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1 WARNING: The following presentation uses copyright protected materials used under the Multimedia guidelines and fair use exemptions of U.S. Copyright law. Further use is prohibited.

2 Sexual Assault Prevention & Response
Annual Chaplain Training Move to the next slide …

3 Introduction Sexual assault is a pervasive problem in our nation and the military is not immune. In 2004, there were 1,700 reported sexual assaults in the U.S. military. Victims may suffer physically and emotionally for months or years; friends and family members experience a wide range of emotional distress; unit morale is damaged, and the whole military community is adversely affected. Sexual assault threatens our greatest asset, our people, and damages mission readiness. It will not be tolerated in the Department of Defense.

4 Introduction The Department of Defense implemented the Sexual Assault Prevention and Response (SAPR) program to reduce the number of assaults and to ensure active duty military members who are victimized receive prompt appropriate care, are treated with dignity and respect, and that their perpetrators are held accountable. SAPR is designed to streamline victim care and standardize prevention and response efforts throughout the services. The success of this program requires ongoing training of all members, especially commanders and care-givers.

5 Introduction Let’s get started …
Throughout this training, you will have an opportunity to go forward or backup and review using the arrows at the bottom of each page. You will also find “checkpoints” to test your knowledge at several transition points in the material. Review the material carefully. After you complete each checkpoint successfully, you can proceed to the final test. To receive credit for this training, you must receive a minimum score of 70% on the final test. Print out your training certificate and give it to your supervisor. If you’re ready to begin, hit, “Let’s get started.” Let’s get started …

6 Course Outline Follow these links to complete the training.
Caring for Victims – an Introduction Learning Objectives Sexual Harassment vs. Sexual Assault Sexual Assault: Myths and Facts Who Are the Perpetrators? The Undetected Rapist – a video production (caution: uses frank and graphic language) Responding to Sexual Assault Victim Responses Secondary Victimization Cultural and Religious Sensitivities Final Test Print Certificate of Completion

7 Caring for Victims Return to menu
Sexual assault is one of the most devastating crimes. It is not unusual for victims to experience short or even long-term physical and psychological reactions to the assault, which can inhibit their ability to function normally on even simple day-to-day tasks, strain even the closest of relationships, and impede other life-goals. Choosing not to tell anyone about the assault or to internalize their reaction to the assault can further exacerbate the problem. Yet for a number of reasons, many victims choose not to talk about what happened. Return to menu

8 Caring for Victims Return to menu
One critical component of pastoral care to victims requires the chaplain to be a good listener, and when appropriate, to encourage victims to report the assault, tell their story, and recognize the real strength of those who do. This training provides information some of the reasons victims often don’t talk about their assault and define the role of the chaplain as caregiver to victims of sexual assault. Next you’ll see the learning objectives for this training. Pay careful attention to them as they will be used in questions in your final test. Return to menu

9 Learning Objectives Return to menu
After completing this section, you should be able to: Identify the difference between sexual assault and sexual harassment Distinguish between long believed misconceptions and reality concerning the nature of sexual assault Identify three types of sexual assault Identify at least one drug used in drug facilitated sexual assault Identify possible psychological consequences associated with sexual assault Return to menu

10 Sexual Harassment vs. Sexual Assault
Before we can consider being caregivers to victims or survivors of sexual assault, first it is critical to understand the terminology. Specifically, we must be able to draw the sometimes fine line between the terms Sexual Harassment and Sexual Assault. First, let it be stated clearly, both are crimes according to the UCMJ, and the Air Force has zero tolerance for either behavior. Return to menu

11 Sexual Harassment vs. Sexual Assault
This is what the UCMJ says: Sexual Harassment is any unwanted and repeated attention that is sexual in nature and unreasonably interferes with an individual’s work performance or create an intimidating, hostile, or offensive environment. This behavior and the perceived threat or intimidation may be explicit or implicit. This would include unwelcome sexual advances, requests for sexual favors, and other verbal and physical conduct of a sexual nature. Return to menu

