilize help-seeking sources. Given the

documented benefits of counseling and therapy for survivors of SV, important questions
are raised regarding the help-seeking attitudes of SV survivors.
Emotional Social Support

Examining the role of social support among survivors may provide insight into
their help-seeking behaviors and attitudes as well as post-SV adjustment. Social support
refers to a survivor’s belief that she is cared for, loved, esteemed, valued and a member
of a group or network that places value on mutual obligation (Cobb, 1976; Cwik, 1996).
Friends, family, the community, and romantic partners of the survivor are important
sources of social support. Emotional social support has been defined as “demonstrating
care or sympathy toward another person; listening to someone or just being there when a
person needs a fiien ” (Birch, 1998). It is often measured via the survivor’s perceptions
of family members’ and partner’s/spouse’s’ sensitivity to her specific needs.

Current investigations of social support demonstrate the need for greater
specificity in the examination of emotional aspects of social support (Crarner, 1999;
Neville & Pugh, 1997; and Ruch & Leon, 1986). Gaps in the literature related to
emotional social support include measurement, specificity, and impact on survivor help-
seeking. It has been observed that Afiican American women fail to disclose to others
about incidents of rape because they are fearful of receiving negative social support
(Neville & Pugh 1997). Although Neville and Pugh (1997) did not address emotional
support specifically, fear of receiving negative social reaction may be similar to a
survivor’s fear of not receiving emotional social support, raising the question whether
presence or absence of emotional social support influences post-SV adjustment. Ruch

and Leon (1986) argued that perceived social support might buffer against trauma-related

symptomology, yet their measurement of social support was more general and not
intended to tap emotional social support. Past research indicates that people tend to seek
help when their support network is impaired or ineffective (Crarner, 1999). It is possible
that when a survivor’s support network is deficient, they may be more inclined to seek
more formal sources of help (i.e. psychotherapy and counseling). Literature has
minimally addressed how social support influences attitudes towards psychological
treatment, supporting the need for a closer examination of the role of emotional social
support among survivors, a focus in this study below.
Statement of Purpose

The purpose of this exploratory investigation was to examine the emotional social
support and help-seeking experiences of women survivors of SV. The overarching
research questions of this study concern; 1) How do survivors describe their help-seeking
experiences post SV; and 2) How do survivors describe perceived emotional social
support from others in their lives post SV. More specifically, whom do survivors
describe as most helpful and their descriptions of why this person (s) was most helpful
guide this exploratory investigation. Additionally, this study intended to assess whether
family members, partners, and spouses are emotionally supportive of survivors of SV
(feminine pronouns are used to refer to survivors’ because the current sample is women;

However, SV is also prevalent among boys and men).

10

Chapter 2
Methodology

Qualitative methodology (i.e. in-depth interviews) was employed in this study as
an effective method of exploring new constructs and as a method of inquiry that is
empowering and validating for participants (Reid, 2003; Campbell & Wasco, 2000; and
Kitzinger, 1995). One-on-one semi-structured interviews were used within a
phenomenological framework (Creswell, 2000), a method that seeks to understand the
subjective everyday experiences and interpretations of those experiences unique to the
individual. A grounded theory framework that involves developing theory via
observation, conversation, and interviews was also utilized (Glaser, 1992). This
framework allowed the investigator to have a better understanding of survivors’
experiences, and ultimately provided useful information regarding the help-seeking
experiences of survivors of SV.

Qualitative methods have been enumerated in the literature as a feminist research
tool, and such methods generate information regarding the unique experiences of an
underrepresented population (Wilkinson, 1999; Buchanan & Orrnerod, 2002). Intended
to empower participants as they share personal experiences, using such methodology
generates meaning from those experiences with the participants serving as experts and
co-constructors of that meaning. In particular, qualitative methods have been found to be
effective when investigating sensitive topics, specifically when exploring cultural
variables (Kitzinger, 1995).

Participants

11

Eight female participants from a large, Midwestern university were recruited for
this investigation. To ensure ethnic diversity of the sample, ethnic minorities were over-
sampled. Participants ranged from 19 to 22 years in age (M=20, SD 1.41). All
participants had some college education, ranging from two years of completed
coursework to a four-year college degree. None of the participants were married. All of
the participants except one described themselves as being middle class, with the
remaining participant describing herself as lower middle class.

Method of Recruitment

A total of 210 flyers were posted in academic buildings, dormitories, gathering
spots, and on public bulletin boards on campus inviting women to participate in a study
concerning stress and sources of support. Prior research has found differences in labeling
incidents of SV as such, particularly across racial/ethnic groups (George Winfield, &
Blazer, 1992; Neal-Barnett & Crowther, 2000); therefore, the study’s focus on SV was
not included in the original flyer in order to reduce labeling effects that could bias the
sample. Instead, the focus on unwanted sexual experiences was presented during the pre-
screening, which also provided a more private setting within which participants could
answer sensitive questions regarding SV.

Prescreen ing Participants

A total of 69 women contacted the researcher during a 19 day time period; 53 of
those women contacted the researcher via email, and 16 participants contacted the
researcher by phone. Thirty-five of these women did not return messages or emails (after
initially expressing interest in the study) to set up a prescreening interview. Thirty-four

women participated in the pre-screening interview; 27 identified as Caucasian, 2

12

identified as African American, 3 identified as Asian, 1 identified as Latina, and 1
identified as a Vietnamese international student.

The pre-screening interviews were conducted by phone. Participants provided
demographic information and were then asked if they had experienced any of five
unwanted physical and/or sex-based behaviors. Questions were behaviorally-based to
avoid labeling effects and included: 1) Have you ever been hit or grabbed by someone?
2) Has anyone ever tried to touch you without your consent? 3) Has anyone ever touched
you in a way that made you feel uncomfortable 4) Have you ever experienced forced
touching that was sexual in nature? 5) Have you ever had intercourse against your will?
All participants were instructed that they could refrain from answering any questions or
discontinue the interview at anytime. Subjects that had experienced unwanted sex-based
behaviors were asked to set up an hour-long interview, and were told of their rights as
research participants and the legal limits of confidentiality and anonymity. Nine women
met criteria, and 8 agreed to participate in further in—depth interviews.

Interviews

At the beginning of the in-depth interview, participants signed an informed
consent detailing their rights as a participant (see Appendix A). All participants
consented to the interviewer taking written notes during the interview. Participants also
chose whether or not to have the interview taped, and were informed that they could ask
that it be turned off at any time. All interviews took place in mutually decided upon
private locations and 7 of the 8 women agreed to have their interviews audiotaped.
Participants were told that tapes would be kept in a secure locked location, transcribed by

a member of the research team, and that all identifying information would be removed or

13

changed to protect their confidentiality.

To ease possible anxiety and increase comfort level, care was taken to establish
rapport with each participant including thanking them for talking about potentially
personal and painful experiences. Additionally, the investigator spoke about her interest
in the proposed research area, and commitment towards working with diverse populations
of women in present/ future research and clinical endeavors. The interview format was
semi-structured, accompanied by appropriate follow-up questions. The first part of the
interview included gathering demographic information, including age, socioeconomic
status (SES), and level of education. Subsequent questions focused on specific areas
related to how participants described their racial/ ethnic background, family, support
system, incidences of SV, and what type of help, if any, they sought/received following
incidence of SV. Participants were asked to respond to the pre-screening questions a
second time to begin the discussion of experiences of unwanted sexual activity. To foster
participant empowerment and create a safe environment within which to tell their
experiences, participants were given full control over the amount of information shared.
Debriefing and Completion of Interview

Due to the sensitive nature of this topic, participants received information about
SV, including phone numbers about local opportunities for counseling and support
groups (see Appendix B). At the end of the interview participants were encouraged to
discuss the debriefing materials with the researcher. Participants received $15 for their
participation, selected a local organization for which a $5.00 donation was made on their
behalf, and signed for receipt of reimbursement. Audiotapes were transcribed and all

related investigation materials were stored in a secure location.

14

Data Analyses

Following guidelines outlined by Creswell (2003) regarding qualitative analysis,
several steps were taken to analyze interview data. Audio transcriptions were read to get
an initial sense of the data. Coding (notes and keywords placed on each transcription)
and careful reflection initially identified emerging patterns and the general tone of
participants’ responses. Charts were used to organize data and connect information in a
more systematic manner as abstract categories emerged. Emerging themes and patterns
were assessed with certain phrases from each participant grouped together, allowing for a
systematic method of examining responses.
Validating Findings

Important strategies outlined by Creswell (2003) have been included in this
investigation to support the findings. To validate, and bring credibility to the findings: the
bias of the researcher was clarified for participants; careful self-reflection was used as a
means of creating an honest and open interpretation of the participants’ responses to
questions; peer debriefing was employed in an attempt to increase the accuracy of
participants’ responses; and competing ideas are presented in the discussion section in the

attempt to acknowledge that perspectives in the real world are often contradictory.

15

Chapter 3
Results

Nancy (all names have been changed), age 21, described herself as “Caucasian
with several minority friends,” having a “close family” and no prior mental illness (self-
report). She responded to questions regarding unwanted sexual activity with an account
about being “slapped on my butt by a younger boy co-worker,” and referenced other
incidents, without detailing particulars, regarding incidents of sexual forced touching.

Beth, age 19, described herself as having a close relationship with her family, and
reported no history of mental illness. Regarding her racial/ethnic identification, she
stated that she was, “White, boring, just American.” Beth described three incidents of
forced sexual touching that occurred while consuming alcohol. One incident occurred
with an older man and resulted in the loss of her virginity.

Claire, age 19, reported a strained relationship with her family and divorced
parents. Claire described her racial ethnic background as Caucasian and noted that her
stepfather was half Native American. Claire experienced depression during high school
and sought the assistance of a counselor for a short time. Claire described an incident of
unwanted sexual activity that included oral sex that occurred one evening after a few
drinks with a man that she knew casually. She had little recollection of what transpired
and stated, “It was really scary not knowing.”

Alex, age 19 and Caucasian, grew up with her adoptive father and his wife (not
her original adoptive mother), whom she refers to as her mother. Her father sustained
brain damage after an accident and has made multiple suicide attempts. Alex’s adoptive

mother was extremely physically and sexually abusive, and she preferred not to elaborate

l6

on that abuse. In ninth grade Alex suspects that a male classmate put drugs in her soda,
recalling that she woke up with the boy on top of her. Alex reported that she was
diagnosed with PTSD as a teenager, which she attributed to her father’s accident and
being sexually abused by her adoptive mother as a young child. Alex was also diagnosed
with Bipolar Disorder and took medication for two years, believing that being a hormonal
teenager incorrectly contributed to this diagnosis.

Lucy, age 19, identified as Korean American, and reports no history of prior
mental illness. Her friends are “pretty diverse” in terms of racial/ethnic background,
although she does not “hang out with other Asian Americans,” and she has close
relationship with her family, which includes extended family. Lucy reported one incident
of unwanted sexual activity occurring three months prior to the interview. While at an
acquaintances’ apartment, a male dragged her down the hallway and began touching her
while taking down his pants. This man let her go when she yelled for a female friend.

Susan, age 22, was the only African American participant. She has a close
family, no history of mental illness, a deep involvement in her church, and friendships
with people “of all races.” Susan spoke of three incidents of unwanted sexual activity:

1) When an older married man recently grabbed and touched her breasts; 2) When she
was a teenager dancing with a boy that tried to put his hand up her shirt; 3) When a friend
of her brother’s kissed her without her consent and asked her to have sex with him.

Mary, age 22 and Caucasian, is a recent college graduate. Mary reported
estranged family relationships, and that she was diagnosed with Bipolar Disorder. Mary
incurred two incidents of sexual touching without her consent: 1) Her grandfather

touched her breasts when she was ten; and 2) A younger brother repeatedly molested her

17

over the period of a week when she was 15 years old. Additionally, she had a lot of
“non-consensual sex” in high school and a college boyfriend “pressured” her to have sex.

Lisa, age 19 and Mexican American reported that her friends were all minorities
and described her family as, “Not really close, strict, and tied to cultural beliefs.” Lisa
briefly battled depression as a teenager, and contemplated suicide once. Lisa detailed
several instances of unwanted sexual activity. At age five, two separate males touched
her on two occasions: a ten year-old male stuck his finger in her anus; and a 16-year-old
boy lured her into a bedroom, pinned her down on a bed, and “rubbed himself” on her.
At age 11, an older male cousin put his finger in her vagina while riding with her on a
bicycle. At age 17, an uncle by marriage placed his hand on her knee and continued to
move it up until it almost touched her vagina. Lisa’s Godfather acted inappropriately
when he took her to dinner when she was 17, he held her hand and asked her sexually
related questions which made her feel uncomfortable.
T wo Overarching Themes

The findings can be divided into two overarching themes: themes promoting help-
seeking, and themes that inhibited help-seeking. Themes promoting help-seeking
included being willing to listen, believing survivors’ descriptions of what happened, and
having a shared-connection. Themes inhibiting help-seeking also emerged: self-blame
and shame, others not believing and i gnoring/acting like it did not happen, negative
interactions with medical support, protecting family members, cultural beliefs, and
readiness for counseling. These two overarching themes were evident as survivors
described seeking help from friends, parents, psychologists, counselors, medical doctors,

and other sources.

18

Emerging Themes Promoting Help-Seeking

Willing to listen and believing. Participants found friends, older women, romantic
partners, and professional counselors helpful because they were willing to listen,
available, and believing of their accounts of SV.

Three participants found fiicnds to be most helpful. Lisa remarked, “My best
friends don’t judge me, they’re not going to look down on me because my life is a certain
way. . .So I don’t even have to censure anything I tell them.” Nancy’s friends were most
helpful because “they listened to me and they understood that this was the type of guy he
was.” Claire found a male friend to be most helpful; “I felt more comfortable. . .it just
feels that I would be able to be more honest with him and Since he knows me...” Claire’s
responses also suggested availability and access to fi'iends was helpful. “He [male friend]
was there whenever I needed him, unlike the counselor, where I would have to make an
appointment.”

Other women were also found to be helpful. Alex found her mom as a primary
source of help and support; “My mom [father’s second wife] took me in when no one else
was there. She was just always there. . .I sometimes just wanted someone to listen, and
she was always willing and there to listen.” Alex also sought help from a female
gynecologist, whom she saw as a small child after the sexual abuse was discovered. She
resumed contact with this doctor yearly when she entered high school and reports, “I can
always call her if I need something.” Lisa found her mentor (an older woman to be most
helpful and described her as, “She totally understands...When I would have a problem,
whenever I was stressed-out or depressed. . .She would pull me out from that

environment.”

19

Two participants sought help from romantic partners. Susan shared her
experience with a boyfriend, and reported that he expressed worry and wanted to know
who the person was who assaulted her. Mary found that sharing her experiences with her
boyfiiend were particularly helpful, stating, “I got to do a lot of things with my
emotions. He was really patient. . .. he was good about hearing me, he was good about
how I was being affected.”

Three participants sought help from professional counselors, and their
descriptions also capture the themes of “willing to listen” and “available.” Alex’s
psychologist was, “. . .always willing to listen. She made time in her schedule for me, I
never felt like I was a client. I felt like I was a friend to her.” Mary describes her current
female therapist of two years as “awesome, there for me. . .she has been really
supportive.” Lisa indicated that she saw a counselor briefly in high school regarding
family issues and her SV experiences. This interaction was helpful because the
counselor, “Told me to look at things from a realistic point of view, like I shouldn’t
probably expect my family to change their beliefs... hearing the truth was helpful. . .to
keep me focused.”

Shared connection. Participants revealed that shared connections with others
validated and normalized their experiences and allowed them to see that they could
survive. Claire shared her experience with a male debate coach who disclosed that he
had been abused as a child. “It made me feel more comfortable telling him, because there
was some sort of shared connection, and trust.” This coach disclosed to her that he also
blamed himself, and she stated, “It was nice to hear him say that he thought it was his

fault, and then he realized that it was not.” Susan disclosed to one female friend who

20

later disclosed to her that she also had a history of SV. “Our discussions, that really
helped. . .to say that we’re not alone. You can tell people, and if they haven’t been
through what you have, then you really can’t help people.” Susan commented on the
impact of her friend’s strength: “She really is a strong individual, she has her life
together, and that’s what helped me.” Mary worked at a local crisis hotline during
college and confided in members of the training group (many who were survivors of SV).
The overall experience was the “impetus for change” and she cited the female training
leader as most helpful because, “She told me it was okay to be pissed off and express it.”

Culturally-bound shared connections were related to positive help-seeking. Claire
recently identified as “non-heterosexua ” and shared this revelation with a male gay
fiiend. Claire was able to share her history of SV with this male because he really
accepted and knew her. Such a connection also existed for Lisa and her mentor: “She
totally understands, she has a lot of knowledge about my culture. She knows how to
speak Spanish.” Shared connections may have a deeper significance; survivors sought
others who understood their experiences as a member of a marginalized group.
Connections over these similarities provided an avenue for sharing about the SV,
knowing that they would not be judged out of misunderstanding their identified group.
Emerging Themes Inhibiting Help-Seeking

Shame and blame. Shame and self-blame were the most salient themes
represented by survivors, specifically as they recounted feeling violated as a result of
their experiences of SV. For example, Susan stated, “I felt like, violated. He knew my
principles [not engaging in sexual intercourse outside of marriage]... I was thinking if you

present yourself a certain way, you won’t get approached like that.” Susan had a similar

21

reaction when describing another incident, “I just felt so violated by it. . .I knew about
sex, and I knew enough to say no to him. . .. I was like no.” People often sought Susan
out to talk about their own experiences and she revealed that she does not disclose her
own experiences for fear of portraying weakness. Beth and Claire had difficulty
classifying their SV experiences as intercourse against their will and subsequently
blamed themselves. Both were under the influence of alcohol, and therefore felt
responsible for what happened, even if they were unwilling participants. Beth remarked,
“I feel like I should come up with a label for it, to make myself feel better, so I want to
play it off like something of the rape nature, so that I can not feel bad for it, or punish
myself.” In response to whether she had ever had sexual intercourse that was against her
will, Beth stated:

I certainly did not want to; I was not planning on doing it at all. . .. and I

have regretted it so tenibly. So maybe it would be called against my will,

but I feel that it was my fault anyway, so I am responsible for myself, and

if I can’t take care of myself, then I think it is my fault. So I say no, I can’t

be responsible for someone else’s actions, but it wasn’t like he stopped me

and raped me . . .but I did try to stop him when he was kissing me.
Similarly, Claire stated:

I felt bad about the incident because I was like really drunk, and I was not

like reactive. . .. I mean I was like ‘no, I don’t really want to do that’...But

I was just so messed up that I did not do anything about it. I just remember

him trying to force me to give him oral sex.

22

When asked what she would define as rape Claire remarked, “I feel bad defining
it, but when someone says no, or is not able to give consent.” When asked whether she
had ever had sexual intercourse against her will, she stated that:

I felt really bad because I was drunk, it was partly my fault. . .I mean I

guess that I would say no. . .. a lot of females in heterosexual relationships

maybe don’t want to have sex, but are just socialized, are pressured

without them even knowing, because of their social situation, into having

sex, so I guess in some broad definition, it could fit, yes, but I have never

said no, and I mean I have never been raped in that way.

Participants’ experiences of help-seeking from parents and family captured
themes related to self-blame and shame. When remarking about telling her parents, Beth
stated, “I don’t tell my family about that; would you tell your family about that?
Absolutely not.” Similarly, Claire reported that that she did not tell her mother, “How
my mom raised me, we didn’t have a relationship where we could talk about that.” Lucy
did not tell her family, including her sister; claiming, “. . .I did not want her to say I told
you so. She is always telling me to be careful, and I didn’t really listen. I guess I could
be more careful and think about what I am doing sometimes.”

Not believing or ignoring/acting like it did not happen. Participants found that
some family, friends and counselors ignored what happened or did not believe their
interpretation of their experiences. Some encountered family members whose
relationships with the perpetrator caused them act as if nothing happened. Lisa’s family
did not understand: She told her brother about the incident that occurred at age 1 1, and

believes that he has forgotten “because he still hangs out with this cousin (the

23

perpetrator)” Lisa told her mother about the incidents involving her uncle and
Godfather, and stated, “I really didn’t receive any support from my mom. . .because when
I told her (about my uncle). . .she questioned me was I sure, I just didn’t imagine it?
Mary’s parents were present in the room when her grandfather abused her and did
nothing about the abuse, which encouraged her reaction: “I don’t feel like I have a right
to (say anything)” Mary’s stepmother did not initially believe her when she disclosed
that she was molested by her brother. “She made me tell my dad... and I felt like I was
getting in trouble.” Lucy shared her experience with a friend who was present while she
was assaulted and reported that this friend “acted like it was not a big deal.” Alex told a
female friend about the incident that occurred in the 9th grade, but this friend thought that
Alex was lying. Regarding telling friends in general, she stated:

It is really hard for me to find someone to go in depth for, because I have

to tell the whole; it is hard too, because a lot of people my age did not

experience what I did, and a lot of them are really turned off by it.

Claire sought assistance from two female counselors on campus, but reported that
this experience was not helpful. Because of summer availability, she had to see two
different counselors. She attributed the support of the counselors to their job
specifications, “Because that is their job to do. . .I just had a hard time making a
connection over there.”

Negative interactions with medical support. Two participants described negative
experiences when seeking help from medical doctors. Negative interactions prior to the
SV made it less likely for these participants to seek care. Claire sought medical treatment

from an on-campus doctor and reported that “Doctors on campus always assume you are

24

pregnant or have a STD. . .. I don’t feel comfortable around them at all and the
[receptionists] treat you like your time doesn’t matter.” Alex found that her experience
of SV was viewed by her female gynecologist as being extreme, ’strange,’ and “difficult
to grasp” because a female abused her, but reports that this woman was helpful and
available nonetheless.

Protecting others. Some survivors did not seek help as a result of wanting to
protect others. Lucy did not tell her family, including her sister; claiming, “She just
worries about me.” Susan’s lack of sharing with her family echoed Lucy’s concern
about worrying, “I don’t want them to worry about me...”

