A lifetime of therapy is the last thing rape victims need

Sexual assault was once an issue shrouded in guilt and shame. Too often, victims were made to feel that they were to blame for what had happened to them.

recently, though, there has been a sea-change in attitude. People are encouraged to report such incidents to the police and to talk openly about their experiences as a way of dealing with the trauma.

This, combined with a greater understanding of mental health, has prompted calls for improved psychological services — and this week, the NHS responded with a pledge that victims of sexual assault will be offered a ‘lifetime of counselling’.

Having worked with victims of sexual violence over the years, I can think of nothing worse.

The idea that they need — or would even want — a ‘lifetime’ of counselling is ludicrous.

yes, they may seek treatment for any acute psychological effects they suffer, but what they really want is to get on with their lives.

They don’t want to be defined by what has happened, or for it to dominate their future, but this offer of a lifetime of counselling casts them as perpetual victims.

In a heartfelt article in the Mail this week, Jenni Murray, doyenne of BBC radio 4’s Woman’s Hour, wrote about how, after a horrific, violent rape when she was a teenager, she resolved that she would not let it shape her life.

Murray was responding to controversial comments by the author and feminist Germaine Greer, who also experienced violent rape aged 18. like Murray, Greer said she refused to live the rest of her life as a ‘rapee’.

She then went on to call for the lowering of punishment for rape, saying society should not see it as a ‘spectacularly violent crime’, but view it more as ‘bad sex’. Quite rightly, those latter comments infuriated many who felt that Greer was trivialising rape.

What struck me, though, was the similarly robust response of both women — a reaction that is shared by so many of my patients, men and women.

and at a time when the NHS is advocating ‘evidence-based treatment’, I wonder why a strategy of ‘lifetime counselling’, for which there is no evidence of benefit, is being promoted. On the contrary, there’s good evidence that time-limited therapy best helps those with mental health problems, while periods away from treatment are an opportunity for them to consolidate what they have learned in therapy and to develop their own coping skills.

Too much therapy can lead to them becoming dependent on a therapist and never trying to overcome their problems.

THenew pledge risks making things worse for patients — so why is the NHS suggesting it? The real reason, I suspect, is political, rather than medical.

With the spread of the #MeToo movement, being seen to ‘ do something’ about sexual violence is in vogue.

However, the NHS should not be responding to fashionable diktats, but only to what patients need and what is clinically indicated.

Timely therapy should be the focus, not never-ending therapy.

Prompt psychological support can reduce the risk of long-term problems, yet waiting lists for those who need help following sexual assault are too long.

recently, a patient of mine was raped and needed expert therapy. She was too distressed to call the local rape support centre, so I did it for her while she sat beside me.

I was told that after an initial assessment by a nurse, she would be put on a waiting list — currently around six months.

In some areas, the waiting list is even longer.

What are these very distressed women and men meant to do in the meantime?

access to mental health support at the time of need is what the NHS should be focusing on.

Instead, it chases headlines with meaningless offers of never-ending therapy.