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Special Collection: The Intersection of Domestic Violence and the Military: Working across disciplines

The purpose of this collection is to:

  • Examine the prevalence of Traumatic Brain Injury (TBI), and Post Traumatic Stress Disorder (PTSD) (including relevant references to Military Sexual Trauma (MST)) among veterans returning from the wars in Iraq and Afghanistan1;
  • Examine the implications for the domestic and sexual violence fields of veterans returning with co-occurring issues (PTSD, TBI, MST);
  • Provide information related to best practices when addressing these co-occurring issues through a multi-systems approach;
  • Explore some of the challenges experienced by female service members and veterans through the lens of violence against women; and
  • Increase awareness about organizations that are currently working to address TBI, PTSD, MST and domestic violence (DV).

A brief glossary of terms has been included for your reference and to assist with understanding the information discussed here. This special collection is intended to expand on the previous collection Traumatic Brain Injury and Domestic Violence: Understanding the Intersections published by the NRCDV in March 2010. As you read through this collection of resources and materials, please refer to the chart below, "Total Force" U.S. Armed Forces for an understanding of how the U.S. military is organized.

US Armed Forces Chart

This resource was developed by the National Resource Center on Domestic Violence. Special thanks to the National Center on Domestic and Sexual Violence, the Battered Women's Justice Project, the Service Women's Action Network, the VA Center for Health Equity and Promotion, and the Family Advocacy Program, Office of the Deputy Assistant Secretary of Defense for their contributions. To recommend additional resources for this collection, please Contact Us.

1. The wars in Iraq and Afghanistan are also known as Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) respectively.

Table of Contents:

   
  • Glossary
    Click here for a glossary containing military-related terms used throughout this collection for clarification and easy reference.

Prevalence and Implications of TBI, PTSD and MST | Back to top

This section explores co-occurring issues that could potentially have an effect on trauma responses and behavior in general. The prevalence of Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD) among veterans returning from the wars in Iraq and Afghanistan is presented along with information related to Military Sexual Trauma (MST). Best practices for distinguishing TBI, Post-Traumatic Stress Disorder (PTSD), and Domestic Violence (DV) are identified. Additionally, how to design effective interventions to best address these challenging issues when they co-occur are highlighted. A glossary of the most used military-related terms is included throughout this collection for clarification. Lastly, we offer information about existing partnerships between anti-violence organizations, TBI service providers and the military as well as other similar successful collaboration models.

Traumatic Brain Injury (TBI)

A traumatic brain injury (TBI) is defined as a specific type of damage to the brain that is caused by external physical force and is not present at birth or degenerative. A blow (or blows) to the head, shaking of the brain, exposure to blasts, loss of oxygen (anoxia), and/or colliding with a stationary object can cause a TBI.

Direct exposure to explosions is among the leading causes of TBI among active military duty personnel. Blasts account for 69% of TBI cases in the recent conflicts (Schell & Tinney, 2010). In light of the high number of veterans returning from the recent conflicts with a brain injury, there are reasons to expect that the anti-violence field will encounter this growing population from different entry points (domestic violence victims’ service providers, rape crisis centers, batterer intervention programs, victim advocates located within the civil/criminal legal system).

Persons with a TBI may experience some of the common behavioral problems associated with this kind of brain damage. They may include impulsivity, irritability, decreased frustration tolerance, impaired judgment, tension/anxiety, depression, aggressive behaviors, disinhibition, changed sexual drive and overall, and changes in that individual’s personality (Avner, 2010).

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after experiencing a traumatic event. During this type of event, the person feels like her/his life or others' lives are in danger as well as loss of control over what is happening. Anyone who has experienced a life-threatening event can develop PTSD. These events can include:
Combat exposure, child sexual or physical abuse, terrorist attacks, sexual or physical assault, serious accidents, and natural disasters, such as a fire, tornado, hurricane, flood, or earthquake. Exposure to a traumatic experience does not always result in PTSD.

Experts think PTSD occurs:
~ In about 11-20% of Veterans of the Iraq and Afghanistan wars (Operation Iraqi Freedom and Operation Enduring Freedom)
~ In as many as 10% of Gulf War (Desert Storm) Veterans
~ In about 30% of Vietnam Veterans (US Department of Veterans Affairs, National Center for PTSD)

  • Invisible Wounds of War. Psychological and cognitive injuries, their consequences and services to assist recovery | PDF PDF (499 p.)
    by Terri Tanielian & Lisa H. Jaycox, Editors for the Center for Military Health Policy Research (RAND) (2008)
    This report highlights the psychological toll of deployments involving prolonged exposure to combat-related stress over multiple rotations and how these types of deployments may be disproportionately high compared with the physical injuries of combat.
    + View Summary
  • Supporting our troops, veterans and their families: Lessons Learned and Future Opportunities for Philanthropy | PDF PDF (74 p.)
    by Vanessa Williamson (November 2009)
    This report discusses the impact of the wars in Iraq and Afghanistan on veterans, including psychological wounds.
    + View Summary
  • Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury: Annual Report 2009 | PDF PDF (21 p.)
    by Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (2009)
    Report from the Defense Centers of Excellence (DCoE) for Psychological Health (PH) and Traumatic Brain Injury (TBI) from 2007-2008.
    + View Summary
  • Special report: For U.S. veterans, the war after the wars | PDF PDF (4 p.)
    by Nick Carey for Reuters (November 2009)
    This articles analyses the consequences of the Wars in Iraq and Afghanistan.
    + View Summary

More information:
  • Military reckons with the mental wounds of war | HTML HTML (4 p.)
    by Greg Jaffe and Whitney Shefte for The Washington Post (July 18, 2010)
    This article tells the story of Staff Sgt. James Ownbey, a Marine who served in Iraq as an explosive ordinance disposal technician in 2007, and two other deployments who now suffers from a traumatic brain injury (TBI), post-traumatic stress disorder (PTSD) and numerous physical ailments.
    + View Summary
  • Purple Hearts Elusive For Traumatic Brain Injuries | HTML HTML (4 p.)
    by T. Christian Miller And Daniel Zwerdling for National Public Radio (September 2010)
    This article explains how soldiers who sustain a brain injury are often determined ineligible to receive the Purple Heart medal.
    + View Summary
Military Sexual Trauma (MST)

NOTE: See the parallel collection, Sexual Violence in the Military by the National Sexual Violence Resource Center for a fully-developed discussion on Military Sexual Trauma.

