To facilitate a discussion about how to identify and assess for moral injury, let’s review the account below written by Ms. Tessa Poppe, who served in the Army National Guard as a Military Police Officer for seven years and was deployed to Afghanistan in 2010. It’s titled, When the Hardest Thing is Doing Nothing: Moral Injury Caused by Inaction in War and appeared in Foreign Policy on 12 June 2015. Through her narrative, Ms. Poppe paints a picture of a moral dilemma when she felt paralyzed about what to do while deployed and the inner turmoil associated with it.
Blog posts with the tag "Clinical Skills"
It is my pleasure to announce a brand new resource that is now available on our website: Cognitive Processing Therapy (CPT) Session Notes! Drs. Lefkowitz, Nofziger, and myself have been working hard for the better part of the last year to put together a series of brief videos that review the key agenda items and interventions for each session in the CPT protocol. We chose to use a platform that allowed us to present the material in a unique and engaging manner (spoiler alert: each video includes a cartoon version of yours truly).
While working with clients, it can be all too easy to give into the desire to avoid our own discomfort. We buy into our own emotional reasoning and rob our clients of the opportunity to discover their ability to be resilient. When we are staring suffering in the face, our clients need us to put aside our own fears. We cannot cater to the irrational thoughts and emotions that would have us take a “safer” and “more supportive” approach. We need to trust in our training and the principles that operate behind the drama. Our clients need us to help them to discover these principles in action so that they can begin to understand the way to recovery for themselves.
Over the last several years there has been an increased emphasis on providing evidence-based psychotherapies (EBPs) in military and Veteran healthcare environments to treat PTSD. The Institute of Medicine (2007) produced a report indicating that the DoD and VA lacked evidence to demonstrate the effectiveness of the treatments they are providing. The report was not suggesting the treatments themselves were not effective, but simply that both the VA and DoD did not have a system in place for measuring the effectiveness of the treatment in those environments. Further inquiry in a variety of studies indicated that only a small portion of individuals diagnosed with PTSD even received EBPs.
SrA Pruitt slumps in the chair in her primary care provider’s exam room. She’s frustrated she hasn’t slept much in the past five months since her promotion and just wants a magic bullet to help her fall asleep faster and stay asleep longer. She clearly did not expect her provider to ask her to see me; she crosses her arms and says bitterly “…but I’ve already tried all those things that are supposed to make my sleep better.”