Adaptive Disclosure: An Open Trial of a Novel Exposure-Based Intervention for Service Members With Combat-Related Psychological Stress Injuries

A review of PTSD and shame in military veterans

“…Shamerelated PTSD is believed to have a distinct pathological process and therefore requires specific interventions (Lanius, Bluhm, Lanius, & Pain, 2006). Studies in this literature review noted that current approaches are inadequate for addressing moral injury and shame (Baskin & Enright, 2004;Drescher et al, 2011;Gray et al, 2012;Rector, Bagby, Segal, Joffe, & Levitt, 2000;Vargas et al, 2013). Studies have found that eliciting memory related to trauma can inadvertently increase shame and lead to poorer outcomes (Robinaugh & McNally, 2010;Van Vliet, 10 C. GAUDET ET AL.…”

Psychotherapy for military-related posttraumatic stress disorder: Review of the evidence

“…AD builds on established techniques such as imaginal exposure and cognitive restructuring, but also includes strategies, such as empty chair techniques, to address traumatic loss and moral conflicts (e.g., due to killing), two issues that have historically received less attention in established PTSD treatments (Steenkamp et al, 2011). In a recent open trial, Marines (N= 44) received six 90-minute weekly sessions of AD while in garrison (Gray et al, 2012). The intervention promoted reductions in self-reported PTSD and depression symptoms from preto post-treatment.…”

Chaplaincy and Mental Health in the Department of Veterans Affairs and Department of Defense

“…Much recent attention has been devoted to the construct of "moral injury"-that is, the idea that war can present profound moral and ethical challenges that can have corresponding deleterious spiritual and psychosocial consequences (Drescher et al, 2011;Gray et al, 2012;Litz et al, 2009). In research examining Veterans with PTSD, more severe PTSD has been found among those who harbor combat guilt (Henning & Frueh, 1997) and those who have difficulty with forgiveness (Witvliet, Phipps, Feldman, & Beckham, 2004).…”