MST is the official phrase for the psychological trauma that may result from sexual assault or repeated, threatening acts of sexual harassment while in the military. In other words, if these experiences occurred while on active duty or active duty for training, they are considered to be MST. MST is the primary causal factor of Post-Traumatic Stress Disorder (PTSD) for women, whereas combat experience is the strongest predictor of PTSD for men (Street et al. 2008).

This is the definition of MST used by the U.S Department of Veterans Affairs (U.S. Code 1720D of Title 38):

MST is "psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty or active duty for training." Sexual harassment is further defined as "repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character."

In more concrete terms, MST includes any sexual activity against the person’s will. Other MST experiences include unwanted sexual touching or grabbing, threatening, offensive remarks about the person’s body or sexual activities, and threatening and unwelcome sexual advances.

The Department of Veterans Affairs (VA) has a system in place to respond to MST including MST screening and treatment, training staff on MST-related issues and outreach to Veterans about available services. Every VA facility has an MST Coordinator who serves as a contact person for MST-related issues. (US Department of Veterans Affairs, National Center for PTSD - Military Sexual Trauma)

DoD Safe Helpline: Department of Defense (DoD) Safe Helpline is a groundbreaking crisis support service for members of the DoD community affected by sexual assault. Safe Helpline provides live, one-on-one support, and information to the worldwide DoD community. The service is confidential, anonymous, secure, and available worldwide, 24/7 by click, call, or text — providing victims with the help they need, anytime, anywhere.

  • What is Military Sexual Trauma? | HTML HTML (6 p.)
    by Catherine McCall for Gift From Within (May 2011)
    This article offers information to MST survivors with the intent of providing them with resources to assist them in their recovery. It was also written for partners, friends, or family members of MST survivors.
    + View Summary
  • Rape, Sexual Assault and Sexual Harassment in the Military: The Quick Facts | PDF PDF (2 p.)
    by Service Women Action Network (SWAN) (July 2012)
    This 2-page fact sheet includes information about the incidence of MST, its emotional and financial costs, and other valuable information highlighting the devastating effects of this problem.
    + View Summary
  • Department of Defense Annual Report on Sexual Assault in the Military: Fiscal Year 2010 | PDF PDF (622 p.)
    by Department of Defense (March 2011)
    This report presents the number of reported sexual assault cases in 2010 among military service members. It also highlights DoD’s strategies and interventions for investigating and responding to sexual assault claims.
    + View Summary
  • 2010 Workplace and Gender Relations Survey of Active Duty Members: Overview Report on Sexual Assault | PDF PDF (126 p.)
    by the Defense Manpower Data Center (March 2011)
    This report includes a summary of Department of Defense (DoD) policies and programs associated with sexual assault and a description of the WGRR 2008 survey content and methodology.
    + View Summary
  • Military Academies: Rape, Sexual Assault, And Sexual Harassment | PDF PDF (9 p.)
    by Brittany L. Stalsburg for the Service Women’s Action Network (SWAN) (February 2011)
    This document is an analysis based on the Department of Defense’s Annual Report on Sexual Harassment and Violence at the Military Service Academies as well as two surveys commissioned by the Department of Defense that examine “gender relations” in U.S. military academies.
    + View Summary

More information:
  • Sexual assault in military ‘jaw dropping,’ lawmaker says | HTML HTML (4 p.)
    by Cable News Network (CNN), Turner Broadcasting System, Inc. (July 2008)
    This is a news article and accompanying video in which Rep. Jane Harman, D-California is quoted saying that her "jaw dropped" when military doctors told her that four in ten women at a veterans hospital reported being sexually assaulted while in the military.
    + View Summary

Articles

Kimerling, R., Gima, K., Smith, M.W., Street, A., & Frayne, S. (2007). The Veterans Health Administration and military sexual trauma. American Journal of Public Health, 97, 2160-2166.

Street et al. 2008. “Sexual harassment and assault experienced by reservists during military service: Prevalence and health correlates.” Journal of Rehabilitation Research and Development 45: 409-420

Kang et al. 2005. “The role of sexual assault on the risk of PTSD among Gulf War veterans.” Annals of Epidemiology 15(3):191-195.

Suris, A., & Lind, L. (2008). Military sexual trauma: A review of prevalence and associated health consequences in veterans. Trauma, Violence, & Abuse, 9, 250-269.

Turchik, J. A., & Wilson, S. M. (2010). Sexual assault in the U.S. military: A review of the literature and recommendations for the future. Aggression and Violent Behavior, 15, 267-277.

Williams, I., & Bernstein, K. (2010). Military sexual trauma among U.S. Female Veterans. Archives of Psychiatric Nursing.

Best practices for understanding violence perpetration and co-occurring issues | Back to top

Based on the prevalence of TBI, PTSD and MST among veterans it is safe to assume that these issues could exist simultaneously, or “co-occur,” complicating responses to trauma. Within the context of domestic violence perpetration, survivors may face additional challenges, not necessarily present in cases where perpetrators do not have a military history or current military affiliation. The following examples describe dynamics that may exist among intimate partners experiencing domestic violence within the military context. However, many other combinations of these complex themes are also possible, such as when both victim and perpetrator are service members or veterans.

Co-occurring issues: impact
For a domestic violence survivor, her/his partner may have returned from the war a changed person with new and ongoing needs for care and support related to TBI, PTSD, MST or other mental health related issues. In some cases, this set of problems can generate devastating results for the survivor who has to deal with an additional layer of guilt that could prevent her/him from seeking help or ending the relationship.

