It is important to be able to provide culturally-appropriate and effective interventions to assist survivors of torture and trauma in their country of resettlement. Counselling is a major form of treatment provided to survivors globally. This study investigated the effectiveness of a counselling intervention for 124 clients presenting at a torture and trauma service based in Western Australia. The Association of services to Torture & Trauma Survivors (ASeTTS) has sought to systematically evaluate the effectiveness of counselling interventions with torture and trauma survivors and demonstrate positive mental health outcomes, through the embedding of evaluation and research into core centre work.
Through partnership with the Community, Culture and Mental Health Unit at The University of Western Australia, in 2011 ASeTTS instigated the use of a standardised instrument, the Hopkins Symptom Checklist- 25 (HSCL-25), as part of clinical practice. This study involved the analysis of pre-existing non-identifiable data that was collected as part of routine clinical counselling assessment and intervention. A variety of standard client socio-demographic data was also collected to comply with funding requirements. Clinicians administered the HSCL-25 during the client's assessment phase to identify symptom severity. The HSCL-25 was administered again after approximately six counselling sessions, every further six sessions and at the point of case closure. The results from these HSCL-25 assessments and the socio-demographic information were entered by the clinicians into ASeTTS' client records database. This de-identified data were then provided to the researcher for analysis. Results were analysed to determine if there was a change in symptom severity from the Initial Assessment to Subsequent and Closure Assessments. Correlations between symptomology and demographic factors and interpreter usage were also investigated.
HSCL-25 scores for the 124 participants were analysed to investigate if there was a significant difference be- tween scores at the Initial Assessment, Subsequent Assessment and Closure Assessment stages. In this study a high proportion of participants were symptomatic for anxiety and depression at initial assessment. This shows the high prevalence of mental health disorders among torture and trauma survivors accessing counselling services. The data analysis indicates that counselling intervention has had a positive impact for both anxiety and depression symptoms. Results further indicate that the counselling intervention had an immediate positive impact, as demonstrated by the decline in anxiety and depression symptomology after six sessions. The effectiveness of counselling interventions becomes apparent at the closure assessment, where both anxiety and depression are well below symptomatic levels. This suggests that specialised counselling is an appropriate intervention for torture and trauma survivors with the aim to reduce symptoms of depression and anxiety.
Funding & No Conflicts Declaration
This research was not funded. All authors declare no conflicts of interest.