Spiritual Wellness as a Predictor for Moral Injury in Combat Veterans

Spiritual Wellness as a Predictor for Moral Injury in Combat Veterans by Stephen Zappalla MA, Marymount University, 2010 MS, Command and General Staff College, 1993 BS, United States Military Academy, 1981 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Counselor Education and Supervision Walden University July 2018 Abstract Many combat veterans face difficulties coping with their personal lives, relationships, and families when they leave the service and return to civilian life. Most studies examining the effects of combat on veterans focus on posttraumatic stress disorder (PTSD) as well as a collection of related consequences. Interest in the term moral injury of military veterans as a related mental health construct has grown. Researchers have investigated the effects of spiritual wellness of combat veterans. However, there is a paucity of counseling literature on the relationship between spiritual wellness and moral injury when combat veterans return to civilian life. Investigating the relationship between spiritual wellness and moral injury as based in existential theory could offer insights to improve quality of life of veterans, families, and society. This study examined the connection between spiritual wellness and moral injury among combat veterans using a quantitative survey with a cross-sectional, correlational analysis and incorporating demographic variables. Results showed that the relationship of spiritual wellness on moral injury is statistically significant. Participants with low spiritual well-being were likely to have an elevated level of moral injury. Those with strong levels of life meaning and purpose were less likely to experience moral injury. These findings can be used to help combat veterans heal from the wounds of war. Clinical interventions associated with life meaning and purpose could enable successful reintegration of combat veterans into society. Results could be used to identify and test specific treatment options. Outcomes could also be used to explore the relationship of combat veterans to other professions subject to moral injury and further explore the relationship of moral injury to PTSD.Many combat veterans face difficulties coping with their personal lives, relationships, and families when they leave the service and return to civilian life. Most studies examining the effects of combat on veterans focus on posttraumatic stress disorder (PTSD) as well as a collection of related consequences. Interest in the term moral injury of military veterans as a related mental health construct has grown. Researchers have investigated the effects of spiritual wellness of combat veterans. However, there is a paucity of counseling literature on the relationship between spiritual wellness and moral injury when combat veterans return to civilian life. Investigating the relationship between spiritual wellness and moral injury as based in existential theory could offer insights to improve quality of life of veterans, families, and society. This study examined the connection between spiritual wellness and moral injury among combat veterans using a quantitative survey with a cross-sectional, correlational analysis and incorporating demographic variables. Results showed that the relationship of spiritual wellness on moral injury is statistically significant. Participants with low spiritual well-being were likely to have an elevated level of moral injury. Those with strong levels of life meaning and purpose were less likely to experience moral injury. These findings can be used to help combat veterans heal from the wounds of war. Clinical interventions associated with life meaning and purpose could enable successful reintegration of combat veterans into society. Results could be used to identify and test specific treatment options. Outcomes could also be used to explore the relationship of combat veterans to other professions subject to moral injury and further explore the relationship of moral injury to PTSD. Spiritual Wellness as a Predictor for Moral Injury in Combat Veterans by Stephen Zappalla MA, Marymount University, 2010 MS, Command and General Staff College, 1993 BS, United States Military Academy, 1981 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Counselor Education and Supervision Walden University July 2018 Dedication This research is dedicated to all veterans, families, and those in our society who suffer from the consequences of combat trauma and need help. May the merits of this investigation serve to benefit all people everywhere and offer insights, direction, and implications for current treatment and future study. I also dedicate this effort to all clinical mental health clinicians so that they can expand their own knowledge and skills needed to treat individuals healing from moral injury, post-traumatic stress and addictions. Acknowledgments I acknowledge my family and close friends for all their love and support through my own transition in this healing and education process. I wish to acknowledge my many close spiritual teachers that have given me the wisdom and courage to know what I can change and what I cannot. I am grateful that my dissertation committee was a role model of professional leadership. Most importantly, my committee practices what they teach. This allowed me to learn by seeing first-hand how to approach and cope with this effort and life with care, kindness, and compassion. They displayed the delicate balance of how to meet our own needs while considering those of others. Their patience, willingness, and dedication to help me grow was a true blessing in every respect. Dr. Haddock’s trust and support helped me build confidence in my abilities and improve as a professional in the counseling education and supervision field.