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

Time: 11:10 to 11:30 Download Presentation

The Freedom from Torture Measure of Clinical Change & Outcome (MOCCO): Development and usage

Presenter(s) and co-author(s): Ms. Susan Munroe ( Freedom from Torture - United Kingdom ), Ms. Nicola Anne Witcombe ( IRCT - Denmark ), Mr. Andy Keefe ( Freedom from Torture - United Kingdom )


The paper will explore the process of development of the MOCCO at FfT; present the tool itself and explain how it is deployed with clients and the recording of data onto the FfT client database. Data collected since April 2014 will be presented with reflections on what we have learnt from it about the efficacy and impact of our work. Finally I will cover the limitations of the tool and issues with its implementation and our plans to develop it further, including external validation. The MOCCO was developed on behalf of FfT by Dr Rebecca Horne.


Fft therapists and a number of survivors of torture in therapy were consulted to develop a list of “signs of distress and wellbeing'” which were formulated into a 40 question questionnaire before being piloted with 150 of our clients. After validation of the pilot results and feedback from those involved, developed a final list of twenty questions were developed, these now form the basis of the tool. Clients are also asked about the positive and negative impact of external factors such as their legal situation or housing to give context as well as a question about their quality of life in general and are invited to feedback on the quality of our work. This final tool is now administered at the beginning of therapy, at three, six and twelve months and every twelve months after that. It has been translated and is client rated. For each question, the client is asked to what extent they have been affected by a certain issue (e.g. nightmares) over the past week - not at all, a little, quite a lot, very much. The client is then invited to comment further in a narrative box. Quantitative and qualitative data is therefore recorded.


Results from the tool are recorded on Daylight, the FfT clinical database, which allows clinicians and managers to keep track of compliance with the tool. FfT have been working with Essex University Human Rights Centre, Computer Science and Social Science Departments since early 2016 to develop all of our clinical data to make it more accessible and available for research purposes. This work has included a detailed analysis of the data from the tool and what it tells us about the progress of survivors through the rehabilitation programme at FfT which will be presented. By February 2016, 1,281 MOCCOs had been completed with 638 FfT clients and this number will grow by the end of the year. Use of MOCCO data in work with clients, casework management and service development will be discussed and the findings from the current analysis presented.

Funding & No Conflicts Declaration

Our collaboration with Essex University is funded by ESRC (Economic & Social Research Council) funding. We declare no conflicts of interest.

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