Joseph Currier

• PhD in Clinical Psychology
• Managing Director at University of South Alabama

Spirituality is a multifaceted construct that might affect Veterans’ recovery from posttraumatic stress disorder (PTSD) in adaptive and maladaptive ways. Drawing on a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD symptom severity among Veterans in a residential treatment program for combat-re...

Unlabelled: Moral injury is an emerging construct related to negative consequences associated with war-zone stressors that transgress military veterans' deeply held values/beliefs. Given the newness of the construct, there is a need for instrumentation that might assess morally injurious experiences (MIEs) in this population. Drawing on a communit...

Objective: Veterans with posttraumatic stress disorder (PTSD) and moral injury often struggle with their spirituality and/or religion (S/R) in ways that hinder recovery from these conditions and perpetuate risk for suicide over time. Focusing on veterans who were engaged in a peer-led spiritual intervention program with a Veteran Service Organizati...

Spirituality and religion are core areas of diversity and psychological functioning that mental health graduate education programs will ideally address in effective ways. This study examined the acceptability and feasibility of infusing a hybrid version of Spiritual Competency Training in Mental Health (SCT-MH) in required courses in accredited cou...

Religious communities and traditions often discuss the preconditions necessary for God to forgive a believer’s sin or transgression. This study examines adult American Christians’ beliefs about the preconditions for divine forgiveness (DF) and whether these beliefs differ based on features of a forgiveness-relevant situation or features of the indi...

Longitudinal evidence indicates struggles with spirituality/religion (S/R; e.g., feeling distant or abandoned by God, guilty for not attaining standards of moral perfection, judged by one’s family or community) may cause distress and hinder recovery from mental health challenges. However, research has not examined temporal associations between spir...

Training in how to ethically and effectively approach spirituality and religion (R/S) diversity in mental health (MH) care is lacking. Strong evidence exists for the relevance of R/S to MH, and most clinicians agree that such training is needed. This study investigated the barriers and facilitators to including R/S in MH professional training acros...

The purpose of this study was to develop a five-item form of the Religious and Spiritual Struggles Scale (RSS; Exline et al., Psychology of Religion and Spirituality, 6, 208-222, 2014), (2022). Drawing upon three samples – 711 depressed adults from prior studies that utilized the RSS (Study 1), 303 undergraduates from a public university in the Sou...

Despite practice guidelines for multiculturally competent care, including spiritual/religious diversity, most mental health graduate training programs do not formally address spiritual/religious competencies. Thus, we enhanced the Spiritual Competency Training in Mental Health (SCT-MH) course curriculum to train graduate students in foundational at...

The healthcare industry continues to experience high rates of burnout, turnover, and staffing shortages that erode quality care. Interventions that are feasible, engaging, and impactful are needed to improve cultures of support and mitigate harm from exposure to morally injurious events. This quality improvement project encompassed the methodical b...

Spirituality and religion (R/S) are important aspects of diversity and functioning for most people, and training in these areas for mental health professionals is needed. But how much training is enough? This paper proposes R/S training guidelines that can be used to inform coursework, practicum/internship didactic training, and supervision.

Persons with substance use disorders (SUDs) often act in ways that are harmful to others and incongruent with deeply held values and beliefs, which can result in painful thoughts and emotions related to critical self-evaluation (e.g., shame). In turn, substance misuse often serves as a maladaptive coping strategy that perpetuates a substance–shame...

The purpose of this study was to examine associations between clinicians’ use of varying types of spiritual interventions in the first session of spiritually integrated psychotherapies (SIPs) and clients’ likelihood of returning for a second session. In total, 154 practitioners of SIPs from 33 settings in a practice-research network reported on the...

An experimental study of Spiritual and Religious Competency Training for Mental Health Professionals

Background Meaning in life is a benchmark indicator of flourishing that can likely mitigate the severity of depression symptoms among persons seeking mental healthcare. However, patients contending with serious mental health difficulties often experience a painful void or absence of ultimate meaning in their lives that might hinder recovery. This t...

