How might you facilitate an initial counseling session with this young woman?

Counseling Across Cultures

Seventh Edition

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Counseling Across Cultures Seventh Edition

Edited by

Paul B. Pedersen Syracuse University (Emeritus); University of Hawaii (Visiting); Maastricht

School of Management Walter J. Lonner

Western Washington University (Emeritus) Juris G. Draguns

Pennsylvania State University (Emeritus) Joseph E. Trimble

Western Washington University María R. Scharrón-del Río

Brooklyn College City University of New York

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For INFORMATION:

SAGE Publications, Inc.

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Copyright © 2016 by SAGE Publications, Inc.

All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher. Printed in the United States of America

A catalog record of this book is available from the Library of Congress.

ISBN 9781452217529

This book is printed on acid-free paper.

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Acquisitions Editor: Kassie Graves

Associate Editor: Abbie Rickard

Editorial Assistant: Carrie Montoya

Production Editor: Claudia A. Hoffman

Copy Editors: Judy Selhorst, Linda Gray

Typesetter: C&M Digitals (P) Ltd.

Proofreader: Victoria Reed-Castro

Indexer: Karen Wiley

Cover Designer: Candice Harman

Cover Photograph: Walter J. Lonner

Marketing Manager: Shari Countryman

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Contents

Acknowledgments Foreword Dedication Introduction: Learning From Our “Culture Teachers” PART I. ESSENTIAL COMPONENTS OF CROSS-CULTURAL COUNSELING

1. Toward Effectiveness Through Empathy 2. Counseling Encounters in Multicultural Contexts: An Introduction 3. Assessment of Persons in Cross-Cultural Counseling 4. Multicultural Counseling Foundations: A Synthesis of Research Findings on Selected Topics

PART II. ETHNOCULTURAL CONTEXTS AND CROSS-CULTURAL COUNSELING 5. Counseling North American Indigenous Peoples 6. Counseling Asian Americans: Client and Therapist Variables 7. Counseling Persons of Black African Ancestry 8. Counseling the Latino/a From Guiding Theory to Practice: ¡Adelante! 9. Counseling Arab and Muslim Clients

PART III. COUNSELING ISSUES IN BROADLY DEFINED CULTURAL CATEGORIES 10. Gender, Sexism, Heterosexism, and Privilege Across Cultures 11. Counseling the Marginalized 12. Counseling in Schools: Issues and Practice 13. Reflective Clinical Practice With People of Marginalized Sexual Identities

PART IV. COUNSELING INDIVIDUALS IN TRANSITIONAL, TRAUMATIC, OR EMERGENT SITUATIONS

14. Counseling International Students in the Context of Cross-Cultural Transitions 15. Counseling Immigrants and Refugees 16. Counseling Survivors of Disaster 17. Counseling in the Context of Poverty 18. The Ecology of Acculturation: Implications for Counseling Across Cultures

PART V. PROFESSIONAL COUNSELING IN A SELECTION OF CULTURE-MEDIATED HUMAN CONDITIONS AND CIRCUMSTANCES

19. Health Psychology and Cultural Competence 20. Well-Being and Health 21. Family Counseling and Therapy With Diverse Ethnocultural Groups 22. Religion, Spirituality, and Culture-Oriented Counseling 23. Drug and Alcohol Abuse and Health Promotion in Cross-Cultural Counseling 24. Group Dynamics in a Multicultural World

Index About the Editors

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About the Contributors

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Elder Wisdom

An elder Lakota was teaching his grandchildren about life. He said to them, “A fight is going on inside me… it is a terrible fight and it is between two wolves.

One wolf represents fear, anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.

The other stands for joy, peace, love, hope, sharing, serenity, humility, kindness, benevolence, friendship, empathy, generosity, truth, compassion, and faith.

This same fight is going on inside you, and inside every other person, too.”

The grandchildren thought about it for a minute, and then one child asked her grandfather, “Which wolf will win?”

The Elder replied simply, “The one you feed.”