Cultural themes. Cultural beliefs influenced seeking help from family members,
specifically parents. Lucy, who identified as Korean American described her parents, in

. general, to be supportive and understanding. “Culture is so based on school or success,
money wise, and education, so there is not much support or open-mindedness to talk
about other things.” Susan, who identified as Afiican American also cited cultural
reasons for not seeking help. She commented:

You have to be strong to make it in the world; if you are not strong, you

are not going to succeed; I felt like they taught me to be strong, and if I

was to go to them, it would be that I wasn’t presenting that principle of

being strong, and they would feel like I need more help, which they really

may not have the time to give or the resources. I want to maintain...this

whole thing that I am strong.

When inquiring about the use of professional counselors, Susan also commented,

“Within our culture we don’t go and talk to counselors... we are more religion based.

25

You can suppress those things you need to get rid of. . .. you always want to pray about
stuff, and not deal with it.” She had mixed reactions regarding this practice and indicated
that although she did not share specific incidents with her church community, she felt

supported by her relationships in the church, especially women.

Yes, God can resolve stuff in your life. . .. you get encouragement from the

word of God, but I don’t believe the bible in essence really wanted us to

keep it like that. It is really important for African American women to

really be aware that it is okay to talk to people, and that it is not healthy to

hold a lot of stuff in.

Readiness for counseling. One participant who was sexually abused as a child
indicated that her first experience seeking counseling was not helpful because she was
“not ready.” On her first counselor during high school, Mary stated, “It didn’t work
because I was in a situation where there was really no way out. . .. She didn’t have much
to work with. I was not in a place where I could admit that my boyfriend was raping

me. . .. I really think it just wasn’t the right time.”

26

Chapter 4
Discussion

The results of the qualitative interviews yielded many pattenrs, and for the sake of
this investigation, two overarching themes related to promoting and inhibiting help-
seeking are discussed, with an emphasis on the cultural context within which they
occurred.

Sources Most Helpful to Survivors

The qualitative interviews revealed several patterns with regard to people
survivors found most helpful. Six of the eight survivors interviewed reported fiiends to
be helpful, and 3 reported friends as the most helpfiil of all sources. Two participants
reported that counselors were most helpful. It is important to note that both of these
participants worked with these psychologists for several years, and both were sexually
abused as children. One participant reported her mother as most helpful. Others
identified as helpful included a male debate coach, a mentor, a training leader, and a
professor. Overall, sources other than psychologists and counselors were found most
helpful.

An examination of the current literature provides insight into the findings.
Survivors in this study reported unwanted sexual activity by an acquaintance, which may
explain the lack of help-seeking from formal sources of help like rape-crisis centers and
mental health professionals. Prior literature posits that the nature of the assault may
influence help-seeking behavior of survivors; survivors of stranger rape are more likely to
seek help as compared to survivors of acquaintance rape (Koss et al., 1988; Mahoney,

1999; and Ullman & Siegel, 1993). Additional explanations regarding lack of formal

27

help-seeking have been enumerated. Drauker (1999) reports that survivors may not seek
formal treatment for a variety of reasons: 1) inability to assume the patient role; 2)
treatment location is not local; 3) natural resistance to talk about the assault; and 4) fear
that therapy providers may not meet their needs. All of these reasons may or may not be
applicable to the survivors who participated in this inquiry.

The majority of participants in this investigation found friends to be most helpful
and studies examining social support corroborate this finding. SV may be related to the
need for emotional support, and survivors generally turn to family and fiiends for this
reassurance and validation (Golding, Siegel, Sorenson, Burnam, & Stein et al, 1989). In
a study investigating sources of social support for survivors, Golding et al., (1989)
observed that 2/3 of the participants disclosed their experiences of sexual assault to
others, 59.3% told a family member or a friend, and 16.1% told a mental health
professional (the second most fiequently told source reported in this study). It was also
observed that fiiends and family were indicated as most helpful (60.3%) and mental
health professionals were second most helpful (43.2%) in a study examining social
support and sources of support (Ullman, 1996). Popiel and Susskind (1985) observed
that survivors found female friends as most helpful, followed by boyfriends and
husbands, with support varying according to stressfulness of the assault. The current
findings are consistent with past findings regarding social support.

Emerging Themes Related to Why Persons Were Helpful

,9 ‘6

Phrases such as having a “willing to listen, available,” “believing” and “shared-
connection,” were used to describe persons that survivors found most helpful. These

sentiments were continual throughout the survivors’ interviews. Several participants

28

indicated that it was helpful to talk with someone who had experienced what they had
been through, and attributed that help to having a “shared connection.” Both Claire and
Susan reported that it was helpful to talk about their experiences with people that had
been though similar experiences, and who had similar reactions to those experiences,
including blaming themselves for what happened. Susan reported having this “shared
connection” with a female fiiend, and Claire reported having this “shared connection”
with her debate coach, who also had a history of SV. Phrases like, “to say that we’re not
alone, and “it was nice to hear that [they thought] it was their fault too,” were evident
among several participants.

Alex’s experiences further support the importance of having a shared connection.
She noted that she felt that she often could not seek help from friends because they had
not experienced similar trauma in their lives. Alex reported that she found her therapist
and mom to be most helpful because they were “always willing to listen,” and were
“always there for her” when she needed them. Alex’s experience of unwanted sexual
activity was notably different from other participants (repeated childhood sexual abuse by
her father’s first wife, the women she describes as her original adoptive mother), which
may provide insight into her unwillingness to share her experience with friends. Shame,
a salient emotion associated with incest and childhood sexual abuse, may have prevented
her from sharing her experience with others.

Lisa and Mary expressed that a mentor and psychologist, respectively, were most
helpful. The theme of shared connections transmits to these interactions as well. Lisa
worked with an older mentor for over ten years, and found this woman to be most helpful

because “she was always there when I had a problem.” It is plausible that this shared

29

connection may be attributed to the length of time and commitment each invested in the
relationship, which made it possible for Lisa to seek support from her mentor. Moreover,
Mary worked with her therapist for over two years, and described this woman as most
helpful. The length of time they worked together may have also contributed to the
“shared connection” between Mary and her therapist.

Limited research exists regarding social support, and few studies specifically
address emotional social support among survivors of SV. A review of the literature on
working alliance may further advance the understanding of help-seeking behaviors
among survivors and the role of social support. Working alliance is most often
conceptualized as collaboration between the therapist and client, emotional bonds, and
agreed upon goals, all of which have been identified as key factors in positive therapeutic
outcomes (Howarth & Symonds, 1991).

Although the literature minimally addresses the role of working alliance in the
therapeutic process with survivors, the descriptions of helpful emotional social support
received by participants in the current study parallel components of the working alliance
in the therapeutic relationship: “shared connection, availability, willing to listen,
understanding, and joking around.” The literature indicates that it takes several sessions
for the working alliance to be established, which may explain the difficulty that
participants experienced making a “connection” with professional mental health care
providers. Claire reported having to see 2 therapists at a counseling center due to
summer availability, and reported that she only had a few therapy sessions. The transfer
to a new therapist may have impeded the establishment of a strong working alliance, and

may have led her to leave counseling prematurely. A prior relationship with friends for

30

Claire may have felt more comfortable and safe, which may have facilitated seeking help
fi'om friends. Mary worked with her therapist for over 2 years, suggesting the existence
of a strong working alliance that enabled her to seek help from this psychologist.

A few participants responded that they found fiiends to be most helpful because
they were able to “joke around” with them. This theme was especially true for the two
participants that reported that alcohol was involved in their experiences of unwanted
sexual activity. Beth and Claire reported male friends were most helpful because they
“made it seem like I was not such a big deal,” and “he knew it was serious, but he could
joke around to make me feel better.” Furthermore, initial joking may have allowed for
cognitive and/or emotional distancing (i.e. separation or de-identification) from the SV
experience.

Cultural Factors and Help-Seeking

Although this qualitative investigation was not comprehensive in terms of the
diversity of the participants, results pertaining to cultural variations in help-seeking and
social support were evident and merit discussion. The findings indicated that four of the
five Caucasian women sought or intended to seek formal sources of help from a
professional counselor or psychologist. However, regarding incidents of SV, the three
women of color did not seek out or intend to seek out services from a professional
counselor or psychologist.

The African American survivor reported that cultural factors influenced her
choice to not seek formal sources of help, a finding that mirrors the current literature
examining diversity and help-seeking. General help-seeking behaviors of Afiican

American women differ from those of Caucasians. For example, Wyatt (1992) reported

31

that Afiican American women are less likely to seek counseling compared to Caucasian
women. As depicted in Susan’s experience, research suggests that African Americans
have favorable attitudes regarding mental health care centers, yet often underutilize such
services (Gary, 1987, Thompson & West, 1992). Susan proclaimed that “Afiican
American women should talk to someone and not hold it all in,” yet, she did not seek
formal sources of help following her own experiences with SV.

Reluctance to seek professional help may result from long-standing differences in
how African American and Caucasian women are treated by medical staff and law
enforcement officers after SV. Neville and Hammer (2001) assert that social institutions
continue to oppress African American women. Herman (2003) posits that longstanding
discriminatory practices against persons of color by law enforcement systems
(disproportionate arrests of African Americans as compared to Caucasians) may suppress
help-seeking from these institutions. Popiel and Susskind (1985) observed that survivors
in their study experienced victim-blaming responses from police. Campbell (1998)
observed that SV survivors reporting minimal injury, a non-stranger assailant, and
mismatch of race between assailant and survivor encountered negative experiences
among legal, medical, and mental health institutions. Deviations from accepted
definitions (e. g. assailant was a non-stranger) of SV may impact legal, medical, and
mental health systems and result in negative experiences for treatment seekers. As a
result of such treatment, many African American women may believe that they are not
viewed as possible victims of rape by the larger society and therefore shun services to
protect themselves from further mistreatment (Collins, 2000, 2004; Holzman, 1996;

McNair & Neville, 1996; Wyatt, 1992).

32

Past legal response to SV also impacts help-seeking. Stranger rape is
investigated more thoroughly by the legal system (Kerstetter, 1990) and SV committed
by an acquaintance yields a lower conviction rate (Petersilia, 1994, as cited in Sinclair &
Boume, 1998). Low conviction rates related to SV may contribute to decreased
psychological help-seeking. Court cases involving SV rarely matriculate to the court
room and if they do, non- guilty verdicts reinforce and bolster rape-myth acceptance
(Sinclair & Boume, 1998). Past research revels that women of color are less likely to
have cases of SV pursued by the legal system (Campbell 1998; Razack, 1998). The legal
systems failure to punish acts of aggression and to protect the rights of people may
influence African Americans interpretation of their experience as well as their help-
seeking behaviors. African American women survivors may integrate a “why bother”
attitude regarding seeking legal or psychological help.

Many African American women do not consider their incident of SV as “real
rape,” and therefore do not seek counseling (Holzman, 1996; Neville & Pugh, 1997;
Wyatt, 1992). Stereotypes depicting female African Americans as being promiscuous
and the African American historical context of rape of female slaves may fire] this current
belief held by some Afiican American women. It has been observed that Afiican
American women internalize the depiction of themselves as promiscuous and wanton (the
Jezebel stereotype) as a motive for SV experiences (Neville et al., 2004). Assailant
characteristics have been found to impact labeling and interpretations of SV. It has been
observed that certain assailant traits (stranger vs. acquaintance) preclude survivors from
labeling vaginal, oral, or anal intercourse as rape (Kahn et a1, 2003). For African

American survivors, SV by a stranger justifies help-seeking from social resources,

33

including mental health professionals (U llrnan and F ilipas, 2001). These observations
shed light on possible factors associated with Susan’s lack of psychological help-seeking
and inability so share her experience with family.

Afiican American women may be hesitant to label events as SV in order to
protect themselves from negative treatment from others. For example, Afiican American
survivors report that they believe others (family, friends, and society) will discount their
experience as not “real rape” and therefore various forms of sexual violence is minimized
(McNair & Neville, 1996; Neville & Pugh, 1997; Wyatt, 1992). Researchers posit that
African American women remain silent about their victimization experiences to protect
families and themselves (Ritchie, 1996; Collins, 1998). Collins (1998) asserts that
African American women must choose between the protection of Caucasians and being
reviled by their own black communities regarding sharing their experiences of violence.
A “code of silence” also exists regarding Afiican American women that have endured
violence at the hands of Afiican American men. These women may feel the need to
protect African American men who have endured longstanding racism (Bell, 1992) and
therefore remain silent about their own victimization experiences. Inability to label
themselves and needing to protect themselves and their families may prevent them from
seeking needed psychological treatment.

Afiican American women may be less inclined to seek counseling services
because it could threaten their ability to be a source of strength for their families (McNair
& Neville, 1996; VanHook, 1999). Professional help-seeking may threaten internalized
self-schemas of themselves given the long-standing tradition of viewing Black women as

strong and independent. Susan commented on needing to remain strong, and that her

34

farme raised her to be strong. It has been observed that some African American women
support this historical belief that life would be difficult, believe it to be true, and that they
must overcome all adversity, suggesting that if you could not meet demands and
challenges, treatment seeking would be revered as weakness (Thompson et al., 2004).
Although this internalized self-schema can be protective and a source of resilience, it may
create an unexpected burden of needing to appear strong, even when in need of care
themselves. As such, denying and avoiding negative emotions, such as anxiety or
depression, has been found to be an adaptive coping strategy among African American
women (Zeal-Barnett & Crowther, 2000) because they allow these women to function in
times of adversity.

These data also provide some important preliminary cultural considerations for
Latina and Asian women. An examination of prior literature provides insight into the
help-seeking behavior and intentions of Latina and Asian survivors. It has been reported
that Asians and Latinas are less inclined to seek help fi'om community mental health
services and are more inclined to turn to culturally approved alternatives (Akustsu,
Snowden & Organista, 1996 as cited in VanHook, 1999) such as prayer, biblical
readings, community church elders (Mattis, 2002; Chiang, 2004). Lisa, the only Latina
participant, reported that she found her mentor to be most helpful, and may have tumed
to this woman because she was a culturally accepted source of help, an observation
supported by past findings. Among a sample of sexually harassed Latina women, Cortina
2004) observed social reactions by fiiends and family were received as more helpful as
compared to more formal organizational sources. However, Santiago and Morash (1995)

observed that 47% of battered Hispanic women did not seek family members as sources

35

of assistance, and only half of the women seeking help found sources in general as
helpful.

Cultural norms may influence help-seeking among Latina women. Cultural
beliefs related to acceptance of suffering and respect for authority are inherent among
Latinas (Gracia-Petro, 1996; Falicov, 1996, as cited in VanHook, 1999). The notion of
familismo, kinship among immediate and extended families, and respeto, respect of
person in positions of higher power (Marin & Marin, 1991) may influence help-seeking
(Cortina, 2004). An additional cultural norm possrbly impacting help-seeking among
Latinas includes machismo, actions emphasizing masculinity (Marin & Marin, 1991).
Cortina (2004) posits that a women incurring sexual harassment at the hands of a family
member may not share their experience with family members for fear of being silenced or
not believed. Such sharing may threaten, violate, or contradict the norms of farnilismo,
respeto, and machismo. It is plausible that this finding can be extrapolated to Lisa, who
encountered unwanted sexual touching by a male cousin, uncle and godfather. She was
met by disbelief when sharing incidents of SV with her mother, yet, found her mentor
very helpful and understanding

Statistically, Asian Americans also underutilize mental health professionals as
sources of help, partially because the nature of traditional psychotherapy is incongruent
with the cultural values of Asian Americans. It is more culturally-acceptable to seek
solution-focused short term help for academic reasons, than treatment for non-academic
psychological distress (Leong, 1993; Bui & Takeuchi, 1992; Snowden & Cheung, 1990;
Uomoto & Gorsuch, 1984, as cited in Atkinson, Lowe & Matthews, 1995). This may

explain Lucy’s (the only Korean American participant in the current investigation) lack

36

of disclosure regarding her attempted sexual assault. The findings also support her report
about her family’s culturally expressed emphasis on academic achievement and general
success.

Caucasian cultural values, including individualism and independence are
important to consider regarding the help-seeking experience of Caucasian survivors. Prior
bodies of literature indicate that White culture is characterized by individualist values,
such as self- purpose, self-interest, and self-actualization and individual goals (see Coon
and Kemmelrneier, 2001). Individualist cultures also emphasize verbal expression that is
direct and expressive, equality in relationships, and consistency between the public and
private self. These values are consistent with many components and the overall ideology
of individual psychotherapy (e. g., verbal expressiveness, disclosure of private
information, self-focused goals, independence, and examination of self). This is not
surprising given that, historically, the foundation of psychology was built largely by
Caucasians with the intention of serving other Caucasian people (Jackson, 1995). These
communalities may promote help-seeking among Caucasian survivors. The incongruity
between therapy norms and collectivist ideals, particularly disclosure of private
information and self- rather than community-focus may inhibit this form of help-seeking
for Africa American survivors (V ontress, 1995).

Significance of study

This study has valuable implications for clinical practice, training, community
education and outreach, and research. In general, clinicians should 1) be cognizant of the
impact of race and ethnicity and how they may influence the therapeutic process and

family reactions to SV; 2) provide a therapy experience that conveys being available,

37

believing, and willing to listen; and 3) communicate the significance of outside emotional
social support that conveys notions of being available, believing, and willing to listen.
Group counseling consisting of same racial/ethnic background participants and leaders
may promote the “shared connections” that these women desire. Taylor (2000) observed
that many African American women survivors of intimate male partner violence
participating in therapeutic groups attributed discomfort and lack of investment in the
group experience to differences in racial, ethnic, and SES among participants. These
same women also reported that they perceived white women as having difficulty
understanding their experiences and unable to provide support. It is evident that African
American survivors SV may have similar experiences in therapy groups, and therefore
may benefit from therapy groups consisting of members from similar racial and ethnic
backgrounds.

The results have valuable implications for training and community education and
outreach. Future counselors and therapist must engage in training opportunities that
educate them about racial/ethnic difference regarding help-seeking and working alliance
across cultures. Additionally, an understanding of the role of the working alliance
specific to working with survivors, and communicating to clients about its development
in the therapeutic relationship may prove beneficial to successful therapy outcomes.
Mental health organizations should direct outreach efforts to women of color and
promote the use of mentors of similar racial/ethnic backgrounds that have experienced
similar trauma in their lives. Promoting such interactions may generate a sense of
“shared connections,” normalization, and validation of survivors’ experiences and

feelings.

38

This exploratory investigation provides the basis for future studies that further
explore these concerns. As women of color continue to be understudied populations,
future research should increase their recruitment of women of color. Investigations
should also focus on examining within culture differences, as variations related to
acculturation level, SES, education level, and other demographic factors may provide
additional insight to the help-seeking needs and social support experiences of non-
majority culture survivors.

Another future research trajectory includes investigating specific definitions
women use to describe their SV experiences. For example, this study did not solicit
definitions of important terms like sexual intercourse against one’s will or rape from all
participants, which may provide valuable information regarding how survivors define and
share their experiences and seek informal and formal help. More information is required
regarding definitions that participants used to describe how certain events impact them.
Many participants used “uncomfortable” and “comfortable” concerning interactions with
sources of help. Yet, these phrases may have different meanings for participants, and
should be explored further when given as responses. In an attempt to better understand
survivors’ help-seeking experiences, future investigations should help clarify the
distinction between “telling” and “disclosing” about the abuse as compared to “help-
seeking.” Assessment of women’s access and knowledge of help resources will also
provide valuable information regarding possible barriers professional help-seeking.
Limitations

Several limitations must be considered for this investigation, including external

validity. External validity refers to whether the findings can be generalized beyond the

39

sample to and across pOpulations of interest. Typically, qualitative studies have limited
external validity, and in this case, the small number of participants limits the
generalizability of the results. Limited diversity among the sample may make it difficult
to make assertions about cultural factors. Yet, the exploratory nature of this topic and
limited research regarding social support, SV, and help-seeking supports the timeliness of
this study. Careful consideration must be applied when generalizing these finding to
underrepresented groups, not only because of the varied experiences of sexual violence
reported by the participants, but also because of their variations in interpreting/labeling
these events as sexual violence. Because participants experienced various forms of
unwanted sexual activity occurring at varying times in their lives, it is challenging to
develop uniform and comprehensive themes regarding help-seeking attitudes, behaviors
and intentions, and social support across all participants. It is possible that differing
lengths of time since each occurrence of sexual violence may have influenced
participants’ responses; therefore this information should be considered when examining
the findings. Although qualitative data limits generalizability of the findings, it is
essential for exploring new constructs and may have an effect of improving the external
validity of a theory by demonstrating the extent to which it applies to other groups.

In addition, use of a self-report interview format may have resulted in relevant
information being filtered out by participants. For example, the women in this study
provided their own account of how they perceived emotional social support; however,
support networks may have intended to be helpful, but were not perceived to be. Further,
the presence of the researcher during the interview, as opposed to an anonymous survey,

may have generated biased responses. As a white interviewer, it is also plausible that

40

participants of color may have censored their responses, particularly if they felt they had
represented their cultural group or family in a potentially negative manner (e. g. family
was not supportive or understanding). As a result, the findings presented here are
subjective and alternative interpretations may be plausible. Nevertheless, a qualitative
interview format is appropriate for exploratory investigations, particularly when the topic
is of a sensitive nature, because it allows for meaning making of experiences in a
balanced format that exposes researcher biases, and provides support; framework
consistent with feminist methodology ( Bergen, 1996, as cited in Campbell & Wasco,
2000)

In summary, hearing the voices of survivor’s experiences has powerful
implications for clinicians, outreach, training, and firture research. The results indicate
that survivors of SV, and more specifically, survivors of color, are an underserved
population with unique help-seeking attitudes, behaviors, and intentions. This study
contributes to the limited extant literature on help-seeking attitudes of survivors of SV,
particularly among people of color, and provides a foundation for future studies exploring
these concerns.

