The effects of a combined psychotherapy and physiotherapy group treatment program for survivors of torture incarcerated in an adult prison in Kurdistan, Iraq: A pilot study

Abstract


 
 
 
 Introduction: Survivors of torture have high rates of mental health problems and can experience a sequela of physical effects with the most common being persistent pain. Similar to survivors of torture, persons that are incarcerated have high rates of mental health problems, persistent pain and pain-related disability.The purpose of this study is to assess the effect of an interdisciplinary group treatment approach, involving psychotherapy and physiotherapy, with survivors of torture whom are incarcerated in a prison in Kurdistan, Iraq.
 
 
 Methods: A parallel group study design was used to compare a treatment group (n=11) and a wait-list control group (n=16). The treatment group participated in an interdisciplinary treatment service for a total of 10 weekly group sessions for each discipline.The primary outcome measures were symptoms of nociplastic pain, anxiety, depression, and PTSD. Secondary outcome measures evaluated physical functioning, sleep quality, and general self-efficacy.
 Results: A statistically significant reduction in outcome measure scores was seen in all symptoms measured immediately post-treatment.
 Discussion and Conclusion: These findings suggest that a culturally and contextually appropriate interdisciplinary group treatment in- tervention for survivors of torture in a prison could be effective for short-term reductions in symptoms of anxiety, depression, PTSD, per- sistent pain, and function. The study has limitations including a small sample size, lack of long-term outcome measures, and an inability to isolate effect of each component of care.The study does demonstrate the feasibility of implementing research that follows international research standards and practices within under- researched settings and post-conflict areas.
 
 
 

Influence of international commitments against torture on prison indicators: measuring human rights

“…One of the factors reported in the study for the onset or worsening of these disorders is the psychosocial experience of prison, and torture and other cruel treatments certainly contribute to the worsening of this scenario. It has even been shown that survivors of torture have high rates of mental illness (Gamble et al, 2020). A systematic review corroborated the results of this research by concluding that female prisoners are at higher risk for physical and mental health problems (McGinley & McMillan, 2019).…”

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

“…Three trials were conducted at clinics serving refugees in Europe or the United States, and one trial was conducted in an Iraqi prison ( Table 1 ). In total, the four trials included 114 men and 196 women, with one trial only including men [ 34 ]. The ages of participants ranged from 18 to 65 years, and three studies reported an average age range of 31–48 years [ 34 , 35 , 37 ].…”

“…In total, the four trials included 114 men and 196 women, with one trial only including men [ 34 ]. The ages of participants ranged from 18 to 65 years, and three studies reported an average age range of 31–48 years [ 34 , 35 , 37 ].…”

“…The types of traumatic events reported by the study population included physical assault, verbal abuse, solitary confinement, torture, sexual harassment, assault, and witnessing an assault on a familiar person [ 34 , 35 , 37 ]. One trial did not report the types of torture experienced by participants [ 36 ].…”

Collaborative effort to increase the physiotherapist’s competency in rehabilitation of torture survivors

“…There is not one single method available that can address the pain and discomfort that can be experienced by persons with a traumatic background. A broad and contextual understanding of concepts of pain are therefore paramount (Gamble et al, 2020). The aim must be to create opportunities to change for the better, which might require additional measures and use of a more holistic approach.…”