ABSTRACT
This chapter examines the role that religious/spiritual (R/S) beliefs and practices play in recovery from moral injuries resulting from combat, other violent situations, or natural disasters, where there is a serious threat to life or witnessing of a traumatic, violent act to others. In particular, I review research that indicates religion to be a positive factor in the prevention of the adverse mental health effects of trauma and/or in improving the victim’s ability to cope with them. Also explored is the development of a new spiritually oriented version of cognitive processing therapy (SOCPT) designed to treat moral injury in the setting of traumatic stress. While standard CPT addresses some of the psychological aspects of moral injury (guilt and shame), it does not utilize the traumatized person’s R/S resources to help process those experiences, nor does it specifically address the spiritual struggles that occur following a traumatic event. I argue here that both psychological and spiritual aspects of moral injury are factors that lead to treatment resistance in post-traumatic stress disorder (PTSD). We are now exploring the prevalence of moral injury symptoms and their relationship to PTSD and comorbid psychological and physical disorders in military and veteran populations. These studies will provide the groundwork for an initial pilot randomized clinical trial to examine the efficacy of SOCPT vs. standard CPT in the treatment of moral injury (and its consequences, i.e., PTSD symptoms, depression, anxiety, substance abuse, chronic pain, and work disability).
