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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014).

Sessions: Case histories. Laureate International Universities Publishing.

Talia

Talia is a 19-year-old heterosexual Caucasian female, who is a college sophomore

majoring in psychology and minoring in English. She has a GPA of 3.89 and has been

on the dean’s list several times over the last 2 years. She has written a couple of short

articles for the university’s newspaper on current events around campus and is active in

her sorority, Kappa Delta. She works part time (10–15 hours a week) at an accessory

store. Talia recently moved off campus to an apartment with two close friends from her

sorority. She is physically active and runs approximately three miles a day. She also

goes to the university’s gym a couple of days a week for strength training. Talia does

not use drugs, although she has smoked marijuana a few times in her life. She drinks a

few times a week, often going out with friends one day during the week and then again

on Friday and Saturday nights. When she is out with friends, Talia usually has about

four to six drinks. She prefers to drink beer over hard liquor or wine but will occasionally

have a mixed drink.

Talia has no criminal history. She reports a history of anxiety in her family (on her

mother’s side), and on a few occasions has experienced heart palpitations, which her

mother told her were due to nervousness. This happened only a handful of times in the

past and usually when Talia was “very stressed out,” so Talia had never felt the need to

go to the doctor or talk to someone about it until now. Talia is currently not dating

anyone. She was in a relationship for a year and a half, but it ended a few months ago.

She had since been “hooking up” with a guy in one of her English classes, but does not

feel it will turn into anything serious and has not seen him in several weeks.

Talia’s parents, Erin (40) and Dave (43), and her siblings, Lila (16) and Nathan (14), live

2 hours away from the university. Erin works at a salon as a hairdresser, and Dave is

retired military and works for a home security company. Erin is on a low-dose

antidepressant for anxiety, something she has been treated for all of her life.

Talia came to see me at the Rape Counseling Center (RCC) on campus for services

after she was sexually assaulted at a fraternity party 3 weeks prior. She told me she had

thought she could handle her feelings after the assault, but she had since experienced a

number of emotions and behaviors she could no longer ignore. She was not sleeping,

she felt sad most days, she had stopped going out with friends, and she had been

unable to concentrate on schoolwork. Talia stated that the most significant issues she

had faced since the assault had been recurrent anxiety attacks.

Talia learned about the RCC when she went to the hospital after the sexual assault. At

the hospital, she requested that a rape kit be completed and also asked for the morning-

after pill and the HIV prevention protocol (Post Exposure Prophylaxis, or PEP). A nurse

contacted me through the Sexual Assault Response Team (SART) to provide Talia with

support and resources. I spent several hours with Talia at the hospital while she went

through the examination process. Talia shared bits and pieces of the evening with me,

although she said most of the night was a blur. She said a good-looking guy named Eric

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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014).

Sessions: Case histories. Laureate International Universities Publishing.

was flirting with her all night and bringing her drinks. She did not want to seem

ungrateful and enjoyed his company, so she drank. She also mentioned that the drinks

were made with hard liquor, something that tends to make her drunk faster than beer.

She said that at one point she blacked out and has no idea what happened. She woke

up naked in a room alone the next morning, and she went straight to the hospital. Once

Talia was done at the hospital, I gave her the contact information for RCC. I encouraged

her to call if she had any questions or needed to talk with someone.

Rape Crisis Center

During our first meeting at the RCC, I provided basic information about our services. I

let her know that everything was confidential and that I wanted to help create a safe

space for her to talk. I told her that we would move along at a pace that was comfortable

for her and that this was her time, and we could use it as she felt best. We talked briefly

about her experience at the hospital, which she described as cold and demeaning. She

told me several times how thankful she was that I had been there. She said one of the

reasons she called the RCC was because she felt I supported and believed her. I used

the opportunity to validate her feelings and remind her that I did, in fact, believe her and

that the assault was not her fault.

We talked briefly about how Talia had been feeling over the last 3 weeks. She was very

concerned about her classes because she had missed a couple of assignment

deadlines and was fearful of failing. She told me several times this was not like her and

she was normally a very good student. I told her I could contact the professors and

advocate for extensions without disclosing the specific reason Talia was receiving

counseling services and would need additional time to complete her assignments. Talia

thanked me and agreed that would be best. I introduced the topic of safety and

explained that she might possibly see Eric on campus, something that might cause her

emotional distress. We talked about strategies she could use to protect herself, and she

agreed to walk with a friend while on campus for the time being. She also agreed she

would avoid the gym where she had seen Eric before.

