Combating Social Isolation Among Female Survivors of Military Sexual Trauma

Social isolation and Military Sexual Trauma Definitions 

Military sexual trauma (MST) a term adopted by the United States Department of Veterans Affairs to refer to the different forms of sexual assault or sexual molestation experienced by the veterans when they served in various military operations (United States Department of Veterans Affairs, 2015). 

Social isolation is the state whereby individuals disintegrate themselves from social environments ( Wilson, Hill & Kiernan, 2018). Often, the state is encompassed by individuals reducing their social network and the frequency of their social interactions. 

How social isolation affects/impacts survivors of MST 

Social isolation is one of the negative coping mechanisms usually adopted by female survivors of military sexual trauma. These veterans tend to distance themselves from social circles and chose to go through the emotional distress of the sexual trauma on their own. The reason for social distancing is due to the fear of stigmatization if they happen to disclose the ordeals that they went through ( Cloitre Jackson & Schmidt , 2016). Social isolation negatively impacts the survivors of MST. The survivors perceive social support in a negative light. As such, they experience a lot of difficulties in establishing relationships, and they tend to have dysfunctional social and relationship lives ( Cloitre Jackson & Schmidt , 2016). Worse still, the social isolation renders the veterans vulnerable to develop posttraumatic stress disorder (PTSD) and the symptoms of the disorder being more pronounced (Make The Connection, n.d.). 

Socially isolated survivors of military sexual assault are also likely to experience feelings of loneliness. Loneliness is described as the distressing feeling usually experienced when persons perceive their social circles and relationships as not meeting their desired expectations, e.g., feeling left out (Richman, 2018). The feeling of loneliness has been found to have various adverse effects on the MST survivors. The victims are likely to experience feelings of low self-esteem (Richman, 2018). When loneliness is experienced in extreme levels, it is likely to trigger depression. Suicide ideation is also a possible consequence ( Cichowski et al., 2019). The feeling of loneliness is more likely to be experienced in veterans who experienced some form of trauma during their service (Stein, 2017). The feeling is likely to be elevated in female veterans who experienced MST due to the fear of being stigmatized (Holland et al., 2016). 

Importance of Social Connectedness for Female Veteran Survivors of MST 

Humans have been described as social beings. They cannot exist in complete isolation from each other. Humans derive some benefits from this social connectedness. Social connectedness is even more critical for female veterans who have experienced military social isolation. Social connectedness for the female veteran survivors of MST creates a social support network where the veterans can share their ordeals with friends, partners or relatives (Mattocks et al., 2012; Russell & Russell, D. W., 2018 ). Engagement in such social interactions helps them to lighten the burden of their tribulations and helps to put them on a recovery path from the MST ( Cloitre Jackson & Schmidt , 2016). Social support helps in dealing with stressful events amongst the veterans (Mattocks et al., 2012). The social circle creates an informal counseling mechanism in which the victims are more likely to be open to about their encounters ( Russell & Russell, D. W., 2018). The veterans’ social circle can also encourage them to seek professional help, such as counselors. Having some social support also helps to cushion against disorders such as PTSD ( Cloitre Jackson & Schmidt , 2016). 

Social Justice Principles 

The propagation of military sexual assault and harassment during different member’s service times has been enhanced by different social justice principles that work against the victims. The principles include cultural humility, challenging oppression and privilege, and commitment to action amongst other principles. In various ways, these principles have made victims of military sexual assault and harassment remain silent throughout their service life and result in social isolation after re-joining civilian lifestyle. The principles of social justice have worked against both male and female veterans. 

Cultural and bureaucratic barriers hinder the successful reporting and prosecution of sexual assault and harassment cases in the military. The perpetrators of the assault are mostly individuals who are more powerful than the victim (Zottarelli, 2015) . The perpetrator may also be in the same command unit as the victim but ranks higher than the victim. The occurrence of such situations, especially when involving female members, makes the females shy away from reporting the perpetrators. The fear of reporting the assault is further entrenched by the social justice principle of cultural humility whereby junior members are expected to follow the commands of their seniors. Under the principles of social justice, the perpetrators feel more privileged than the victims. Such perpetrators tend to trivialize the assault (Zottarelli, 2015) . When victims report the assault incidences, the victims are threatened with more work and being sent on risky missions (Zottarelli, 2015) . Thus, it calls for a lot of conviction for the victims to report sexual assault or harassment. 

