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Dissertation

Sythesis and extension of the literature on the use of psychotherapy in the treatment of adult refugee torture survivors

24 July 1998

Abstract

The problem of torture appears to have existed since early human history and it continues today in every region of the world. Torture involves the total control by a dominant individual or group over others who are weaker, oppressed, or despised. The devastating effects of torture can potentially harm any area of physical or psychosocial function. This dissertation reviews and critiques relevant journal articles and book chapters on the psychotherapeutic treatment of adult refugee torture survivors. The findings suggest important factors and techniques for consideration in the treatment of torture survivors. For example, trust between therapist and torture survivor is the single most important element in psychotherapy, without which the success of treatment is unlikely. Another decisive factor in the success of psychotherapy is therapists' ability to handle their own intense, potentially overwhelming emotional reactions which are commonly elicited by torture survivors' trauma stories. Concurrent, coordinated psychological, medical, and social assistance, as is found at specialized
treatment centers, often appears essential. A knowledge base of the effects of torture, survivors' cultures/ and treatment techniques is critical in conducting psychotherapy with torture survivors. Psychotherapy models, regardless of
torture survivors! backgrounds, appeared to incorporate four treatment phases, which included trust building and assessment, cognitive, emotional, and reintegration. A core component of psychotherapy is caretul work on the memories and distressing emotions associated with the central trauma story. This core therapeutic component while varying in form from one survivor to another is regarded as essential regardless of survivors' cultural backgrounds or therapists' models of treatment. Because of the great individual variability among torture survivors even among those from similar ,cultural backgrounds the findings from the literature should be applied with caution to the treatment of any particular torture survivor.


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