Understanding clinicians' perspectives of treating moral injury

Abstract

Posttraumatic Stress Disorder (PTSD) has been widely researched and evidenced based treatment protocols have been developed to address the symptoms of the disorder (Shalev, Liberzon, & Marmar, 2017). This diagnosis covers four clusters of symptoms including intrusion, avoidance, negative cognitions/mood, and hyper arousal/reactivity. Recent research suggests that the diagnostic criteria for PTSD including the key symptoms, and the treatment protocols do not fully cover the emotional and existential impact of experienced events (Maguen & Litz, 2014). In 2009, Litz et al. published an article examining the concept of moral injury. This term described the arduous emotional experiences of individuals who witness or were involved in an event which deeply transgressed their personal feelings or beliefs of what is right, moral, or just. There is limited research of this presenting problem being effectively treated with existing evidenced based protocols for PTSD. Thus, the need to understand what clinicians have found to be effective when treating this is imperative for recovery of these individuals. In this phenomenological qualitative study, clinicians who identified as having experience working with the concept of moral injury will be interviewed. The interview questions will be grounded in existentialism and inquire what the clinician’s unique lived experience is, as well as their experience of what is effective when treating veteran clients presenting with moral injury. An additional focus group will be conducted to gain deeper insight and allow group members to clarify initial themes. Utilizing Giorgi’s (2009) method of analysis, themes and units of meaning will be pulled out to develop an understanding of what is effective for alleviating the symptoms associated with the issue. Findings from this study may be useful in helping to develop an evidenced based treatment protocol for clinical use.