Being a civilian accessing services within the military system
Civilian domestic violence victims/survivors may know little about military practices, regulations and effective interventions. It is often the fear of potentially “ruining” the perpetrator’s career if a report is made. This is particularly challenging in cases where the perpetrator is active duty personnel, or where the perpetrator is the primary source of income for the family. Both of these instances create concrete economic challenges for the survivor to navigate.

Establishing cause: Intent versus co-occurring issues

Determining the history of violent behavior and the intent behind it are both critical elements in addressing domestic violence without solely linking its causes to the acquired disability. Separating violent behaviors when they are motivated by power and control from those which might be a direct result of brain injury or trauma will assist survivors, the anti-violence field, the criminal justice system and others in their response to these difficult situations.

To understand these differences, it is imperative that domestic violence survivors are provided with the opportunities to remain actively involved in the processes of establishing causation and history. At the same time, regardless of the intent and intensity of the abuse, it is crucial to support and respect survivors’ choices while they safety plan and make decisions that improve their quality of life, as defined by each individual in response to his/her own situation.

What can be done

Not all domestic violence assaults, murders or other violent incidents are related to military service and not all of these offenses can be attributed to PTSD or TBI. “Rather, we must strive to understand how domestic violence, PTSD and TBI can be distinguished and how to craft interventions that prevent further violence and loss of life” (Tucker, 2009). To date, there are a number of initiatives taking place at the national level aimed at addressing these complex situations.

DoD Family Advocacy Program
The DOD Family Advocacy Program is dedicated to the prevention, education, early identification and prompt reporting, investigation, intervention and treatment of spouse and child abuse. The Family Advocacy Program (FAP) provides a variety of services to active duty military personnel and families to enhance their relationship skills, strengthen family functioning, competency and self sufficiency to improve their quality of life. This mission is accomplished through a variety of life skills seminars and workshops, counseling and other intervention services.

The Department of Defense is headed by a civilian, the Secretary of Defense, appointed by the President of the United States. Under the Secretary of Defense, there are three military departments: The Department of the Army, The Department of the Air Force and the Department of the Navy, which encompasses the Navy and Marine Corps. The Family Advocacy Program (FAP) in the Office of the Secretary of Defense provides the Services with policy guidance and funding for execution of the FAP. Implementation of FAP differs among the services. In the Air Force and Army, FAP is a clinical service under medical and/or behavioral health and may operate out of a hospital or clinic. Navy and Marine Corps offer FAP services as a part of their family support and services programs; FAP staff are typically based in the family services center. In addition, specific FAP services may vary by Service as well as by installation.

Domestic Abuse Victim Advocates provide comprehensive services and support to victims of domestic abuse and intimate partner violence e, including crisis intervention, safety planning, and assistance in securing medical treatment for injuries, information on legal rights and proceedings, and referral to military and civilian shelters and other resources available to victims. Victim Advocacy services are available 24 hours a day/7 days a week to active duty members and their families. Domestic Abuse Victim Advocates are also available to assist with questions regarding reporting options, transitional compensation and other relevant options.

The Department of Defense has comprehensive Victim and Witness Assistance Programs (VWAP) in order to enhance and protect the rights of victims of crimes committed within the military setting. (VWAPs are in addition to specialized assistance for victims of sexual assault or domestic violence.) The VWAP is designed to ensure victims and witnesses of crime are afforded their rights throughout the criminal process – from initial contact with investigators through adjudication and any period of confinement. VWAPs assist victims with exercising their federally mandated rights and with navigating the criminal justice system. VWAPs also provide information on services and resources, and they interact with lawyers and commanders. VWAPs help ensure the victim’s situation is respected. VWAPs help ensure that the victims are treated with respect, have a voice in the process, and are kept informed of the status of the investigation and prosecution.

