Traditional views of trauma often emphasize physical danger and threat, but not all trauma stems from these factors. Moral stressors—situations that violate one’s deeply held moral beliefs—sit alongside physical danger and are increasingly recognised as significant contributors to traumatic stress injuries. Research shows that moral injury (MI) is associated with more severe PTSD, greater functional and psychosocial impacts, and higher rates of suicide. However, traditional treatments for PTSD, which primarily focus on threat-based trauma, have proven less effective and potentially harmful when applied to those suffering from moral injury.

As moral injury becomes a central focus in the field of traumatic stress, it is crucial to address the divergent treatment needs associated with different types of trauma. This presentation introduces an integrative clinical model developed from 24 years working with military and emergency services personnel. It outlines a broader, more inclusive typology of traumatic stress injuries that emphasises the important role of emotions in helping clinicians accurately identify the specific and very personal nature of the injury. Case material will demonstrate how to adapt interventions to address specific emotional and psychological impacts of moral injury and other trauma, equipping participants with tools to identify and tailor treatments to improve outcomes for those they support.

Presentation Key Learnings:
1. A framework for understanding and treating multiple dimensions of service-related psychological injuries – useful for agency wellbeing teams, PSOs, chaplains and clinicians alike.

2. Mechanisms of and outcomes of injury: What does MI look like? What does MI feel like?

3. An integrative framework to help clinicians adapt existing treatment modalities to unique aspects of moral injury, including difficult to treat concerns like betrayal, injustice and embitterment.