Traditional views of trauma often emphasise physical danger and threat, but not all trauma stems from these factors. Moral stressors sit alongside physical danger and are increasingly recognised as significant contributors to psychological and traumatic stress injuries. Research shows that moral injury (MI) is associated with more severe PTSD, greater functional and psychosocial impacts, and higher rates of suicide. However, traditional treatments for PTSD, which primarily focus on threat-based trauma, have proven less effective and potentially harmful when applied to those suffering from moral injury.

As moral injury becomes a central focus in the field of traumatic stress, it is crucial to address the divergent treatment needs associated with different types of trauma. This presentation introduces an integrative clinical model developed from 25 years working with military and emergency services personnel. It outlines a broader, more inclusive typology of traumatic stress injuries, emphasising the central role of emotions in helping clinicians identify the specific, deeply personal nature of each injury. Case material will illustrate how to adapt interventions to the unique emotional and psychological impacts of moral injury and other traumas, providing participants with practical tools to tailor treatments and improve outcomes.

Presentation Key Learnings:
1. A framework for understanding and treating multiple dimensions of service-related psychological injuries – useful for agency wellbeing teams, PSOs, chaplains and clinicians alike.
2. Mechanisms of and outcomes of injury: What does MI look like? What does MI feel like?
3. An integrative framework to help clinicians adapt existing treatment modalities to unique aspects of moral injury, including difficult to treat concerns like betrayal, injustice and embitterment.