Murray Hannah, Ehlers Anke
Department of Experimental Psychology, University of Oxford, Oxford, UK and Oxford Health NHS Foundation Trust, Oxford, UK.
Cogn Behav Therap. 2021 Jan 13;14:e8. doi: 10.1017/S1754470X21000040. eCollection 2021.
Moral injury is the profound psychological distress that can arise following participating in, or witnessing, events that transgress an individual's morals and include harming, betraying, or failure to help others, or being subjected to such events, e.g. being betrayed by leaders. It has been primarily researched in the military, but it also found in other professionals such as healthcare workers coping with the COVID-19 pandemic and civilians following a wide range of traumas. In this article, we describe how to use cognitive therapy for post-traumatic stress disorder (CT-PTSD) to treat patients presenting with moral injury-related PTSD. We outline the key techniques involved in CT-PTSD and describe their application to treating patients with moral injury-related PTSD. A case study of a healthcare worker is presented to illustrate the treatment interventions.
(1)To recognise moral injury where it arises alongside PTSD.(2)To understand how Ehlers and Clark's cognitive model of PTSD can be applied to moral injury.(3)To be able to apply cognitive therapy for PTSD to patients with moral injury-related PTSD.
道德伤害是指个体参与或目睹违背自身道德的事件后可能产生的深刻心理困扰,这些事件包括伤害、背叛他人或未能帮助他人,或遭受此类事件,例如被领导者背叛。它主要在军事领域进行研究,但也在其他专业人员中发现,如应对新冠疫情的医护人员以及经历各种创伤后的平民。在本文中,我们描述了如何使用创伤后应激障碍认知疗法(CT-PTSD)来治疗患有与道德伤害相关的创伤后应激障碍的患者。我们概述了CT-PTSD所涉及的关键技术,并描述了它们在治疗与道德伤害相关创伤后应激障碍患者中的应用。本文还呈现了一名医护人员的案例研究,以说明治疗干预措施。
(1)识别与创伤后应激障碍同时出现的道德伤害。(2)理解埃勒斯和克拉克的创伤后应激障碍认知模型如何应用于道德伤害。(3)能够将创伤后应激障碍认知疗法应用于患有与道德伤害相关创伤后应激障碍的患者。