Building a culture of support: The use of a social norms campaign to create a trauma-informed campus community.

In 2019, (Michigan State University) conducted a campus-wide climate survey on relationship violence and sexual misconduct (RVSM; the 'Know More' Survey), which revealed that many students, faculty, and staff did not know where to go for help or how to support survivors. Objective: The authors collaborated on the design and launch of the 'Support More' Campaign in 2021-2022, a trauma-informed social norms campaign created to educate the campus community on how to respond to disclosures of RVSM and how to access campus-based services. Methods: Undergraduate students, graduate/professional students, faculty, and staff (n = 10,993) completed another 'Know More' Survey in spring 2022. Results: Nearly one-half of respondents reported being very or somewhat aware of the 'Support More' campaign. Respondents who had utilized campaign materials found them helpful. Conclusions: Social norm campaigns can help campus communities become aware of RVSM services and how to support survivors.

Teen dating violence and the COVID-19 pandemic: trends from a longitudinal study in Texas.

PURPOSE: Teen dating violence (TDV) is a global public health and safety issue causing health impacts to youth people. This study aimed to examine: (1) the impact of the pandemic on TDV victimisation rates and (2) socioecological factors associated with sustained risk for TDV victimisation during the first year of COVID-19. METHODS: Data are from an ongoing randomised controlled trial of a TDV prevention programme in Texas (n=2768). We conducted annual assessments in 2019-2021. We used regression modelling to assess demographic, individual, peer and family factors associated with TDV risks. RESULTS: TDV rates declined from 11.9% in 2019 to 5.2% in 2021. While demographic, peer and family/household factors were not associated with TDV victimisation during the pandemic, individual-level factors (ie, early sexual debut, substance use, acceptance of violence and prior TDV involvement) were related to COVID-era risks. Only early sexual debut was uniquely linked to TDV victimisation risk the first year of COVID-19. CONCLUSIONS: While TDV rates declined during the pandemic, previous victimisation, substance use and early sexual debut remained potent risks for relationship harm.

Understanding how peers respond to online child maltreatment disclosures: A qualitative content analysis of family violence discussions on social media.

BACKGROUND: Positive, supportive responses to child maltreatment disclosure are critical for victims to receive appropriate resources and support for healing. Young people often prefer to disclose to their peers, frequently on social media platforms. OBJECTIVE: We assessed young people's use of TalkLife, an online peer-to-peer support platform, to respond to the disclosure of child maltreatment. METHODS: We conducted a qualitative content analysis of 1090 comments on childhood maltreatment-related posts on TalkLife between 2013 and 2020. We used an iterative, team-based qualitative content analysis approach to understand how peers responded to maltreatment disclosure. FINDINGS: Peer responses tended to be supportive, including asking questions about the abuse and offering advice, emotional support, and other positive responses. Most commonly, peers advised the victim to report, focus on their strengths instead of the abuse, reach out to adults for more support, or confront the perpetrator. On occasion, however, peers began an irrelevant discussion, joked about the situation, or even directly attacked the discloser. CONCLUSIONS: Learning about child maltreatment disclosures on social media builds the foundation for research to assist in identifying and applying interventions on online platforms. Further, these findings can inform programs that teach how to provide healthy responses to child maltreatment disclosures.

BARRIERS TO REPORTING AND LACK OF EQUITABLE SUPPORT: ABORTION ACCESS FOR ADULTS WITH AUTISM EXPERIENCING RAPE-RELATED PREGNANCY POST-ROE.

Following the overturning of Roe v. Wade, individuals with autism experience unique barriers to accessing abortion for rape-related pregnancies in states restricting reproductive health care. Barriers to reporting rape include inadequate sex education which contributes to a lack of information about sexual violence (SV), difficulties labeling and recognizing SV, and potential difficulties navigating the role of a caregiver or conservator when reporting SV. Individuals with autism often experience a lack of equitable support from formal SV support services. Both barriers to reporting and lack of equitable support from formal SV support services reflect that individuals with autism are marginalized and often overlooked when receiving sexual and reproductive health care. Suggestions are provided for sexuality educators, SV support services, police, healthcare providers and policymakers, for better supporting individuals with autism experiencing rape-related pregnancy in states with abortion restrictions.

