Narrative Therapy for Treatment Refractory Moral Injury Syndrome: A Case Study

Moral Injury Syndrome (MIS) is a constellation of psychological symptoms associated with challenges to an individual’s fundamental beliefs and values. It is associated with increased risk of suicide, but current evidence-based therapies do not meet the needs of all clients. This paper describes narrative moviola therapy, a new approach designed for clients who are not appropriate for, or do not derive benefit from, existing evidence-based treatments for moral injury syndrome. The therapy allows a client to integrate multiple moral contexts by telling a story as though filming a movie from several perspectives. Use of the intervention is demonstrated in a case study of a veteran who completed 8 sessions of therapy and attended a 3-month follow-up. In the study, robust effects were observed, supporting the need for further research in the feasibility and effectiveness of narrative moviola therapy.