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Examining the outcomes and acceptability of a peer-led spiritual intervention for moral injury in a veteran service organization

APA Citation:

Currier, J. M., McDermott, R. C., Fernandez, P., Salcone, S., Hinkel, H. M., Schuler, K., Fadoir, N., & Smith, P. N. (2023). Examining the outcomes and acceptability of a peer-led spiritual intervention for moral injury in a veteran service organization. Psychological Services. Advance online publication. https://doi.org/10.1037/ser0000762

Abstract Created by REACH:

Heroes to Heroes is a program that offers a 10-day peer-led retreat to Israel to promote spiritual healing and social connections for Veterans struggling with moral injury and/or posttraumatic stress disorder (PTSD). This study examined Heroes to Heroes’ preliminary acceptability and effectiveness. 101 Veterans provided data at 4 time points: baseline (before the trip), 1 month after the trip, 6 months after baseline, and 1 year after baseline. Both quantitative and qualitative data were collected. The 4 main themes that emerged supported the program’s acceptability. In addition, Veterans’ moral injury generally decreased, while their spiritual transcendence and life satisfaction increased over time.


Mental health

Branch of Service:

Multiple branches
Air Force
Marine Corps

Military Affiliation:


Subject Affiliation:



Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Longitudinal Study
Quantitative Study
Qualitative Study


Currier, Joseph M., McDermott, Ryon C., Fernandez, Paola, Salcone, Sarah, Hinkel, Hannah M., Schuler, Kaitlyn, Fadoir, Nicholas, Smith, Phillip N.


The purpose of this proof-of-concept study was to examine the outcomes and acceptability of a spiritual intervention for moral injury led by veteran peers in a Veteran Service Organization (VSO), called “Heroes to Heroes.” From baseline to 1-year follow-up, 101 veterans who participated in the intervention completed the evaluation surveys at four time points assessing psychological outcomes (moral injury, posttraumatic stress disorder [PTSD] symptoms, and life satisfaction), spiritual outcomes (spiritual struggles and spiritual transcendence), and their perceived helpfulness of the program. In addition, we conducted four focus groups with six to eight alumni to more fully understand veterans’ views and experiences of the program. Focusing on the longitudinal surveys, latent growth modeling analyses revealed veterans generally improved across the psychological and spiritual outcomes in the study. Specifically, veterans reported steady decreases in moral injury outcomes, PTSD symptoms, and spiritual struggles along with increased life satisfaction and spiritual transcendence over the 1-year period. An inductive content analysis of veterans’ responses to open-ended items in the surveys and focus group interviews revealed four possible mechanisms or facilitators of these outcomes: (a) social connectivity and belonging (e.g., shared vulnerability and camaraderie); (b) behavioral engagement in core aspects of their spirituality (e.g., sacred practices and visiting sacred places); (c) spiritual transformation and growth (e.g., closeness with God and divine forgiveness); and (d) appreciation for diversity (e.g., religious and military). Overall, these findings affirm the potential effectiveness and acceptability of the VSO’s peer-led spiritual intervention for promoting the holistic healing among veterans who are contending with emotional and spiritual wounds of war. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Publication Type:

REACH Publication


heroes, intervention, life satisfaction, military veterans, moral injury, peers, posttraumatic stress disorder, spirituality, treatment outcomes

View Research Summary:

REACH Publication Type:

Research Summary

REACH Newsletter:

  July 2023

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