Why SAFE Trainings May Be the Most Vital Training You Ever Take

For all medical professionals, the Sexual Assault Forensic Examiner training (better known as SAFE training) is one of the most important tools to learning how to provide trauma-informed, compassionate medical care to all patients. While over the past year we’ve written  on the NYCAASA blog about the vital role of sexual assault advocates in emergency rooms and what the process of receiving a sexual assault forensic exam entails, this month we’re learning more about the Alliance’s SAFE training programs from the two woman who know it best: Course Director for the Alliance Karen Carroll and Manager of SAFETI Programs at the Alliance, Monica Castro.

“Every single doctor or nurse who has taken care of a patient has taken care of a survivor,” shares long-time Course Director Karen Carroll. “They may not know it but if they’ve taken care of 10 patients in a day, chances are they’ve taken care of two or three survivors. If they’re not trained [in trauma-informed, survivor-centered care] they’re not thinking, let me ask a few more questions like ‘Do you feel safe at home?’ or ‘Have you ever been forced to do something you didn’t want to do?’ Questions that can allow, if left open ended, patients to disclose trauma that they’re currently living with. If they don’t ask, they might never know and they’ll lose the opportunity to provide resources.”

Offered multiple times a year by the Alliance, the Sexual Assault Forensic Examiner training, officially titled “The Assessment and Evaluation of Adult/Adolescent Survivors of Sexual Assault and Intimate Partner Violence (Intro Level),” is a comprehensive 40 hour course that trains medical professions on how to provide competent, compassionate care to sexual assault survivors and how to use the most advanced technology associated with DNA and other forensic evidence collection and preservation. While primarily for medical professionals interested in becoming certified to conduct sexual assault forensic exams for survivors if desired in the emergency room, this training also teaches participants about the biology of trauma, how to write up an objective chart, and how to use trauma-informed language when working with all types of patients — skills that are deeply valuable for service providers across all specialties.

“You have to be survivor and patient centered when you’re doing this exam because you’re meeting someone in one of the toughest days of their lives,” says Manager of SAFETI Programs at the Alliance Monica Castro who teaches many of the Alliance’s courses. “You have to be aware of the different reactions a survivor might be exhibiting and feelings they might be coming into the space with. You have to be aware of your own biases. You have to be aware of the different resources that are available to the survivor. All of this in order to give the survivor the best experience and not retraumatize them because that’s the last thing you want to do. This course equips you with all the different information you need to know about.”

The SAFE trainings are now being held virtually due to the pandemic, which has allowed the Alliance to hold an increased number of trainings throughout the year — which include courses on both adult and adolescent care and a further specialization in pediatric care. While the SAFE trainings are specifically geared for medical professionals, the Alliance does offer other trauma-informed trainings for social workers, community-based organizations, colleges and universities, and more. To learn more about our upcoming trainings, or to request a training for your organization, please visit our Training Institute.

During the SAFE training, participants are required to attend four “in classroom” days of lectures and instruction, along with take-home assignments and tests. The first day is instructed by Carroll herself who has held the title of Course Director since 2008. Certified as a SANE (Sexual Assault Nurse Examiner) in the late 90s in New York, Carroll has been at the helm of creating a SAFE course that’s comprehensive and collaborative. In her time as Course Director, Carroll has taught over 5,000 students, and for each training, still teaches the entire first day herself. As part of her curriculum, Carroll walks her students step-by-step through the process of conducting a forensic exam, collecting forensic evidence, unbiasedly documenting a forensic exam chart, and tips on language or techniques that can put survivors more at ease. Things such as, “Putting on six pairs of gloves, one on top of the other, so as you complete a step of the exam you pull off a layer and keep going because you don’t want the survivor to be in the stirrups for a long period of time,” Carroll explains. “Using two speculums for the exam, one you show and present to the patient to touch and manipulate before they lie down, and one you’ll use for the exam.”

Across the four days of classroom instruction, participants learn about/from:

• How to conduct a forensic exam
• How to document and collect forensic evidence
• How to conduct a compassionate pelvic exam as taught by dedicated teaching associates
• Resources available to survivors of sexual assault and intimate partner violence
• Lessons on how the brain processes and reacts to trauma
• How to write an unbiased patient chart
• Lessons on trauma-informed language and how to ask questions that empower, rather than potentially blame, the survivor
• Presentations from the NYPD describing the process of reporting to the police and pursuing criminal charges
• Presentations from the District Attorney’s Office on what it takes to build and present a case surrounding sexual violence or intimate partner violence in court
• Mock trials teaching medical professionals how to testify in a courtroom. Participants will learn how to talk about their credentials, walk a jury through their charts and the evidence collected from a forensic exam, and how to give an expert opinion if asked by the judge

“The first thing that a victim needs to know is that they’re believed,” Carroll says, “If they get the feeling the doctor believes them or the nurse believes them, then that’s going to make them more likely to do other things that will enhance their healing process. [Through this course] you gain better insight into human behaviors and your own personal biases which hopefully you can learn to control once you understand them. I think that’s what trauma-informed care is about, to do no further harm. You can’t take away the harm that occurred but you can try not to add to it because we know being in an emergency room can also be traumatic.”

Upon completion of this training, participants are certified as Sexual Assault Forensic Examiners with the New York State Department of Health and will then be able to begin conducting SAFE exams. The role of SAFEs is to believe and support the survivors seeking their help while ensuring survivor-centered care, and hopefully through this trauma-informed experience, survivors will continue to seek healing resources that best serve them moving forward. This training is recommended for all medical service providers in order to begin integrating trauma-informed care into their daily patient interactions.

If you’re interested in signing up for the next SAFE training or learning about more available courses, visit the NYCAASA’s Training Institute for more information.

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Written by Carly Lanning (She/Her)

Writing Portfolio/ Blog/ Instagram/ LinkedIn

Currently based in Brooklyn with my two cats Hemingway and Fitzgerald and about 115 unread books on my shelves, I have spent my career passionately trying to use my pen to make the world a more informed, better place. During the day, I lead a marketing department dedicated to all things books, leveraging my long-time experience with digital storytelling to create interactive campaigns that feel authentic and representative of diverse reading audiences. Outside of the 9-5, I continue to work as a freelance journalist focused on culture reporting and features writing, and have been published in Psychology Today, NBC, Thrillist, Ms. Magazine, The Daily Dot and more.

While the majority of my writing tends to dig into topics surrounding YouTube culture, mental health, media representation, human interest, and feminism, I hold an additional editorial expertise in trauma-informed storytelling and content creation for violence prevention organizations — such as New York Alliance Against Sexual Assault. At the heart of it all, I’m deeply committed to using storytelling to help others feel heard, to feel empowered, and to heal.