The aims of this practice-based evidence study were to (a) examine clients’ trajectories of psychological and spiritual distress over the course of spiritually integrated psychotherapies (SIPs) and (b) explore the role of varying types of spiritual interventions in these outcomes. In total, 164 practitioners of SIPs from 37 settings in a practice-r...

Purpose of Review Moral injury is increasingly recognized as a problem across various populations. Moral injury symptoms can occur when an individual’s action, lack of action, or witness of an event violates their moral beliefs, and include dysphoric emotions such as guilt, shame, and disgust; loss of meaning and purpose; withdrawal from valued rel...

Spiritual Competency Training in Mental Health (SCT-MH) is an eight-module online training program with initial support for the effectiveness of promoting facets of foundational competence for addressing clients’ religion and/or spirituality (R/S) in mental health practice (Pearce et al., 2020). Focusing on 181 mental health professionals who compl...

The purpose of this proof-of-concept study was to examine the outcomes and acceptability of a spiritual intervention for moral injury led by veteran peers in a Veteran Service Organization (VSO), called “Heroes to Heroes.” From baseline to 1-year follow-up, 101 veterans who participated in the intervention completed the evaluation surveys at four t...

Spiritual Care in Psychological Suffering: How a Research Collaboration Informs Integrative Practice highlights spiritually integrative research and demonstrates the evolution of a national partnership of psychologists and chaplains collaborating for optimal results. Interdisciplinary teams are the gold standard in spiritual care provision, and thi...

The overall purpose of this study was to examine the role of core dimensions of theistic relational spirituality (doctrinal God representations, experiential God representations, and doctrinal–experiential congruence) in divine spiritual struggles among Christians engaging in spiritually integrated psychotherapies. In total, 189 clients completed a...

Objective: Military service may place veterans at increased risk for perpetrating, witnessing, or failing to prevent events that violate deeply held moral values. In some cases, veterans may develop moral injury (MI) symptoms that transcend and/or overlap with mental health conditions such as posttraumatic stress disorder (PTSD) and major depressi...

Understanding how forgiveness relates to mental health outcomes may improve clinical care. This study assessed 248 adult psychiatric inpatients, testing associations of forgiveness, religious comfort (RC), religious strain (RS), and changes in depressive symptomatology from admission to discharge. Experiencing divine forgiveness and self-forgivenes...

Religion can influence recovery from the many stressors and traumas that may occur during war-zone service. On the one hand, religious faith might provide an array of resources for healthy coping and relational connections. However, military trauma can also affect veterans spiritually in ways that lead to conflict and struggles in this cultural dom...

Objective This mixed methods study aimed to understand ways of viewing and experiencing religious attachment among Christians in spiritually integrated psychotherapies. Method In total, 190 Christian‐affiliated clients completed narrative responses about religious and parental attachment along with validated measures of spiritual and psychological...

Theologians, philosophers, and biblical scholars have long honored the spiritual and moral dimensions of human suffering. Adding to nearly a century of groundbreaking discoveries on the biological and psychological effects of trauma, there is increasing recognition in mental health professions that these events also affect patients morally and spir...

Religion and spirituality (R/S) often play crucial roles in the lives of people seeking mental health care. However, patients’ preferences for addressing R/S in their treatment, especially in inpatient settings, has not been understood. This study examined preferences for R/S integration and factors that predict inpatients’ attitudes toward specifi...

Objective: Suicidal behavior is a leading cause of injury and death, so research identifying protective factors is essential. Research suggests gratitude and life hardships patience are character strengths that might protect against the deleterious association of struggles with ultimate meaning and suicide risk. However, no studies have evaluated...

Objective: Military veterans often encounter events with chronic or repeated traumas of an interpersonal nature that might lead to emotional, relational, and spiritual suffering. Research is needed to assess whether and/or how emerging conceptions of moral injury (MI) align with existing trauma-related conditions. Method: Focusing on 173 veteran...

Objective Religious beliefs and practices may augment a sense of meaning in life that could support quality of life (QOL) in physical, social, and emotional domains amid mental health crises. However, these associations have not been thoroughly tested among persons with serious mental illness (SMI). Methods Focusing on 248 adults who had recently...

