So when one wants to think about how do you go about screening for these issues,
there's two questions that you can ask on any introductory visit and those could be.
And this is for any patient, whether they have experienced military service or not.
You really wanna ask everyone,
has anyone ever touched you in a sexual way that made you uncomfortable?
And have you had an unwanted sexual experience?
Those are two questions that are screening for everyone.
The way that you actually might make that more specific as to addressing a veteran
or someone who's active duty, you will then ask, and the way you change that is,
when you were in the military did you ever receive unwanted, threatening,
or repeated sexual attention, and when you were in the military,
did you have sexual contact against your will or when you ere unable to say no?
And again, we know that for you as a health professional or
a health professional trainee, issues around unwanted sexual assault and
sexual contact are in the news, and
these are good screening questions that you should be asking all of your patients.
Here is a sample questionnaire that the military and
the Department of Defense use either at intake or in various ways in order to
get more details about how an experience or an assault might have occurred.
And you can read the questions here on the slide.
Again, there's more specific issues, but the two questions we
talked about before allow you to see, do you need to do a deeper dive, and
one of interesting, if you look at question seven here is, sometimes you'll
actually find a history of abuse that actually predates military service.
But you also want to know about childhood sexual trauma.
Again, these are questions that you wanna ask everyone and
you add a slight different twist in terms of trying to understand the experience or
where it might happen if you're dealing with a veteran or
someone who's active duty military.
The thing you wanna be very clear about is not to use jargon.
Once you add words like rape, sexual assault or abuse, incest,
you're patient, or the person that you're screening actually might shut down.
So that's why I ask you about sexual contact that you might not have wanted,
sometimes is actually a quite useful way to start to do a deep dive on some of
these issues, and also you wanna avoid non-judgmental questionings,
like shaking your head.
You haven't had any sexual assault related, do you?
When I shake my head like that I'm actually conveying to you a clear message
that the answer is no, and that's the answer I want to hear.
And if I phrase it from a negative point of view, I'm also conveying a judgment.
So again, these are things that we ask for my perspective medical students
to practice prior to engaging in real life clinical experiences.
But those are things you wanna get used to asking in a very non-judgmental way,
being very aware of your non verbal communication as well as your
verbal communication.
The issue is when you ask these questions,
you have to really be able and ready to expect to hear an answer.
And those answers actually vary across the spectrum.
You actually might hear from perpetrators who actually feel guilty,
who have been holding in a lot of issues over time, and
you have to be prepared to hear what a patient or
a person that you might be screening is willing to tell you.
You're gonna hear circumstances around the assault, the nature, and the response.
And so, you need to be just as prepared to what the answer is you might
get as to asking the question with the sensitivity that expect.
These things take time in the clinical encounter.