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While trauma perpetuated by traumatic loss or imminent threat to one’s life is familiar and salient to most psychotherapists, the pervasiveness & severity of trauma precipitated by "moral injury" experienced during and/or after a trauma is frequently underestimated and overlooked as a factor that can exacerbate and/or maintain PTSD.  Internationally recognized expert in PTSD, psychologist, researcher & author, Dr. Brett Litz, joins us for an interview around the Adaptive Disclosure (AD) psychotherapy protocol.  In this episode we cover:  

• the nuances involved with conceptualizing and treating operational stress injuries among military personnel, including a review of the biggest misconceptions that clinicians unfamiliar with this population might harbour and how this could impact treatment
• the definition of a moral injury and an overview of the two major types of moral injury (i.e., moral injury "self" & moral injury "other")
• consideration of the "moral" emotions of shame & anger in the context of moral injury
• challenges of treating moral injury as well as subtle or overt signs that a client might be affected by a moral injury
• the origin of Adaptive Disclosure (AD) and where it departs from other CBT-based trauma therapies such as Prolonged Exposure Therapy or Cognitive Processing Therapy
• the basic theoretical framework/some of the core assumptions of Adaptive Disclosure
• descriptions of some of the core therapeutic interventions in Adaptive Disclosure
• the unique challenges of delivering any psychotherapy - including Adaptive Disclosure - within the context of a military population (e.g., over control, overregulation)  
• a brief outline of the next iteration of Adaptive Disclosure - Adaptive Disclosure Enhanced (ADE), which emphasizes to an even great extent increased flexibility in provision of therapy, an emphasis on functioning (as opposed to symptoms) and integration of compassion training

Dr. Litz is a clinical psychologist and Professor in the Departments of Psychiatry and Psychological and Brain Sciences and is also the Director of the Mental Health Core of the Massachusetts Veterans Epidemiological Research and Information Center at the VA Boston Healthcare System. Dr. Litz is internationally recognized as an expert on PTSD, military trauma, and the early intervention and treatment of trauma, traumatic loss, and moral injury.  Dr. Litz recent work entails the development and validation of a new measure of moral injury as a multidimensional outcome (the Moral Injury Outcome Scale; a public domain scale available by emailing Dr. Litz) and conducting a VA funded multi site clinical trial testing an expanded version of Adaptive Disclosure on Veterans with PTSD. Adaptive Disclosure is a flexible multidimensional psychotherapy that employs different strategies to target threat-based, loss-related, and moral injury-related trauma. Dr. Litz has over 370 peer reviewed publications and is a fellow of the Association of Behavioral and Cognitive Therapies, the American Psychopathological Association, and the Association for Psychological Science.

https://www.bu.edu/psych/people/litzb/

http://www.guilford.com/books/Adaptive-Disclosure/Litz-Lebowitz-Gray-Nash/9781462523290