Objective This practice‐based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs). Methods In total, 17 clinicians practicing SIPs in a mid‐sized city on the US Gulf Coast implemented session‐to‐session assessments of these outcomes w...

There is increasing theoretical, clinical, and empirical support for the hypothesis that psychospiritual development, and more specifically, postconventional religious reasoning, may be related to moral injury. In this study, we assessed the contributions of exposure to potentially morally injurious events, posttraumatic stress symptoms, and psycho...

Focusing on 472 religiously heterogenous adult patients seeking psychotherapy at a university-based outpatient clinic, this brief report examined (1) these patients' preferences about clinicians appreciating their religion and/or spirituality (R/S) backgrounds (spiritually affirming) and addressing spiritual concerns in treatment (spiritually integ...

Recent research has documented a link between spiritual struggles and suicidal factors in veterans. Despite this evidence base, research has not examined possible intervening variables or applied contemporary ideation-to-action frameworks to understand the role of spiritual struggles on suicide risk. Drawing on a sample of 110 treatment-seeking vet...

Moral injury has developed in earnest since 2009 within psychology and military studies, especially through work with veterans of the U.S. military’s wars in Afghanistan and Iraq. A major part of this work is the attempt to identify means of healing, recovery, and repair for those morally injured by their experiences in combat (or similar situation...

Military personnel may encounter morally injurious events that lead to emotional, social, and spiritual suffering that transcend and/or overlap with mental health diagnoses (e.g., post‐traumatic stress disorder [PTSD]). Advancement of scientific research and potential clinical innovation for moral injury (MI) requires a diversity of measurement app...

Guilt and shame are commonly related to PTSD. Yet, research has not examined whether guilt- and shame-proneness affect posttraumatic symptomatology due to difficulty making meaning of stressors. Using structural equation modeling (χ²(36) = 40.44, p = .282), difficulty making meaning was examined as a mediator between proneness to guilt/shame and PT...

Many people draw strength and comfort from a relationship with God or a Higher Power in recovery from substance use disorders (SUDs). However, research indicates divine struggles may increase risk for suicide. Focusing on 144 men in the first 6 months of recovery from SUDs who were recruited from community-based programs providing housing and subst...

While a considerable amount of theoretical literature has explored core values and characteristics of the U.S. Armed Forces, limited empirical research has examined veterans’ accounts of military culture. To elucidate military culture and help inform ongoing efforts to incorporate military culture into the provision of healthcare services for veter...

The objective of the current study was to inform the understanding of how firearms confer risk for suicide in military service members and veterans. Relations among firearm ownership and storage practices with mental health and interpersonal theory of suicide constructs were examined in a sample of 201 military service members and veterans using a...

Few studies in positive psychology have examined associations between virtues and mental health in highly distressed samples. This study demonstrates the relevance of the virtue of patience, conceptualized as the capacity to calmly face frustration and suffering, within a spiritually integrated treatment program offering inpatient psychiatric hospi...

Suicide is a leading cause of death among Service Members and Veterans (SM/Vs) who suffer from posttraumatic stress disorder (PTSD). Recent research has found significant associations between the interpersonal theory of suicide (ITS) and PTSD symptomatology. Furthermore, findings suggest positive and negative forms of religious coping can varyingly...

War‐related traumas can lead to emotional, relational, and spiritual suffering. Drawing on two community samples of war zone veterans from diverse military eras (Study 1, N = 616 and Study 2, N = 300), the purpose of this study was to examine patterns of constellations between outcomes related to moral injury (MI) and common ways in which veterans...

War zone veterans who experience posttraumatic stress disorder (PTSD) symptoms might struggle with co‐occurring cognitive, emotional, and behavioral expressions of suffering that align with conceptual definitions of moral injury (MI). However, given that PTSD is a multidimensional condition, disentangling the apparent interplay with MI may inform c...

