HJNO May/Jun 2024

SEXUAL VIOLENCE 24 MAY / JUN 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS   the potential for retraumatization while providing compassionate support. This may involve gently redirecting the conver- sation, encouraging limits on the depth of disclosure, or offering referrals to other pro- fessionals who can provide more special- ized care. Is it recommended for a provider who is a survivor of sexual violence to share this information with their patient to validate the patient’s experience? While connecting over shared experi- ences can have healing effects for survi- vors, providers should consider situational and individual factors that may influence how a patient receives such a disclosure from their provider. For instance, certain aspects of a provider’s story may be trig- gering for a patient whether or not they resemble that of the patient’s own expe- rience. Furthermore, a provider disclosure may inadvertently lead to a role reversal wherein the patient feels inclined to care for their provider taking time and attention away from their own care needs. Is there anything else providers should take into account when working with patients who have experienced sexual violence? When navigating these delicate con- versations, it’s essential for providers to know the boundaries of their own exper- tise. Practicing beyond one’s level of com- petence can lead to unintended negative consequences for both the patient and the provider. On the other hand, provid- ers can enhance the patient’s experience and outcomes through consultation when indicated. This may involve leaning on the expertise of colleagues such as SANEs or psychologists who specialize in trauma care. Additionally, it’s important to acknowl- edge that some patients may be inclined to delve deeply into their traumas, partic- ularly when they feel safe with their pro- vider or when they are experiencing a trauma response. However, it’s essential to remember that our patients may not always be aware of or hold in mind our professional training and current bandwidth. It’s also important to keep in mind that survivors will likely be asked to tell their story at least twice, once to perform the forensic exam and once to law enforcement if they want to report. As such, it becomes our respon- sibility to establish and maintain appropri- ate boundaries on their behalf, especially as patients may find it distressing to share their experience repeatedly. By gently guiding patients to share their experiences in a manner that feels safe and manageable, we can help minimize we should start with believing patient disclosures. While some healthcare providers may be primed and aware that a patient is seeking medical care following a sexual assault, this is not always the case. Patients may unex- pectedly share their trauma history when seeking care for an unrelated matter. These unexpected disclosures can be shocking to the provider and require a sensitive and trauma-informed response. What should I do if a patient discloses a history of sexual assault during a routine medi- cal visit? First and foremost, it’s crucial to com- municate belief and validate the patient’s experience. It takes courage to disclose a trauma. So, when a patient does choose to share, we want to support their decision to be vulnerable. When someone chooses to open up about their trauma, especially when they were the victim of some form of interpersonal violence, it is important to acknowledge the injustice. When responding to a patient disclosure of sexual assault during a medical visit, how can a provider be supportive without overstepping or offending? Over half of women have experienced sexual violence involving physical contact during her lifetime. Almost 1 in 3men have experienced sexual violence involving physical contact during his lifetime. Source: Centers for Disease Control and Prevention (2022). National Center for Injury Prevention and Control, Division of Violence. https://www.cdc.gov/violenceprevention/sexualviolence/fastfact.html