Specialized Therapy Improves Veteran Functioning

The 10-session program shows promise for veteran-heavy workforces managing the lingering mental health impacts of wartime.

Updated on Oct. 21, 2026 in Military Jobs

Gouache-painted editorial illustration showing two leather-bound journals and a smooth stone on a wooden surface, evoking quiet mental health reflection. — A five-year clinical trial found that a specialized 10-session 'Impact of Killing' therapy program can improve functional outcomes for veterans. AI Illustration. Upload story photo >

Live Poll

Do you trust specialized psychotherapy programs focused on self-forgiveness to effectively treat combat-related moral trauma?

A 2018-2023 clinical trial of 100 veterans found that a 10-session 'Impact of Killing' psychotherapy program outperformed present-centered therapy in improving participant functioning. The study highlights potential mental health interventions for employers managing veteran-heavy workforces.

Why it matters

Understanding the mental health impacts of service, particularly regarding moral injury, is essential for HR and operations teams supporting veteran employees. About 40% of Iraq War veterans report exposure to killing-related trauma, which can manifest as anger or self-destructiveness that disrupts workplace performance.

The clinical trial included 100 veterans, where the Impact of Killing (IOK) group demonstrated a Sheehan Disability Scale mean score improvement of -3.50 compared to the control group. The study group was composed of 98% men, with a mean age of 48.4 years.

The players

VA Health Care System

The federal provider of integrated healthcare services for military veterans, which operates medical facilities across California, New York, and North Carolina.

The details

The IOK program consists of 10 weekly individual sessions aimed at helping veterans process the mental health impact of killing during wartime through acceptance and self-forgiveness. In contrast, present-centered therapy focuses exclusively on the current effects of trauma without exploring past actions. While the IOK program showed significant functional improvement immediately posttreatment, those benefits were not sustained relative to the control group at the 6-month follow-up mark.

The clinical trial was conducted between 2018 and 2023.
Improvement differences between therapy groups were measured immediately posttreatment.
Disability scale performance differences between the groups disappeared at the 6-month follow-up mark.

Market Landscape

This study evaluates a specialized psychological intervention against the VA's existing standard of present-centered therapy protocols. It underscores a growing research focus on moral injury as a distinct mental health challenge within veteran populations.

Businesses with high veteran employment counts should monitor specialized mental health programs that address moral injury and PTSD. Employers should focus on providing flexible support environments that accommodate the specific recovery needs of veterans struggling with trauma-related functioning.

The takeaway

Veterans grappling with moral injury may require specialized therapeutic approaches beyond standard trauma-focused sessions to maintain long-term functional stability. HR departments should track emerging research on IOK-style therapies to better assess the effectiveness of their own veteran support programs.