The timely provision of information is important to demonstrate caring as well as to help prepare the victim/survivor for system’s challenges:
“Victim/survivors regularly translated the lack of information and communication into a message about their relative (lack of) worth and status in the system. Victim/survivors who did receive information about the [justice] system expressed relief, as it provided them with forewarning about the system, and they were able to adjust and manage their expectations accordingly.” Clark (2010) P 32
“Victim/survivors who were better informed about the legal system’s handling of sexual assault cases (through research, and practitioners’ and others’ experiences) were more likely than those with less knowledge to view the system with frustration, and as being unethical and unjust.” Clark (2010) P 32
The advocate faces several challenges in providing honest and accurate information to help victim/survivors make informed decisions:
- While being realistic, information should be supportive not undermining of colleagues and victim/survivors should be reassured supports will be available
- Information to victim/survivors should be coordinated across disciplines and key agencies to ensure consistency of messages as well as to enhance professional partnerships
However, more comprehensive information does not always result in positive experiences:
- Trauma related stress from the sexual and associated violence as well as from system pressures may reduce the cognitive abilities of victim/survivors including memory and processing
- Complexities of the legal, welfare and health systems need to be presented in a way which provides enough information for informed decision making and consent without being overwhelming
- Factors such as development, literacy levels, language, culture and different information sources/preferences (print, video, pictures, face to face) all require competent management
- While empowered self-advocacy and informed decision making is a goal in some areas, in other areas such as some court processes, victim/survivors may prefer advocates to take charge and represent their best interests
- Legal and ethical requirements exist in seeking consent for procedures and release of information, these can be challenging in some situations such as younger teens
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To develop the knowledge base for self, clients and colleagues advocates may:
- Access and develop clearly organised data bases of electronic, print, video and audio materials.
Click here for some web-base information on services, fact sheets, brochures as well as some innovative methods for presenting information.
Where possible, resource materials should be branded with your agency and local contact details. Please contact the owners of any materials linked in this web should you wish to incorporate their materials into your agency’s resources
- Develop local knowledge of services and procedures including names of key contacts, wait lists and feedback from other clients to help to inform decision making
- Utilise local networks, colleagues and supervisors to help fill in knowledge gaps in specific areas.
- Use helplines for further knowledge. It can be helpful to call a helpline while the victim/survivor is with you, to model using these resources.
To provide consistency of information as well as enhance collaboration common types of information such as reporting options, legal and medical procedures, consultation and agreement between multidisciplinary and multi-agency key players should be sought. Information provided should be realistic; provide both positive and negative elements; explain options; include supports options; and demonstrate a team approach.
Good decision making is a skill which advocates can facilitate. There are many different decision making models decision making techniques and models. These and other skills may be required for group decision making. Below are some factors and techniques to consider when working with victim/survivors and their families:
- Trauma informed – Cognitive abilities reduce with trauma, victim/survivors may be overwhelmed and/or dissociated
- Positive decision making environment – Private, calm environment, access to information resources (e.g. phone, computer, materials), decisional facilitator if required
- Key stakeholders – Who else needs to be involved – are interpersonal relationships stable enough for their involvement?
- Prioritise – What is the most important decision/s and which decisions are possible to make now? Do some decisions need to be made so other things can happen (critical path analysis)?
- What’s the goal? – This is especially important around legal issues. Haley Clark (2010) outlines common victim/survivor justice goals which may be met in a variety of ways (see also Legal Support)
- Decisional balance – Beneficial and negative consequences (including consequences of no decision or decision to stay the same). The fulcrum point for decision making are values. That is, what’s really important to victim/survivor around this issue and how they view themselves. Risk analysis is an important part of this step
- Motivational interviewing techniques – Some of these techniques are useful to facilitate decision making but should not be used by advocates to sway decisions one way or the other (as is the case in motivational interviewing regarding drug use)
- Stage of change – Is the victim/survivor ready to make a decision on this or are they pre-contemplative or just moving into contemplation stage?
- Decisional factors – Matrix mapping of the helps and hinders against Individual (Internal) Interpersonal and Environmental (external) factors can help
- Solution-focused techniques – e.g. Miracle question, exceptions to the problem, when did you last successfully make an important decision & how did you do it? (from Hands on Scotland).
- Generate multiple options (take care not to overwhelm).
- G.R.O.W. coaching questions – Goal, Reality, Options, Way forwards – Aims to support client exploration.
- Next step, support and follow-up – Link decision (cognitive) to a next step (behavioural) to make them concrete. Offer support including follow-up on how the action went, outcomes and if the decision is holding up…
- How Good is Your Decision-Making? A short questionnaire about your decision making with tips below.
Granting of permission for procedures and release of information occurs in the context of supporting victim/survivors whose consent was violated by the perpetrator of sexual violence. (Can I wear your hat is a cute, two minute video on consent as is Tea consent). Consent in a professional therapeutic setting carries legal, therapeutic and ethical considerations. Client led advocacy recognises the need for clients to understand and consent to all aspects of service provision (within the limitations of safety and legislative mandatory reporting requirements). However, some procedures such as medical examinations and release of information require formal, legally sound consent procedures.
“An informed consent can be said to have been given based upon a clear appreciation and understanding of the facts, implications, and future consequences of an action. In order to give informed consent, the individual concerned must have adequate reasoning faculties and be in possession of all relevant facts at the time consent is given. Impairments to reasoning and judgment which may make it impossible for someone to give informed consent include such factors as basic intellectual or emotional immaturity, high levels of stress such as PTSD or as severe mental retardation, severe mental illness, intoxication, severe sleep deprivation…” Wikipedia
The key elements of the above include;
- a clear explanation of what is involved and what are possible positive and negative consequences (including likely and less likely consequences)
- understanding – the person consenting needs to have emotional maturity and reasoning abilities to comprehend the issues and to be able to explain them back to the worker. Asking a close ended question such as “do you understand?” is not enough to indicate comprehension
Common issues which impact on the victim/survivor’s ability to provide consent include high levels of stress, immaturity (age and emotional) and intoxication. Agencies should have or develop guidelines to assist staff in such issues. These guidelines should contain examples of commonly occurring issues (e.g. a recently sexually assaulted teenager who requires medical treatments and does not want her/his parents informed). All staff should be clear about who is able to authorise consent if the victim/survivor is unable to provide informed consent and a procedure is required. Where there is any doubt about consent, supervisory staff should be consulted.
Guidelines for consent by young people, including informing and involving non-offending parent/caregivers is commonly based on Gillick competency and more specifically the Fraser_Guidelines which advocates should be familiar with.
Even when children or others are unable to provide informed consent and others have been authorised to provide this consent on their behalf, they should be fully informed about procedures and decisions with their wishes being considered and facilitated in decisions and explanations.
- Click here for Standard 12 – Provision of information from “Advocacy Standards for working with Children, Young People and Adults who have Experienced Sexual Violence” (Australian).
- Click here (bottom of page) for summary view of above standard.
- Click here for Provide access to information and support for victims/survivors of sexual violence National Occupational Standards (UK)