Leanne R Brecklin

INTRODUCTION

Between 13% and 20% of adult women experience rape in their lifetime, according to data from both community and college student samples.1,2,3,4 Rape has been linked with several negative consequences including posttraumatic stress disorder (PTSD), depression, anxiety, fear, suicidal ideation, alcohol/substance abuse, poorer physical health, lower self-esteem, and sexual dysfunction.5,6 Efforts to reduce these negative effects and prevent repeat sexual victimization need to be made a priority, given that prior victimization is such a strong predictor of future victimization.7,8,5,10,11,12,13 According to a recent literature review, two of three sexually victimized women will experience sexual revictimization.14 Traditional rape risk reduction programs (without self-defense training) targeting college women have typically been unsuccessful at reducing the revictimization of sexual assault survivors,15,16 even when specifically targeting women with victimization histories.15

Self-defense training is an additional option that sexual assault survivors may seek out in the hopes of reducing their risk of revictimization. Even though it is always the offender who is to blame for committing sexual assault, it is still key to educate women about how they can effectively respond to and hopefully avoid potential assaults. Self-defense training prepares women both mentally and physically for potential assaults17 by providing them with opportunities to learn, observe, and practice physical, social, and cognitive skills through the use of role-plays, discussion, and simulation exercises.18,19,20 This training gives women access to a new set of assertive and combative responses to various forms of intimidation and threat along the continuum of sexual violence.21,22

ARE SELF-DEFENSE TECHNIQUES EFFECTIVE?

Are the techniques taught in self-defense classes actually effective at reducing the sexual victimization of women? Prior research studies suggest that participation in self-defense training may be related to rape avoidance for participants.23,24,25 In addition, several empirical studies of the role of victim resistance strategies in rape incidents have demonstrated that victims' use of forceful physical resistance (e.g., hitting, kicking, biting), nonforceful physical resistance (e.g., fleeing, hiding, blocking blows), and forceful verbal resistance (e.g., screaming, yelling at, or threatening offender) are typically related to avoiding completed rape and unrelated to physical injury. On the other hand, nonforceful verbal resistance (e.g., pleading, begging, or reasoning with the offender) has been found to be related to greater severity of sexual abuse but not related to physical injury. For a more in-depth review on resistance strategies and rape outcomes, see Ullman's (2007) article.26 In sum, more physical and assertive responses seem to be related to less severe sexual assaults.

Based on the above research, it appears that the techniques taught most often in self-defense training (e.g., hitting, kicking, yelling) are related to rape avoidance, implying that participation in self-defense training may reduce women's severity of sexual victimization and may be a fruitful avenue for the prevention of revictimization of sexual assault survivors. Prior research has demonstrated that previously victimized women are less likely to report that they would use verbal assertiveness and physical defense strategies (strategies related to rape avoidance) and more likely to use indirect methods of resistance in response to an assault compared with nonvictimized women.27,28,29,30,31 In addition, Gidycz, Van Wynsberghe, and Edwards (2008) discovered that women with sexual victimization histories were more likely to either be immobile or use nonforceful verbal resistance when actually faced with another assault compared to women without a victimization history.32

Thus, it would appear that sexual assault survivors would benefit from participation in self-defense training where they could learn not only self-defense skills but also about the skills' effectiveness in reducing victimization severity. Evaluations have demonstrated that training participants do increase their self-defense skills and perceive themselves to be more physically competent after course completion (see Brecklin, 2008 for a review of women's self-defense training evaluations).33 With training, perhaps sexual assault survivors would be able as well as more willing to effectively fight back and avoid revictimization. Teaching survivors effective resistance strategies is especially important in light of research showing that women who intend to use assertive resistance strategies actually do use these strategies when faced with an attack.32 Based on this result, Gidycz and colleagues (2008) suggested that women need to be knowledgeable about effective resistance strategies while at the same time practicing and planning to use them in a potential assault situation.32 In addition, victims who feel future rapes are avoidable report fewer psychological symptoms and disruptions in their beliefs,34 a feeling that could be affected by participation in self-defense training.