  • Victim Advocate Guide: Intimate Partner Violence (IPV) and Combat Experience | PDF PDF (7 p.)
    by the Battered Women's Justice Project (BWJP) for the Avon Foundation for Women (April 2011)
    This guide provides advocates will tools to help understand and support victims whose partners have been exposed to the trauma of combat and are exhibiting violent or abusive behavior.
    + View Summary
  • Domestic Violence, PTSD and Brain Injury: Military and Civilian Challenges | PDF PDF - Part 1 (10 p.) PDF PDF - Part 2 (8 p.)
    by Deborah Tucker for the National Center on Domestic and Sexual Violence (NCDSV) (2009)
    This two-part article explores the military and civilian challenges presented by domestic violence and behavior that is more often associated with PTSD or TBI.
    + View Summary
  • The Military Power and Control Wheel | PDF PDF (1 p.)
    by National Center on Domestic and Sexual Violence
    This wheel describes tactics used to control abuse victims within the context of a relationship rooted in the military. It is adapted from the Power and Control Wheel developed by the Domestic Abuse Intervention Project of Duluth, MN.
    + View Summary
  • Maze Map | PPT (12 p.)
    by the Battered Women’s Justice Project and Praxis International (May 2005)
    These Powerpoint slides include processes involving domestic violence victims and the military response to domestic violence when it applies to active duty military personnel.
    + View Summary
  • What has changed. Understanding Stress: A guide for Military Families | PDF PDF (1 p.)
    by Helga Luest for Witness Justice
    This is a one-page guide on understanding stress and triggers after deployment.
    + View Summary
  • Collaborating for Safety: Coordinating the Military and Civilian Response to Domestic Violence | PDF PDF (60 p.) HTML HTML
    by Jane M. Sadusky for the Battered Women’s Justice Project (2010)
    This handbook provides an overview of the processes used in the implementation of the OVW funded Military/Civilian Coordinated Community Response Demonstration Project.
    + View Summary
  • At a Glance: Military Resource Handbook For Virginia’s Sexual and Domestic Violence Centers | PDF PDF (59 p.)
    by the Virginia Sexual and Domestic Violence Alliance (January 2008)
    This resource kit was designed for civilian advocates working with active duty members, spouses, partners and family members who have experienced or been exposed to sexual and/or domestic violence.
    + View Summary
  • Department of Defense Instruction 6400.6: Domestic Abuse Involving DoD Military and Certain Affiliated Personnel | PDF PDF (50 p.)
    by the Department of Defense (August 2007)
    This link provides an overview of DoD’s domestic abuse policy including information on restricted and unrestricted reporting.
    + View Summary
  • PTSD, TBI and DV: True or False? | PDF PDF (8 p.)
    from the National Bulletin on Domestic Violence Prevention, Volume 15, Number 7, Thomson Reuters (July 2009)
    This article offers tips to determine when domestic violence is occurring and cautions justification of domestic violence when the perpetrator is a veteran returning from the war suffering from PTSD and/or TBI.
    + View Summary
  • Supporting Stalking Victims In The Military - Advice For Advocates | PDF PDF (2 p.)
    by the National Center for Victims of Crime (2005)
    This is a two-page list of recommendations for how to handle stalking situations when the stalker is in the military.
    + View Summary
  • The Traumatic Brain Injury and Military Veterans Services Project | HTML HTML
    by the Brain Injury Association of New York
    This page of the Brain Injury Association of New York State’s website describes their collaboration with the New York State Department of Health to raise awareness about traumatic brain injury (TBI) in the military.
    + View Summary
  • Domestic Violence In Veterans With Posttraumatic Stress Disorder Who Seek Couples Therapy | HTML HTML (14 p.)
    by Michelle D Sherman, Fred Sautter, M Hope Jackson, Judy A Lyons, & Xiaotong Han for the Journal of Marital and Family Therapy (October 2006)
    This article discusses the incidence of domestic violence among couples seeking marital therapy in which one partner had a diagnosis of PTSD.
    + View Summary
  • Domestic Violence and Post-Traumatic Stress Disorder Severity for Participants of a Domestic Violence Rehabilitation Program | HTML HTML (9 p.)
    by April A. Gerlock for Military Medicine (June 2004)
    This article examines the correlation between PTSD, DV and history of violence in the family of origin.
    + View Summary

Video:
  • Military Mental Health - Educational Video | HTML HTML
    by Give an Hour (March 2010)
    This video relates experiences of veterans of Iraq and Afghanistan and psychological issues they face as a result of combat stress. It highlights the Give an Hour initiative to provide free mental health services to help heal these invisible wounds.
    + View Summary

Training Tools:
  • BWJP Military-Related Webinar Recordings | HTML HTML
    from the Battered Women’s Justice Project (2011)
    This page provides access to webinar recordings organized by date on the topics of intimate partner violence and the military.
    + View Summary
  • Domestic Violence and the Military Services: Analyzing Acts of Violence | PDF PDF (70 p.)
    by Deborah D. Tucker for VAWnet (May 2011)
    This presentation suggests an approach to analyzing acts of violence committed by service members to determine the most appropriate intervention while also ensuring the safety and well being of family members.
    + View Summary
Articles

Elbogen, E. B., Fuller, S., Johnson, S. C., Brooks, S., Kinneer, P., Calhoun, P. S., & Beckham, J. C. (2010). Improving risk assessment of violence among military veterans: An evidence-based approach for clinical decision-making. Clinical Psychology Review, 30, 595-607.

Jeffreys, M. D., Leibowitz, R. Q., Finley, E., & Arar, N. (2010). Trauma disclosure to health care professionals by veterans: Clinical implications. Military Medicine, 175, 719-724.

Marshall, A. D., Panuzio, J., & Taft, C. T. (2005). Intimate partner violence among military veterans and active duty servicemen. Clinical Psychology Review, 7, 862-876.

O’Campo, P., Kub, J., Woods, A., Garza, M., Jones, A. S., Gielen, A. C., Dienemann, J., & Campbell, J. (2006). Depression, PTSD, and comorbidity related to intimate partner violence in civilian and military women. Brief Treatment and Crisis Intervention, 6, 99-110.

Schaffer, B. J. (2010). Male veteran interpersonal partner violence and associated problems. Journal of Aggression, Maltreatment, and Trauma, 19, 414-423.

Teten, A. L., Schumacher, J. A., Bailey, S. D., & Kent, T. A. (2009). Male-to-female sexual aggression among Iraq, Afghanistan, and Vietnam veterans: Co-occurring substance abuse and intimate partner aggression. Journal of Traumatic Stress, 22, 307-311.

Teten, A. L., Schumacher, J. A., Taft, C. T., Stanley, M. A., Kent, T. A., Bailey, S. D., Dunn, N. J., & White, D. L. (2010). Intimate partner aggression perpetrated and sustained by male Afghanistan, Iraq, and Vietnam veterans with and without posttraumatic stress disorder. Journal of Interpersonal Violence, 25, 1612-1630.

Challenges Specific to Female Veterans | Back to top

“A growing number of women are serving in the US military. In 2008, 11% of Veterans from the Afghanistan and Iraq military operations were women. These numbers are expected to keep rising. In fact, women are the fastest growing group of Veterans” (National Center for PTSD). While this number continues to grow, women face challenges that routinely place them at risk for victimization and isolation while deployed. Additionally, reintegrating successfully to their home communities proves extremely difficult as female veterans often face systems that remain primarily male centered in their service delivery for historical and societal reasons. Although women have served in the U.S. military since the Revolutionary War, it wasn’t until 1988 that the VA began offering medical and mental health services to female veterans. A manager from a clinic dedicated to female veterans at the VA Medical Center in Salt Lake City said “the legacy of that exclusion is still being felt today” (Salt Lake Tribune, 2011)

Women also face higher rates of homelessness in comparison to their male counterparts. “Not only are returning service women nearly four times as likely as men to become homeless, but roughly 40% of those who experience homelessness also report having been sexually assaulted while in the military” (Natelson, 2010).