12 Sexual Harassment vs. Sexual Assault
You selected: B. Repeatedly asking the same co-worker after being told no once or twice This MIGHT be an example of sexual harassment. Although it does meet the requirement for repeated (and perhaps unwanted) actions, the action is not necessarily of a sexual nature, and by itself may not unreasonably interfere with a person’s work or performance, or create a hostile environment. The best way to end this behavior is to state clearly, “Please do not ask me again.” According to that definition, which of the following do you think constitutes sexual harassment? A. Asking a co-worker on a date B. Repeatedly asking the same coworker after being told no once or twice C. Repeatedly asking the same coworker after the coworker has asked you to stop asking D. Telling jokes and stories of a sexual nature E. Displaying sexually graphic or suggestive photos or images in the office space You selected: C. Repeatedly asking the same co-worker after the coworker has asked you to stop asking This PROBABLY is an example of sexual harassment. Although it may not be specifically sexual in nature, it clearly meets the requirement for repeated and unwanted actions, and may be seen as unreasonably interfering with a person’s work or performance, or create a hostile environment. If this behavior persists, it is time to report it to the supervisor or chain of Command! Test your knowledge You selected: D. Telling jokes and stories of a sexual nature This is an example of sexual harassment. Off-color or sexual jokes and conversation can clearly create an uncomfortable environment for everyone, and should not be tolerated. One male officer reported repeatedly hearing one enlisted female’s phone conversations about complications of breast feeding her newborn. Even this kind of “innocent” conversation of intimate details is best left for other venues! You selected: Asking a co-worker on a date By itself, this is NOT an example of sexual harassment. Remember the definition of sexual harassment requires unwanted and repeated actions of a sexual nature that unreasonably interfere with a person’s work or performance, or create a hostile environment. Simply being asked on a date does none of these. You selected: E. Displaying sexually graphic or suggestive photos in or images in the office space This is an example of sexual harassment. Gone are the days of pin-up posters in the workplace or nude nose art on aircraft. Such behavior demonstrates a lack of respect for others and establishes an unprofessional environment. It has no place in today’s Air Force! A B C D E Continue Return to menu

13 Sexual Harassment vs. Sexual Assault
People who believe they have experienced or witnessed sexual harassment should follow normal chain of Command: Begin at the lowest level by simply telling the perpetrator to stop. Be polite but assertive. Report continued behavior to your supervisor. If these steps don’t end the unwanted behavior, report the situation to the Command Equal Opportunity Officer. Return to menu

14 Sexual Harassment vs. Sexual Assault
This is what the UCMJ says: Sexual assault is “intentional sexual contact, characterized by use of force, physical threat or abuse of authority or when the victim does not or cannot consent.” It is critical to understand sexual assault can occur without regard to gender or spousal relationship or age of the victim. Sexual assault includes rape, nonconsensual sodomy (oral or anal sex), indecent assault (unwanted, inappropriate sexual contact of fondling), or any attempts to commit these acts. Return to menu

15 Sexual Harassment vs. Sexual Assault
Here are a few important things to remember: Consent does not mean failing to offer physical resistance. Simply because the victim didn’t “fight back,” does not mean he or she was giving implied consent. Consent is not given when the assailant uses force, threat of force or coercion. Consent cannot be given by a person who is asleep, incapacitated (by too much alcohol, drugs, or other means), or unconscious. Even if a person seems to participate willingly, if alcohol or drugs were involved, they may have legal grounds for claiming sexual assault! Return to menu

16 Sexual Harassment vs. Sexual Assault
It is critical that airmen be educated in the legal implications of these terms both to protect themselves from unwanted harassment or assault and to protect themselves from the appearance of inappropriate behavior and perhaps unwarranted charges. Next we will consider why victims of sexual assault often fail to report the crime, but first it’s time for our first checkpoint to see how you’re doing! Return to menu

17 Checkpoint Test your knowledge Oops! Think Again! You are correct!
Choose Assault, Harassment, or Neither TSgt Snuffy and SSgt Whozit have been dating for three months, but have never had sexual intercourse. Tonight TSgt Snuffy bought dinner at a very expensive restaurant, paid for great concert tickets to SSgt Whozit’s favorite band, and provided lots of alcohol to “set the mood.” By the time he gets her home, SSgt Whozit is staggering and nearly unconscious. TSgt Snuffy is feeling amorous and has spent a lot of money, so he figures he deserves intercourse tonight, besides, SSgt Whozit is so out of it, she hasn’t said, “No.” He completes the sexual act with barely a protest from her. Choose Assault, Harassment, or Neither Capt Smith has asked Lt Whynot out on several occasions. Lt Whynot has always said no and indicated she was uncomfortable with him asking. Last time she asked him to please not ask her out again. Today, Capt Smith asked her out again and reminded Lt Whynot her OPR was due in a couple weeks. Test your knowledge Oops! Think Again! You are correct! It was sexual assault! Even though TSgt Snuffy didn’t use force, there are a couple critical factors that point to assault. First – SSgt Whozit is clearly drunk, nearly unconscious, when the sexual act occurs. She cannot give legal consent to have sex in that condition. Second – notice the word BARELY. Any indication either party wants to end the sexual act is enough to put the brakes on. No means NO, no matter how loudly it is spoken! It was sexual harassment! Although Capt Smith didn’t come right out and say it, pointing out that Lt Whynot’s OPR was coming due soon immediately after asking her on a date could be interpreted to indicate he was willing to trade a night out for a favorable OPR. This is especially likely since he has established a pattern of asking her out despite being declined several times before. You’ve completed the check point. Use the back arrow below to review the material you got wrong, then click the Return to menu button to go on to the next section. Assault Harassment Neither Assault Harassment Next Question Neither Continue Return to menu

