Suchergebnisse

Background: Moral injury (MI) involves distress over having transgressed or violated core moral boundaries, accompanied by feelings of guilt, shame, self-condemnation, loss of trust, loss of meaning, and spiritual struggles. MI is often found in Veterans and Active Duty Military personnel with posttraumatic stress disorder (PTSD). MI is widespread among those with PTSD symptoms, adversely affects mental health, and may increase risk of suicide; however, MI is often ignored and neglected by mental health professionals who focus their attention on PTSD only. Methods: A review of the literature between 1980 and 2018 conducted in 2018 is presented here to identify scales used to assess MI. Databases used in this review were PsychInfo, PubMed (Medline), and Google Scholar. Search terms were "moral injury," "measuring," "screening," "Veterans," and "Active Duty Military." Inclusion criteria were quantitative measurement of MI and health outcomes, Veteran or Active Duty Military status, and peer-review publication. Excluded were literature reviews, dissertations, book chapters, case reports, and qualitative studies. Results: Of the 730 studies identified, most did not meet eligibility criteria, leaving 118 full text articles that were reviewed, of which 42 did not meet eligibility criteria. Of the remaining 76 studies, 34 were duplicates leaving 42 studies, most published in 2013 or later. Of 22 studies that assessed MI, five used scales assessing multiple dimensions, and 17 assessed only one or two aspects (e.g., guilt, shame, or forgiveness). The remaining 20 studies used one of the scales reported in the first 22. Of the five scales assessing multiple dimensions of MI, two assess both morally injurious events and symptoms and the remaining three assess symptoms only. All studies were cross-sectional, except three that tested interventions. Conclusions: MI in the military setting is widespread and associated with PTSD symptom severity, anxiety, depression, and risk of suicide in current or former military personnel. ...

Australian legislation and policies over the last fifteen years have reinforced the rights of students with disabilities to be included in mainstream classrooms. To make this a reality, change has been necessary in a number of areas such as teacher knowledge, resource allocation, curriculum reform, and support services. This paper presents a profile of an inclusive secondary school teacher from the perspective of Australian educational leaders. A qualitative methodology was used in this study. Fifty leaders in inclusive education across Australia were interviewed. Shulman's (1986) model of teacher knowledge was used to analyse and report the data. The paper identifies the skills, knowledge and attributes deemed necessary for inclusion by the educational leaders.

A randomized clinical trial was conducted over a three year period to compare the effectiveness of religiously-integrated cognitive behavioural therapy (RCBT) with conventional CBT (CCBT) for the treatment of a major depressive disorder (MDD). A total of 132 participants with chronic medical illness and MDD were enrolled in the trial (CCBT=67, RCBT=65). Ten 50-minute treatment sessions were delivered by master's level certified counsellors over 12 weeks. All sessions were delivered remotely, largely over the telephone. In this review, we describe the findings from this trial, including the effects on depressive symptoms, positive emotions, and immune and endocrine markers in blood and urine. We also examine the effects of treatment based on genotype, in particular polymorphisms of the serotonin transporter, serotonin receptor, and monoamine oxidase genes. Lessons learned from conducting this trial are also discussed. Although not designed as a non-inferiority trial, the results suggest that RCBT is as effective as standard CBT in the treatment of major depression in this setting, especially among highly religious clients, and can be delivered by appropriately trained chaplains.

Background: Post-traumatic stress disorder (PTSD) is a debilitating disorder, and current treatments leave the majority of patients with unresolved symptoms. Moral injury (MI) may be one of the barriers that interfere with recovery from PTSD, particularly among current or former military service members. Objective: Given the psychological and spiritual aspects of MI, an intervention that addresses MI using spiritual resources in addition to psychological resources may be particularly effective in treating PTSD. To date, there are no existing empirically based individual treatments for PTSD and MI that make explicit use of a patient's spiritual resources, despite the evidence that spiritual beliefs/activities predict faster recovery from PTSD. Method: To address this gap, we adapted Cognitive Processing Therapy (CPT), an empirically validated treatment for PTSD, to integrate clients' spiritual beliefs, practices, values, and motivations. We call this treatment Spiritually Integrated CPT (SICPT). Results: This article describes this novel manualized therapeutic approach for treating MI in the setting of PTSD for spiritual/religious clients. We provide a description of SICPT and a brief summary of the 12 sessions. Then, we describe a case study in which the therapist helps a client use his spiritual resources to resolve MI and assist in the recovery from PTSD. Conclusion: SICPT may be a helpful way to reduce PTSD by targeting MI, addressing spiritual distress, and using a client's spiritual resources. In addition to the spiritual version (applicable for those of any religion and those who do not identify as religious), we have also developed 5 religion-specific manuals (Christianity, Judaism, Islam, Buddhism, and Hinduism) for clients who desire a more religion-specific approach. ; https://doi.org/10.1177/2164956118759939 ; http://www.ncbi.nlm.nih.gov/pmc/articles/pmc5824894/

Abstract
Despite a growing interest in the relationship between religion and spirituality (RS) and mental health across helping professions, less is known about clients' perceived relevance of these areas. This article describes the development and validation of the Relevance of Religion and Spirituality to Mental Health (RRSMH) scale, and responses to the first national survey of clients' perceived relevance of RS to mental health. Specifically, a sample of 989 U.S. adults who saw a mental health care provider in the last month responded to an online survey that included 27 new items to measure clients' perceptions of the relevance of RS to mental health, both positive and negative. A confirmatory factor analysis revealed that the sample's data had an adequate fit to the final 12-item model, and the instrument's overall reliability was very good (α = .96). Descriptive analyses indicated that clients view RS as both supportive and relevant to their mental health. The RRSMH scale may be used in mental health research and practice settings. Authors recommend that RS be assessed and included in treatment planning, where appropriate, and addressed in training for mental health professionals.