Specifically, the findings from this study informed the development of study two.
For example, several questions related to help-seeking and emotional support among non-
white women were raised. Study one revealed that 4 out of 5 Caucasian survivors sought
or intended to seek therapy, yet none of the women of color survivors sought counseling
for their SV experiences. Friends were found to be a great source of emotional support in
the current study, and were reported as helpful by the African American participant. This

raises the question of whether a larger sample of African American female survivors

41

would also find fiiends and other informal sources as emotionally supportive or not. The
long history of the sexual exploitation of African American women would predict that
African American survivors of SV would have differing perspectives, coping strategies,
and help-seeking practices compared to non-Black women (West, 2002) . Thus, strong
connection and identification with Black culture (racial identity) may also impact
survivors SV experiences. It is clear that several questions regarding the help-seeking

behaviors of Afiican American women remain.

42

Chapter 5
Study Two African American Female Survivors of Sexual Violence: Emotional Social
Support, Racial Identity Development, and Psychological Help-Seeking Attitudes
Introduction and Literature Review

Sexual violence is an all-encompassing construct characterized by any unwanted
sexual activity forced by one person upon another, including rape (e. g. stranger, date,
acquaintance, marital, and gang), forced sodomy, child sexual abuse, and incest.
Incident rates of sexual violence (SV) vary, with estimates ranging from 1 out of 6
women to as many as 1 out of 3 women experiencing some form of SV in their lifetime
(Koss & Harvey, 1992; Tjaden & Thoennes, 2000; 1998; Ullman & Knight, 1992). More
alarming is the fact that many of these incidents go unreported, suggesting that the
available statistics may underestimate the actual number of women who have
experienced SV (Mahoney, 1999).

An examination of the short-term and long-term aftereffects experienced by
survivors provides initial insight in to the counseling needs of this population. Common
aftereffects include: shame, isolation, sexual inhibition, sleep disturbances, mistrust,
intrusive thoughts, dissociation, helplessness, feeling overwhelmed, feeling loss of power
and autonomy, fear, guilt, anxiety, impairment of concentration, depression, and an
exaggerated startle response (Delahunta & Baram, 1997; Foa, Rothbaum, & Steketee,
1993; Resick, 1993). Although it is plausible that psychological counseling contributes
to positive post-SV adjustment among survivors, there is limited research on this topic.
Neville and Pugh (1997) reported that counseling was associated with increased long-

term self-esteem among rape survivors. Moreover, Cohen and Roth (1987, as cited in

43

Neville & Pugh, 1997) observed that survivors who seek counseling may experience a
decrease in intrusive thoughts regarding SV. It was observed that survivors who sought
immediate counseling experienced less anxiety and depression as compared to those
survivors who delayed seeking treatment (Stewart, Hughes, Anderson, Kendall, & West,
1987). These studies illustrate that counseling may reduce symptomology related to SV
among women survivors. As such, these findings encourage the need for continued
research regarding help-seeking of SV survivors.

Research has minimally addressed the role of perceived emotional social support,
and help-seeking, particularly among African American female survivors. Perceived
emotional social support, defined as the belief that love, caring, sympathy, and
understanding are available from significant others (Thoits, 1995) may impact post-SV
adjustment. Overall, it has been suggested that SV results in the need for emotional
support, and survivors often turn to friends and family for this support (Golding et al.,
1989). Yet, African American women often fail to disclose their rape experiences to
others because they are fearful of receiving negative social support (Neville & Pugh,
1997). Where do Afiican American female survivors get help for incidents of SV if they
are unable to get emotional social support needs met?

An examination of racial identity development, the developmental process that
involves a person’s interpretation of racial information and his/her own attitudes and
behaviors towards his/her own racial group and other racial groups (Neville & Lilly,
2000) may provide insight into African American female survivor help-seeking. Previous
research has shown that differing racial identity statuses have different beliefs about help-

seeking (Austin, Carter, Vaux, 1990; Helms, 1995; Ponterotto, Anderson, & Grieger,

44

1986). Therefore, an exploration of racial identity and help-seeking will provide insight
in to the unique needs of Afi'ican American female survivors.

Incident rates of SV necessitate research in this area. It is highly likely that
practicing psychologists will encounter survivors experiencing some combination of SV
aftereffects, which supports the critical need for research in this area. Toward this end,
the following study examines the interrelationships among emotional social support,
racial identity development, and psychological help-seeking attitudes among female
African American survivors of SV. Valuable insight regarding the help-seeking attitudes
of women survivors of SV with a special emphasis on racial and cultural context will be
generated by this investigation.

Literature Review

The following literature review is organized into the following sections providing
information regarding interrelationships among emotional social support, racial identity
development, and help-seeking attitudes of female African American survivors of SV: 1)
historical context of Afiican American female victimization experiences; 2) incidence
rates of SV; 3) sexual harassment and racialized sexual harassment; 4) help-seeking and
help-seeking sources; 5) African American help-seeking and theoretical considerations
precluding help-seeking; 6) racial identity development; and 7) emotional social support.
Inconsistencies and gaps in the prior literature are identified, providing support for
continued research in this area.

Historical Context of Sexual Violence and African American Women
An examination of the historical context of African American women and SV

provides valuable insight into the current help-seeking behavior and attitudes, coping

45

behaviors, and reporting rates of African American female survivors of SV. Bodies of
literature examining stereotypes and assumptions related to African American women’s
sexuality (Collins, 2000; West, 2004), sexual harassment, and racialized sexual
harassment (Buchanan, 2005; Buchanan & Orrnerod, 2002; Martin, 1994; Texiera, 2002),
not only provide an important framework for understanding Afiican American female
victimization experiences, but also provide significant support for continued research in
this area. Additionally, a review of the literature captures the continued oppression and
exploited sexuality of Afiican American women at many levels.

Researchers have enumerated many factors as reasons contributing to the limited
research regarding mental health issues and psychological disorders among African
American women. Relevant factors include: misdiagnosis, financial constraints, and lack
of African American researchers (Neal & Turner, 1991), and investigations that combine
African American women with African American men or Caucasian females (Neal-
Barnett & Crowther, 2000). These factors affinn the necessity of continued research,
specifically regarding Afiican American survivors of SV.

Historical context of sexual violence. Current SV experiences are informed by
the historical sexual victimization experiences and enslavement of Afiican American
women. Davis (1983) provides a historical account of rape within the African American
community, describing the sexual assault of African American female slaves during the
1800’s as a demonstration of a slave owners property rights over Afiican American
people as a whole. The rape of Afiican American female slaves was a demonstration of
dominance and also fulfilled slave owners’ sexual urges (Davis, 1983). Such exploitation

also served to generate productive offspring, meaning the rape of slave women led to

46

racially nrixed progeny who were born enslaved. Slave women’s forced procreation was
the only way to increase the number of available slaves after their importation was
outlawed. Also, lighter slaves that were part Caucasian were more highly valued and
could bring higher prices at auction—making their rape not only a form of violence, but
an institutionalized means of generating wealth (Brownrrriller, 1975, as cited in Adams,
1997). Fredrick Douglass’s sentiment, as outlined by Adams (1997) asserted that African
American women were victims of forced prostitution, and void of rights. Nevertheless,
the myth that enslaved women were accountable for their sexual assault was perpetuated,
and the stereotype of the sexually promiscuous female slave shifted blame from slave
owners to African American women (hooks, 1981). This shift in blame from perpetrator
to victim has had a continual impact on the African American community, as evidenced
by the perpetuation of specific stereotypes for African American women.

Stereotypes and assumptions about African American women. Assumptions and
stereotypes regarding Afi'ican American female sexuality are profoundly impacting and
longstanding. Since the time of slavery, offensive labels such as Jezebel have been
assigned to describe African American women’s sexuality and infer that African
American women are promiscuous and libidinous. These derogatory descriptions have
served as rationale for the sexual exploitation and rape of African American female
slaves by white males (Neville & Hammer, 2001). As legal property, enslaved Afiican
American women were unable to seek legal justice for their experiences of SV. The
Jezebel stereotype inferred that Afiican American women were always welcoming and

wanting of sex, and white men were unable to resist and obligated to have sex with them.

47

Therefore, these experiences of victimization could not be viewed as rape, denying these
women the ability to identify as survivors of SV (Neville & Hammer, 2001).

The Mammy is a second pejorative stereotype associated with African American
women. An overweight, asexual, dutiful employee of a white family exemplifies this
stereotype (Adams, 1997). Society’s perception of a happy and compliant woman, often
attributed to this label, is historically inaccurate because it is derived from the time of
slavery, where women were savagely abused and raped (West, 2004). Out of economic
necessity, African American women continued to work as employees in domestic roles in
Caucasian households roles during the mid 19th century (Adams, 1997). These work
roles vastly contradicted the Caucasian perceptions of femininity associated with
Victorian times, which placed greater emphasis on home and family. In these working
roles, African American women continued to be perceived as explicitly sexual (Adams,
1997). These domestic roles may have reinforced the Mammy and Jezebel stereotype.

These stereotypes continue to exist. West (2004) attributes the continual
adherence to these stereotypes to the media’s unfavorable portrayal of Afiican American
women, specifically in domestic positions, which continues to exploit power differentials.
West (2004) offers the Aunt J emirna image as a recent example of this stereotype, citing
that positive characterizations of Afiican American women are greatly limited. Sexual
victimization histories of African American women and related pejorative stereotypes
have a significant impact on the current labeling of sexually violent behaviors, reporting,

and professional help-seeking of African American female survivors.

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Incidence of Sexual Violence

Although we know that as many as one-third of all women will experience some
form of SV in their lifetime (Tjaden & Thoennes, 2000; 1998), the research findings are
inconsistent regarding racial and ethnic differences in prevalence rates. Some researchers
argue that there are established racial and ethnic differences in the prevalence rates of
SV, yet these differences are rarely investigated (Neville & Heppner, 1999). Some report
that women of color are more than 1.7 times likely to be survivors of sexual assault
(Mcdermott, 1979 as cited in Howard, 1988) and Wyatt (1997) observed that African
American women are more likely to be sexual violated than women of other racial/ethnic
groups. In a study examining anxiety among Afiican American women, Neal-Barnett and
Crowther (2000) observed that 26% of the sample comprised of 50 women reported an
incident of sexual victimization post age thirteen. The sexual victimization rates in this
study were slightly higher than the National Violence Against Women Survey (Tj aden &
Thoennes, 1998), which revealed that 18.8% of Afiican American women experienced
rape at some point in their lives. These rates confirm the prevalence of SV among
Afiican American women, and given the earlier reported finding of psychological
problems associated with SV (e. g. depression, anxiety, PTSD, and low-self esteem), it is
evident that SV is a serious problem detrimental to the health of African American
women survivors.

Other investigations found no racial and ethnic differences in prevalence rates of
SV. For example, Wyatt (1992) found no disparity in the prevalence of rape among
Afiican American and Caucasian women. In a more recent study examining support for

the Culturally Inclusive Ecological Model of Sexual Assault Recovery (CIEMSAR),

49

Neville, Heppner, Oh, Spainerman, and Clark (2004) found similar rates of SV among 97
total participants, 47 identifying as African American and 52 identifying as Caucasian.

Disparities in prevalence findings may be attributed to sampling methods and
different operational definitions of SV. Wyatt (1992) used a community-based sample of
55 participants from the Los Angeles area recruited by random digit telephone dialing of
11,834 numbers. The Neville et al., (2004) study utilized random sampling and
snowballing from a predominately Caucasian Midwestem University. Differing
geographic locations and unique sample characteristics may limit generalizability of the
findings, and also provide possible explanations regarding differences in incident rates
between African American and Caucasian participants.

Inconsistent definitions of SV across studies may have also affected the detection
of the racial and ethnic differences in prevalence rates (George, Winfield, & Blazer,
1992). Use of different terminology may impact whether participants report SV. The
term sexual assault includes a wide array of behaviors that may or may not include sexual
intercourse, where as the term rape explicitly refers to sexual intercourse (George et al.,
1992). Wyatt’s (1992) investigation asked participants whether they had experienced any
form of sexual abuse, and those participants that responded “yes” were asked additional
questions using the term rape. Use of the actual rape definition in Wyatt’s (1992) study
as opposed to the term “sexual assault” or “sexual violence” may explain why a non-
significant difference between Caucasians and African Americans was reported. Afiican
American females may have felt that their incidents of SV did not fit the criteria of rape
used in Wyatt’s (1992) investigation. Neville et al., (2004) used the term rape to assess

victimization experiences, which may have limited some women from reporting incidents

50

of SV as such. Use of a less strict defrrrition of sexual assault in McDermott’s (1979, as
cited in Howard, 1988) study may explain the report of a racial and ethnic disparity in the
incidence of SV.

Broader definitions of sexual assault increase estimates of prevalence (George et
al., 1992). In diagnostic interviews conducted by Neal-Bamett and Crowther (2000)
African American women were more likely to use phrases like “he forced me to have
sex” as compared to using the label “rape” when discussing sexual victimization
experiences. This finding supports the earlier assertion that labeling of behavior may
impact reporting rates of SV, as Afiican American women may not label their
experiences of sexual victimization as rape. Future studies must incorporate an all-
encompassing definition of SV when attempting to assess whether racial and ethnic
differences exist concerning the prevalence of sexual violence. Regardless of these
inconsistencies in prevalence rates, African American women are experiencing sexual
victimization at an alarming rate, and with detriment to their physical and psychological
well-being (Neal-Bamett & Crowther, 2000; Delahunta & Baram, 1997; F oa, Rothbaum,
& Steketee, 1993; Resick, 1993).
Sexual Harassment and Racialized Sexual Harassment

Sexual harassment. Sexual harassment experiences of African American women
are worthy of consideration, because these experiences serve as an extension of the abuse
of power associated with the SV endured by enslaved women. The Equal Employment
Opportunity Commission’s (EEOC, 1980) guiding principles provide a framework for the
definition of sexual harassment that is used in the judicial system and in the relevant

literature. These guidelines indicate that sexual harassment may include the following

51

behaviors: gender harassment (e. g., assertions that women do not belong in certain
professions or college majors), unwanted sexual attention (more explicitly sexual
behaviors such as repeated requests for dates, lewd gestures, and attempts to touch or kiss
someone against his/her will), and sexual coercion (also called quid pro quo includes
performance-related threats or benefits that are intended to coerce sexual cooperation)
(Fitzgerald, Gelfand, & Drasgow, 1995; Gelfand, Fitzgerald, & Drasgow, 1995).

Compared to prevalence rates of SV, sexual harassment prevalence rates are
equally alarming. The literature denotes that as many as 1 out of 2 women may
experience some form of sexual harassment during her lifetime employment history
(Fitzgerald & Orrnerod, 1993). In one investigation using two samples, one comprised of
447 participants from a large corporation, and 300 participants employed at a large
university, 68% and 63% of the women, respectively, indicated that they had experienced
at least one incident of sexual harassing behavior within the past 2 years, as measured by
the Sexual Experiences Questionnaire (SEQ, Fitzgerald et al., 1988). The
aforementioned samples were comprised of predominately Caucasian participants, and
therefore may not be generalizable to the experiences of African American women.

Historical stereotypes of African American women impact their sexual
harassment experiences, and their labeling and reporting of such experiences. Given the
belief that they are sexually promiscuous, African American women often do not want to
draw attention to their being targeted with behaviors of a sexual nature, and may not want
to label their experiences as sexual harassment (Kalof, Eby, Matheson, & Kroska, 2001,
as cited in Buchanan & Orrnerod, 2002). This finding supports the notion that the

longstanding stereotype depicting African American women as overly sexual beings (The

52

Jezebel) continues to impact these women. In one investigation of 100 African American
women, 52% endorsed at least one item on the SEQ (Fitzgerald et al., 1998), yet 96% did
not define their experience as sexual harassment (Mecca & Rubin, 1999). This finding
supports the above assertion that Afiican American women may not define or label
experiences of sexual harassment as such. Adams (1997) posits that deciphering accurate
rates of reporting of sexual harassment experiences among women of varying ethnic
backgrounds is hindered as a result of the influence of respective cultural norms related to
labeling, reporting, and acceptance. This observation is comparable to the findings
concerning the significance of labeling of SV behaviors in research examining
victimization experiences of Afiican American women.

Power dynamics and bonds of oppression also influence reporting of sexual
harassment experiences of African American women. Power differentials between the
abuser and the victim may also preclude reporting (Adams, 1997). Specifically, this may
occur in the case where a female employee is being harassed by a male superior. The
shared historical experience of oppression for African Americans also creates an
additional dynamic for African American women sexually harassed by African American
men (Crenshaw, 1992, as cited in Adams, 1997). Reporting of sexual harassment
experiences may be suppressed in an attempt to protect Afiican American men, who have
endured centuries of racism (Bell, 1992). Women who break this “code of silence” risk
being shunned from the African American community, reinforcing the notion that racism
supersedes sexism (Bell, 1992). The highly publicized sexual harassment court case in
1991 of Anita Hill, an African American professor, against Clarence Thomas (who

sexually harassed her), an African American Supreme Court judge, is noteworthy. Many

53

people questioned Hills credibility because she failed to file a formal complaint against
Thomas at the time of the alleged harassment. As earlier addressed, when Hill broke the
“code of silence” her credibility was questioned.

Racialized sexual harassment. The significance of race within the context of
sexual harassment is an important construct that only recently has been explored. Mecca
and Rubin (1999) found that half of 100 African American women responded to an
inquiry about perceived differences in sexual harassment and indicated that there were
racial differences between their experiences and the sexual harassment experiences of
Caucasian women. Specifically, participants noted that sexualized racial stereotypes of
Black women (e. g. that they are promiscuous) factored into their experiences of sexual
harassment.

Buchanan and Ormerod’s (2002) qualitative study revealed a unique construct,
separate from both sexual harassment and racial harassment: racialized sexual
harassment. Thirtycseven African American females shared their experiences of
harassment via focus groups. The results indicated that participants were unable to
separate experiences of harassment as solely sexually or racially based, and as anticipated
by the researchers, participants reported varied dimensions of racialized sexual
harassment. Three dimensions of racialized sexual harassment were identified: 1) covert
(e.g., conflict with a white secretary in a lower position of power; 2) subtly overt (e.g.,
assumptions and stereotypes about Black women’s sexuality, such as “I bet you are slave
to sex.” —male co-worker to female co-worker); and 3) overt, which included blatant
integration of sexually and racially motivated harassment (e. g., comments about a

woman’s “Sexy black ass”). Direct allusions to the longstanding victimization

54

experiences of Afiican American women (e. g. slavery and sexually promiscuous
stereotypes) were evident (Buchanan & Onnerod, 2002). These findings indicate the
inclusion of racial and cultural variables is meaningful when examining victimization
experiences of women and also supports the assertion that sexual victimization
experiences of Afiican American women are impacted by the historical experiences of
African American female slaves.
Help-seeking and Identified Sources of Help

Help-seeking is generally conceptualized as a sharing of problems with others in
an attempt to receive aid, guidance, or assistance for problems causing distress (Goulash,
1978 as cited in Neal-Barnett & Crowther, 2000) and is termed mental health help-
seeking when it is psychological in nature (N eal-Bamett & Crowther, 2000).
Terminology related to mental health help-seeking is confirsing; psychotherapy and
counseling have been used in describing such behaviors. Some researchers view
counseling, also termed professional counseling, as a more brief intervention (up to 12-15
sessions) and infer that psychotherapy is more long-term (more than 12 sessions), with
the term therapy often used interchangeably with psychotherapy (Gelso & Fretz, 2001).
Psychotherapy has also been described as work with more distressed individuals that: 1)
attempts to restructure personality; 2) features in-depth examination; and 3) focuses on
analytic processes (Gelso & Fretz, 2001). A supportive environment with an emphasis
on situational events and conscious process defines the process of counseling (Brammer,
Abrego, & Shostrom, 1993). The more common combination of these events suggests

that counseling and psychotherapy can be used interchangeable (Gelso & Fretz, 2001).

55

The majority of available research relevant to survivors of SV focuses on the
different types of help-seeking available. Help-seeking sources identified and utilized
include police, emergency rooms, crisis centers, friends and/or family, and professional
sources of counseling. Discrepancies exist regarding how sources of help are utilized;
limitations of generalizability, differences in study methodologies, and sample
characteristics may account for these inconsistencies. Furthermore, investigations often
fail to delineate between the types of mental health services that survivors utilize.
Methodological limitations such as these make determining the help-seeking rates of
survivors difficult, particularly if one hopes to examine these rates in reference to specific
support sources.

The nature of the rape experience may also influence help-seeking behavior of
survivors such that survivors of stranger rape are more likely to seek help as compared to
survivors of acquaintance rape (Koss et al., 1988; Mahoney, 1999; Ullman & Siegel,
1993). One study using a probability sample of survivors in Los Angeles, California
found that 55% of survivors experiencing stranger rape sought help from a “professional
helper” whereas 30% of women assaulted by an acquaintance sought professional help
(Ullman & Siegel, 1993). In a non-random university sample, 3.1% of survivors raped
by an acquaintance, and 24% of women raped by a stranger sought crisis counseling
(Koss et al., 1988). Adaptive sampling, defined as sampling that systematically samples
locations in which the target population congregate, was used in a study of 102 survivors
from the Chicago area (Campbell, Sefl, Barnes, Ahrens, Wasco, & Zaragoza-Diesfield,
1999). Results revealed that 39% of these subjects utilized mental health care services

(Campbell, et al. 1999). Elsewhere it was observed that survivors are more likely to seek

56

help from medical doctors as compared to seeking help from mental health care providers
or victim assistance organizations (Koss, Koss, & Woodruff, 1991). Despite many
aftereffects associated with SV and the demonstrated need for psychological treatment,
survivors underutilize sources of help.
African American Help-Seeking Behaviors and Theoretical Considerations

General help-seeking behaviors of African American women appear to differ
from those of Caucasians. African American women are less likely to seek professional
counseling as compared to Caucasian women (VanHook, 1999; Wyatt, 1992; Sattler
(197 7, cited in Boesch & Cirnbolic, 1994). Instead these women use family networks
and fiiends (Chiang, 2004; VanHook, 1999), church organizations (Mattis, 2002;
Thompson et al., 2004), and alternative sources of coping (Chiang, 2004); only tuming to
more formal sources of psychological help when those initial sources of help are
exhausted (Siegel, 1994).