18 Sexual Assault: Myths vs. Facts
There are a number of common misconceptions regarding sexual assault. Such myths are often driven by social, cultural, racial and gender-based stereotypes. These myths influence society’s attitudes about sexual assault, characteristics of offenders or victims, and who is to blame. Such attitudes tend to pressure victims to keep silent about the assault for fear of embarrassing themselves or their family, reprisal by the perpetrator or others, or fear of being blamed or judged. We’ll try to bust some of these myths with a simple quiz on the next page. Return to menu

19 Select M for MYTH or F for FACT
Rape is not really about sex A person should always fight back Men and women can both be victims of sexual assault Sexual assaults are rare and affect few people You can tell sexual offenders by their appearance Most sexual assaults are committed by an individual known by the victim Only certain kinds of people get assaulted Most sex offenders are repeat offenders The way a woman dresses affects her likelihood of being sexually assaulted Test your knowledge YOU’RE RIGHT! THINK AGAIN! M F M F It’s a MYTH! The way a woman dresses or acts doesn’t influence the attacker’s choice of victim! Sexual assault is a premeditated act of violence, not a spontaneous act of passion or sexual gratification based on uncontrollable lust. Offenders are looking for available and vulnerable targets. It’s a MYTH! You can’t tell sexual offenders by their appearance! Sex offender are not physically identifiable. They may appear friendly, normal, and non-threatening. Many are young, married, have children, and are viewed as “top performers.” It’s a MYTH! Fighting back during a sexual assault is not always the right thing to do! Since sexual assault is often life-threatening and each assault is unique, the best thing a victim can do is follow his/her instincts. If a victim escapes alive, he or she has done the right thing! It’s a FACT! Men and women can both be victims of sexual assault According to the National Institute of Justice (200), 1 in 33 men in the US have been the victim of an attempted or completed rape at some time in their lives. In 2004, there were 101 male-on-male sexual assaults reported in the Armed Forces! It’s a MYTH! Sexual assaults happen all too frequently and affect hundreds of thousands of people each year! In 2002, the Department of Justice reported 240,730 rape / sexual assault victimizations among U.S. residents 12 years old and over. In 2004, there were 1,700 reported sexual assaults in the Armed Forces. It’s a FACT! Most sex offenders are repeat offenders! Most offenders assault multiple times – until caught. Often they have committed other crimes as well, including robbery and child molestation. It’s a FACT! Rape is not really about sex. Rape is experienced by the victims as an act of violence. It is a life-threatening experience. While sexual attraction may be influential, power, control and anger are the primary motives. Most rapists have access to a sexual partner. Gratification comes from gaining power and control and discharging anger. It’s a MYTH! All kinds of people get assaulted! Offenders act without considering their victim’s physical appearance, dress, age, race, gender, or social status. Assailants seek out victims who they perceive to be vulnerable. It’s a Fact! Most sexual assaults are committed by an individual known by the victim More than 83% of sexual assaults are committed by a person the victim knows. Among these may be intimate family members, close friends, dates, coworkers, or just casual acquaintances. M F M F M F M F M F M F M F Return to menu Continue

20 Who Are the Perpetrators?
Anyone can be a victim, and nearly anyone can be considered a potential perpetrator of sexual assault. In reality, the only common elements found among most assailants are issues of power, anger, and control. For this study, we will briefly discuss four types of assault, each identified by the assailant’s relationship to the victim and the methods used in the assault: Non-stranger assault Stranger assault Gang rape or multiple rape Drug-facilitated assaults Return to menu

21 Non-Stranger Assaults
Most sexual assaults are committed by non-strangers. Check out these startling statistics from the National Violence Against Women survey from 2002: 57.7% were committed by an intimate partner 9.9 % were committed by a relative 12.7% were committed by an acquaintance 16.7% were committed by strangers 83.3% of sexually assaulted women knew their assailants at least as casual acquaintances! These assaults included acquaintance rape, date rape and marital rape. Return to menu

22 Non-Stranger Assaults
Intrusion – the perpetrator violates the victim’s personal space, perhaps by unwanted touching or caressing. Desensitization – ignoring “sixth sense” warnings, the victim dismisses feelings of discomfort, perhaps attributing the misbehavior to too much alcohol or being the kind of person who touches a lot. Isolation – the assailant manipulates the victim into positions of vulnerability by getting them alone in a room, car, or other secluded area. The assailant may use alcohol or so-called “date rape” drugs to disable the victim. Perpetrators of non-stranger assaults often follow a three-step pattern: Return to menu

23 Non-Stranger Assaults
Alcohol Use – Assailants often use alcohol to disinhibit themselves and their victims, rendering their victims more vulnerable. Many assaults occur after the victim is only semi-conscious or entirely unconscious from the effects of alcohol. Previous consensual sexual contact – Assailants incorrectly reason prior sexual consent guarantees perpetual consent. Often the victim fails to report the crime because the victim also believes this myth and somehow believes he or she is ultimately responsible for the act. Age – Victims are typically between 16 to 25 years. Other common patterns in non-stranger sexual assault: Return to menu

