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Erschienen in: Journal of Religion and Health 6/2018

09.08.2018 | Original Paper

A Qualitative Examination of VA Chaplains’ Understandings and Interventions Related to Moral Injury in Military Veterans

verfasst von: Kent D. Drescher, Joseph M. Currier, Jason A. Nieuwsma, Wesley McCormick, Timothy D. Carroll, Brook M. Sims, Christine Cauterucio

Erschienen in: Journal of Religion and Health | Ausgabe 6/2018

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Abstract

This study examines VA chaplains’ understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains’ definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains’ intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.
Literatur
Zurück zum Zitat Acosta, J. D., Becker, A., Cerully, J. L., Fisher, M. P., Martin, L. T., Vardavas, R., et al. (2014). Mental health stigma in the military. Santa Monica, CA: RAND Corporation.CrossRef Acosta, J. D., Becker, A., Cerully, J. L., Fisher, M. P., Martin, L. T., Vardavas, R., et al. (2014). Mental health stigma in the military. Santa Monica, CA: RAND Corporation.CrossRef
Zurück zum Zitat Bonner, L., Lanto, A., Bolkan, C., Watson, G., Campbell, D., Chaney, E., et al. (2013). Help-seeking from clergy and spiritual counselors among veterans with depression and PTSD in primary care. Journal of Religion and Health, 52(3), 707–718.CrossRefPubMed Bonner, L., Lanto, A., Bolkan, C., Watson, G., Campbell, D., Chaney, E., et al. (2013). Help-seeking from clergy and spiritual counselors among veterans with depression and PTSD in primary care. Journal of Religion and Health, 52(3), 707–718.CrossRefPubMed
Zurück zum Zitat Bryan, A. O., Theriault, J. L., & Bryan, C. J. (2015). Self-forgiveness, posttraumatic stress, and suicide attempts among military personnel and veterans. Traumatology, 21(1), 40–46.CrossRef Bryan, A. O., Theriault, J. L., & Bryan, C. J. (2015). Self-forgiveness, posttraumatic stress, and suicide attempts among military personnel and veterans. Traumatology, 21(1), 40–46.CrossRef
Zurück zum Zitat Bulling, D. B., DeKraai, M., Abdel-Monem, T., Nieuwsma, J. A., Cantrell, W. C., Ethridge, K., et al. (2014). Confidentiality and mental health/chaplaincy collaboration. Military Psychology, 25, 557–567.CrossRef Bulling, D. B., DeKraai, M., Abdel-Monem, T., Nieuwsma, J. A., Cantrell, W. C., Ethridge, K., et al. (2014). Confidentiality and mental health/chaplaincy collaboration. Military Psychology, 25, 557–567.CrossRef
Zurück zum Zitat Carey, L. B., Hodgson, T. J., Krikheli, L., Soh, R. Y., Armour, A.-R., Singh, T. K., et al. (2016). Moral injury, spiritual care and the role of Chaplains: An exploratory scoping review of literature and resources. Journal of Religion and Health, 55(4), 1–28. https://doi.org/10.1007/s10943-016-0231-x.CrossRef Carey, L. B., Hodgson, T. J., Krikheli, L., Soh, R. Y., Armour, A.-R., Singh, T. K., et al. (2016). Moral injury, spiritual care and the role of Chaplains: An exploratory scoping review of literature and resources. Journal of Religion and Health, 55(4), 1–28. https://​doi.​org/​10.​1007/​s10943-016-0231-x.CrossRef
Zurück zum Zitat Creswell, J. W. (1998). Qualitative inquiry & research design. Thousand Oaks, CA: SAGE Publications. Creswell, J. W. (1998). Qualitative inquiry & research design. Thousand Oaks, CA: SAGE Publications.
Zurück zum Zitat Currier, J. M., Drescher, K., & Harris, J. I. (2014a). Spiritual functioning among veterans seeking residential treatment for PTSD: A matched control group study. Spirituality in Clinical Practice, 1(1), 3–15.CrossRef Currier, J. M., Drescher, K., & Harris, J. I. (2014a). Spiritual functioning among veterans seeking residential treatment for PTSD: A matched control group study. Spirituality in Clinical Practice, 1(1), 3–15.CrossRef
Zurück zum Zitat Currier, J. M., Holland, J. M., Drescher, K., & Foy, D. (2015a). Initial psychometric evaluation of the moral injury questionnaire—military version. Clinical Psychology & Psychotherapy, 22(1), 54–63.CrossRef Currier, J. M., Holland, J. M., Drescher, K., & Foy, D. (2015a). Initial psychometric evaluation of the moral injury questionnaire—military version. Clinical Psychology & Psychotherapy, 22(1), 54–63.CrossRef
