Evaluation of the efficacy of a South African psychosocial model for the rehabilitation of torture survivors

Abstract

Introduction: To address the consequences of past torture experiences as well as current traumas and daily stressors, the Centre for the Study of Violence and Reconciliation (CSVR) developed a contextually appropriate psychosocial framework for the rehabilitation of individuals who have been affected by torture. Method: To test the efficacy of this framework, a quasiexperimental study was conducted with torture survivor clients of the CSVR who met the 1985 United Nations Convention Against Torture (UNCAT) definition. A comparison group of clients (n=38) was initially included on a waiting list and thereafter received treatment, whilst the treatment group of clients (n=44) entered straight into treatment. Results: Baseline t-test comparisons conducted on 13 outcome indicators revealed significantly better initial psychological health and functioning of clients in the treatment group than those in the comparison group, with moderately large differences on PTSD, trauma and anxiety, and strong difference in depression scores. Three-month follow-up comparisons using the conservative Wilcoxon test revealed significantly greater improvement on the functioning and anxiety indicators of the treatment group relative to the waiting-list comparison group (odds ratios = 2.49 and 2.61 respectively). After a

Treatments and interventions addressing chronic somatic pain in torture survivors: A systematic review

“…Six studies can be generally categorized as pre-post-test studies. Three studies collected data at baseline and at a singular time-point post-intervention [ 38 , 40 , 41 ], while the remaining three studies collected data for at least two time-points in addition to baseline data [ 39 , 42 , 43 ]. Five studies used baseline data in their analysis of the impact of the interventions, and one study used a three-month waiting list condition as a comparator for the initial treatment group [ 42 ].…”

“…Three studies collected data at baseline and at a singular time-point post-intervention [ 38 , 40 , 41 ], while the remaining three studies collected data for at least two time-points in addition to baseline data [ 39 , 42 , 43 ]. Five studies used baseline data in their analysis of the impact of the interventions, and one study used a three-month waiting list condition as a comparator for the initial treatment group [ 42 ]. The duration of each intervention exposure episode was similar for all six studies, with the sessions of the different interventions lasting from one hour to two hours.…”

“…Regarding treatments, two of the pre-post-test studies utilized Narrative Exposure Therapy (NET) in some capacity within the intervention [ 42 , 43 ]. One of these studies also utilized physiotherapy [ 43 ], while the other also utilized a wider multi-modal framework with trauma-focused CBT (TFCBT) and other broader therapies [ 42 ].…”

“…Regarding treatments, two of the pre-post-test studies utilized Narrative Exposure Therapy (NET) in some capacity within the intervention [ 42 , 43 ]. One of these studies also utilized physiotherapy [ 43 ], while the other also utilized a wider multi-modal framework with trauma-focused CBT (TFCBT) and other broader therapies [ 42 ]. The remaining four studies are otherwise heterogeneous in their intervention types, with interventions consisting of Testimonial Therapy (TT), complex manual therapy, multi-disciplinary therapy, and “pain school” [ 38 , 39 , 41 ].…”

“…Two studies assessed the number of areas of pain, with one study using body diagrams to mark areas of pain [ 39 ] and another using verbal identification of pain [ 42 ]. Two studies used scales for pain intensity, one study used a pain analogue Likert scale from 0 to 5 [ 38 ], and one study used the Visual Analog Scale (VAS) to identify pain scores directly on a scale of 0 to 10 [ 41 ].…”