The Western conception of the person as a bounded, unique, more or less integrated motivational and cognitive universe, a dynamic center of awareness, emotion, judgment, and action, organized into a distinctive whole and set contrastively—both against other such wholes and against social and natural background—is however incorrigible it may seem to us, a rather peculiar idea within the context of the world’s cultures. (p. 34)

Geertz, C. (1973). The interpretation of cultures: Selected essays. New York: Basic Books.

The first peace, which is the most important, is that which comes within the souls of men when they realize their relationship, their oneness, with the universe and all its Powers, and when they realize that at the center of the universe dwells Wakan-Tanka, and that this center is everywhere,it is within each of us. This is the real Peace, and the others are but reflections of this.

The second peace is that which is made between two individuals, and the third is that which is made between two nations. But above all you should understand that there can never be peace between nations until there is first known that true peace which… is within the souls of men. (p. 198)

Black Elk, in Neihardt, J. G. (1961). Black Elk speaks: Being the life story of the holy man of the Oglala Sioux. Lincoln: University of Nebraska Press.

Conscientization does not consist, therefore, of a simple change of mind about reality, of a change in individual subjectivity that leaves intact the objective context; conscientization supposes a change in people in the process of changing their relationship with the environment, and above all, with others.

True knowledge is essentially bound with transformative social action and involves a change in the relationship between human beings.

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Martín-Baró, I., & Blanco Abarca, A. (1998). Psicología de la liberación. Madrid: Editorial Trotta.

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Acknowledgments

Nearly every academic book ever published has acknowledged individuals who in some way played important roles in the book’s development. In this book we depart from the usual custom and acknowledge those who, on one hand, were important in organizing, editing, and producing the book, as well as those who, on the other hand, played important roles in the lives of the five coeditors. The former can be considered general acknowledgments that we all share. The latter are necessarily different for each of us. Thus we have agreed to contribute individually.

In the general category we want to thank SAGE Publications for the confidence it has shown in us throughout the years. The two key SAGE people with whom we have worked are Kassie Graves, who has been part of this effort for many years, and her assistant, Carrie Baarnes. Although a relative newcomer to SAGE, Carrie was a big help in the latter stages. We were flattered that Claudia Hoffman, SAGE’s director of U.S. book production, pointedly selected Counseling Across Cultures as a book she wanted to usher through its final copyediting and production stages. In characteristic good judgment, Claudia chose Judy Selhorst to be copy editor for the book. It is remarkable how careful and efficient Judy was during the latter part of the process, when it is so important to be complete and precise. Candace Harman and her crew in the graphics department did an excellent job with the cover. Further north, on the campus of Western Washington University, is Genavee Brown. A graduate student in the Department of Psychology and a most promising young scholar, Genavee was “the organizer” in crucial stages. When the book is published, the first copy will go to Paul Pedersen and the second will go to Genavee.

On the personal side, we offer the following highly individualized acknowledgments:

Paul B. Pedersen. I would like to acknowledge and to dedicate my role in the preparation of this book to Anthony J. “Tony” Marsella, professor emeritus of the University of Hawaii. Tony was my prime teacher at so many different levels. He was as comfortable in the village council of a Borneo community as he was, for example, during a World Health Organization committee meeting many years ago, or as he was in his lectures throughout his illustrious career. The classes he taught would frequently end with standing ovations by his students. He originated the awareness, knowledge, and skill model, which became the basis of the measures for competence within the field of multicultural counseling. Many other examples of his influence come to mind. Most important, he has in recent years become a first-class friend and co-traveler in life’s journey. In the metaphor of family, Tony has fathered many children among his students, his colleagues, and his other brothers and sisters. For all that you have given, Tony, I send you my thanks.

