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Enq: Rithuri MJ

Date: 2014 July 11




Department of Psychology
University of Limpopo
Private Bag X 1106
Sovenga
0727

SUBJECT: APPLICATION FORMS FOR MASTERS IN CLINICAL PSYCHOLOGY.

I Merriam Jacoline Rithuri id no. 8501060273082 hereby request the application forms for
Masters in Clinical Psychology at your institution.

I have achieved my BA Degree at university of Limpopo and I am currently doing BA Honours
in Psychology at university of Venda.

Hope my request will be considered


Yours Faithfully

Rithuri MJ
0725589102











Sexual assault is defined as any sexual act performed by one (or more) person(s) on another without consent. It may
include the use or threat of force. In some cases, the person cannot give consent to have sex because he or she is
unconscious or otherwise incapacitated. A person may be raped by a stranger, an acquaintance or date, or a family
member. Rape is a legal term and in the United States it refers to any penetration of a body orifice (mouth, vagina, or anus)
involving force or the threat of force or incapacity (ie, associated with young or old age, cognitive or physical disability, or
drug or alcohol intoxication) without consent.
One in three women in the United States will be a victim of sexual assault sometime in her life; 7 to 10 percent of rape
victims are male [1]. One in four women will experience rape or attempted rape during her college years. Large population-
based surveys indicate a lifetime prevalence of 13 to 39 percent among women and 3 percent among men [2,3]. Only 10 to
15 percent of all sexual assaults are reported to police. Rape victims are less likely to report assault when the assailant i s
known to them.
Sexual assaults that are facilitated by the use of alcohol and drugs, which in some cases are voluntarily ingested by the
victim, are increasingly recognized and are more common than classic forcible assaults among college students [4,5].
This article is intended as a general guide for victims and family members or friends of a person who has been sexually
assaulted. You should seek specific guidance about your situation from a person who is experienced in the care and
management of crime victims, such as an emergency department doctor or nurse or a sexual assault nurse examiner.
AFTER SEXUAL ASSAULT
After being sexually assaulted, you may have a lot of questions, including:
Why did this happen to me?
Could I have prevented this?
Will I develop an infection or become pregnant as a result of the assault?
Who should I call first?
Should I report this to the police?
Is this reportable?
Since I was drinking, isn't this my fault?
In all cases, it is important to know that you did not cause the sexual assault. Sexual assault is an act of violence,
intimidation, and control. No one ever "deserves" to be assaulted, even if you wore tight clothing or initially showed interest
in your assailant. You cannot consent to sex if you are under the influence of alcohol or drugs.
The following steps are recommended after sexual assault:
Find a safe environment away from the assailant
Call a close friend or relative someone who will offer unconditional support
Seek medical care; do not change clothes, bathe, douche, or brush your teeth
until evidence is collected. A complete medical evaluation includes evidence
collection, a physical examination, treatment and/or counseling. You do not
have to do any part of this evaluation that you do not want to do.
Discuss filing a police report with a crisis counselor, experienced social
worker, sexual assault nurse examiner, or healthcare provider.
Follow-up with a healthcare provider one to two weeks later
Seek counseling services
Inquire about victim compensation services
You should seek medical care, even if some time has elapsed since the event or there is scant or no evidence for collection.
A healthcare provider can offer advice on reporting the event, address concerns regarding infection, pregnancy, and safety,
and help you to begin to recover.
SEEK MEDICAL CARE
It is important to seek emergency medical care as soon as possible to begin coping with the complex emotional issues
surrounding rape. Medical care is usually provided by a doctor and/or a sexual assault nurse examiner (SANE) in a hospital
emergency department or medical clinic. Evidence collection may occur up to 120 hours from the assault and occurs with
the consent of the patient.
A sexual assault nurse examiner is a specially trained and certified professional who will provide needed care, document the
details of the assault, and collect evidence. The nurse can recommend treatment for sexually transmitted infections and
pregnancy prevention if needed. In addition, the nurse is available to testify in court [6].
To locate a center that provides medical care after rape, call a local or national sexual assault hotline, available in the United
States by calling 1-800-656-4673 (HOPE). Some hotlines offer a trained crisis counselor to accompany you to the hospital;
alternately, a supportive friend or family member can go with you.
If there is no local hospital with access to a crisis counselor or sexual assault nurse examiner, ask your physician to collect
evidence as part of the physical examination. Laboratory testing may also be needed. (See 'Laboratory testing' below and
'Physical examination' below.)
Reporting sexual assault to the police Only 16 to 38 percent of rape victims report the rape to law enforcement, and
only 17 to 43 percent present for medical evaluation after rape; one-third of victims of rape never report the assault to their
primary care doctor [3,7]. We encourage all victims to seek medical evaluation
In most states, evidence may be collected without reporting to the police. The best chance of collecting accurate information
and evidence is within the first 24 hours of the sexual assault, although many states allow evidence to be collected up to
seven days later. Changing clothes, showering or bathing, eating, douching, going to the bathroom, and brushing your hair
or teeth should be delayed until evidence is collected, if possible.
History of events Care after sexual assault includes talking with a clinician about what occurred before, during, and after
the incident, and describing the assailant(s). A sexual assault nurse examiner or another healthcare provider usually
conducts this interview with you privately, without family member or friends. After the interview, a physical examination with
or without evidence collection may be done.
