{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:21:55Z","timestamp":1788387715885,"version":"build-2803163510"},"reference-count":57,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012345","name":"Forces in Mind Trust","doi-asserted-by":"publisher","award":["NO GRANT NUMBER"],"award-info":[{"award-number":["NO GRANT NUMBER"]}],"id":[{"id":"10.13039\/100012345","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,21]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exposure to potentially morally injurious events is increasingly recognised as a concern across a range of occupational groups, including UK military veterans. Moral injury-related mental health difficulties can be challenging for clinicians to treat and there is currently no validated treatment available for UK veterans. We developed Restore and Rebuild (R&amp;R) as a treatment for UK veterans struggling with moral injury-related mental health difficulties. This trial aims to examine whether it is feasible to conduct a pilot randomised controlled trial (RCT) of R&amp;R treatment compared with a treatment-as-usual (TAU) control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We will use a feasibility single-blind, single-site RCT design. The target population will be UK military veterans with moral injury-related mental health difficulties. We will recruit N=46 veteran patients who will be randomly allocated to R&amp;R (n=23) or TAU (n=23). Patients randomised to R&amp;R will receive the 20-session one-to-one treatment, delivered online. Veterans allocated to TAU, as there are currently no manualised treatments for moral injury-related mental health problems available, will receive the one-to-one treatment (online) typically provided to veterans who enter the mental health service for moral injury-related mental health difficulties. We will collect outcome measures of moral injury, post-traumatic stress disorder (PTSD), alcohol misuse, common mental disorders and trauma memory at pretreatment baseline (before randomisation), end of treatment, 12 weeks and 24 weeks post-treatment. The primary outcome will be the proportion of patients who screen positive for PTSD and moral injury-related distress post-treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This trial will establish whether R&amp;R is feasible, well-tolerated and beneficial treatment for veterans with moral injury-related mental health difficulties. If so, the results of the trial will be widely disseminated and R&amp;R may improve access to effective care for those who struggle following moral injury and reduce the associated negative consequences for veterans, their families and wider society.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN99573523\">ISRCTN99573523<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082562","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T02:30:41Z","timestamp":1715826641000},"page":"e082562","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Restore and Rebuild (R&amp;R): a protocol for a phase 2, randomised control trial to compare R&amp;R as a treatment for moral injury-related mental health difficulties in UK military veterans to treatment as usual"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"isrctn99573523","registry":"10.18810\/isrctn"},{"clinical-trial-number":"nct04752072","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-9856","authenticated-orcid":false,"given":"Victoria","family":"Williamson","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Exeter, Exeter, UK"},{"name":"King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9530-2743","authenticated-orcid":false,"given":"Dominic","family":"Murphy","sequence":"additional","affiliation":[{"name":"King\u2019s College London, London, UK"},{"name":"Combat Stress, Leatherhead, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Bonson","sequence":"additional","affiliation":[{"name":"King\u2019s College London, London, UK"},{"name":"Combat Stress, Leatherhead, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3471-6472","authenticated-orcid":false,"given":"Natasha","family":"Biscoe","sequence":"additional","affiliation":[{"name":"Combat Stress, Leatherhead, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9512-752X","authenticated-orcid":false,"given":"Daniel","family":"Leightley","sequence":"additional","affiliation":[{"name":"King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Aldridge","sequence":"additional","affiliation":[{"name":"Combat Stress, Leatherhead, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4550-2971","authenticated-orcid":false,"given":"N","family":"Greenberg","sequence":"additional","affiliation":[{"name":"King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"2025121605454387000_14.5.e082562.1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2018.55"},{"key":"2025121605454387000_14.5.e082562.2","doi-asserted-by":"crossref","unstructured":"Williamson V , Lamb D , Hotopf M , et al . 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