"Moral injury is defined as the sort of harm that results when someone has perpetrated, failed to prevent, or witnessed acts that transgress deeply held moral beliefs. Social workers and other human services professionals are well versed in the ravages, symptoms, and treatment of the complicated forms of posttraumatic stress that accompany moral injury, and the issue has been gaining attention. The purpose of this book is to provide in-depth discussion of the concepts of moral injury, moral distress, and moral demoralization; common causes; the ways in which moral injury, moral distress, and moral demoralization are manifested; the causes of moral injury, moral distress, and moral demoralization; secondary trauma, including the ways in which moral injury, moral distress, and moral demoralization affect practitioners; ethical/moral dilemmas; prevention strategies; the role of advocacy and moral courage; and practitioner self-care and resilience. The book includes extensive case examples (clinical, administration, policy practice, advocacy) drawn from the author's experience in and consultation with practitioners employed in public welfare offices, mental health agencies (residential and nonresidential), child and family services programs (residential and nonresidential), substance use programs (residential and nonresidential), housing and homelessness programs, prisons, schools, hospitals, military settings, private/independent practice, immigration and refugee resettlement programs, nursing homes, HIV/AIDS programs, disabilities services programs, hospice programs, and parole/probation offices, among others"--

"Moral injury is defined as the sort of harm that results when someone has perpetrated, failed to prevent, or witnessed acts that transgress deeply held moral beliefs. Social workers and other human services professionals are well versed in the ravages, symptoms, and treatment of the complicated forms of posttraumatic stress that accompany moral injury, and the issue has been gaining attention. The purpose of this book is to provide in-depth discussion of the concepts of moral injury, moral distress, and moral demoralization; common causes; the ways in which moral injury, moral distress, and moral demoralization are manifested; the causes of moral injury, moral distress, and moral demoralization; secondary trauma, including the ways in which moral injury, moral distress, and moral demoralization affect practitioners; ethical/moral dilemmas; prevention strategies; the role of advocacy and moral courage; and practitioner self-care and resilience. The book includes extensive case examples (clinical, administration, policy practice, advocacy) drawn from the author's experience in and consultation with practitioners employed in public welfare offices, mental health agencies (residential and nonresidential), child and family services programs (residential and nonresidential), substance use programs (residential and nonresidential), housing and homelessness programs, prisons, schools, hospitals, military settings, private/independent practice, immigration and refugee resettlement programs, nursing homes, HIV/AIDS programs, disabilities services programs, hospice programs, and parole/probation offices, among others"--

Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.

Moral Injury and Beyond: Understanding Human Anguish and Healing Traumatic Wounds uniquely brings together a prominent collection of international contributors from the fields of psychiatry, psychology, philosophy, theology, military chaplaincy and acute crisis care to address the phenomenon of moral injury. Introduced in the 1990s to refer to a type of psychological trauma, experienced especially by soldiers who felt that their actions transgressed the expected moral norms, this innovative volume provides a timely update that progresses and redefines the field of moral injury. The ten ground-breaking essays expand our understanding of moral injury beyond its original military context, arguing that it can fruitfully be applied to and address predicaments most persons face in their daily lives. Approaching moral injury from different perspectives, the contributors focus on the experiences of combat veterans and other survivors of violent forms of adversity. The chapters address thought-provoking questions and topics, such as how survivors can regain their hope and faith, and how they can, in time, explore ways that will lead them to grow through their suffering. Exploring moral injury with a particular emphasis on spirituality, the early Church Fathers form the framework within which several chapters examine moral injury, articulating a new perspective on this important subject. The insights advanced are not limited to theoretical innovations but also include practical methods of dealing with the effects of moral injury. This pioneering collection will be essential resource for mental health practitioners and trainees working with people suffering from severe trauma. Due to its interdisciplinary nature, it will be useful not only to those academics and professionals engaged with moral injury but will be a source of inspiration for any perceptive student of the complexities and dilemmas of modern life, especially as it interfaces with issues of mental health and spirituality. It will also be invaluable to academics and students of Jungian psychology, theology, philosophy and history interested in war, migration and the impact of extreme forms of adversity.

The first book to explore the idea and effect of moral injury on veterans, their families, and their communities Although veterans make up only 7 percent of the U.S. population, they account for an alarming 20 percent of all suicides. And though treatment of post-traumatic stress disorder has undoubtedly alleviated suffering and allowed many service members returning from combat to transition to civilian life, the suicide rate for veterans under thirty has been increasing. Research by Veterans Administration health professionals and veterans’ own experiences now suggest an ancient but unaddressed wound of war may be a factor: moral injury. This deep-seated sense of transgression includes feelings of shame, grief, meaninglessness, and remorse from having violated core moral beliefs. Rita Nakashima Brock and Gabriella Lettini, who both grew up in families deeply affected by war, have been working closely with vets on what moral injury looks like, how vets cope with it, and what can be done to heal the damage inflicted on soldiers’ consciences. In Soul Repair, the authors tell the stories of four veterans of wars from Vietnam to our current conflicts in Iraq and Afghanistan—Camillo “Mac” Bica, Herman Keizer Jr., Pamela Lightsey, and Camilo Mejía—who reveal their experiences of moral injury from war and how they have learned to live with it. Brock and Lettini also explore its effect on families and communities, and the community processes that have gradually helped soldiers with their moral injuries. Soul Repair will help veterans, their families, members of their communities, and clergy understand the impact of war on the consciences of healthy people, support the recovery of moral conscience in society, and restore veterans to civilian life. When a society sends people off to war, it must accept responsibility for returning them home to peace.

Sexual assault is a traumatic event from which many survivors never fully recover. They may develop a range of disorders, including post-traumatic stress disorder, depression, poor self-esteem, interpersonal difficulties and sexual dysfunction. This volume provides insight into the effects of rape and explores a treatment approach that assists in the healing process.