Moral Injury, Agency, and the Importance of Connection in Teams: An ACT Perspective

When moral injury arises from systemic constraints — when people feel unable to act on what they believe is right — it doesn’t just cause distress. It can create a kind of paralysis. A deep sense that nothing will change until everything changes.

This is understandable. The roots of moral distress are often structural, cultural, and deeply embedded — beyond the reach of any one person. Many professionals reach a point where they feel exhausted, disillusioned, or emotionally shut down. They care deeply, but feel powerless to act on that care.

This loss of agency is often what deepens the injury.

In many workplaces, especially in health and care systems, the conversation around moral injury gets stuck between two poles:

• Waiting for systemic change (which is vital, but slow and often outside our control)

• Or focusing purely on individual coping (which can unintentionally locate the problem in the person rather than around them)

But there is a third way — a path grounded in Acceptance and Commitment Therapy (ACT). This middle path honours the reality of systemic harm while supporting individuals, teams, and organisations to stay connected to values, agency, and care.

Why This Matters to Teams and Organisations — Beyond Being “Nice to Staff”

Moral injury and burnout aren't just individual problems — they’re team and system-level risks. Ignoring them affects:

• Staff retention: People leave not because they don’t care, but because they can no longer bear caring in a system that feels morally compromising.

• Team cohesion: When distress goes unspoken, staff withdraw, conflicts escalate, and teams fracture.

• Service quality: Emotional fatigue and moral disconnection reduce compassion, attentiveness, and decision-making quality.

• Organisational culture: When values are routinely violated or dismissed, cynicism spreads — and with it, disengagement.

Supporting teams to respond to moral injury isn’t just about wellbeing — it’s about sustainability, performance, safety, and ethical practice.

ACT provides an evidence-based, structured way to:

• Reconnect people with why they came into this work

• Support staff to engage without burning out

• Strengthen reflective, compassionate, values-driven teams

• Keep purpose alive, even in hard systems

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What ACT Offers in the Face of Moral Injury

ACT is a psychological flexibility model. It doesn’t ask us to fix or avoid difficult feelings, but to make space for them, connect with our core values, and take meaningful action — even in hard contexts.

In the face of burnout and moral distress, ACT offers a framework for:

🔹 Individuals:

• Naming and acknowledging moral pain without needing to resolve it

• Practising defusion from harsh self-judgement or “stuck” narratives

• Reconnecting with personal and professional values

• Taking small, values-aligned actions, even when change feels out of reach

🔹 Teams:

• Building cultures of care and reflection, not just performance

• Making space to talk openly about moral injury and distress

• Supporting one another to respond to pain with presence and compassion

• Developing shared values that guide how the team operates

🔹 Organisations:

• Recognising moral injury as more than burnout — a values-based injury

• Creating environments that support psychological flexibility and shared meaning

• Using ACT principles to guide reflective practice, supervision, and wellbeing strategies

A Values-Based Path Forward

We don’t have to choose between waiting for system-wide transformation or silently enduring harmful environments. ACT gives us tools to navigate morally complex systems with clarity, care, and purpose.

This middle path includes:

• Caring for ourselves and each other with intention

• Creating team environments where support and compassion are active

• Making space to name moral pain, even if it can’t be resolved

• Responding to distress in ways that deepen connection, not isolation

• Taking small but significant actions aligned with our values

• Staying rooted in purpose, even in imperfect systems

Why Connection Enables Change

Systems need to change — absolutely. But how we respond to distress in the meantime matters deeply.

When moral pain leads to self-blame, withdrawal, or disconnection, we are harmed — and the system remains unchanged.

But when we stay in connection, when we support each other, witness each other’s pain, and take action (however small), we create the conditions for change — within ourselves, in our teams, and potentially, in our organisations.

Change may not be guaranteed, but through connection and values-based action, it becomes possible. And possibility is powerful.

Bring This Conversation to Your Team:

Christian Hughes is a Psychotherapist, Clinical Supervisor, and Trainer, specialising in Acceptance and Commitment Therapy, Moral Injury & Prosocial ACT for Teams & Workplaces. If you'd like to know more about applying Prosocial ACT to your workplace, please get in touch.

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