Zurück zum Zitat Currier, J. M., Holland, J. M., Jones, H. W., & Sheu, S. (2014b). Involvement in abusive violence among Vietnam veterans: Direct and indirect associations with substance abuse problems and suicidality. Psychological Trauma: Theory, Research, Practice, and Policy, 6(1), 73–82. https://doi.org/10.1037/a0032973.CrossRef Currier, J. M., Holland, J. M., Jones, H. W., & Sheu, S. (2014b). Involvement in abusive violence among Vietnam veterans: Direct and indirect associations with substance abuse problems and suicidality. Psychological Trauma: Theory, Research, Practice, and Policy, 6(1), 73–82. https://​doi.​org/​10.​1037/​a0032973.CrossRef
Zurück zum Zitat Currier, J. M., Holland, J. M., & Malott, J. (2015b). Moral injury, meaning, and mental health in returning veterans. Journal of Clinical Psychology, 71(3), 229–240.CrossRefPubMed Currier, J. M., Holland, J. M., & Malott, J. (2015b). Moral injury, meaning, and mental health in returning veterans. Journal of Clinical Psychology, 71(3), 229–240.CrossRefPubMed
Zurück zum Zitat Drescher, K. D., Foy, D. W. (2008). When they come home: Posttraumatic stress, moral injury, and spiritual consequences for veterans. Reflective Practice: Formation and Supervision in Ministry, 28, 85–102. Drescher, K. D., Foy, D. W. (2008). When they come home: Posttraumatic stress, moral injury, and spiritual consequences for veterans. Reflective Practice: Formation and Supervision in Ministry, 28, 85–102.
Zurück zum Zitat Farnsworth, J. K., Drescher, K. D., Nieuwsma, J. A., Walser, R. B., & Currier, J. M. (2014). The role of moral emotions in military trauma: Implications for the study and treatment of moral injury. Review of General Psychology, 18(4), 249–262.CrossRef Farnsworth, J. K., Drescher, K. D., Nieuwsma, J. A., Walser, R. B., & Currier, J. M. (2014). The role of moral emotions in military trauma: Implications for the study and treatment of moral injury. Review of General Psychology, 18(4), 249–262.CrossRef
Zurück zum Zitat Fontana, A., & Rosenheck, R. (2004). Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD. Journal of Nervous and Mental Disease, 192(9), 579–584.CrossRefPubMed Fontana, A., & Rosenheck, R. (2004). Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD. Journal of Nervous and Mental Disease, 192(9), 579–584.CrossRefPubMed
Zurück zum Zitat Fontana, A., & Rosenheck, R. (2005). The role of loss of meaning in the pursuit of treatment for posttraumatic stress disorder. Journal of Traumatic Stress, 18(2), 133–136.CrossRefPubMed Fontana, A., & Rosenheck, R. (2005). The role of loss of meaning in the pursuit of treatment for posttraumatic stress disorder. Journal of Traumatic Stress, 18(2), 133–136.CrossRefPubMed
Zurück zum Zitat Koenig, H. G., Boucher, N. A., Oliver, J. P., Youssef, N., Mooney, S. R., Currier, J. M., et al. (2017). Rationale for spiritually-oriented cognitive processing therapy in active duty military and veterans with post-traumatic stress disorder. Journal of Nervous & Mental Disease, 205(2), 147–153. https://doi.org/10.1097/NMD.0000000000000554.CrossRef Koenig, H. G., Boucher, N. A., Oliver, J. P., Youssef, N., Mooney, S. R., Currier, J. M., et al. (2017). Rationale for spiritually-oriented cognitive processing therapy in active duty military and veterans with post-traumatic stress disorder. Journal of Nervous & Mental Disease, 205(2), 147–153. https://​doi.​org/​10.​1097/​NMD.​0000000000000554​.CrossRef
Zurück zum Zitat Maguen, S., & Burkman, K. (2013). Combat-related killing: Expanding evidence-based treatments for PTSD. Cognitive and Behavioral Practice, 20(4), 476–479.CrossRef Maguen, S., & Burkman, K. (2013). Combat-related killing: Expanding evidence-based treatments for PTSD. Cognitive and Behavioral Practice, 20(4), 476–479.CrossRef
Zurück zum Zitat Nieuwsma, J. A., Jackson, G. L., DeKraai, M. B., Bulling, D. J., Cantrell, W. C., Rhodes, J. E., et al. (2014b). Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services. Journal of General Internal Medicine, 29(S4), S885–S894. https://doi.org/10.1007/s11606-014-3032-5.CrossRef Nieuwsma, J. A., Jackson, G. L., DeKraai, M. B., Bulling, D. J., Cantrell, W. C., Rhodes, J. E., et al. (2014b). Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services. Journal of General Internal Medicine, 29(S4), S885–S894. https://​doi.​org/​10.​1007/​s11606-014-3032-5.CrossRef
