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Symposia

Military and Veterans Psychology

Identification and Assessment of Factors Affecting Veterans' Therapeutic Engagement

4 - (SYM 75) The Effects of Feeling Inspired by Group Members in a Veteran PTSD Residential Program: Examining Associations of Weekly Moral Elevation with Weekly Group Climate and Pre-post Outcomes

Sunday, November 23, 2025
3:09 PM - 3:30 PM CST
Location: Strand 12 A&B, Level 2
Keywords: Veterans, Treatment, PTSD (Posttraumatic Stress Disorder)
Recommended Readings: Johnson, E. M., & Possemato, K. (2019). Correlates and predictors of mental health care utilization for veterans with PTSD: A systematic review. Psychological Trauma: Theory, Research, Practice, and Policy, 11(8), 851-860. https://doi.org/10.1037/tra0000461,   Sherrill, A. M., Wiese, C. W., Abdullah, S., & Arriaga, R. I. (2025). Teaming with Artificial Intelligence to learn and sustain psychotherapy delivery skills: Workplace, ethical, and research Implications. Journal of Technology in Behavioral Science, 1-9. https://doi.org/10.1007/s41347-025-00484-4,   Parry, K. J., Hicken, B. L., Chen, W., Leng, J., Allen, S., & Burningham, Z. (2023). Impact of moral injury and posttraumatic stress disorder on health care utilization and suicidality in rural and urban veterans. Journal of traumatic stress, 36(1), 117-128. https://doi.org/10.1002/jts.22889,   McGuire, A. P., Rodenbaugh, M., Howard, B. A. N., & Contractor, A. A. (2024). Response styles to positive affect during a positive psychology intervention for veterans with PTSD and moral injury: Preliminary results from a moral elevation intervention pilot trial. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001774,   Rauch, S. A. M., Yasinski, C. W., Post, L. M., Jovanovic, T., Norrholm, S., Sherrill, A. M., Michopoulos, V., Maples-Keller, J. L., Black, K., Zwiebach, L., Dunlop, B. W., Loucks, L., Lannert, B., Stojek, M., Watkins, L., Burton, M., Sprang, K., McSweeney, L., Ragsdale, K., & Rothbaum, B. O. (2021). An intensive outpatient program with prolonged exposure for veterans with posttraumatic stress disorder: Retention, predictors, and patterns of change. Psychological Services, 18(4), 606–618. https://doi.org/10.1037/ser0000422
Abstract Body

Moral elevation is a positive emotional state described as feeling inspired or uplifted after witnessing others’ virtuous acts. Past work has demonstrated that eliciting moral elevation could be used as an innovative therapeutic tool for veterans with posttraumatic stress disorder (PTSD) as evidenced by links with reduced negative cognitions and increased motives to engage in recovery-oriented behaviors. Further, a pilot trial of a web-based moral elevation intervention found large decreases in PTSD symptoms and medium-sized increases in quality of life for veterans randomized to the elevation intervention. However, these findings are restricted to settings in which veterans experienced elevation in isolation, whereas group or residential treatment for PTSD is a widely used format that could potentially elicit elevation and its benefits. This study collected data from 126 veterans who were admitted into 12-week residential program for PTSD treatment to assess (1) if veterans experience elevation in response to the actions of their fellow veterans or group members and whether it changes over time; (2) if weekly elevation by group members is related to concurrent and prospective perceptions of group dynamics; and (3) if average levels of elevation by group members is associated with pre-post changes in PTSD symptoms or posttraumatic growth (PTG).

 

Veterans completed a baseline and posttreatment assessment with self-report measures including PTG, and a structured clinical interview for PTSD (CAPS-5). Veterans also completed weekly measures of elevation in response to fellow group members (Elevation by Group), and a group climate questionnaire that assessed group dynamics. On average, results indicated participants reported scores above the moderate level on the Elevation by Group measure and scores decreased slightly over the course of treatment. Next, using linear mixed models, person-centered elevation scores were negatively associated with conflict and positively associated with avoidance and engagement in the same week. Prospective analysis indicated elevation scores were positively associated with group engagement for future weeks. Lastly, average level of elevation across the residential program was associated with greater decreases in PTSD symptom severity and greater increases in the relating to others domain of PTG. Overall, these findings highlight the potential of elevation to occur in a group treatment setting for veterans with PTSD and a potential link with desired outcomes consistent with trauma recovery.