Responding to Emma's Immediate Concerns
Case One
Emma, a 17-year-old Latina high school student, walked into the mental health center where you are doing your internship. You are working on the emergency team, so she is referred to you as a walk-in client. Emma is tearful, shaking, and barely holding it together. Through her sobbing, she tells you she was raped the night before by a boy at a party. She did not know his name. Emma has not told anyone, especially her parent who she describes as being of strict Catholic faith. She is terrified they will blame her because she snuck out of the house after midnight. Emma refuses to go to the police, hospital, school, or home. She states, “I’d rather be dead than have my parents find out.” She appears immobilized.
Respond to the following questions:
1.How do you respond to Emma’s immediate concerns?
2.What are your priorities with Emma in this session?
3.Who else may you involve in the conversation?
4.What skills will you utilize?
5.What additional information or resources are required for you to assist Emma?
6.What are the desired outcomes for Emma and you in this session?
7.Describe your assessment and treatment plan.
Responding to Emma's Immediate Concerns
Validate Emma's feelings: Let her know that her feelings of fear, shame, and guilt are normal reactions to a traumatic experience. Assure her that she is not alone and that her feelings are valid.
Ensure her safety: Reiterate that her safety is of utmost importance. Assure her that you will do everything in your power to keep her safe and support her through this difficult time.
Assure confidentiality: Explain the importance of confidentiality and assure Emma that her information will be kept private unless there is an immediate threat to her safety or the safety of others.
Priorities in the Session
Establish rapport and trust: Create a safe and non-judgmental environment where Emma feels comfortable sharing her experiences and emotions.
Provide emotional support: Validate Emma's emotions and provide empathy and understanding. Help her process her feelings and cope with the trauma she has experienced.
Assess for immediate risk: Determine if Emma is at immediate risk of harm to herself or others. If necessary, develop a safety plan to ensure her well-being.
Explore options and resources: Discuss potential options for support, such as seeking medical attention, reporting the assault, and accessing counseling services. Provide information about available resources that can assist her in her healing journey.
Involving Others in the Conversation
Law enforcement: While Emma may be hesitant to involve the police, it is important to discuss the option of reporting the assault. Inform Emma about the potential benefits of reporting, such as holding the perpetrator accountable and accessing resources for survivors.
Medical professionals: Discuss the importance of seeking medical attention to address any physical injuries, potential risks of sexually transmitted infections, and the possibility of pregnancy resulting from the assault.
School counselor or social worker: If Emma feels comfortable, involving a school counselor or social worker can provide additional support and resources within the school setting.
Utilizing Skills
Active listening: Demonstrate active listening skills to show empathy, understanding, and validate Emma's emotions.
Trauma-informed approach: Utilize a trauma-informed approach to create a safe and supportive environment for Emma to share her experience.
Crisis intervention: Apply crisis intervention techniques to help Emma manage her immediate distress and develop coping strategies.
Psychoeducation: Provide information about the effects of trauma, common reactions, and available resources to empower Emma and increase her understanding of the situation.
Additional Information and Resources
Local rape crisis centers: Gather information about local rape crisis centers that provide specialized services for survivors of sexual assault, including counseling, advocacy, and support groups.
Legal information: Research the legal rights and options available to survivors of sexual assault in Emma's jurisdiction.
Support groups: Identify support groups or therapy options that cater specifically to survivors of sexual assault. These can provide Emma with a community of individuals who have experienced similar traumas.
Desired Outcomes
Safety: Ensure Emma's immediate safety and well-being.
Emotional support: Provide a safe space for Emma to express her emotions and validate her experiences.
Empowerment: Help Emma regain a sense of control and agency by providing information about her options and resources available to her.
Coping strategies: Collaboratively develop coping strategies to help Emma manage her emotions and navigate the healing process.
Referrals: Connect Emma with appropriate resources, such as counseling services and support groups, to facilitate her long-term healing and recovery.
Assessment and Treatment Plan
Assessment: Conduct a comprehensive assessment of Emma's current emotional state, trauma history, social support system, and immediate safety needs.
Safety plan: Develop a safety plan in collaboration with Emma to address any immediate risks or concerns for her well-being.
Psychoeducation: Provide psychoeducation on the effects of trauma, common reactions, and coping strategies to help Emma understand and normalize her experiences.
Trauma-focused therapy: Consider referring Emma to a trauma-focused therapist who can provide specialized support in processing the assault and its aftermath.
Collaborative decision-making: Involve Emma in decision-making regarding reporting the assault, seeking medical attention, and accessing support services, ensuring she feels heard and empowered throughout the process.
Follow-up and ongoing support: Schedule regular check-ins with Emma to monitor her progress, provide ongoing support, and adjust the treatment plan as needed.