Secondary Institutional Betrayal: Implications for Observing Mistreatment of Sexual Assault Survivors Secondhand.

Institutional betrayal has been used to describe the experiences of sexual assault survivors who are harmed by institutions which they rely on for safety or survival. This concept has primarily been studied in the context of survivors' direct relationships with institutions they are members of (e.g., universities, churches, military) and how the said institutions either failed to protect them or were unsupportive following their disclosure. Institutional betrayal can exacerbate negative mental and physical health outcomes for survivors, highlighting a need to hold institutions accountable for harm they cause. A limitation to this conceptualization is that many adults in the general public are not proximally connected to institutions (as they have historically been defined), and the majority of survivors do not formally report. Drawing on semi-structured interviews conducted with young women survivors (n = 12), the present study aims to address this gap by abstracting the conceptualization to a more macro level, proposing the term secondary institutional betrayal. Secondary institutional betrayal refers to survivors' feelings of mistrust and disillusionment toward institutions they are distally connected to which are not directly involved in their own assault (e.g., the media, U.S. government, U.S. criminal legal system, their university), yet still have influence over their personal safety and survival. This sense of betrayal stems from secondhand observations, through the news media, of how other survivors are treated by these institutions. Many survivors in the present study reported their secondhand observations of institutional betrayal would likely deter them from reporting future assaults. Establishing research in this area is important to understand how survivors in the general public are impacted by news stories which highlight institutional betrayal, particularly in the context of ongoing social movements (e.g., #MeToo) which amplify public discourse about sexual assault.

Recruitment strategies in couple intervention studies: A systematic review of recruitment methods and sample characteristics in the United States from 2015 to 2020.

Including diverse participants in couple intervention studies is critical for developing an evidence base that informs best practices for all potential clients. Research has shown that subgroups of clients respond differently to different interventions and that interventions that have been adapted to fit the needs of a given population are more effective than non-adapted interventions. Unfortunately, couple intervention samples often exclude participants with marginalized identities and culturally adapted couple intervention research is limited. The lack of information about best practices for diverse client subgroups perpetuates mental and relational health disparities. We conducted a systematic review to examine recruitment strategies and sampling characteristics of diverse races/ethnicities, incomes, ages, and sexual identities. We reviewed articles published between January 2015 and December 2020. Articles were eligible for inclusion in our review if they implemented an intervention with couples in the United States. Of 4054 articles identified, 54 articles were eligible for our review. Findings suggest that couple intervention studies lack diversity across multiple identity domains (i.e., races/ethnicities, incomes, ages, and sexual identities). Further, descriptions of recruitment strategies are often vague, limiting opportunities to better understand methods used to recruit diverse samples.

Rape Myth Acceptance in a Community Sample of Adult Women in the Post #MeToo Era.

Rape myth acceptance (RMA) is commonly targeted in anti-rape activism (e.g., the #MeToo Movement) and prevention work due to its association with perpetration, risk of victimization, survivor outcomes, and injustices in the criminal legal system. The 22-item updated Illinois Rape Myth Acceptance (uIRMA) scale is a widely used, reliable measure for assessing this construct; however, it has primarily been validated within samples of U.S. college students. To assess the factor structure and reliability of this measure for community samples of adult women, we analyzed uIRMA data from 356 U.S. women (age 25-35) collected via CloudResearch's MTurk toolkit. Confirmatory factor analysis demonstrated high internal reliability for the overall scale (α = .92) and supported a five-factor structure (subscales: She Asked For It, He Didn't Mean To, He Didn't Mean To [Intoxication], It Wasn't Really Rape, She Lied) with good model fit. The rape myth ''He Didn't Mean To'' was most highly endorsed in the overall sample, while ''It Wasn't Really Rape'' was endorsed the least. Analyses of RMA and participant characteristics demonstrated that women identifying as politically conservative, religious (predominantly Christian), or heterosexual endorsed rape myth constructs at significantly higher rates. Education level, social media use, and victimization history yielded mixed findings across RMA subscales, while age, race/ethnicity, income level, and regional location showed no associations with RMA. Findings suggest the uIRMA is an appropriate measure of RMA in community samples of adult women; however, the field would benefit from more consistent administration of the scale (i.e., 19-item vs. 22-item version; directionality of Likert-type scale) to allow for comparability across time and samples. Rape prevention work should target ideological adherence to patriarchal and other oppressive belief systems which may represent a common underlying factor across groups of women showing higher endorsement of RMA.