Significant progress has been made towards simplifying the process for applying for benefits in the case of returning veterans who suffer from PTSD through the new PTSD regulations (US Department of Veterans Affairs, 2010); however, these new regulations still fall short in meeting the needs of those whose source of PTSD is military sexual trauma related, the majority of whom are women. “Among the most pervasive stressors experienced by military women are incidents of sexual assault and harassment. By some accounts, nearly a third of female veterans report episodes of sexual assault during military service, while 71 to 90 percent report experiences of sexual harassment. These experiences are closely associated with PTSD in a variety of studies; in fact, military sexual assault is a stronger predictor of PTSD among women veterans than combat history” (Natelson’s, 2009; Murdoch et. al, 2003).

Within the context of violence against women, this is a matter of growing concern for anti-violence advocates. Responding to the needs of female veterans who experience domestic and sexual violence is among the services that many local community programs will likely be providing in the near future. For some programs across the country, this is already taking place. As we honor these service members and veterans, we need to understand the dynamics surrounding violence that come into play when working with this population. What follows are things to consider:

  • What may be some of the co-occurring issues unique to these survivors?
  • Are female service members and veterans at a higher risk for victimization?
  • What are the challenges faced by female veterans/survivors who are also mothers?

We compiled resources that are expected to grow over time, as more information continues to emerge in response to these needs. Included here are are testimonies, news articles, online tools, research papers and other related materials. However, one of our goals with this section of the collection is to highlight the paucity of research and funding opportunities specifically devoted to address the needs of female service members and veterans at this point in time. The few isolated efforts taking place at the national level and within some communities are currently not enough to respond to the needs of female service members and veterans. Without the institutionalization of effective interventions designed to prevent violence and address the trauma experienced by these veterans and service members, they will likely continue to be at risk for ongoing victimization and further physical and psychological harm.

  • Prevalence of Intimate Partner Violence, Stalking, and Sexual Violence Among Active Duty Women and Wives of Active Duty Men - Comparisons with Women in the U.S. General Population, 2010 | PDF PDF (54 p.)
    by Michele C. Black and Melissa T. Merrick for the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (March 2013)
    The findings in this technical report, based on 2010 NISVS data, reveal that overall, the prevalence of IPV, SV, and stalking were similar among women in the U.S. population, active duty women, and wives of active duty men.
    + View Summary
  • Issues Specific to Women (Fact Sheets) | PDF PDF (1 p.)
    by the National Center for PTSD, US Department of Veterans Affairs
    These fact sheets relate to issues affecting women veterans specifically.
    + View Summary
  • Military Sexual Trauma (MST) Fact Sheet | PDF PDF (2 p.)
    by Brittany L. Stallsburg for the Service Women Action Network (SWAN) (June 2010)
    This 2-page fact sheet includes information about the incidence of MST, its emotional and financial costs, and other valuable information highlighting the devastating effects of this problem.
    + View Summary
  • Interview with Anuradha Bhagwati, Executive Director, Service Women Action Network (SWAN) | HTML HTML (22 p.)
    by Ronnie M. Eldridge for City University of New York TV
    This video interview with SWAN’s Executive Director, a former marine, provides an overview of the challenges faced by female veterans while deployed and after returning to their communities.
    + View Summary
  • Testimony before Congress by Anuradha Bhagwati | PDF PDF (2 p.)
    by Anurada Bhagwati for the Service Women’s Action Network (SWAN) (May 20, 2010)
    This testimony that highlights the challenges experienced by female veterans when trying to access health care benefits through the Veterans’ Administration.
    + View Summary
  • Separate, Unequal, and Unrecognized | PDF PDF (1 p.)
    by Rachel Natelson for The Huffington Post (August 4, 2010)
    This article describes the obstacles that female service members and veterans are faced with during deployment and when trying to reintegrate to their home communities.
    + View Summary
  • Homeless Women Veterans: The Facts | PDF PDF (4 p.)
    by Service Women’s Action Network (SWAN) (August 2009)
    This fact sheet provides statistics and other information related to homeless women veterans.
    + View Summary
  • Back from combat, women struggle for acceptance | PDF PDF (3 p.)
    by Kimberly Hefling for the Associated Press, AirForceTimes (December 2009)
    The article reports, "More than 230,000 American women have fought in those recent wars and at least 120 have died doing so, yet the public still doesn't completely understand their contributions on the modern battlefield."
    + View Summary
  • Command Indiscretion | PDF PDF (1 p.)
    by Rachel Natelson for The Huffington Post (January 4, 2010)
    This article highlights some of the challenges experienced by military women while deployed related to sexual violence, reproductive justice, motherhood and other issues.
    + View Summary
  • Sexual assault in military ‘jaw dropping,’ lawmaker says | HTML HTML (4 p.)
    by Cable News Network (CNN), Turner Broadcasting System, Inc. (July 2008)
    This is a news article and accompanying video in which Rep. Jane Harman, D-California is quoted saying that her "jaw dropped" when military doctors told her that four in ten women at a veterans hospital reported being sexually assaulted while in the military.
    + View Summary

Blog:
  • Mothers in the Military: Punishing Mothers Who Serve | HTML HTML (2 p.)
    by Jessica Scott for Regarding War (April 13, 2010)
    This blog post captures some of the challenges faced by mothers who are serving in the military.
    + View Summary

Training Tools | Back to top

New eLearning Course from the Battered Women's Justice Project
Safety at Home–Intimate Partner Violence, Military Personnel, and Veterans (November 2012) is designed for advocates (military and civilian) who provide services to military-related families experiencing intimate partner violence. The course is also be helpful for social service and mental health practitioners who are working with these victims and their families. It pulls together information about military and combat-related issues and intimate partner violence.

This section includes materials from past military-related webinar sessions that focused primarily on women.