Commitment to duty is the other social justice principle that undermines the rights of the female sexual assault victims. Servicemen and women are trained on the need for loyalty and unity within their respective units (Zottarelli, 2015) . Thus, when a female victim experiences sexual assault during their service life, they are conflicted about whether they should report the incident. The victims deserve justice, and reporting the incidence is the right thing to do. However, their acts may be interpreted to be disloyalty to the unit. Reporting the incidence may also cause friction within members of a particular unit. Thus, the victims may feel as if they are not dutiful and supportive of their units when they report the assault (Zottarelli, 2015) . Therefore, they suffer in silence until they leave the service life. Afterward, they are likely to result in social isolation as one of the ways of coping with the emotional distress that they went through. 

Prevalence of Social Isolation among Female Survivors of MST 

The United States Department of Veteran Affairs (2015), estimated the prevalence of military sexual assault amongst female veterans to be 1 in every four women. The statistics were collected out of responses given by veterans who had sought health care services from the Veteran Health Administration (VHA) facilities. Thus, the prevalence might be higher or lower depending on the number of survivors who do not seek services from the VHA facilities. According to Baltrushes and Karnik (2013), external audits estimate MST prevalence among females to range from 3% to 71%. 

Interventions to Combat Social Isolation among Female Survivors of MST 

Eradication of social isolation among female survivors of MST involves helping them to reconnect to their emotional and social lives. Different interventions have been used to enable this reconnection. One of the effective strategies involves the use of cognitive behavior therapy (CBT). Skills Training for Affective and Interpersonal Regulation (STAIR) is one such strategy that deploys CBT to enable individuals to develop emotion management and gain the relevant interpersonal skills to aid them in making social interactions and create healthy relationships ( Cloitre Jackson & Schmidt , 2016). The strategy involves the use of about 8 to 10 sessions during which individuals are trained on how to identify emotions, express them, and relationship building skills. Cloitre, Jackson & Schmidt (2016) state of the success of the strategy in helping a female veteran patient who had gone through MST to rebuild her confidence and social interactions. Besides helping to reduce social isolation, the strategy has been credited in reducing hostility and aggression. Various reasons have made the strategy to be described as appropriate for use among veterans. One is that the strategy concentrates on developing an individual’s strengths. Secondly, when compared to psychotherapy, the strategy is found to be less stigmatizing. Thirdly, the strategy is correspondent to the military’s principles of goal setting and attainment. 

Russell and Russell, D. W. (2018), carried out a study investigating the effectiveness of belonging to a veterans service organization (VSO) in helping to reduce social isolation. The authors involved veteran members in their research and undertook different tests to determine the level of isolation of the members, the posttraumatic stress, and their level of engagement in activities of their respective veteran social organization. The study found out that members who were actively engaged with the activities of their organizations and had robust social identification with the organizations registered lower social isolation levels. The decreased social isolation levels translated to reduced posttraumatic stress, which indicated healthier lives for these members (Russell and Russell, D. W., 2018). The results showed that veteran service organizations could be used to help veterans to shift from the military to civilian lifestyle without isolating themselves. Although the study involved only 21 female veterans as compared to 407 males whose responses were analyzed in the study, the phenomenon would not be any different for the female veterans. This is because the organizations act as social network sites that help the members to maintain effective relationships. 

