Acceptance and commitment therapy for moral injury (ACT-MI) and present-centered therapy for moral injury (PCT-MI): Results from a randomized controlled pilot trial with war zone deployed veterans.
Lauren M Borges, Jacob K Farnsworth, Robyn D Walser, Kent D Drescher, Jeri E Forster, Lisa A Brenner, Jacob P S Johnson, Christin N Miller, Gabriel E Aharoni, Craig S Rosen, Jason A Nieuwsma, Joseph M Currier, Sean M Barnes
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引用次数: 0
Abstract
Acceptance and commitment therapy for moral injury (ACT-MI) and present-centered therapy for moral injury (PCT-MI) were developed and piloted through the study. ACT-MI was created to improve psychosocial functioning among veterans experiencing moral injury. PCT-MI was developed as a transdiagnostic process-based moral injury intervention and an active comparison condition for a future ACT-MI efficacy trial. A randomized controlled pilot trial was conducted where 74 war zone-deployed veterans were randomized to ACT-MI or PCT-MI. Aims were to test the acceptability of ACT-MI and PCT-MI, evaluate study design feasibility, and determine candidate outcomes and sample size for a future efficacy trial. ACT-MI and PCT-MI are 15-session psychotherapies, including group (12 sessions) and individual case conceptualization (three sessions) sessions. ACT-MI was acceptable to veterans as evidenced by Client Satisfaction Questionnaire (CSQ) scores (M = 29.52, SD = 3.73, 95% CI [28.10, 30.94]). In qualitative interviews, ACT-MI was described as impacting psychosocial functioning and providing alternatives to suicidal behavior and substance use. PCT-MI was also acceptable to veterans (CSQ M = 26.41, SD = 5.07; 95% CI [24.40, 28.40]). Veterans reported PCT-MI contributed to social connection, understanding moral injury symptoms, and present moment problem solving. The study design was feasible to implement. The Outcome Questionnaire-45 was the candidate psychosocial functioning measure most sensitive to change (ACT-MI: N = 29, M = -17.45, SD = 19.33, 95% CI [-24.80, -10.10]; PCT-MI: N = 27, M = -5.89, SD = 15.29, 95% CI [-11.94, 0.16]). Next steps are described, including a full-scale efficacy trial to evaluate the impacts of the interventions on psychosocial functioning. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
期刊介绍：
Psychotherapy Theory, Research, Practice, Training publishes a wide variety of articles relevant to the field of psychotherapy. The journal strives to foster interactions among individuals involved with training, practice theory, and research since all areas are essential to psychotherapy. This journal is an invaluable resource for practicing clinical and counseling psychologists, social workers, and mental health professionals.
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