The nature of moral injury and moral distress
- The danger of perpetrating harm
- Witnessing and learning about harm
- Failing to prevent harm
- Patterns of moral injury
- Signs and symptoms of moral injury
- The role of demoralization
- Research risks and limitations
- Case examples:
- Clinician who witnesses harm inflicted on clients
- Clinician who fails to prevent harm caused to clients
Causes of moral injury in the behavioral health professions
- Professional burnout
- Professional impairment
- Workplace conditions
- Social conditions and policies
- Ethical dilemmas
- Case examples:
- Workplace conditions that cause harm
- Clinician who experiences burnout
Consequences of moral injury: Secondary trauma, compassion satisfaction, and moral repair
- Secondary trauma
- Vicarious traumatization
- Compassion fatigue
- Vicarious resilience, posttraumatic growth, and compassion satisfaction
- Moral repair and apology
- Restorative justice: Addressing harm to individuals and communities
- Transitional justice: Organizational and institutional accountability
- Case examples: A clinician who experiences secondary trauma and vicarious traumatization
Professionals’ ethical responsibilities: Moral choices and whistleblowing
- The nature of whistleblowing: Ethical standards
- Ethics violations that cause moral injury
- Practitioner impairment
- Disclosure of moral injury and defamation risks
- Standards of care
- Case examples:
- Clinician who considers blowing the whistle on misconduct
- A clinician who violates ethical standards
Prevent moral injury: The role of prevention protocols, advocacy, and moral courage
- Organizational change
- Community advocacy
- Policy advocacy
- Alternative dispute resolution
- Moral courage to expose and address moral injury
- Case examples: Clinicians engaging in change and advocacy
Ethical standards as they relate to self-care
- Key concepts
- Codes of ethics and self-care standards
- Barriers to self-care
- Reflective practice
- Case examples:
- Clinician’s efforts to engage in ethicsinformed self-care
- Clinician who engages in reflective practice


