Date of Award


Document Type


Degree Name



Clinical and Counseling Psychology

Committee Chair

Phillip, Smith, Ph.D.


Belongingness is a fundamental human motivation to be a part of something larger than oneself. Many combat Veterans who return to civilian life lack a sense of belonging and, in turn, possess elevated rates of depression, substance use, and suicide. Compounding these issues, Veterans may separate from the military bearing psychosocial-spiritual war injuries, including posttraumatic stress disorder (PTSD) and moral injury. Recently, spiritually integrated treatment interventions have addressed the psychological, moral, and spiritual effects of combat trauma. However, Veteran mental health interventions and supports must also acknowledge the ways a loss of belonging further impacts the psychosocial-spiritual functioning of returning combat Veterans. There is an extensive literature on the mitigating effects of social support and religion and spiritual faith on trauma recovery. Experiences of psychospiritual belonging, in the form of relationships with others and with one’s higher power, may help Veterans reconnect with something larger than themselves and, as a result, find meaning and purpose and heal from the psychological wounds of war and reintegration. Therefore, the purpose of the current study was to examine how changes in trauma-related mental health conditions were understood within the context of experiences of belongingness among a sample of xiii combat Veterans taking part in a spiritually integrated retreat-based intervention aimed at mitigating the psychological and spiritual effects of war trauma. An explanatory-sequential mixed methods design was used to: (1) assess changes in participant measures of PTSD, moral injury, and thwarted belongingness before and after the intervention; (2) qualitatively interview select participants to further understand the experience and effects of belonging during and after the intervention; (3) explore differences in qualitative themes across exceptional and nonexceptional responders to the intervention. This study provided insight into how the experiences of belonging may be related to changes in trauma-related symptoms. Results support the notion that experiences of belonging were associated with participant descriptions of internal healing and external behavior change suggestive of movement toward healthier intra-, inter-, and spiritual functioning. Specifically, belongingness counteracted feelings that participants were alone in their struggles while also helping them engage with challenging material related to trauma and spiritual struggles. Moreover, the experience of positive self-transcendent emotions that belongingness may provide, may be particularly salient for creating further opportunities for interpersonal and spiritual behavior changes indicative of trauma recovery. While such experiences and effects of belongingness may have accounted for decreases in PTSD-symptoms across time, participants did not experience similar reductions in symptoms of moral injury and, interestingly, thwarted belongingness. Ultimately, spiritually integrated retreat-based programs may require additional efforts after the intervention to address moral pain and a lack of belonging.