Moral Injury Treatments
Moral injury is not a diagnosable mental health disorder and may occur
from a ‘mixed’ event that causes both a challenging moral dilemma and a
life threat event (Williamson et al., 2021). Many veterans who
experience traumatic warzone events seek treatment via Veterans Health
Administration settings (i.e., Veterans Affairs Medical Centers, Vet
Centers) and receive evidence-based treatments for PTSD, such as
cognitive processing therapy (CPT) and prolonged exposure (PE). These
treatments often focus on the hyperarousal and intrusion symptoms of a
fear-based disorder (Held et al., 2018). However, investigators have
called for mind-body programs as events that cause moral distress may
require different treatment approaches (Cenkner et al., 2021; Kopacz et
al., 2016; Steenkamp et al., 2015; Walser & Wharton, 2021). In
addition, existing PTSD treatments might not be designed to attend to
moral injury developing from certain combat or non-combat experiences
including remote combat theatre (Kelley, Bravo et al., 2021), military
sexual assault (Hamrick et al., 2022; Maguen et al., 2022), or acts for
which no one is to blame (Fleming, 2021). Thus, moral injury might
extend beyond bioneurological effects (Starnino et al., 2020) into the
moral realm (Litz et al., 2009) in ways that treatments for PTSD may not
address the diverse trauma needs of veterans.