Walter J. Lonner. Above all else I want to thank my immediate family, consisting of many people, both living and dead. Among the living are my everything-and-then-some wife, Marilyn, and our three great children (Jay, Alyssa, and Andrea), each of whom has two daughters with terrific spouses. The world had better watch out for those six little dynamos. By name and current age they are Sika (14) and Brenna (11) Lonner, Sophia (11) and Alena (8) Naviaux, and Nina (7) and Sage (4) Howards. I was blessed with great parents and two

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brothers: Terry, the youngest of us, who is a beacon of honor and dependability and a jack-of-all-trades; and George, the oldest. We grew up in beautiful and generous western Montana. George died October 8, 2012,

about midway through the work on this book. George was the family’s Don Quixote, dreaming big things and imagining the impossible. It is he, not I, who should have been a university professor, for he would have dazzled thousands of students with his talent of mixing fact with fantasy. The encouragement and praise that Terry and George and the rest of my family piled upon me, through thick and thin, has always kept me going. I also want to acknowledge the multidimensional influence that an international network of scholars has had on my 50-plus years of trying to understand the nature of culture’s influence on everything we say, think, and do. Part of this network consists of the many talented people, including the current slate of coeditors, who have contributed to one or more of the seven editions of Counseling Across Cultures.

Juris G. Draguns. Throughout the seven editions of Counseling Across Cultures, I have enjoyed marvelous support, encouragement, and understanding from my wife, Marie. We have shared 52 wonderful years, and Marie’s love and empathy have helped me overcome whatever obstacles have stood in my way, sometimes tangible, more often subjective. As I thought about, wrote, and edited Counseling Across Cultures, I would temporally disappear into the book, and Marie was always there to welcome me when I reemerged from its pages. My two children, Julie and George, were young when Counseling Across Cultures first appeared. They grew up as the book evolved through its several transformations, and the two processes intertwined. What has remained constant is our mutual love and my vicarious enjoyment of and pride over Julie’s and George’s families, careers, and achievements. Thinking back on my early years, I gratefully remember my parents, especially my mother, who instilled in me a curiosity and love of learning and protected me from the dangerous world outside our home. It is thanks to her that I survived and was able to work toward the realization of my version of the American Dream. And in the course of the ensuing multiple transitions I benefited from a host of culture teachers who helped me become more empathetic and perhaps more helpful across cultural barriers. They are too numerous to mention, but my sincerest thanks go to them all.

Joseph E. Trimble. I owe Paul Pedersen a special measure of personal gratitude and appreciation. In August 1972 Paul met with me and my wife, Molly, at a lanai in Honolulu. Over a late-morning breakfast he vividly described his new triad theory of counseling training to underscore his strong growing interest in culture and psychological counseling. It was a memorable occasion for the three of us. A few years later, Paul invited me to give a symposium paper on counseling American Indians and later publish a chapter in the first edition of Counseling Across Cultures. Molly was extremely helpful when I wrote that first chapter and continues to be insightful and helpful in almost all of my writing activities. She has a keen eye for detail and a spirited mind for novel concepts and ideas. Throughout the course of each of the Counseling Across Cultures editions our three lovely and talented daughters, Genevieve, Lee Erin, and Casey Ann, have been with me when each edition arrived home for their review and comment, and it has always been a proud moment for me when they read their names in the acknowledgments and commented on it. Also, I am deeply grateful for all of the people who have provided me with guidance, advice, and collaboration on the contents of the various chapters put together for the seven editions. Thank you especially to Candace Fleming, Fred Beauvais, Pamela Jumper Thurman, and John Gonzales.

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María R. Scharrón-del Río. I am very grateful for the love, guidance, and support of mi familia. My mother, Rosarito, and my sister Marilia housed and fed me in Puerto Rico as I was finishing the final editing process for this book. My sister Marichi also assisted me with her commentary during this time, and my father, Rafael, accompanied me on a couple of hour-long mental health escapades to the ocean. I am also grateful to my partner, Yvonne, for her love, support, and understanding, and for providing a home for me in Germany during part of my sabbatical. Many thanks also to my chosen family in New York City—Cody, Mara, Barb, Wayne, Paul, and Flo—who helped in too many ways to count. I owe a special thanks to Joseph Trimble and Guillermo Bernal, who have been outstanding mentors and friends since I was an undergraduate student in the Career Opportunities in Research (NIMH-COR) program at the University of Puerto Rico. I also want to thank Eliza Ada Dragowski for her exceptional work and support in the completion of this book. Finally, my thanks to the wonderful group of people who provided additional guidance on the content of various chapters of the book: Priscilla Dass-Brailsford, Stuart Chen-Hayes, Hollyce Giles, Vic Muñoz, Delida Sánchez, and Avi Skolnik.

