New Moral Injury Treatment shows early successes for UK veterans

30 November 2023

Combat Stress and King’s College London have successfully developed and trialled a new psychological treatment for veterans affected by moral injury – distress resulting from events that violate one’s moral or ethical code.

This innovative treatment led to significant improvements for veterans in several areas including symptoms of depression and PTSD, as well as moral injury-related distress.

The treatment named Restore & Rebuild represents the first evidence of an effective specific treatment for moral injury in the UK. It allows participants to build a relationship with a therapist over 20 sessions delivered weekly. The sessions first focus on the participants’ life experiences, as well as psychoeducation on moral injury, and involve revisiting the original morally injurious event(s). Later sessions aim to reframe their negative beliefs. Participants are also encouraged to bring a close companion along to a treatment session.

Due to the success of this pilot study, Forces in Mind Trust has awarded a further £260,000 to fund the next phase: a randomised controlled trial to more robustly evaluate the Restore & Rebuild treatment.

Professor Dominic Murphy, Head of Research at Combat Stress, said:

“This study is one of the first of its kind to develop a new treatment for moral injury.  The results of our study are promising, and we hope to be in a position to roll out this new treatment to support more veterans in the near future.”

In a military environment, moral injury may include when service personnel have to make decisions that affect the survival of others; when medics are not able to care for all who were harmed; or engaging in (or witnessing without intervening to prevent) acts of disproportionate violence. However, moral injury is not exclusive to the military. Health workers and emergency services, for example, may also experience it.

People who suffer moral injuries are at increased risk of mental health conditions such as PTSD or depression. Routine PTSD treatments are less effective when someone is experiencing a moral injury.

For a brief explanation of Moral Injury and the R&R treatment, please watch this short video.