By Brett T. Litz PhD, Leslie Lebowitz PhD, Matt J. Gray PhD, William P. Nash M.D.
Read Online or Download Adaptive Disclosure: A New Treatment for Military Trauma, Loss, and Moral Injury PDF
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Extra resources for Adaptive Disclosure: A New Treatment for Military Trauma, Loss, and Moral Injury
The relationship service members, veterans, and family members hold, after war zone deployments, with the once-cherished values and ideals that led them into and through their traumatic experiences in the first place may serve either as powerful risk or as protective factors: as either doorways or obstacles to meaning making, self-compassion, and acceptance. Adaptive disclosure respects the primacy, for warfighters and their kin, of warrior values and guiding ideals, and it holds the process of reconciling with them to be fundamental to treatments for war-related psychological injuries.
Military and Veteran Cultural Factors Operating Outside the Clinical Setting May Be Robust Predictors of Outcome To the extent service member and veteran patients participate in the military cultures within which they now or in the past lived and 34 ADAPTIVE DISCLOSURE worked, their psychological outcomes may be determined by these external sociocultural vectors, regardless of input by the therapist. In their review of the role of therapeutic relationships in treatment outcomes cited earlier, Lambert and Barley (2002) concluded that the largest contributor to outcome is not therapeutic technique (15% of variance) or even the patient–therapist relationship (30% of variance), but factors operating outside the therapy (40% of variance).
The goal is to promote new learning through corrective feedback about the appraised implications and to introduce actively the possibility of forgiveness, compassion, reparation and repair. The approach is designed to facilitate perspective taking and to shift beliefs from blameworthiness (which may be objectively true) to forgiveness and compassion (which are nonetheless possible), and in so doing to facilitate the potential for living a moral and virtuous life going forward. Homework exercises are essential to provide exposure to corrective information to reinforce this sense of goodness and to begin the process of repair by making amends.