Background: Persons contending with serious mental health difficulties often experience struggles with religious faith and/or spirituality that may also demand clinical attention. However, research has not examined the relative importance of specific forms of spiritual struggles in mental health status or treatment outcomes of psychiatric patients....

Understanding the role of religion in mental illness has always been complicated, as some people turn to religion to cope with their illness, whereas others turn away. The overarching purpose of this study was to draw on quantitative and qualitative information to illuminate ways in which religiousness might be associated with changes in depressive...

This study examines VA chaplains’ understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains’ definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning si...

This study examined help-seeking behavior from professional, informal, and religious sources in veterans with a probable need for treatment. In total, 93 veterans who screened positive for posttraumatic stress disorder/major depressive disorder completed assessments of help-seeking at two time points spaced apart by 6 months. Less than half (40%) r...

Faith leaders who are working to promote justice and healing in Colombia might confront stressful circumstances that challenge their spiritual meaning systems and limit ministry-related quality of life. However, whether focusing on domestic or international samples, research has not examined potential effects of spiritual struggles on ministry-rela...

Background: Traumatic experiences can cause ethical conflicts. "Moral injury" (MI) has been used to describe this emotional/cognitive state, and could contribute to the development of posttraumatic stress disorder (PTSD) or block its recovery. We examine the relationship between MI and PTSD, and the impact of religious involvement (RI) on that rel...

Estimates suggest that hundreds of thousands of military service members will transition out of the U.S. military in the coming years. The state of Alabama has among the highest concentrations of veterans per capita in the United States. The purpose of this study was to provide an initial picture of the prominent barriers and resources for veterans...

Emerging research has documented greater risk for posttraumatic stress disorder (PTSD) and depression among young adults with prior adverse childhood experiences (ACEs). Building upon prior findings, we hypothesised that religious/spiritual (R/S) struggles may serve as an intervening pathway through which accumulation of ACEs impacts mental health...

Objectives: Examine differences in mental health treatment-related stigma in student service members and veterans (SSM/Vs) and peers from 57 post-secondary institutions across the United States. Methods: In total, 909 SSM/Vs and 1818 demographically- and institutionally-matched non-SSM/Vs completed assessments of stigma-related barriers to menta...

Amassing research findings suggests that religious faith and/or spirituality (R/S) can both help and hinder recovery from mental health conditions that might prompt military veterans to seek psychotherapy or counseling. As such, there is increasing interest among psychologists and other professionals working with military populations in the helpful...

Moral injury (MI) involves feelings of shame, grief, meaninglessness, and remorse from having violated core moral beliefs related to traumatic experiences. This multisite cross-sectional study examined the association between religious involvement (RI) and MI symptoms, mediators of the relationship, and the modifying effects of posttraumatic stress...

Background: There is consensus that struggles with religious faith and/or spirituality likely contribute to risk for suicidal behavior in military populations. However, a lack of longitudinal information has limited the ability to clarify the temporal associations between these variables. Methods: This study examined cross-lagged associations be...

This book presents the latest in neuroscience and resiliency research alongside the personal stories of military veterans to advocate for an empirically validated training protocol. In Bulletproofing the Psyche: Preventing Mental Health Problems in Our Military and Veterans editors Kate Hendricks Thomas and David L. Albright lead an interdisciplina...

There is consensus that military personnel can encounter a far more diverse set of challenges than researchers and clinicians have historically appreciated. Moral injury (MI) represents an emerging construct to capture behavioural, social, and spiritual suffering that may transcend and overlap with mental health diagnoses (e.g., post-traumatic stre...

The purpose of this study was to explore mental health literacy for religious and/or spiritual (R/S) struggles and help-seeking patterns. In total, 791 college students from 2 institutions on the Gulf Coast completed an online survey with Exline, Pargament, Ellison, and Flannelly’s (2014) Religious and Spiritual Struggles Scale and a modified versi...

Record numbers of military veterans are enrolling at colleges/universities across the United States. Although a substantive subset might suffer from mental health problems, the majority of these students might not be amenable to utilizing services. The purpose of this study was to examine the role of treatment-related stigma in intentions to seek p...