24 Non-Stranger Assaults
Non-stranger assault can be the most damaging to one’s psychological wellbeing. Because victims knew and trusted the offender, they often question their ability to make good decisions or to trust others in the future. Recovery is complicated by the “friendly-fire” nature of the harm because it came from a completely unexpected source. Such victims are also more likely to be blamed and/or revictimized by family members, friends, and others who may perceive the victim as somehow “participating” in the assault. We’ll deal with revictimization later. Return to menu

25 Stranger Assaults Return to menu
The 16.7% of stranger assaults are more likely to be reported, and their victims are more likely to receive higher levels of support from authorities, family members, and friends. These attacks are often crimes of opportunity, and common crime-prevention techniques such as using the “buddy system,” locking doors, and practicing situational awareness can help to lessen but not eliminate the likelihood of victimization. Return to menu

26 Gang Rape Return to menu
Gang rapists reduce their victim to an object, and repeatedly rape the individual in the company of their peers. They seek confirmation of their own power and authority over the victim. Some common patterns include: Gang members typically age 10 to mid-thirties Victim likely knew one or more gang members Alcohol or drug use by assailants and/or victim Victims are more often male than female More likely to suffer physical injuries which require medial attention. Return to menu

27 Drug-Facilitated Sexual Assault
Drug-facilitated assault is believed to be increasing. More than 20 drugs have been implicated in recent years, the most popular include: Alcohol and Marijuana Benzodiazepines Tranquilizers, anti-anxiety, & hypnotic drugs Xanax Valium “Date rape” drugs like Rohypnol Gamma Hydroxybutyrate (GHB) “Rave drug” known as “Liquid Ecstasy” For more information, check out these links: Date Rape Drugs Benzodiazepines Rohypnol GHB Return to menu

28 Drug-Facilitated Sexual Assault
Many drugs can be administered by being slipped into an unattended drink, and affect the victim within 20 minutes causing passivity, muscle relaxation, and a certain level of amnesia. Affects are increased by alcohol. Victims report numerous sensations and symptoms including disassociation of mind and body and residual muscle weakness. Within six to eight hours of ingestion, vital signs may be depressed. Urine testing can be positive for drug presence up to 96 hours after ingestion. Suspected drug-facilitated sexual assault should be reported as soon as possible. Return to menu

29 Drug Facilitated Assault Drug Facilitated Assault
Checkpoint What type of sexual assault is committed in the following situations? Ann has been on several dates with Tom. They have been intimate before, but on this particular night, Ann doesn’t want to have intercourse. Tom decides since they have been dating a while and have had sex before, Ann just needs to be convinced tonight. He doesn’t listen when Ann says, “No,” and forces her into a sexual act. Which is NOT part of the three-step pattern used by perpetrators of non-stranger assault? Intrusion Destabilization Desensitization Isolation What type of sexual assault is committed in the following situation? Gina is walking home at night, and is attacked on the street. Her attacker drags her into an alley, rapes her and flees. Gina immediately calls the police. Test your knowledge You’re right! You’re wrong Which factor is common to all types of sexual assault? Victim knows the assailant Use of alcohol Victim is usually female Perpetrator uses drugs to disinhibit or disable victim You chose: C. Victim is usually female That is not the correct chose because men or women can be assault victims. In fact, in the category of Gang Rape, men are more often the victims than women! Try again! You chose: Perpetrator uses drugs to disinhibit or disable victim This is incorrect because use of drugs like date rape or rave drugs describes Drug Assisted Assaults. Try again! You chose: B. Use of alcohol by the victim and/or assailant Alcohol is a common contributing factor in every type of assault. Victims are often desensitized or disabled through consumption of alcohol, and perpetrators are disinhibited through the use of alcohol. Ann is among the more than 83% of sexual assault victims who were assaulted by a family member, friend, date, co-worker, or acquaintance. This type of assault is categorized as Non-stranger assault, and is considered the most psychologically damaging because it challenges the victim’s ability to trust his or her own decisions and to trust others in the future. You chose: The victim knows the assailant This is incorrect, because in nearly 17% of assaults, “Stranger Assaults,” the victim doesn’t know the assailant. Try again! Gina has been the victim of an unknown rapist. This is categorized as a Stranger Assault. Although this is typically what people think of when they hear the words rape or sexual assault, less than 17% of sexual assaults fall into this category. Congratulations! You have completed your second checkpoint. You can use the arrow below to return to the section and review the material you missed. Or use the Return to menu button and move on to the next section. The three step-process used by many perpetrators of Non-stranger assault are: Intrusion Desensitization Isolation 83.3% of sexually assaulted women knew their assailants at least as casual acquaintances! Most sexual assaults are committed by strangers. A A B B C True False C Continue D Non-stranger Assault Stranger Assault D Gang Rape Drug Facilitated Assault Next Question Next Question Non-stranger Assault Stranger Assault Next Question Gang Rape Drug Facilitated Assault Next Question Try Again Return to menu

