Narrative Therapy for Treatment-Refractory Moral Injury Syndrome: A Case Study

Abstract

Moral Injury Syndrome is a constellation of psychological symptoms associated with challenges to an individual’s fundamental beliefs and values. It is associated with suicide ideation and attempts and poor mental health outcomes, so it is an important target for treatment. This paper describes narrative moviola therapy, a new approach designed for clients who are not appropriate for, or do not derive benefit from, existing evidence-based treatments for moral injury syndrome. This therapy allows the client to integrate complex moral contexts by telling the story as though filming a movie from different perspectives. Use of the intervention is demonstrated in a case study of a veteran who completed 8 sessions of therapy and attended a 3-month follow-up. In this case, robust effects were observed, supporting the need for further research in the feasibility and effectiveness of narrative moviola therapy.