N/A
N=74
Thriving in the Midst of Moral Pain: The Acceptability and Feasibility of Acceptance and Commitment Therapy for Moral Injury (ACT-MI) Among Warzone Veterans
Moral Injury
Bottom Line
View on ClinicalTrials.gov: NCT03760731 ↗Enrolled (actual)
74
Serious AEs
0.0%
Results posted
Dec 2025
Primary outcome: Primary: Client Satisfaction Questionnaire — 27; 22 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Acceptance and Commitment Therapy for Moral Injury (ACT-MI) (Behavioral); Present Centered Therapy for Moral Injury (PCT-MI) (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Oct 2024
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Client Satisfaction Questionnaire |
27; 22 | — |
| PRIMARY Narrative Evaluation of Intervention Interview |
29; 27 | — |
| PRIMARY Reasons for Termination (Client and Therapist Versions) |
10; 14 | — |
| SECONDARY Valued Living Questionnaire |
40.9; 41.55; 49.83; 42.63; 50.16; 42.01 | — |
| SECONDARY Outcome Questionnaire-45 (OQ-45) |
69.89; 69.78; 53.62; 63.30; 60.76; 66.92 | — |
| SECONDARY PROMIS Short Form v2.0-Satisfaction With Social Roles and Activities 8a |
21.53; 21.33; 27.14; 25.33; 24.92; 23.28 | — |
| SECONDARY PROMIS v2.0-Social Isolation |
14.14; 14.39; 12.24; 13.22; 13.40; 14.08 | — |
| SECONDARY Ecological Momentary Assessment |
9; 5 | — |
| SECONDARY Inventory of Psychosocial Functioning |
2.78; 2.77; 2.41; 2.57; 2.43; 2.74 | — |
Summary
The need for moral injury interventions is increasingly being recognized as a domain in Veteran care that must be addressed. Consequences of exposure to morally injurious events include risk for suicide, substance abuse, and refractory symptoms of PTSD and depression. Exposure to morally injurious events is also highly prevalent among Veterans. Thus, interventions addressing moral injury are crucial to helping Veterans build meaningful lives. Psychotherapies explicitly targeting moral injury and functional recovery associated with this construct are limited in VHA. The proposed study serves as a first step in addressing this gap in the literature through the development of a recovery-oriented, evidence-based treatment approach for moral injury among warzone Veterans who report functional impairments related to moral emotions. The proposed pilot study will evaluate the acceptability of this intervention and the feasibility of the design for a future study to test the treatment's capacity to improve patients' functioning.
Eligibility Criteria
Inclusion Criteria
- Eligible for VHA care
- Has been deployed to a warzone
- Has experienced a morally injurious event which continues to interfere with functioning
- Willing to be randomized and participate in either of the two conditions
Exclusion Criteria
- Inability to provide informed consent
- Inability to complete study measures, e.g.:
- due to significant acute intoxication/withdrawal symptoms
- mania
- psychosis
- aggression
- catatonia
- cognitive impairment
- Imminent suicide risk
- Membership in a vulnerable population, e.g.:
- pregnant women
- History of significant violence towards VA staff
- Participation in another psychotherapy research study
- Current participation in an EBP for a condition related to moral injury
Data sourced from ClinicalTrials.gov (NCT03760731). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.