30 The Undetected Rapist Return to menu
This video is a dramatic reenactment of an actual interview with an admitted rapist. It contains language and descriptions of a frank and graphic nature. You may choose to skip this part of the training. No questions from this material will be included in the final test Click video screen to view film. © National Judicial Education Program Return to menu

31 Responding to Assaults
Victims of any type of sexual assault should be encouraged to report the attack or attempted attack immediately. They should go directly to a hospital for examination and collection of potential evidence. They should be encouraged to refrain from any activity that might change or destroy evidence of the assault such as: Changing clothes or undergarments Showering Washing Urinating or defecating Brushing teeth or rinsing the mouth Return to menu

32 Responding to Assaults
Many assaults go unreported and victims refuse to seek help fearing their case will be reported to law enforcement. Victims have a right to seek medical care including sexual assault forensic evidence (SAFE) examination without criminal referral. Evidence gathered will be safely stored for one year in the event the victim later chooses to report the case. Military members also have the right to advocacy service provided by a trained victim advocate, and pastoral care by members of the civilian clergy or Air Force Chaplain Service. Return to menu

33 Responding to Assaults
Why offer restricted reporting? Allows victims to seek medical and mental health care without a criminal investigation Allows victim personal space to consider options and begin healing while safely preserving key evidence Empowers the victim to seek information and support, and make an informed decision about participating in a criminal case Allows victim to control management and release of personal information and to decide if and when to move forward with the case When a victim selects “restricted reporting,” Commanders are notified that an assault has occurred, but no specific information is made available. This enables increased diligence in prevention and awareness efforts. Return to menu

34 Responding to Assaults
The Consequences of Restricted Reporting: Assailant remains at liberty and unpunished, and may be continuing threat to victim or others Without reporting, victim cannot receive legal restraining order or Military Protective Order (MPO) against perpetrator Without a search warrant, key crime scene evidence can be lost or damaged Only chaplains, medical personnel, SARC, and victim advocate can offer restricted reporting Victim cannot talk to anyone else about the crime without making them mandatory reporters Return to menu

35 Victim Responses to Sexual Assault
Victims of sexual assault experience a wide range of short and long-term psychological reactions to the assault. It must be stressed that each person’s experience, response, and recovery process is unique. However, we will discuss typical physical and mental health responses to sexual assault and their symptoms. These responses include Rape Trauma Syndrome with four phases, each with distinct symptoms, and Post Traumatic Stress Disorder, a clinical diagnosis not unusual among victims of sexual assault or other trauma. Rape Trauma Syndrome (RTS) Shock Phase Adjustment Phase Depressed Phase Integration Phase Post Traumatic Stress Disorder (PTSD) Return to menu

36 Rape Trauma Syndrome Return to menu
Medical and legal professionals often refer to post-assault reactions as Rape Trauma Syndrome. Some victims may reject being labeled with RTS or any other psychological diagnosis; others will find it comforting to know their feelings and reactions are legitimate and appropriate. RTS establishes a baseline of “normal” behaviors to help understand the not-so-normal behaviors following a rape or assault experience. Chaplains can help remind victims their feelings are a normal reaction to an abnormal and traumatic experience. Return to menu

37 Rape Trauma Syndrome Return to menu
RTS follows a linear pattern of recovery, but victims may spend more time in one stage and less in others or may loop back through one or more stages repeatedly before progressing on. It is worth repeating the obvious, each victim’s response is unique. Since, most victims do NOT follow a set pattern, and many professionals question the idea that anyone ever fully “recovers” from a sexual assault, caregivers should stress to victims that each person’s response is different and there are no “timelines” for recovery. Return to menu

38 Shock Phase Return to menu
Typically occurs immediately and lasts for several days to weeks after the assault. May include: Disbelief, anxiety, and fear Self-blame, guilt and self-hatred are common Lost trust in own judgment and decisions Lost trust in others’ ability to respect or empathize Physical symptoms may include: Insomnia – Nightmares – Depression Loss of appetite – Irritability – Headaches Nausea – Stomach Aches – Diarrhea Effects can be ongoing and chronic unless there is support for the victim from qualified personnel as well as from family members and friends. Return to menu

39 Adjustment Phase Return to menu
Can appear several days to weeks after the assault depending upon the coping mechanisms of the victim, the severity and type of the assault, the victim’s relationship to the offender, the victim’s prior trauma history, and the meaning the victim attaches to the assault. Critical to the victim’s recovery are the support system and reactions of family, friends, first response groups, and others to the assault. The greater the humiliation or fear for his/her life, the longer it will take to get through this phase. Return to menu

