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. 2020 Mar;76(3):377-391.
doi: 10.1002/jclp.22887. Epub 2019 Nov 12.

Veterans' perspectives on discussing moral injury in the context of evidence-based psychotherapies for PTSD and other VA treatment

Lauren M Borges  1   2 , Nazanin H Bahraini  1   2   3 , Brooke Dorsey Holliman  1   4 , Maura R Gissen  1 , W Cole Lawson  1 , Sean M Barnes  1   2
Affiliations

Veterans' perspectives on discussing moral injury in the context of evidence-based psychotherapies for PTSD and other VA treatment

Lauren M Borges et al. J Clin Psychol. 2020 Mar.

Abstract

Objective: We examined Veterans' perspectives on discussing moral injury in veterans affairs (VA) evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) and other VA treatment.

Methods: Fourteen male warzone veterans (ages 25-74) who completed an EBP for PTSD within the past year participated in semistructured interviews related to discussing moral injury in VA treatment (e.g., EBPs for PTSD, chaplaincy). Qualitative interviews were evaluated using a thematic analysis.

Results: Four themes were identified; moral injury is often not identified or discussed during therapy, therapeutic relationships can promote or inhibit discussion of moral injury, treatment has limited impact on moral injury, and it is difficult to cope with moral injury even after treatment.

Conclusion: The majority of Veterans interviewed identified moral injury persisting within a year of completing a PTSD EBP. These findings highlight the value of asking about, assessing, and treating moral injury in Veterans. Our results suggest the importance of developing specific moral injury interventions for warzone Veterans.

Keywords: mental health; moral injury; thematic analysis; trauma; veterans; warzone.

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References

REFERENCES

    1. Battles, A. R., Brave, A. J., Kelley, M. L., White, T. D., Braitman, A. L., & Hamrick, H. C. (2018). Moral injury and PTSD as mediators of the associations between morally injurious experiences and mental health and substance use. Traumatology, 24(4), 246-254.
    1. Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489-498. https://doi.org/10.1002/jts.22059
    1. Borges, L. M. (2019). A Service Member's experience of Acceptance and Commitment Therapy for Moral Injury (ACT-MI): “Learning to accept my pain and injury by reconnecting with my values and starting to live a meaningful life.”. Journal of Contextual Behavioral Science, 13, 134-140. https://doi.org/10.1016/j.jcbs.2019.08.002
    1. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.
    1. Bryan, C. J., Bryan, A. O., Roberge, E., Leifker, F. R., & Rozek, D. C. (2018). Moral injury, posttraumatic stress disorder, and suicidal behavior among National Guard personnel. Psychological Trauma: Theory, Research, Practice, and Policy, 10(1), 36-45.

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