Moral Injury: Acceptance and Commitment Therapy Interventions for Trauma, Guilt, Shame, and Anger

Credit

Program Information

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Speaker

Wyatt R. Evans, PhD, ABPP Related seminars and products

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Wyatt R. Evans, PhD, ABPP, is a licensed and board-certified psychologist who specializes in moral injury theory, assessment, and interventions. He is a staff psychologist with the VA North Texas Health Care System and assistant professor at UT Southwestern Medical Center. Dr. Evans’ expertise in posttraumatic stress, resilience, and recovery comes from his training a work in military treatment facilities, veterans affairs hospitals, and PTSD research institutions. He is lead author of The Moral Injury Workbook and founded the Moral Injury Special Interest Group of the International Society for Traumatic Stress Studies (ISTSS). Dr. Evans has consulted with healthcare providers and administrators as well as organizations supporting emergency mangers and first responders to support the recognition, prevention, and treatment of moral injury.

Speaker Disclosures
Financial: Dr. Wyatt Evans maintains a private practice and has employment relationships with the United States Army Reserve, the University of Texas, the VA North Texas Health Care System, Central Texas College, Vanthcs, and UT Southwestern Medical Center. He receives royalties as a published author. Dr. Evans receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Wyatt Evans is a member of the American Board of Professional Psychology, the American Psychological Association, the Association for Behavioral and Cognitive Therapies, the Association for Contextual Behavioral Science, and the International Society for Traumatic Stress Studies. He is an examiner for the American Board of Behavioral and Cognitive Therapy. Dr. Evans is a reviewer for several peer review journals, for a complete list contact PESI, Inc.

Alternate Dates

Additional Info

Program Information

For live CE credit, you must watch the live webcast in its entirety at its scheduled time and complete the CE quiz and evaluation within one week. You will have access for 90 days after the program for review.

Please note: There will be a 70-minute lunch and two 15-minute breaks; one in the morning and one in the afternoon. Lunch and break times will be announced by the speaker and at their discretion. A more detailed schedule is available upon request.

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Objectives

1. Assess moral injury exposure and experiences.
2. Differentiate natural moral pain, functionally impairing moral injury, and PTSD.
3. Construct a moral injury-informed case conceptualization to inform selection of treatment interventions.
4. Utilize cognitive defusion techniques to shift clients’ relationship to their thoughts about morally injurious events.
5. Develop opportunities for clients to engage with moral values that were violated in the past.
6. Utilize mindfulness, compassion, and forgiveness strategies to reduce moral injury.

Outline

Pain is Inevitable, Suffering is Optional

• Identify morally injurious events, transgressions, and betrayals
• Typical aftermath of moral injury and where suffering arises
• How to help clients understand the social function of moral emotions
• Assessment strategies to recognize moral injury
• Distinguish PTSD, depression, anxiety, and more from moral injury
• Case example – complicated assessment of moral injury

Interventions to Target Beliefs Fueling Moral Injury

• Potential pitfalls of traditional cognitive interventions - why ACT fits
• How the relationship to moral pain can cause suffering
• Challenge beliefs with compassion and emphasis on common humanity
• Utilize openness to experience
• Position personal values as criteria of truth
• Cognitive defusion techniques to cultivate freedom from suffering
• How to understand the self in the context of moral injury
• Case example – working with “sticky” thoughts after moral injury

Behavioral Interventions for Guilt, Shame, Disgust, and Disillusionment

• Strategies to help clients establish presence and willingness
• Acceptance versus extinction - the role of exposure
• Values clarification – re-evaluation, realignment, and release
• Behavioral activation rooted in values
• Use of mindfulness to cultivate compassion and forgiveness of self
• How to overcome barriers to valued action
• Case example – working with unwillingness

Clinical Considerations

• Integrate ACT with trauma processing and other approaches
• How to speak hexaflex - framing psychological flexibility as a goal
• Troubleshooting when clients are stuck in moral pain
• Manage therapist avoidance and strong emotional reactions
• Ethics of values clarification
• Limitations of the research and potential risks

Target Audience

• Counselors
• Social Workers
• Psychologists
• Psychiatrists
• Marriage & Family Therapists
• Addiction Counselors
• Other Mental Health Professionals
• Physicians
• Physician Assistants
• Nurse Practitioners
• Nurses