CHARACTERISTICS OF SEXUAL ASSAULT SURVIVORS

Because victimization can shatter women's assumptions of personal invulnerability and positive views of themselves,35 sexual assault victims frequently suffer long-lasting fear, anxiety, and helplessness in addition to lower levels of assertive communication, self-esteem, perceived control, and self-efficacy.5,6,36,37,38,35 All of these detrimental attributes have been shown to be positively affected by self-defense training participation in several evaluation studies (see Brecklin, 2008 for a review).33 Increasing survivors' assertiveness skills is especially important in light of a prospective study showing that low assertiveness specific to situations with men and prior victimization were consistent predictors of future sexual victimization in a sample of 274 college women.9 In addition, studies have shown that successful rape resisters were more assertive, confident, perceived more control over their lives, and showed more initiative, persistence, and leadership compared with women who were raped,40,41,42 demonstrating that psychological changes due to participation in self-defense training may have substantial implications for subsequent rape avoidance.

Not only are there differences between sexual assault victims and non-victims in psychological outcomes, revictimized women experience more distress, depression, PTSD, and feelings of shame and powerlessness than women with only one victimization.14 Furthermore, research shows that women with a history of child sexual abuse and current PTSD who were revictimized in the previous six months described themselves as overly responsible, socially avoidant, and nonassertive compared with nonrevic-timized women.43 Vanzile-Tamsen, Testa, and Livingston (2005), using a sample of 318 community women, found that women sexually victimized in both childhood and adulthood were less likely to say they would use direct verbal resistance if faced with another attack compared to nonvictims and women victimized in a single life phase.44 In addition, women without a sexual assault history intended to use the highest level of sexual refusal assertiveness, while revictimized women demonstrated the lowest level. Lower assertiveness was then related to a lower likelihood of using direct resistance against an attack. Based on results from their experimental study, Wilson, Calhoun, and Bernat (1999) suggested that women with multiple victimization experiences may show delays in recognizing and responding to cues of sexual assault.45 Women with multiple victimization incidents may particularly benefit from participation in self-defense training.

CHARACTERISTICS OF SURVIVORS WHO PARTICIPATE IN SELF-DEFENSE TRAINING

Little research has been conducted on why certain women choose to take self-defense training after assault experiences. According to DeWelde (2003-b), one of the main reasons why recently victimized women reported enrolling in feminist self-defense training was so that they could be better prepared in case they were faced with another assault.46 Various studies have shown that the majority of self-defense training participants (44%-90%) have been physically or sexually abused in their lifetime.38,46,47,48,49,50,51,52,53 A prior study using a sample of 3,187 female college students found that women who took self-defense/assertiveness training were more likely to have suffered adult sexual victimization as well as both child sexual and physical abuse than women without training.54 Furthermore, Follansbee (1982) found that almost one-third (30%) of women taking self-defense were victims of rape compared with only 12% of subjects from a general studies course.17 However, one study of women found that this relationship was only true for the offense of attempted rape,50 and three other studies found no significant differences in sexual assault history between women with and without self-defense55,56 and martial arts training.57

A study of 1,623 sexual assault survivors showed that victims who took self-defense/assertiveness training after their assaults were more likely to have experienced completed rape with more offender aggression than did victims without training.58 Therefore, it is possible that more severe assaults may lead to self-defense training enrollment. Because another study demonstrated that greater sexual victimization severity in the past increased the chances of future victimization,8 it may be especially important for women with severe assault histories to participate in self-defense training as a way of reducing revictimization.

Brecklin and Ullman (2004) also discovered that victims with postas-sault training were more likely to have used forceful physical resistance (e.g., hitting), nonforceful physical resistance (e.g., fleeing), and forceful verbal resistance (e.g., yelling) during their assaults than victims without training.58 This finding can possibly be explained by the higher levels of offender aggression in the assaults experienced by training participants, because victims typically match their degree/type of resistance to offender level of aggression.32,55,60,61,62,63 Even though victims with postassault training were more likely to use resistance, they were actually less likely to report that their resistance was effective compared to nonparticipants.58 Women may choose to enroll in postassault training because their past resistance was unsuccessful at preventing the rape. If rape survivors enrolled in post-assault self-defense training more frequently, it is possible that the cycle of revictimization could be broken for at least some women. For example, Bart and O'Brien (1985) reported that one rape survivor learned judo after her sexual assault and subsequently was able to avoid a second attack.23