Adopting a "Both/And" Mindset to Address Relationship Violence and Sexual Misconduct (RVSM) in Institutions of Higher Education.

Michigan State University (MSU) created a long-term, values-based strategic plan to increase help-seeking and reduce the incidence of relationship violence and sexual misconduct. Creating systemic change in institutions of higher education is challenging, particularly so in the wake of massive institutional crises and betrayal, as we had at MSU. In this paper, we address the challenges and critiques of our strategic planning efforts offered by esteemed scholar-activists: Jacobson López (2023), Hirsch and Khan (2023), McMahon (2023), and Boots et al. (2023).

Creating a University Strategic Plan to Address Relationship Violence and Sexual Misconduct (RVSM): An Application of Principles-Focused Evaluation at Michigan State University.

This paper describes a multi-year initiative at Michigan State University (MSU) to change our institutional response to relationship violence and sexual misconduct (RVSM) in the aftermath of a large-scale institutional crisis. While the circumstances at MSU are unique, many universities have faced or will face moments that bring RVSM issues into the spotlight. To inform other colleges and universities, we describe how we developed a 5-year strategic plan to transform services for survivors and develop prevention programming for multiple audiences and at multiple levels of analysis. We titled this framework Know More. Do More. Support More, whereby "know more" reflects our ongoing use of campus climate surveys and data sharing to educate our community about RVSM; "do more" includes our institutional-level strategic plan for culture change; and "support more" provides guidance to our community members on how to respond to disclosures in a trauma-informed way and connect survivors to support services. We discuss the challenges and opportunities that stemmed from our choice to work "within the system" to create this model, as well as the ethical dilemmas we faced in these partnerships.

"They are Assuming That We are Going to Accuse Them of Rape, and We are Assuming That They are Going to Rape us": A Developmental Perspective on Emerging Adults' Consent Conversations Post #MeToo.

Prevalence of sexual assault remains high on American college campuses, and sexual consent education is lacking within school-based sexual health education programming. Much empirical research has aimed to reduce sexual violence through a deeper understanding of college students' perceptions of sexual consent. However, researchers have not yet examined the impact of broader social discourse, such as that initiated by the #MeToo movement, on emerging adults' conceptualizations of sexual consent. Gendered focus groups were conducted with 34 college students at a large midwestern university in spring of 2019. Qualitative analyses using a phenomenological framework revealed a developmental process of consent education shaped by socialized sexual scripts and public discourse of the #MeToo movement. Four distinct themes emerged: (1) Introductions to Consent in Childhood, (2) Lack of Sexual Consent Education in Adolescence, (3) The Nuanced College Context, and (4) Consent in the Era of #MeToo. Findings reveal that consent is introduced in childhood, outside the context of sexuality, but is generally not revisited within the context of sexual consent by parents or educators during adolescence, leaving media messaging and socialized sexual scripts to serve as guides for sexual consent. This lack of sexual consent education in adolescence then leaves emerging adults unprepared for nuanced sexual experiences in the college context and unable to critically engage with public discourse surrounding consent such as the #MeToo movement, which has caused both fearful and positive outcomes. Findings support the need for earlier and more comprehensive education about sexual consent in childhood and adolescence and the need for college sexual assault prevention programs to include further instruction on navigating ambiguous sexual consent experiences.

