Women’s History Month: Reflecting Representation in Therapeutic Services
By Erik Eging, Outreach & Communications Specialist at NVRDC
While sexual assalt can happen to anyone, the data points to it disproportionately affecting women.
According to the Center for Disease Control (CDC), 1 in 5 women experience sexual violence in their lifetime, as opposed to 1 in 14 men, and 81% of those women report that the violence occured before the age of 25.
Complicating this picture further is the higher rate at which marginalized communities experience sexual violence and the additional barriers they face when interacting with the criminal legal system. According to a similar CDC report, “Approximately 4 out of every 10 non-Hispanic Black women, 4 out of every 10 American Indian or Alaska Native women (43.7% and 46.0%, respectively), and 1 in 2 multiracial non-Hispanic women (53.8%) have been the victim of rape, physical violence, and/or stalking by an intimate partner (IPV) in their lifetime”. The data also suggests that members of the LGBTQ community face sexual violence at higher rates than their straight counterparts. What is clear is that a person’s background and identity play a role in how they experience victimization, the likelihood of that occurring, and the ways in which they are treated when seeking support from justice systems and victim service providers. From issues of systemic power differentials, institutional failings, to nuances in reporting, many survivors have valid reasons to distrust the process and people they come into contact with while seeking justice.
This is a lot to unpack, and attempting to do so in the aftermath of an assault can be discouraging if not downright debilitating. That is why NVRDC exists, because we recognize that it is a matter of human rights to help survivors seek healing so they can return to their lives and communities with a sense of dignity and empowerment, so that they are not further marginalized or locked out of economic opportunities while healing from trauma. That's why working with a licensed therapist during this time can be so transformative in the lives of survivors.
In honor of Women’s History Month, I sat down with Reesie Sims, NVRDC’s Therapeutic Services Manager, who pioneered our in-house Therapeutic Services Program to discuss what lead to the inception of the program, the barriers many survivors face when trying to seek help, especially women, as well as the importance of representation in both her practice and within nonprofit organizations.
Interview with Reesie Sims
What gaps in services did you identify as a Senior Advocate that led you to create the Therapeutic Services Program?
“As a Senior Advocate, I often interacted with survivors of violence in the immediate aftermath of traumatic events. When providing support to these individuals, the topic of mental and emotional support was almost unequivocally requested. There are several partner organizations in which Advocates provide referrals for such services, but the availability of these services varied greatly. Waitlists would extend into double and sometimes triple digits. Private therapy practices would also vary in availability and if there were openings, the costs of services would be a financial strain for many of the survivors we serve. Even access to resources available to assist with these costs would face barriers - some private therapy practices do not accept payment from the Crime Victims Compensation Program (a government entity that provides financial assistance and reimbursement to victims of violent crime). Witnessing these struggles compelled me to think of ways NVRDC might address the barriers. It then dawned on me that this was a gap in the continuum of services we offer and one in which we could close.”
2. How do barriers to access [mental health support] impact sexual assault survivors' path towards healing? How does gender play a role in what barriers a survivor faces when seeking mental health services and how do you address this in your practice?
“A mental health professional can guide survivors in identifying social support networks and ways to expand self-soothing capabilities. They can provide space for survivors to reconnect to self and reconcile worldview perspectives that had been challenged by the violence. Without this type of emotional processing, it can be difficult for someone to truly heal from being hurt. A sexual assault survivor may feel discouraged from seeking professional help if they have tried numerous times to no avail. Additionally, some clients feel more comfortable receiving therapeutic services from people who identify as women. Not having that option available may add onto feelings of hopelessness when it comes to healing. I think certain aspects of my lived experience (such as my gender identity) help overcome barriers related to concerns about emotional safety or comfort.”
3. Why was it important to make these services available in-house at NVRDC?
“The Therapeutic Services Program provides immediate mental health support to survivors who connect to an Advocate at the hospital, in the community, or via office intake. Because this service is available in the aftermath of violence, it strengthens the vertical continuum of care that NVRDC champions. It allows NVRDC staff to serve clients in a holistic way, adding to the menu of services that we offer in support of survivor-defined justice. The organization has facilitated successful survivor support groups in the past - NVRDC’s core value of innovation is epitomized by fully fleshing out therapeutic services.”
4. 3 out of 4 NVRDC clients are women who have survived a sexual assault. In FY21, 83% of our clients self identified as women and 46% self identified as African American. From your own perspective as a woman of color, how important is representation for those searching for help after a traumatic event? How did this inform the way you designed your program?
