Collaborative spiritual care for moral injury in the veterans Affairs Healthcare System (VA): Results from a national survey of VA chaplains

Abstract

The psychospiritual nature of moral injury invites consideration regarding how chaplains understand the construct and provide care. To identify how chaplains in the VA Healthcare System conceptualize moral injury, we conducted an anonymous online survey (N = 361; 45% response rate). Chaplains responded to a battery of items and provided free-text definitions of moral injury that generally aligned with key elements in the existing literature, though with different emphases. Over 90% of chaplain respondents indicated that they encounter moral injury in their chaplaincy care, and a similar proportion agreed that chaplains and mental health professionals should collaborate in providing care for moral injury. Over one-third of chaplain respondents reported offering or planning to offer a moral injury group. Separately, nearly one-quarter indicated present or planned collaboration with mental health to provide groups that in some manner address moral injury. Previous training in evidence-based and collaborative care approaches appears to contribute to the likelihood of providing integrated psychosocial-spiritual care. Results and future directions are discussed, including a description of moral injury that may be helpful to understand present areas of emphasis in VA chaplains’ care for moral injury.

Keywords:

• Chaplain
• collaborative care
• moral injury
• veteran

Acknowledgments

The authors thank Chaplain Keith Ethridge, MDiv, BCC, ACPE Certified Educator, former director of VA National Chaplain Center, for his support of this work.

Disclosure statement

The views expressed in this manuscript are those of the authors and do not reflect the position or policy of the Department of Veterans Affairs, United States government, or other organizations with which authors are affiliated.

Additional information

Funding

Integrative Mental Health is administratively supported by the VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC). This work was supported by the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) [CIN 13-410] at the Durham VA Health Care System.