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Adaptive Disclosure: Theoretical Foundations, Evidence, and Future Directions

  • Moral Injury (JI Harris, Section Editor)
  • Published:
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Abstract

Purpose of Review

Modern evidence-based practice (EBP) primarily consists of the blanket application of treatment packages to purportedly treat behavioral health syndromes regardless of patient characteristics or context, which may be why current EBPs for posttraumatic stress disorder (PTSD) are less effective for treating veterans and military service members (SMs) than for civilians. Adaptive Disclosure is designed to operate within the culture and ethos of the military, and developments since the publication of the original manual reflect further effort to meet the needs of this population. This review presents to providers the rationale and evidence for the original AD manual, as well as an overview of the more recent developments and directions of the literature.

Recent Findings

The original AD manual has demonstrated efficacy in two clinical trials and noninferiority when compared to another EBP for PTSD. Additional treatment elements and enhancements are based on a rehabilitative model for treatment, primarily targeting functional outcomes over symptom reduction and promoting shared decision-making.

Summary

AD and its recent enhancements target symptoms related to PTSD, moral injury, and traumatic loss, but more importantly, they target the functional concerns of veterans and SMs within the military cultural context. Current research is focused on maximizing treatment flexibility to provide clinicians and patients with an adaptable and evidence-based framework for treatment.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, 150 South Huntington, Ave, Boston, MA, 02130, USA

    Benjamin C. Darnell Ph.D., Maya Bina N. Vannini B.S., Breanna Grunthal B.A., Natasha Benfer Ph.D. & Brett T. Litz Ph.D.

  2. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA

    Brett T. Litz Ph.D.

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Darnell, B.C., Vannini, M.B.N., Grunthal, B. et al. Adaptive Disclosure: Theoretical Foundations, Evidence, and Future Directions. Curr Treat Options Psych 9, 85–100 (2022). https://doi.org/10.1007/s40501-022-00264-4

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