https://aub.ie/MilitaryREACH-Cenkner2021

Cenkner, D. P., Yeomans, P. D., Antal, C. J., & Scott, J. C. (2021). A pilot study of a moral injury group intervention co-facilitated by a chaplain and psychologist. Journal of Traumatic Stress, 34(2), 367-374. https://doi.org/10.1002/jts.22642

Moral injury refers to experiencing betrayal by trusted others (e.g., military leadership) or a transgression of one’s own moral values. The Moral Injury Group (MIG) is a 12-week, 90-minute group intervention, led by a psychologist and Veterans Affairs chaplain, to address lasting moral injury that occurred during warfare. Using a sample of 40 Veteran men, this pilot study examined whether the MIG intervention was effective in improving Veterans’ depressive symptoms, psychological health, selfcompassion, posttraumatic growth, and religious/spiritual struggles over 35 months. Before the MIG intervention, the study collected Veterans’ PTSD diagnosis status and demographic information. Overall, participation in the MIG was associated with reductions in depressive symptoms and improvement in psychological health, self-compassion, and posttraumatic growth.

https://doi.org/10.1002/jts.22642

Mental health
Veterans

Army
Marine Corps
Air Force
Navy
Multiple branches

Veteran

Veteran
Military families
Other

Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)

Quantitative Study

Cenkner, David P., Yeomans, Peter D., Antal, Chris J., Scott, J. Cobb

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.

Wiley Online

Article
REACH Publication

Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, CPC
Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, PDY
Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, CJA
Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, JCS
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, JCS