THERAPEUTIC BENEFITS OF SELF-DEFENSE TRAINING FOR ASSAULT SURVIVORS

Women's self-defense tactics are meant to be practical, simple, and effective in common situations so that all women can learn them regardless of age, size, previous experiences, or physical strength.64,65,66,67,68 Many different types of self-defense training are available to women, including brief singlesession classes, twelve-hour Rape Aggression Defense courses, twenty-two half-hour padded attacker courses (e.g., Model Mugging), semester-long college courses, and multiyear martial arts training degree programs. These courses also vary in philosophical foundation. However, for most women, self-defense courses with a feminist philosophy are recommended,18,69 as they demonstrate how gender socialization inhibits women from fighting back against assault and teach participants that they have the right to act in their own defense.18,70,71,72

In addition, female instructors of courses can serve as models of strong, confident, and capable women to their students.18,68,69,71,72,73,74 However, male instructors can also be useful, especially as mock offenders in self-defense classes with simulated attacks, which dramatically increase the perceived reality of the attack situations and allow female participants to successfully defend themselves against powerful attackers.75 Evaluations have shown that participants in programs with simulated assaults and padded attackers have stronger self-defense skills49 and moderately higher self-defense self-efficacy76 than participants in programs without these simulations.

Similarly, researchers have strongly advocated women-only self-defense classes,18,71 as they provide a more supportive environment where women can be more open about their past experiences and fears of sexual assault. After women-only self-defense courses, participants have commented on the importance of the group environment for encouragement, emotional support, bonding, and sisterhood both in semistructured interviews48 and qualitative questionnaires.38,77 This emotional support may be particularly important for sexual assault survivors, which will be discussed more in a later section of this chapter.

According to Stevenson (2006), "A self-defense class is not only an opportunity to learn a practical, physical skill; it is an opportunity for connection and healing" (p. 213).75 Self-defense training can have several positive benefits for sexual assault survivors. Two prior studies reported that, before enrollment in self-defense training, women with assault histories had lower self-efficacy, felt more vulnerable to assault, and perceived less personal control over their lives than women without an assault history.38,78 Victims and nonvictims no longer differed on these traits immediately after the training38,78 and at a six-month follow-up.78 Ozer and Bandura (1990) argued that self-defense classes might be able to override preexisting adverse effects of abuse and instill enhanced perceptions of control in survivors.78 Moreover, McCaughey (1998) stated that child sexual abuse survivors in her self-defense classes had to overcome their tendencies toward helplessness.74 In addition, Shim (1998) discovered a significant increase in the physical self-efficacy of participants, regardless of assault history, after participation in Model Mugging.52 Qualitative statements from the survivors of physical and sexual abuse show that Model Mugging participation helped to increase their self-awareness, assertiveness, confidence in ability to handle potential assaults, and appreciation for their physical and emotional strength.52 Furthermore, another study's multivariate results demonstrated that women who took self-defense/assertiveness training after their assaults exhibited less current anxiety than nonparticipants.58 As a psychiatric nurse who previously experienced victimization, Ellensweig (1997) reported the following about her participation in Model Mugging: "I experienced a letting go of a feared event. I now could and would defend myself in a similar situation. This experience had a positive effect on my self-esteem, self-reliance, and self-assurance" (p. 44).79

A seventy-two-year-old Caucasian woman who participated in the Rape Aggression Defense course reported similar positive changes, according to my post-training interview with her. She had been victimized in the past and stated, "I lived in fear, there was buried fear for years and years and years, and I was able to deal with a great deal of that. Today I still have fear, but it's a manageable fear and I feel like I can take care of myself." She also spoke of increased confidence as a result of the self-defense course. When asked about any changes within herself as a result of participating in Rape Aggression Defense, she declared,

A lot more confident, I feel a lot more confident about myself. When one is attacked, I lost a part of myself. A lot of that was buried deep within me. And, there were years that I could hardly talk above a whisper and being empowered of learning to use my voice gave me so much confidence . . . it was like that inner spirit of mine began to blossom again and to be able to say I am okay. I am just like anyone else. I cannot speak too highly of how empowering it was for me, an old lady (laugh) And, I know that it helped me back in many areas of my life. It doesn't matter when you get it back, you get it back.

Clearly, this self-defense course benefited her in many ways.

Peretz (1991) conducted an evaluation of a self-defense training program and a psychotherapy group, each targeting women who had experienced rape at least three months prior to the study.19 She randomly assigned rape survivors to three groups of twenty-four each: self-defense, psychotherapy, and wait-list control, and both treatment strategies lasted for eight 1 1/2-hour sessions. Peretz (1991) found that both treatment groups significantly reduced their levels of psychological distress, fear, and vulnerability compared with a wait-list control group at an immediate post-test.19 She argued that the two treatments were effective because they both discussed issues of control, vulnerability, trust, and the impact of rape myths, and provided support and validation for survivors' experiences.

