Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
November 2024, Vol. 11(1), pp. 001-017
Copyright © 2024 Global Advanced Research Journals

 

Full Length Research Paper

Navigating Moral Injury and Trauma in US Army Soldiers: A Holistic Approach Incorporating Self-Care, CBT, Personal Strength, and Spiritual Resilience

Dr. Ojore Solomon Akwue¹, Dr. Michael A.D. Smith²*, Dr. Jennifer Marazzo³, and Ricardo A. Woolcock, PsyD(c), M.A.⁴

¹United States Army Chaplain Corp
²Adjunct Professor, Universidad Isabel I, European Business School of Barcelona, Spain
³Academy of Certified Brain Injury Specialists, Fairfax, VA
⁴ Office of the Chaplain Inc., Loma Linda, CA

*Corresponding Author E-mail: michael.smith@alumnos-eneb.es

Accepted 21 November, 2024 

Abstract

This study explores a holistic approach to addressing trauma and moral injury in US Army soldiers, integrating four key elements: self-care, cognitive-behavioral therapy (CBT), personal strength, and spiritual resilience.  Moral injury and trauma are essential experiences for military people at war that both challenge the individual's psychological and existential frameworks.  The proposed multifaceted approach aims to provide comprehensive support by addressing physical, emotional, cognitive, and spiritual aspects of well-being.  Self-care practices form the foundation for overall health, while CBT offers tools for restructuring maladaptive thought patterns.  Personal health is the basis of general well-being, and CBT is a set of skills that can change negative, distorted thinking patterns.  The personal strength approaches include Resilience and post-trauma growth, where soldiers are encouraged to acknowledge their strengths.  Spiritual resilience activities also build the subject's meaning and purpose for life to deal with moral dilemmas.  Thus, the outlined approach provides an opportunity to adjust the work with participants depending on their needs and consider patient-oriented goals, providing the possibilities for their recovery and personal development during a more extended period.  Aspects of this paper include analyzing activities and directions of these components, potential combined impacts of the components, and combined approaches of all the elements to adequately respond to multiple facets of well-being.  While further research is needed to confirm this approach fully, its comprehensive nature and alignment with evidence-based practices suggest significant potential for supporting US Army soldiers in overcoming the impacts of moral injury and trauma.

Keywords: Moral Injury and Trauma, US Army, CBT, Spiritual Resilience and Personal Strength.

References

Adler Amy B, Paul D Bliese, Dennis McGurk, Charles W Hoge, Carl Andrew Castro  (2011).  "Battlemind Debriefing and Battlemind Training as Early Interventions with Soldiers Returning from Iraq: Randomization by Platoon." Sport, Exercise, and Performance Psychology 1 (S): 66–83.  https://doi.org/10.1037/2157-3905.1.s.66.

Bandura Albert  (2015).  "Cultivate Self-Efficacy for Personal and Organizational Effectiveness." Handbook of Principles of Organizational Behavior, August, 179–200.  https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119206422.ch10.

Bartone Paul T (2005). "The Need for Positive Meaning in Military Operations: Reflections on Abu Ghraib." Military Psychol. 17 (4): 315–24.  https://doi.org/10.1207/s15327876mp1704_5.

Cusack Karen, Daniel E Jonas, Catherine A Forneris, Candi Wines, Jeffrey Sonis, Jennifer Cook Middleton, Cynthia Feltner, et al (2016).  "Psychological Treatments for Adults with Post-traumatic Stress Disorder: A Systematic Review and Meta-Analysis." Clin. Psychol. Rev. 43 (February): 128–41.  https://doi.org/10.1016/j.cpr.2015.10.003.

Farnsworth Jacob K, Kent D Drescher, Jason A Nieuwsma, Robyn B Walser, Joseph M Currier  (2014a). "The Role of Moral Emotions in Military Trauma: Implications for the Study and Treatment of Moral Injury." Rev. Gen. Psychol. 18 (4): 249–62.  https://doi.org/10.1037/gpr0000018.

Koenig, Harold G (2019). "Religion, Spirituality, and Health: The Research and Clinical Implications." ISRN Psy. 2012 (278730): 1–33. https://doi.org/10.5402/2012/278730.

Koenig HG, Al Zaben F (2021). Moral Injury: An Increasingly Recognized and Widespread Syndrome. J. rel. health. 60(5): 2989–3011. https://doi.org/10.1007/s10943-021-01328-0

Litz Brett T, Nathan Stein, Eileen Delaney, Leslie Lebowitz, William P Nash, Caroline Silva, Shira Maguen (2009).  "Moral Injury and Moral Repair in War Veterans: A Preliminary Model and Intervention Strategy." Clin. Psychol. Rev. 29 (8): 695–706.  https://doi.org/10.1016/j.cpr.2009.07.003.

