April is Sexual Assault Awareness and Prevention Month. The Department of Defense Sexual Assault Prevention and Response Office has created a campaign “Protecting our People Protects our Mission” for April 2018. The awareness campaign is one of several efforts to increase awareness of sexual assault, build a culture that will not tolerate sexual harassment or assault, and work to eliminate sexual assault in the military. This blog will briefly review reminders of important information for providers to consider or share during the initial session when treating someone who has been sexually assaulted.
The first step to effective treatment is to get the patient to return to the next session. If your patient has been sexually assaulted, please consider these important steps:
- First, listen. Believe your patient. The service member has just been traumatized. Focus on making them feel safe and heard. Do not focus on the circumstances of the assault (such as whether your patient was drinking). Your job is to provide information, resources, support and most importantly hope that your patient will feel better soon. Validate, support, and empathize.
- Ask if the patient completed a sexual assault forensic exam (SAFE). Offer referral information and provide support as needed. If drugging is suspected, you may advise them to request a urine sample for testing. Likewise, offer medical care. Provide resources to seek medical care or treatment if appropriate.
- Notify the sexual assault response coordinator (SARC) or sexual assault prevention and response victim advocate (SAPR VA) as soon as possible. The SARC is well versed in the resources, information, and non-clinical support available to those who have experienced sexual assault in the military. The SARC completes the Victim Reporting Preference Statement, which documents the service member’s reporting option.
- Explain (or confirm) restricted and unrestricted reporting options to the patient. Restricted reporting is for patients who want to disclose confidentially to a provider without command notification or triggering an investigation. Unrestricted reporting is for those who wish to allow command notification and an investigation. Regardless of reporting option, service members should be offered medical care, information, resources and support. The SARC or SAPR VA will also discuss reporting options in detail.
- Complete a safety assessment and engage in safety planning if needed. Document accordingly and ensure the patient has a safety plan to take with them if appropriate.
Sexual assault is an event, not a diagnosis. Yet individuals may experience a number of emotions following sexual assault, and for many, psychotherapy will be helpful. Diagnostically, the potential consequences of sexual assault are numerous. Research suggests that veterans reporting a history of sexual trauma are more likely to meet diagnostic criteria for posttraumatic stress disorder (21.2 percent of women, 25.7 percent of men); depression (13.5 percent of women, 9.1 percent of men); and substance use (0.8 percent of women, 2.1 percent of men), than those who do not report a history of sexual trauma. Research also indicates that veterans reporting a history of sexual trauma in the military are twice as likely to endorse thoughts of suicide as those without such history. Find information on the current clinical practice guidance for evidence-based treatment of these conditions on our website.
Resources for sexual assault and sexual harassment in the military
- DoD Sexual Assault Prevention and Response Office (SAPR)
- Army Sexual Harassment/Assault Response & Prevention (SHARP)
- Navy Sexual Assault Prevention and Response (SAPR)
- Air Force Sexual Assault Prevention and Response (SAPR)
- Marine Corps Sexual Assault Prevention and Response (SAPR)
- National Guard Sexual Assault Prevention and Response (SAPR)
- Coast Guard Sexual Assault Prevention and Response (SAPR)
- DoD Safe Helpline
- Military Crisis Line
- LGBT National Hotline
- Trans Lifeline
O’Reilly is a contracted clinical psychologist and evidence-based practice subject matter expert at the Psychological Health Center of Excellence. Her specialties include the consequences of traumatic exposure and gender studies.
The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.