Initial steps in developing acceptance and commitment therapy for moral injury among combat veterans: Two pilot studies

Moral injury is an emerging construct often related to the aftermath of warzone transgressions that violate deeply held moral values. The post-moral injury fallout includes various longstanding, distressing, and impactful experiences ranging from depression to substance abuse to posttraumatic stress disorder and other problems in life functioning. Developing effective treatments is crucial in assisting those affected by moral injury. This article describes the early development of acceptance and commitment therapy (ACT) for moral injury with two samples of veterans using theoretical and “bottom-up” processes. Revisions were based on an iterative discussion process that included pre- and post-group briefings and recordings of sessions. Descriptive and qualitative data linked to the delivery of the intervention and ACT processes data are also presented.