Paul B. Pedersen

Walter J. Lonner

Juris G. Draguns

Joseph E. Trimble

María R. Scharrón-del Río

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Summative Assessment: Cross-Cultural Research Paper

wk 2

Select 1 of the cross-cultural research articles located in the University Library to use in your assignment.

Write a 700- to 1,050-word paper analyzing cross-cultural research. Complete the following in your paper:

  • Explain the value of cross-cultural research, in general.
  • Summarize the research design.
  • Summarize the findings from the research.
  • Evaluate its conclusion.
  • Discuss the applicability of the research.
  • Discuss if the study adequately handled the different cultures without bias.

 

wk3 -Summative Assessment: Cultural Influences Presentation

You are the first chief diversity officer at a Fortune 100 company. To help employees understand cross-cultural diversity and the value of diversity in the workplace, you are assigned to create a presentation on the cultural influences in your life. Include pictures to show how social practice and the culture you grew up in helped shape you.

Think about the person you are now. Think of all the cultural influences that may have impinged on you. Some examples include your parents, your parental milieu, your ethnic group, your religion, the areas or countries you lived in, your gender, the schools you went to, the schools’ ideology, and your peers and their backgrounds.

Create a 12- to 19-slide PowerPoint presentation with detailed speaker notes that includes or does the following:

  • (1 slide) Introduction
  • (4–6 slides) Describes the major cultural influences on your life
  • (3–5 slides) Explains the impact of cultural influences on you and your way of being (make sure you don’t focus on individual influences)
  • (1–2 slides) Describes what would have been different about you without some of the cultural influences
  • (2–4 slides) Applies Erikson’s psychosocial theory
  • (1 slide) References

wk 4 – Culture and Communication Memo

You work in the human resources department of a company that does business in 25 different countries. You have learned that communication culture in your workplace has a significant impact on your employees’ experience, motivation, engagement, and overall business success. Your manager has asked you to write a memo on why and how to build a great communication culture at your company.

Write a 700- to 1,050-word memo that covers at least 2, but not more than 4, of the communication topics in 2 different cultures of your choice. Complete the following in your memo:

  • Identify 2 cultures you selected.
  • Identify 2 to 4 communication topics to discuss in your memo:
  • Language and verbal communication
  • Nonverbal communication
  • Family communication
  • Workplace communication
  • The expression of emotions
  • Friendship communication
  • Romantic relationships, including dating, nonmarital commitments, and marriage
  • Discuss how the 2 cultures are similar and different in your selected communication topic areas.
  • Discuss additional common communication practices in each culture.
  • Discuss how the communications practices in each culture are similar and how they are different.
  • Discuss how culture influences the way we communicate and form relationships with others.
  • List ways employees can improve their ability to communicate competently in cross-cultural interaction

wk 5 – Gender Equality Proposal

You are working on supporting gender equality in your community or culture. You are writing a proposal that will focus on gender equality because it is an important development (and human rights) issue. Create a developmental proposal (for example, cultural and diversity programs, diversity mentoring, and outreach programs) that will focus on building greater gender equality. Your proposal should help to increase awareness of inequalities, offer constructive solutions, and enable all genders to have a voice in the initiative.

Write a 700- to 1,050-word proposal that includes or does the following:

  • Section 1: Initiative Overview
  • States the community or culture you hope to influence
  • States the mission, vision, and program objectives
  • Section 2: Visibility, Awareness, and Participation
  • Develops appropriate awareness-raising tools to stimulate broad interest
  • Develops a communication strategy that leverages national and local-level education and culturally sensitive activities
  • Section 3: Funding Strategy that Promotes Cultural Diversity
  • Describes your funding strategies
  • Explains how funding strategies promote diversity of cultural expressions
  • Discusses measurable outcomes of the funding strategies

wk 6 – Summative Assessment: Social Justice and Healthcare Report

Identify a current health concern that influences cultures differently.

