Editorial : Emerging treatments and approaches for moral injury and moral distress

Current evidence-based therapies to treat trauma-affected populations, especially military members and first responders, have had variable success. Treatment response may be impeded by a lack of clinical attention to moral aspects of psychotrauma. Despite abundant evidence clouded in personal experiences (1), persistent cognitions of shame and negative beliefs long remained a diagnostically unacknowledged phenomenon (2–4). Recent discourse around moral injury (MI) and moral distress (MD), however, has stimulated further consideration of these clinical observations (5). MI/MD refer to the psychosocial-spiritual harm associated with committing, failing to prevent, observing, or learning about an event that violates one's morals and values (6, 7). Such real or perceived transgressions or betrayals by self or others may cause harm to a person's wellbeing. MD/MI can have devastating impacts on the lives of many, leading to persistent guilt, social withdrawal and self-destructive behavior. While a better understanding of these constructs is needed, it is also important to advance the exploration of interventions that address the impacts of MI/MD on the human condition.