Community Case Study_ Part 4_Greer

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MILITARY MALE SEXUAL ASSAULT RESPONSE 1 Community-Based Approach to Military Male Sexual Assault Prevention and Response Paul B. Greer School of Behavioral Science Liberty University Author Note Paul Brian Greer I have no known conflict of interest to disclose. Correspondence concerning this article should be addressed to Paul Brian Greer. Email: pbgreer@liberty.edu

MILITARY MALE SEXUAL ASSAULT RESPONSE 2 Abstract When it comes to prevention and support for this unique military population, religious and veterans’ organizations, social services and military supported services are often not aligned in planning or support efforts thereby leading to redundancy in services or creating gaps in service to the veteran and military population. Since the COVID pandemic, the mental health system has been overtaxed among the military and community health systems leading to greater outsourcing and increase of military chaplain care to fill the gap. One trend that has emerged is male sexual assault victim self-reporting to chaplains. Military chaplains are unique positioned to offer pastoral care, but are often ill-equipped for this type of service, as are many community support resources such as churches and veterans support organizations. As such, a sociological-ecological model that ties together military and community resources in a coordinated community response as a coalition to organize prevention and response, as well as education and advocacy programs is critical to assist with the unmet needs of military male sexual assault victims. Keywords : military, veteran, male sexual assault, community-based approaches, veteran support organization partnerships, community partnerships, community coalition, prevention, advocacy, religious support, moral injury, triphasic model of trauma recovery, spiritually integrated psychotherapy, forgiveness therapy.

MILITARY MALE SEXUAL ASSAULT RESPONSE 3 Community-Based Approach to Military Male Sexual Assault Prevention and Response As a provider in the military-centric community of Hampton Roads, Virginia, which includes Langley Air Force Base, Army’s Fort Story and Fort Eustis, Naval Weapons Station Yorktown, Naval Air Station Oceana and Dam Neck Annex, Joint Expeditionary Based Little Creek, and Naval Station Norfolk which is the largest naval base in the world. According to the Hampton Roads Economic Development Alliance (2022), the military represents approximately 45% of the region's economy and supports over 315,000 jobs. In terms of military personnel, there are over 87,000 active-duty service members, over 25,000 civilian personnel, and over 80,000 military family members living in the Hampton Roads region yielding a military population of over 192,000 (Hampton Roads Economic Development Alliance, 2022). As a result, the community and military are inextricably linked and mutually interdependent, especially when caring for the large population of military members and their dependents. Caring for this unique population, especially among military male sexual assault victims, requires a community-based approach for prevention and responsive care. A community-based approach is after all biblical due to the diverse giftedness and equipping for action as noted in Romans “Just as our bodies have many parts and each part has a special function, so it is with Christ’s body. We are many parts of one body, and we all belong to each other. In his grace, God has given us different gifts for doing certain things well ( New Living Translation , 1996/2015, Romans 12:4-6). Lack of Coordination and Outsourcing However, when it comes to prevention and support for this unique military population, religious and veterans organizations, local government based social services, military social support services and programs, and medical/mental health support services are often not aligned

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MILITARY MALE SEXUAL ASSAULT RESPONSE 4 in program planning or prevention efforts. This lack of coordination often leads to either a redundancy in services or creating gaps in service to the veteran and military population. This, combined with military referrals and outsourcing of uniformed service members and dependents mental health care through the TRICARE network and utilization of Military One Source for patient self-referrals has exacerbated the lack of coordination of efforts. In fact, according to Bond et al., droves of military personnel are seeking non-uniformed network providers due to increased wait-times as much as an average of 22 days (Bond et al., 2019). To address this issue, TRICARE has significantly outsourced mental health care to civilian providers. As a result, in Hampton Roads and in military-centric communities at large, community partnerships and coalitions are critical to assist with the unmet and under supported mental health needs for military members, especially military male sexual assault survivors. Chaplains Filling the Gap Chaplains are members of the military who are trained to provide religious and spiritual support to military personnel and their families. In addition to their religious duties, chaplains can also serve as counselors to military personnel who may be struggling with personal or professional issues. With the significant increase in mental health needs among the military, it is crucial to provide adequate support to service members with the shortfall of mental health caregivers, especially embedded within commands (Wilson, 2023). One way to provide such support is by having more chaplains (Dyer et al., 2019). The naval service in the Hampton Roads area in particular is looking to significantly increase the number of chaplains to help support mental health efforts and support to service members (Wilson, 2023). Military chaplains offer a unique resource to male sexual assault victims not found in the local community. Military chaplains have the unique benefit in the Department of Defense as not

