The effects of a combined psychotherapy and physiotherapy group treatment program for survivors of torture incarcerated in an adult prison in Kurdistan, Iraq: A pilot study

Introduction: Survivors of torture have high rates of mental health problems and can experience a sequela of physical effects with the most common being persistent pain. Similar to survivors of torture, persons that are incarcerated have high rates of mental health problems, persistent pain and pain-related disability. The purpose of this study is to assess the effect of an interdisciplinary group treatment approach, involving psychotherapy and physiotherapy, with survivors of torture whom are incarcerated in a prison in Kurdistan, Iraq. Methods: A parallel group study design was used to compare a treatment group (n=11) and a wait-list control group (n=16). The treatment group participated in an interdisciplinary treatment service for a total of 10 weekly group sessions for each discipline. The primary outcome measures were symptoms of nociplastic pain, anxiety, depression, and PTSD. Secondary outcome measures evaluated physical functioning, sleep quality, and general self-efficacy. Results: A statistically significant reduction in outcome measure scores was seen in all symptoms measured immediately post-treatment. Discussion and Conclusion: These findings suggest that a culturally and contextually appropriate interdisciplinary group treatment intervention for survivors of torture in a prison https://doi.org/ 10.7146/torture.v30i2.119199 International Rehabilitation Council for Torture Victims. All rights reserved. The effects of a combined psychotherapy and physiotherapy group treatment program for survivors of torture incarcerated in an adult prison in Kurdistan, Iraq: A pilot study April Gamble PT, DPT, CLT1, Ahmed M. Amin Ahmed MBChB, MA, PhD2, Salah Hassan Rahim BSc3, Jeff Hartman PT, DPT, MPH4 Key points of interest • Novel interdisciplinary treatment approach for incarcerated survivors of torture using a culturally and contextually appropriate physiotherapy and psychotherapy group treatment service • Initial treatment effects on symptoms of mental health, physical health, and functioning are positive despite ongoing exposure to the stress and trauma of prison • Reveals feasibility of implementing research that follows international research standards and practices within under-researched settings like prisons and post-conflict areas 1) Physiotherapy Technical Coordinator, Wchan Organization for Victims of Human Rights Violations; Founder of ACR – The American Center for Rehabilitation Correspondence to: april.dpt@gmail.com 2) Executive Director, Wchan Organization for Victims of Human Rights; Lecturer, Sulaimani Polytechnic University – Technical College of Health 3) Mental Health Director, Wchan Organization for Victims of Human Rights 4) Assistant professor, University of Wisconsin School of Medicine and Public Health, Doctor of Physical Therapy program, Madison, WI. T O R T U R E V o lu m e 3 0 , N u m b e r 2 , 2 0 2 0 59 S P E C I A L S E C T I O N : P H Y S I O T H E R A P Y F O R T O R T U R E S U R V I V O R S ( 1 ) could be effective for short-term reductions in symptoms of anxiety, depression, PTSD, persistent pain, and function. The study has limitations including a small sample size, lack of long-term outcome measures, and an inability to isolate effect of each component of care. The study does demonstrate the feasibility of implementing research that follows international research standards and practices within underresearched settings and post-conflict areas.