Physical examination During a physical examination, a healthcare provider will document any cuts or bruises on your
body. The most commonly injured areas include the breasts, external genitals, vagina, anus, and rectum; these areas will be
carefully examined, swabbed, and cultured. With your permission, these areas may be photographed. A friend, family
member, or crisis counselor may be present during the physical examination if you wish.
In addition, fingernail scrapings and clippings, pubic and head hair samples, and blood and saliva samples are usually
obtained. These samples are labeled, packaged, and sealed, along with your clothing and any other evidence, in an
evidence collection kit. This kit must be given directly to a police officer or stored in a secure and locked location to ensure
that no one tampers with this evidence.
Preventive treatments There is a small risk of becoming infected or pregnant as a result of sexual assault. The risk that
a woman will become infected with HIV after a single episode of consensual vaginal intercourse (not sexual assault) with an
HIV infected man is estimated at 0.1 percent, and from a single episode of consensual anal intercourse at 2 percent. The
risk of developing HIV from a sexual assault may be higher, especially if your skin is torn or cut, if there was bleeding, or if
there were multiple assailants.
The Centers for Disease Control and Prevention (CDC) and other expert groups recommend preventive treatment if your
mouth, vagina, anus, or non-intact skin (eg, a cut) was exposed to the assailant's blood or bodily fluids.
Preventive treatment for gonorrhea, chlamydia, and trichomonas usually
includes three antibiotics. (See "Patient information: Gonorrhea (Beyond the
Basics)" and "Patient information: Chlamydia (Beyond the Basics)".)
Preventive treatment for hepatitis B may not be needed if you were previously
vaccinated with the full series of three hepatitis B vaccines. If you were not
previously vaccinated with hepatitis B vaccine, one dose is given immediately,
followed by additional doses one and six months later. (See "Patient
information: Hepatitis B (Beyond the Basics)".)
Preventive treatment for HIV may be recommended if you are evaluated
within 72 hours of being assaulted. A healthcare provider will discuss the
potential risks and benefits of preventive HIV treatments. Preventive
treatments for HIV are not usually recommended if more than 72 hours have
passed since the assault. Most emergency departments will provide five days
of preventive medication; you are then encouraged to follow-up with a
healthcare provider who specializes in the treatment of infectious diseases.
See the Center for Disease Control Web site:
www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm.
If you are female and are seen within five days (120 hours) after sexual
assault, ask about medication to reduce your risk of becoming pregnant. The
treatment usually includes one dose of a hormone, which is specifically
designed to reduce the risk of pregnancy. This treatment does not induce
abortion and will not end a pregnancy. (See "Patient information: Emergency
contraception (morning after pill) (Beyond the Basics)".)
If you seek care five or more days after being assaulted, you may consider having a copper intrauterine device (IUD) placed
to prevent pregnancy. (See "Patient information: Emergency contraception (morning after pill) (Beyond the Basics)".)
Laboratory testing Testing for chlamydia, gonorrhea, trichomonas, hepatitis B, and HIV is recommended if you have
signs or symptoms of one of these infections. However, testing for these infections in the days following the acute assault
will only confirm prior infection, not an infection as a result of the assault.
If you are tested for sexually transmitted infections (STI) during the evaluation, it is important to understand that the results
will become part of your medical record and will be available to the assailant's attorney if the case goes to trial. Thus, the
information could potentially be used to try to discredit you. For these reasons, some victims choose to avoid STI testing at
this time and receive prophylactic treatment for STIs. To locate a clinic that provides anonymous HIV testing in the United
States, call 1-800-CDC-INFO (1-800-232-4636) or check http://aids.gov/hiv-aids-basics/prevention/hiv-testing/hiv-test-
locations/.
If you are female, you may have a blood or urine pregnancy test during your evaluation; testing within five days after sexual
assault can tell if you were pregnant at the time of the assault, but does not indicate if you will become pregnant as a result
of the assault. The risk of becoming pregnant after assault depends upon several factors, including the timing of your
menstrual cycle (table 1). A pregnancy test is recommended at the follow-up visit to determine if you became pregnant as a
result of the rape. (See 'Follow-up care' below.)
A blood and urine test to test for drugs (eg, Rohypnol or GHB, benzodiazepines) that can affect your level of consciousness
are recommended if you have difficulty remembering events during or after the assault. However, it is important for you to
understand that these tests can also provide evidence of drug or alcohol use. The assailant's attorney will have access to
these results, and could potentially use this information to try to discredit you. Discuss the risks and benefits of drug testing
with an experienced healthcare provider or sexual assault counselor.
FOLLOW-UP CARE
Most experts recommend that you have a follow-up visit with a healthcare provider within two weeks of the assault. At this
visit, you can have follow-up testing, get treatment if needed, and discuss how you are recovering.
Testing for gonorrhea and chlamydia does not need to be repeated if you took preventive antibiotic treatments. Testing for
gonorrhea, chlamydia, trichomonas, and bacterial vaginosis may be recommended after the assault if you did not take
preventive treatments at the initial evaluation. Testing is also recommended if you develop symptoms of an infection or
would like to be tested. (See "Patient information: Symptoms of HIV infection (Beyond the Basics)".)
Testing for pregnancy is recommended four weeks after the initial examination if you took an emergency contraceptive pill. If
you did not use this treatment and you do not have your menstrual period on time, a pregnancy test is recommended.
Testing for HIV is usually repeated at six weeks, three months, and six months after the assault. This schedule of testing is