MILITARY MALE SEXUAL ASSAULT RESPONSE 5 being required to abide by mandatory reporting requirements of any kind, including compliance with local and state law requirements while performing their duties as federal employees, and have unlimited confidentiality under the clergy penitent tradition and protections of military law per the Uniform Code of Military Justice, Rule 503 (US Congress, 1958). As such, victims of trauma and sexual assault primarily seek out chaplain support services first before other resources knowing their story is kept strictly confidential and can avoid revictimization often associated with reporting. This lends to a unique problem and need for specialized training for military chaplains to avoid doing harm for this unique and sensitive population in their most critical time of need. Description of the Population It is important to note that sexual assault can happen to anyone, regardless of their gender or age. However, men are often less likely to report sexual assault than women due to a variety of factors including stigma, shame, and fear of not being believed (Davies et al., 2002). In general, men may be less likely to report sexual assault compared to women and may take longer to come forward due to attitudes about masculinity and the societal stigma and shame associated with male sexual assault (Davies et al., 2002). According to a study by Dr. John Briere and colleagues (2004), the average age of men reporting sexual trauma is around 52 years old, thus lending to the hypothesis that male sexual assaults are significantly underreported and there is a significant male population suffering in silence and not receiving the care needed leading to maladaptive coping impacting society at large. According to the Department of Defense's "Population Representation in the Military Services" report as of September 30, 2020, the United States Military is 85.6% male (Department of Defense, n.d. ). This uniquely patriarchal organization with its cultural norms of toughness and

MILITARY MALE SEXUAL ASSAULT RESPONSE 6 compartmentalization of stressors for mission prioritization does not lend itself to encourage self- reporting or help-seeking among victims dealing with the effects of sexual trauma. Identification of Need To determine any identification of need, there are several steps and approaches to identification of need. These include social indicators as noted among chaplain caregivers as an initial indicator in Hampton Roads. Additional assessments is needed, but may include community forums, surveys, interviews with potential consumers or service providers (Lilley, 2023) as well as additional research including longitudinal studies. The following highlights existing research. Demographic Research According to a study by the Department of Defense, out of the estimated 20,500 incidents of sexual assault in the military in 2018, approximately 38% involved male victims (Department of Defense, 2019). Another study by the Rand Corporation found that among military personnel who experienced unwanted sexual contact, approximately 23% were male (Lefebvre et al., 2014). In a study of male veterans seeking treatment for PTSD at a VA hospital, 15.1% reported experiencing sexual trauma during their military service (Kimerling et al., 2007) illustrating the disparity in reporting. The United States military as a male dominated organization poses unique challenges for chaplains and mental health providers in caring for male sexual assault victims. Recruits come from a large swath of American society, especially from socio-economically challenged subset of culture often associated with neglect and abuse which often leads to revictimization in the military (Loughran et al., 2018). The is research that there is an increased likelihood of recruits choosing to enter military service seeking structure and discipline as they seek to escape

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MILITARY MALE SEXUAL ASSAULT RESPONSE 7 childhood abuse and trauma (Ruscio et al., 2001). In the United States, a study published in the Journal of Interpersonal Violence found that 1 in 6 males had experienced sexual violence at some point in their lives, predominantly before the age of 18 (Swartout et al., 2014). It can be assumed from the data that the military reflects this societal statistic but poses unique challenges for male victims of sexual trauma due to military recruitment pools compared to other civilian hiring agencies. Military cultural values including those of masculinity, stoicism, toughness and resiliency, further negatively impacting self-reporting and help seeking among make victims, as well as contributing to increased maladaptive coping and destructive behaviors. Intervention Strategies Triphasic Model The triphasic model of trauma recovery is a framework developed by Judith Herman (1992), a psychiatrist and trauma specialist, which describes the stages of recovery that individuals go through after experiencing trauma. The triphasic model has been widely used in the field of trauma treatment and has informed many evidence-based interventions. In Herman’s (1992) theory, she suggests that recovery from trauma involves a process of resolving contradictions between two opposing needs: the need for safety and the need for connection. In an effort to explain these dialectics, Goodwin (2023) developed what he calls the wobble adaptation proposing that survivors may experience a "wobble" between these two needs as they move through the recovery process which help describe how a male sexual assault survivor experiences the recovery process. The three phases of the triphasic model are Safety and Stabilization, Remembrance and Mourning, and Reconnection and Integration (Herman, 1992). Each phase is progressive beginning with a focus on establishing safety, both physically and emotionally, and establishing

