Using Mindfulness to Manage Moral Injury in Veterans: Feasibility and Satisfaction of a Pilot Randomized Controlled Trial.

Abstract

Objective: The present study assessed program feasibility and satisfaction 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: In total, 56 post-9/11 veterans were recruited with 28 randomized to the MMMI condition and 28 to the Education and Support (ES) condition. Most participants identified as being White (71.4%), male (66.1%), and had a reported mean age of 41.50 years (Median = 39.50, SD = 9.26).

Results: Among the 56 participants, 82.1% attended at least one treatment session and 44.6% completed all seven sessions. There were no significant differences in the average number of sessions attended between the MMMI (M = 4.79, SD = 2.70) and the ES (M = 4.68, SD = 2.84) conditions, t(54) = 0.145, p = 0.87. Regarding randomization, there were no statistically significant differences on almost all demographic (i.e., years in military, gender, ethnicity) characteristics and baseline scores on all outcomes across treatment conditions, thus ensuring randomization was adequately met. Of the 56 who consented, 41 (73.21%) completed most study components (i.e., completed baseline and follow-up surveys, at least 1 weekly survey, and attended at least one treatment session). Regarding treatment satisfaction, individuals in the MMMI condition reported higher treatment satisfaction (Cohen's d = 0.66).

Conclusions: Preliminary findings suggest MMMI is 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.