Resources Available to Female Survivors of MST Experiencing Social Isolation 

Veteran Affair Policies regarding MST 

The Veteran Health Administration (VHA) has enacted different policies to guide the care of veterans who have experienced MST. VHA’s initial step in addressing MST involves mandatory screening for MST for all veterans checking in VA medical facilities (Veterans Health Administration, 2018) . Physical and mental health issues related to MST are treated free of charge for the veterans. The provision of MST associated services is not dependent on a veteran’s Veteran Benefits Administration (VBA) subscription. The VHA 2018 directive also sought to expand the entitlement of veterans to the MST services by allowing the provision of services for experiences encountered during inactive duty training. The VHA policies seek to ensure the best care for MST survivors. Consequently, it is a mandatory requirement for health care staff working in VHA facilities to undergo MST training (Veterans Health Administration, 2018) . To address the varying needs of male and female veterans, the VHA strives to provide male and female designated services for the MST survivors. The VHA policies also give MST survivors the option of choosing their preferred MST healthcare providers (Veterans Health Administration, 2018) . Specialized sexual trauma treatment is also provided in residential facilities (United States Department of Veterans Affairs, n.d.). Each VHA facility has an MST Coordinator who is responsible for MST related issues at the facility. 

Therapy Options, Engagement Groups, Non-profits Organizations for Catering to Female Veteran MST Survivors 

Various therapy options have been available to female veteran MST survivors. The most notable resource is the Veteran Health Administration medical facilities that provide gender-inclusive and neutral services to survivors of MST. The therapy options adopted in these facilities include female-only mental health groups, psychosocial rehabilitation, and specialty posttraumatic stress disorder clinics ( Cichowski et al., 2019) . 

One of the notable not for profit organization offering support to female MST survivors is the Grace After Fire. The organization strives to provide social support to female survivors of MST. Through the use of peer groups, the organization offers female veterans an opportunity to speak about their experiences, thus opening their path to self-knowledge and renewal (Grace After Fire, n.d.). The peer groups help the veterans overcome the impacts of MST, such as anger and self-isolation (Grace After Fire, n.d.). The organization also uses social activities and annual retreats to help the MST survivors rekindle their social lives. 

Operation We are Here is a useful website platform that offers different resources to military members, including veterans and their supporters. The platform provides various materials that can be used by military members and veterans who need help (Operation We Are Here, n.d.). The diverse organizations that are available to help the veterans to cope with different stressors are provided. The website offers web links to these organizations and the various hotlines that one may call in case they need help. VA military sexual trauma support website is one such platform. It informs members of the different healthcare services available to MST survivors (Operation We Are Here, n.d.). Taking Back Ourselves is another organization offering recovery therapy to female survivors of MST. Protect Our Defenders is also a committed organization that gives a voice to sexually assaulted veterans. Vets 4 Warriors provides 24-hour peer support through telephone calls to veteran members going through different stressors. No Vet Alone offers nationwide support to veterans through group interactions and community service to help them cope with stressors such as isolation and depression. There are also several other organizations in different states that strive to support MST survivor veterans through various programs. 

Changes Proposal to Current Interventions and/or Resources in Eradicating Social Isolation Components of MST. 

The current interventions and resources in eradicating social isolation in MST have been challenged on different fronts. According to Cichowski et al. (2019), female veterans regard the therapy options offered by the VHA to be inadequate and not fully responsive to their needs. The female veterans suggested the expansion of the therapy programs to include measures such as art therapy, yoga, and tai chi. I concur with the suggestions of these veterans since the issues faced by the MST survivors require a multifaceted approach to achieve the desired goals. 

About half of the female survivors of MST do not seek care from the VHA (Cichowski et al., 2019). The reasons are varied, with some citing the care environment in VHA providing triggers (Cichowski et al., 2019). The other is the perception of the facilities offering care as male-centered (Oregon Health Authority et al., 2019) . The failure of female veterans to seek care from VHA facilities due to this reason emanates from lack of sensitization on female-centered care, and the VHA policies that support are for female veterans. Thus, I propose that the VHA should carry out more advocacy and awareness-raising of its programs to help attract more female veterans. 

To circumnavigate the problem of female veterans experiencing triggers when they visit VHA facilities due to sighting individuals who resemble their perpetrators, I suggest that the VHA adopt telehealth programs. Telehealth programs would help the survivors receive care without physically visiting the facilities. 