MILITARY MALE SEXUAL ASSAULT RESPONSE 8 routines and structure, and developing coping strategies to manage symptoms. Then there is a focus is on processing and integrating the traumatic experience, including emotional processing. Finally, there is a focus on reconnecting with the world and establishing a new sense of normalcy, establishing new goals and interests, and finding meaning in the trauma experience. Spiritually Integrated Approaches One way to build spiritual strength with trauma survivors is through a therapeutic approach that integrates trauma informed spirituality into the healing process (Van Denend et al., 2022; Harris et al., 2018). Spiritually integrated psychotherapy is an evidence-based approach that incorporates the client's spiritual and religious beliefs into the therapeutic process. It involves using spiritual practices, such as prayer, meditation, and mindfulness, as well as exploring the client's beliefs and values to help them find meaning and purpose in their lives (Currier et al., 2020). Trauma informed spiritually integrated therapy can help trauma survivors increase their sense of hope, meaning, and purpose, which can lead to greater psychological and emotional well-being (Currier, et al., 2020). Overall, chaplains and clinicians incorporating spirituality as a biopsychosocial-spiritual approach to the therapeutic process can be an effective way to build spiritual strength and resilience in trauma survivors (Harris et al., 2018). 2 Corinthians teaches “Three times I pleaded with the Lord about this, that it should leave me. But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me” ( English Standard Version , 2011, 2 Cor. 12:8-9). This verse speaks to the heart of those struggling spiritually and the need to spiritual integration and clergy support.

MILITARY MALE SEXUAL ASSAULT RESPONSE 9 Clergy Interventions Chaplain and clergy interventions for trauma can include spiritual care, emotional support, and pastoral counseling, as well as dealing with moral and spiritual injuries and provide a safe space to process their trauma (Harris et al., 2018; Hunsinger, 2021), which can help promote healing and recovery. Overall, chaplains can offer important support for individuals who have experienced trauma and can complement the work of mental health professionals in providing holistic care with targeted intervention strategies that include trauma informed spiritual care. One such intervention strategy is that of forgiveness therapy. Role of Forgiveness Chaplains can play an important role in providing forgiveness therapy to survivors of sexual assault as part of a larger spiritual care approach to promote healing and reduce symptoms of distress in survivors of sexual assault, but it must be used appropriately, timely and judiciously as part of a process in the recovery journey. To address forgiveness too quickly and not a part of a forgiveness process could do harm to the recovery process. Forgiveness therapy is a type of psychotherapy that aims to help individuals who have experienced trauma to forgive themselves and others who have caused harm. For victims of sexual trauma, forgiveness therapy can aid in healing from the emotional and psychological wounds caused by their experiences and reduce symptoms of distress (Worthington et al., 2007). Forgiveness therapy is a multi-step process which includes acknowledging the harm done, accepting negative feelings, offering empathy and compassion to the offender, making a commitment to forgive, and finally, working to release negative emotions and thoughts related to the offense (Worthington et al. 2007).

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MILITARY MALE SEXUAL ASSAULT RESPONSE 10 Forgiveness is a critical biblical principle that aids in healing and one’s own relationship with the divine. Matthew 6:14-15 states “For if you forgive others their trespasses, your heavenly Father will also forgive you, but if you do not forgive others their trespasses, neither will your Father forgive your trespasses” ( English Standard Version , 2001). While one may not be the offender and justice not be fully recognized, the Bible helps to teach that it is bitterness that hurts from the inside out. In fact, the book of Ephesians teaches “Let all bitterness and wrath and anger and clamor and slander be put away from you, along with all malice” ( King James Version , 1611/1769, Ephesians 4:31). Bitterness itself is described by the Bible in Hebrews 12:15 as an internal poison that creates self-harm and can even harm others. As such, Jesus example serves as a model to address forgiveness among those who had wronged him unjustly. 1 Peter states “Look to Jesus, who despite being betrayed, persecuted, hated and left to die a sinner’s death alone did not respond with insults or scorn but entrusted Himself to the Father who judges all things justly” ( English Standard Version , 2001, 1 Peter 3:21-23). Resiliency Factors Resilience factors for male victims of sexual violence are crucial for their recovery and well-being. According to Dworkin et al. (2017) factors that can contribute to resilience in male victims of sexual violence include social support, positive coping strategy development, self- efficacy, cognitive restructuring, positive interpersonal relationships and self-image, incorporation of spirituality, access to mental health, and education and awareness. This is why a community-based approach and coalition is so important for trauma recovery, especially among military male sexual assault survivors due to their sense of camaraderie among the military community. Here, veteran support organization and religious organizations and churches helps provide social support to the recovery process.