  • Challenges Faced by Female Veterans Webinar Materials | PDF PDF (31 p.)
    presented by Anu Bhagwati, Rachel Natelson, and Star Lara for the National Resource Center on Domestic Violence (January 12, 2011)
    This presentation focused on the challenges experienced by female service members and veterans as well as some of the services that are currently available to this population.
    + View Summary
  • Domestic Violence and the Military: The Traumatic Impact on Women Webinar Materials | PDF PDF (35 p.)
    presented by Helga Luest and Trina Parker for the National Resource Center on Domestic Violence (February 9, 2011 & March 1, 2011)
    Taking a gender-specific look at what female military veterans experience after combat stress and trauma, presenters explored how this trauma impacts personal, family and professional lives.
    + View Summary

Services available for female veterans and service members | Back to top

The following resources are currently available for female service members and veterans. This list is not inclusive and expects to continue growing over-time. If you are aware of a resource that is not currently listed please, feel free to let us know by using our Online Contact Form.

Military Sexual Trauma while still in the military

If the person is an active duty service member and has been a victim of Military Sexual Assault (or knows someone who has), visit MyDuty.Mil. This organization provides information and guidance on the person’s reporting options and rights.

Sexual Assault Prevention and Response
The Sexual Assault Prevention and Response Office (SAPRO) is responsible for oversight of the Department of Defense’s sexual assault policy. SAPRO works hand-in-hand with the Services and the civilian community to develop and implement innovative prevention and response programs.

General services for women veterans

Department of Veterans Affairs - Center for Women Veterans
The center’s mission is to monitor and coordinate VA’s administration of health care and benefits services, and programs for women Veterans; serve as an advocate for a cultural transformation (both within VA and in the general public) in recognizing the service and contributions of women Veterans and women in the military; and raise awareness of the responsibility to treat women Veterans with dignity and respect.

VA Women Veterans-Women Veterans Health Care (OEF/OIF)
At each VA Medical Center nationwide, a Women Veterans Program Manager is designated to assist women Veterans. She can help coordinate all the services the veteran may need, from primary care to medical services to Mental Health and Sexual Abuse Counseling.

Services for homeless women veterans

May E. Walker House
A 30-bed transitional residence for homeless women veterans. Located on the grounds of the Coatesville VA Medical Center in Eastern PA.

Veterans shelter in Fayetteville, NC
A 4-bed facility that assists female veterans of domestic violence and sexual assault. Call (910) 977-2303.

Community Connections, Washington, DC
Provides comprehensive, respectful and effective mental health and residential services to residents of the District of Columbia and Montgomery County, Maryland. As part of the residential programs, Community Connections offers housing subsidies to homeless veterans with mental health needs.

The following programs identify themselves as having expertise with MST and/or sexual trauma more generally and the ability to provide treatment targeting these issues in a residential or inpatient setting.

NOTE: Programs vary widely. For example:

  • Some programs identify as “MST programs” and MST-related care is a core part of their programming; others do not identify as MST programs, but do have staff with expertise in MST. In these latter programs, staff can often work individually with veterans who need MST-specific care as an adjunct to the care they receive through the more general program. In these programs, veterans may also be able to receive specialized MST-related group or individual therapy through a local outpatient clinic.
  • Some programs serve women only; only one (Cincinnati) has a men’s-only program, although other programs serve very few women and often end up with men’s only cohorts. Others see both men and women concurrently but may have single-sex groups or other programming.

TRUST House. Boston, MA (Jamaica Plain)
Trust (Transitional Residence Utilizing Support and Treatment) House is a therapeutic residential program that offers secure and affordable housing along with a communal atmosphere in a treatment-focused setting in Jamaica Plain. The residence is home for seven women veterans and two house managers. Each resident participates fully in the daily operations of the house (including food shopping, cleaning, gardening, laundry, and cooking).

Women’s Integrated Treatment & Recovery Program. Boston, MA (Brockton)
This treatment program is designed to help women veterans who have both Post-Traumatic Stress Disorder (PTSD) and a Substance Use Disorder (SUD). Designed to fill the gap between short-term inpatient and long-term outpatient and residential programs, the program offers approximately eight weeks of specialized, intensive treatment based on individual needs and strengths. The primary goal is to help women develop skills to maintain abstinence and manage PTSD symptoms. Veterans will have the opportunity to address specific trauma issues, including military sexual trauma. Other important issues such as medical, vocational, housing, family, and interpersonal problems will also be addressed as participants are encouraged to develop short- and long-term plans for their own recovery.

Women Veterans’ Residential Program. Batavia, NY
The Women’s Residential Program (WRP) provides state-of-the art treatment for women veterans who have experienced military-sexual and/or combat trauma. The all-female in-house treatment team includes psychiatrists, psychologists, social workers, nurses, and social services assistants. The team works closely with other VA clinicians and makes referrals to Vet Centers, veterans’ organizations, and other federal, state, and local agencies to ensure that the needs of the female veteran are met. The program is a drug and alcohol-free environment.

Women’s Trauma Recovery Treatment Center (WTRC). Temple, TX
WTRC is located at the Central Texas Veterans Health Care System in Temple, Texas. The WTRC is an intensive 7-week, patient centered, residential treatment program for women Veterans with a history of MST. Women Veterans are admitted to the WTRC in classes, or cohorts, of no more than eight. Women from any state in the USA are eligible for admission.

Women’s Trauma Recovery Program (WTRP). Menlo Park, CA
The WTRP was designed to treat Women Veterans, active duty service members, National Guard, and Reservists with post-traumatic stress disorder (PTSD). It is the first residential program of its kind and is open to women across the country. Many of the women who are referred to the program have experienced traumas that include but are not limited to military sexual trauma (MST), combat trauma, and training accidents.

Women’s Treatment Unit. Lyons, NJ.
The mission of the VA, NJ is to honor America's veterans by providing exceptional health care that improves their health and well being.

