What do we want to know?
We wanted to map the available evidence on any specialist adult services for victim-survivors of sexual violence and abuse. We use ‘specialist services’ to describe any provision of support specifically for victim-survivors of sexual violence or abuse. This covers statutory and voluntary services, as well as adaptations of general services tailored towards supporting victim-survivors.
We included the following in our map:
- studies of people’s views about services in the UK
- evaluations of interventions (using controlled and before-and-after designs, and cost-effectiveness studies) from OECD countries,
- systematic reviews containing these kinds of studies
Who wants to know?
The map was commissioned by the Department of Health and Social Care and will be of interest to a range of policymakers, commissioners and practitioners working across the statutory and voluntary sector.
What did we find?
We included 163 studies in our systematic map: 36 views studies, 106 evaluation studies, and 21 systematic reviews.
EPPI-Mapper software was used to produce online interactive maps to visually display the findings and allow users to see the detail of included studies. See links to these interactive maps under the link to the full report.
Of the 36 studies of people’s views about services in the UK, 26 focused on targeted services for victim-survivors of sexual violence and 10 focused on adaptations of general services, such as maternity or health services.
The majority of the 106 evaluation studies were US-based (n=62). Across all OECD countries, most evaluations aimed to assess a therapy for improving mental health outcomes (n=84). Other interventions included education for professionals (n=8) or victim-survivors (n=4), services such advocacy or police services (n=9) and secondary prevention of HIV among victim-survivors (n=1). Most evaluations reported quantitative findings about outcomes or impact (n=86), eight studies were qualitative evaluations of processes only, and 12 studies were evaluations of both outcomes and processes.
Of evaluations conducted in the UK, four evaluated the outcomes of therapies (n=4). Eight UK-based process evaluations examined a national advocacy service in Scotland; a Rape Crisis Centre in Tyneside; training for mental health practitioners to improve practice around abuse histories; a pilot project to support victim-survivors of historic child sex exploitation in Leeds; a specialist sexual assault police investigation unit; and two evaluations of specialist services for female victim-survivors of childhood sexual abuse.
The 21 systematic reviews focused on four distinct populations of victim-survivors of sexual violence including those who had experienced: female genital mutilation (FGM) (n=8), sexual violence including rape and sexual assault (n=6), sexual abuse as a child (n=5) and human trafficking (n=2). Most reviews (n=16) examined the effectiveness of interventions, these were predominantly mental health and psychological interventions (n=11). Three reviews explored views and experiences of service-users and two explored the views of professionals about skills and attitudes.
We identified no effectiveness or cost-effectiveness studies of UK specialist services for victim-survivors of sexual violence. UK views studies focussing on a range of perspectives and populations were included in the map. However, none included the views of male victim-survivors.
What are the conclusions?
We identified a lack of evidence on the effectiveness (and cost-effectiveness) of UK statutory and voluntary specialist services for victim-survivors of sexual violence. However, a lack of evidence should not be interpreted to mean that these services are not effective.
We identified eight process evaluations and a range of UK views studies which give insight into the views and experiences of victim-survivors and the professionals that support them. Some studies focus on services that serve all types of victim-survivor of sexual violence, whereas others focus on different subgroups of victim-survivor populations and victim-survivors who have additional vulnerabilities or disadvantage.
These sets of UK studies warrant quality appraisal and in-depth synthesis or syntheses which could provide a nuanced understanding of UK victim-survivors’ service needs across a range and population subgroups and types of sexual violence.
How did we get these results?
We conducted searches of electronic databases; website searches; reference list harvesting and contacted topic experts to identify potentially relevant items. We applied exclusion criteria to screen all items on title and abstract alone, and then retrieved reports and screened the full-text of all records included at title and abstract stage. All studies included at full-text screening were coded to describe their main characteristics – for example, the study’s purpose (people’s views of services, evaluation to improve services, or reviewing other studies), its geographic setting, who had provided data, and which type of sexual violence and/or service was being explored.
We held a stakeholder event to consult on the initial findings from the map with victim-survivor advocates, service providers and practitioners and policy representatives. Suggestions from this event informed further analysis and the structure for presenting the narrative about the studies identified.
This report should be cited as:
Lester S, Khouja C, Khatwa M, Raine G, Rees R, Kwan I, Wright K, Sowden A, Thomas J (2022) Adult specialist services for victim-survivors of sexual violence and abuse: a systematic map of evidence. London: EPPI Centre, Social Science Research Unit, UCL Institute of Education, University College London.