Brief interventions with survivors of torture

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Brief interventions with survivors of
torture Virginia Leggatt  Angela Burnett  

The Medical Foundation for the Care of Victims of
Torture
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• Learning Objectives
• By the end of the session participants should
• Be able to identify potential stressors
• Recognise practical ways to prevent exacerbation
  of distress
• Recognise practical ways to address and alleviate
  distress
•  
•                   

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Potential Stressors 1 The situation small space
/ interpreter gender               Multiple
practical needs may be unrelated to
pre-flight experiences Illness physical
ill-health / pain / depression / anxiety /
post traumatic stress / self-medication Issues
in home country loss of family, home, culture,
identity / torture or death of family and
friends / away from home but still there
emotionally
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Potential Stressors 2 Difficulties in UK
culture shock / racism / xenophobia /
homelessness / housing problems / loss of
privacy / isolation Uncertainty delays in
asylum process / threat of detention removal
/ uncertain financial support /unfamiliar
systems Loss status / political social role
/ communication / language barrier   Shame
may be culturally shameful to disclose rape
/ torture / suicidal ideation
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Prevent exacerbation of distress Provide
non-threatening environment    not confined /
easy exit Adopt non-threatening stance   calm,
assertive, neutral voice / non-threatening
posture / appropriate eye contact / avoid
mirroring angry gestures     Suggest / ask about
unmet needs hurt / powerlessness / panic / fear
/ feeling unsafe or out of control  
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Alleviate distress Flashbacks contain / talk
through / distract from triggers Take their
side I want to understand Involve them build
on their resources / what helped before? Enlist
mutual allies family / friends / colleagues
Expect them to cope  how have they already
coped? what has helped in past? Establish
trust make a plan prioritise see again
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• Key Issues
• Establish, dont assume, cause(s) of distress
• Minimise exacerbating factors
• Cultural sensitivity
• Recognise exile and loss / torture experience
• Establish trust
• Risk assessment
• Take care of yourself
• Support and supervision for doctors