MILITARY MALE SEXUAL ASSAULT RESPONSE 11 Further, there is specific evidence to suggest that certain spiritual disciplines and practices enhance resiliency and can also be beneficial for trauma recovery (Harris et al., 2018). These practices include mindfulness and meditation, prayer, forgiveness, scripture reading and gratitude (Van Denend et al., 2022). These practices can help individuals develop a sense of meaning and purpose, improve coping skills, and reduce feelings of anxiety and depression (Van Denend et al., 2022). By supporting these resiliency factors, clinicians and caregivers address the biopsychosocial-spiritual components for resiliency which in turn is a solid biblical principle for holistic care in the tripartite approach to man (mind, body, spirit). 1 Thessalonians teaches ““Now may the God of peace Himself sanctify you completely; and may your whole spirit, soul, and body be preserved blameless at the coming of our Lord Jesus Christ” ( New International Version , 2011, 1 Thessalonians 5:23). Coalition A coordinated community response to male sexual assault involves the collaboration of various community agencies and organizations to provide support, prevention, and intervention services to male survivors of sexual assault (Greeson et al., 2015). This approach recognizes that male sexual assault is a complex issue that requires a comprehensive response from various sectors of the community, including law enforcement, healthcare, social services, education, and advocacy groups, which by extension includes veteran support organization, local government and community clergy for holistic care, prevention and advocacy. The impact of a coordinated community response program cannot be overstated. Coordinated community responses help to improve access the service, seek justice, positively cope with the psychological impact of sexual assault and receive the necessary medical care and support needed (Mallios et al., 2011). Utilizing tools such as the State of Arizona (2018)

MILITARY MALE SEXUAL ASSAULT RESPONSE 12 Recommended Guidelines to a Coordinate Community Response offer a promising approach for addressing male sexual assault and best practices for implementing a coalition approach. Gleaning from this guide, community approaches to military male sexual assault clients can be expanded to include veteran and military centric organizations, religious and local leadership for a more holistic approach to care. Collaboration Local, state and federal governments, military leadership, religious organizations, clergy, veteran support organizations, social services, mental health practitioners, professional counseling organizations and their lobbyists, non-government organization and not for profits such as 1in6.org have a unique opportunity to develop a community-based ecological approach in support of male sexual assault survivors. By coordinating and collaborating in planning and programming, their combined efforts could reduce redundancies, fill gaps in services provided, maximize resources and community-based efforts to share the case management and prevention, thereby increasing program capacity, capability and effectiveness. By aligning as a community- based collation, the combined efforts can aid to promote greater professional advocacy resulting in policy changes, greater accountability for offenders, increased resources for funding and support services for victims, as well as strengthening efforts in outreach and education which aid in reducing male sexual assault stigmatization (Greeson et al., 2018). Advocacy Program Community-based approaches to advocacy for requires collaboration for policy change, enhanced services, and additional research (White et al., 2019). According to White (2019) advocacy includes specific research to examine the contexts of victims and offender experiences, as well as cultural contexts to develop partnerships at the local and national levels, and to be

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MILITARY MALE SEXUAL ASSAULT RESPONSE 13 open to new approaches to care through various methods or mixed-method approaches. Developing these partnerships is a critical effort to combine resources and voice. This is where clergy, military leaderships, veterans, local government social services and community influencers all converge to bring awareness, advocacy, finances and resources together to lobby and create change and increase services. Unfortunately for male sexual assault victims, there are significant barriers to that advocacy. Challenges and Barriers to Services Non-male Focus A cursory review of available service in the greater Hampton Roads area demonstrates that the Virginia Sexual and Domestic Violence Coalition, as well as local crisis services focus primarily on women, children, and the LQBTQ community, but rarely mention or provide services specific to males. In fact, it was not until 2012 when the American Psychological Association published a report highlighting the need for greater attention to male sexual victimization and addressing some of the barriers to reporting and treatment (Stemple et al., 2014). When the definition of sexual assault was expanded to include nonconsensual sexual contact, the rates of sexual assaults began to equalize between men and women (Stemple et al., 2014). While professional associations and laws have begun to catchup to the equality needed in recognizing male sexual assault, society and culture at large have a long way to go. Perceptions of Masculinity in Culture Men may experience unique challenges in disclosing and seeking support for sexual trauma due to social attitudes and stigma surrounding male victimization. Research suggests that men may face societal pressures to conform to traditional masculine norms, which may discourage them from disclosing experiences of sexual trauma (Koss, 1990; Bullock et al., 2011).

