# Mental Health Clinician/Chaplain Collaboration (MC3): A Pilot Study

> **NIH VA I21** · CENTRAL ARKANSAS VETERANS HLTHCARE SYS · 2024 · —

## Abstract

Background: Moral injury symptoms include guilt, shame, and self-isolation. Moral injury is also
associated with increased suicide risk. Moral injury symptoms are common in Veterans being
treated for posttraumatic stress disorder (PTSD) or substance use disorder (SUD) and current
treatments do not always improve these symptoms. The Mental Health Clinician / Chaplain
Collaboration (MC3) intervention is delivered by VA chaplains who facilitate forgiveness and
community reintegration. MC3 is a collaboration between resources in the mental health clinic,
chaplain service, and community to support moral injury symptom recovery.
Significance: MC3 addresses the VA HSR&D research priority of mental health including
PTSD because moral injury symptoms are often comorbid with PTSD. MC3 also addresses the
HSR&D cross-cutting principle of coordinating and integrating care, in this case between mental
health, chaplain, and community resources. The MC3 intervention is also consistent with the
following VHA goals: the National Strategy for Preventing Veteran Suicide 2018-2028 (i.e.,
clinical and community prevention), integrating VA and community resources (i.e., MISSION
Act), and learning healthcare system priorities (i.e., multidisciplinary research methods).
Innovation & Impact: The new directions associated with MC3 are utilizing VA chaplains to
facilitate forgiveness and community reintegration. If MC3 is successful, then Veterans will have
an intervention that does not stop at the doors of the VA facility but takes advantage of
community resources that already exist to facilitate long-term recovery in a community of the
Veteran’s choosing. The explicit focus on community reintegration is what sets MC3 apart from
other moral injury interventions.
Specific Aims:
1. Pre-implementation: Adapt the intervention that was originally delivered by community clergy
 for delivery by VA chaplains. Stakeholders in this process will include VA chaplains and
 mental health clinicians at the Little Rock and Pittsburgh VAMCs.
2. Conduct a single arm pilot study (total N = 20 across 2 sites) of the MC3 intervention to
 assess feasibility, acceptability, and fidelity (primary outcomes).
3. Post-implementation: Conduct a formative evaluation with stakeholders of the recruitment
 methods, MC3 intervention, and outcome measures. This information will be used to refine
 the MC3 intervention and study procedures for a subsequent RCT.
Methodology: The study design is a two site one arm trial. The population is Veterans being
treated in specialty mental health who have symptoms of moral injury. MC3 will be delivered by
VA chaplains who will facilitate forgiveness and community reintegration. The primary outcomes
are feasibility and acceptability. Quantitative and qualitative data will be collected at baseline
and 6-months (end of intervention). Evidence-based quality improvement methods will be used
to implement MC3 at the Little Rock and Pittsburgh VAMCs.
Next Steps/Implementation:...

## Key facts

- **NIH application ID:** 10753048
- **Project number:** 1I21HX003715-01A1
- **Recipient organization:** CENTRAL ARKANSAS VETERANS HLTHCARE SYS
- **Principal Investigator:** JEFFREY M. PYNE
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-01-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10753048

## Citation

> US National Institutes of Health, RePORTER application 10753048, Mental Health Clinician/Chaplain Collaboration (MC3): A Pilot Study (1I21HX003715-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10753048. Licensed CC0.

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