Like a Blanket Over a Fire: Group Work and Spiritual Repair in Military Trauma

Starnino, Vincent R.; Sullivan, William P.; Angel, Clyde T.; Davis, Louanne W.

doi:10.1177/1044389419862081

Cited by 6 publications

(5 citation statements)

References 60 publications

(91 reference statements)

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“…The fact that patients reported mixed success in their search for moral and spiritual healing invites realism about SERT dynamics in treatment for trauma and ongoing questions about factors that might account for differential outcomes. Interviews with patients following the group intervention also revealed the important role of relational dynamics between group leaders and patients, many of whom had suffered betrayals by authority figures in the military (Starnino et al, 2020). This project also offered the relatively unique clinical practice of therapist and chaplain collaboration, which some patients described as helpful to their treatment.…”

Section: Synthetic Review Of the Practice-based Evidencementioning

confidence: 99%

Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions.

Captari¹,

Sandage²,

Vandiver³

2022

Psychotherapy

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A comprehensive review of the practice-based evidence for spiritually integrated psychotherapy (SIP) is necessary in order to catalyze research and training in this important diversity area. In this article, we identify and synthesize key findings from 35 studies in six key areas: (a) SIPs in trauma treatment, (b) SIPs in treating eating disorders, (c) SIPs in general psychotherapy, (d) existential concerns as part of SIPs, (e) patients and therapist attitudes about SIPs, and (f) SIP supervision and training models. Building on this, we propose a culturally contextual understanding of this diversity area, drawing from the Relational Spirituality Model (RSM). Finally, we discuss best practices for spiritually responsive clinical care and offer a research prospectus to strengthen the evidence base for real-world effectiveness. Clinical Impact Statement Question:In what ways are clients' spirituality, religion, theology, and/or existential concerns relevant in real-world mental health treatment? Findings: Clients' spiritual and religious context have important implications for their symptom alleviation and well-being, and may intersect with other areas of their identity. Meaning: Therapists should consider spirituality as an important diversity area that may be a source of strength or struggle for clients. Next Steps: Ongoing research is needed to understand the nuances of how clients' spirituality is best integrated into psychotherapy with different populations.

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Section: Synthetic Review Of the Practice-based Evidencementioning

confidence: 99%

Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions.

Captari¹,

Sandage²,

Vandiver³

2022

Psychotherapy

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“…A preliminary evaluation of 24 US veterans completing the Search for Meaning Program at the VA Medical Center found significant improvements in PTSD symptoms, spiritual injury and negative religious coping (Starnino et al, 2019 ). A qualitative study involving interviews with 18 US veterans following completion of the Search for Meaning Program reported that the veterans found the intervention to be helpful but not sufficient to enable them to make meaning from their PMIE (Starnino et al, 2019 , 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Moral Injury, Chaplaincy and Mental Health Provider Approaches to Treatment: A Scoping Review

et al. 2022

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The aim of this research was to describe the evidence examining the approaches taken by mental health providers (MHPs) and chaplains to address symptoms related to moral injury (MI) or exposure to potentially morally injurious events (PMIEs). This research also considers the implications for a holistic approach to address symptoms related to MI that combines mental health and chaplaincy work. A scoping review of literature was conducted using Medline, PsycINFO, Embase, Central Register of Controlled Trials, Proquest, Philosphers Index, CINAHL, SocINDEX, Academic Search Complete, Web of Science and Scopus databases using search terms related to MI and chaplaincy approaches or psychological approaches to MI. The search identified 35 eligible studies: 26 quantitative studies and nine qualitative studies. Most quantitative studies (n = 33) were conducted in military samples. The studies examined interventions delivered by chaplains (n = 5), MHPs (n = 23) and combined approaches (n = 7). Most studies used symptoms of post-traumatic stress disorder (PTSD) and/or depression as primary outcomes. Various approaches to addressing MI have been reported in the literature, including MHP, chaplaincy and combined approaches, however, there is currently limited evidence to support the effectiveness of any approach. There is a need for high quality empirical studies assessing the effectiveness of interventions designed to address MI-related symptoms. Outcome measures should include the breadth of psychosocial and spiritual impacts of MI if we are to establish the benefits of MHP and chaplaincy approaches and the potential incremental value of combining both approaches into a holistic model of care.

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“…In addition, existing PTSD treatments might not be designed to attend to moral injury developing from certain combat or non-combat experiences including remote combat theatre , military sexual assault (Hamrick et al, 2022;Maguen et al, 2022), or acts for which no one is to blame (Fleming, 2021). Thus, moral injury might extend beyond bioneurological effects (Starnino et al, 2020) into the moral realm (Litz et al, 2009) in ways that treatments for PTSD may not address the diverse trauma needs of veterans.…”

Section: Moral Injury Treatmentsmentioning

confidence: 99%

Using Mindfulness to Manage Moral Injury in Veterans: Feasibility, Satisfaction, and Initial Evidence of a Live Web-based Randomized Controlled Trial

Kelley,

Bravo,

Burgin

et al. 2024

Preprint

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Objective: The present study assessed initial evidence of program feasibility, satisfaction, and pre-to post-intervention changes in moral injury symptoms among recent-era veterans who participated in Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based 7-week mindfulness-based program targeting moral injury among veterans. Method: Of 56 recent-era veterans who met study criteria and were randomized, 40 (71.4%) completed the pre- and post-intervention survey and attended at least one treatment session. Of these 40, 21 completed MMMI and 19 completed an equally intensive educational support (ES) control intervention. Among the analytic sample ( n = 40), most participants identified as White (77.5%), were men (62.5%), and reported a service-connected disability (82.5%). Results: Participants attended on average 6.11 sessions. Program satisfaction was moderately high across both conditions. Several significant condition x time interactions were found, with those in the MMMI condition reporting greater pre- to post-intervention decreases in moral injury (η2=.121), impaired functioning due to moral injury (η2=.129), shame-related experiences due to moral injury (η2=.105), and other-directed moral injury (e.g., betrayal, difficulty forgiving others; η2=.129) as compared to the ES condition. Conclusions: These preliminary findings suggest MMMI appears feasible and acceptable and may be able to reach veterans who may not seek traditional Veterans Affairs Medical Center care or who prefer a web-based program. Given its promise for the treatment of moral injury among veterans, MMMI warrants additional large-scale clinical-trial testing.

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Like a Blanket Over a Fire: Group Work and Spiritual Repair in Military Trauma

Cited by 6 publications

References 60 publications

Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions.

Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions.

Moral Injury, Chaplaincy and Mental Health Provider Approaches to Treatment: A Scoping Review

Using Mindfulness to Manage Moral Injury in Veterans: Feasibility, Satisfaction, and Initial Evidence of a Live Web-based Randomized Controlled Trial

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