Center for Sexual Trauma Services. Bay Pines, FL.
Treatment available to female and male veterans, reservists, active duty personnel with PTSD secondary to sexual trauma (MST, CSA, ASA). The patients are seen in Residential or Outpatient setting. The focus of the residential program is on patients who have been unable to resolve MST issues/symptoms by traditional outpatient care. Participants range in period of service from Korean Conflict through OIF/OEF. Currently there is an increase in the number of OIF/OEF females, many of whom have experienced both MST and combat-related trauma.

Villages at Cabrillo VA Community Based Outpatient Clinic. Long Beach, CA.
The Villages at Cabrillo is a unique residential community offering transitional housing for homeless veterans, families, and youth. This 26-acre facility is administered by the United States Veterans Initiative. ADVANCE Women’s Program is a 35-bed female veterans program that offers sexual trauma counseling within the Villages.

Articles

Campbell, J. C., Garza, M. A., Gielen, A. C., O’Campo, P., Kub, J., Dienemann, J., Jones, A. S., & Jafar, E. (2003). Intimate partner violence and abuse among active duty military women. Violence Against Women, 9, 1072-1092.

Suris, A., Lind, L., Kashner, T. M., & Borman, P. D. (2007). Mental health, quality of life, and health functioning in women veterans: Differential outcomes associated with military and civilian sexual assault. Journal of Interpersonal Violence, 22, 179-197.

Williams, I., & Bernstein, K. (2010). Military sexual trauma among U.S. Female Veterans. Archives of Psychiatric Nursing.

Relevant organizations/Resources | Back to top

The following organizations provide services to veterans and/or have expertise on the intersection of violence as it relates to the military. This list is not all-inclusive and it is expected to continue growing over time.

Americans Overseas Domestic Violence Crisis Center
The Americans Overseas Domestic Violence Crisis Center can be reached internationally toll-free from 175 countries. To contact the toll-free crisis line from overseas, first dial your AT&T USADirect access number and at the prompt, enter our phone number: 866-USWOMEN (879-6636). The center serves abused Americans, mostly women and children, in both civilian and military populations overseas.

American Women Veterans
The mission of this organization is to engage and advocate for new or improved policies that improve the lives of women veterans and their families. The promotion of positive images and public awareness of women’s contributions from all branches and eras of service is also part of the mission of this organization.

Battered Women’s Justice Project (BWJP)
The Battered Women's Justice Project is a nationally recognized partnership and collaboration between the programs of the Domestic Abuse Intervention Programs (formerly Minnesota Program Development, Inc.) and the National Clearinghouse for the Defense of Battered Women. The Building Effective Civilian Responses to Military-Related Victims of Intimate Partner Violence is a project funded by the Office on Violence Against Women (OVW) to provide a resource network, technical assistance, training, and support for all advocates, military and civilian, who serve military and veteran families and work with victims of domestic violence/sexual assault/stalking and dating violence perpetrated by military personnel or veterans. The project also includes the development of a blueprint for an effective community response to the co-occurrence of combat-related post-traumatic stress disorder and intimate partner violence.

Brain Injury Association of New York State
Together with individuals and agencies across New York State, the Brain Injury Association of NYS is working to build awareness about combat-related traumatic brain injury and its impact on our returning military through the Traumatic Brain Injury and Military Veterans Services Project. Through training and outreach, the Association encourages collaboration within the network of TBI service providers, veterans’ organizations, and the community.

Gift From Within
A non-profit organization dedicated to those who suffer post-traumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals, Gift from Within develops and disseminates educational material, including videotapes, articles, books, and other resources through its website and maintains a roster of survivors who are willing to participate in an international network of peer support.

Give an Hour
This organization is developing national networks of volunteers capable of responding to both acute and chronic conditions that arise within our society. Its first target population is the U.S. troops and families who are being affected by the current military conflicts in Afghanistan and Iraq. Give an Hour™ is asking mental health professionals nationwide to literally donate an hour of their time each week to provide free mental health services to military personnel and their families.

Grace after Fire
Is a place for women veterans and their loved ones, to connect with one another and with its professional partners, to find resources, to learn and to get involved.

Iraq and Afghanistan Veterans of America (IAVA)
Iraq and Afghanistan Veterans of America is the nation's first and largest group dedicated to the Troops and Veterans of the wars in Iraq and Afghanistan, and the civilian supporters of those Troops and Veterans.

Lawyers Serving Warriors
This program offers pro-bono legal help to veterans serving in Iraq and Afghanistan facing administrative separation, going through a mental evaluation board or physical evaluation board, or pursuing a claim with the VA for disability compensation.

Military OneSource
Military OneSource is provided by the Department of Defense at no cost to active duty, Guard and Reserve (regardless of activation status) and their families. It is a virtual extension of installation services. 1-800-342-9647.

National Center on Domestic and Sexual Violence (NCDSV)
The NCDSV helps a myriad of professionals who work with victims and perpetrators; law enforcement; criminal justice professionals such as prosecutors, judges and probation officers; health care professionals including emergency response teams, nurses and doctors; domestic violence and sexual assault advocates and service providers; and counselors and social workers. In addition to these professionals, NCDSV also works with local, state and federal agencies; state and national organizations; educators, researchers, faith community leaders, media, community leaders, elected officials, policymakers, and all branches of the military.

National Center for Posttraumatic Stress Disorder at the U.S. Department of Veteran Affairs
The Center aims to help U.S. Veterans and others through research, education, and training on trauma and PTSD.

National Domestic Violence Hotline
Hotline advocates are available for victims and anyone calling on their behalf to provide crisis intervention, safety planning, information and referrals to agencies in all 50 states, Puerto Rico and the U.S. Virgin Islands. Assistance is available in English and Spanish with access to more than 170 languages through interpreter service 1.800.799.SAFE (7233) 1.800.787.3224 (TTY)

Pine Grove Women’s Center
The Pine Grove Women's Center is a residential treatment center offering programs for women coping with eating disorders and chemical dependency. Its multi-disciplinary staff determine treatment components based on the patient's individual and unfolding needs.

