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Operation Allies Refuge Foundation is conducting extensive research into the nature of moral injury and the most effective ways to treat it. This research involves studying the experiences of veterans who have suffered from moral injury and developing new and innovative treatment methods to help them heal.

What Is Moral Injury

Moral injury is the psychological distress that arises when actions or witnessed events contradict an individual's deeply held moral beliefs. It often leads to feelings of guilt, shame, anger, and a loss of trust in oneself, others, or institutions. While commonly associated with the military, moral injury can occur in various professions and situations where individuals face ethically challenging or ambiguous circumstances.

Distinct from post-traumatic stress disorder (PTSD), moral injury centers on the moral dimension of the event and the subsequent inner conflict or moral distress experienced by the individual. It can be triggered by engaging in or witnessing acts that violate one's moral principles or when external pressures hinder one from acting in accordance with their ethical values. Treatment approaches for moral injury typically involve psychotherapy, including cognitive-behavioral therapy (CBT), group therapy, and counseling. Addressing issues of meaning, purpose, and spirituality is also important in the healing process. Creating an environment that fosters moral resilience, ethical decision-making, and open dialogue about moral dilemmas is crucial for prevention and effective management of moral injury

82nd Airborne Paratrooper, 1st Brigade Combat Team, Devils in Baggy Pants, HKIA Afghanistan

Our Research

Our Research on moral injury involves qualitative studies to understand its causes, consequences, and interventions. Qualitative methods explore personal experiences through interviews and narratives, while quantitative research uses surveys and measures to quantify prevalence and identify risk factors. Longitudinal studies track moral injury over time. Military-focused research examines its unique aspects and implications for mental health. Ethical considerations ensure participant well-being. The research aims to develop effective strategies for prevention and treatment of moral injury.


Educating people on moral injury involves defining it, discussing causes and risk factors, highlighting signs and symptoms, explaining its impact on well-being, sharing coping strategies and support resources, and promoting prevention and resilience-building. This awareness helps individuals recognize, address, and prevent moral injury, fostering empathy and ethical engagement.


Veterans Crisis Line: Call 988 then press 1.
National Suicide Prevention Hotline. Dial 1-800-273-TALK (8255). When prompted, press '1' to be connected to a VA call center. This hotline also provides a confidential chat option for veterans on the Veterans Crisis Line website.
Domestic Violence National Hotline. Call 1-800-799-7233 or 1-800-787-3224. The National Domestic Violence Hotline is staffed 24 hours a day by trained counselors who can provide crisis assistance and other information. Resources can also be found on The National Domestic Violence Hotline website.
National Child Abuse Hotline. Call 1-800-422-4453. This hotline is dedicated to preventing child abuse and is staffed 24 hours a day by professional counselors. Additional resources are available on the Child Help website.
In non-emergency situations, other hotlines can help connect you and your family to resources. Here are a few options:

National Veterans Foundation. Call 1-888-777-4443 or visit the National Veterans Foundation website. The National Veterans Foundation's mission is to offer crisis management, information referrals and outreach for veterans in need.
Homelessness Hotline. If you are currently experiencing homelessness or are on the verge of homelessness, call the VA’s homelessness hotline at 1-877-424-3838.
SAMHSA National Helpline. The Substance Abuse and Mental Health Services Administration (SAMHSA) helpline offers free, confidential information on where to find mental health and substance abuse resources. You can also search for mental health treatment centers on the SAMHSA website.
It's Up to Us. Call (888) 724-7240 or visit their website. This San Diego-based organization offers an informational access line for veterans in need of mental health resources.
Free Clinics And Outreach
In addition to VA clinics, several other national programs provide free mental health counseling and outreach.

The Soldiers Project. This program helps soldiers and veterans by providing free, 100 percent confidential psychological treatment. So far, the program has locations in Chicago, Houston, Long Island, New York City, Sacramento, southern California, Pennsylvania, Washington state and Wyoming. Find local contact information on The Soldiers Project website.
Give An Hour. This organization connects you to a local mental health clinic for a free, in-person counseling session. Volunteer mental health professionals offer help with anxiety, depression, substance abuse, PTSD, grief and any other mental health concerns. Find a local mental health provider by searching Give An Hour's provider directory.
Homecoming For Veterans. The Homecoming For Veterans directory includes a list of clinicians who have agreed to see veterans for 20-minute sessions at no cost.

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