ABSTRACT
Step 1: Establishment of the Therapeutic Alliance and Clarification of the Clinician’s Role
Managing the Initial Referral Clarifying the Clinician’s Role and the Boundaries of
Treatment
Assuming an Appropriate Therapeutic Stance Step 2: Assessment of the Severity of the Immediate Crisis and
Appropriate Validation and Support Regarding the Challenges Presented
Sample Evaluation Format Relevant Cultural and Economic Factors to Consider Guidelines for Effective Individual Responses to Sexual
Harassment and Gender Discrimination
Step 3: Evaluation and Treatment of Immediate Symptomatology and Negotiation of a Therapeutic Contract for Ongoing Collaborative Monitoring of Symptoms
INTRODUCTION
The treatment of sexual harassment and other forms of gender discrimination is a complex and challenging clinical task about which relatively little has been written. Victimized individuals enter treatment (1) at different stages of the discriminatory experience, requiring different intervention styles and focuses; (2) with differing levels of insight and motivation, requiring a variety of alliance-building
techniques; and (3) with diverse and variable symptom complexes of different degrees of severity, requiring a broad range of treatment modalities. In general, the degree of psychological distress and psychiatric illness in the patient or client will depend upon (1) the nature of the experience, (2) the context in which it occurs, and (3) the preexisting condition of the victimized person with regard to both external and internal resources and vulnerabilities (Mary Rowe, Personal Communication, 1994). For example, a severe response would be anticipated if a socially isolated, financially strapped woman with a past history of sexual abuse was exposed to prolonged discrimination involving both sexual assaults and severe work inequities from a respected mentor, in the context of a highly specialized, nontransferable career track, in which the woman was highly invested both financially and emotionally. In contrast, a mild response would be anticipated if a psychologically healthy, economically stable woman with a supportive family and coworkers was exposed to critical gender-focused remarks and negative differential treatment during quarterly public meetings with an off-site manager who had little impact on her job evaluations and with whom all contact would cease in 3 months, when she is being promoted to a new work station. The literature addressing the negative consequences of sexual harassment and gender discrimination has evolved from early accounts that focused primarily on economic and productivity losses, to more recent accounts that address medical and psychological consequences from multiple perspectives (Avina & O’Donohue, 2002; Bernstein & Lenhart, 1993; Charney & Russell, 1994; Clark & Lewis, 1977; Esacove, 1998; Fitzgerald, 1993; Gutek, 1985; Gutek & Koss, 1993a; Hamilton, 1989; Hamilton & Jensvold, 1992; Hughes & Sandler, 1986; Klein, 1988, 1989; Koss et al., 1994; Lenhart & Evans, 1991; Powell, 1999a, 1999b; Richman, Rospenda et al., 1999; Roy, 1974; Russell, 1984; Sandroff, 1988; Sanford, 1981; Schneider, Swan, & Fitzgerald, 1997; Shrier, 1996; Stockdale, 1996; Thacker & Gohmann, 1996; U.S. Merit Systems Protection Board, 1987,1995; Van Roosmalen & McDaniel, 1998).