Zurück zum Zitat Nieuwsma, J. A., King, H. A., Cantrell, W. C., Jackson, G. L., Bates, M. J., Rhodes, J. E., et al. (2015a). Improving patient-centered care via integration of chaplains with mental health care: Department of Veterans Affairs (VA)/Department of Defense (DoD) Joint Incentive Fund project final report. Durham, NC: Department of Veterans Affairs Mental Health and Chaplaincy Program. Nieuwsma, J. A., King, H. A., Cantrell, W. C., Jackson, G. L., Bates, M. J., Rhodes, J. E., et al. (2015a). Improving patient-centered care via integration of chaplains with mental health care: Department of Veterans Affairs (VA)/Department of Defense (DoD) Joint Incentive Fund project final report. Durham, NC: Department of Veterans Affairs Mental Health and Chaplaincy Program.
Zurück zum Zitat Nieuwsma, J. A., Rhodes, J. E., Jackson, G. L., Cantrell, W. C., Lane, M. E., Bates, M. J., et al. (2013). Chaplaincy and mental health in the Department of Veterans Affairs and Department of Defense. Journal of Health Care Chaplaincy, 19(1), 3–21.CrossRefPubMed Nieuwsma, J. A., Rhodes, J. E., Jackson, G. L., Cantrell, W. C., Lane, M. E., Bates, M. J., et al. (2013). Chaplaincy and mental health in the Department of Veterans Affairs and Department of Defense. Journal of Health Care Chaplaincy, 19(1), 3–21.CrossRefPubMed
Zurück zum Zitat Nieuwsma, J. A., Walser, R. D., Farnsworth, J. K., Drescher, K. D., Meador, K. G., & Nash, W. (2015b). Possibilities within acceptance and commitment therapy for approaching moral injury. Current Psychiatry Reviews, 11(3), 193–206.CrossRef Nieuwsma, J. A., Walser, R. D., Farnsworth, J. K., Drescher, K. D., Meador, K. G., & Nash, W. (2015b). Possibilities within acceptance and commitment therapy for approaching moral injury. Current Psychiatry Reviews, 11(3), 193–206.CrossRef
Zurück zum Zitat Pargament, K. I. (2013). Searching for the sacred: Toward a nonreductionistic theory of spirituality. In K. I. Pargament (Ed.), APA handbook of psychology, religion, and spirituality: Vol. 1. Context, theory, and research (pp. 257–273). Washington, DC: American Psychological Association.CrossRef Pargament, K. I. (2013). Searching for the sacred: Toward a nonreductionistic theory of spirituality. In K. I. Pargament (Ed.), APA handbook of psychology, religion, and spirituality: Vol. 1. Context, theory, and research (pp. 257–273). Washington, DC: American Psychological Association.CrossRef
Zurück zum Zitat Sayer, N., Noorbaloochi, S., Frazier, P., Carlson, K., Gravely, A., & Murdoch, M. (2010). Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care. Psychiatric Services, 61(6), 589–597.CrossRefPubMed Sayer, N., Noorbaloochi, S., Frazier, P., Carlson, K., Gravely, A., & Murdoch, M. (2010). Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care. Psychiatric Services, 61(6), 589–597.CrossRefPubMed
Zurück zum Zitat Shafranske, E. P., & Cummings, J. P. (2013). Religious and spiritual beliefs, affiliations, and practices of psychologists. In K. I. Pargament, A. Mahoney, & E. Shafranske (Eds.), APA handbook of psychology, religion, and spirituality (Vol. 2). Washington, DC: American Psychological Association. Shafranske, E. P., & Cummings, J. P. (2013). Religious and spiritual beliefs, affiliations, and practices of psychologists. In K. I. Pargament, A. Mahoney, & E. Shafranske (Eds.), APA handbook of psychology, religion, and spirituality (Vol. 2). Washington, DC: American Psychological Association.
Zurück zum Zitat Shay, J. (1995). Achilles in Vietnam: Combat trauma and the undoing of character. New York, NY: Simon & Schuster. Shay, J. (1995). Achilles in Vietnam: Combat trauma and the undoing of character. New York, NY: Simon & Schuster.
Zurück zum Zitat Witvliet, C. V. O., Phillips, K. A., Feldman, M. E., & Beckham, J. C. (2004). Posttraumatic mental and physical health correlates of forgiveness and religious coping in military veterans. Journal of Traumatic Stress, 17(3), 269–273.CrossRefPubMed Witvliet, C. V. O., Phillips, K. A., Feldman, M. E., & Beckham, J. C. (2004). Posttraumatic mental and physical health correlates of forgiveness and religious coping in military veterans. Journal of Traumatic Stress, 17(3), 269–273.CrossRefPubMed
Metadaten
Titel
A Qualitative Examination of VA Chaplains’ Understandings and Interventions Related to Moral Injury in Military Veterans
verfasst von
Kent D. Drescher
Joseph M. Currier
Jason A. Nieuwsma
Wesley McCormick
Timothy D. Carroll
Brook M. Sims
Christine Cauterucio
Publikationsdatum
09.08.2018
Verlag
Springer US
Erschienen in
Journal of Religion and Health / Ausgabe 6/2018
Print ISSN: 0022-4197
Elektronische ISSN: 1573-6571
DOI
https://doi.org/10.1007/s10943-018-0682-3

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