Abstract
Moral injury is a complex trauma related syndrome involving a correlation of biological, psychological, social, and spiritual symptoms that can have substantial impact upon health and well-being. This paper argues for a holistic bio-psycho-social-spiritual approach to moral injury, by including chaplaincy in the screening and treatment of moral injury among actively serving military members and retired veterans. As part of the moral injury treatment process, and in alignment with the World Health Organization's Spiritual Intervention Codings, a new technique is proposed, “Pastoral Narrative Disclosure” (PND), as a guide for chaplains and others trained in spiritual care to assist those suffering from moral injury.
Highlights
Over the centuries, chaplains have been educated, commissioned, and professionally engaged to provide religious and pastoral care to military members and veterans who have survived the traumatic effects of war
While there exists some excellent therapy techniques that could be used to model a moral injury intervention [e.g., Religiously Integrated Cognitive Behavior Therapy; RCBT [46]], similar to Litz et al’s Adaptive Disclosure Therapy” (ADT) [41], we have developed a “Pastoral Narrative Disclosure” (PND) intervention for use by chaplains
Some will attempt to exclude or minimize the role of chaplains or clergy down to occasional referrals or argue that the chaplaincy role can be accomplished by non-religious personnel or even replace the chaplain with an empty chair! Given the complexity of moral injury it is important for “medical, nursing and allied health personnel to work alongside chaplains to assist with moral injury rehabilitation
Summary
Chaplains have been educated, commissioned, and professionally engaged to provide religious and pastoral care to military members and veterans (hereafter “personnel”) who have survived the traumatic effects of war. The WHO-SPICs are useful for chaplains and other spiritual carers to formally notate their spiritual screening and treatment interventions used to assist the health and well-being of their clients. It is arguable that the naming of the WHO-SPICs and associated interventions were only possible given a common understanding and consensus definition of the term “spirituality”: “Spirituality is that aspect of humanity which refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness, to God, to self, to others, to nature, and to the significant or sacred” [(6), based on [7]]. While not all academics and health care practitioners agree with this definition, it has (or similar variations) become increasingly utilized across medical, nursing and allied health professions (including chaplaincy) by providing a common understanding internationally of what “spirituality” means
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