‘Waiting for the Cold to End': A Qualitative Exploration of Photovoice As a Therapeutic Intervention for Survivors of Sexual Assault

Purpose: Sexual assault has reached epidemic proportions, and disproportionately affects college-aged women. Posttraumatic Stress Disorder (PTSD) is the most commonly associated mental health disorder associated with sexual assault. There are many scientifically proven successful interventions for treating PTSD among survivors; however, these interventions fail to address posttraumatic growth as a form of recovery. Research states that without posttraumatic growth, symptoms associated with PTSD will continue to surface. This study explored PhotoVoice – a participatory action research method – as a brief therapeutic intervention for survivors of sexual assault. The purpose of this research was to examine how PhotoVoice allowed survivors to grow post-trauma as they reconstructed their identities through a process of cognitive restructuring, exposure, and narrative group work. The study was designed to answer how PhotoVoice evoked change in survivors of sexual assault, as well as whether or not PhotoVoice has an impact on overall PTSD symptoms, posttraumatic growth, and rape attributions.

 Method: Nine women participated in PhotoVoice as a therapeutic intervention, and each woman was given a camera to photograph images that represented her sexual assault, or healing experiences. They met together three times to discuss their photos. A semi-structured questionnaire called SHOWeD was used to guide the discussion. SHOWeD stands for: What do you See here? What is actually Happening? How does it relate to Our lives? What can we Do to fix the problem or enhance its strengths? Each group held an exhibit where they displayed their photos and invited attendees. These exhibits were designed to raise awareness regarding sexual assault, PTSD, and healing. The exhibits were also symbolic of the participants reclaiming their identity, and entering back into their worlds with a self-narrative authored solely by them. All focus groups were recorded and transcribed – verbatim –for qualitative coding. Photos and individual interviews were also included in the qualitative data. Qualitative data were analyzed using thematic analysis, and a constant comparative method. Quantitative data were entered into Microsoft Excel, and analyzed using the Data Analysis Toolpak. All data were triangulated to support the four themes derived by the qualitative analysis.

 Results: Qualitative results revealed four themes regarding how PhotoVoice evoked change among survivors: 1) participants were able to confront their triggers through a process of exposure, as well as 2) address any negative distortions through a process of cognitive reframing and meaning-making. 3) The exhibits allowed participants to reclaim control over their self-narratives, as well as 4) educate stakeholders about the traumatic impacts of sexual assault at a Midwestern university. Quantitative results revealed a decrease in symptoms of PTSD, as well as an increase in posttraumatic growth and positive rape attributions for participants.

 Implications: This study’s findings highlight the value of trauma interventions designed to reduce symptoms of PTSD while also fostering posttraumatic growth. In addition, it supports the importance of qualitative, rich text, when exploring survivor trauma and healing. Further research is needed to generalize results, as well as develop a theory of PhotoVoice as a therapeutic intervention.