Spokane program empowers survivors of sexual assault

From the time a sexual assault survivor walks into an emergency department (ED) to the moment they leave, they’ve likely told their story three to five times — each in varying degrees of detail.

They’ve shared it at the patient intake desk, to the nurse checking their vitals, to the provider who treats them, to the sexual assault nurse examiner collecting evidence and to the officer taking their report.

The last thing a survivor needs is more questions.

Lutheran Community Services Northwest (LCSNW) advocates are there instead as a nonjudgmental and unbiased shoulder to lean on.

“Our most important duty as an advocate is that we’re entirely there on [the survivor’s] terms,” says Kristina Poffenroth, LCSNW victim advocate. “We’re there as much or as little as they want … We’re the one person who is entirely on their side and not there to gather information, evidence or give opinions.”

Lutheran Community Services Northwest by the numbers

(7/1/22-6/30/23)

• 188 advocate responses to hospital
• 270 sexual assault survivors received medical advocacy
• 3,940 calls to 24-hour support line
• 640 sexual assault survivors received legal advocacy

That support continues for as long as a survivor wants, whether just during those first few hours, at peer groups months later or through the years that follow in court.

As Spokane County’s dedicated community sexual assault program, LCSNW is available 24 hours a day with a hotline and emergency resources for any sexual assault that occurs within the community or against someone who lives locally, explains Roshelle Cleland, LCSNW director of advocacy and education.

Services are free, confidential and require no religious affiliation.

“We know that sexual assault is about control and power,” Cleland says. “And we want to give that back to survivors … to empower them.”

The moments after

Some survivors may choose to go to the emergency department (ED) or call the police immediately, while others may wait days or never report the assault to their doctor or law enforcement. The survivor makes the choice.

For those who seek medical care at a Spokane County ED within the first five days of an assault, an LCSNW advocate is called. They answer questions, ensure survivors know their options and rights, provide resources, or may simply be there to sit or talk with, says advocate Poffenroth.

The medical exam alone can be a three- to four-hour long and often re-traumatizing process, says Juliane Rohr, BSN, RN, SANE-A, sexual assault nurse examiner with LCSNW.

Rohr walks survivors through what to expect and the purpose of each step — and remind them it’s their body and choice, she says.

“The purpose is to address any medical needs and collect any DNA evidence, if present,” Rohr says. “That way [adult patients] have what they need and can decide then or later if they want to report to law enforcement.”

Benefits of an advocate

(Courtesy of End Violence Against Women International)

• Survivors more likely to receive STD treatment (86 vs. 56 percent)
• Survivors more likely to be tested for pregnancy (42 vs. 22 percent) and receive emergency contraception to prevent pregnancy (33 vs. 14 percent)
• Survivors less likely to be treated “coldly” when advocate present (36 vs. 69 percent)
• Medical providers less likely to conduct exam because assault occurred “too long ago” (24 vs. 36 percent) — all in study were reported within 96 hours

Those who choose not to seek medical care can access support through the hotline or by contacting LCSNW directly during business hours. LCSNW also partners with many local colleges, including Gonzaga University, where Poffenroth holds office hours for students and Title IX staff.

Every decision is driven by the survivor, Cleland says. Survivors don’t need to undergo an exam or evidence collection or file a police report to receive support. (Keep in mind there are mandatory reporting laws in place for minors.)

LCSNW does, however, advocate for medical care and education to ensure survivors can make informed decisions, she adds. There are many choices to make during what is already a stressful situation, and it’s helpful to have an advocate there as a guide.

The years after

Whether immediately after or years later, every person’s response to trauma is different, Poffenroth says. It’s not uncommon for a victim to talk to their abuser in the days after, become hypersexual or completely abstain from sex as a way to take back control. Some may feel anxious or depressed, while others may block out the memory entirely.

“We often have a picture of a victim and how they should act,” she adds. “We tell people, though, that everything is a normal response to trauma.”

LCSNW also works with survivors identified through backlogged kits from the Spokane Police Department, or those who never reported their assault but are seeking support, Cleland explains.

“Our hotline is used a lot by people who are being triggered or have unhealthy coping mechanisms,” she says. “Or maybe they’ve done all the coping, but something has brought the memory back and they need confidential support for a few moments.”

LCSNW offers a variety of additional support services, including psycho-educational support groups, education, coping tools, and assistance with navigating the criminal justice system, locating safe housing and building safety plans.

While LCSNW can’t meet every need, the most important thing Cleland says they can do is believe survivors and show kindness.

Changing our mindset

As a community, we need to improve how we approach and care for sexual assault survivors, Cleland says. Every conversation is an opportunity to create an environment of belief and support, rather than blame and shame.

That change begins with reducing the long-held stigmas around sexual assault and survivors — which can be directed at others and oneself.

Many of the college students Poffenroth works with have feelings of self-blame if substances like alcohol were involved, or they accept assault as part of college culture.

“It makes the trauma more insidious, and you think it’s bothering you more than it should,” she says. “Your feelings are valid, and you’re allowed to feel however you feel.”

If someone discloses their experience of sexual assault to you, your reaction is important. It will affect whether the survivor tells anyone else, Cleland says. Minimizing or changing the subject, placing blame or asking for unnecessary details can re-traumatize a survivor.

Sometimes we say the wrong thing without meaning to, Poffenroth says. It can be as simple as saying “You can report.” versus “You should report.” Or working to reduce the number of times a survivor must tell their story.

It’s especially important in health care and criminal justice environments to create a space where people feel safe to disclose — and not shamed — while sharing their experience, Rohr says. Community hospitals could benefit from a more uniform approach to sexual assault reports and better knowledge of what resources are available to ensure a seamless experience for all survivors.

“We know that people who experience sexual assault and are then re-traumatized by their health care experience are overall less likely to seek care later on,” which could have damaging impacts on their overall health and well-being, Rohr says.

It’s your story, no one else’s

Most prevention and support practices come down to education, Poffenroth says.

Many people still believe sexual assault is perpetrated by strangers jumping out of the shadows at night, she says. While that does happen sometimes, it’s more common that a survivor’s attacker is someone they know — especially in cases involving adolescents.

Sexual assault is also far more common within intimate partner relationships and teen and college-aged relationships, she adds.

One of the best prevention tools is comprehensive sex education for youth, Poffenroth says. That begins with age-appropriate lessons around consent and boundaries and learning how to respect other people’s boundaries.

No one gets anything out of reporting a sexual assault, Poffenroth says. But we can all get something out of supporting and believing survivors.

“Partnering for healing and a healthy future” is MultiCare’s mission, and it inspires us to form connections that help improve the quality of life for our communities. Community organizations all around us are doing amazing work, and we’re inspired and excited to support that work.

Stories from our Community is an ongoing series conceived to dive into some of these organizations*, bring their stories to life and spread the word about how they are making our communities better.

*Some of the organizations profiled in this series are recipients of MultiCare’s Community Partnership Fund, which awards funds to nonprofit organizations working on initiatives, programs and projects that improve our community.