Implementing a Multi-Disciplinary, Evidence-Based Resilience Intervention for Moral Injury Syndrome: Systemic Barriers and Facilitators

• Published in: Behavioral sciences Vol. 14; no. 4; p. 281
• Main Authors: Harris, J Irene, Dunlap, Shawn, Xanthos, Danielle, Pyne, Jeffrey M, Hermes, Eric, Griffin, Brandon J, Kondrath, Susannah Robb, Kim, Se Yun, Golden, Kristin B, Cooney, Nathaniel J, Usset, Timothy J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.04.2024
• Subjects: Analysis; Clergy; Consolidated Framework for Implementation Research; Evidence-based medicine; Mental health; Mental health care; Moral injury; moral injury syndrome; Post traumatic stress disorder; Psychotherapy; Social networks; Social workers; spirituality; spiritually integrated care; Suicidal behavior; Suicide; Suicides & suicide attempts; Training; Veterans; United States > US; moral injury syndrome; veterans; Consolidated Framework for Implementation Research; dissemination; implementation; qualitative research; spirituality; spiritually integrated care; moral injury
• ISSN: 2076-328X; 2076-328X
• DOI: 10.3390/bs14040281

Moral injury syndrome (MIS) is a mental health (MH) problem that substantially affects resilience; the presence of MIS reduces responsiveness to psychotherapy and increases suicide risk. Evidence-based treatment for MIS is available; however, it often goes untreated. This project uses principles of the Consolidated Framework for Implementation Research (CFIR) to assess barriers and facilitators to the implementation of Building Spiritual Strength (BSS), a multi-disciplinary treatment for MIS. Interviews were conducted with chaplains and mental health providers who had completed BSS facilitator training at six sites in the VA. Data were analyzed using the Hamilton Rapid Turnaround method. Findings included multiple facilitators to the implementation of BSS, including its accessibility and appeal to VA chaplains; leadership by VA chaplains trained in the intervention; and effective collaboration between the chaplains and mental health providers. Barriers to the implementation of BSS included challenges in engaging mental health providers and incorporating them as group leaders, veterans' lack of familiarity with the group format of BSS, and the impact of the COVID-19 pandemic. Results highlight the need for increased trust and collaboration between VA chaplains and mental health providers in the implementation of BSS and treatment of MIS.