By Brett T. Litz PhD, Leslie Lebowitz PhD, Matt J. Gray PhD, William P. Nash M.D.
Read Online or Download Adaptive Disclosure: A New Treatment for Military Trauma, Loss, and Moral Injury PDF
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Extra resources for Adaptive Disclosure: A New Treatment for Military Trauma, Loss, and Moral Injury
The following assumptions guide our approach to the treatment of moral injury: (1) Pain means hope. Anguish, guilt, and shame are signs of an intact conscience and self- and other-expectations about goodness, humanity, and justice; (2) goodness is reclaimable over the long haul; and (3) forgiveness (of self and others) and repair are possible regardless of the transgression. Summary In this chapter, we have reviewed the core conceptual underpinnings and foundational assumptions of adaptive disclosure and compared it to other treatments for PTSD.
Because we were charged with the task of developing a very brief intervention for active duty service members who might soon be deployed again, the initial variant of adaptive disclosure was a mere six sessions. The first session was designed to conduct a needs assessment, provide psychoeducation about the intervention, and identify a target event to process. The last session was devoted to summarizing insights and gains made, and promoting adaptive ways to move forward. Accordingly, the “active” portion of treatment was extraordinarily brief—four sessions devoted to processing of morally injurious or otherwise overwhelming combat experiences.
It should be noted that CPT also targets traumatic loss-related beliefs. The goal in CPT is to address/remove cognitive barriers that get in the way of an otherwise normal grief process, rather than target Introduction 13 the loss specifically as a separate injurious experience. In CPT, patients write an impact statement about what the loss means to them, focusing on meanings regarding safety, trust, power/control, esteem, and intimacy. They also write about how the death has affected their memory of the deceased.