Adaptive Disclosure A New Treatment for Military Trauma, Loss, and Moral Injury

A complete guide to an innovative, research-based brief treatment specifically developed for service members and veterans, this book combines clinical wisdom and in-depth knowledge of military culture. Adaptive disclosure is designed to help those struggling in the aftermath of traumatic war-zone experiences, including life threat, traumatic loss, and moral injury, the violation of closely held beliefs or codes. Detailed guidelines are provided for assessing clients and delivering individualized interventions that integrate emotion-focused experiential strategies with elements of cognitive-behavioral therapy (CBT). Reproducible handouts can be downloaded and printed in a convenient 8 1/2" x 11" size.

Brett T. Litz, PhD, is Professor in the Departments of Psychiatry and Psychology at Boston University and Director of the Mental Health Core of the Massachusetts Veterans Epidemiological Research and Information Center at the VA Boston Healthcare System. He is also Assessment Core Director of the STRONG STAR Consortium and the Consortium to Alleviate Posttraumatic Stress Disorder (PTSD). Dr. Litz focuses on evaluating the mental health outcomes associated with military deployments across the lifespan, with an emphasis on early intervention and treatments for combat and operational trauma, loss, and moral injury.

Leslie Lebowitz, PhD, is a clinical psychologist in private practice in Newton Center, Massachusetts. She consults extensively in forensic contexts and provides training in the area of trauma in both community and military settings. Dr. Lebowitz developed the psychological portion of the curriculum for training Air Force Sexual Assault Response Coordinators and continues to do biannual training for the Air Force. Her research focuses on the psychological meaning of trauma and the implications for treatment. Previous research examined the aftermath of sexual violence, and more recent work addresses traumatic loss and moral injury. She has published numerous articles in peer-reviewed journals.

Matt J. Gray, PhD, is Professor of Psychology at the University of Wyoming. His research focuses on treatment development for broad emotional and psychological impacts of combat, as well as prevention and treatment of sexual violence and intimate partner violence. Dr. Gray has published numerous articles in peer-reviewed journals. He has received the Extraordinary Merit in Research Award and the Outstanding Psychology Faculty Member Award on multiple occasions from the University of Wyoming.

William P. Nash, MD, a former Navy psychiatrist, is an independent consultant and researcher in military, veteran, and military family psychological health in the Washington, DC, area. Dr. Nash was forward-deployed to Iraq with Marines of the 1st Marine Division during the Second Battle of Fallujah. His current interests focus on the prevention, recognition, and treatment of combat and operational stress injuries, including moral injury. He is coeditor of Combat Stress Injuries: Theory, Research, and Management and founding chair of the Military Committee of the Group for Advancement of Psychiatry.

1. Introduction
2. Background and Evidence
3. Military Culture and Warrior Ethos
4. Guiding Principles of Adaptive Disclosure
5. Assessment, Case Conceptualization, and Treatment Planning
6. Beginning Adaptive Disclosure: Session 1
7. The Exposure Component: Active Treatment Sessions 2 to 7
8. Breakout Components for Loss and Moral Injury: Active Treatment Sessions 2 to 7
9. Ending Treatment and Planning for the Future
10. Using Adaptive Disclosure when Prior Complex Trauma is Present
Appendix 1. Diversity of Military Missions, Organizations, and Relationships
Appendix 2. The Meaning and Implication of Key Events
Appendix 3. Calming and Attention Focusing Techniques
References
Index