“While no one group of people are a monolith, some experiences are uniquely shared between individuals in any given culture. You can imagine the comfort a survivor feels when the professional helping them can relate to some aspect of the survivor’s identity or experience. Sometimes my racial identity is the greenlight for a person of color to engage in and trust the therapeutic process. Likewise, my gender identity indicates a certain level of understanding. These commonalities with many of our clients foster a safe space to manage the aftermath of traumatic events. It is the idea that clients can show up as their full selves irrespective of how their identities are perceived by the world. That was very important to me in considering how the program should operate.”
4. In an interview for the blog “Why Mental Health Is A Feminist Issue” Dr. Mindy J. Erchull, professor of psychological science at the University of Mary Washington in Virginia said, “The mental health challenges for a white, cisgender, heterosexual, well-educated, upper-middle class woman working in management at a Fortune 500 company are likely to be different than those of a Latinx, transgender woman who doesn’t have access to safe housing, is food insecure, and can’t find stable employment outside of sex work, we need to complicate rather than simplify these discussions.” How do you address the needs of your clients while taking into account the intersections of race, class, sexual orientation and gender-identity when seeking mental health services and processing trauma?
“I think this is an excellent quote from Dr. Erchull. Because our socioeconomic statuses, race, gender identities, and sexual orientations all factor into the types of experiences we have or the lives we lead, our realities are likely to differ. I work with a variety of communities and I’m committed to maintaining a space where all can show up and feel respected.
In an effort to make the program accessible to underserved populations, sessions are offered both in-person or virtually with a wide range of time availability to ease barriers to service. For clients requesting in-person sessions and facing financial difficulties, NVRDC is able to cover transportation costs. I have provided sessions over the phone for clients struggling with video technology and I have increased the number of sessions offered to clients anxious about paying for longer-term support. It can be incredibly challenging for a survivor to process trauma and focus on their overall wellbeing when an urgent need like housing stability or food security is unmet. To this point, I’m thankful for our Advocates who show up day in and day out to assist survivors in meeting these needs.”
5. Historically, women’s mental health has either not been taken seriously or weaponized against them. Given that the majority of sexual assault victims are women, how does your program help validate the mental health needs of women and what approaches do you use to reduce the stigma surrounding mental health services?
“We hear historical stories of women being confined to psychiatric institutions for experiencing postpartum depression, anxiety, or even fictitious mental health illnesses like “extreme jealousy,” or “madness” for being assertive. These acts of institutionalization existed to quiet women or abandon care for their wellbeing. While it appears that we have progressed from those times, mental health diagnoses can still influence the care a woman receives. Mental health providers can be subpoenaed by legal defense teams; these teams often discount the impact of assault on a woman, alluding to the idea that mental health struggles are the real culprit in a violent crime. And to expound upon another barrier surrounding mental health services, insurance agencies require a mental health diagnosis for providers to be paid. Because NVRDC’s Therapeutic Services Program is free of cost to survivors, insurance is not required. Therefore, neither is a mental health diagnosis. Survivors' emotions are validated - whatever those emotions may be - and women do not have to worry that their expressions or processing will be taken out of context. It allows a more trusting and relaxed environment to truly address the reasons the survivor is seeking help.”
6. When designing this program you cited a Women of Color Network report, stating that individuals from underrepresented groups are more likely to be employed in low-level positions in small to medium size anti-violence organizations, regardless of the length of time in the field. For individuals from underrepresented groups, there is an invisible ceiling in terms of advancement and mobility within the field of anti-violence. How important was it for you to create an opportunity for representation in a higher level of leadership at NVRDC given how integral diversity in life experience is to innovation within organizations like NVRDC?
“I imagined that some of the employees in that report may have had innovative ideas - things that could have enriched their organizations. And I thought about the implications of an invisible ceiling being felt but not acknowledged. How a work culture such as that can result in disempowered staff keeping groundbreaking ideas to themselves. How the thought of even striving for advancement could feel out of reach. It was a moment of humility for me because I had finally found an organization where those experiences were not my reality. When I first started working at NVRDC, I was informed that a Latina staff attorney realized her interests had expanded, proposed a new position related to those interests, and received enthusiastic support from leadership in developing an all encompassing role. The seed of innovation had been planted from the very beginning! I included the Women of Color Network report in my proposal because it underscores the importance of maintaining such progress (the attorney is now Head of an NVRDC organizational domain). I think it is just as important to have representation in leadership roles as it is to have at the direct service level. Diverse lived experiences can heighten the level of care in developing and managing programs. I was fully supported and affirmed in creating this program while the intersection of my Blackness and womanhood was celebrated and embraced. It has been a transformative experience.”