Write a 700- to 1,050-word report on social justice issues related to healthcare quality and access that are impacted by culture and race. Complete the following in your paper:

  • Evaluate the importance of social justice.
  • Discuss the psychological influences and sociocultural influences of physical health and disease.
  • Discuss the differences in healthcare and medical delivery systems related to a health outcome (for example, high blood pressure or obesity) that is impacted by culture differently.
  • For example, you could look at differences in healthcare systems in a large metropolitan area versus ones in a rural area.
  • Analyze how the following five cultural influences may contribute to different health outcomes.
  • Genetics
  • Lifestyles and behaviors
  • Attitudes and beliefs
  • Healthcare
  • Environment
  • Analyze the importance of culture to health overall.
  • Discuss the value of diversity, the value of diversity of cultures, and the impact of diversity on health outcomes.

Describe how the words we use to discuss gender and sexuality shape our perception of what is considered normal or abnormal.

Overview

In this journal activity, you will explore the ways in which use of language influences perceptions of human behavior.

Scenario

To better understand the elements that shape our view of human abnormality, Jamal has begun to reflect on his own lived experiences. During Jamal’s adolescence, no element seemed more powerful to him than language. Jamal clearly recalls boys taunting him as he prepared for gym class, “Hey freak, you’re in the wrong locker room!” Likewise, when boys and girls would disperse into gender-specific groups, Jamal often found himself gravitating toward the girls because they didn’t appear to be as mean as the boys; however, his female peers felt that he was too “weird” to be included in their clique. For Jamal, these emotionally painful events caused him to experience feelings of confusion, ostracism, isolation, and despair.

For as long as he can recall, Jamal has had difficulty identifying with society’s views of gender and sexuality. He has never felt as though he is singularly male or female; these categories have simply never aligned with his idealized self-concept. Likewise, Jamal has never felt as though he was exclusively gay. On the contrary, he has always felt as though he could fluidly move between sexual orientations, depending on the situation and context, as though human sexuality existed on a spectrum from heterosexual to homosexual. For these reasons, Jamal has recently begun to identify as bisexual and gender non-binary and, for the first time in his life, feels normal.

The word abnormal carries a lot of humanistic weight. Like a practitioner who is bound by ethical codes of conduct to ensure that no harm is done within the scope of clinical practice, each of us has a moral obligation to ensure that we don’t inflict psychological harm on others—intentionally or unintentionally—with the language we use when discussing gender and sexuality. As we learn to value our individual differences, one idea resonates: It’s our implicit responsibility to embrace all people with compassion, empathy, and acceptance as they attempt to be what comes most naturally: themselves.

Prompt

The following resources support your work on this activity:

  • Module Six Activity Template: You may use this template to complete the Module Six Activity assignment.
  • Psychology Research Guide: This resource was created to help you find psychology related content.

For this journal activity, you will focus on the influence of language on shaping perceptions of human behavior. Specifically, consider how the words we use can have a dramatic positive or negative influence on how we view the biological, psychological, and social orientations of others. Respond to the following prompts with a minimum of 3 to 5 sentences. Address the rubric criteria listed below and support your answers with a credible source when necessary.

  • Describe how the words we use to discuss gender and sexuality shape our perception of what is considered normal or abnormal. Provide an example within your response.
  • Imagine engaging in conversation with family, friends, or colleagues and eventually realizing that they were inadvertently promoting stereotypes about gender or sexuality. Describe the thoughts and feelings that you might experience during such a conversation.
  • Describe the language used within your own culture (e.g., family members, friends, colleagues) when discussing gender and sexuality.

Guidelines for Submission

Submit your completed Module Six Activity Template. Sources should be cited according to APA style.

Interview And Background Research

Assignment 2: Course Project Part I: Interview and Background Research

 

 

 

Refer to the Course Project Overview in Module 1. Early in the course, you have selected a specific disorder. Research it using your textbook and Argosy University online library resources. A minimum of 5 sources in addition to your text book should be used. At least three of those sources should be peer-reviewed journal articles. The remaining 2 sources may be books, journal articles, or reputable web sites (like those from professional organizations or governmental agencies, not Wikipedia or similar sites).