recommended because, in some cases, it takes up to six months for the blood test to become positive. (See "Patient
information: Testing for HIV (Beyond the Basics)".).
Protecting others If you are exposed to blood or bodily fluids during an assault, you must understand the importance of
preventing the spread of any potential infection to others (for example, sexual partner(s)) during the follow-up period. These
measures are especially important during the first three months after exposure.
During this time, you should use a condom with any sexual activity to reduce the risk of transmitting the potential infection to
your partner. Condoms reduce, but do not completely eliminate, the chances of transmitting hepatitis and HIV infection to
others. Women should avoid becoming pregnant for three months. Donations of blood, plasma, organs, tissue, or semen are
not recommended during the first three months.
EMOTIONAL SUPPORT
Sexual assault victims often need extensive emotional support. Symptoms of anger, fear, anxiety, physical pain, sleep
disturbance, lack of appetite, shame, guilt, depression, and intrusive thoughts can develop in the days to weeks following the
assault. Many victims are reluctant to seek help because of their fear that thinking or talking about their experience will be
too painful. However, most victims find counseling helpful in the process of recovering and moving on with their life.
In the weeks after an assault, some victims develop physical and emotional symptoms, such as pain in the muscles, joints,
genitals, pelvis and/or abdomen, lack of appetite, difficulty sleeping, or nightmares. Some victims find it very difficult to
resume their habits, lifestyles, and sexual relationships. This collection of symptoms is called the rape trauma syndrome; this
can last several months.
A number of treatment options can help you to cope with the complicated emotional issues surrounding sexual trauma. Early
treatment may help to reduce your risk of long-term problems with depression, anxiety, or posttraumatic stress disorder.
Crisis centers such as the Rape, Abuse, & Incest National Network (www.rainn.org or 1-800-656-HOPE (4673)) can help
you to obtain information about resources and qualified providers in your area.
Counseling or psychotherapy Counseling or psychotherapy can be helpful in dealing with the events of the assault
itself as well as the anger, fear, depression, or anxiety that many people feel afterwards.
Several types of healthcare providers provide counseling, including social workers, psychologists, nurses, and psychiatrists.
Some people prefer to meet one-on-one with a counselor while others prefer to meet in a group setting with other people
who have had similar experiences.
Medication Antidepressant and/or antianxiety medications may be recommended if you have emotional or psychological
problems that are severe or do not improve with counseling alone. Medication can help to manage the following symptoms:
Intrusive thoughts, nightmares, and flashbacks
Feeling jumpy or startling easily at sudden noise
Remaining "on guard" or constantly alert
A class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are often recommended first.
Medications in this class include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa),
fluvoxamine (Luvox) and escitalopram (Lexapro). These medications may be prescribed by an internist, family physician,
or other healthcare provider. (See "Patient information: Depression treatment options for adults (Beyond the Basics)".)
In most cases, the antidepressant medication is continued for 6 to 12 months. When you stop an antidepressant, you should
taper the dose over two to four weeks to minimize medication withdrawal symptoms.
LEGAL ISSUES
The procedures for reporting and prosecuting sexual assault and collecting evidence vary by state. In the United States,
sexual assaults that involve children under 16 or 18 years or elderly people must be reported. Some states require reporting
of any and all sexual assaults. In some states, victims are not required to file a police report immediately, while in other
states, an evidence kit will not be collected unless the police are notified.
Many states have witness assistance programs that can provide advice on the pros and cons of reporting sexual assault,
assistance in navigating the legal system, and financial compensation for the victim.
Information about individual state laws is available online at the United States Department of Justice Office of Violence
Against Women website: (www.usdoj.gov/ovw/).
WHERE TO GET MORE INFORMATION
Your healthcare provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as
selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.
Patient level information UpToDate offers two types of patient education materials.
The Basics The Basics patient education pieces answer the four or five key questions a patient might have about a given
condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.
Patient information: Care after rape or sexual assault (The Basics)
Patient information: Screening for sexually transmitted infections (The Basics)
Patient information: Syphilis (The Basics)
Beyond the Basics Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed.
These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Patient information: Gonorrhea (Beyond the Basics)
Patient information: Chlamydia (Beyond the Basics)
Patient information: Hepatitis B (Beyond the Basics)
Patient information: Emergency contraception (morning after pill) (Beyond the Basics)
Patient information: Symptoms of HIV infection (Beyond the Basics)
Patient information: Testing for HIV (Beyond the Basics)
Patient information: Depression treatment options for adults (Beyond the Basics)
Professional level information Professional level articles are designed to keep doctors and other health professionals
up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple
references to the research on which they are based. Professional level articles are best for people who are comfortable with
a lot of medical terminology and who want to read the same materials their doctors are reading.
Blunt genitourinary trauma: Initial evaluation and management
Intimate partner violence: Childhood exposure
Differential diagnosis of suspected child abuse
Evaluation and management of lower genital tract trauma in women
Evaluation and management of adult sexual assault victims
Evaluation of sexual abuse in children and adolescents
Management and sequelae of sexual abuse in children and adolescents
Nonoccupational exposure to HIV in adults
Prevention of sexually transmitted infections

