Using Prolonged Exposure and Cognitive Processing Therapy to Treat Veterans with Moral Injury-Based PTSD: Two Case Examples

Cognitive and Behavioral Practice
Philip HeldAlyson K Zalta

Abstract

Moral injury refers to acts of commission or omission that violate individuals' moral or ethical standards. Morally injurious events are often synonymous with psychological trauma, especially in combat situations; thus, morally injurious events are often implicated in the development of PTSD for military service members and veterans. Although Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have been well-established as effective treatments for veterans who are struggling with posttraumatic stress disorder (PTSD), it has been suggested that these two evidence-based therapies may not be sufficient for treating veterans whose PTSD resulted from morally injurious events. The purpose of this manuscript is to detail how the underlying theories of PE and CPT can account for moral-injury based PTSD and to describe two case examples of veterans with PTSD stemming from morally injurious events who were successfully treated with PE and CPT. The manuscript concludes with a summary of challenges that clinicians may face when treating veterans with PTSD resulting from moral injury using either PE or CPT.

Citations

Jan 29, 2019·Journal of Traumatic Stress·Brandon J GriffinShira Maguen
Apr 24, 2019·The Journal of Neuropsychiatry and Clinical Neurosciences·Haleigh A BarnesKatherine H Taber
Jul 19, 2019·Frontiers in Psychiatry·Harold G KoenigMichelle Pearce
Dec 29, 2020·Depression and Anxiety·Chantelle S LloydRuth A Lanius
Dec 30, 2020·Journal of Traumatic Stress·David P CenknerJ Cobb Scott
Apr 18, 2021·Journal of Religion and Health·Jeffrey M PyneBrandon Griffin
Jul 1, 2021·Cognitive Behaviour Therapist·Hannah Murray, Anke Ehlers
Jul 11, 2021·Journal of Religion and Health·Harold G Koenig, Faten Al Zaben
Sep 24, 2021·Journal of Religion and Health·Timothy J HodgsonHarold G Koenig

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