Brett Litz
Moral injuryAdaptive disclosurePotentially morally injurious event
in Moral injury
American clinical psychologist (PhD), professor of psychiatry and psychology at Boston University, and director of the Massachusetts Veterans Epidemiological Research and Information Center at the Boston VA. Litz's career has been on PTSD assessment and treatment in service members and veterans; from the late 2000s he has been the principal architect of the clinical case for moral injury as a distinct construct from PTSD.
Stake§
Litz writes from inside the Department of Defense and VA research apparatus, with funding and clinical-trial commitments tied to treatment-outcome research. The stake is professional and scientific: his framework has to be usable inside DoD and VA care pathways, and his definitions and instruments (the potentially morally injurious event, the adaptive disclosure protocol) reflect that institutional location. Critics in the philosophical and theological literature read this as the source of what they call the medicalisation or pathologisation of moral injury; Litz and his collaborators read it as the discipline required to make the construct measurable and treatable.
Litz is first author on the 2009 Clinical Psychology Review paper that became the most-cited single article in the field — "Moral injury and moral repair in war veterans: A preliminary model and intervention strategy." The paper redefines moral injury to centre on acts of transgression — perpetrating, failing to prevent, or witnessing acts that violate deeply held moral beliefs — rather than on Shay's narrower betrayal by legitimate authority. The widening of the definition is what made the construct portable beyond the combat-leadership setting Shay was writing about, and is why most subsequent clinical and healthcare research uses Litz's framework rather than Shay's.
His later work — including the validation of the Expressions of Moral Injury Scale and the development and trial of the adaptive disclosure psychotherapy protocol — operationalises the 2009 paper into measurement and treatment. The clinical-research programme is the standard against which philosophical and theological accounts of moral injury position themselves.