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The Moral Injury Workbook: Acceptance and Commitment Therapy Skills for Moving Beyond Shame, Anger, and Trauma to Reclaim Your Values
A lifeline for healthcare workers in the midst of moral pain during the COVID-19 crisis
On the front line of the COVID-19 response are thousands of healthcare providers working in strained systems with limited resources. Difficult decisions will be part of the experience of working under these circumstances. The moral dilemmas that providers may face in this crisis will undoubtedly lead to moral distress and emotional pain.
Providers may have to make decisions about life and death, determining who gets life-saving equipment and attention and who does not. Working long and stressful hours may lead to accidental mistakes, oversights, or inaction. Providers working in overburdened or under-resourced systems may experience a sense of being thwarted in their effort to keep their oath and live their values. For providers who hold values such as service, caring, or protection, these potentially morally injurious events may have lasting consequences. Anger, guilt, and shame may plague those suffering from these seemingly impossible situations. If providers become mired in this moral pain, they may find their personal and professional lives become increasingly burdened by moral injury.
The Moral Injury Workbook was developed to facilitate healing for people who have experienced a variety of moral violations and addresses a wide range of moral emotions—from guilt and shame to contempt and anger. It offers a step-by-step program to help readers move beyond their moral pain, reconnect with a fuller sense of self, and re-engage with deeply held values.
This workbook is a lifeline for healthcare providers in the midst of moral pain. Oriented toward and guided by values of caring and compassion, the content of this workbook may be meaningfully applied to and engaged in the personal and professional practices of all who read it. The six core processes of acceptance and commitment therapy (ACT) are broadly addressed in the workbook to apply to a range of moral injuries. They may be used in service of the healing needed by those suffering in the presence and aftermath of this pandemic.
On the front line of the COVID-19 response are thousands of healthcare providers working in strained systems with limited resources. Difficult decisions will be part of the experience of working under these circumstances. The moral dilemmas that providers may face in this crisis will undoubtedly lead to moral distress and emotional pain.
Providers may have to make decisions about life and death, determining who gets life-saving equipment and attention and who does not. Working long and stressful hours may lead to accidental mistakes, oversights, or inaction. Providers working in overburdened or under-resourced systems may experience a sense of being thwarted in their effort to keep their oath and live their values. For providers who hold values such as service, caring, or protection, these potentially morally injurious events may have lasting consequences. Anger, guilt, and shame may plague those suffering from these seemingly impossible situations. If providers become mired in this moral pain, they may find their personal and professional lives become increasingly burdened by moral injury.
The Moral Injury Workbook was developed to facilitate healing for people who have experienced a variety of moral violations and addresses a wide range of moral emotions—from guilt and shame to contempt and anger. It offers a step-by-step program to help readers move beyond their moral pain, reconnect with a fuller sense of self, and re-engage with deeply held values.
This workbook is a lifeline for healthcare providers in the midst of moral pain. Oriented toward and guided by values of caring and compassion, the content of this workbook may be meaningfully applied to and engaged in the personal and professional practices of all who read it. The six core processes of acceptance and commitment therapy (ACT) are broadly addressed in the workbook to apply to a range of moral injuries. They may be used in service of the healing needed by those suffering in the presence and aftermath of this pandemic.
200 pages, Kindle Edition
Published June 1, 2020
38 people are currently reading
104 people want to read
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Displaying 1 - 9 of 9 reviews
July 6, 2024
This book is a great resource on moral injury. I draw on ACT principles pretty heavily in my spiritual care, so I’m glad to have something I can offer patients specifically applying ACT to moral injury. I thought the exercises throughout the book were great. Also, I really like how to book provided education about emotions without sounding too childish or silly, which I feel like a lot of emotion talk can be. I look forward to offering this as a resource to my moral injury patients and working through it with them.
July 12, 2020
3.5 stars rounded up to 4. Interesting and well-written workbook to help conceptualize and frame moral injury and find a path to healing. Not everything in this work resonated with me, but the authors state early on that this is to be expected, and that we can find the guidance and stories that do resonate and build from them. Also, the definition of what constitutes a moral injury is mostly clear but somewhat ambiguous, which the authors also acknowledge. Because of this, I think but am not sure that my personal trauma counts as a moral injury. In fact, there are few things that I think wouldn't count as moral injury based on the definition, which makes it feel less useful as a stand-alone concept. But the overall guidance and psychological conceptualization towards healing is helpful and this workbook will be a great resource to many.
