SAFE is committed to providing trauma-informed services rooted in the experience of survivors of domestic violence and sexual assault as well as that of recovering women. Rules are kept to a minimum and advocates provide accommodation as needed.
SAFE has developed tools to reduce barriers for shelter residents and other people they serve who experience Fetal Alcohol Spectrum Disorder and/or behavioral health issues.
Individuals experiencing cognitive disabilities have access to information in multiple formats. Pictures are used to communicate complex steps and information is provided in manageable chunks.
Among the excellent resources developed by SAFE are the videos “The Heart of the Grizzly” and “The Woman and the Moon.” These videos portray the experiences of survivors of sexual assault and domestic violence in rural Alaska.
Ongoing programs for women also include:
Maintaining Our Mothers’ Sobriety (MOMS): Evening child care for parents in aftercare treatment or attending support groups.
Ending Violence in Our Lives through Validation and Empowerment (EVOLVE): Services for women who have resorted to using violence in their lives or relationships.
Thursday Night Support Group: Dinner, Talking Circle and Maqiq (steam).
For more information about SAFE or the SISTR Program contact: Ginger Baim or Karen Carpenter, SAFE, P.O. Box 963, Dillingham, AK 99576. Email: [email protected]. Website: www.besafeandfree.org. Office Phone: 907-842-2320. Fax: 907-842-2198.
Alaska Network on Domestic Violence and Sexual Assault
This section provides more detail about some of the co-occurring issues faced by people who are survivors of multi-abuse trauma.
Advocates and other service providers are sometimes reluctant to ask about certain issues, lest they appear to be blaming victims for violence perpetrated against them. One of the fundamental principles of the advocacy movement, after all, is the belief that individuals do not experience violence or abuse because of mental illness or because of some kind of problem, behavior or pathology on the part of the victim (Ferencik & Ramirez-Hammon, 2011).
Advocates may also be anxious about the stigma attached to certain co-occurring
problems, as well as the potential consequences to the survivor if knowledge of the issue gets into the wrong hands. For example, there is the risk that an abuser could use the situation in court in an attempt to gain custody of children.
It is vitally important to emphasize that people who experience domestic violence, sexual assault or other violence neither “ask for” nor deserve violence or abuse – no matter what else is going on. The most important message you can give a person whose experience includes multiple abuse issues is, “This is NOT your fault.”
This message is especially important if individuals were under the influence of alcohol or drugs, were experiencing psychiatric symptoms, or were coping with other co-occurring issues at the time an abuser took advantage of and hurt them.
However, this does not preclude us from addressing co-occurring issues. If we do not acknowledge and address other issues an individual may be facing, we miss crucial opportunities to help the people we serve to get safe and heal from violence and abuse. And we can – by our silence – inadvertently contribute to the sense of stigma attached to certain issues, as well as to the re-traumatization from the social service system
experienced by a survivor who is unable to access the right kinds of help.
Advocates must be very mindful of confidentiality concerns and a survivor’s right to privacy, autonomy and safety. When addressing co-occurring issues, providing advocacy, accommodations and referrals can be very helpful. But it is important for advocates to refrain from listing a specific referral or making notes in someone’s chart that are labeling, diagnostic or that could be used against the individual.
As a matter of policy, advocates should refrain from writing notes in an individual’s file or log whenever possible. This is particularly important since notes can be subpoenaed and could put the people you serve at risk.
Alaska Network on Domestic Violence and Sexual Assault
On the following pages, we take a closer look at several of these co-occurring issues: complex trauma, substance use disorders, mental health concerns, disabilities, societal oppression, intergenerational grief and historical trauma, poverty, homelessness, sex trafficking and incarceration.
Included are the role trauma plays in each of these issues, the special safety concerns surrounding each issue, barriers each issue may pose for survivors of multi-abuse trauma seeking safety or services, how staff can empower survivors coping with each issue, and suggestions for working with other providers.
Alaska Network on Domestic Violence and Sexual Assault
Mental health professionals in recent years have begun to speak of complex traumatic stress or complex psychological trauma (Courtois & Ford, 2009), complex posttraumatic stress disorder (Herman, 1997, 2009), and complex trauma (Warshaw, 2010) that can result from prolonged and repeated abuse, especially if the abuse began in early childhood or came from multiple sources.
Some experts distinguish between “Type I” trauma – resulting from a single incident such as a serious car accident, a natural disaster, or a one-time episode of abuse or assault – and “Type II” complex or repetitive trauma resulting from child physical or sexual abuse, severe domestic violence or community violence that is ongoing and chronic (Courtois & Ford, 2009).
The histories of people with complex trauma generally include a variety of abusive experiences across the life cycle rather than a single act of abuse (Warshaw, 2010). That is, they live in chronically abusive environments that combine varied types of abuse and neglect. As children they often experienced combinations of emotional, physical and sexual abuse; parental substance abuse; being a witness to domestic violence; having a parent or parents with psychiatric illness; and/or incarceration of a parent (Kinsler, Courtois & Frankel, 2009).
Social marginalization and oppression are likely to exacerbate or complicate complex trauma symptoms (Briere & Spinazzola). Courtois and Ford (2009) list several
cumulative adversities faced by individuals, communities, ethnocultural minority groups and societies that may lead to – as well as worsen the impact of – complex trauma. Some of these include living in an impoverished neighborhood; incarceration; homelessness; having physical, developmental, intellectual or psychiatric disabilities; being sexually or physically re-victimized as children or adults; and victimization through political
repression, genocide, “ethnic cleansing,” torture or displacement.
Judith Herman (2009) emphasizes two major points about complex trauma:
Such trauma is embedded in a social structure that permits the abuse and exploitation of subordinate individuals or groups.
Such trauma is relational. It takes place when the victim is in a state of captivity, under the control and domination of the perpetrator.