MILITARY MALE SEXUAL ASSAULT RESPONSE 14 Male socialization can contribute to male sexual victimization by fostering beliefs and attitudes that condone and normalize sexual aggression and discourage men from reporting or seeking help for victimization experiences (Peterson et al., 2004). These attitudes and behaviors can perpetuate sexual violence and make it difficult for male survivors to seek support or disclose their experiences (Davies, 2002). Moreover, men who disclose experiences of sexual trauma may face skepticism or disbelief from others, including mental health professionals, due to prevailing societal stereotypes that men are perpetrators rather than victims of sexual violence (Rozée et al., 2001). How the culture views men through the social lens of beliefs and attitudes, and the misperception of how men on a personal level experience trauma creates the need for greater education through this social lens due to the barriers it creates in society and in male victims seeking help. Lack of Education and Awareness One approach to a community-based coalition to overcome this barrier it to partner with education and advocacy groups such as in6.org and the Rape Abuse and Incest National Network (RAINN) through the education and advocacy programs. Specifically, 1in6.org utilizes their “Truth Telling” seminar which could be used for community clergy, veterans support organizations, caregivers, first responders, sexual assault victim advocates, sexual assault response coordinators, mental health providers and military social workers (Goodwin, 2023). This seminar focuses on male-centered approaches to psychotherapy, male psychology and how this “coding” of masculinity intersects with the lives of men facing trauma and post-traumatic responses (Goodwin, 2023). An overview of current research on both male sexual abuse and assault, and an analysis of how trauma commences, and a conceptual lens to the recovery process. With proper awareness, education and skills-based learning, community coalition

MILITARY MALE SEXUAL ASSAULT RESPONSE 15 stakeholders could fill a critical void in the community by meeting the needs of military male survivors of sexual assault with support and resources that do not currently exist. Lack of Advocacy Systemic barriers also play a significant role in hindering advocacy for male sexual assault victims. For example, services such as rape crisis centers are often geared towards female survivors, making male survivors feel unwelcome or uncomfortable seeking help. Furthermore, there may be a lack of funding and resources dedicated to male sexual assault advocacy, resulting in a lack of programs and services available to support male survivors. Cultural factors also contribute to barriers to male sexual assault advocacy. Stereotypical notions of masculinity and gender norms that associate men with power, strength, and control that reinforce the idea of men as powerful and in control may make it challenging for male survivors to come forward and seek help (Rozée et al., 2001). These stereotypes may lead to assumptions that men cannot be victims of sexual assault, or that if they are, they should be able to man up and deal with it on their own (Peterson et al., 2004). These cultural messages perpetuate the myth that sexual assault only happens to women may lead to the marginalization of male survivors and a lack of public awareness and understanding of their experiences that leads to advocacy, support and funding for male oriented sexual assault recovery programs. Conclusion In conclusion, sexual trauma can have significant and lasting impacts on men, including physical, emotional, and psychological consequences. However, social attitudes and stigma surrounding male victimization can make it difficult for men to disclose and seek support for sexual trauma, highlighting the need for increased awareness and understanding of male sexual victimization. Addressing these barriers requires a multifaceted approach that involves

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MILITARY MALE SEXUAL ASSAULT RESPONSE 16 addressing societal stereotypes and myths, as well as increasing funding and resources for male sexual assault advocacy programs and services, and providing education and training to professionals, as well as community-based stakeholders. By developing a community-based approach in a coordinated community response to military male sexual assault support and prevention, planning and programming can reduce redundancies, fill gaps in services, maximize existing resources and increase service utilization among potential clientele and provide the social support needed that these men may no longer suffer in silence. Partnerships with clergy and veteran support organizations provide a critical linchpin for social support and with specialized education, an avenue for spiritual and group intervention strategies for male veterans in their recovery from sexual trauma. While this community-based approach is worthwhile, there are significant areas for further research for consideration. Research is needed by way of local surveys to determine specific needs among military male sexual assault clientele to determine needs and effectiveness of community-based approaches to include spiritually integrated approaches as well as the Triphasic Model application in male sexual assault therapy. More research is also needed on the effectiveness of community-based support organization partnerships and peer led support groups and their effectiveness with the military male sexual assault survivor population.