Gidycz et al. (2006) evaluated a sexual assault risk reduction program (including 2 1/2 hours on self-defense) for college women.37 The authors randomly assigned participants to either a treatment (N = 234) or wait list control group (N = 266). Six months after the program, participants exhibited significantly more protective behaviors than the control group. The program participants also reported several instances of actual use of self-defense techniques taught in the course since program completion. Unfortunately, the program was not successful in reducing women's sexual victimization at a three- or six-month follow-up. Because the study also found that treatment group participants demonstrated more accurate knowledge on sexual assault and were more likely to report sexual victimizations on a survey after the program than the control group, Gidycz and colleagues (2006) maintained that this may have affected results pertaining to program effects on victimization.37 Women in the treatment group may be labeling experiences as rapes that they wouldn't have prior to the program and may be more likely to report them in a research study. In another evaluation of a slightly revised version of this sexual assault risk reduction program with 300 college women, Orchowski, Gidycz, and Raffle (2008) found that the incidence of rape was lower among program participants over the two-month follow-up than the control group.80 The program participants also used more self-protective behaviors and assertive sexual communication compared to the control group.

Brecklin and Ullman (2004) found that survivors with postassault training felt less responsible for their previous assaults than victims without training.58 Similarly, in an evaluation of a sexual assault risk reduction program including a self-defense component, the women who were sexually victimized after participating in the program were less likely to feel responsible for their assault and were more likely to place responsibility on the attacker compared to the victimized control group participants.37 This is consistent with self-defense evaluations that found that sexual assault survivors who took self-defense came to understand that they were not to blame for the incident.38,81 Research has shown that decreasing behavioral self-blame is important for sexual assault victims' recovery.82 Furthermore, using structural equation modeling with 415 college women who experienced some form of sexual victimization by a male acquaintance, Nurius, Norris, Macy, and Huang (2004) found that reduced self-blame predicted more assertive responses and less diplomatic responses and immobility during victimization.83

Based on her participant observation of a feminist self-defense course, DeWelde (2003-a) reported that some survivors were able to determine where their loss of control in past victimization experiences occurred.84 Furthermore, in another study, a female martial artist stated that martial arts helped her not to be a victim anymore.57 Similarly, according to women enrolled in Model Mugging, several abused women felt the training helped them to become angry about the victimization,48,52 which is important because past research has shown that women who reported feeling more anger during their attacks were more likely to avoid rape.23,42,85 This may in part be explained by the fact that feelings of anger are often related to more physically assertive responses to sexual assault.60,83

A common thread noted in several self-defense evaluations was the importance of the group dynamic in facilitating the survivors' healing pro-cess.19,52 DeWelde (2003-a) used participant observation in a self-defense course and discovered that many of the women shared their personal victimization experiences with the rest of the class.84 In fact, the female instructor shared her own experience with violent crime at the start of the course, which may have encouraged the students to do the same. Discovering this commonality of victimization experiences can help survivors to combat isolation and stigma and to confront challenges presented by the course.75 According to a Model Mugging participant,

Every woman that takes that class, there's some importance for them to take this class, because they've been violated, because they are afraid of being violated. And that's the bottom line . . . We were all real unified in that goal . . . to learn how to defend ourselves (p. 408).73

In addition, several Model Mugging participants reported that the group process was therapeutic and provided them with support and a sense of belonging.48,52 Many of the fifty-nine Model Mugging graduates in Fraser and Russell's (2000) study stated that the self-defense group was their primary source of emotional support for their intense feelings developed during the course.73

Some sexual assault survivors choose to act out past assault experiences in self-defense classes so that they can fight back against the offender and be victorious.38,73 It is "important for women to see how the same bodies that they believed once betrayed them can now be transformed to help keep them safe" (p. 115).86 This helps victims to overcome their fears, reclaim the power that their offenders took away, and increases their determination to fight back in the future.22,87 According to a Model Mugging participant who acted out a past victimization in a mock simulation, "I realized how powerful it was when I looked down and I saw several people crying . . . it was an incredible validation for how I had been feeling and what I had been experiencing" (p. 412).73 Fraser and Russell (2000) discussed how the group allowed women to face experiences they couldn't alone.73 As explained by the following participant, "The emotions stirred up . . . were such that no one person could contend with it. So you had to have this clump . . . You're limited if you contain within yourself, limited in a way that you are not with a group" (p. 410).73 During the mock attack simulations, the female participants cheer each other on, which also encourages the women to keep fighting even when faced with emotionally difficult scenarios.

