Using Mindfulness to Manage Moral Injury in Veterans: Feasibility,
Satisfaction, and Initial Evidence of a Live Web-based Randomized
Controlled Trial
Abstract
Objective: The present study assessed initial evidence of
program feasibility, satisfaction, and pre-to post-intervention changes
in moral injury symptoms among recent-era veterans who participated in
Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based
7-week mindfulness-based program targeting moral injury among veterans.
Method: Of 56 recent-era veterans who met study criteria and
were randomized, 40 (71.4%) completed the pre- and post-intervention
survey and attended at least one treatment session. Of these 40, 21
completed MMMI and 19 completed an equally intensive educational support
(ES) control intervention. Among the analytic sample ( n = 40),
most participants identified as White (77.5%), were men (62.5%), and
reported a service-connected disability (82.5%). Results:
Participants attended on average 6.11 sessions. Program satisfaction was
moderately high across both conditions. Several significant condition x
time interactions were found, with those in the MMMI condition reporting
greater pre- to post-intervention decreases in moral injury (η2=.121),
impaired functioning due to moral injury (η2=.129), shame-related
experiences due to moral injury (η2=.105), and other-directed moral
injury (e.g., betrayal, difficulty forgiving others; η2=.129) as
compared to the ES condition. Conclusions: These preliminary
findings suggest MMMI appears feasible and acceptable and may be able to
reach veterans who may not seek traditional Veterans Affairs Medical
Center care or who prefer a web-based program. Given its promise for the
treatment of moral injury among veterans, MMMI warrants additional
large-scale clinical-trial testing.