The Posttraumatic Stress Disorder (PTSD) Alliance
The Posttraumatic Stress Disorder (PTSD) Alliance is a group of professional and advocacy organizations that have joined forces to provide educational resources to individuals diagnosed with PTSD and their loved ones; those at risk for developing PTSD; and medical, healthcare and other frontline professionals.

Safe Helpline
Department of Defense (DoD) Safe Helpline is a groundbreaking crisis support service for members of the DoD community affected by sexual assault. Safe Helpline provides live, one-on-one advice, support, and information to the worldwide DoD community. The service is anonymous, secure, and available 24/7 — providing victims with the help they need, anytime, anywhere.

Santé Center for Healing
The Mission of Santé Center for Healing is to address addictive behaviors and associated conditions with an integrated addiction treatment model, drawing from traditional and innovative approaches. Our services are open to individuals and families who seek recovery from addictive behaviors, with a focus on treating the addicted professional. We provide treatment with integrity, promoting wellness for the patient, family and public in a safe and pleasant setting.

Service Women’s Action Network (SWAN)
SWAN is a non-partisan, non-profit human rights organization that works to improve the welfare of U.S. servicewomen and all women veterans. SWAN advocates for servicewomen and women veterans by educating the public, recommending sound policy reform to legislators, developing creative, healing and empowering community programs, offering personal support and guidance from fellow women veterans and providing pro bono legal referrals from military law experts. 


The Refuge-A Healing Place
The Refuge-A Healing Place is an adult residential extended care addiction rehab facility located in Marion County central Florida (FL), specializing in addictions and PTSD “Post Traumatic Stress Disorder” resolution that’s based on the premise of healing with care, spirituality and gentleness.

Witness Justice
Founded in 2002, Witness Justice is a national, grassroots, non-denominational 501(c)(3) nonprofit organization whose mission is to empower and assist victims of violence and their loved ones in healing from trauma and in navigating the criminal justice process.

Glossary of military-related terms | Back to top

This brief glossary defines military-related terms used throughout this collection for clarification and easy reference.

Active duty: Military members who are currently serving full-time in their military capacity. Members of reserve units and the National Guard are on active duty only when mobilized by the President.
Department of Defense (DoD): The Department of Defense provides the military forces needed to deter war and to protect the security of our country. The department’s headquarters is at the Pentagon.
Family Advocacy Program (FAP): The Department of Defense (DoD) Family Advocacy Program is dedicated to the prevention, early identification, prompt reporting, intervention and treatment of spouse and child abuse. The program provides a variety of services to active duty military personnel and their families to enhance their relationship skills and improve their quality of life. This mission is accomplished through a variety of, life skills seminars and workshops, public awareness campaigns, counseling and other intervention services. (source)
Military personnel: A term used to refer to members of any armed force. Military personnel are divided into four (4) branches of service roughly defined by certain circumstances of the deployment of the personnel.

  • The United States Army is the main ground force of the United States. Its’ main function is to protect and defend the United States (and its interest) by way of ground troops, armor (tanks), artillery attack helicopters, tactical nuclear weapons, etc. Those who serve in this typical large land force are called soldiers.
  • The Navy makes it possible for the United States to use the seas where and when our national security require it. Navy aircraft carriers can often deploy aircraft to areas where fixed runways are impossible. The Navy is also responsible for transporting Marines to areas of conflict. Those who serve in the Navy’s seagoing forces are called sailors.
  • The mission of the Air Force is to defend the United States (and its interest) through exploitation of air and space. The Air Force is also responsible for all military satellites and the nation’s strategic nuclear ballistic missiles. Those in the Air Force are referred to as airmen.
  • Marines are members of a body of troops within the Department of the Navy who are trained to serve on land or at sea. Their primary specialty is to assault, capture and control “beach heads” which then provide a route to attack the enemy from almost any direction. Marines are sometimes referred to as the “Infantry of the Navy.”
(source)
Military Sexual Trauma (MST): Psychological trauma resulting from physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty or active duty for training. Sexual harassment is further defined as "repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character." (source)
Operation Enduring Freedom (OEF): The official name used by the U.S. Government for the War in Afghanistan together with three smaller military actions, under the umbrella of the global War on Terror (GWOT). (source)
Operation Iraqi Freedom (OIF): The war in Iraq was a military campaign that began on March 20, 2003, with the invasion of Iraq by a multinational force led by troops from the United States under the administration of President George W. Bush and the United Kingdom under Prime Minister Tony Blair. (source)
Post-traumatic Stress Disorder (PTSD): An anxiety disorder that can occur after experiencing a traumatic event. During this type of event, the person feels like her/his life or others' lives are in danger as well as loss of control over what is happening. (source)
Reserve components: Military organizations whose members generally perform a minimum of 39 days of military duty per year and who augment the active duty (or full-time) military when necessary. The reserve components are also referred to collectively as “the Guard” and “Reserves”. (source)
Service member: All military personnel, from the lowest ranking to highest ranking, are service members. Service members are identified by service branch, uniform, specialties and rank. The lowest ranking commissioned officer outranks the highest grade non-commissioned officer. (source)
Traumatic Brain Injury (TBI): A specific type of damage to the brain that is caused by external physical force and is not present at birth or degenerative. A blow (or blows) to the head, shaking of the brain, exposure to blasts, loss of oxygen (anoxia), and colliding with a stationary object can cause a TBI. (source)
VA: United States Department of Veterans Affairs, formerly the “Veterans Administration” is a government-run military veteran benefit system with Cabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense. (source)
Veteran: A person who has served in the armed forces, and had direct exposure to acts of military conflict, commonly known as “war veterans.” Note that service in military conflicts may not involve direct combat, and not all cases in which armed combat takes place are necessarily referred to as "wars." (source)