Religion can provide a powerful meaning-making framework that promotes adaptive processing of potentially traumatic events. However, spiritual strain or distress might be associated with maladaptive perceptions of the meaning of possible traumas. These theoretical propositions have yet to be tested in the empirical literature (to our knowledge). Th...

Trauma and spirituality represent an understudied area of community experience. As in introductory article for this themed issue for the Journal of Prevention & Intervention in the Community, this article describes the importance of considering these topics together for individuals and communities across the world.

Despite established connections between traditional masculinity ideologies and self-stigma of seeking psychological help, few studies have examined relevant constructs in samples of veterans. The present study addressed this gap by testing a model specifying conformity to the masculine role norms of self-reliance and emotional control as mediating...

he purpose of this brief report was to ascertain student veterans' patterns of help-seeking from professional, informal, and religious sources. In total, 350 veterans from an academic institution on the Gulf Coast completed assessments of help-seeking intentions from a range of potential sources in their communities. Analyses revealed that veterans...

Religion and/or spirituality (R/S) can play a vital, multifacted role in mental health. While beliefs about God represent the core of many psychiatric patients’ meaning systems, research has not examined how internalized images of the divine might contribute to outcomes in treatment programs/settings that emphasize multicultural sensitivity with R/...

A mixed method design was implemented to examine the spirituality and emotional well-being of Veterans Health Administration (VHA) chaplains and how potential changes in spirituality and emotional well-being may affect their professional quality of life. Four distinct categories of changes emerged from the narrative statements of a nationally repre...

Wartime experiences have long been known to cause ethical conflict, guilt, self-condemnation, difficulty forgiving, loss of trust, lack of meaning and purpose, and spiritual struggles. "Moral injury" (MI) (also sometimes called "inner conflict") is the term used to capture this emotional, cognitive, and behavioral state. In this article, we provide...

Objective: Adverse childhood experiences (ACEs) are associated with increased risk for suicide and appear to occur in disproportionately high rates among men who served in the U.S. military. However, research has yet to examine a comprehensive range of ACEs among Iraq/Afghanistan veterans with combat-related posttraumatic stress disorder (PTSD) or...

Objective: Research indicates that trauma can precipitate a loss of faith and struggles in the spiritual domain, leading to increased suicide risk. However, little is known about the specific types of spiritual struggles that may confer risk. This brief report examines the utility of a newly developed measure, the Religious and Spiritual Struggles...

Pastors play a crucial role in promoting well-being and justice in communities throughout the world. Particularly in the context of natural disasters or human-engineered injustice, clergy frequently stand in the gap to attend to the multifaceted needs of impoverished and underserved individuals. However, whether in times of stability or extreme soc...

Objective: This study was conducted (1) to examine differences in post-traumatic stress disorder (PTSD) symptoms, perceived quality-of-life (QoL) and post-concussive symptoms (PCS) among veterans who experienced deployment-related mild traumatic brain injuries (mTBIs) with or without loss of consciousness (LOC) and (2) to test the additive role of...

Objectives: This study examined patterns of professional and nontraditional help-seeking in a national sample of veterans from 57 colleges/universities and demographically matched students from the same institutions who had not served in the US Armed Forces. Methods: In total, 945 veterans and 2835 demographically matched nonveteran students fro...

Background and objectives: This study examined prospective associations between changes in mental health symptoms (posttraumatic stress disorder [PTSD], depression) and health-related quality of life (physical health, psychological well-being) for veterans with PTSD. Design: This study focused on 139 patients who completed a residential treatmen...

The purpose of this study was to examine the interplay between daily spiritual experiences and meaning making in a sample of 254 Salvadoran teachers with histories of exposure to violence and potential trauma. When controlling for rates of lifetime community violence exposure and demographic factors (age, gender), teachers with higher daily spiritu...

In a sense, every psychotherapeutic intervention targets a specific set of problems, symptoms, or disorders—those brought in by a specific client. In contrast, much of psychotherapy research examines the outcome of more general interventions, sometimes modified slightly to accommodate a particular set of problems (e.g., CBT for depression versus an...