Moral injury (MI) is gaining traction within the Department of Veterans Affairs (VA) as an essential construct for understanding an important dimension of suffering experienced by U.S. combat-deployed Veterans. A VA chaplain and a psychologist at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia co-facilitate a 12-week Moral Injury Group (MIG) to provide education about MI, the collective responsibility for the consequences of warfare, and related topics. A Community Ceremony in the VA chapel, immediately following Week 10, brings together VA staff, family, and friends of MIG Veterans as well as the wider society. MIG Veterans define MI and deliver a personal testimony about their MI and its effects. As Veterans’ burdens are shared by a community made more conscious of the realities of warfare, Veterans and civilians reconcile and Veteran identity shifts from that of a disabled patient to that of an adaptive leader and “prophet.” Data on the MIG has thus far been collected for purposes of quality improvement and measurement-based care. We report outcomes, through a case study of a MIG Veteran who shows decreases in suicidality, religious struggles, and depression, along with increases in posttraumatic growth, self-compassion, and life functioning. We also discuss plans for future research and development.
Moral injury, an experience of betrayal or transgression of moral values, continues to receive attention because of its associations with psychiatric disorders, including posttraumatic stress disorder and suicidality. There is growing recognition that moral injury may require novel interventions that involve religious or spiritual paradigms. This pilot study presents feasibility data and exploratory outcomes for 40 veteran participants across seven cohorts who participated in a novel 12‐week moral injury group (MIG) over 35 months. The MIG was cofacilitated by a Veterans Affairs chaplain and psychologist and designed to reduce distress and improve functioning in individuals with histories of morally injurious experiences from military service. The intervention included a ceremony in which participants shared testimonies of their moral injury with the general public. Recruitment feasibility and retention were high, with participants completing an average of 9.45 (SD = 2.82) sessions of the 12‐week group, and 32 participants (80.0%) attending nine or more sessions and the community healing ceremony. Exploratory analyses revealed medium effect sizes, ω2 = 0.05–0.08, for reductions in depressive symptoms, improvements in psychological functioning, and self‐compassion after the intervention, with small effect sizes, ω2 = 0.03, in anticipated directions for personal growth and spiritual struggles. The results were not impacted by participant engagement in concurrent psychological treatments. Taken together, these findings support the feasibility of the MIG, the potential merit of an interdisciplinary approach to addressing moral injury, and justification for further research into the efficacy of this approach.
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