References 

Baltrushes, N., & Karnik, N. S. (2013). Victims of military sexual trauma—you see them, too.  The Journal of Family Practice ,  62 (3), 120-125. 

Cichowski, S., Ashley, M., Ortiz, O., & Dunivan, G. (2019). Female Veterans’ Experiences With VHA Treatment for Military Sexual Trauma.  Federal Practitioner ,  36 (1), 41. 

Cloitre, M., Jackson, C., & Schmidt, J. A. (2016). STAIR for strengthening social support and relationships among veterans with military sexual trauma and PTSD.  Military medicine ,  181 (2), e183-e187. 

Grace After Fire.  Military sexual trauma survivor helps others overcome abuse . Graceafterfire.org. Retrieved 19 March 2020, from https://www.graceafterfire.org/employment-education/50-hire-heroes-usa.html . 

Holland, K. J., Rabelo, V. C., & Cortina, L. M. (2016). Collateral damage: Military sexual trauma and help-seeking barriers.  Psychology of Violence ,  6 (2), 253. 

Make The Connection.  Military Sexual Trauma | Real Stories From Military Veterans | Make the Connection . Maketheconnection.net. Retrieved 19 March 2020, from https://maketheconnection.net/conditions/military-sexual-trauma. 

Mattocks, K. M., Haskell, S. G., Krebs, E. E., Justice, A. C., Yano, E. M., & Brandt, C. (2012). Women at war: Understanding how women veterans cope with combat and military sexual trauma.  Social science & medicine ,  74 (4), 537-545. 

Operation We Are Here.  Counseling Crisis Help Suicide Prevention Resources for Military & Veterans . Operationwearehere.com. Retrieved 19 March 2020, from http://www.operationwearehere.com/Counseling.html . 

Oregon Health Authority, Oregon Department of Veterans’ Affairs, & Rede Group. (2019).  OREGON VETERANS’ Behavioral Health Services Improvement Study: Needs Assessment & Recommendations Report  [Ebook]. Retrieved 19 March 2020, from https://www.oregon.gov/oha/HSD/AMH/Documents/Veterans%20Behavioral%20Health%20Services%20Improvement%20Study%20Report.pdf . 

Richman, M. (2018).  The loneliness factor: How much does it drive depression in Veterans? . Research.va.gov. Retrieved 19 March 2020, from https://www.research.va.gov/currents/0218-The-loneliness-factor-in-depression.cfm. 

Russell, C. A., & Russell, D. W. (2018). It’s not just showing up: How social identification with a veterans service organization relates to benefit-finding and social isolation among veterans.  Psychological services ,  15 (2), 154. 

Stein, J. Y. (2017). The meaning of” loneliness” for traumatized veterans: A semiotic investigation of veterans’ written narratives.  Journal of Veterans Studies ,  2 (2), 121-139. 

United States Department of Veterans Affairs. (2015).  Military Sexual Trauma  [Ebook]. Retrieved 19 March 2020, from https://www.mentalhealth.va.gov/docs/mst_general_factsheet.pdf . 

US Department of Veterans Affairs.  VA.gov | Veterans Affairs . Womenshealth.va.gov. Retrieved 19 March 2020, from https://www.womenshealth.va.gov/trauma.asp . 

Veterans Health Administration. (2018).  VHA Directive 1115: Military Sexual Trauma (MST) Program  [Ebook]. Retrieved 19 March 2020, from https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6402 . 

Wilson, G., Hill, M., & Kiernan, M. D. (2018). Loneliness and social isolation of military veterans: systematic narrative review.  Occupational medicine ,  68 (9), 600-609. 

Zottarelli, M. (2015).  Military Sexual Assault: Understanding prevalence, resources, and considerations to care  [Ebook]. Swords to Plowshares. Retrieved 19 March 2020, from https://www.swords-to-plowshares.org/wp-content/uploads/Military-Sexual-Trauma-Understanding-2015.pdf . 

Annotated Bibliography 

Cichowski, S., Ashley, M., Ortiz, O., & Dunivan, G. (2019). Female Veterans’ Experiences With VHA Treatment for Military Sexual Trauma.  Federal Practitioner ,  36 (1), 41. 