There are many contributing factors to why African American survivors may not
seek professional help for experiences of SV. Theoretical explanations for this lack of
help-seeking include: 1) Afiican American female attitudes towards SV; 2) African
American male attitudes towards SV; 3) attitudes towards help-seeking; 4) utilization of
alternative coping strategies; and 5) conviction rates related to SV.

African American female attitudes towards sexual violence. Afi'ican American
attitudes and beliefs about SV may influence their help-seeking experiences. It has been
noted in the literature that African American women survivors may believe that society
does not view them as true victims of rape (McNair & Neville, 1996; Wyatt, 1992) and

that others (family, friends, and society) will discount their experience as not “real rape”

S7

(McNair & Neville, 1996; Neville & Pugh, 1997; and Wyatt, 1992). Stereotypes
depicting African American females as being promiscuous and the African American
historical context of rape among female slaves may fuel this current belief among some
Afiican American women. As a result of these beliefs, African American women may
feel that society does not view African American females as plausible victims of SV
(Holzman, 1996; McNair & Neville, 1996;Wyatt, 1992) and therefore do not seek
counseling (Wyatt, 1992).

Attitudes towards SV provide insight into African American survivors’ help-
seeking behavior, such as the degree to which an individual ascribes to rape myths. Rape
myths are defined as a set of beliefs about rape that place blame on the victim and not the
perpetrator. Two common examples of rape myths are the idea that a woman who
dresses provocatively invites rape, and that women often falsely accuse men of rape
(Giacopassi & Dull, 1986). Acceptance of rape myths may support the lack of help-
seeking among African American female survivors of SV.

Earlier research posits that rape myth acceptance differs among African
American and Caucasians, and limited psychological help-seeking among Afiican
American female survivors of SV may be influenced by this rape myth acceptance.
Compared to Caucasian women, Afiican American women have been found to view
survivors of sexual assault as more blame-worthy, and are more likely to believe that
women cannot be forced to have sex against their will (Giacopassi & Dull, 1986). These
findings support the earlier discussed belief that Afiican American women do not view
rape as “real rape.” If African American female survivors believe that they cannot be

forced to have sex against their will and that their experiences do not constitute rate, help-

58

seeking attitudes may differ (Giacopassi & Dull, 1986). However, their findings have
been challenged recently.

Cannody and Washington (2001) investigated adherence to rape myths among
college women (178 Afiican American females; 445 Caucasian females), 34.3% of who
identified as survivors of sexual assault, and observed no significant statistical differences
in rape myth acceptance between Afiican American and Caucasian participants.
Additionally, the researchers observed no difference in rape myth acceptance among
survivors and non-survivors. Their results also support past findings that prior
victimization experiences do not impact rape myth acceptance. Interactive effects of race
and SES may explain disparities in the findings (Nagel, Matusuo, McIntyre, & Morrison,
2005). The length of time between the two studies (10 plus years) and an increase in
sexual assault awareness and prevention programs may account for some differences and
limit generalizability outside of a college (Carmody & Washington, 2001; Giacopassi &
Dull, 1986).

Other studies illustrate the possible impact of rape myths on help-seeking. It was
observed that individuals that have experienced SV or who are acquainted with a survivor
are less accepting of rape myths (Burt, 1980, cited in Anderson, Cooper, & Okamura,
1997). Beliefs that a woman is at fault and that SV is not a criminal behavior may
exacerbate the aftereffects of SV on Afiican American survivors and prevent them from
seeking helpful counseling. In a study comprised of 47 African American females and 52
Caucasian females ranging in age from 18-59 years of age, factors influencing rape
survivors’ self-esteem were examined. Participants were similar regarding demographic

and psychological features, and in general post-rape responses, yet differed regarding

59

cultural blame attributions (Neville et al., 2004). In this study, Afiican American
participants endorsed cultural attribution statements associated with the Jezebel
stereotype, and internalized the depiction of African American women as promiscuous as
a motive for why they were sexually assaulted (Neville et al., 2004). Additionally, the
findings revealed these cultural-blame attributions were associated with increased victim-
blame attributions. Women may not seek professional help because they view
themselves as blame-worthy and that the SV was their fault. Beliefs about how they
acted, dressed, or talked may prevent them from seeking help because they feel that these
factors brought on the SV.

African American male attitudes towards sexual violence. African American
males provide potential support as romantic partners or family members of a survivor,
which supports the examination of their attitudes towards SV. Their attitudes towards SV
may impact the help-seeking behaviors of African American female survivors. It has
been observed that Afiican American males, as compared to Caucasian males, agree
more strongly with the following rape myths: 1) that SV is an act of passion rather than
criminal behavior; 2) that females cannot be forced to engage in sexual activity against
their wills; and 3) and that females may often falsely accuse males of rape (Giacopassi &
Dull, 1986). Because of their inability to see rape as criminal behavior, African
American males may not believe African American female survivors’ claims of SV.

A recent study examining attitudes towards rape among males and females of
varying SES and race merits discussion. In a study of randomly selected participants
from a community sample comprised of 104 males and 101 females, it was observed that

African American males had less sympathetic attitudes towards female survivors as

60

compared to Caucasian males and females and Afiican American females. (Nagel,
Matusuo, McIntyre, & Morrison, 2005). However, the effect of race becomes
insignificant when SES and education are controlled for, suggesting that education and
SES are better at explaining variance in attitudes towards rape as compared to race.
Afiican American female survivors who internalize these messages may reaffirm their
own beliefs that their experience of SV was not a criminal act. Failure to recognize
incidents of SV as such and lack of sympathy from some African American males in their
lives may prevent African American female survivors from seeking the emotional social
support and psychological help needed to facilitate post-SV adjustment.

African American male attitudes towards domestic violence are also relevant
because historical stereotypes associated with African American female sexuality
continue to be endorsed by African American malesregarding justification of domestic
violence. Gillum (2002) investigated the link between male acceptance of negative
stereotypes of black women and violence against African American women. Two
stereotypes investigated included: 1) the matriarch, operationally defined as aggressive,
unfeminine, and emasculating; and 2) the jezebel, defined as sexually aggressive and
promiscuous (Gillum, 2002). The study was comprised of 221 African American male
participants with varied SES, education, and relationship demographics. The results
indicated that 48% of the sample accepted the Jezebel stereotype, 71% accepted the
Matriarch stereotype, and 33% endorsed both stereotypes. Endorsement of these
stereotypes was positively related to justifying domestic violence. Although this study

investigated domestic violence, it is likely that this relationship holds for other forms of

61

violence as well. Women may internalize these beliefs, fear that others will have similar
beliefs, and avoid seeking help as a result.

African American help-seeking attitudes. African American attitudes concerning
help-seeking vary. Some authors suggest that African Americans have favorable
attitudes regarding mental health care centers; yet often underutilize such services (Gary,
1987, cited in Thompson & West, 1992). While others have observed that Afiican
American’s have unfavorable attitudes towards help-seeking (Thompson et a1, 2004;
Chiang, 2004). A study utilizing 24 focus groups comprised of a total of 134 female and
66 male participants investigated African American community attitudes towards
psychotherapy and psychotherapists (Thompson et al., 2004). Participants were not
opposed to seeking treatment from mental health services, yet had several negative
attitudes and beliefs related to seeking services that ultimately precluded seeking
treatment. Participants identified schizophrenia, depression, substance abuse, SV, and
suicidal ideation as serious mental health concerns, warranting mental health services.
Substance abuse/dependence and SV were also seen as mental health issues necessitating
intervention. Participants preferred mental health service interventions that they viewed
as counseling (which is perceived as assistance and focused on problem solving) rather
than psychotherapy (perceived as unknown and more stigrnatizing), and also felt
counseling was less stigrnatizing. Another investigation found that African American
and Latino college students possess less favorable attitudes towards counseling and more
positive attitudes towards family and social support (Chiang, 2004).

An earlier study examining attitudes towards help-seeking is relevant. Using an

analogue design, 155 African American adult attitudes towards the need for treatment in

62

cases of rape were examined. The participants reported favorable help-seeking attitudes
(Thompson & West, 1992), and the findings indicate that Afiican Americans participants
were indeed aware of the need for psychological treatment in cases of sexual assault.
However, female participants did not recognize the short-term symptoms associated with
rape. Not recognizing the symptoms associated with SV may cause survivors to delay
seeking counseling (Thompson & West, 1992). It is also important to note that this was
an analogue study of hypothetical events; therefore this may not be indicative of whether
or not they would actually seek counseling if they experienced SV.

Several barriers to professional help-seeking among African Americans’ have
been identified. These include mistrust of law enforcement and medical professionals,
lack of access to health insurance, stigma associated with sexual victimization, concerns
that therapists may hold race-based stereotypes, and cultural beliefs such as desires to be
the strength of the family, cultural mandates regarding resolving family problems within
the family, and pride (Thompson et al., 2004). Noteworthy are the findings that indicated
that many African American women are less inclined to seek counseling services because
they need to remain strong, and seeking professional help may threaten their ability to be
the strength of the family (McNair & Neville, 1996; VanHook, 1999). Additionally, a
majority of participants in the Thompson et al., (2004) study supported the historical
belief that life would be difficult and that they must overcome all adversity, a sentiment
suggesting that if one cannot meet demands and challenges, seeking treatment is an
indication of weakness. These culturally relevant beliefs may influence help-seeking

attitudes, behaviors and intentions of African American female survivors.

63

Coping and non-traditional forms of help-seeking. Alternative coping strategies
commonly employed by African American women may preclude them from seeking
professional psychological help. Historically, Afiican American women have turned to
spirituality, prayer, biblical readings, and other religious practices to cope with
oppression and racism (Mattis, 2002). Other coping strategies identified include exercise,
hobbies, activities with family, religious activities, studying, and social activities
(Chiang, 2004), and mind/mood altering substances (Zeal-Bamett & Crowther, 2000).
Past research indicates that African American women turn to non-professional sources of
help in times of need (e.g., community elders, the Black religious community and prayer,
and beauty shops; Chiang, 2004, Mattis, 2002) and as a coping strategy for personal
problems, such as grief and loss, cancer, substance abuse recovery, and bipolar disorder
(see El-Khoury, Dutton, Goodman, Engel, Belarnaric, & Murphy, 2004).

Recent studies support the above findings. In a qualitative investigation
comprised of 23 African American women, eight themes emerged related to meaning-
making and coping with misfortune (Mattis, 2002). Most notably, content analysis
revealed that 70% of the participants recognized religion and prayer as the emotional
resource that promoted acceptance of reality, and 57% engaged in “spiritual surrender,”
described as “turning things over” to a greater authority (Cole & Argument, 1999, as
cited in Mattis, 2002), when uncertain how to cope (Mattis, 2002). Another investigation
examining sources of help among African Americans observed that religious participants
often turned to prayer and the church as resources, and were likely to address relationship
concerns with a church official (Thompson et al., 2004). In an investigation comprised of

324 African American women and 52 Caucasian women examining ethnic differences,

intimate partner violence, and the use of resources (medical, mental health, and spiritual)
it was observed African American women, as compared to Caucasian women, were more
likely to use prayer as a means of coping and less inclined to seek professional mental
health resources (El-Khoury et al., 2004). Because they are culturally accepted sources
of help, and are widely used by this population in times of need, Afiican American
survivors of SV may turn to prayer and religion as a source of coping, as opposed to
seeking more professional sources of help.

Avoiding is another adaptive coping behavior employed by African American
women. When examining anxiety and panic disorder among African American females,
Neal-Barnett and Crowther (2000) found that middle class African American women
were unlikely to seek professional help for psychological problems, and were only more
likely to seek professional help when relationship concerns or bereavement issues
elevated to crisis levels. Participants were able to recognize anxiety related issues as
problematic, yet still did not seek professional help. An analysis of diagnostic interviews
revealed two additional explanations for this finding. First, African American women do
not seek professional help because of the belief that anxiety is a part of being a Black
women and that as such they must “’keep on keeping on.”’ Second, the authors posit that
Afiican American women may recognize that anxiety is problematic, yet they choose not
to recognize such feelings because doing so will hinder their ability to function, and
denying such emotions is viewed as adaptive behavior (Zeal-Bamett & Crowther, 2000).
The practice of avoidant coping may prevent African American female survivors of SV

from seeking psychological help.

65

Other theoretical considerations. Disparate treatment by the legal and therapeutic
community may also prevent African Americans from seeking professional help. Neville
and Hammer (2001) assert that structural (political, economic, and social institutions) and
ideological mechanisms uniquely oppress African American women. Law enforcement
systems have engaged in longstanding discriminatory practices against people of color
(e.g., disproportionate arrests of Afiican Americans) which may suppress help-seeking
fi'om these institutions and increase victim-blame when the survivor is Black (Herman,
2003). Popiel and Susskind (1985) observed that participants in their sample experienced
victim-blaming responses from police regarding their experiences of SV.

Conviction rates of perpetrators of SV may not only contribute to low reporting
rates among African American survivors, but may also contribute to decreased
psychological help-seeking. Reporting rates that have resulted in conviction have ranged
from 2.5% to 19.85% (for complete listings see Sinclair & Boume, 1998). Court cases
involving SV rarely matriculate to the court room and if they do, non-guilty verdicts
reinforce and bolster rape-myth acceptance (Sinclair & Boume, 1998). For example, SV
committed by an acquaintance yields a lower conviction rate (Petersilia, 1994, as cited in
Sinclair & Boume, 1998). Past research revels that women of color are less likely to
have cases of SV pursued by the legal system (Campbell 1998; Razack, 1998), which
may discourage Afiican American women from using legal redress.

A final consideration involves the focus on individual counseling as a mode of
treatment. In many ways, the premise of this paper rests on the assumption that
traditional individual counseling is one of the primary intervention strategies for SV

survivors. However, values within African American culture may make other modes of

66

therapy more beneficial. For example, the focus on the community as a collective, rather
than an individualistic focus, and the use of extended kin networks (McAdoo, 1978), as a
source of support may be counter to the traditional dyadic therapy intervention. Taylor
(2000) suggests that group social support networks enable women survivors of intimate
partner violence to fluctuate between both individual and collective experiences,
providing an avenue for healing, and thus, may be more culturally-congruent for African
American women. Taylor (2000) posits that sharing experiences of violence in a group
of other African American women, also seeking self-healing and recovery, enables these
women to publicly share and disclose themselves and their partners, ultimate leading to
healing, and integration of their experiences at a social and personal level. Such an
experience of social and personal healing may not occur in a one-on-one counseling
experience.
Racial Identity Development

Examining racial identity deveIOpment may provide additional insight into the
help-seeking attitudes of African American survivors of SV. Racial identity development
refers to a developmental process that involves a person’s interpretation of racial
information and his or her own attitudes, cognitions and behaviors towards his or her own
racial group, other racial groups, and the majority culture racial group (Neville & Lilly,
2000). Cross (1971) proposed an initial model of racial identity that includes the
following four stages: preencounter, encounter, immersion-emersion, and internalization.
Different levels of Black and White culture identification characterize each of the stages.

The Racial Identity Scale, RIAS-B (also termed BRIAS, Helms & Parham, 1990)

is a widely used scale that uses four dimensions based on Cross’s (1971) model to assess

67

African American’s racial identity development. Healthy Black racial identity
development occurs when African Americans’ progress through the four stages and move
from initial negative feelings into more positive feelings about themselves, their racial
group and other racial groups. The first stage of conformity (pre-encounter) is
characterized by an individual’s internalization of racial stereotypes and an idealization
of Caucasians. At this stage Afiican Americans believe that they are inferior to
Caucasians. The second stage, dissonance (encounter) is characterized by an increased
awareness of racism, and a “pro-Black” attitude. The third stage of immersion/emersion
is characterized by an adulation of Blackness and a condemnation of Caucasian beliefs,
attitudes, and ideals. Internalization, the final stage, is characterized by an incorporation
of Black identity and greater respect for others (Hehns, 1990; Neville & Lilly, 2000).
Research examining African American racial identity development and help-
seeking attitudes has yielded inconsistent findings. The most favorable attitudes toward
counseling have been found among males and females in the internalization stage of
racial identity development, and it has been observed that males and females in the
internalization stage and females in the encounter stage rank friends and parents as
preferred sources of help (Ponterotto et al., 1986). These findings suggest that African
Americans at higher levels of racial identity development (internalization stage and
encounter stage) may be more inclined to seek help from friends, partners, and family as
opposed to seeking psychological services when experiencing SV. Another study
hypothesized that pre-encounter attitudes, where an individual adopts a majority culture
worldview, would be related to willingness to use psychological counseling services and

would also be related to more positive attitudes towards counseling (Austin et al., 1990).

68

It was observed that higher levels of pre-encounter attitudes are related to perceptions of
counseling being effective, and higher levels of internalization attitudes are related to
perceiving counseling as less effective. The authors posit that individuals identifying with
the internalization stage may need more information about the counseling process in a
manner that fits their cultural worldview to facilitate utilization of those resources (Austin
et al., 1990).

One’s racial identity development also relates to their mistrust of counseling.
Helms (1995) observed that Afiican Americans at the immersion/emersion status are
more likely to underutilize mental health centers on predominately Caucasian campuses,
as a result of general mistrust towards counseling staff. It was also observed in another
study that African American’s identifying with the immersion/emersion status prefer
counselors of the same race, and are more likely to utilize counseling centers if African
Americans are on staff (Want, Parham, Baker, & Sherman, 2004). Research also reveals
that higher endorsement of Dissonance/Anti-White ideals associated with the
immersion/emersion status is related to more negative problem-solving appraisals,
defined as lacking confidence and avoiding problems (Neville, Heppner & Wang, 1997).
This body of research suggests that African American female survivors at the
immersion/emersion stage are unlikely to seek professional help.
Emotional Social Support

Social support refers to a survivor’s belief that she is a cared for, loved, esteemed,
valued, and a member of a group or network that places value on mutual obligation
(Cobb, 1976, cited in Cwik, 1996). Friends, family, the community, and romantic

partners of the survivor are important sources of social support. Social support was

69

conceptualized in more specific terms in this investigation to address emotional aspects
of social support. Emotional social support has been defined as “demonstrating care or
sympathy toward another person; listening to someone or just being there when a person
needs a frien ” (Birch, 1998).

Most of the social support literature is conceptually focused, or evaluates
measures of general social support. Four types of social support have been discussed in
the general social support literature: informational, instrumental, appraisal, and emotional
(Birch, 1998; Tardy, 1985). Informational support refers to knowledge and providing
information; instrumental support refers to providing tangible help like money and
transportation; appraisal support refers to letting individuals know how they are doing in
the form of praise and feedback; and emotional social support refers to demonstrating
care or sympathy toward another person, listening to someone, or just being there when a
person needs a friend (Birch, 1998). Emotional social support also involves trust,
empathy, and love (Tardy, 1985). Perceived emotional support has been defined as a
belief that love and caring, sympathy and understanding and/or esteem and values are
available from significant others (Thoits, 1995). Some have suggested that SV results in
the need for emotional support (validation, and reassurance) and survivors are more
likely to turn to family and fiiends for this reassurance and validation (Golding et al.,
1989). Yet, only one empirical study examining perceived emotional support and
survivors exists.

Empirical research regarding social support, emotional social support, and
survivors is scarce. Golding et a1. (1989) investigated possible social support sources of

survivors. The results indicated that 2/3 of the participants disclosed the SV to others.

70

Of these, 59.3% told a family member or a friend, and 16.1 % told a mental health
professional (the second most frequently told source reported in this study). However,
although this investigation used a large random sample, it did not provide information
about satisfaction with social support sources or what type of social support was
provided. The investigation merely considered to whom survivors disclosed.

Only one investigation has examined the relationship between emotional social
support and SV survivors. Ullman (1996) examined whether social reactions to survivors
vary by support provider using a convenience sample of 155 survivor participants from
Los Angeles County. Emotional social support was hypothesized to be more common
among women telling friends and family members as compared to more formal sources
of support (e. g. police, rape crisis centers, mental health counselors). Emotional support
was associated with better survivor adjustment when received from fiiends as compared
to other support sources. It was observed that friends and family were indicated as most
helpful (60.3%) and mental health professionals were second most helpful (43.2%). The
survivors in this study reported more emotional support and validation from rape crisis
centers as compared to telling friends and family. The findings indicated that survivors
need to be encouraged to disclose and seek help from friends, family, mental heath care
providers, and rape crisis centers, as these sources of help have been found to be
beneficial in providing helpful responses to survivors (U llrnan, 1996).

Social support may act as a buffer against psychological effects of stress including
stress related to SV (Golding et al., 1989; Popiel & Susskind, 1985; Ruch & Leon, 1983).
Using a sample of 25 survivors, Popiel and Susskind (1985) examined social support as a

moderator of stress among rape survivors. All participants were assaulted within three

71

months prior to data collection. The sample was representative of national statistics
regarding age, weapon involvement, injury, and percentage of assaults completed, yet
their sample had a significantly higher rate of interracial assaults compared to national
statistics (Popiel & Susskind, 1985). Results indicated that female fiiends were most
supportive, support from boyfriends and husbands was ranked second (although support
from this source varied greatly across subjects), and female family members provided
more support as compared to male family members. Amount of perceived support varied
according to the stressfulness of the assault. Despite the finding that their adjustments
were equally difficult, survivors of completed rape received more support compared to
those survivors of non-completed rape. The researchers found that survivors found
providers of social support helpful, findings relevant to the current inquiry (Popiel &
Susskind, 1985).