40 Adjustment Phase Return to menu
Initial characteristics of this phase include: Victim loses interest in seeking help and wants to talk less about the experience Physical distress diminishes and nightmares lessen in frequency and/or severity Victims may attempt to reorganize and “move on” Move to a new home or city Change jobs Seek a new phone number Victims in counseling may choose a new counselor or cease sessions altogether Beginning about six weeks after the assault: Beginning to cope Repeated testing for pregnancy and STDs Return to menu

41 Depressed Phase Return to menu
Because the person seems to begin recovery in the previous stage, moving into this stage may cause alarm to the victim or family members and friends. This stage may last several days to several months and may include: Loss of self-esteem as defenses breakdown Flashbacks or nightmares Uncertainty about being able to control life and environment Crying Return to menu

42 Depressed Phase Return to menu
Physical symptoms and behaviors may include: Changes in sleeping and eating patterns Fatigue, headaches, stomachaches, and other unexplainable aches and pains Noticeable changes in behavior or interests (i.e., decreased interest and enjoyment of activities, sports, hobbies, going out with friends, etc.) Difficulty concentrating or making decisions Neglect of responsibilities and personal appearance Return to menu

43 Integration Phase Return to menu
During this final phase of recovery, the victim may withdraw from contact with other people, and can recycle through prior phases, especially the depressed stage. Some victims return to counseling while others do not. The emotional and psychological damage suffered during sexual assault can be permanent. Sexual assault can lead to severed relationships, permanently change a victim’s outlook, and result in a more serious psychological disorder described in the next section. Return to menu

44 Post Traumatic Stress Disorder
Sexual assault is among the most violent of crimes. In response to an assault, many victims develop short and long-term psychological disorders, including post-traumatic stress disorder (PTSD), major depression, and general anxiety, among other reactions. It is not unusual for sexual assault victims to experience PTSD. Nearly a third of rape victims report they have contemplated suicide or experienced PTSD or Major Depression. A 1992 study suggested 94% of rape victims who reported a recent rape met the criteria for PTSD two weeks after the attack. Return to menu

45 Post Traumatic Stress Disorder
Symptoms of PTSD include: Chronic anxiety Depression Flashbacks Symptoms develop after significant trauma like combat, natural disaster, or violent crime. PTSD can be triggered by something one has experienced or a traumatic event someone has simply witnessed. Sexual assault is considered one of the most prevalent triggers for PTSD. Return to menu

46 Post Traumatic Stress Disorder
PTSD is influenced by multiple factors including: Age and developmental maturity of the victim Support network available to the victim Victim’s relationship to the attacker Response to the attack by police and medical personnel Response of victim’s loved ones to the attack Frequency, severity, and duration of the assault(s) The setting of the attack Level of violence and injury inflicted Response of the justice system Community attitudes and values Meaning attributed to the event by the victim Return to menu

47 Post Traumatic Stress Disorder
PTSD is diagnosed by mental health professionals and is characterized by all of the following: Symptoms usually begin within three months of the trauma Diagnosed if symptoms continue more than a month Some victims recover relatively quickly; others feel the lasting effects of their victimization throughout their lifetime Occasionally PTSD doesn’t show up until years after the event when triggered by another related or unrelated event Return to menu

48 Post Traumatic Stress Disorder
Re-experiencing Upsetting memories Flashbacks Nightmares Intrusive thoughts related to the assault Avoidance and Numbing Actively avoiding trauma-related thoughts and memories Loss of memory regarding particular aspects of the assault Shutting down emotionally or feeling numb Feeling disconnected Difficulty concentrating Avoidance of certain people/places associated with the assault Hyper arousal Heightened sense of being on guard Feeling “jumpy” Difficulty sleeping To be diagnosed with PTSD, the victim must be experiencing symptoms in each of these three clusters at least one month after the assault: Return to menu

49 Post Traumatic Stress Disorder
Victims who have experienced multiple triggers in addition to their attack, (e.g., recently returned from deployment to combat zone, witnessed or experienced a serious accident, etc.) obviously will experience greater levels of stress. Uniformed victims of sexual assault may exacerbate symptoms of PTSD already present from a time in theater. Likewise, sexual assault victims may seem to have recovered, and a deployment to a combat area can trigger latent PTSD symptoms. Return to menu

50 Summary RTS, PTSD, and the symptoms we have described, are considered normal reactions to an abnormal and traumatic event. Victims often state they fear they are “going crazy” because of the way they feel. It may be helpful to remind victims that the feelings, moods, and physical changes they are experiencing are the body’s normal part of recovery and the healing process. Return to menu

51 Summary Victims of sexual assault are at higher risk for suicidal ideation or attempts than the average individual. According to Victims of Rape and Sexual Harassment (Kilpatrick, 1997) a national survey of women demonstrated over 13% of rape victims attempted suicide as compared to 1% of women who were not crime victims. A victim who discloses any suicidal ideation should be referred to a healthcare provider immediately! Return to menu