The three individuals who have authored the journal article are engaged in medical work. The medical background of the authors makes the article credible as it is investigating a health care phenomenon. The authors examine the experience that female veteran survivors have in VHA facilities. They conduct a well-controlled study using focus groups comprising of female veterans. I regarded the article to be quite useful since it involved first-hand data collection from the veterans. I found the material appropriate for my research paper since it explores critical aspects that I am investigating in my paper, such as therapy treatment options for female veterans who have experienced MST and isolation. The article also explores the various impacts that MST has on the victims, which are all crucial aspects that I am considering in my paper. 

Cloitre, M., Jackson, C., & Schmidt, J. A. (2016). STAIR for strengthening social support and relationships among veterans with military sexual trauma and PTSD.  Military medicine ,  181 (2), e183-e187. 

The article is authored by three active researchers in different fields, such as PTSD and cognitive behavioral therapy. I regarded the article to be credible as it is authored by individuals who are well versed in their different research fields, which are incorporated in their study. The authors investigate the effectiveness of Skills Training in Affective and Interpersonal Regulation (STAIR) in helping to better the social lives of MST survivors and those who have PTSD. I selected the article because it touches on one of the components that I am investigating in my paper, interventions to eradicate social isolation. The authors use authoritative sources in stating their claims. Further, they elaborate on the effectiveness of STAIR by documenting case scenarios in which it has been successfully applied. Thus, they conclude that STAIR is an effective intervention for isolation amongst veterans. 

Russell, C. A., & Russell, D. W. (2018). It’s not just showing up: How social identification with a veterans service organization relates to benefit-finding and social isolation among veterans.  Psychological services ,  15 (2), 154. 

The article is authored by two university professors who are actively engaged in various research works. The authors investigate the usefulness of social identification through veteran service organizations in helping to improve the social isolation phenomenon in veterans. The authors carry out a first-hand study involving veterans in which they undertake different tests. They carry out an in-depth review using authoritative sources of different phenomenons such as social isolation, disclosure, and posttraumatic stress. They state that VSO’s are an effective measure in improving the social lives and overall health of veterans. I regarded the article to be credible as two university professors have authored it. I selected the article because it provides a reliable source for some of my claims on interventions of eradicating social isolation. 

Mattocks, K. M., Haskell, S. G., Krebs, E. E., Justice, A. C., Yano, E. M., & Brandt, C. (2012). Women at war: Understanding how women veterans cope with combat and military sexual trauma.  Social science & medicine ,  74 (4), 537-545. 

The article is authored by six authors, all engaged in different research works, one in the Department of Veteran Affairs and others in universities. The authors undertake an in-depth review of the various documented ways that veterans use as coping mechanisms. Further, they conducted a qualitative research study in which they investigate the various phenomenons surrounding female veterans and the coping mechanisms that they use. Their study categorized the coping strategies into behavioral avoidance, cognitive avoidance, and behavioral approach. I selected the article because it investigated some of the elements of my paper, including social isolation amongst female veteran MST survivors. I deemed the material to be credible since it is authored by active researchers who were funded by the US government. 

Stein, J. Y. (2017). The meaning of” loneliness” for traumatized veterans: A semiotic investigation of veterans’ written narratives.  Journal of Veterans Studies ,  2 (2), 121-139. 

The article is authored by an active researcher in the fields of trauma and loneliness and has been engaged in research on various topics. The author explores the semantics around loneliness. He provides the various definitions that are often clustered together, such as loneliness, alone, social isolation, amongst others. The author provides the meanings in the context of traumatized veterans, thus giving more importance to his work. Further, the author links the loneliness phenomenon with different health conditions such as posttraumatic stress. The findings of the study are essential for the clinical treatment of traumatized veterans. I regarded the article to be credible because it is authored by an active researcher in the particular topic. I selected the material for use in my study because it helped in the comprehension of the various terms surrounding social isolation, a crucial topic in my study.