On the other hand, simulated assault scenarios in self-defense training may remind female participants of repressed traumas,48 which may make the training more emotionally difficult. One-quarter of participants in a mastery-modeling self-defense program remembered an assault during training; however, their statements demonstrated that the supportive environment helped them to explore these memories and led to healing.38 At the same time, women who participate in training may expand their definition of victimization, resulting in more women recognizing themselves as survivors.84 In another study, a female Model Mugging participant reported disliking the class because the assault scenarios triggered bad memories, while another participant felt too overwhelmed by reminders of past abuse to complete her survey packet.77 According to Anderson (1998), most self-defense courses are not structured to help women with abuse histories to process their intense memories.81 Perhaps therapy or referral programs are needed for sexual assault survivors enrolled in training with simulated assaults. Courses combining self-defense training and therapy are discussed next.

SELF-DEFENSE TRAINING AND THERAPY FOR ASSAULT SURVIVORS

Traditional psychotherapy can be effective in treating the long-term symptoms resulting from either child sexual abuse or adult sexual assault, but this form of treatment often fails to address the physical aspects of healing and the prevention of revictimization.81 Victims of sexual abuse have stated that healing through martial arts training is qualitatively different than healing from traditional therapy, mainly due to the physical component of martial arts.88 Fifty-eight percent of the assault survivors enrolled in self-defense training in Lidsker's (1991) evaluation were also in therapy, and all of these women said that the self-defense training was complementary to their therapy.38 Several of the participants noted that their therapy helped them to deal with the emotions brought up by their participation in self-defense training.38 The combination of self-defense training and therapy may offer both treatment for the long-term symptoms of abuse and opportunities for survivors' empowerment.

In her dissertation, Daniels (2001) created a template for a treatment program for female child sexual abuse survivors incorporating self-defense training and traditional group therapy techniques; however, this program had not been implemented.87 She argued that therapy would allow the abuse survivors to discuss any feelings and reactions surfacing from their self-defense training. Because several evaluations have noted the importance of group interactions and discussion for assault survivors,19,52,89 it is believed that group therapy (when composed only of female sexual assault survivors) would be more effective than individual therapy. These group therapy sessions could offer survivors support, normalization for their experiences and reactions, and a safe place to explore their feelings about their abuse histories as well as the self-defense training.19 These groups may even form their own support networks; for example, rape survivors enrolled in Peretz's (1991) group psychotherapy continued to meet weekly on their own after the sessions ended.19

Anderson (1998) conducted an evaluation of an eight-week program with both self-defense training (one hour each week) and group psychotherapy (1 1/2 hours each week) for eight female survivors of childhood incest recruited through newspaper ads and mental health professionals.81 Whenever possible, the topic of the group therapy was coordinated with the self-defense topic for that week. Program participants were asked to describe their experiences in two-hour focus group sessions one month after the program (N = 8) and individual interviews immediately (N = 8) and one year after the program (N = 5). Participants found the experience to be both empowering and healing. The combination of self-defense and therapy deepened the experience for all eight participants, with therapy helping them to process their emotional reactions to the self-defense training. One survivor commented on the importance of the order of the sessions; participating in therapy right after the self-defense gave her time to calm down.81 All of the women commented on the supportive group environment and participant bonding, and in fact, one year after the program, several members were still in touch with each other.81 For many participants, telling the story of their victimization to the group was cathartic, and they also mentioned the importance of a female-only setting. Several of the survivors commented that they saw other group members as role models and that watching other survivors perform the self-defense techniques was helpful. The eight participants also appreciated learning that their experiences were not unique and that others were facing similar problems, feelings, and symptoms. Seven of the participants specifically stated that the sessions advanced their healing.

