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Treatment of Moral Injury in U.S. Veterans with PTSD Using a Structured Chaplain Intervention


Moral injury is a complex phenomenon characterized by spiritual, psychological, and moral distress caused by actions or acts of omission inconsistent with an individual’s moral and ethical values. We present two cases from an ongoing randomized controlled trial of a spiritually integrated structured intervention delivered by chaplains for individuals suffering from moral injury. Chaplains met with Veterans for twelve 50-min sessions that each focused on a specific domain of moral injury. Participants were asked to complete validated scales assessing symptoms of moral injury and PTSD, including the PTSD Checklist for DSM-5 (PCL-5), Moral Injury Symptom Scale-Military Version Short Form, and Moral Injury Symptom Scale-Military Version Long Form. We report on two Veterans who completed the intervention and demonstrated significant improvement in moral injury and PTSD symptoms.

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This study was funded through Greater Los Angeles VA Research and Education Foundation through a generous donation by Harold G. Koenig, M.D.

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Correspondence to Donna Ames.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

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The authors affirm that human research participants provided informed consent for treatment and research involvement. This research project was double-blinded, and participation in this study was approved by the VA Internal Review Board. Each subject was aware that they were involved in research and signed written informed consent forms as well as a HIPAA release form. All subjects signed an additional release consenting to publish.

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Ames, D., Erickson, Z., Geise, C. et al. Treatment of Moral Injury in U.S. Veterans with PTSD Using a Structured Chaplain Intervention. J Relig Health 60, 3052–3060 (2021).

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  • Moral injury
  • PTSD
  • Religion
  • Spirituality
  • Intervention
  • Veterans