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도덕적 손상의 연구동향과 심리치료 및 상담에 주는 함의

A Review of Research on Moral Injury with its Implications to Psychotherapy and Counseling

손은령|권창모
한국재활심리학회 (Korean Association For Rehabilitation Psychology)|2020.12|재활심리연구 (The Korean Journal of Rehabilitation Psychology)|제27권 제4호|pp. 83-99|DOI 10.35734/karp.2020.27.4.005

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참고문헌

키워드

죄책감심리치료외상 후 스트레스 장애Psychotherapy상담CounselingGuilt도덕적 손상Moral Injury(MI)Post-traumatic Stress Disorder(PTSD)
주제분류심리과학

초록

도덕적 손상은 참전 경험으로부터 개념화된 이후 최근 들어 해외 학계에서 더욱 활발히 연구되고 있다. 참전군인을 만나온 임상가들이 도덕적이고 명예로운 규범이 위배 됨으로써 뒤따르는 내적 고통을 통찰한 이후로 도덕적 손상은 심리적 외상에 대한 보완적 또는 대안적 접근으로 발전되어 왔다. 최근에는 사회복지, 윤리, 영성 등 다양한 영역에서 ‘민간’에 적용한 이론 및 실천적 논의가 전개 중이다. 예컨대 코로나바이러스감염증-19 의료 인력의 도덕적 손상 노출이 다뤄지고 있다. 그러나 국내에서는 근래 들어서야 도덕적 손상이 소개되기 시작하였고 그나마 도덕적 손상의 개념과 연구동향을 심도 있게 고찰한 문헌은 거의 없다. 주된 실천 영역인 심리치료 및 상담에 적용하여 논의한 경우는 더욱이 찾아볼 수 없다. 이에 본 연구는 학술연구정보서비스(RISS)를 통해 해외 85건과 국내 5건의 관련 문헌을 선별하여 연구동향 및 주요 내용을 체계적으로 제시하였다. 도덕적 손상의 정의, 외상 후 스트레스 장애와의 관계, 측정, 개입 등 핵심적인 하위 주제들을 살폈고 이로부터 심리치료 및 상담에 함의되는 바를 논의하였다. 또한, 참전 외상의 심리적 재활을 넘어 최근의 확장된 논의를 고려함으로써 도덕적 손상에 대한 국내 학계의 관심을 촉진하고 다양한 조력직에 해당할 실천적 의미를 조명하고자 하였다.

Abstract

With its conceptualization from combat experiences, moral injury(MI) is now an internationally burgeoning field of research. Since clinicians treating war veterans had found inner wounds among them as an aftermath of betrayals of their moral codes and values, MI has been developing as an complementary or alternative approach to psychological trauma. Accordingly it expands into various disciplines such as social work, ethics and spirituality with discussions applied to civilian life. MI exposure in medical folks dealing with COVID-19 is a recent example. Internally, however, MI remains on its initial stage of research and practice. Thorough reviews are rarely found and the same with entailed discussions focused on psychotherapy or counseling. Thus, current review examined total 85 foreign studies and 5 domestic studies searched through Research Information Sharing Service(RISS), resulting in MI’s research trend in a systematic manner from its original context through to interventions. Following implications centered on psychotherapy and counseling were not necessarily limited to veterans’ psychological rehabilitation but included wider discussions relevant to various helping professions.

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전투원의 도덕적 손상(moral injury)과 한국군의 과제권창모육군군사연구소 · 군사연구2018 · 제145호한국판 도덕손상 사건 척도 및 도덕손상 경험 척도 개발 연구장은영한국심리학회 · 한국심리학회지:일반2021 · 제40권 제3호상담자들의 대리외상: 개관연구성승연, 이미혜한국심리학회 · 한국심리학회지:일반2014 · 제33권 제1호A New Approach to Moral Injury of Soldiers during WARPark Gyun-yeol, Seo Eun-sook, Shin Hee-jeong동북아학술저널연합 · International Journal of Military Affairs2019 · 제4권 제1호Military Chaplain’s Christian Counseling Method on Moral Injury전요섭한국실천신학회 · 신학과 실천2024 · 제90호외상관련 정서의 확장: 수치심, 죄책감, 분노를 중심으로박철옥, 안현의, 주혜선한국상담학회 · 상담학연구2012 · 제13권 제2호

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