The following organizations also provide reliable health information [1,8-11]:
United States Department of Justice Office of Violence Against Women
(www.usdoj.gov/ovw/)
United States Department of Health and Human Services
(http://www.womenshealth.gov/violence-against-women/get-help-for-
violence/resources-by-state-violence-against-women.cfm)
United States Centers for Disease Control
(www.cdc.gov/violenceprevention/sexualviolence/index.html)
Rape, Abuse, & Incest National Network
(www.rainn.org)
1-800-656-HOPE (4673)
National Library of Medicine
(www.nlm.nih.gov/medlineplus/healthtopics.html)
Literature review current through: Jun 2014. | This topic last updated: May 28, 2013.
Find Print
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of
your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate
Terms of Use 2014 UpToDate, Inc.
References
Top
1. Koss MP. The women's mental health research agenda. Violence against
women. Am Psychol 1990; 45:374.
2. National Center for Victims of Crime and Crime Victims Research and
Treatment Center. Rape in America: A Report to the Nation. Arlington, VA,
1992.
3. Tjaden PG, Thoennes N. Extent, nature, and consequences of rape
victimization: Findings from the National Violence Against Women Survey.
Publication no. NCJ210346, National Institute of Justice, Washington, DC,
2006.
4. Krebs CP, Lindquist CH, Warner TD, et al. College women's experiences with
physically forced, alcohol- or other drug-enabled, and drug-facilitated sexual
assault before and since entering college. J Am Coll Health 2009; 57:639.
5. Lawyer S, Resnick H, Bakanic V, et al. Forcible, drug-facilitated, and
incapacitated rape and sexual assault among undergraduate women. J Am Coll
Health 2010; 58:453.
6. Linden JA. Clinical practice. Care of the adult patient after sexual assault. N
Engl J Med 2011; 365:834.
7. Feldhaus KM, Houry D, Kaminsky R. Lifetime sexual assault prevalence rates
and reporting practices in an emergency department population. Ann Emerg
Med 2000; 36:23.
8. Smith DK, Grohskopf LA, Black RJ, et al. Antiretroviral postexposure
prophylaxis after sexual, injection-drug use, or other nonoccupational exposure
to HIV in the United States: recommendations from the U.S. Department of
Health and Human Services. MMWR Recomm Rep 2005; 54:1.
9. Wiley J, Sugar N, Fine D, Eckert LO. Legal outcomes of sexual assault. Am J
Obstet Gynecol 2003; 188:1638.
10. A National Protocol for Sexual Assault Medical Forensic Examination
Adults/Adolescents. Available at www.ncjrs.gov/pdffiles1/ovw/206554.pdf
www.ncjrs.gov/pdffiles1/ovw/206554.pdf (Accessed on December 01, 2007).
11. Lewis-O'Connor A, Franz H, Zuniga L. Limitations of the national protocol for
sexual assault medical forensic examinations. J Emerg Nurs 2005; 31:267.
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