The impact of clinical social workers\u27 conceptualizations of moral injury on their treatment actions in work with veterans

This exploratory study was designed to determine how clinical social workers’ conceptualizations of Moral Injury impacted their treatment actions in work with veterans. Additionally, this study allowed insights into the clinical social workers’ education and practice on Moral Injury. Using semi-structured interviews with licensed clinical social workers who each held a Master of Social Work degree and held at least two years of experience working with veterans, this study gathered data from 7 participants. This study gathered data categorized under five major areas: demographics, conceptualizations and related data, sources of learning and frequency of contact, treatment actions, and perceived skill level and desired education. This study found that clinical social workers largely feel unconfident in their ability to define and treat moral injury, and thus have little defined treatment strategies. Further, clinical social workers identified the high frequency of their contact with morally injured veterans and their perception that moral injury increases the clinical severity of the client. Clinical social workers conceptualizations were largely divided between those who understood moral injury to be a separate concept from posttraumatic stress disorder (PTSD), and those who believed it described a particular presentation of PTSD. Therefore, this study suggests further research on the role of trauma in the definition of moral injury, and alternatively, examination of the link between moral emotions such as guilt and shame and hyper- and hypo-arousal states. Additionally, the development of educational and training opportunities on moral injury for clinical social workers is discussed toward more effective care for military veterans