One investigation examined social support and use of psychological services as
moderators on psychological distress, severity of physical symptoms, subjective health
ratings, and the use of medical services (Kimerling & Calhoun, 1994). It was observed
that survivors did not seek professional psychological services at any greater frequency
than women who were not survivors. Additionally, survivors confiding in friends and
family experienced less somatic symptoms associated with stress and were more likely to
perceive herself as healthy as compared to those who did not have strong social support
(Kimerling & Calhoun, 1994). Social support may impact post-SV adjustment, although
information regarding a more specific aspect of social support, emotional social support,

requires additional investigation.

72

The findings of Kimerling and Calhoun (1994) and Popiel and Susskind (1985)
have several limitations. Small sample sizes and urban location of both studies threaten
the generalizability of the findings. Popiel and Susskind (1985) studied survivors at three
months post- trauma, and their findings regarding social support may not be applicable to
Stu'vivors at differing times/stages post trauma.

Research examining the relationship between emotional social support and post-
rape adjustment is limited and outdated, and several questions remain unanswered
regarding the role of emotional social support for Afiican American survivors. It has
been observed that African American women fail to disclose their rape experience to
others because they are fearful of receiving negative social support (Neville & Pugh
1997). Although Neville and Pugh (1997) did not address emotional support specifically,
it is plausible that fear of receiving negative social reaction is similar to a survivor’s fear
of not receiving emotional social support, raising the question whether presence or
absence of emotional social support influences post-SV adjustment and help-seeking
among female Afiican American Survivors. Literature has minimally addressed how
emotional social support influences attitudes towards psychological treatment; a closer
examination of the role of emotional social support among survivors is required.

The question is raised whether African American female survivors view their
family members, partners, and spouses as emotionally supportive and as providing the
emotional support that they need in response to sexual victimization. More specifically,
does the survivor perceive that family members or their partner is willing and able to
discuss the survivors feelings related to the sexual violence?

Summary

73

Limited research in the areas of help-seeking, emotional social support, and SV
among women in general, and more specifically among African American survivors,
speaks to the need for continued research in this area. Previous research on SV has failed
to address racial identity development, despite its relevance to both the interpretation of
SV and to psychological help-seeking. The purpose of this preliminary investigation was
to examine interrelationships among racial identity development, emotional social
support, and help-seeking attitudes of Afiican American women survivors of SV.
Statement of Purpose and Research Questions

Existing research supports the importance of examining the impact of racial
identity development and emotional social support on psychological help-seeking.
However, to date, minimal attention has been given the potential interaction of racial
identity development and emotional social support on psychological help-seeking among
African American female survivors of SV. Accordingly, the following research
questions and hypotheses have been proposed within a population of African American
female survivors of SV:

1) Is there a relationship between emotional social support and psychological
help-seeking? This question is intended to be exploratory in nature, and as such, no
hypothesis is offered as this is one of the first investigations to explore perceived
emotional social support and help-seeking among Afiican American female survivors.
Research has demonstrated that general social support is positively related to help-
seeking, but the current investigation seeks to explore whether a specific form of social
support, emotional social support has a relationship with help-seeking among African

American survivors.

74

2) Is there a relationship between racial identity development and psychological
help-seeking? To test the role of racial identity development the following hypotheses
were proposed:

Hypothesis 2a: As racial identity development status becomes more consolidated,
(racial integration of ones Black identity and respect for others, associated with
identification with internalization status), survivors will have less favorable psychological
help-seeking attitudes.

Hypothesis 2b: As African American female survivors identify more with the
immersion/emersion status, they will have less favorable psychological help-seeking
attitudes.

3) Does emotional social support significantly contribute to the prediction of
psychological help-seeking above and beyond that of racial identity development? To test
the incremental validity of emotional social support, the following hypothesis was
proposed:

Hypothesis 3: Emotional social support will add incremental validity in the
prediction of psychological help-seeking attitudes above and beyond the effects of racial
identity.

4) Does racial identity development moderate the relationship between emotional
social support and psychological help-seeking? To test the incremental validity of the
effect of their multiplicative interaction above the additive contributions of emotional
social support and racial identity development together, the following research hypothesis

was proposed:

75

Hypothesis 4: The multiplicative interaction of emotional social support and racial
identity development will improve the prediction of psychological help-seeking above
and beyond the additive effects of emotional social support and racial identity
development.

To explore these questions, correlational analyses and a series of hierarchical
regressions for the four subtypes of attitudes towards seeking psychological help (N eed:
perceived need for professional psychological help, Stigma: tolerance of stigma
associated with receiving psychological help, Openness: openness about disclosing
personal problems, and Confidence: confidence psychological professionals to be useful
assistance) were conducted. First, the role of racial identity development was examined
in a regression model predicting each of the subtype’s related psychological help-seeking.
Second, emotional social support was added to the models above to determine the
incremental validity of emotional social support to each of the four types of help-seeking.
Finally, the contribution of the multiplicative interaction was added to the model
containing each of the main effects (RID and ESS) to determine if their interaction added

incremental validity to the model.

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Chapter 6
Methodology

Participants

The goal of this study was to explore racial identity development, emotional
social support and psychological help-seeking among adult Afiican American women.
There were four criterion for inclusion in this study. Participants had to: 1) be African
American, 2) be female, 3) be 18 years old or older, and 4) have experienced at least one
sexually violent event. To acquire a sufficient sample of women meeting these criteria,
253 surveys were collected, 108 of which met all four of the criteria for inclusion in the
study. Participants meeting criteria for inclusion ranged in age from 18 to 57 years old
(M = 22.16, SD=6.23). Approximately 79% of the participants were current college
students, 5.6% were college graduates, and 16.7% percent of the sample were currently
enrolled in or had completed graduate or professional school. Self-reported
socioeconomic status (SES) indicated that 9.3% of the sample identified their family as
lower SES, 28.7% as lower-to-middle SES, 39.8% were middle SES, 21.3% identified as
upper middle SES, and 1% identified as upper SES.
Procedure and Method of Recruitment

Participants were recruited to complete the survey hosted on an independent
website (herein described as the “subject pool” and “website pool,” respectively) via the
psychology subject pool of a large Midwestern university, email solicitations, and

respondent referrals (snowballing).

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Psychology subject pool. The sub-sample drawn fiom the university subject pool
consisted of 196 women, 79 of which met the four inclusion criteria. These participants
received course credit for their participation in this study.

Website subject pool. The survey was also available on an independent website,
resulting in a total of 57 participants, 29 of which met the study. Participants were
solicited by email from university and private sector organizations and by respondent
referrals. Targeted email and list-serve postings were used to over-sample Afiican
American women. These solicitations asked those interested in participating to contact
the investigator for the web address of the study and a unique password that provided
access to the survey. A unique respondent ID number was automatically and randomly
assigned to each subject, ensuring participant anonymity and confidentiality.

Preliminary analyses were conducted to compare demographic characteristics of
the two subject pools. T-tests revealed no statistically significant differences between the
university subject pool or the website subject pool participants for SES, but statistically
significant differences for age (t= 7.62 and p= .00), level of education (t= 13.61 and p=
.00), and trauma scores (F 2.72 and p=.001) were found.

Prior to starting the survey, participants from both recruitment sites were provided
with an overview of the study, and a consent form that outlined their rights as research
participants. After completion of the study, all participants were provided with a full
debriefing regarding the purpose of the study and they were also provided a list of
national and local resources. As compensation for their time, a $1 donation was made on
behalf of each participant to a women’s organization and, based on voluntarily provided

email addresses, participants were entered into a raffle to win one of four $50 prizes.

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Responses were automatically encrypted and stored on a computer server, which could
only be accessed by the researcher, and personal information was stored separately from
the data. Copies of the consent forms, survey, debriefing, and reference materials are
available in Appendices C-G.
Measures

Participants first completed a demographic questionnaire asking participants to
report their age, level of education and socioeconomic status. The Attitudes Towards
Professional Psychological Help-Seeking Scale (ATPPHS, Fischer & Turner, 1970) was
completed second. A sexual trauma history assessment (e.g., type of sexual violence,
length of time since the incident of sexual violence, degree and nature of the assault, and
whether they sought counseling, including the type of counseling sought) followed the
ATPPHS. The remaining measures were completed in the following order by all
participants: Social Support Questionnaire (SSQ, Sarason, Levine, Basharn, & Sarason,
1983), Feminism and the Women’s Movement Scale (FMW, Fassinger 1994), and Racial
Identity Attitude Scale (RIAS-B, Helms & Parham, 1990) (see Appendix G),

Help-seeking attitudes. Help-seeking attitudes represented the outcome variable
under investigation and was Operationalized as sexual violence survivors’ general
attitudes about seeking psychological help. Attitudes about counseling specifically refers
to general beliefs regarding counseling and seeking psychological treatment. The 29-item
Attitudes Towards Seeking Professional Psychological Help Scale (ATSPPHS; Fischer &
Turner, 1970) was used to assess this variable. This measure was developed to reflect
general attitudes towards seeking professional psychological help and uses a 4-point scale

(0= disagreement and 3=agreement) with higher summed total scores indicating more

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favorable attitudes towards seeking psychological help. Sample items include: “At some
future time, I might want to have psychological counseling” and “There is something
admirable in the attitude of a person who is willing to cope with his conflicts and fears
without resorting to professional help.” Test-retest reliability for 5 days and two months
were .86 and .84 respectively (Fischer & Turner, 1970).

The following mean scores and internal reliability estimates were observed for
the total ATSPPHS and its four subscales (need, stigma, openness, and confidence): total
summed score of the ATSPPHS (M=55.16, SD=10.96, a=.85), need (perceived need for
professional help) (M=15.21; SD=4.00, a=.71), stigma (tolerance of stigma associated
with receiving psychological help) (M=9.37; SD=3.09, a=.69), openness (openness about
disclosing personal problems) (M=13.59, SD=3.71, a=.63), and confidence (confidence
in psychological professionals to be useful assistance) (M=l6.82, SD=4.29, a=.68). The
coefficient alphas found for this sample are comparable to those reported by Fischer and
Turner (1970).

Sexual violence and trauma assessment. Trauma scores were generated by adding
the affrrrnative responses to behavior-based questions (out of a possible 7) to the
affirrnative responses to questions addressing the nature/degree of the SV (out of a
possible 8) for a total possible score of 15. The total score reflects the number of the
different kinds of experiences participants experienced, endorsement of attempted or
completed SV, and the severity of the attempted and/completed SV (M=3.80, SD=2.89).
Questions assessing different trauma experiences included: 1) Have you ever been hit or
grabbed by someone? 2) Has anyone ever tried to touch you without your consent? 3)

Has anyone ever touched you in a way that made you feel uncomfortable 4) Have you

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ever experienced forced touching that was sexual in nature? 5) Have you ever had
intercourse against your will? In addition to the behavior-based questions, two additional
questions assessing SV trauma were asked: 1) Have you ever experienced attempted
sexual violence (any attempted unwanted sexual activity forced by another person
including anal, vaginal, or oral penetration; stranger rape, acquaintance rape, date rape,
martial rape, gang rape, and/or incest)? 2) Have you ever experienced completed sexual
violence (see Appendix G)? For these two final questions participants were asked to
denote whether they experienced the following by the assailant: 1) verbal threats; 2)
threats to use a weapon; 3) threats to use physical force; and 4) physical force (e.g.
punching or choking).

Perceived emotional social support. The Social Support Questionnaire, SSQ,
developed by Sarason et al., (1983) was used to assess participant perceptions of social
support. Research indicates that this measure addresses emotional social support (Tardy,
1985), such as the availability of and satisfaction with the support they received from
others. The measure lists 27 items (e. g., “Who accepts you totally, including both your
worst and best points?” and “Who will comfort you when you need it by holding you in
their arms?”) and participants list the name of someone who provided that form of
support. Participants then rate their satisfaction with the support received for each
statement using a 6-point rating scale ranging from 1=”very satisfied” to 6=”very
dissatisfied.” The availability of social support is calculated by dividing number of
people providing support by number of items (27) and has a four-week test-retest
reliability of .90 (Sarason, 1983). Participant satisfaction with social support is

calculated by dividing the summed score of overall satisfaction received for each item by

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the number of items (27). Scores of the two subscales were aggregated to provide a total
perceived emotional support score (M=7.65 SD=2.26, a=.97).

Because the SSQ does not address those who were not helpful, an additional item
was added which asked, “Who was not helpful in regards to your experience of sexual
violence?” This item was modeled after the SSQ questions, such that participants were
asked to provide the initials of those who were not supportive and their relationship with
that person. For this added item, space was also permitted for additional comments and
for participants to state whether these individuals were later found to be helpful.

Attitudinal scale. Fassinger’s (1994) Feminism and the Women’s Movement
Scale (F MW) was used as an additional attitudinal measure. This measure was not the
focus of the analysis, but was included to deflect the oddity of the use of the one racial
attitude scale (RIAS-B, Helms & Parham, 1990) and to make the point of the survey less
obvious. The FMW consists of 10 items measuring affective attitudes towards the
feminist movement on a five-point likert-like scale (1=strong disagreement and 5=strong
agreement). Sample items include, “The leaders of the women’s movement may be
extreme, but have the right idea,” and “I am overjoyed that the women’s liberation is
finally happening in this county.” Fassinger (1994) reports for her sample an internal
reliability estimate of a=.89 (.90 for men, .86 for women).

Racial identity development. The 50—item Racial Identity Attitudes Scale RIAS-
B, long-fonn (Helms & Parham, 1990) is based on Cross’s (1971) model of racial
identity development and was used to assess participants’ agreement with each of four
stages (referred to as status) of racial identity development: conformity (preencounter),

dissonance (encounter), immersion-emersion, and internalization. This measure

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examines an individual’s interpretation of racial information and his or her own attitudes,
cognitions and behaviors towards his or her own racial group, other racial groups, and
those of the majority culture (Neville & Lilly, 2000). Conformity (M=2.09, SD=.47,
a=.80) is the equivalent of Cross’s preencounter stage and is typified by pro-white and
anti-black attitudes (e.g., “I feel Black people do not have as much to be proud of as
White people”). Dissonance (M=2.69, SD=.58, a=.55) represents racial confusion and
commitment to explore Black racial identity (e.g., “I am determined to find my Black
identity.”). Immersion-emersion M=2.59, SD=.52, a=.7l) represents pro-Black and anti-
White attitudes, sample item: “I believe that everything that is Black is good, and I limit
myself to Black activities. Internalization (M=4.05, SD= .4127, a=.67) represents the
internalization of positive Black identity sample item: “I feel good about being Black, but
not limiting myself to Black activities.” For each subscale, participants responded using
a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). Items were
summed such that higher summed scores represent greater identification with the status.
The majority of the sample identified with the internalization status of the BRIAS
(n=100), 5 identified with the encounter stage, and 3 participants had identical high
scores on 2 or more subscales. The coefficient alphas found in this study are comparable
to the reliability reported by Helms (1990).

Confounds and covariates. Possible confounding variables were considered in the
analyses. Trauma history varied for each of the participants, including the nature of the
violence, and degree of force used. Given these variations, these variables were
controlled in the regression analyses. Socioeconomic status, SES, represented a second

confound/ covariate impacting general help-seeking attitudes. Thus, SES was controlled

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in the data analyses. Low SES has been identified in the literature as a factor associated

with reluctance to seek professional psychological help (Tessler & Schwarts, 1972).

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Chapter 7
Results

Table 1 displays the correlation matrix, means, standard deviations, and internal
consistency reliability estimates for the variables under study. Trauma and openness to
disclosing personal problems were significantly and positively correlated (r=.24).
Indicating that as women reported more trauma they were more open to disclosing
personal problems. A significant and negative relationship existed among openness to
disclosing personal problems and Preencounter attitudes (r=-.21) and among
immersion/emersion attitudes (r=.-24). As women endorsed less pro-white/anti—black
(preencounter) attitudes, women were more open to disclosing problems. Additionally,
as Pro-Black/anti-White (immersion/emersion attitudes) identification decreased,
participants reported more openness to disclosing problems. There was a significant
inverse correlation among preencounter attitudes (pro-white/anti-black attitudes) and
perceived need for professional help (r=-.30). As women reported less pro-white/anti-
black attitudes they reported a greater perceived need for professional help.

Significant correlations were observed among tolerance of stigma associated with
receiving psychological help and several predictor variables. A significant inverse
relationship existed for tolerance of stigma associated with receiving psychological help
and two of the racial identity statuses: encounter and immersion/emersion. As women
reported less encounter attitudes (characterized by racial confusion and commitment to
explore Black racial identity), they reported more tolerance of stigma associated with
receiving psychological help (r=-.21). Additionally, as Irnmersion/Emersion attitudes

(pro-black/anti-white) decreased, tolerance of stigma related to psychological help

85

increased (r=-.20). A positive correlation between social support and tolerance of stigma
associated with receiving psychological help was also significant (r=.20). Specifically, as
women reported more satisfaction and availability of social support, tolerance of stigma
associated with psychological help-seeking increased.

Multiple Regression

Four hierarchical multiple regressions were used in this investigation, one for
each of the four subscales of the ATSPPHS (Need, Stigma, Openness, and Confidence).
Data were entered in the following order for each of the four subscales of the ATSPPHS.
Trauma scores and SES were entered as control variables in block 1. In block 2, each of
the 4 RIAS-B subscale scores was entered as a block (to test the main effect of racial
identity development). Scores from the SSQ were entered at step three. At step four the
interaction of each status of racial identity development multiplied by the social support
score was entered as a block (to test the multiplicative interaction). To reduce
multicollinearity, the continuous predictors (SSQ, perceived emotional support; racial
identity subscales: preencounter, encounter, immersion/ emersion, internalization) were
centered before computing interaction terms (Aiken & West, 1991). The centered scores
for social support and each racial identity development status were multiplied to create 4
interaction variables.

For each analysis, the models were examined to determine their contribution to
explaining additional percentages of variance. The significance level of the beta weights
of the subscales for the RIAS-B were examined to determine which of the racial identity
subscales (i.e. Preencounter, Encounter, Immersion-Emersion, or Internalization)

significantly contributed to the variance explained in the dependent variable, the

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ATPPHS subscale. Despite the possibility that multiple analyses can inflate Type 1 error,
a Bonferonni’s correction was not utilized, because statistical corrections are not essential
when analyses are pro-determined (Pemeger 1998). Standardized regression coefficients
([3), which speak to effect size, and R2 , a measure of the strength of the relationship, are
provided in an attempt to minimize Type II errors when interpreting null results (Cohen,
1988). Statistical assumptions regarding data normality, multicollinearity, and
homoscedasity of residuals were all met.

Tables 2 and 3 provide the results for the hypotheses related to the four research
questions. One of the exploratory purposes of the study was to examine the relationship
between emotional social support and psychological help-seeking (research question 1).
However, as seen in tables 2 and 3, emotional social support, entered at step 3, did not
account for any additional significant portion of explained variance in any of the
regression models. However, in the regression models examining the stigma subscale
(tolerance of stigma associated with receiving psychological help) the contribution of
emotional social support was significant. These results reveal that there is a relationship
between tolerance of stigma associated with help-seeking and emotional social support
such that as emotional social support increases, tolerance of stigma associated with
receiving psychological help increases. Finally, hypothesis 3, which posited that
emotional social support would add incremental validity above and beyond the effects of
racial identity was not supported, suggesting that emotional social support does not
predict help-seeking attitudes related to the four subscales beyond that of when racial

identity has already been accounted for.

87

Research question 2 inquired about the relationship of racial identity development
and help-seeking attitudes among Afiican American female survivors of SV. Hypothesis
2a, which speculated that as racial identity development consolidates (identification with
internalization status), attitudes towards psychological help-seeking attitudes become less
favorable, was not supported. Hypothesis 2b, which posited that African American
female survivors identifying with the immersion/emersion will have less favorable
psychological help-seeking attitudes was partially supported. Racial identity
development, lower status identification predicted statistically significant amounts of
variance in 2 of 4 of the help-seeking subscales: Openness (openness about disclosing
personal problems), and Need (perceived need for professional psychological help).
Hypotheses 3 and 4 were also not supported, such that emotional social support was not
found to add statistically significant incremental validity above the effects of racial
identity development. Additionally, a multiplicative interaction of emotional social
support and racial identity development was not statistically significant.

Openness. The adjusted R2 , a conservative estimate considering the small sample
size (Tabachnick & Fidel], 2001), indicates that the RIAS-B explained 11.2% of the
variance in the openness (openness about disclosing personal problems) subscale, F
(6,101) = 3.24, p < .05, with Immersion/Emersion significantly contributing to the
amount of variance explained, B: -.30, t (101) = -2.51,p< .014. Trauma scores also
significantly contributed to the amount of variance explained: beta = .23, t (101) = 2.48
p<.015 (see Table 2). Lower immersion/emersion attitudes and higher trauma scores were

associated with stronger openness about disclosing personal problems.

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Need. The adjusted R2 indicates that RIAS-B scores explained 6.5% of the
variance in the need (perceived need for professional psychological help) subscale, F
(6,101) = 2.23, p < .05, with Pre-encounter significantly contributing to the amount of
variance explained, 13: -.26, t (101) = -2.430, p< .017 (see Table 3). Lower pre-encounter
attitudes were associated with a stronger perceived need for professional psychological
help.

Stigma and confidence. None of the models for the remaining two help-seeking
subscales were found to be statistically significant. Additionally, no simple effects for
racial identity attitudes were found in the two remaining ATPHSS subscales (see table 3):
stigma (tolerance of stigma associated with receiving psychological help) and confidence
(confidence in psychological professionals to be useful assistance).

Emotional social support x racial identity development. Hypothesis 4 asserted that
the multiplicative interaction of emotional social support and racial identity development
would improve the prediction of psychological help—seeking above and beyond the
additive effects of emotional social support and racial identity development. Analyses
revealed that the interaction terms (comprised of emotional social support and each of the
4 subscales of racial identity development) did not explain additional variance for any of
the help-seeking subscales, indicating that this hypothesis was not supported.

