Conclusions
Overall, MMMI appeared to be feasible and acceptable for addressing issues related to moral injury among veterans in our sample. Initial evidence based on changes in effect sizes from the small RCT indicated MMMI is a promising strategy for reducing moral injury symptoms and impaired functioning related to moral injury in veterans. Moral injury has been associated with a host of problems including depression, suicidality, substance misuse, interpersonal conflicts, and stress-related illness (Bravo et al., 2020; Dennis et al., 2017; Evans et al., 2018; Forkus et al., 2021; Kelley, Chae et al., 2021). Whole person approaches that target integrated primary prevention for service members (Cabrera, 2023) and improve global functioning among veterans (U.S. Department of Veterans Affairs, 2020) are now key to service members and veteran health. These findings warrant large-scale randomized trials and follow-up testing to determine whether MMMI can be used as a first-line treatment or complementary treatment for veterans with moral injury.