Comparing Two Moral Injury Treatments

Purpose of this study: The purpose of this study is to evaluate the effectiveness of two psychological treatments for moral injury: Acceptance and Commitment Therapy for Moral Injury and Present Centered Therapy for Moral Injury. The main questions it aims to answer are: 1. Determine the efficacy of ACT-MI for building functional recovery among 180 warzone deployed Veterans. 2. Identify barriers and facilitators to implementing ACT-MI in VA mental health clinics or a national telehealth hub in preparation for future dissemination efforts. Participants will be asked to: * Complete a two to two and a half hour initial assessment session online using videoconferencing. Participants will be asked to complete surveys and questionnaires. * Be randomized to either ACT-MI or PCT-MI * Meet with the study clinicians for 15 virtual outpatient sessions (12-group and 3-individual sessions). * Complete a post-treatment assessment session offered online using videoconferencing within one week of treatment completion to complete surveys and questionnaires. * Complete one- and three-month follow-up assessments offered online using videoconferencing to complete surveys and questionnaires.

Inclusion Criteria: 1. Eligible for VHA care 2. Age 18-89 3. Has been deployed to a warzone 4. Has experienced moral injury from a morally injurious event in war that is impacting psychosocial functioning 5. Willing to be randomized to either of the two conditions (ACT-MI or PCT-MI) Exclusion Criteria: 1. Inability to provide informed consent (operationalized as inability to answer 7 questions about the study and research participants' rights) 2. Inability to complete study measures (e.g., due to significant acute intoxication/withdrawal symptoms, mania, psychosis, aggression, catatonia, cognitive impairment) 3. Imminent suicide risk 4. Participation in another interventional mental health research study 5. Membership in a vulnerable population (e.g., cognitively impaired) 6. Current participation in an EBP for a condition related to moral injury 7. Past participation in ACT (based on medical record review and Veteran self-report)