Furthermore, survivors reported increases in self-confidence, self-care, assertiveness, perceived control, self-efficacy, and feelings of anger due to the sessions. The participants commented on an increased physicality and connection with their bodies, and many women saw themselves as more capable of defending themselves and believed now that they had the right to do so after the training sessions. The opportunity to physically fight back against attackers helped them work through some of their traumas.81 Some participants mentioned that hitting the punching bag helped them to release their anger.81

Schuiteman (1990) used participant observation and post-treatment interviews to examine a course combining self-defense training and therapy for sixteen sexual assault survivors (two classes of eight).68 The first class (pilot study) included eight two-hour sessions, with one hour each of self-defense and unstructured group therapy. Using the pilot study's results, she improved on the second class, by expanding each class session an extra half-hour, adding four extra sessions, and adding structure to the group therapy sessions (e.g., themes). After the class, participants reduced their helplessness and increased their confidence to defend themselves and their ability to set boundaries.68 Similar to Anderson (1998),81 the physicality of the self-defense training was an important component of the healing process, helping them to feel more in touch with their bodies and to integrate their mind, body, and spirit. Several participants mentioned that self-defense helped them to feel empowered. Expressing anger was an emotionally freeing experience for many of the women. As in Anderson's (1998) study,81 participants remarked on the sense of community and trust in the group, due to the commonality of experience, and they also mentioned that the other class members and instructors served as role models.68

David, Simpson, and Cotton (2006) created a pilot therapeutic self-defense course "for women veterans who were sexually traumatized and who had PTSD" (p. 557).90 Of the twelve women in the pilot group, ten participated in the research study. The program lasted twelve weeks for a total of thirty-six hours and was led by three psychologists and two martial artists. In each session, the first hour included sexual assault facts and role-plays involving assertive behavior, while the second hour focused on the actual self-defense training. In the final hour of each session, group debriefing took place, with an emphasis on supportive psychotherapy. All twelve program participants successfully completed the program.

Results demonstrated that the participants were less fearful of assault immediately after the program compared to their pretest levels, but this reduction was not maintained at the three- or six-month follow-ups. The women's perception of general assault risk did not change as a result of the program, but they demonstrated significant improvement in identifying risky situations at immediate and three-month post-tests. In addition, the participants exhibited less PTSD symptom severity at the three- and six-month follow-ups (but not immediately after the program), primarily due to decreased avoidance and hyperarousal symptoms. The female veterans also exhibited less depression and increases in interpersonal, self-defense, and activity self-efficacy immediately, three months, and six months after the program. David et al. (2006) concluded that a therapeutic self-defense course was a viable treatment for sexual assault survivors.90

In a case study of a participant in the program described above,90 "Phyllis," a Caucasian woman in her late sixties, initially had some skepticism about completing the program at her age.91 At first, she had difficulty with some of the self-defense moves, as they "were highly triggering for her as they reminded her of past traumas. She worked hard on grounding, breathing, and concentrating throughout these lessons, and ultimately, was able to execute all moves effectively without panicking." (p. 117).91 She successfully finished the program, gained confidence, and found the training empowering. Upon graduating from the self-defense course, "Phyllis" proclaimed, "I feel I can go places, do things, live again. I got my life back" (p. 117).91 It is likely that without the therapeutic component of this self-defense program, "Phyllis" wouldn't have successfully completed the course.

Similarly, in both Anderson's (1998)81 and Schuiteman's (1990)68 evaluations, participants said that they would not have been able to complete a regular self-defense class, as they would have been too overwhelmed by the realism of practice situations. All of the participants in Anderson's (1998) study remarked that the self-defense training brought back memories of their abuse but did help them learn how to defend themselves.81 However, one participant limited her involvement in the self-defense training due to her memories. Schuiteman (1990) discussed her dilemma in balancing the use of realistic simulated assault scenarios while still trying to help the survivors' healing process.68 Overall, the combination of self-defense training and therapy provided abuse survivors with a safe place to process their feelings.