During our second meeting, Talia seemed very anxious. We talked about how she had

been feeling over the last week, and she indicated she was still not sleeping well at

night and that she was taking long naps during the day. She had missed days at work,

something she had never done before, and was in jeopardy of losing her job. Talia

reported experiencing several anxiety attacks as well. She described the attack

symptoms as feeling unable to breathe, accompanied by a swelling in her chest, and an

overwhelming feeling that she was going to die. She said that this was happening

several times a day, although mostly at night. I provided some education about trauma

responses to sexual assault and the signs and symptoms of post-traumatic stress

disorder (PTSD). We went over a workbook on trauma reactions to sexual assault and

reviewed the signs and symptoms checklist, identifying several that she was

experiencing. We practiced breathing exercises to use when she felt anxious, and she

reported feeling better. I told her it was important to identify the triggers to her anxiety so

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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014).

Sessions: Case histories. Laureate International Universities Publishing.

that we could find out what exactly was causing her to be anxious in a given moment. I

explained that while the assault itself had brought the attacks on, it would be helpful to

see what specific things (such as memories, certain times of the day, particular smells,

etc.) caused her to have anxiety attacks. I gave Talia an empty journal and asked her to

record the times of the episodes over the next week as well as what happened right

before them. She agreed.

We met over several sessions and continued to address Talia’s anxiety symptoms and

feelings of sadness. She told me she was unable to talk about what happened on the

night of the rape because she felt ashamed. She said that it was too difficult for her to

verbalize what happened and that the words coming out of her mouth would hurt too

much. I reassured her that she could talk about what happened whenever she felt

comfortable. We practiced breathing and reviewed her journal log each week.

It had become clear that the evenings seemed to be the peak time for her anxiety,

which I told her made sense as her assault had occurred at night. I described how sleep

is often difficult for survivors of sexual assault because they fear having nightmares

about what happened. She looked surprised and said she had not mentioned it, but she

kept having dreams about Eric in which he was talking to her at the party. The dreams

ended with him holding her hand and walking her away. She said she also thought

about this during the day and could actually see it happening in her mind. We talked

about the intrusive thoughts that often occur after trauma, and I tried to normalize her

experience. I told her that often people try to avoid these intrusions, and I wondered if

she felt she was doing anything to avoid them. She told me she had started taking a

sleep aid at night. When I asked about her exercise habits, she said that right after the

assault she had stopped running and going to the gym. We set a goal that she would

run one to two times a week to help her with anxiety and sleeping. I also suggested that

now would be a good time to start writing her feelings down because journaling is a very

useful way to express feelings when it is difficult to verbalize them. Talia mentioned that

she had decided not to go to the police about the sexual assault because she did not

want to go through the process. I informed her that if she wanted to, she could address

the assault in another way, by bringing it to the campus judicial system. She said she

would think about this option.

During another session weeks later, Talia came in distraught. She said she had been

feeling better overall since working on her breathing and journaling, but that a few things

had happened that were making her more and more anxious and that her attacks were

increasing again. Talia said her parents were pushing her to drop out of school and to

come home. She said they had been calling and texting her often, something she found

annoying but understandable. They were very upset about what had happened,

although they were more upset with her that she had waited weeks to tell them about

“it.” Her father threatened to come and beat the guy up, and her mother cried. She

avoided talking with them, but they had become relentless with the calls. Her mother

had shown up with her sister unannounced the previous weekend and had treated Talia

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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014).

Sessions: Case histories. Laureate International Universities Publishing.

like she had a cold—making chicken soup and rubbing Talia’s feet. The pressure from

her parents was weighing on her and upsetting her. Talia was also distressed by a

friend who kept pushing her to talk about what happened. When Talia finally relented,

her friend asked her why she had gone upstairs with him. Talia said this made her feel

terrible, and she started to cry. This friend also told her that Eric had heard she had

gone to the hospital and was telling people that she had wanted to have sex. Eric had

been telling people she was “all over him” and that she had taken her own pants off.

This made Talia very angry and upset.

We talked about how there are certain myths in society around sexual assault and that

the survivor is often blamed. We also talked about how perpetrators often blame

survivors to make themselves feel better. Talia said she has felt some sense of blame

for what happened and that she should not have drunk so much. She started to cry. I

gently reminded her that she was not at fault for Eric’s actions, and her drinking was not

an invitation to have sex. I reminded her that he should have seen how incapacitated

she was and that she could not have consented to sex. Talia continued to cry. She

clearly had a number of emotions she wanted to express but was having difficulty

sharing them, so I offered her some clay and asked her to use it to mold representations

of different areas in her life and how she felt about them. We spent the rest of the

session talking about the shapes she made and how she felt.

Toward the end of the session, Talia told me she had decided to put in a complaint with

the campus judicial system about the assault. She worried that Eric would assault

another woman and she would feel responsible if she did not alert the university. I

offered my support and told her I would be there for her through the process.