52 Summary PTSD is a mental health diagnosis. However, it is critical chaplains and other caregivers be aware of the symptoms in order to recognize potential signs and assist in referring victims, with their permission, to proper medical channels for professional care. At the same time, there is another condition with which caregivers must also be familiar and careful to avoid. That is Secondary Victimization which is covered in the next unit. First, however, it’s time for another checkpoint to review what we’ve learned. Return to menu

53 Sorry, you better re-think that answer!
Checkpoint Test your knowledge Sorry, you better re-think that answer! You are correct! Symptoms of Post Traumatic Stress Disorder must continue for at least three months in order to be clinically diagnosed as PTSD. Congratulations! You just completed the third checkpoint. Only one left before the final test. Keep going! You can use the arrow below to go back through this section and review, or use the Return to menu button, and move on to the next section. Military Medical personnel are required to file a police report when a sexual assault victim seeks medical treatment in a military facility. Sexual Assault Victims who choose Restricted Reporting can talk about their assault with any of the following except: Chaplain SARC 1st Sergeant Victim Advocate Which is NOT one of the stages of Rape Trauma Syndrome? Denial Phase Adjustment Phase Depressed Phase Integration Phase Victims who choose Restricted Reporting may speak with the chaplain, SARC, victim advocate, or medical personnel without filing a police report. However, all other persons are required to report the assault to authorities if information is divulged to them. Sexual assault victims have the right to seek medical treatment without filing an unrestricted report. This allows victims to get help immediately, preserve evidence, and take time to determine whether to seek a legal investigation at a later time. The stages of Rape Trauma Syndrome are: Shock Phase Adjustment Phase Depressed Phase Integration Phase A A Symptoms of PTSD must continue at least one month after the trauma to be clinically diagnosed as PTSD. True False B B True False C C D D Next Question Next Question Next Question Continue Return to menu

54 Secondary Victimization
Secondary Victimization results from the careless response of institutions, caregivers, and individuals to the victim. Behaviors or attitudes that explicitly or implicitly place blame for the assault on the victim are examples that can cause Secondary Victimization. Such actions may be unintentionally communicated by family, friends, co-workers, and care-givers, and can slow the victim’s recovery. Chaplains must work aggressively to identify and assist the victim in avoiding situations in which such behaviors may be encountered. Return to menu

55 Secondary Victimization
Here are practical ways a chaplain can help prevent or minimize secondary victimization: Be careful not to demonstrate personal attitudes and behaviors that are condescending or judgmental of the victim or individuals close to the victim Report to the SARC any concerns regarding inappropriate or victimizing behavior by first responders or other personnel. It is the responsibility of the SARC to address these concerns within the appropriate chain-of-command Help other caregivers become aware of the damaging consequences of secondary victimization Return to menu

56 Secondary Victimization
In addition to helping steer victims around potential secondary victimization “landmines,” chaplains must primarily be attuned to the spiritual needs of the victim. This requires an understanding of and sensitivity to cultural and religious differences as discussed in the next section. Return to menu

57 Cultural and Religious Sensitivities
A victim’s reaction to an assault is likely to be influenced by the victim’s cultural and religious background. When working with a victim who shares many of the same values and cultural and religious background, the victim’s behavior is generally more predictable than if the victim is of an unfamiliar religious or cultural orientation. To address the needs of each individual, chaplains must recognize, acknowledge, and accept cultural and religious differences. Ideally, any advocacy program will include caregivers representing a wide range of cultures and faiths to help educate responders. Return to menu

58 Cultural and Religious Sensitivities
The SARC or chaplain can identify other agencies, civilian and military, that can provide assistance to victims from diverse backgrounds. These agencies may include: Rape crisis centers Local AIDS task force Ethnic-oriented service groups or business organizations Community action agencies Religious or ethnic oriented social service agencies Student services or international offices at local colleges or universities Domestic violence shelters Return to menu

59 Pastoral Issues Return to menu
The victim may have been a virgin until the assault In the victim’s culture, losing one’s virginity before marriage may be a sin punishable by death or may simply be opposed to one’s personal moral or religious beliefs. Such an individual may experience more profound levels of self-blame and a belief s/he his somehow “dirty” or “damaged.” The forensic exam may be the victim’s first gynecological exam This may be cause for additional anxiety, fear, or embarrassment for the victim. Emergency contraception A victim may decline emergency contraception due to personal religious beliefs or cultural values. Medical personnel can work with victims to ensure they are given adequate information on the potential consequences of their choices. A chaplain should be aware of how the victim’s culture or religious orientation may affect the victim’s response to the assault, medical exam, counseling, and investigation. Issues to consider include: Return to menu

60 Summary Awareness of the physical and psychological consequences of sexual assault will help the Chaplain provide support, education, and appropriate referrals to assist victims in their recovery process. Familiarity with cultural and religious factors that may affect a victim’s reaction to sexual assault allows the Chaplain to respond to each victim with greater sensitivity and awareness to each individual’s unique needs. Return to menu