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MILITARY MALE SEXUAL ASSAULT RESPONSE 19 Hunsinger, D. van D. (2021). Trauma-Informed Spiritual Care: Lifelines for a Healing Journey. Theology Today, 77(4), 359–371. https://doi.org/10.1177/0040573620961145 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 (12), 2160-2166. https://doi.org/10.2105/AJPH.2006.093490 Korbman, M. D., Pirutinsky, S., Feindler, E. L., & Rosmarin, D. H. (2022). Childhood sexual abuse, spirituality/religion, anxiety and depression in a Jewish community sample: The mediating role of religious coping. Journal of Interpersonal Violence, 37 (15–16). https://doi.org/10.1177/08862605211001462 Koss, M. P. (1990). The hidden rape victim: Personality, attitudinal, and situational characteristics. Psychology of Women Quarterly, 14 (3), 327-354. https://doi.org/10.1111/j.1471-6402.1985.tb00872.x Lefebvre, R., Srinivasan, S., & DeVoe, E. (2014). Sexual assault and sexual harassment in the U.S. military: Volume 2. Estimates for Department of Defense Service Members from the 2014 RAND Military Workplace Study. Retrieved from https://www.rand.org/pubs/research_reports/RR870z2.html Lilley, S. (2023). Subject matter conversations: program development [PowerPoint slides]. Retrieved from https://canvas.liberty.edu/courses/421318/discussion_topics/3837754? module_item_id=48004028 Loughran, D. S., & Humphreys, M. (2018). The US military and the socioeconomic divide. Annual Review of Sociology, 44 (1), 599-620. https://doi.org/10.4324/9781315126616

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MILITARY MALE SEXUAL ASSAULT RESPONSE 21 Ruscio, A. M., Borkovec, T. D., & Ruscio, J. (2001). A taxometric investigation of the latent structure of worry. Journal of Abnormal Psychology, 110 (2), 193–200. https://doi.org/10.1037/0021-843X.110.2.193 State of Arizona. (2018). Training on 2018 Arizona Guidelines for a coordinated community ... Recommended Guidelines for a Coordinated Community Response. Retrieved March 16, 2023, from https://www.juvenilejustice.az.gov/sites/default/files/meeting- documents/materials/cpvaw.acesdv_zip.pdf Stemple, L., & Meyer, I. H. (2014). The sexual victimization of men in America: New data challenge old assumptions. American Journal of Public Health, 104 (6). https://doi.org/10.2105/ajph.2014.301946 Swartout, K. M., Koss, M. P., White, J. W., & Thompson, M. P. (2014). Trajectories of the likelihood of experiencing forced sex: Effects of victimization and characteristics of sexual assaults. Journal of Interpersonal Violence, 29 (13), 2333-2357. https://doi.org/10.1177/0886260514534524 Thomas, K. H., Haring, E. L., McDaniel, J., Fletcher, K. L., & Albright, D. L. (2017). Belonging and support: Women veterans' perceptions of veteran service organizations. Journal of Veterans Studies, 2 (2), 2. https://doi.org/10.21061/jvs.12 U.S. Congress. (1958) United States Code: Uniform Code of Military Justice, 10 U.S.C. §§ 801- 940 . [Periodical] Retrieved from the Library of Congress, https://www.loc.gov/item/uscode1958-002010047/ Van Denend, J., Ford, K., Berg, P., Edens, E. L., & Cooke, J. (2022). The body, the mind, and the spirit: Including the spiritual domain in mental health care. Journal of Religion and Health, 61(5), 3571–3588. https://doi.org/10.1007/s10943-022-01609-2

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MILITARY MALE SEXUAL ASSAULT RESPONSE 22 White, J. W., Sienkiewicz, H. C., & Smith, P. H. (2019). Envisioning Future Directions: Conversations With Leaders in Domestic and Sexual Assault Advocacy, Policy, Service, and Research. Violence Against Women, 25 (1), 105–127. https://doi.org/10.1177/1077801218815771 Wilson, A. (2023, February 27). Chaplains to serve as counselors aboard all Navy destroyers by 2025. Stars and Stripes. Retrieved March 17, 2023, from https://www.stripes.com/branches/navy/2023-02-27/navy-chaplains-destroyers- counseling-suicide-9268265.html Worthington, E. L., Witvliet, C. V. O., Pietrini, P., & Miller, A. J. (2007). Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgiveness, and reduced unforgiveness. Journal of Behavioral Medicine, 30 (4), 291-302. https://doi.org/10.1007/s10865-007-9105-8

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