May 23, 2020
Heart and mind talk, explorations of morals and emotions.
The exercises in the book engages and challenges readers to understand and recognise why certain thoughts are presented and ways to comprehend our reactions and feelings.
A good read when you need to reflect, understand and realise why is it you do the things you do.
The exercises in the book engages and challenges readers to understand and recognise why certain thoughts are presented and ways to comprehend our reactions and feelings.
A good read when you need to reflect, understand and realise why is it you do the things you do.
March 2, 2023
Saya menuntaskan buku ini selama sekitar 2,5 bulan, menyicilnya sedikit-sedikit tiap pagi (tentunya ada hari-hari yang bolong) sambil berusaha mengaitkannya dengan pengalaman, pengetahuan, dan kepercayaan yang dimiliki. Di ujung, saya merasa buku ini kurang berefek mungkin karena cara membacanya yang begitu. Namun menimbang bahwa di akhir saya dapat mendefinisikan values serta committed action atau bold move yang pertama-tama mau saya ambil, juga ketika membaca catatan dari awal dan menemukan kembali pikiran-pikiran yang telah lampau, tampaknya buku ini telah berhasil memperbaiki cara pandang saya. Ya, tentunya itu masih perlu diuji dalam kehidupan nyata setelah saya move on dari buku ini. Saya mungkin bakal perlu lagi menengok catatan pembacaan buku ini untuk mengingatkan diri akan pelajaran-pelajaran yang telah diperoleh.
Catatan acak:
Commit to acting on your values rather than reacting to pain and suffering.
A morally injurious event = a situation that is perceived by the person experiencing it as violating an important moral value in a high-stakes context.
These violations may be:
- something you have done, or failed to do,
- something that someone else has done, or failed to do, to you or for you,
- something you have witnessed,
- something you learned about after it had already happened.
The focus of this workbook is to healing from the suffering that emerges from struggling against this kind of pain.
Morally injurious events violate your deeply held values, and the stakes for these events are high, kalau boleh saya kaitkan dengan kerangka pikir orang beragama: misalkan, sudah tahu salah menurut agama tapi tetap dilakukan atau terjadi karena kurangnya kemampuan mengendalikan diri, dan tahu akibatnya bakal diganyang di neraka, tapi tetap sulit berubah sehingga akibatnya timbul keresahan, penderitaan, bahkan keputusasaan. Termasuk values yang berlaku di masyarakat; misal pernah tergabung dalam peer group tertentu, tapi seiring dengan berjalannya waktu, tidak mampu mengimbangi standar-standar dalam kelompok tersebut (lebih spesifik lagi bisa menyangkut pekerjaan, pernikahan, dsb). Ketidakmampuan memenuhi standar tersebut berpotensi pada masa depan yang lebih kejam dari sekarang, kalau kata Andy Liany mah :v
Akibatnya terjadi penghukuman diri dalam bentuk-bentuk sebagai berikut:
- withdrawing,
- engaging in self-loathing,
- keeping yourself from being connected to others.
Latihan pertama di buku ini mengajak untuk mengingat kembali kejadian-kejadian traumatis itu secara terperinci, untuk memunculkan awareness. Meskipun sekadar lebih aware saja terhadap permasalahan tidaklah cukup untuk penyembuhan.
Pain serves a purpose, important signal, alert to something that requires prompt attention and perhaps action. Once you understand your pain's purpose, what will your relationship with your pain be? Will you struggle against your pain and then begin to suffer? Or will you turn toward the pain, face its urgency, and meet it, to learn from it and direct your energy toward living a vital life?
Building a new relationship with yourself is the beginning ....
Be observant at changes, experiences. Amati apa yang terjadi di dalam diri, gejolak pikiran, perasaan, sensasi, silih bergantinya.
Change the way you relate to what you are saying, feeling, and sensing.
This is an important part of moral healing.
Memang ujungnya tentang mindfulness lagi sih ini, memisahkan atau menjarakkan diri dari apa yang dipersepsikan sebagai diri.