Trauma Responses

The mean of trauma scores was 3.80 (SD=2.89). This mean does not reflect the
number of SV experiences participants encountered, but reflects responses to behavior-
based questions. Participants’ responses to questions assessing prior physical trauma and

sexual violence revealed that: approximately 60% of the sample indicated that they had

89

been aggressively hit or grabbed by someone; 55% responded that someone had tried to
touch them without their consent; 71% responded that someone had touched them in a
way that made them feel uncomfortable; 46% responded that they had experienced forced
touching that was sexual in nature; and 16% responded that they had sexual intercourse
against their will. Participants were also asked to respond to questions that used a more
global label: sexual violence, and 27.8% responded that they had experienced attempted
SV, and 16% responded that they had experienced completed SV. Regarding
experiencing attempted SV, 12% of the sample reported that they experienced verbal
threats, 1% reported threats to use a weapon, 11% reported threats to use physical force,
and 19.4% reported the use of physical force. Regarding completed SV, the sample
reported experiencing the following: verbal threats (8%), threats of use of a weapon
(1%), threats to use physical force (6.5%), and the use of physical force (11%).

When assessing familiarity with assailant, it was observed that a small percentage
perceived the assailant as a stranger, and many denoted “other” as their level of
familiarity. Regarding the question assessing attempted SV, 81 participants responded,
with 1.1% indicating a stranger, 19.1% indicating an acquaintance, 11.2% denoting a
romantic partner, 2.2% indicating a spouse, and 66.3% noting “other” as the assailant.
Familiarity with the assailant concerning completed SV was reported by 81 participants:
2.5% noted stranger, 12.3% indicated acquaintance, 4.9% reported romantic partner, and
80.2% reported “other” as the assailant.

Reported Help-Seeking
Help-seeking behaviors varied by the type of sexual violence participants

experienced. Women who experienced attempted SV reported the following help-

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seeking behaviors and sources for help: 4.6 % sought help from a private therapist, with
(1%) utilized crisis counseling (4 or fewer sessions), 2.8% utilized short-term counseling
(5-12 sessions), and 1% used long-term counseling (13 or more sessions). One percent of
the sample utilized an Employee Assistance Program and Rape Crisis Center for short-
terrn counseling. Approximately 2.8% of the sample sought help from a University
Counseling Center for short-term counseling, and none of the participants sought help
from a Community Mental Health Center or Veterans Administration. Approximately
6% sought help from another source, which included: a close fiiend, an adult fiiend, a
friend who is a therapist, God, Jesus, and their mother.

The following help-seeking behavior was reported in response to incidence of
completed SV. Approximately 4% of the sample sought help from a private therapist,
with 2% of those participants utilizing short-term counseling, and 1% utilizing both crisis
and long-tenn counseling. None of the sample utilized an Employee Assistance Program
or Veterans Administration. One percent of the sample sought help from a Rape Crisis
Center and University Counseling center, and utilized crisis counseling at these sources.
One percent of the sample sought help from a Community Mental Health center, and
engaged in both crisis and long-term counseling. Two percent of the sample reported that
they sought help from other sources, which included a close friend and God.

Who Was Not Helpful

Website participants had the opportunity to provide information conceming who
was not helpful surrounding their incidents of SV. Seven participants responded to this
inquiry and varied in both the number of people who were not helpful to them and the

people they listed as being unhelpful. Three listed one person as unhelpful, another 3

91

listed two people, and one stated that four people were not helpful. Participants listed
parents, other family members, romantic partners, therapists/counselors, fiiends, and

religious persons when naming those who were not helpful.

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Chapter 8
Discussion

Results indicate that racial identity status is significantly linked with help-seeking
attitudes among African American survivors of SV. Greater identification with Caucasian
ideals and racial stereotypes was associated with greater perceived need of psychological
help, and greater tolerance of stigma associated with receiving such help. Additionally, as
SV trauma scores increase in conjunction with greater identification of Caucasian ideals,
African American survivors are more inclined to disclose personal problems.

The primary purpose of the study was to explore the emotional social support and
help-seeking attitudes of African American survivors of SV. It was hypothesized that
emotional social support would add statistically significant incremental validity beyond
the effects of racial identity development. Despite the lack of support for the hypothesis,
the findings of this investigation generate valuable preliminary insight regarding
emotional social support and African American female survivors of SV. African
American women in this study may not have found informal sources, such as parents and
family, as providing of emotional social support. This finding may be explained in terms
of historical stereotypes associated with Afiican American women. Researchers posit that
stereotypes associated with African American women’s sexuality may result in less
support from community members (U llman and Filipas, 2001). African American
women survivors may believe that society does not view them as true victims of rape
(McNair & Neville, 1996; Wyatt, 1992) and that others (family, fiiends, and society) will
discount their experience as not being a “real rape” (McNair & Neville, 1996; Neville &

Pugh, 1997 ; and Wyatt, 1992). Stereotypes depicting African American women as

93

promiscuous, in conjunction with the historical sexual exploitation female slaves being
commonplace and legal may firel this current belief.

The second explanation for this finding may relate to cultural interpretations of
emotional social support. Ullman and Filipas (2001) hypothesized that assessments of
social support may find that ethnic minority women receive less emotional support fiom
informal sources because of differing conceptualizations and perceptions of the definition
of emotional social support. The definition of emotional social support in current
assessment instruments may reflect “westernized” ideals and may not represent ways in
which African Americans support one another. The lack of satisfaction with informal
sources of emotional social support combined with the results of this study is concerning.
Taken together, these findings suggest that African American female survivors may not
be getting the post-SV support they need, formally or informally. The results of this
study indicate African American survivors are unlikely to seek support from formal
sources, such as therapists and counselors, causing one to wonder how these survivors
will recover if the adequacy of their support is insufficient.

Although inconsistent with the proposed hypotheses regarding racial identity
development, the hierarchical multiple regression analysis revealed statistically
significant findings regarding the relationship among status of racial identity and
survivors’ psychological help-seeking attitudes. Lower immersion/emersion scores and
higher trauma scores were related to openness about disclosing personal problems within
a traditional therapy setting. The fact that increased trauma does not lead to a decrease in
willingness to disclose problems is a surprising finding, given the possible consequences

that survivors may face as a result of sharing multiple experiences of trauma. Increased

94

trauma may create more opportunities for others to send victim-blaming messages.
Further, often SV is intra- rather than interracial, increasing the likelihood that the
assailant was also the same race, which may cause survivors to protect the larger
community by not reifying stereotypes of Afiican American men as sexually violent
(West 2004). These two factors would appear to suppress disclosure, making it surprising
that survivors reporting more trauma were more willing to disclose. Hypothesis 2b,
posited that Afi'ican American female survivors identifying with the immersion/emersion
status will have less favorable psychological help-seeking attitudes. The
immersion/emersion stage of racial identity development is characterized by an adulation
of Blackness and a rejection of Caucasian beliefs and attitudes (Helms, 1990; Neville &
Lilly, 2000). The current findings suggest that greater identification with Caucasian
beliefs, ideals, and attitudes is associated with a greater willingness to disclose personal
problems. Otherwise stated, a decrease in identification with the immersion/emersion
status will be related to more favorable attitudes conceming openness to disclosing
personal problems. This finding is consistent with previous research findings (Neville,
Heppner & Wang, 1997). For example, higher immersion/emersion status and
endorsement of anti-White ideals was found to be related to more negative problem-
solving appraisals, which the authors defined as having less confidence in their problem-
solving abilities and avoiding problems as a result (Neville, Heppner, & Wang 1997). In
the current sample, survivors who endorsed less Dissonance/anti-White ideals, were more
open to professional help and perhaps more likely to receive it as a result.

It was also observed that lower pre-encounter scores were associated with a

stronger perceived need for professional psychological help. The pre-encounter stage is

95

characterized by an individual’s internalization of racial stereotypes and an idealization
of Caucasians (Helms, 1990; Neville & Lily, 2000). Lower pre-encounter scores suggest
that less Afiican American-centered values, characterized by greater internalized
stereotyping and identification with Caucasian culture, leads to greater recognition of
psychological help. This finding implies that African American survivors may be
impacted by the historical context of counseling as a White profession, suggesting that
the more one identifies with white culture, the more likely one is to seek counseling.

Despite a significant and positive correlation among emotional social support and
tolerance of the stigma associated with receiving psychological help, the relationship
between emotional social support and psychological help-seeking attitudes was not
significant in the regression models. Similarly, Neville et al., (2004) found no
relationship between social support and psychological adjustment, which invites the
question of what happens to the women who do not seek psychological help?
Factors Facilitating and Inhibiting Labeling

Research indicates that Afiican American women are less likely than Caucasian
women to classify sexually violent incidents as rape or sexual assault (Holzman, 1997;
Neville & Pugh, 1997; Wyatt, 1992), which is consistent with the results found here. In
the current study, almost half of the respondents experienced forced touching that was
sexual in nature (which constitutes SV), yet only slightly more than half of this group
labeled their experience as attempted SV and only a third of the group labeled it as a
completed SV. Rather than labeling these incidents as SV, the women in this study felt
more comfortable disclosing their experiences when questions were behaviorally-based

rather than using the term “sexual violence.” SV may be a term that respondents are

96

reticent to use, similar to the findings on the use of “rape” and “sexual assault.” This
finding has important implications for future studies and survivor assessments in clinical
and legal settings. Specifically, researchers and practitioners are likely to obtain a more
accurate assessment of SV if they allow survivors to label their own experiences, instead
of providing those labels for them. Such practices will enable emphasis to be placed on
the sequalea associated with the behaviors, opposed to the labeling of behavior.

Other factors may contribute to participants’ reluctance to label their experiences
as SV. One such factor is whether or not the survivor knew the assailant. Research has
found that when the assailant is someone a woman knows, survivors are less likely to
label vaginal, oral, or anal intercourse as rape (Kahn et a1, 2003). Only a small
percentage of women reported a stranger as the assailant in this study and being assaulted
by an acquaintance may have inhibited their willingness to label such behaviors as SV.
The degree of force used by the assailant may also impact participants’ labeling of SV as
such. Past findings indicate that survivors experiencing force during SV are more likely
to label the experience as rape (Bondurant, 2001; Koss & Dinero, 1989). In this sample,
use of physical force was uncommon and it is possible that this hindered women from
labeling their experiences as SV. Finally, use of alcohol during the SV experience is
another factor that may have impacted participants’ labeling of their experiences as SV.
The research reveals that women who report intoxication at time of a sexual assault are
less likely to label the assault as rape (Kahn & Mathie, 2000, as cited in Kahn et al.,
2003). In this study alcohol consumption was not assessed, but if labeling SV is similar
to the labeling of rape, it is possible that women were unlikely to label an experience as

SV if inebriated at the time.

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Reported Help-Seeking

The extant literature suggests that 30% of SV survivors enter psychotherapy as a
result of their trauma (Miller & Cohen, 1995; George, Winfield & Blazer, 1992), but the
rates of psychological help-seeking among women in this study were lower than these
estimations would suggest. Of the participants reporting attempted SV, approximately
8.4% sought counseling from a private therapist, Employee Assistant Programs (EAP’s),
or a university counseling center. Among participants reporting completed SV, 6%
sought counseling from a private therapists, rape crisis center, and/or community mental
health organization.

The differences between previous research findings and the current study may be
related to racial and ethnic differences between these participants and those of earlier
investigations. Previous estimations are intended to be general across all SV survivors,
but are based primarily on Caucasian samples (e.g., Miller & Cohen, 1995; George,
Winfield & Blazer, 1992), while this study is comprised solely of Afiican American
survivors. Researchers posit that African American women remain silent about their
victimization experiences to protect families and themselves (Ritchie, 1996; and Collins,
1998). Collins (1998) asserts that Afiican American women may feel conflicted between
their own self care (e. g., seeing a therapist) and the values of the black community, which
may discourage sharing experiences of sexual violence, particularly with out-group
members. If the perpetrator is an Afiican American man the “code of silence” may be
even more strictly enforced, with dire consequences for those who chose to disclose such
events. The confirmation hearing of Supreme Court Judge Clarence Thomas and the

treatment of Dr. Anita Hill (a woman he sexually harassed) is one example of the

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negative treatment a Black woman may face if she breaks this code. In addition, women
may remain silent out of a desire to protect African American men because of the history
of racism they have faced (Bell, 1992) and to avoid reinforcing stereotypes of black men
as sexually violent predators (Adams, 1997).

There has been a long-standing tradition of viewing Black women as strong and
independent, which has often been a source of pride (McNair & Neville, 1996; VanHook,
1999). Seeking psychological help may threaten these internalized self-schemas and their
ability to be a source of strength for their families; making them less inclined to seek
counseling services (McNair & Neville, 1996; VanHook, 1999). Under such
circumstances, denying negative emotions, such as depression or anxiety, has been an
adaptive coping strategy among African American women (Zeal-Bamett & Crowther,
2000). Use of denial and avoidance may be protective because they allow women to
function in times of adversity, but they may also prevent them from seeking needed
psychological assistance.

Participants’ help-seeking behaviors may have been inhibited for some of the
same reasons women did not label their experiences as SV. In addition to cultural
considerations, factors such as being unaware of SV symptomology, having negative
attitudes towards seeking services, labeling experiences as a SV or not, and experiencing
greater force during the SV may have impacted help-seeking. In a study of African
American women, participants were aware of the need for psychological services
following sexual assault, but often did not recognize the short-term symptoms associated
with sexual assault and trauma (Thompson & West, 1992). In the current sample, it is

possible that the women had favorable attitudes regarding psychological help-seeking,

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but did not pursue psychological services because they did not associate their symptoms
with their experience of SV. Negative attitudes and beliefs regarding the cultural
sensitivity of psychologists may also hinder seeking treatment (Thompson et al., 2004).
Most notably, the focus group members in their study viewed psychologists as being
largely absent from community education and outreach in the Afiican American
community. Additionally, focus group participants also indicated concern about a highly
educated Caucasian’s ability to understand and relate to their experiences. To the extent
that participants in this study also held such attitudes, they may have contributed to help-
seeking avoidance.

Problem severity is a factor influencing treatment-seeking among African
American women (Thompson et al., 2004). Not labeling experiences as SV may impact
help-seeking because participants may not recognize its severity or see the need for
treatment. In this study, help-seeking was assessed in response to the terms “attempted
SV” and “completed SV” as opposed to assessing help-seeking in response to the specific
behavior-based questions. Given the discrepancies in responses regarding labeling of SV
behavior with formal terminology or behavior-based items, it is possible that asking this
information with the latter would have changed the findings.

Assailant characteristics and the presence of physical injury (not assessed in this
inquiry) have also been found to impact help-seeking behaviors. In a study examining
323 SV survivors, 26.1% of which were Afiican American, it was observed that the
presence of physical injury and greater perceived threat made women more likely to seek
help from various sources, including mental health professionals (U lhnan and F ilipas,

2001). The researchers posit that an unknown perpetrator and visible injury generate

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legitimacy for survivors seeking help, as both function as objective evidence that can be
seen by help sources. In the current study, few women reported threats of force or
assaults by strangers, which may have inhibited their help-seeking and increased their
fear that they would not be viewed as legitimate survivors. Consistent with this theory,
women sexually assaulted by a stranger were 78% more likely to use formal support
sources as compared to women assaulted by acquaintances (57.6%).

Participants’ degree of racial identification may have contributed to the low rates
of psychological help-seeking among this sample. The majority of the sample identified
with the internalization status of racial identity development, which has been associated
with preferring friends and parents as sources of help (Ponterotto, Anderson & Grieger,
1986) and perceiving counseling as ineffective (Austin, Carter, & Vaux, 1990). It is
possible that the low rate of psychological help-seeking was due to participants seeking
help from other sources, such as family, friends, and parents. Individuals at this status
may need information about the counseling process that is culturally-congruent with their
worldview (Austin et al., 1990) and that additional information about culturally-sensitive
resources and sources of support would increase utilization of therapeutic services.

Conversely, higher racial identity development may act as a buffer, protecting
women from high levels of psychological distress and precluding the need for therapeutic
services. Sellers and Shelton (2003) observed that greater identification with one’s racial
group buffered participants from negative outcomes following racial discrimination,
which supports prior studies (e. g. Branscombe, Schmitt, & Harvey, 1999). Such group
identification and connection allows the individual to direct attention to what is

affirmative about that group as opposed to discrimination. As participants identified more

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with being Black, they reported more perceived racial discrimination. Similarly it is
possible that in the current study, as women in the internalization stage incorporate a
Black identity, it buffers them from the adverse effects of sexual victimization, ultimately
making help-seeking unnecessary.

The fluidity of Racial Identity statuses described by Helms (1990) is also worthy
of consideration when examining the relationship among help-seeking attitudes and racial
identity development. Helms (1990) posited that individuals cycle though statuses
throughout their lives. When interpreting whether certain attitudes towards help-seeking
are associated with a specific racial identity status, one must consider whether these
attitudes towards help-seeking change as a function of the racial identity status changes.
More specifically, do help-seeking attitudes also fluctuate? If help-seeking attitudes
fluctuate as frequently as that of the racial identity development statuses, it would be
reasonable to consider that help-seeking attitudes are reliably associated with a variable
as fluid as racial identity development. However, if help-seeking attitudes are found to be
relatively stable compared to the identity stages, it may suggest that the relationship
between racial identity status and help-seeking behaviors are mediated by an unknown
variable. Additional research examining the stability of help-seeking attitudes will
provide additional insight regarding the relationship among these two variables.

Most of the sample scored in internalization stage of identity development defined
by the BRIAS (Helms & Parham, 1990). The homogenous nature of the sample regarding
racial identity development may have been impacted by several factors including
education level, SES, and geographic location. Collins and Lightsey (2001) observed that

income was positively associated with internalization attitudes among a sample of

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African American women when examining self-esteem and self-efficacy. In the current
study, approximately 62% of the women reported and SES of middle class or higher,
which may indicate that like income, as higher SES may be associated with greater
internalization attitudes, which was reflected in the correlational analyses.

Although one-on-one counseling has been related to positive post-rape adjustment
(Stewart, Hughes, Anderson, Kendall, & West, 1987), the assumption that it may also be
helpful for African American women may be inaccurate. Taylor’s (2000) research
explored the role of group social support experiences among African American survivors
of intimate partner violence. Such group experiences enable women to share their
experience in a group setting, allowing them seek support, validation, and ultimately
healing in both a private and social arena. Perhaps alternative interventions, such as
support networks comprised of similar participants in terms of race, SES, and ethnicity,
may serve as a better means of psychological improvement among Afiican American
survivors.

General Implications of Findings

Applied implications. These findings have implications for clinical practice,
training, community education and outreach. Clinicians should be cognizant of the roles
of race and ethnicity and their relationship to help-seeking among this population.
Greater awareness is needed of the cultural concerns of Afiican American women that
may act as barriers to help-seeking and labeling sexually violent behaviors as such. For
example, using behavior-based questions to assess trauma, as opposed to using the terms,
“sexual assault”, “sexual violence”, or “rape,” may elicit more accurate reports of SV

experiences. Clinicians should be skilled in understanding racial and ethnic differences

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in help—seeking, including the role of racial identity development, the historical context of
African American female victimization and its impact on labeling behavior. With this
information, counselors may be better equipped to help survivors understand the meaning
and influence of emotional social support on post-SV adjustment. If participants are not
getting their emotional support needs met by informal sources, exploring this
phenomenon may enable survivors to better communicate these needs to others.
Outreach programs can be instrumental in efforts to better serve this population.
Rape crisis centers and counselors can promote psychological services for African
American survivors via targeted educational campaigns designed for the African
American community. Informing the community of the realities and stereotypes
surrounding SV, symptoms following SV, and the emotional social support needs of
survivors may increase the effectiveness of informal social support sources.
Depathologizing therapy services should also be an emphasis of educational outreach
programs in order to reduce the stigma associated with formal support sources. It is also
important that formal sources of support utilize more culturally-congruent therapy
modalities, such as racially homogenous psychoeducational groups. Creating
community-based support networks comprised of other Afiican American women with
SV histories may further reduce the stigma associated with help-seeking. Taylor (2000)
observed that many African American women survivors of intimate male partner
violence participating in therapeutic groups attributed discomfort and lack of investment
in the group experience to differences in racial, ethnic, and SES among participants.
These same women also reported that they perceived white women as having difficulty

understanding their experiences and unable to provide support. Such culturally-sensitive

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interventions can facilitate psychological help-seeking over time, particularly when
others have participated in these programs and can testify to their benefit.

Research implications. The findings of this exploratory investigation highlight
several possible directions for future research. Studies should focus on increasing sample
diversity along multiple domains, such as ethnicity, SES, geographic location, age, and
education. Further explorations of the interrelationships of SV, psychological help-
seeking, emotional social support, and racial identity will enhance generalizability of the
findings and their appropriateness for Afiican American survivors. Focus groups
comprised of survivors that label their experiences of sexual violence compared with
survivors that do not label their experience is another future research direction. An
exploration of the differences and similarities of these groups in a setting that provides an
opportunity for dialogue among several survivors will yield valuable insight regarding
the relationship among help-seeking and labeling. Research should also address Afiican
American men, as they are also victims of SV, and are likely to have unique
psychological needs.

Future research should investigate help-seeking sources. Assessing accessibility
to help-sources, including informal sources, will provide information regarding help-
seeking among African American female survivors. Future studies should continue to
examine who survivors find unhelpful. Only 16% of the website participants (6% of the
overall sample) responded to questions about who was not helpful. It is curious that so
few chose to answer these questions and may be worthy of investigation. Too few
respondents completed this section, but understanding why some sources and manners of

support do not help may be as informative as explorations of what types of support are.

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Limitations

Design and internal validity. Using a field correlational design, this study
investigates the interrelationships between and among characteristics of the person (e.g.,
racial identity development, emotional social support, trauma history, and psychological
help-seeking). Given the exploratory nature of the study, these correlations allow
conclusions to be drawn about how emotional social support, SV, help-seeking attitudes
and racial identity are interrelated and supports firrther research of the interrelationships.
A correlational field design typically has low internal validity and high external validity,
and prohibits the researcher from making inferences regarding causal relationships.
Therefore, although some racial identity development statuses and help-seeking attitudes
are significantly correlated, one cannot assume that identification with a particular racial
identity status causes certain help-seeking attitudes or vice versa.