Exploring Survivor Experiences on Social Media in the #MeToo Era: Clinical Recommendations for Addressing Impacts on Mental Health and Relationships.

Since the inception of the viral #MeToo Movement in 2017, news coverage of sexual assault incidents and related public discourse have become much more prevalent on social media platforms. While this hashtag activism has prompted important social discourse, little is known about how exposure to this type of trauma-related content affects survivors of sexual violence navigating these online spaces. To explore this phenomenon, we conducted in-depth, semi-structured interviews with young adult women survivors of sexual assault who regularly use social media (e.g., Facebook and Twitter). Participants were asked to reflect on sexual assault-related content (i.e., news stories and related public discourse) which they have observed on social media platforms. Thematic analysis of the qualitative data found survivors described (1) negative changes to their mental health and relationships in the face of these exposures, (2) certain types of content (e.g., rape culture narratives) which were particularly distressing to them, (3) how they coped with distress tied to this exposure, and (4) recommendations for clinicians on how to help survivors navigate social media in a healthier way. The present study is a first step toward understanding the impact of online social movements on trauma survivors and provides concrete clinical recommendations for therapists working with sexual assault survivors in this unique post-#MeToo context.

Reproductive coercion, intimate partner violence, and pregnancy risk among adolescent women with a history of foster care involvement.

BACKGROUND: The current study is the first to explore the prevalence of reproductive coercion among adolescent women currently or previously involved in the U.S. foster care system. Reproductive coercion (RC), a form of intimate partner violence (IPV) involving exertion of power over a partner by controlling their reproductive health and decision making, is a significant public health concern. Existing research on RC has primarily been conducted in either healthcare settings or on college campuses. Foster youth are disproportionately impacted by both adolescent pregnancy and interpersonal violence. RC may contribute to this elevated risk. METHODS: We conducted a cross-sectional survey in 2015 and 2016 of adolescent women (n=136), ages 16-24 years old, seeking services from youth-serving agencies affiliated with a child welfare system in Pennsylvania, United States. Participants completed measures assessing RC, experiences of physical and sexual violence, sexual behaviors, and pregnancy. We used multivariable logistic regression to assess associations between RC and study outcomes. RESULTS: The sample was predominantly African American (67.4%) and largely identified as something other than heterosexual (46.6%). Nearly one-third of the sample (30.1%) reported a history of RC, with the most common being male partners telling them not to use birth control. High rates of IPV (62.1%), lifetime pregnancy (43.4%), and unwanted pregnancy (30.9%) were also reported. RC was associated with significantly higher odds of IPV (Adjusted Odds Ratio (AOR) = 4.22, 95% Confidence Interval (CI): 1.60, 11.13), multi-perpetrator rape (AOR 3.56, 95% CI: 1.04, 12.24), pregnancy (AOR = 5.39, 95% CI: 2.14, 13.60), and unintended pregnancy (AOR 5.39, 95% CI: 2.04, 14.25). Young women reporting RC also had elevated odds for using alcohol or drugs before sex (AOR = 4.34, 95% CI: 1.72, 10.97) and having sex with a male partner 5 years or more older (AOR = 7.32, 95% CI: 2.84, 18.87). No significant differences emerged between RC and sociodemographic characteristics. IMPLICATIONS: These data suggest women involved in the U.S. foster care system, particularly women of color and/or LGBTQ+ identified who comprised the majority of participants in the current study, may be at an increased risk for experiencing RC and other forms of IPV associated with adolescent pregnancy. In addition to efforts to prevent IPV and sexual violence, assessment for RC, healthy relationships education, and access to sexual and reproductive health care may mitigate these risks and improve outcomes for these young women.

Representation of Diverse Populations in Couple and Family Therapy Intervention Studies: A Systematic Review of Race/Ethnicity, Sexual Orientation, Age, and Income in the United States from 2014 to 2019.

