Deal with that patient in a very sensitive way watch your tone and body language dont rush in this type of case and pace along the patient
Reassure them its a safe environment
Appreciate them how brave they are like when they are opening up to you Remeber confidentiality
Thn start taking the history of incident
How when where who did that
If someone else was there
Who else knows about it
How is abuser related to them
What did they do after that What did abuser do after that
What was the route of abuse and was any protection used?
Were the abuser under the influence of drugs
Have they ithappen ed bone about it
Support (parents/friends)
How they are coping up
Any anxiety/panic attacks/sucidal thoughts
Effects on school sleep mood
Social hx
Relationship hx/sexual history
What worries them the most right now?
Have they thought of reporting it to police
If not why? Are they threatened?
Tell them its sexual abuse and should be reported to police
Involve senior
Offer counselling
Refer to sexual abuse assessment clinic/GUM
clinic/sexual assualt reporting centre
They will examine n take swabs
Ask them to talk to parents for support
In this management take patient with you involve him n choose right words for this case
Do practise these type of cases so you will know where you lack!
Approach to Sexual assault case
-Introduction
-Show sympathy, offer confidentiality to help the patient open up
-Once the patient opened up – reflect and empathize
-Now its time to explore
When? Where? Who? What happened? What exactly happened? What did you do after? What did the other person did after? Route of sexual intercourse? Was there protection used?
Have you talked to anyone? Reported to police? Why? Is he threatening you?
Then based on the route of sexual intercourse you can ask symptoms.
Psychosocial history (mood, support, job/studies)
ICE
No examinations (its a crime scene, do not enter)
Outline the diagnosis
Tell you patient that they can report this to the police
Refer to Sexual Assault Reporting Center (SARC) for forensic investigation so later when they decide to report to the police, they`ll have evidence
Offer support groups, CBT
Thank you for compiling this. I think this is the lady that wants to change her counsellor. I just want to make a small addition: SARC is sexual assault referral centre (rather than ‘reporting’). Thanks 