 

 

 

Review the rubric, as it provides detailed instructions on how best to succeed on this assignment. In the rubric, you will find that you need to address the following in a paper:

 

 

 

  • Description of the selected disorder (Identify the DSM-IV-TR diagnostic category for the disorder and distinguish between diagnostic and commonly used terminology.)
  • Causative factors of the disorder
  • Diagnosis of the disorder
  • Treatment of the disorder
  • Survey of current research on the disorder

 

 

 

Write a 4–5-page paper in Word format. Remember to use the rubric as you write your paper. Apply APA standards to citation of sources, and include an APA style title/cover page and reference page. Use the following file naming convention: LastnameFirstInitial_M3_A2.doc.

 

 

 

By Wednesday, March 6, 2013, deliver your assignment to the M3: Assignment 2 Dropbox.

 

 

 

Working ahead Using the feedback provided to you by your peers and instructors, finalize your interview questions and conduct the interview with a mental health professional in preparation for the paper due in Module 5.

 

 

 

Assignment 2 Grading Criteria
Maximum Points
Description of selected disorder.
20
Causative factors of the disorder
32
Diagnosis of the disorder
32
Treatment of the disorde
36
Survey of current research on the disorder
36
Organization (12 points): Introduction, Thesis, Transitions, Conclusion

Usage and Mechanics (12 points): Grammar, Spelling, Sentence Structure

APA Elements (16 points): Attribution, Paraphrasing, Quotations

Style (4 points): Audience, Word Choice

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Total:
200

 

 

 

The topic I chose for my course project is “PTSD” which stands for posttraumatic stress disorder. My focus will be as it relates to the military. This disorder is very important and to me because I am a combat marine with PTSD and the veterans that I will be working with through my non-profit suffer from the same disorder. I have referenced some statistics. One statistic that is not mentioned that is just arisen is a very saddening one, is the new dilemma of suicide on the battlefield. Research is showing that recently our military is losing more troops to suicide on the battlefield then they are in actual battles firefights.

The Ten questions for my health profession are:

1. What are the accepted diagnostic criteria for PTSD?

2. What would an evidence-based criteria set for diagnosis of PTSD include?

3. What constitutes a stressor?

4. How should stressful events be diagnosed and documented?

5. How can and should a patient document a stressful event?

6. What are the components of an evidence-based diagnosis of PTSD?

7. What would diagnostic criteria be, based on best evidence, either based on or apart from official standards?

8. What constitutes optimal evaluation of a patient for PTSD?

9. What neuropsychological evaluation or other testing should be included in an optimal evaluation of a patient for PTSD?

10. What are useful biomarkers?

PTSD and the Military

If you are in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to PTSD.

Experts think PTSD occurs:

In about 11-20% of Veterans of the Iraq and Afghanistan wars (Operations Iraqi and Enduring Freedom), or in 11-20 Veterans out of 100.

In as many as 10% of Gulf War (Desert Storm) Veterans, or in 10 Veterans out of 100.

In about 30% of Vietnam Veterans, or about 30 out of 100 Vietnam Veterans.

Other factors in a combat situation can add more stress to an already stressful situation. This may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where it’s fought, and the type of enemy you face.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to both men and women and can occur during peacetime, training, or war.

Among Veterans using VA health care, about:

23 out of 100 women (23%) reported sexual assault when in the military.

55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military.

Even though military sexual trauma is far more common in women Veterans, over half of all Veterans with military sexual trauma are men. This is because there are many more male Veterans than there are females.

Sources

Kessler, R.C., Sonnega, A., Bromet, E. Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060.Kessler, R. C., Berglund, P., Demler, O., Jin, R., & Walters, E. E. (2005a). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593-602.

 

Kulka, R.A., Schlenger, W.E., Fairbank, J.A. Hough, R.L., Jordan, B.K., Marmar, C.R., & Weiss, D.S. (1990). Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study, New York: Brunner/Mazel.

 

Tanielian, T. & Jaycox, L. (Eds.)(2008). Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Santa Monica, CA: RAND Corporation.