Sexual assault survivors may enroll in training as a way to exercise control over future assaults and work through some of the trauma. Based on past research, it appears that self-defense training is effective in decreasing sexual assault survivors' feelings of vulnerability, anxiety, and use of avoidance behaviors, while at the same time increasing their self-efficacy, assertive-ness, and perceived control over their environment.15,38,52,58,78 Because the risk of revictimization is higher shortly after the initial assault,14 it may be beneficial for sexual assault victims to enroll in self-defense training soon after an attack. Unfortunately, many survivors may not feel psychologically ready to take a self-defense course so soon after the assault.87 In fact, in two qualitative evaluations of programs combining self-defense training and therapy for assault survivors, several women remarked that they wouldn't have been able to take a regular self-defense course, as they needed help processing their feelings and dealing with the realism of the assault sce-narios.68,81 According to past studies, women who take self-defense training after sexual assaults typically experienced more brutal attacks and have more severe victimization histories than women without training.54,58 Due to their more severe victimization histories, these survivors might benefit more from programs combining self-defense training and therapy, which may increase their capacity to successfully defend themselves and simultaneously ameliorate their psychological distress. As Stevenson (2006) stated, self-defense training should not replace other forms of psychotherapy but rather should be used as a complement.75 Ellensweig (1997) suggested that "psychiatric nurses can use ("Model Mugging") as a resource along with psychotherapy to increase a client's sense of self-esteem and self-defense skill level" (p. 42).79

Efforts to expand the combined offerings of group therapy and self-defense training to female sexual abuse survivors should be a priority of the anti-rape movement. A sample of sixty-seven female veterans with physical or sexual assault histories receiving outpatient mental health services thought self-defense would be a suitable addition to their treatment, and 91% stated that taking self-defense would increase their ability to defend themselves against future attacks.92 Because sexual assault survivors often turn to rape crisis centers for counseling, these centers might be the ideal setting for this undertaking. In addition, some states' victim assistance programs reimburse victims for self-defense training,46 a reimbursement that should be offered by more states, given the therapeutic benefits of this training for assault survivors.

SELF-DEFENSE TRAINING RECOMMENDATIONS FOR SURVIVORS

Sexual assault survivors interested in enrollment in self-defense training should look around their communities for course opportunities; rape crisis centers, therapy groups, colleges, and friends may be able to provide sug-

gestions. If a survivor is reluctant to enroll in a self-defense course alone, they should consider taking the course with a friend or family member who can offer extra support and comfort. In addition, concurrent therapy may help survivors to deal with any emotional stress brought up by training participation. Sexual assault survivors should only enroll in training when they feel emotionally ready. Survivors should also try to assess whether a particular self-defense course is a good fit for them prior to enrollment, which will also help them to know what to expect and how to prepare themselves. According to Stevenson (2006), some questions that should be asked prior to selecting the right self-defense course include, "Do the members participate in role-plays while in an adrenalized state?" "What type of helping relationship is established between the members?" and "How does the first class differ from the last class?" (p. 213-214).75 Self-defense programs that include practical techniques and hands-on repetitive training are recommended, in particular those that offer multiple mock simulations for feedback and eventual perfection of skills,93 but as stated earlier, these may be more difficult for sexual assault survivors to cope with. However, these mock simulations, by offering participants the chance themselves and to see other women successfully fighting off attackers, instills in participants that they too can be victorious. In addition, women should practice moves outside of (and after) the course, and some programs like Rape Aggression Defense offer free refresher training sessions across the United States after initial completion of the course.

CONCLUSION

More research clarifying why prior sexual victimization is such a strong predictor of future victimization is imperative, as this would help practitioners design more effective treatment and prevention programs for these women. Self-defense training may be one avenue for preventing repeat sexual assault victimization; however, more research is needed on how the effectiveness of self-defense training might differ by prior sexual victimization history.20 In addition, the therapeutic benefits of self-defense training for survivors may depend on the type or severity of past abuse, time since the assault, or current social support systems, all variables that should be examined in future research. Very few longitudinal studies on the effectiveness of self-defense programs for sexual assault survivors exist, which clearly should be a priority for future research, along with larger sample sizes and longer follow-up times. In addition, because the majority of participants in past studies were Caucasian, more research needs to be done on the effectiveness of self-defense training with more diverse samples of survivors.

As shown in this chapter, self-defense training offers a variety of benefits and may be therapeutic for rape survivors. For example, according to a female Rape Aggression Defense participant I interviewed about program benefits, "Life is just more joyful. I feel confident, I feel like I could whip the world." A combination of therapy and self-defense training may offer sexual assault survivors additional psychological healing as well as strategies to prevent revictimization.68,81,87 Furthermore, self-defense can provide much-needed emotional support and validation for sexual assault survivors,19,20,52,73 especially if combined with traditional group psychotherapy.68,81,87,88 In summary, self-defense training holds promise for sexual assault risk reduction in women and improved mental health, but sexual assault survivors may require more intensive interventions to reduce their risk of revictimization than women without sexual assault histories.

REFERENCES

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