External validity and generalizability. External validity refers to whether the
findings can be generalized beyond the sample to and across populations of interest.
Sampling methods may limit the external validity of this study. However, emic (within-
group) research, using culturally relevant theory, provides critical understanding in
factors, including the role of race and culture, associated in help-seeking among African
American survivors. Such understanding improves the depth of information on these
phenomena for this group, which in some way increases information on the
generalizability of the construct, because we know the extent and limit to which it
generalizes.

Sexual victimization is common among college students, which speaks to the

relevance and importance of studying this population. However, use of a non-random

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sample predominately from a large Midwestern university limits the generalizability of
the findings to the general African American female population. Subject pool participants
enrolled in introductory and intermediate level psychology classes may have had unique
characteristics that influenced their responses. These women may have been exposed to
information about SV and psychological help-seeking, which may decrease their
perceptions of stigma associated with psychological help-seeking. The website pool
participants were recruited fi'om locations off-campus, which helps increase the study’s
external validity; however participants from both recruitment pools were currently
attending or had completed college or graduate degrees. The high educational attainment
and SES of the sample may limit the ability to generalize these findings to Afiican
American women who do not matriculate into college or are not middle-class.

The use of a web-based survey may also threaten the external validity of the
study. Although common among college students, many people in the United States do
not have access to email and computers. Those that do may have demographic
characteristics that bias the sample, such as higher educational attainment and higher
SES. Nevertheless, Kraut et al., (2004) enumerates the benefits of web-based research
including: reduction of data collection costs, ability to examine unique phenomenon, and
increased recruitment of diverse populations. The web-based survey provided a sense of
anonymity (the researcher did not see respondents) and privacy, increasing access to
understudied populations. Further, use of passwords and unique respondent codes further
protected the integrity of the data by eliminating repeat responders.

Obtaining a sufficient number of participants to achieve adequate power ensures

statistical conclusion validity. The use of a large and representative sample generates

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variability on key variables. Based on Tabachnick and Fidell’s (2001) general rule
regarding sample size for multiple regression, the use of 108 participants was sufficient.
However, using a convenience sample compromises variability and the number of
women in the internalization stage was over-represented. Given the paucity of research, a
convenience sample advances research by allowing the researcher to glean insight into
help-seeking among African American survivors.

This investigation adheres to the “rnaxmincon” theory (Kerlinger, 1986, as cited
in Gelso & Fretz, 2001) by maximizing the variance (the measure of dispersion of the
data) on variables pertaining to the research questions by finding the best fit of data,
which is necessary to detect relationships. Restricting variability increases type I and
type II error and using a large enough sample of 108 participants satisfies the requirement
of maximizing variance. However, an unstandardized method of gathering data may
compromise the goal of minimizing error variance.

Measurement limitations. Use of reliable and valid measures is also relevant to
maximizing variance and therefore limitations of the measures used for the independent
and dependent variables must be considered. The RIAS-B is commonly used to assess
racial identity development; however, its psychometric properties may contribute to error
variance (Swanson, Tokar & Davies, 1994; Tokar & Swanson, 1991; cited in Lemon &
Waehler, 1996). For example, the low reliability coefficient of the encounter subscale
has been criticized and minimal factorial validity has been observed for this stage
(Ponterotto & Wise, 1987, as cited in Lemon & Waehler, 1996). The instability of
subscales may be explained by: 1) the fact that individuals cycle through the stages at

different times in their lives; and 2) that the subscales have few items (Parham, 1989, as

108

cited in Lemon and Waehler, 1996). The modest reliability coefficient of the encounter
stage “may be attributable to the dynamic changeable nature of these attitudes.” The
measure’s developer posits that it is difficult to measure a phenomenon consistently if the
“phenomena itself is not consistent” (Helms, 1990, p. 44).

There are also several limitations of the SSQ measure. First, it was designed using
a college population, and although this study attempts to tap a college population, it
might not be appropriate for older participants. Second, the SSQ only includes people
that were helpful, and does not assess significant others that were not helpful (Popiel &
Susskind, 1985). Third, the SSQ uses a non-specific stressor; however, for this study,
participants were instructed to respond to the items specific to their SV experiences. As
the first study investigating such constructs among Afiican American survivors, the
benefits of using this measure may outweigh its limiting factors.

Other measure limitations exist. The Attitudes Towards Seeking Professional
Psychological Help Scale (ATSPPHS; Fischer & Turner, 1970), used to assess help-
seeking attitudes, has modest reliability coefficients. However, it is a widely used
measure and deemed acceptable for this investigation. The use of a non-standardized
method of assessing trauma also poses limitations, yet further supports the need for a
more encompassing, uniform, and behavior-based measure of SV.

Conclusion

The inclusion or racial and cultural variables continues to be meaningful when
exploring the sexual victimization experiences of African American women and also
supports the assertion that these experiences are impacted by the longstanding historical

experiences of enslaved women. African American are less likely to label their

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experiences of SV as such, which supports prior findings (Holzman, 1997; Neville &
Pugh, 1997; Wyatt, 1992). Racial identity development, specifically the internalization
status, may serve to protect these women from the adverse consequences of SV.
Additionally, low rates of help-seeking among this sample of survivors may indicate that
African American survivors are not receiving needed psychological intervention. If their
emotional social support needs are not being met, it may impact the psychological health
of this population as a whole. Conversely, it is possible that these low rates are an
indication that their psychological well-being was successfully buffered, perhaps as a
result of their racial identity development.

In sum, these findings generate valuable insight regarding the nature of help-
seeking behaviors of African American women who have survived SV. They also create
the basis for future research, interventions, and outreach programming. Continued
exploration of these constructs and related phenomena will enable therapist, researchers,
and others to meet the unique needs of this population. Generated knowledge can serve
as the foundation for important changes regarding how therapists, physicians, the legal

system, and others and provide support and help for these women.

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APPENDIX A

Attitudes Towards Help-Seeking among Women
INFORMED CONSENT

Thank you for your interest in this research project. This project is being conducted by
Sarah Raymond, a doctoral candidate in Counseling Psychology, under the supervision of
Dr. NiCole Buchanan, professor in the Department of Psychology.

The purpose of this investigation is to learn more about factors related to help-seeking
attitudes of women. If you choose to participate in this study, you will be asked to
participate in an hour long audiotaped interview. If you do not feel comfortable having
the interview taped, and feel that you would still like to share your experience, you can
indicate so at the end of this consent form. During the interview you will be asked about
your personal experiences and beliefs, including attitudes towards help-seeking, and
social support. You will also be asked to discuss possible past experiences, including
incidence of sexual violence and unwanted sexual activity.

Please answer each question as thoroughly and honestly as possible. Although most
people report appreciation for the opportunity to share their experiences, there is a risk
that you may feel uncomfortable answering some questions. For example, some of the
questions will ask you about your thoughts and feelings, and about negative experiences
you may or may not have had in your lifetime. Your participation in this study is
completely voluntary. You are under no obligation to answer any of the questions. There
are no right or wrong answers. You may refuse to participate at all, or decline to
participate in certain portions of the interview. At anytime during your participation, you
have the right to discontinue your participation without penalty or loss of benefits to
which you are entitled. You will be reimbursed $15 for your time, and we will make a $5
donation towards a local women’s organization of your choice on your behalf. You will
receive this reimbursement immediately at the end of the interview, and you will still
receive reimbursement if you refrain fiom answering some/all questions.

Your responses will be completely confidential. Your name will not at anytime be
attached to the answers you provide to the questions. All related investigation materials,
including audiotapes, would be stored in a secure location (a locked cabinet in the lab of
the investigators). This location requires one key to enter the floor on which the room is
located, and a separate key to open the door itself. Audiotapes will be transcribed and
data will be stored on computers in the lab. Each member of the lab is designated a
unique password, and only the primary and secondary investigator will have access to the
computer files and audiotapes. At completion of the project, data will be transferred to
disks, and these disks and the audiotapes will be stored in the locked cabinet. Data and
audiotapes will be retained for a minimum of five years in this secure location and
destroyed after 5 years. Only the primary investigator and secondary investigator listed
below will have access to these audiotapes. At no time will your name be released in
association with this study. Your privacy will be protected to the maximum extent
allowable by law.

111

If you are distressed while answering some of the questions, or later after the interview,
you may want to contact the Counseling Center at 335 Olin Student Health, (517) 355-
2319 or 353-7278 (TDD) to consult with a professional. There is no charge for students
carrying one or more credits. Furthermore, you will receive a referral pamphlet with other
people you may contact when you are done with the interview. During and after the
interview, you can also discuss the survey and pamphlet with the interviewer. If you have
questions about this study, please ask the person conducting the interview or contact
Sarah Raymond by phone: (517) 381-9822 or email: mon34@msu.edu or Dr. NiCole
Buchanan at (517) 355-7677, or email: Nbuchana@msu.edu If you have questions or
concerns about your rights as a study participant, or are dissatisfied at anytime with
any aspect of this study, you may contact-anonymously if you wish- Peter Vasilenko,
Ph.D., Chair of the University Committee on Research Involving Human Subjects
(UCRIHS) by phone: (517) 355-2180, fax: (517) 432-4503, email: ucrihs@msu.edu,
or regular mail: 202 Olds Hall, East Lansing, MI 48824.

 

 

My signature below indicates that I voluntarily agree to participate in the above

described research study and choose yes to have the interview audiotaped:

 

 

(Print name here) (Sign your name here) (Date)
My signature below indicates that I voluntarily agree to participate in the above

described research study and choose not to have the interview taped:

 

 

(Print name here) (Sign your name here) (Date)

If you would like the results of this research study, please provide your address below:

 

 

 

PLEASE SEE REVERSE SIDE

112

APPENDIX B
Debriefing and Resources
THANK YOU FOR YOUR PARTICIPATION IN TODAY’S STUDY.

In the United States, as many as 1 out of 3 women will be raped in her lifetime.
Currently, limited research in the areas of help-seeking, social support, and sexual
violence among women speaks to the need for continued research in this area. The
purpose of this investigation is to examine, emotional social support and help-seeking
attitudes of women survivors of sexual violence. It is hoped that the findings of this
investigation might have valuable implications for training, community education, and
clinical practice. This new information can be used by counselors to facilitate the healing
process of survivors. Additionally, outreach programs, clinicians, and educators may be
able to use findings from this investigation to better serve women survivors of sexual
violence. Thank you again for your time and participation, on the backside of this
handout there are local resources and information regarding sexual violence.

Sexual violence affects the lives of survivors in many ways. The symptoms or
reactions to the violence vary from person to person and can be similar to the symptoms
of other problems. There are several aftereffects associated with sexual violence, yet not
all survivors experience the same effects. Survivor aftereffects may include: feelings of
powerlessness, sexual dysfunction, low self-esteem, overeating, bulimia, loss of appetite,
problems with authority figures, depression, guilt, shame, blame, need for control,
intimacy problems, trust issues, promiscuity, Post Traumatic Stress Disorder (PTSD),
somatic complaints, feelings of isolation, substance use, denial, sleep disturbances and
poor social adjustment. If you have experienced these symptoms or if you know someone
who has, talking with a mental health professional may be helpful.

If you are interested in learning more about sexual violence and previous research
in this area, you may want to read some of the following:
Bass, E., & Davis, L. (1988). The Courage to Heal. New York: Harper and Row.

Golding, J., Siegel, J., Sorenson, S., Bumham, A., & Stein, J. (1989). Social support
sources following sexual assault. Journal of Community Psychology, 1 7, 92-107.

Kimerling, R. & Calhoun, KS. (1994). Somatic symptoms, Social support, and
treatment seeking among sexual assault victims. Journal of Counseling and
Clinical Psychology, 62, 333-340.

SEE REVERSE SIDE FOR LOCAL RESOURCES AND INFORMATION

113

Resources

Domestic Violence Services:
MSU Safe Place

G-55 Wilson Hall, MSU campus
www.msu.edu/~safe/

Business Phone: 355-1100
Crisis Line: 372- 5572

Provides temporary and safe shelter, advocacy, support, and referrals for MSU students,
staff, faculty and partners who experience domestic violence, including minor children of
those who are abused.

Sexual Violence Services:
MSU Counseling Center

207 Student Services Building
SSB branch phone: 355-8270

Counseling services available by appointment. Services are free for enrolled MSU
students.

MSU Sexual Assault Crisis and Safety Education Program
207 Student Services Building

24-hour Crisis hotline: 372-6666

Business phone: 355-8270

Crisis hotline available 24 hours a day, 7 days a week. Counseling services available on
appointment basis.

Listening Ear Crisis Intervention Center

1017 E. Grand River, East Lansing, MI 44423
24-hour Crisis Hotline: 337-1717

Business phone: 337-1728

Crisis hotline available 24 hours a day, 7days a week and referral services for counseling.
Web Resources:
Michigan Coalition Against Domestic and Sexual Violence

www.mcadsv.org/

This website has local resources and information regarding domestic and sexual violence
in the state of Michigan.

SEE REVERSE SIDE FOR INFORMATION REGARDING INVESTIGATION

114

APPENDIX C

Informed Consent Subject Pool

Attitudes Towards Help-Seeking Among Women
INFORMED CONSENT (Psychology Subject Pool)

Thank you for your interest in this research project. This project is being conducted by
Sarah Raymond, a doctoral candidate in Counseling Psychology, under the supervision of
Dr. NiCole Buchanan, professor in the Department of Psychology.

The purpose of this investigation is to learn more about factors related to psychological
help-seeking attitudes of women. If you choose to participate in this study, you will be
asked a series of questions about your personal experiences and beliefs, including
attitudes towards help-seeking and social support. You will also be asked to report
possible past experiences, including incidence of sexual violence and unwanted sexual
activity. The entire process should take about one hour and all of these questionnaires
will be completed over the computer.

Please answer each question as thoroughly and honestly as possible. Although most
people report appreciation for the opportunity to share their experiences, there is a risk
that you may feel uncomfortable responding to some questions. For example, some of
the questions will ask you to report about thoughts and feelings, and about negative
experiences you may or may not have had in your lifetime. Your participation in this
study is completely voluntary. You are under no obligation to answer any of the
questions. You may refuse to participate at all, decline to participate in certain portions of
the study, or not answer certain questions. There are no right or wrong answers. At
any time during your participation, you have the right to discontinue your participation
without penalty or loss of benefits to which you are entitled. If you decided to
withdrawal from this study, it will not affect your firture participation in Subject Pool
experiments. You may either participate in other studies within the Psychology
Department, or receive credit by other means, as stated in your psychology course
syllabus. A $1 dollar donation to a local women’s organization will be made on behalf of
each participant. This donation will be made even if you refrain from answering some/all
questions.

Your responses will be completely confidential. Your name will not at anytime be
attached to the answers you provide to the information; an identification number will be
marked instead. No individual results will be reported. We will only provide
information as a general sample. All related investigation materials will be stored in a
secure location (a locked cabinet in the lab of the investigators). This location requires
one key to enter the floor on which the room is located, and a separate key to open the
door itself. Questionnaire data will be entered into a computer, analyzed, and stored on
computers in the lab. Each member of the lab is designated a unique password, and only
the primary and secondary investigator will have access to the computer files. At
completion of the project, data will be transferred to disks, and these disks will be stored

115

in the locked cabinet. Data will be retained for a minimum of five years in this secure
location and destroyed after 5 years. At no time will your name be released in association
with this study. Your privacy will be protected to the maximum extent allowable by law.

If you are distressed while answering some of the questions, or later after completing the
assessment, you may want to contact the Counseling Center at 207 Student Services
Building, (517) 355-8270 or 353-7278 (TDD) to consult with a professional. There is no
charge for students carrying one or more credits. Furthermore, you will receive a referral
pamphlet with other people you may contact. After your participation, you can also
discuss the survey and pamphlet with the researchers. If you have questions about this
study, please feel free to contact Sarah Raymond by phone: (574) 247-9971 or email:
grymon34@msu.edu or Dr. NiCole Buchanan at (517) 355-7677, or email:
Nbuchana@msu.edu If you have questions or concerns about your rights as a study
participant, or are dissatisfied at anytime with any aspect of this study, you may
contact-anonymously if you wish- Peter Vasilenko, Ph.D., Chair of the University
Committee on Research Involving Human Subjects (UCRIHS) by phone: (517) 355-
2180, fax: (517) 432-4503, email: ucrihs@msu.edu, or regular mail: 202 Olds Hall,
East Lansing, MI 48824.

 

I voluntarily agree to participate in this study. YES NO

116

APPENDIX D
Informed Consent Website Pool

Attitudes Towards Help—Seeking Among Women
INFORMED CONSENT (Internet-based Website Survey)

Thank you for your interest in this research project. This project is being conducted by
Sarah Raymond, a doctoral candidate in Counseling Psychology, under the supervision of
Dr. NiCole Buchanan, professor in the Department of Psychology.

The purpose of this investigation is to learn more about factors related to psychological
help-seeking attitudes of women. If you choose to participate in this study, you will be
asked a series of questions about your personal experiences and beliefs, including
attitudes towards help-seeking and social support. You will also be asked to report
possible past experiences, including incidence of sexual violence and unwanted sexual
activity. The entire process should take about one hour and all of these questionnaires
will be completed over the computer.

Please answer each question as thoroughly and honestly as possible. Although most
people report appreciation for the opportunity to share their experiences, there is a risk
that you may feel uncomfortable responding to some questions. For example, some of
the questions will ask you to report about thoughts and feelings, and about negative
experiences you may or may not have had in your lifetime. Your participation in this
study is completely voluntary. You are under no obligation to answer any of the
questions. You may refuse to participate at all, decline to participate in certain portions of
the study, or not answer certain questions. There are no right or wrong answers. At
any time during your participation, you have the right to discontinue your participation
without penalty or loss of benefits to which you are entitled. A $1 dollar donation to a
local women’s organization will be made on behalf of each participant. This donation
will be made even if you refrain fi'om answering some/all questions. You will also have
the chance to enter a raffle for one of 4 cash prizes of $50. One email address (kept
separate fi'om your survey responses) will be drawn at random.

Your responses will be completely confidential. Your name will not at anytime be
attached to the answers you provide to the information; an identification number will be
marked instead. No individual results will be reported. We will only provide
information as a general sample. This website uses a unique respondent ID number,
which is automatically assigned to each subject. Personal information (for purposes of
contacting the winners of the raffle) will be stored separate from the data. Participants’
individual responses will be confidential (e. g. data and back-up files will be secure;
individual cases will only be seen by involved researchers, and will never be discussed
with others; data will only be presented as a group for publication). IP addresses will not
be stored or included with your responses. This website encrypts responses and stores
them on a server, which can only be accessed by the researcher, with the correct
usemame and password. The researcher will have complete control over the data, and its

117

deletion. Once deleted, it will be permanently deleted from the website. Data will be
transferred to disk.

All related investigation materials will be stored in a secure location (a locked cabinet in
the lab of the investigators). This location requires one key to enter the floor on which
the room is located, and a separate key to open the door itself. Data will be retained for a
minimum of five years in this secure location and destroyed after 5 years. At no time will
your name be released in association with this study. Your privacy will be protected to
the maximum extent allowable by law.

If you are distressed while answering some of the questions, or later after completing the
assessment, you may want to contact the Counseling Center at 207 Student Services
Building, (517) 355-8270 or 353-7278 (TDD) to consult with a professional. There is no
charge for students carrying one or more credits. Furthermore, you will receive a referral
pamphlet with other people you may contact. After your participation, you can also
discuss the survey and pamphlet with the researchers. If you have questions about this
study, please feel fine to contact Sarah Raymond by phone: (574) 247-9971 or email:
_r_avmon34@msu.edu or Dr. NiCole Buchanan at (517) 355-7677, or email:
Nbuchaflérlmsuedu If you have questions or concerns about your rights as a study
participant, or are dissatisfied at anytime with any aspect of this study, you may
contact-anonymously if you wish- Peter Vasilenko, Ph.D., Chair of the University
Committee on Research Involving Human Subjects (UCRIHS) by phone: (517) 355-
2180, fax: (517) 432-4503, email: ucrihs@msu.edu, or regular mail: 202 Olds Hall,
East Lansing, MI 48824.

 

I voluntarily agree to participate in this study. YES NO

118

APPENDIX E
Debriefing and Resources
THANK YOU FOR YOUR PARTICIPATION IN TODAY’S STUDY.

In the United States, as many as 1 out of 3 women will be raped in her lifetime.
Currently, limited research in the areas of help-seeking, social support, and sexual
violence among women speaks to the need for continued research in this area. The
purpose of this investigation is to examine emotional social support and help-seeking
attitudes of women survivors of sexual violence from varied cultural, racial and ethnic
backgrounds.

It is hoped that the findings of this investigation might have valuable implications for
training, community education, and clinical practice. This new information can be used
by counselors to facilitate the healing process of survivors. Additionally, outreach
programs, clinicians, and educators may be able to use findings from this investigation to
better serve women survivors of sexual violence.

Thank you again for your time and participation, on the backside of this handout there
are local resources and information regarding sexual violence.

Sexual violence affects the lives of survivors in many ways. The symptoms or reactions
to the violence vary from person to person and can be similar to the symptoms of other
problems. There are several aftereffects associated with sexual violence, yet not all
survivors experience the same effects. Survivor aftereffects may include: feelings of
powerlessness, sexual dysfunction, low self-esteem, overeating, bulimia, loss of appetite,
problems with authority figures, depression, guilt, shame, blame, need for control,
intimacy problems, trust issues, promiscuity, Post Traumatic Stress Disorder (PTSD),
somatic complaints, feelings of isolation, substance use, denial, sleep disturbances and
poor social adjustment. If you have experienced these symptoms or if you know someone
who has, talking with a mental health professional may be helpful.

If you are interested in learning more about sexual violence and previous research in this
area, you may want to read some of the following:
Bass, E., & Davis, L. (1988). The Courage to Heal. New York: Harper and Row.