Disparities in mental health care among marginalized populations have been well-documented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle- to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.

Las desigualdades en la atención para la salud mental entre poblaciones marginadas están muy bien documentadas. Si no se diseñan investigaciones para estudiar intervenciones orientadas a poblaciones diversas, las desigualdades en la calidad de los servicios y en los resultados de los tratamientos seguirán existiendo. Se realizó un análisis sistemático de artículos que evaluaban las intervenciones de la terapia familiar y de pareja para evaluar la representación de poblaciones diversas. Más específicamente, los investigadores intentaron analizar la raza/etnia, la orientación sexual, el nivel de ingresos y la edad de los participantes de la muestra. Se incluyeron en el análisis ciento noventa y seis estudios que evaluaban las intervenciones de la terapia familiar y de pareja en los Estados Unidos en diez revistas médicas. Los resultados indican que la investigación sobre terapia familiar es más representativa de la minoría racial y de los participantes de bajos recursos en comparación con los estudios de intervenciones para las parejas. La investigación sobre terapia de pareja generalmente se sigue realizando con muestras predominantemente blancas, de ingresos medios y altos. Después de los blancos, los afroestadounidenses y los hispanos/latinos fueron los grupos raciales/étnicos más comunes incluidos tanto en la investigación sobre terapia familiar como en la de pareja. Los participantes de relaciones del mismo sexo estuvieron ausentes en las investigaciones sobre intervenciones familiares y se investigaron poco en los estudios sobre intervenciones para parejas. Solo un estudio sobre terapia de pareja reunió una muestra en la cual la edad promedio fue la edad adulta tardía. Estos resultados son motivo de preocupación teniendo en cuenta las desigualdades crecientes en el ámbito de la salud mental en los Estados Unidos.

Therapeutic Utility of Discussing Therapist/Client Intersectionality in Treatment: When and How?

The impact of the therapeutic alliance on positive clinical outcomes has been established in the literature; however, literature is lacking on how the intersection of therapist and client identities influences this process. We propose that the relational intersectionality resulting from similarities or differences in therapist and client identities has the potential to impact the bonds, tasks, and goals of treatment (key components of the therapeutic alliance; Bordin, 1979) depending on how it is addressed or avoided in therapy. In this paper, we present a model containing pragmatic steps therapists can follow to navigate these conversations with clients in a way that is therapeutically beneficial and culturally sensitive and attuned. Additionally, we provide suggestions for using the proposed model to train new student therapists (or expose experienced therapists) to ideas of intersectionality and social justice by reflecting on the intersection of their own identities, acknowledging dynamics of power and oppression, and understanding how this could shape their relationship with clients.

En la bibliografía se ha establecido el efecto que tiene la alianza terapéutica en los resultados clínicos positivos; sin embargo, existe escasa bibliografía sobre cómo la intersección de las identidades del terapeuta y del paciente influye en este proceso. Proponemos que la interseccionalidad relacional resultante de las similitudes o las diferencias en las identidades del terapeuta y del paciente tiene posibilidades de influir en los vínculos, las tareas y los objetivos del tratamiento (componentes clave de la alianza terapéutica; Bordin, 1979) según como se aborde o se evada en la terapia. En este artículo presentamos un modelo que contiene pasos pragmáticos que los terapeutas pueden seguir para orientar estas conversaciones con los pacientes de una manera que sea beneficiosa a nivel terapéutico y que esté adaptada a las particularidades culturales y las tenga en cuenta. Además, ofrecemos sugerencias para usar el modelo propuesto a fin de capacitar a nuevos estudiantes de terapia, o para exponer a terapeutas experimentados, a ideas de interseccionalidad y justicia social mediante la reflexión sobre la intersección de sus propias identidades, el reconocimiento de la dinámica de poder y opresión y la comprensión de cómo esto podría moldear su relación con los pacientes.