Application of the Comprehensive Sexual Assault Assessment Tool (CSAAT)

Contributor: Jacqueline Fawcett
January 30, 2019

Practice/Theory Exemplar (Roy’ Adaptation Model)

Location –

The CSAAT can be used in any setting in which nursologists (including Sexual Assault Nurse Examiners (SANEs)) encounter persons who have experienced a sexual assault.

Date first implemented

The CSAAT was developed in the mid-1990s. This exemplar is a description of how the CSAAT was applied to two case studies of women who had experienced a sexual assault while hospitalized.

Conceptual-Theoretical-Empirical Structure.

© 2019 Jacqueline Fawcett


The attached paper gives an overview of the development of the CSAAT, and two exemplar cases that illustrate use of the instrument

Download the RAM Practice Exemplar (PDF file)

See the original unpublished paper for details about the CSAAT

Practice Recommendations

We encourage all nursologists who encounter persons who have experienced a sexual assault to use the CSAAT to document the experience and relevant nursologists’ activities.

Theory Development Recommendations

We welcome nursologists who work with persons who experience sexual assault to modify the CSAAT for populations of interest, using Roy’s Adaptation Model as a guide to item generation and identification of relevant interventions.

Publications reporting use of the CSAAT in practice

Amar A. F., & Clements P. T. (2008/2009). The intersection of violence, crime, and mental health. Journal of the American Psychiatric Nurses Association, 14, 410-412.

Brozowski, K., & Hall, D. R. (2010). Aging and risk: Physical and sexual abuse of elders in Canada. Journal of Interpersonal Violence, 25, 1183–1199.

Burgess, A. W., & Clements, P. T. (2006a). Elder abuse: A call to action for forensic nurses. Journal of Forensic Nursing, 2,110-111.

Burgess, A., & Clements, P. (2006b). Information processing of sexual abuse in elders. Journal of Forensic Nursing, 2, 113-120.

Burgess, A.W., & Fawcett, J. (1996). The Comprehensive Sexual Assault Assessment Tool (CSAAT). Nurse Practitioner: American Journal of Primary Health Care, 21(4), 66, 71-72, 74-76, 78, 83, 86.

Burgess, A. W., Fawcett, J., Hazelwood, R. R., & Grant, C. A. (1995). Victim care services and the Comprehensive Sexual Assault Assessment Tool (CSAAT). In R. R. Hazelwood & A. W. Burgess (Eds.), Practical aspects of rape investigation: A multidisciplinary approach (2nd ed., pp. 263-281). Boca Raton, FL: CRC Press.

Burgess, A., & Hanrahan, N. (2004). Issues in elder sexual abuse in nursing homes. Nursing & Health Policy Review, 3, 5-17.

Burgess, A., Hanrahan, N., & Baker, T. (2005). Forensic markers in elder female sexual abuse cases. Clinics in Geriatric Medicine, 21, 399-412.

Burgess, A. W., & Phillips, S. L. (2006) Sexual abuse, trauma and dementia in the elderly: A retrospective study of 284 cases, Victims & Offenders, 1, 193-204.

Burgess, A., Ramsey-Klawsnik, H., & Gregorian, S. (2008). Comparing routes of reporting in elder sexual abuse cases. Journal of Elder Abuse & Neglect, 20, 336-352.

Cooper, G. M., & King, M. R. (2006). Interviewing the incarcerated offender convicted of sexually assaulting the elderly. Journal of Forensic Nursing, 2, 130-146.

Hanrahan, N., Burgess, A., & Gerolamo, A. (2005). Core data elements tracking elder sexual abuse. Clinics in Geriatric Medicine, 21, 413-427.

Kent-Wilkinson, A. E. (2010). Forensic psychiatric/mental health nursing: Responsive to social need. Issues in Mental Health Nursing, 31, 425-431

McDonald, L., Beaulieu, M., Harbison, J., Hirst, S., Lowenstein, A., Podnieks, E., & Wahl, J. (2012). Institutional abuse of older adults: What we know, what we need to know. Journal of Elder Abuse and Neglect, 24, 138–160.

McDonald, L., Sheppard, C., Hitzig, S. L., Spalter, T., Mathur, A., & Mukhi, J. S. (2015). Resident-to-resident abuse: A scoping review. Canadian Journal of Aging 34, 215–236.

Mora, J. (2008). PTSD — The application of forensic nursing. On the Edge, 14(1), 4.

Morgenbesser, L. I., Burgess, A. W., Boersma, R. R., & Myruski, E. (2006). Media surveillance of elder sexual abuse cases. Journal of Forensic Nursing, 2, 121-126.

Mukherjee, D. (2011). Organizational structures of elder abuse reporting systems. Administration in Social Work, 35, 517-531.

Murphy, S., Potter, S., Pierce-Weeks, J., Stapleton, J., & Wiesen-Martin, D. (2011). An examination of SANE data: Clinical considerations based on victim-assailant relationship. Journal of Forensic Nursing, 7, 137-144.

Probst, D. R., Turchik, J. A., Zimak, E. H., & Huckins, J. L. (2011). Assessment of sexual assault in clinical practice: Available screening tools for use with different adult populations. Journal of Aggression, Maltreatment and Trauma, 20, 199–226.
women and sexual violence: Recognising and supporting survivors. Journal of Adult Protection, 15, 301-316.

Speak, P. M., Kennedy, B. L., Henry, N. D., & Ernst, E. J. (2013). Analysis of possible sexual assault or abuse in a 67-year-old female with early dementia post-brain attack. Advanced Emergency Nursing Journal, 35, 217-239.

Sullivan-Wilson, J., & Jackson, K. L. (2010). Keeping older adults safe, protected, and healthy by preventing financial exploitation. Nursing Clinics of North America, 49, 201-212

Taylor, W. (1998). Sexual assault: Identification, treatment, and referral in the emergency department. Topics in Emergency Medicine, 20(4), 1-11.