Ways to engage young male survivors of sexual assault

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First couple of sessions

Support is the fundamental interpersonal base on which the rest of development is built (Kepner, 1995). Keeping this in mind, I have found that the first steps in engaging young male survivors of sexual assault is to actively build safety and support. As already mentioned, for many young men, their first issues about coming to counselling are whether they will be believed, further shamed, controlled or misunderstood. I have also noticed how young male survivors have the assumption that they must talk about the abuse straight away. This assumption seems to create more anxiety for the young man. Hence, as early as possible, hopefully on the phone, I will remind them that it is important that they feel in control of what they want to talk about, where they want to meet me (I do outreach counselling) and for how long.

Once I have met them in person, I also believe that it is helpful right from the start to ask young men about what it is like to come to counselling? What is it like being here right now with me? what were they expecting? Did they come of their own volition? Have they been to counselling before? These questions may give the young men permission to express background issues, concerns and fears. it is usually helpful to let them know what counselling involves, and to reassure them that they can go at their own pace, talk about what they want to and not answer any of my questions if they choose not to. Once I have covered these issues, I then think I am in a better position to clarify what is important to them and what they are hoping to get out of counselling. I also notice that most young male survivors feel safer if they are asked if they want to talk about the effects of sexual abuse, rather than the abuse itself. I think this distinction can be a useful concept for young men.

Apart from the other necessary work of establishing boundaries, discussing confidentiality, and getting some demographic information, I also find it counter shaming to be actively responsive, concerned and supportive (not neutral), and to share my appreciation of the young man's courage in seeking counselling. One of the ways to do this is to openly acknowledge a young man's strength in taking a stand against the pressure to tough it out on his own. Some other questions I might ask are:

• 'What messages about being a man have made it hard for you to break the silence or come to counselling?'
• 'What beliefs might others have about sexual assault that can make it hard to talk about?'
• 'Have you disclosed these experiences with others? How did they respond?'
• 'What message are you giving to others in breaking the silence of the abuse?'
• 'What messages do men often get about how they should cope with emotional pain?'

• 'What did it take to make the decision to come to counselling and talk about this?'

These questions can further support young male survivors in locating their experience within the wider context of patriarchy and to begin to question the effect of the boys' code and other myths about sexual assault on their lives. I would like to acknowledge Patrick O'Leary's ideas (1998) for contributing to many of these questions. I have commonly noticed how relieved young male survivors look when I ask these questions and affirm the strength and courage it took for them to seek support, and to risk being real.

It is also worth considering how these dominant messages of masculinity not only impact on the young men we work with, but also on health professionals. I believe that if practitioners do not question their own notions of masculinity (and femininity), they run the risk of colluding with or overlooking the ways that young male survivors' behaviour is shaped by the boys' code. Understanding and working with these gender constructions gives us scope to begin to stand outside their influence and to explore how they impact on young men and ourselves.

Maintaining support and a therapeutic relationship

Other ways I have found useful in establishing support, safety and a relationship with the young men are to:

• share my own experience of the young man in a supportive way;
• encourage choice over the content of the session;
• help regulate the pace of the session;
• use age appropriate language;
• normalise and validate their story and experience;
• name and affirm their trust, and caution or mistrust of me (and counselling) as it arises.

Building support, safety, and a healthy therapeutic alliance is not something one develops to move on from. I believe it is an ongoing process that requires constant attention to what is going on between the young man and the counsellor, and to how the young man and myself are experiencing the counselling process as it unfolds.

It is this essential process, and of working with the 'in between'(e.g. transference and other relationship issues) that can allow the young man to co create skins with me to meet their needs for safety, trust, boundaries and regulation of their self-expression. These new skills, which are often underdeveloped for young male survivors, can help them to avoid becoming overwhelmed and re traumatised during counselling, and can then be transferred to other parts of their lives (Kepner, 1995; Briere, 1996). Asking questions like, 'how is the counselling going so far?', 'how would you know when you feel safe to talk about ... or trust me with this part of your story?, 'what do you need to have in place before you are ready to talk about this?' 'how would you know (in your body) when you have said too much?' are some useful ways, I have found, of doing this.

Lastly, I also consider it helpful to build support by sharing my own impressions and experience of the young man when it feels appropriate. This may include choosing to share my concern for him going too fast into memories, the impact of his survival strategies or communication styles on me, or my appreciation of his courage in exploring feelings and expressing sadness. Some of these ideas are informed by a core component of Gestalt therapy theory, called the 'dialogic approach' (see Hycner and Jacobs, 1995).

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