Evidence-Based Treatment for Veterans with Military Sexual Trauma
May 4, 2016
Increasingly, the suffering of military service members who experienced sexual trauma while on active duty is being recognized. Military sexual trauma, (MST) is used to describe the experiences of thousands of current and former male and female service members who were sexually assaulted or repeatedly sexually harassed.
MST may involve being pressured into sexual activity, often with threats of physical, emotional or career consequences for refusing; being sexually assaulted while unable to consent, for example, while drugged or intoxicated; unwanted sexual touching or grabbing or being physically forced into sexual activities. Perpetrators of MST may be other service members or civilians.
The experience of MST is not uncommon. According to the Department of Veterans Affairs (VA), national MST screening program, in which every veteran seen by the VA is asked directly about MST, about one out of four female veterans reports experiencing MST. Despite popular conceptualizations of sexual trauma as something only suffered by women, male veterans also report experiencing MST – about 1 in 100, according to VA screening data.
Because there are far greater numbers of men than women who have served in the military, the number of male and female veterans reporting an experience of MST is about the same.
It is important to note that MST is an experience and not a mental health condition in and of itself. Indeed, some veterans who report MST are remarkably resilient, have no psychiatric diagnosis and indicate no interest in treatment. However, for many veterans, MST is linked to a host of detrimental outcomes that last for years or decades. Research indicates that veterans with a history of MST are at least twice as likely to have a mental health condition compared to those without MST, with posttraumatic stress disorder diagnosed most commonly.
Major depression and other mood disorders, physical health problems, chronic pain, substance abuse, insomnia, relationship problems, decreased quality of life and suicide attempts are also more common in veterans who report a history of MST. A prior history of trauma, whether the MST was a one time or a repeating event and, crucially, whether any supportive response was received at the time of the MST influence the later impact of the MST.
Due to the ongoing stigma of sexual assault on victims, many do not report or seek help for MST while in the military. Coming forward for help is likely especially difficult for male survivors.
Despite this devastating impact, it is possible for those who experience MST to heal, and help is available. It is a federal law that any veteran who has experienced MST can receive VA treatment free of charge for mental and physical health conditions related to the MST, regardless of whether the veteran is eligible for other VA care.
A veteran does not need to have reported the MST or have documentation that it occurred. If a veteran requests treatment for MST, it is provided. Services are based on substantial research about what helps sexual trauma survivors recover. For some, this might include focusing on strategies for coping with challenging emotions or relationship difficulties. For others, it might involve processing the trauma in more depth, decreasing avoidance and challenging negative thoughts, such as self-blame or difficulty trusting others.
Gold-standard, evidence-based cognitive- behavioral treatments such as Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE) have been found effective for treating PTSD due to MST across the VA.
Some veterans suffering from the impact of MST may need even more intensive treatment, which can be provided in a residential setting. The Bay Pines VA Healthcare System’s Center for Sexual Trauma Services (CSTS), established in 2000, was the first residential program for MST and continues to serve male and female veterans from across the country. CSTS includes a 16- bed, approximately two-month, residential program that provides intensive, personalized evidence-based treatment for the impact of MST.
Individual CPT and PE, as well as education, coping skills, recreation therapy, community reintegration, mindfulness, and gender-specific special topics groups are provided. Approximately 100 male and female veterans, roughly evenly split and in mixed gender cohorts, are treated in the program each year by an interdisciplinary team of MST experts.
The good news is evidence shows this treatment works – with significant reductions in PTSD and depression symptoms by the end of treatment. This program, like many across the VA, continues to develop innovative, evidence based treatment to serve our veterans recovering from the impact of MST.
This material is the result of work supported with resources and the use of facilities at the Bay Pines VA Healthcare System, Department of Veterans Affairs, Bay Pines, Fla. Contents of this paper do not represent the views of the Department of Veterans Affairs or the United States Government.
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Jessica Keith, PhD, is a clinical psychologist and the program manager at the Center for Sexual Trauma Services, Department of Veterans Affairs, Bay Pines Veterans Affairs Healthcare System. Her email is: Jessica.Keith@gmail.com
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