Spring 2026 JSOM Podcast

Perfect.

All right.

So my article this edition is a case report on the augmentation of cognitive processing therapy with spiritual counseling to address faith-based concerns, um, for an operator with high religiosity.

The authors of this case report are Blake Schroeder, Mark Schimmel Pfennig, and Jonathan Murphy.

So essentially, um, this article focuses on treating PTSD and moral injury in a special operations forces service member using a combination of psychotherapy and spiritual counseling.

And kinda a little bit on the background of this is with kind of the advances in military technology, especially with, like, real-time drone feeds, uh, service members are now able to experience trauma indirectly, kinda different from what we've seen in, um, you know, combat and wars previously.

So even though they're not physically present, watching traumatic events unfold can still lead to PTSD and depression and something called moral injury.Uh, this is also especially relevant in special operations forces who already have a high exposure to trauma.

So just kind of like a few key concepts to understand before we kinda dive in is that, um, PTSD results from exposure to certain traumatic events, and then moral injury refers to psychological distress that occurs when somebody feels that they violated or failed to uphold their moral or ethical beliefs.

And then cognitive processing therapy, or CPT, is structured therapy that helps patients challenge, um, negative thoughts related to trauma.

And then the spiritual counseling in this case study was added to address the religious concerns.

So again, the purpose of this case report was to explore whether combining CPT with spiritual counseling could improve outcomes in a patient with PTSD and moral injury, specifically when those injuries are tied to religious beliefs.

And this was really important because this combination really hasn't been studied, um, in special operations populations before.

So getting into the patient case, um, our patient was a 40-year-old special operations officer with very strong religious beliefs.

He developed PTSD after watching via drone footage an ambush involving a unit that he had previously trained.

So he experienced significant guilt and self-blame, along with religious conflicts, um, like questioning why God would allow the event to happen.

He was later then diagnosed with PTSD and major depressive disorder, and some of the symptoms that he had were intrusive thoughts, guilt, shame, and difficulty reconciling with, um, the trauma with his faith.

Um, uh, important, they noted that he also had not, um, previously completed a trauma-focused therapy before this.

The treatment kind of consisted of two main components.

He completed cognitive processing ther- cognitive processing therapy.

Um, he did about 16 sessions in two weeks, um, done virtually, and then he also had one session of spiritual counseling with a chaplain to specifically address his faith-related concerns.

And during the first week, his symptoms actually worsened, which is actually very common in trauma therapy as patients begin to confront these difficult memories.

However, um, after the spiritual counseling session, he became more engaged in therapy and was a- better able to process his beliefs.

So in the second week, his symptoms actually improved significantly, and he was really able to challenge his negative thoughts, especially around, like, the self-blame and the responsibility.

Um, and this kind of led to a rapid decrease in both his PTSD and depressive symptoms.

So overall, his PTSD symptoms decreased significantly with a clinical meaningful drop in his PCL-5 score.