Online proceedings for the IRCT General Assembly and 10th International Scientific Symposium - Delivering on the Promise of the Right to Rehabilitation

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Time: 15:20 to 15:40 Download Presentation

Efficacy of rehabilitation and treatment approaches - indicators likely to contribute to treatment success among survivors of torture

Presenter(s) and co-author(s): Dr. Martin Hill ( Heartland Alliance International - Marjorie Kovler Center - United States of America ), Ms. Mary Lynn Everson ( Heartland Alliance International - Marjorie Kovler Center - United States of America )

Background

Established by volunteers in 1987 and currently in its 29th year of service to survivors of politically sanctioned torture, Heartland Alliance Marjorie Kovler Center (Kovler Center), a program of Heartland Alliance International, provides empowerment-focused, strengths-based, holistic torture treatment services to an international population of survivors resettling in Chicago and the surrounding region. Medical, mental health, social services and coodinated legal services are integrated, culturally-sensitive to each survivor, and focused on safety, dignity, respect, and choice. Utilizing a community-based pro bono model of service with nearly 200 professional and paraprofessional volunteers, Kovler Center serves 350 participants annually representing 84 countries worldwide.

Methodology

The main goal of treatment evaluation has been to assess participants' functioning using a multi-method approach inclusive of structured clinical interviews, observations, and self-reports. The Kovler Center began rigorously evaluating the efficacy of its treatment program and tracking participant progress in 2010, focusing on outcome measures such as symptoms of anxiety, depression, trauma, and functional well-being. Outcomes are tracked via three instruments: Harvard Trauma Questionnaire (HTQ), Hopkins Symptom Checklist-25 (HSCL), and Marjorie Kovler Center Well Being Questionnaire (MKC WBQ). HTQ measures trauma symptoms, HSCL measures anxiety and depression symptoms, and MKC WBQ assesses multiple domains (i.e., legal status, physical health, employment, housing, education, language ability, and personal relationships).

These instruments are administered during the intake process to all new, adult, primary and secondary survivors of torture who come to Kovler Center and re-administered at six-month intervals up to 24-months post intake. Evaluation results over the past four years demonstrate 86% of participants had fewer symptoms of anxiety and depression, and 81.1% had fewer symptoms of trauma after receiving services for 24 months. Furthermore, 54% and 18% are classified as symptomatic for anxiety/depression and trauma, respectively, following 24 months of treatment. Additionally, several psychosocial domains of well-being have shown improvement over time.

Results

Moving forward, the Kovler Center now has a sufficient database of those who have been through the program 24 months to facilitate a more robust data analyses in order to determine variables/indicators that are most likely to yield positive outcomes. For example, we investigate the impact of socio-demographic (e.g., gender, education, marital status,  age at which first tortured),  torture-related (e.g., number of times detained, length of torture, types of torture), psychological (e.g., type of diagnoses, number of different diagnoses), and/or program/service-related (e.g., total number of services received, types of service received, type of therapy received) variables/indicators on a participant's ability to matriculate through the program and ultimately lead a rewarding life and be a positively contributing member of society. The answers to these questions allow a resource limited program to craft a treatment plan that maximizes the strongest program components -- those likely to contribute to positive Sttreatment outcomes.

Funding & No Conflicts Declaration

Kovler Center receives funding for the project from government sources, private foundations, and individual contributions. The presenters receive no financial gain from making this presentation.

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