Perspectives of Emerging Adults with Child Welfare Histories: Supporting Recovery from Moral Injury Experienced in Childhood and Adolescence

Background

This mixed methods study explores emerging adults’ perspectives on recovering from moral injury experienced within the child welfare system. Moral injury refers to the lasting psychological, spiritual and social harm caused by one’s own or another’s actions in a high stakes situation that transgress deeply held moral beliefs and expectations. If unaddressed, the guilt, shame, rage, distrust and existential crises associated with moral injury may persist for years undermining well-being (see Litz et al., 2009; Shay, 1994). The existing literature focuses on military contexts, but previous research indicates that parents, professionals, children and adolescents involved in public child welfare systems also may experience moral injury (Haight et al., 2017a,b,c, under review). These injuries include those resulting from child maltreatment, the failure of adults to protect children, and disrespect towards individuals as members of particular BIPOC communities. Our research question is: what do emerging adults identify as supporting their recovery from moral injury experienced as children and adolescents within the child welfare system?

Methods

Twenty-eight emerging adults between the ages of 18-26 with child welfare histories in four mid-western states were recruited using snowball sampling. Participants completed a modified version of the Moral Injury Events Scale (MIES) (Nash, et al., 2013), and then participated in individual, semi-structured, audiorecorded interviews elaborating their responses to the MIES. Each participant’s MIES was scored. Interviews were transcribed verbatim. Research team members read and re-read each participant’s transcribed interview, and developed a coding system using analytic induction (Schwandt, 2014). Two researchers then independently coded all transcripts, resolving disagreements through discussions. Peer debriefing and member checking enhanced the credibility of our interpretation (Lincoln & Guba, 1985).

Findings

Participants primarily described internal resources for coping with morally injurious events. These included personal characteristics such as fortitude, survival skills, ambition, perseverance and agency. Many participants described that the gradual development of “character virtues” (see Schnitker et al., 2019) such as hope, forgiveness, and gratitude eased their feelings of moral injury. Some described advocacy work as a way of using their difficult experiences to influence the system and help others.

Participants also identified external resources that supported the development of character virtues. These included supportive relationships with adults and contemporaries (e.g., birth, adoptive or foster parents; siblings; and intimate partners), as well as relationships with and interventions by social service professionals. Some described drawing on therapy, sports and other calming activities to address feelings of moral injury. Additionally, many participants used spiritual practices, beliefs and meaning making as resource for easing moral injury.

Implications

Emerging adults who experienced moral injury while engaged in the child welfare system described resilience in coping with the morally injurious events. Most participants drew on both internal and external resources for coping and recovery. The results have implications for practitioners and policy makers when constructing interventions to support the recovery of children and youth from moral injury. More research is needed to identify any relationships between the resources described by participants and the alleviation of moral injury in childhood and adolescence.