“My uncle had returned from the Vietnam War, and he’d wake in the night from a nightmare and say things like, ‘you don’t understand – I did things I know are wrong!' There were particular behaviours that stemmed from that. So it was a concept that really hit home for me,” Dr Rogers says.
But while her initial research focused on helping families dealing with a parent absent on deployment in military families, and the more well-known conditions of post-traumatic stress disorder (PTSD) and physical injuries related to war service, the need for a focused resource on moral injuries would re-emerge.
“I was at a military, veteran and first responder health conference in Canada in 2022 to present our research, and there were people there who work with service families impacted by a moral injury telling me that research-based resources were needed.
Dr Rogers says a moral injury can occur from all kinds of work or life situations, such as an impossible decision faced by a first responder, witnessing bullying or corruption, or a past abuse, and there are particular differences not addressed in any available children’s resources.
All our resources are different in the way they acknowledge that partners and children suffer along with their parent where there is an injury or trauma, and they have a particular focus on helping build understanding, strength and coping skills in children and their support networks.
“A moral injury can be a precursor to mental health conditions like PTSD, depression or anxiety, but the difference with a moral injury is the sense of shame and distrust and feelings of disgust it creates.
“That can manifest in someone not wanting to do things or join activities or organisations because of their general distrust. This attitude can filter down into the lives of their children.
“A person with a moral injury can also become easily frustrated for example with a child whinging over a seemingly trivial problem, because of a difference in perspective due to their experience.
“Someone with a moral injury can then struggle to connect with their partner and children, because of this difference of perspective and their sense of being unworthy or sense they have a toxicity that will rub off on others. Children can then end up feeling a sense of neglect or that their parent doesn’t love them, which can present in them acting out, experiencing increased anxiety and a lowered sense of confidence,” Dr Rogers says.
“All our resources are different in the way they acknowledge that partners and children suffer along with the parent where there is an injury or trauma, and they have a particular focus on helping build understanding, strength and coping skills in children and their support networks.”
One of the challenges in developing a storybook to help children understand what is happening when they have a parent with a moral injury was trying to find the common ground in experience and effectively pictorialising it.
“I came up with the idea of having a cloud hanging over someone with a moral injury – because that’s often what lived experience narratives sounded like, then our team’s ideas flowed from there,” Dr Rogers says.
“It was also difficult to tread the line between not wanting the story to be too rosy, but also not wanting it to be all doom and gloom. And we wanted to show children what they can do to help in this situation, but not put the responsibility on them to fix anything."
An accompanying interactive module for parents includes videos explaining moral injury and experiences with it, information on behavioural impacts, how to support people and where to go to find support in the UK, Canada and Australia. Additionally, a support worker module will be developed so they can better assist these potentially vulnerable children.
As with all the resources developed by the Children and Family Resilience Programs team, the book and module have been developed in collaboration with many researchers, support workers, clinicians and those with lived experience. The book and module are currently available for feedback, including in a formal trial with the Kings College Centre for Military Health Research with families in the UK.
The final, free, online version of ‘Dad’s Moral Injury Cloud: Lara’s Story’ and parent module are due out at the end of July. They’ve been developed with a grant from the Foundation of Graduates in Early Childhood Studies and in-kind funding from the Manna Institute and can be found on the Children and Family Resilience Programs website.
If this article has raised any upsetting issues for you, please reach out for support: Lifeline 13 11 14 (24-hour support for all Australians).