61 Checkpoint Test your knowledge Better look again! Great job!
Congratulations! You’ve finished another checkpoint and are one step closer to completing this important training and taking the final test. Use the back arrow below to return to previous pages to review content, or return to the main menu and continue with the next training section. Secondary victimization is a direct result of what? Sexual assault Sexual harassment Post Traumatic Stress Disorder Response of individuals to victims of any of the above Secondary victimization is the result of often careless responses of friends, family, medical personnel, law enforcement members and even chaplains to the victim and circumstances of a sexual assault. The chaplain, as caregiver, needs to help steer the victim around these emotional landmines, and must be aware of his/her own biases and beliefs to prevent being the cause of secondary victimization. A B C D Continue Return to menu

62 Print Your Certificate!
Congratulations! Your score on the exam was That means you are ready for the final step, printing your certificate. Use the button below to return to the menu and select “Print Certificate.” Make sure your printer is online, then on the certificate screen, use the “Print Certificate” button. Be sure to give a copy of your certificate to your Wing Chaplain. Your training is valid for one year from today. 92. Return to menu

63 Final Test Sorry! Your score is: 40% Return to menu
Decide if each of the following is true or false: You can tell a sexual offender by the way they look. Most acts of sexual assault are committed by a person the victim knows or has just met. Most offenders commit sexual assault multiple times until they are caught. A person should always fight back when attacked. Rape is just sex. Decide if each of the following is true or false: 21. A victim’s recovery from sexual assault is likely to be influenced by the victim’s cultural and religious background. 22. Restricted Reporting allows a victim to seek counseling or medical care without automatically triggering an investigation. 23. If a victim didn’t fight back, he or she was implying consent. 24. Insomnia, nightmares, and nausea are characteristics of the Adjustment Phase of RTS. 25. Symptoms of PTSD can develop after witnessing or experiencing significant trauma like combat, natural disasters, or violent crimes. Match each statement to the type of assault it best describes. A. Non-Stranger B. Stranger C. Gang Rape D. Drug-Facilitated The motive of the type of assault is not sex, but is a way for a group to interact, compete, develop cohesiveness and show power and authority. This type of assault includes acquaintance rape, date rape, and marital rape. The frequency of this type of assault is increasing. Alcohol, marijuana, and GHB may help the offender take control of the victim. This type of sexual assault is the most likely to be reported and victims usually receive the most support following this type of assault. Select the best answer for each question 10. Which of the following is NOT an example of sexual assault? Nonconsensual oral sex Rape Requests for sexual favors Unwanted sexual contact 11. Which of the following is not a phase of RTS? Scared phase Shock phase Depressed phase Integration phase 14. ___________________ is defined as “intentional sexual contact, characterized by the use of force, physical threat, or abuse of authority or when a victim does not give consent.” Sexual Harassment Sexual Assault Gang Rape Secondary Victimization 15. Which of these is a drug used in drug facilitated assault? Benzodiazepines Alcohol and marijuana Gamma Hydroxybutyrate (GHB) All of these are used Your score is: 18. Which of the following is not part of the three step pattern followed by most perpetrators of non-stranger assault. Inclusion Intrusion Isolation Desensitization 19. Which of the following is not true about gang rape? Victims often know one or more of the gang members Victims are more likely to suffer injuries that require medical attention Victims are more often female than male Gang members are typically age 10 to mid-thirties 12. To be diagnosed with PTSD, a victim must be experiencing symptoms at least one month after the assault in which of the following clusters? Avoidance and Numbing Hyper Arousal Re-experiencing All of these clusters 13. Secondary victimization is a direct result of what? the assault the harassment Post Traumatic Stress Disorder The response of individuals to the victim 16. What is the first thing a person should do if they feel they have experienced sexual harassment? Report the situation to the Command EOC Officer Tell the perpetrator to stop. Be polite but assertive. Report continued behavior to your supervisor Call the police 17. What are the only common elements found among most assailants? They were in a gang They were lonely They have issues of power, anger, and control They were abused as children Sorry! You cannot take the final test until you have completed the training. Please return to the main menu and complete the remaining units and checkpoints before returning here to take your final test. Good luck! T T F F A A A A B 20. If a sexual assault victim requests restricted reporting, he / she may talk about the assault with all of the following except which one? Victim advocate Health care provider Chaplain Commander A B A B C D T F B B T F C B C 40% C C C D D A T F D A B C D D D B T F C A T F A A A D B A A B C D T F B B B B T F C C C C C T F D D D D A B C D D Return to menu

64 Certificate Sorry! Print Certificate Return to menu
Certificate of Completion for Chaplain Sexual Assault Prevention and Response (SAPR) Annual Training Presented To Completed on: At: Sorry! You cannot view or print the certificate until you have completed the training and received at least 70% score on the final test. Please return to the main menu and complete the remaining units and checkpoints before returning here to print your certificate of completion. Name Friday, April 28, 2006 k Return to menu Print Certificate

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