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Cited by 161Religion, Spirituality, and PsychologyPosttraumatic Stress Disorder ResearchPsychotherapy Techniques and Applications

Spiritually integrated care for PTSD: A randomized controlled trial of “Building Spiritual Strength

Harris, J. Irene, Usset, Timothy, Voecks, Cory, Thuras, Paul, Currier, Joseph, Erbes, Christopher·2018·Psychiatry Research
DOI 10.1016/j.psychres.2018.06.045
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Abstract

Previous literature documents important cross-sectional and longitudinal relationships between spiritual distress and posttraumatic stress disorder (PTSD) outcomes. This study tests the efficacy of a spiritually integrated intervention "Building Spiritual Strength" (BSS) that can be delivered by trained chaplains. The intervention addresses spiritual concerns expressed by trauma survivors, including concerns in relationship with a Higher Power, difficulty with forgiveness, and theodicy. In a randomized controlled trial with blinded assessment, veterans were randomized to engage in a BSS condition (n = 71) or Present Centered Group Therapy (PCGT; control) condition (n = 67) with assessments at baseline, posttreatment, and a two-month follow up. Both groups showed similar, statistically significant reductions in symptoms of PTSD as measured by the Clinician Administered PTSD Scale (CAPS). BSS was shown to be more effective than PCGT in treating distress in relationship with a Higher Power. This was the second clinical trial of BSS with promising results and highlights the need for further study in psychospiritual interventions. More research is warranted on BSS being offered by non-specialized chaplains and on the application of BSS in suicide prevention.

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  • Evaluations of Building Spiritual Strength demonstrate reductions in spiritual distress and improvements in wellbeing and forgiveness, though causal mediation remains unconfirmed.

    “Evaluations demonstrate reductions in spiritual distress and improvements in wellbeing and forgiveness, though causal mediation remains unconfirmed (94).”

    From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [94]

  • Emerging moral injury treatments frequently incorporate shifts in self-processing characterized by reduced narrative self-focus, increased decentering, broadened attentional scope, affective integration, and enhanced orientation toward meaning and connection beyond the individual self.

    “Emerging MI treatments frequently incorporate shifts in self-processing characterized by reduced narrative self-focus, increased decentering, broadened attentional scope, affective integration, and enhanced orientation toward meaning and connection beyond the individual self (29–32, 94).”

    From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [94]

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Authors
Harris, J. I., Usset, T., Voecks, C., Thuras, P., Currier, J., & Erbes, C.
Affiliations
  • University of Minnesota (US)
  • St. Cloud VA Health Care System (US)
  • University of South Alabama (US)
Corresponding author
Harris, J. Irene
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2018-09
Volume
267
Pages
420-428
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2018.06.045
OpenAlex
W2808948042
Cited by
161
References
41
Citations by year
2026: 9 · 2025: 27 · 2024: 21 · 2023: 53 · 2022: 19 · 2021: 14 · 2020: 9 · 2019: 8 · 2018: 1
FWCI
8.57
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
post-traumatic stress disorder, chaplaincy, trauma survivors, veterans, forgiveness, theodicy, suicide prevention
MeSH terms
Adult, Aged, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Stress Disorders, Post-Traumatic, Veterans, Treatment Outcome, Spirituality

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