Unfortunately, there have been numerous reports, public and private, about the inadequate access to all forms of mental health services for returning veterans in the VA Hospital system. Working with survivors of sexual assault and rape presents a unique challenge which requires very specific skills and experience in order to help that person deal with the abundance of concerns including the hope of feeling safe and being whole again. As someone who spent years providing crisis counseling for survivors of sexual assault in a university setting, I understand the enormity of the responsibility and needed skills to help that person to continue living. In the course of a survivor's care, there are concerns around their sense of and actual physical safety, impaired function in other areas of their lives, decisions as to the pursuit of criminal charges, and the emotional and psychological fallout of a failed prosecution to name just a few. Working with the survivors of sexual assault in the military who may have spent months in very close proximity to their perpetrator presents a greater challenge in the treatment of possible repeated abuse and post-traumatic stress disorder (PTSD). Given the complexity of this problem, it's imperative to have very knowledgeable practitioners to treat this population. Part of the problem is the availability of such qualified psychologists who are willing and able to take on this phenomenal therapeutic challenge has proven to be difficult for the Veterans Administration.

Currently, the American Psychological Association's fundamental requirements for accreditation of a Clinical Psychology doctoral program does not include any specific training for working with or treating survivors of violence against women including sexual assault or intimate partner violence. Doctoral students may customize their training through two avenues of instruction. First, they may select a university which through its own volition includes a specific track or program of doctoral education that provides theoretical and practical preparation in the issues centered on gender-based violence. Another path includes education or internship and externship locations that treat survivors of violence including sexual assault. Clinical psychological education does include training in areas that may be generally related to mental health issues connected to violence survivors. This can include treatment of unusual presentations of depression and post-traumatic stress disorder. Yet specific therapeutic modalities of treatment that help to these survivors are not part of the basic education.

Other therapeutic professionals such as social workers, therapists and counselors are working to fill this gap. It may be time to give serious consideration to the inclusion of such training in the basic educational requirements for clinical psychologists. This dearth of practitioners who are prepared to deal with the complex issues of these returning female veterans needs to be remedied NOW.

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