Mental health counseling (MHC) may help U.S. veterans recover and build resilience after experiencing military sexual trauma (MST), according to a new study from researchers at Penn State.
"We've long known that MST can have devastating consequences," said Mary Mitchell, research professor at the Clearinghouse for Military Family Readiness at Penn State (Clearinghouse) and lead author of the study, published in the Journal of Traumatic Stress. "What's exciting about our findings is that they suggest a path forward - mental health counseling doesn't just offer support, it appears to help veterans bounce back. While counseling rates were generally low in our study, veterans who experienced MST were more likely to obtain counseling, which in turn was associated with increased resilience over time."
MST is associated with a range of mental and physical health conditions. Previous studies, including one published in the American Journal of Public Health, have shown that individuals who experienced MST were three times more likely to develop a mental health condition than those who did not. MST survivors also face significantly higher risks of post-traumatic stress disorder, depression, anxiety, substance-use disorders and suicide, the researchers said. In addition, research has linked MST to increased rates of nearly every major physical health issue tracked in Department of Veterans Affairs (VA) medical records.
The current study used data from the Veterans Metrics Initiative (TVMI) and the Veterans Engaging in Transition Studies, an extension of the TVMI study, which tracked a nationally representative sample of more than 9,500 post-9/11 veterans as they transitioned from military to civilian life. Participants completed surveys at multiple intervals from three months to six-and-a-half years after separating from military service. Results revealed that, while MST negatively impacts veterans' initial resilience, engaging in MHC can significantly improve resilience, or the capacity to adapt to stressors, over time.
Key findings include the following:
- Nearly 40% of female veterans reported experiencing unwanted sexual attention, and 17% reported unwanted sexual contact. Approximately 3% and 1% of male veterans reported these experiences, respectively.
- Women who experienced sexual harassment or both harassment and unwanted contact had significantly lower initial resilience. However, those who experienced unwanted sexual contact alone did not have this outcome; this result may be due to a small sample size, the researchers said. For men, all forms of MST and any adverse childhood experiences (ACEs) were linked to lower initial resilience. In contrast, for women, a reduction in initial resilience only appeared when they had experienced three or more ACEs.
- While veterans who engaged in MHC had lower resilience initially, these veterans showed significantly greater increases in resilience over time than those who did not obtain counseling.
- MHC significantly mediated the relationship between MST and resilience, which indicates that counseling explained some of the association between MST exposure and increases in resilience over time.
"These results validate the potential benefits of mental health counseling for survivors of military sexual trauma," said study author Daniel F. Perkins, principal scientist at the Clearinghouse, an applied research center at the Social Science Research Institute and professor of family and youth resiliency and policy in the College of Agricultural Sciences. "They also emphasize the importance of ensuring that veterans, especially those exposed to trauma, are connected to the proper resources during their transition to civilian life."
The research also found that interventions like MHC can help individuals rebuild resources and foster long-term resilience. The authors stressed the importance of connecting transitioning veterans to VA and non-VA providers and community organizations that offer supportive services. These resources can provide a path to healing by helping individuals process trauma, regain a sense of safety and develop tools to move forward.
The study also highlighted that female veterans continue to face unique challenges. While women were more likely to seek MHC, men who engaged in MHC showed greater resilience gains over time, especially men who had experienced sexual harassment. Past studies, including one published in the Journal of War & Culture Studies, suggest the cumulative impact of traumatic experiences among women may hinder their ability to build resilience compared to men, the researchers said.
"This study underscores how crucial it is to support veterans with accessible, trauma-informed mental health care," Mitchell said. "No one should have to carry the weight of military sexual trauma alone, especially when the evidence shows that counseling can make a difference."
Additional authors include Keith R. Aronson, director of the Clearinghouse, associate director of the Social Science Research Institute and research professor in the Department of Biobehavioral Health, and Ryan P. Chesnut, research and evaluation scientist at the Clearinghouse.
The Henry M. Jackson Foundation for the Advancement of Military Medicine, The Pew Charitable Trusts, The Heinz Endowments, May & Stanley Smith Charitable Trust, The Arthur M. Blank Family Foundation and Wounded Warrior Project supported this work. In addition, this work leveraged funds from the U.S. Department of Agriculture's National Institute of Food and Agriculture and Hatch Appropriations.
