Moral injury is a significant concern across contexts and has features beyond typical trauma, such as loss of meaning, guilt, and unforgiveness. This reveals the limits of purely event-based trauma models. This presentation introduces a new framework for understanding moral injury through the lens of spiritual health, offering practice-ready prevention and intervention strategies for managing it.
Drawing on Fisher’s (2011) domains of spirituality, we define spiritual health as “the quest for the authentic self in relationship with the transcendent, community, and environment.” Moral injury can be understood as a fracture in one or more domains: personal (self-condemnation; loss of integrity), communal (ruptured trust; alienation), environmental (moral bleakness; loss of stewardship), or transcendent (anger at God; loss of ultimate orientation). Growth across these domains fosters authenticity, belonging, stewardship, and orientation to meaning.
Because moral injuries manifest within the specific domains of spiritual health, interventions should be targeted to the relevant domain. We outline historically effective practices designed for psycho-spiritual values development that are adaptable across faith traditions, spiritualities, and secular worldviews. These practices are most effective when sequenced, repeated, embedded in an accountable community, matched to the individual’s psycho-spiritual developmental stage, and take their cognitive capacity into consideration.
This model integrates Fowler’s (1981) faith-development theory and Harris’s (2015) psycho-spiritual developmental approach, situating moral injury within broader processes of moral and spiritual growth. Crises of moral meaning coincide with “wall” experiences, developmental thresholds where earlier frameworks collapse and new, complex capacities for meaning-making are required. Linking these transitions to moral challenges allows interventions to move beyond symptom reduction toward functional improvement, cultivating resilient moral worldviews.
This practice-ready model will equip chaplains, clinicians, and leaders to foster moral resilience within their communities. It offers a structured yet flexible framework that acknowledges the moral and spiritual dimensions of injury while pointing to concrete pathways for recovery. Future research could include mapping domain-specific moral challenges and applying validated measures to test whether targeted spiritual health practices accelerate healing, reduce symptoms, and deepen moral maturity. Ultimately, our framework aims not only to repair injury but to cultivate more resilient, nuanced, and enduring moral worldviews.