(Catatan mengenai isi buku ini sebetulnya masih berlembar-lembar lagi, tapi karena terbatasnya jatah waktu untuk menulis review, saya cukupkan sampai sini :P)
Catatan acak:
Commit to acting on your values rather than reacting to pain and suffering.
A morally injurious event = a situation that is perceived by the person experiencing it as violating an important moral value in a high-stakes context.
These violations may be:
- something you have done, or failed to do,
- something that someone else has done, or failed to do, to you or for you,
- something you have witnessed,
- something you learned about after it had already happened.
The focus of this workbook is to healing from the suffering that emerges from struggling against this kind of pain.
Morally injurious events violate your deeply held values, and the stakes for these events are high, kalau boleh saya kaitkan dengan kerangka pikir orang beragama: misalkan, sudah tahu salah menurut agama tapi tetap dilakukan atau terjadi karena kurangnya kemampuan mengendalikan diri, dan tahu akibatnya bakal diganyang di neraka, tapi tetap sulit berubah sehingga akibatnya timbul keresahan, penderitaan, bahkan keputusasaan. Termasuk values yang berlaku di masyarakat; misal pernah tergabung dalam peer group tertentu, tapi seiring dengan berjalannya waktu, tidak mampu mengimbangi standar-standar dalam kelompok tersebut (lebih spesifik lagi bisa menyangkut pekerjaan, pernikahan, dsb). Ketidakmampuan memenuhi standar tersebut berpotensi pada masa depan yang lebih kejam dari sekarang, kalau kata Andy Liany mah :v
Akibatnya terjadi penghukuman diri dalam bentuk-bentuk sebagai berikut:
- withdrawing,
- engaging in self-loathing,
- keeping yourself from being connected to others.
Latihan pertama di buku ini mengajak untuk mengingat kembali kejadian-kejadian traumatis itu secara terperinci, untuk memunculkan awareness. Meskipun sekadar lebih aware saja terhadap permasalahan tidaklah cukup untuk penyembuhan.
Pain serves a purpose, important signal, alert to something that requires prompt attention and perhaps action. Once you understand your pain's purpose, what will your relationship with your pain be? Will you struggle against your pain and then begin to suffer? Or will you turn toward the pain, face its urgency, and meet it, to learn from it and direct your energy toward living a vital life?
Building a new relationship with yourself is the beginning ....
Be observant at changes, experiences. Amati apa yang terjadi di dalam diri, gejolak pikiran, perasaan, sensasi, silih bergantinya.
Change the way you relate to what you are saying, feeling, and sensing.
This is an important part of moral healing.
Memang ujungnya tentang mindfulness lagi sih ini, memisahkan atau menjarakkan diri dari apa yang dipersepsikan sebagai diri.
(Catatan mengenai isi buku ini sebetulnya masih berlembar-lembar lagi, tapi karena terbatasnya jatah waktu untuk menulis review, saya cukupkan sampai sini :P)
August 13, 2020
The Moral Injury Workbook is as thoughtfully composed as it is professionally thought out. The authors have found a way to provide a compassionate voice in the pages which gently, but firmly, walks the reader through the issues, the work and by the end leaves you at the trail head to the journey up the hill to healing and into the valley of hope. This is a serious book requiring deep thought and plenty of time and a safe place (there are possible "trigger" moments in stories told and work you'll do), but the reading is at an easy comprehension level and full of professional care. This is truly a remarkable work.
April 29, 2020
I love how detailed and involving this book is which lives up to it being essentially a workbook. You learn, reflect and apply what is herein and often we overlook the trauma we experience as observers- and that's why I wanted to read this, to know how best to deal with this and heal from some of the injustices I have seen and never been in a position to act or change the situation.
Thanks Netgalley for the eARC.
Thanks Netgalley for the eARC.
November 17, 2023
Good basic study and contents to help those who are dealing with moral injury
November 24, 2024
worth reading.free from filler words.
May 30, 2025
Very good book, study on how to help people who are trying to reconcile what they do to serve with the injury that others may suffer. A police officer who has to kill someone in the line of duty
Displaying 1 - 9 of 9 reviews