Golding, J., Siegel, J ., Sorenson, S., Bumham, A., & Stein, J. (1989). Social support
sources following sexual assault. Journal of Community Psychology, 17, 92-107.

Kimerling, R. & Calhoun, KS. (1994). Somatic symptoms, Social support, and

treatment seeking among sexual assault victims. Journal of Counseling and
Clinical Psychology, 62, 333-340.

119

Resources

Domestic Violence Services:

MSU Safe Place

G-55 Wilson Hall, MSU campus
www.msu.edu/~safe/

Business Phone: 355-1 100
Crisis Line: 372- 5572

Provides temporary and safe shelter, advocacy, support, and referrals for MSU students,
staff, faculty and partners who experience domestic violence, including minor children of
those who are abused.

Sexual Violence Services:

MSU Counseling Center
207 Student Services Building
SSB branch phone: 355-8270

Counseling services available by appointment. Services are free for enrolled MSU
students.

MSU Sexual Assault Crisis and Safety Education Program
207 Student Services Building

24-hour Crisis hotline: 372-6666

Business phone: 355-8270

Crisis hotline available 24 hours a day, 7 days a week. Counseling services available on
appointment basis.

Listening Ear Crisis Intervention Center

1017 E. Grand River, East Lansing, MI 44423

24-hour Crisis Hotline: 337-1717

Business phone: 337-1728

Crisis hotline available 24 hours a day, 7days a week and referral services for counseling.

Web Resources:

Michigan Coalition Against Domestic and Sexual Violence
www.mcadsvorgl

This website has local resources and information regarding domestic and sexual violence
in the state of Michigan.

120

APPENDIX F
Demographic Information

Age:

 

Race: please circle:
African American
Caucasian

Asian

Latina

Native American
Other (please specify)

 

Ethnicity:

 

Please indicate the percentage of your university who are of your same
ethnicity:

Level of education:

Some College (Current College Student)
College Graduate

Graduate/Professional School

Family of Origin Socioeconomic status:
Lower economic status

Lower middle economic status

Middle economic status

Upper middle economic status

Upper economic status

121

Appendix G
Measures

The Attitudes Towards Seeking Professional Psychological Help Scale, ATSPPHS

Directions: Below are a number of statements pertaining to psychology and mental
health issues. Read each statement carefully and indicate your agreement, probable
agreement, probable disagreement, or disagreement. Please express your frank
opinion in rating the statements. There are no “wrong” answers, and the only right
ones are whatever you honestly feel or believe.

1. Although there are clinics for people with mental troubles, I would not have much faith

in them.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

2. If a good friend asked my advice about a mental problem, I might recommend that he

see a psychiatrist.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

3. I would feel uneasy going to a psychologist because of what some people would think.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

4. A person with a strong character can get over mental conflicts by himself, and would

have little need of a psychiatrist.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

5. There are times when I have felt completely lost and would have welcomed

professional advice for a personal or emotional concern.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

6. Considering the time and expense involved in psychotherapy, it would have doubtful

value for a person like me.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

7. I would willingly confide intimate matters to an appropriate person if I thought it

might help me or a member of my family.
1 2 3
Disagreement probable disagreement probable agreement agreement

 

8. I would rather live with certain mental conflicts than go through the ordeal of getting

psychiatric treatment.
0 l 2 3

Disagreement probable disagreement probable agreement agreement

 

122

9. Emotional difficulties, like many things, tend to work out by themselves.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

10. There are certain problems that should not be discussed outside of one’s immediate
family.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

11. A person with a serious emotional disturbance would probably feel most secure in a

good mental hospital.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

12. If I believed I was going to have a mental breakdown, my first inclination would be to

get professional attention.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

13. Keeping one’s mind on a job is a good solution for avoiding personal worries and

concerns.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

14. Having been a psychiatric patient is a blot on a person’s life.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

15. I would rather be advised by a close fiiend than by a psychologist, even for an

emotional problem.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

16. A person with an emotional problem is not likely to solve it alone; he is likely to

solve it with professional help.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

17. I resent a person-professionally trained or not-who wants to know about my personal

difficulties.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

18. I would want to get psychiatric attention if I was worried or upset for a long period of

time.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

19. The idea of talking about problems with a psychologist strikes me as a poor way to

get rid of emotional conflicts.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

123

20. Having been mentally ill carries with it a burden of shame.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

21. There are experiences in my life that I would not discuss with anyone.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

22. It is probably best not to know everything about oneself.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

23. If I were experiencing a serious emotional crisis at this point in my life, I would be

confident that I could find relief in psychotherapy.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

24. There is something admirable in the attitude of a person who is willing to cope with

his conflicts and fears without resorting to professional help.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

25. At some future time I might want to have psychological counseling.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

26. A person should work out his own problems; getting psychological counseling would

be a last resort.
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

27. Had I received treatment in a mental hospital, I would not feel that it ought to be

“covered up.”
0 1 2 3
Disagreement probable disagreement probable agreement agreement

 

28. If I thought I needed psychiatric help, I would get it no matter who knew about it.
0 l 2 3
Disagreement probable disagreement probable agreement agreement

 

29. It is difficult to talk about personal affairs with highly educated people such as

doctors, teachers, and clergymen.
O 1 2 3
Disagreement probable disagreement probable agreement agreement

 

124

Trauma History

Please indicate whether you have ever experienced any of the following
frightening/uncomfortable experiences by circling Yes, No, or Unsure. If you
answer yes to any of these questions, please also indicate at what age the incident
occurred.

1) Have you ever been aggressively hit or grabbed by someone?
Yes No Unsure Age(s)

2) Has anyone ever tried to touch you without your consent?
Yes No Unsure Age(s)

3) Has anyone ever touched you that made you feel uncomfortable?
Yes No Unsure Age(s)

4) Have you ever experienced forced touching that was sexual in nature?
Yes No Unsure Age(s)

5) Have you ever had sexual intercourse against your will?
Yes No Unsure Age(s)

Please indicate whether you have ever experienced the following by circling Yes, No,
or Unsure. If you answer yes to any of these questions, please also indicate at what
age the incident occurred.

1) Have you ever experienced attempted sexual violence (any attempted unwanted
sexual activity forced by another person including anal, vaginal, or oral penetration;
stranger rape, acquaintance rape, date rape, martial rape, gang rape, and/or

incest)?
Yes No Unsure Age

Ifyes, please circle whether the experience included any of the following (circle all that apply):
Verbal threats Threats to use a weapon Physical threats Physical force

If yes, please indicate your level of familiarity with the assailant:
Stranger Acquaintance Romantic Partner Spouse Other (please specify):

Please report by circling whether you sought help from any of the following, for the
attempted sexual violence and what type of counseling you received:

1) Private Therapist/Counselor: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

2) Employee assistance program: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(l3 or more sessions)

125

3) Rape crisis center: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

4) University Counseling Center: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

5) Community Mental Health Center: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

6) Veterans Administration: Yes No
Crisis(4 or fewer sessions) Short-term(S-12 sessions) Long—term(13 or more sessions)

7) Other (please specify): Yes
Crisis(4 or fewer sessions) Short-term(S-12 sessions) Long—term(l 3 or more sessions)

Please use the space below to provide additional information (if any) regarding any
of your specific experiences:

2) Have you ever experienced completed sexual violence (any completed unwanted
sexual activity forced by another person including anal, vaginal, or oral penetration;
stranger rape, acquaintance rape, date rape, martial rape, gang rape, and/or
incest)?

Yes No Unsure Age

 

If yes, please circle whether the experience included any of the following (circle all that apply):
Verbal threats Threats to use a weapon Physical threats Physical force

If yes, please indicate your level of familiarity with the assailant:
Stranger Acquaintance Romantic Partner Spouse Other (please specify):

Please report by circling whether you sought help from any of the following, for
completed sexual violence and what type of counseling you received:

1) Private Therapist/Counselor: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(1 3 or more sessions)

2) Employee assistance program: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

3) Rape crisis center: Yes
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

4) University Counseling Center: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long-term(13 or more sessions)

126

5) Community Mental Health Center: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

6) Veterans Administration: Yes No
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

7) Other (please specify): Yes
Crisis(4 or fewer sessions) Short-term(5-12 sessions) Long—term(13 or more sessions)

Please use the space below to provide additional information (if any) regarding any
of your specific experiences:

127

The Social Support Questionnaire, SSQ

The following questions ask about people in your environment who provide you with help or support. Each
question has two parts. For the first part, list all the people you know, excluding yourself, whom you can
count on for help or support in the manner described. Give the person’s initials and their relationship to you
(See Example). Do not list more than one person for each of the numbers beneath the question. For the
second part, circle how satisfied you are with the overall support you have. If you have no support for a
question, circle the words “No one,” but still rate your level of satisfaction. Do not list more than nine
persons per question. Please answer all questions as best you can. There are no right or wrong answers,
and all of your responses will be kept confidential.

EXAMPLE
Who do you know whom you can trust with information that could get you in trouble?
No one 1) TN. (brother) 4) TN. (Father) 7)

2) LM. (friend) 5) L.N. (employer) 8)

3) RS. (girlfriend) 6) 9)

How satisfied?
6-very satisfied 5-fari1y satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

l. Whom can you really count on to listen to you when you need to talk?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S—farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

2. Whom could you really count on to help you if a person whom you thought was a good friend insulted
you and told you that he/ she didn’t want to see you again?

No one 1) 4) 7)
2) S) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

3. Whose lives do you feel that you are an important part of?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

4. Whom do you feel would help you if you were married and you had just separated from your spouse?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied 1-very dissatisfied

 

5. Whom could you really count on to help you out in a crisis situation, even though they would have to go
out of their way to do so?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied 1-very dissatisfied

 

128

6. Whom can you talk with frankly, without having to watch what you say?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied 1-very dissatisfied

 

7. Who helps you feel that you truly have something positive to contribute to others?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied 5-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

8. Whom can you really count on to distract you from your worries when you feel under stress?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

9. Whom can you really count on to be dependable when you need help?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

10. Whom could you really count on to help you out if you had just been fired from you job or expelled
from school?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied 5-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

11. With whom can you totally be yourself?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied 5-farily satisfied 4-a little satisfied 3-litt1e dissatisfied 2-fairly satisfied 1-very dissatisfied

 

12. Whom do you feel really appreciates you as a person?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

l3. Whom can you really count on to give you useful suggestions that help you to avoid making mistakes?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

129

 

14. Whom can you count to listen openly and uncritically to your innermost feelings?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

15. Who will comfort you when you need it by holding you in their arms?

No one 1) 4) 7)
2) 5) 3)
3) 6) 9)

How satisfied?
6-very satisfied S—farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

16. Whom do you feel would help if a good friend of yours has been in a car accident and was hospitalized
in serious condition?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

17. Whom can you really count on to help you feel more relaxed when you are under pressure or tense?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

18. Whom do you feel would help if a family member very close to you died?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

19. Who accepts you totally, including both your worst and best points?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied 5-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

20. Who can you really count on to care about you, regardless of what is happening to you?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

21. Whom can you really count on listen to you when you are very angry at someone else?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

130

 

22. Whom can you really count on to tell you in a thoughtful manner, when you need to improve in some

way?

No one 1) 4) 7)
2) 5) 3)
3) 6) 9)

How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

23. Whom can you really count on to help you feel better when you are feeling generally down-in-the-

dumps?

No one 1) 4) 7)
2) 5) ‘ 8)
3) 6) 9)

How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

24. Whom do you feel truly loves you deeply?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-litt1e dissatisfied 2-fair1y satisfied l-very dissatisfied

 

25. Whom can you count on to console you when you are very upset?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?

6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

26. Whom can you really count to support you in major decisions you make?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied 5-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied 1-very dissatisfied

 

27. Whom can you really count on to help you feel better when you are very irritable, and ready to get

angry at almost anything?

No one 1) 4) 7)
2) 5) 8)
3) 6) 9)

How satisfied?
6-very satisfied S-farily satisfied 4-a little satisfied 3-little dissatisfied 2-fairly satisfied l-very dissatisfied

 

131

Feminism and the Women’s Movement Scale, F WM

1) The leaders of the women’s movement may be extreme, but the have the right idea.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

2)There are better ways for women to fight for equality than through the women’s movement.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

3) More people would favor the women’s movement if they knew more about it.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

4) The women’s movement has positively influenced relationships between men and women.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

5) The women’s movement is too radical and extreme in its views.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

6) The women’s movement has made important gains in equal rights and political power for women.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

7) Feminists are too visionary for a practical world.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

8) Feminist principles should be adopted everywhere.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

9) Feminists are a menace to this nation and the world.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

10) I am overjoyed that women’s liberation is finally happening in this country.

Strongly Somewhat Neutral Somewhat Strongly
Disagree DIS agree Agree Agree

132

Black Racial Identity Attitude Scale (Form RIAS-B)

This questionnaire is designed to measure people’s social and political attitudes. There are no right or
wrong answers. Use the scale below to respond to each statement. Circle the number that corresponds with
how you feel for each question.

 

1. I believe that being Black is a positive experience.

 

1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
2. I know through experience what being Black in America means.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

3. I feel unable to involve myself in white experiences and I am increasing my involvement in Black
experiences.

 

 

 

 

 

 

 

 

Strongly ldisagree Disazgree Unce31tain Agjee Stroneg Agree
4. I feel that a large number of Blacks are untrustworthy.
Strongly 1disagree Disazgree Uncgrtain Aggee Stroneg Agree
5. I feel an overwhelming attachment to Black people.
Strongly 1disagree Disazgree Uncgrtain Agjee Strongly Agree
6. I involve myself in cases that will help all oppressed people.
Strongly 1disagree Disazgree Unce3rtain Agjee Stroneg Agree
7. I feel comfortable wherever I am.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
8. I believe that White people look and express themselves better than Blacks.
Strongly ldisagree Disazgree Uncgrtain Agiee Strongly Agree
9. I feel very uncomfortable around Black people.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
10. I feel good about being Black, but do not limit myself to Black activities.
Strongly 1disagree Disazgree Unce31tain Agiee Strongfy Agree
1 1. I often find myself referring to White people as honkies, devils, pigs, etc.
Strongly ldisagree Disazgree Uncgrtain Agjee Stroneg Agree

 

133

12. I believe that to be Black is not necessarily good.

 

1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
13. I believe that certain aspects of the Black experience apply to me, and others do not.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

14. I frequently confront the system and the man.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

15. I constantly involve myself in Black political and social activities (art shows, political meetings, Black
theater, etc.)

 

1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
16. I involve myself in social action and political groups even if there are not other Blacks involved.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

17. I believe that Black people should learn to think and experience life in ways which are similar to White
people.

 

 

 

 

 

 

 

Strongly 1disagree Disazgree Uncgrtain Agiee Strongfy Agree
18. I believe that the world should be interpreted from a Black perspective.

Strongly ldisagree Disazgree Uncgrtain Aggee Strongfy Agree
19. I have changed my style of life to fit my beliefs about Black people.

Strongly 1disagree Disazgree Unce3rtain Agfiee Strongfy Agree
20. I feel excitement and joy in Black surroundings.

1 2 3 4 5

Strongly disagree Disagree Uncertain Agree Strongly Agree
21. I believe that Black people came from a strange, dark, and uncivilized continent.

Strongly 1disagree Disazgree UnceBrtain Agiee Stronglsy Agree
22. People regardless of their race, have strengths and limitations.

Strongly 1disagree Disazgree Unce3rtain Agjee Stroneg Agree
23. I find myself reading a lot of Black literature and thinking about being Black.

Strongly ldisagree Disazgree Unce3rtain Agiee Strongly Agree
24. I feel guilty and/or anxious about some of the things I believe about Black people.

Strongly ldisagree Disazgree Unce3rtain Agiee Strongfy Agree

 

134

25. I believe that a Black person’s most effective weapon for solving problems is to be part of the White
person’s world.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

26. I speak my mind regardless of the consequences (e.g., being kicked out of school, being imprisoned,
being exposed to danger).
l

 

 

 

 

 

 

 

 

 

 

 

2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
27. I believe that everything Black is good, and consequently, 1 limit myself to Black activities.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
28. I am determined to find my Black identity.
1 2 3 4 S
Strongly disagree Disagree Uncertain Agree Strongly Agree
29. I believe that White people are intellectually superior to Blacks.
l 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
30. I believe that because I am Black, I have many strengths.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
31. I feel that Black people do not have as much to be proud of as White people do.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
32. Most Blacks I know are failures.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
33. I believe that White people should feel guilty about the way they have treated Blacks in the past.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
34. White people can’t be trusted.
l 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
35. In today’s society if Black people do not achieve, they have only themselves to blame.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
36. The most important thing about me is that I am Black.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
37. Being Black just feels natural to me.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

135

38. Other Black people have trouble accepting me because my life experiences have been so different from
their experiences.

 

 

 

 

 

 

 

 

 

 

 

 

1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
39. Black people who have any White peoples’ blood should feel ashamed of it.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
40. Sometimes, I wish I belonged to the White race.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
41. The people I respect the most are White.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
42. A person’s race usually is not important to me.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
43. I feel anxious when white people corrrpare me to other members of my race.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
44. I can’t feel comfortable with either Black people or White people.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
45. A person’s race has little to do with whether or not he/she is a good person.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
46. When I am with Black people, I pretend to enjoy the things they enjoy.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
47. When a stranger who is Black does something embarrassing in public I get embarrassed.
l 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
48. I believe that a Black person can be close friends with a White person.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
49. I am satisfied with myself.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree
50. I have a positive attitude about myself because I am Black.
1 2 3 4 5
Strongly disagree Disagree Uncertain Agree Strongly Agree

 

(Not for reproduction or modification without author’s permission.)

I36

Appendix H
Tables

Table 1
Correlation Matrix of Outcome Predictor Variables in Regression Analysis

 

Var Trauma Preenc Enc Im/em Inter ESS Stigma Need Open Conf SES

 

Trauma

Preenc -.02 (.79)

Enc .06 .25* (.55)

hnem .01 .13 .60M (.71)

Inter .04 -.42*"' .03 .04 (.67)

ESS -.06 .12 -.12 -.14 .09 (.97)

Stigma -.04 -.07 -.21* -.20* .04 .20* (.69)

Need .14 -.30** -.10 -.10 .18 -.05 .26** (.71)

Open .24* -.21* -.09 -.24* .15 -.02 .20* .49“ (.63)
Conf -.02 -.15 -.01 -.05 .14 .05 .41" .62" .39" (.68)
SES -.08 -.81 .09 -.25* .20" .26" -.07 .09 .02 -.05
M 3.80 2.09 2.69 2.59 4.05 7.65 9.37 15.21 13.59 16.82 2.76

SD 2.89 2.26 .58 .52 .41 2.26 3.09 4.00 3.71 4.29 .93

 

Note. Alphas appear along diagonals with bivariates below. Preenc=Preencounter status;
Enc=Encounter status; Imem=Immersion/Emersion status; Inter=Intemalization status;
ESS=Emotional Social Support; Stigma= Tolerance of stigma associated with receiving
psychological help; Need=Perceived need for professional help; Open=Openness about
disclosing personal problems; and Conf=Confidence in psychological professionals to be
useful assistance; SES=Socioeconomic Status.

tip <. 01
*p<.05

137

Table 2
Summary of Hierarchical Regression Analyses for ATPHSS Openness and Need
Subscales:

 

 

Openness Need
Variables A R2 B SE B [3 A R2 B SE [3 )3
Step 1 .06* .03*
Family SES .17 .38 .04 .43 .42 .10
Trauma History .32 .12 .25* .20 .13 .15
Step 2 .16* .12*
Preencounter -1.18 .82 -.15 -2.21 .91 -.26*
Encounter .63 .76 . 10 -.05 .84 -.01
Im/Em -2.09 .84 -.30* -.42 .93 -.O6
Internalization .88 .93 .10 .5 l l .03 .05
Step 3 .16 .12
ESS -.03 .16 -.02 -.07 .18 -.04
Step 4 .18 .13
ESS x Preencounter .35 .40 .11 .28 .45 .08
ESS x Encounter .21 .37 .07 -.41 .41 -.13
ESS x Im/Em -.25 .35 -.08 .13 .39 .04
ESS x Internalization .22 .42 .08 .43 .46 .14

 

Note. Preenc=Preencounter status; Enc=Encounter status; Imem=1mmersion/Emersion
status; Inter=Intemalization status; ESS=Emotional Social Support; Stigma= Tolerance
of stigma associated with receiving psychological help; Need=Perceived need for
professional help; Open=Openness about disclosing personal problems; and
Conf=Confidence in psychological professionals to be useful assistance.

*p< .05.

138

Table 3

Summary of Hierarchical Regression Analyses for ATPHSS Stigma and Confidence

 

 

Subscales:
Stigma Confidence
Variables A R2 B SE [3 [3 A R2 B SE [3 [3
Step 1 .01 .00
Family SES -.21 .33 -.06 -.22 .45 -.05
Trauma History -.05 .10 -.05 -.03 .15 -.02
Step 2 .07 .04
Preencounter -.01 .72 -.00 -1.03 1.01 -1.02
Encounter -.67 .66 -.13 .53 .93 .07
Irn/Em -.94 .73 -.16 -.88 1.03 -.11
Internalization .57 .82 .08 1.14 1.15 .1 1
Step 3 .11 .05
ESS .28 .14 .21* .15 .20 .08
Step 4 .15 .06
ESS x Preencounter -.33 .34 - .12 -.15 .50 -.04
ESS x Encounter -.41 .32 -.16 .01 .46 .00
ESS x Irn/Em .12 .30 .05 -.20 .43 -.06
ESS x Internalization -.07 .35 -.03 .23 .52 .07

 

Note. Preenc=Preencounter status; Enc=Encounter status; Imem=Immersion/Emersion
status; InteFIntemalization status; ESS=Emotional Social Support; Stigma= Tolerance
of stigma associated with receiving psychological help; Need=Perceived need for
professional help; Open=Openness about disclosing personal problems; and

Conf=Confidence in psychological professionals to be useful assistance.

* p< .05.

139

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