Acceptance and forgiveness therapy for veterans with moral injury: spiritual and psychological collaboration in group treatment

J Health Care Chaplain. 2022;28(sup1):S57-S78. doi: 10.1080/08854726.2022.2032982. Epub 2022 Feb 8.

Abstract

The authors developed Acceptance and Forgiveness Therapy (AFT), a psychospiritual group intervention that guides veterans with moral injury experientially from a trauma-focused (damaged, broken, guilty, unforgivable, hopeless, unacceptable) to restorative (worthy, connected, hopeful, forgiven, responsible) view of self. A mental health (MH)-trained chaplain and MH provider, as co-leaders, provide psychoeducation, facilitate therapeutic interaction, and encourage home practice. The curriculum includes evidence-driven psychological interventions, spiritually oriented practices, and metaphor, story, and art to illustrate concepts and facilitate self-expression. Scores on the Brief Symptom Inventory-18 and Acceptance and Action Questionnaire-2 showed decreased distress and increased flexibility. Post-group drawings reflect renewed purpose, greater self-acceptance, and meaningful engagement with others. Retention rate across seven group administrations ranged from 50% to 100%. Outcomes suggest AFT is a promising practice for veteran moral injury meriting further study and implementation.

Keywords: Moral injury; chaplain; group; psychospiritual; veteran.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Clergy
  • Forgiveness*
  • Guilt
  • Humans
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Post-Traumatic* / therapy
  • Veterans* / psychology