Adaptive disclosure
A talk-therapy protocol for treating the moral and emotional wounds soldiers carry home — not only fear and trauma, but guilt, grief, and the sense of having broken one's own moral code. Its defining move is to engage the morally fraught content head-on, having the patient disclose it and speak, imaginally, to a forgiving moral figure, rather than treating the wound as a fear to be extinguished.
The structured psychotherapy protocol developed by Brett Litz and colleagues at the Boston VA for the treatment of combat-related moral injury, loss, and life-threat trauma. The intervention pairs imaginal exposure with explicit moral and meaning-making components — a compassionate-other dialogue for moral-injury cases, a conversation with a deceased loved one for loss cases — drawn from but distinct from the existing PTSD treatment protocols (Prolonged Exposure, Cognitive Processing Therapy).
Etymology§
Adaptive disclosure was developed in the late 2000s and manualised in the 2012 Guilford volume Adaptive Disclosure: A New Treatment for Military Trauma, Loss, and Moral Injury (Litz, Lebowitz, Gray, and Nash). The name reflects the protocol's central technical move: disclosure of the morally fraught content to a clinician (and, imaginally, to a compassionate moral other), in order to adapt the agent's relation to what occurred.
Adaptive disclosure is the principal evidence-based psychotherapy targeting moral injury inside the VA / DoD treatment system. It operationalises the Litz et al. (2009) framework: if moral injury is constituted by the dissonance between an act and the agent's moral self-conception, treatment has to engage the moral content directly rather than treat it as fear-conditioning to be extinguished.
For the moral-injury corpus the protocol is significant mainly because it shows what clinical moral repair looks like inside the system Litz is writing inside. The objections to adaptive disclosure from the theological and philosophical literature (Kinghorn, Brock, Sherman) are not that it does not work but that what it does is necessarily limited — moral repair, on those accounts, requires communal and ritual practices that an individual psychotherapy session cannot provide.