Madden Robert G (1998). Legal issues in social work, counseling, and mental health: Guidelines for clinical practice in psychotherapy.  Sage.

Najavits, Lisa.  "The Promise and Perils of Empirically Supported Treatments."

Phelps Andrea J, Adler AB, Belanger SAH, Bennett C, Cramm H, Dell L, Fikretoglu D, et al. (2022).  "Addressing Moral Injury in the Military." BMJ Mil Health 170 (1).  https://doi.org/10.1136/bmjmilitary-2022-002128.

Resick Patricia, Candice Monson, Kathleen Chard  (2006).  "Cognitive Processing Therapy Veteran/Military Version." https://www.alrest.org/pdf/CPT_Manual_-_Modified_for_PRRP(2).pdf.

Rosenbaum Paul R (2020). Design of Observational Studies.  Springer Series in Statistics.  Cham: Springer International Publishing.  https://doi.org/10.1007/978-3-030-46405-9.

Sefidan S, Pramstaller M, La Marca R, Wyss T, Sadeghi-Bahmani D, Annen H, Brand S (2021). Resilience as a Protective Factor in Basic Military Training, a Longitudinal Study of the Swiss Armed Forces. Int. J. Environ. Res. and Public Health. 18(11): 6077. https://doi.org/10.3390/ijerph18116077

Stainton A, Chisholm K, Kaiser N, Rosen M, Upthegrove R, Ruhrmann S, Wood SJ (2019). Resilience as a multimodal dynamic process. Early Intervention in psychiatry, 13(4): 725–732. https://doi.org/10.1111/eip.12726

Steenkamp Maria M, Brett T Litz, Charles W Hoge, Charles R Marmar (2015). "Psychotherapy for Military-Related PTSD: A Review of Randomized Clinical Trials." JAMA 314 (5): 489–500. https://doi.org/10.1001/jama.2015.8370.

Tedeschi Richard G, Lawrence G Calhoun (2004).  "Post-traumatic Growth: Conceptual Foundations and Empirical Evidence." Psychol. Inquiry 15 (1): 1–18.

Tsai Jack, Ilan Harpaz-Rotem, Robert H Pietrzak, Steven M Southwick (2012). "The Role of Coping, Resilience, and Social Support in Mediating the Relation between PTSD and Social Functioning in Veterans Returning from Iraq and Afghanistan." Psychiatry: Interpersonal Biol. Proc. 75 (2): 135–49.  https://doi.org/10.1521/psyc.2012.75.2.135.

Umer Hajra, Sabah Aziz (2022).  "Trauma in the Movie Ordinary People (1980): An Investigation of Psychological Trauma and Recovery from a Traumatic Experience." Int. J. Linguistics and Culture 3 (2): 151–63.  https://doi.org/10.52700/ijlc.v3i2.118.

Weiss M, Lataya Hawkins, Jeffrey S Yarvis (2023).  "Moral Injury in Women Military Members and Veterans: What Do We Know?" J. Military, Veteran and Family Health 9 (4): 129–36.  https://doi.org/10.3138/jmvfh-2022-0075.

Weitzman Steven  (2021).  "Strategic Spirituality: Positive Psychology, the Army, and the Ambiguities of 'Spirituality Fitness.'" J. the Am. Acad. Religion 89 (1): 240–71.  https://doi.org/10.1093/jaarel/lfab010.

Wisco Blair E, Brian P Marx, Casey L May, Brenda Martini, John H Krystal, Steven M Southwick, Robert H Pietrzak  (2017).  "Moral Injury in US Combat Veterans: Results from the National Health and Resilience in Veterans Study." Depression and Anxiety 34 (4): 340–47.  https://doi.org/10.1002/da.22614.

Yehuda Rachel, Charles W Hoge, Alexander C McFarlane, Eric Vermetten, Ruth A Lanius, Caroline M Nievergelt, Stevan E Hobfoll, Karestan C Koenen, Thomas C Neylan, Steven E Hyman (2015).  "Post-Traumatic Stress Disorder." Nature Reviews Disease Primers 1 (15057): 15057.  https://doi.org/10.1038/nrdp.2015.57.

Zaleski Kristen L, Daniel K Johnson, Jessica T Klein (2016a). "Grounding Judith Herman's Trauma Theory within Interpersonal Neuroscience and Evidence-Based Practice Modalities for Trauma Treatment." Smith College Studies in Social Work 86 (4): 377–93.  https://doi.org/10.1080/00377317.2016.1222110..

 

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