Testimonial therapy : a pilot project to improve psychological wellbeing among survivors of torture in India
In developing countries where torture is perpetrated, there are few resources for the provision of therapeutic assistance to the survivors. The testimonial method represents a brief crosscultural psychosocial approach to trauma, which is relatively easy to master. The method was first described in Chile in 1983 and has since been used in many variations in different cultural contexts.
Author: Agger, Inger | Raghuvanshi, Lenin | Khan, Shirin Shabana | Polatin, Peter | Laursen, Laila K.
RCT Author: Inger AggerRCT Author (No longer employed at RCT): Peter B. Polatin, Laila K. Laursen
Source: Torture : journal on rehabilitation of
torture victims and prevention of torture ; vol 19, no. 3
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In this project the method has been supplemented by
culture-specific coping strategies (meditation and a delivery
ceremony).
Methods: A pilot training project was undertaken between
Rehabilitation and Research Centre for Torture victims (RCT) in
Copenhagen, Denmark, and People's Vigilance Committee for Human
Rights (PVCHR) in Varanasi, India, to investigate the usefulness of
the testimonial method. The project involved the
development of a community-based testimonial method,
training of twelve PVCHR community workers, the development of a
manual, and a monitoring and evaluation (M&E) system comparing
results of measures before the intervention and two to three months
after the intervention. Twenty-three victims gave their testimonies
under supervision. In the two first sessions the testimony was
written and in the third session survivors participated in a
delivery ceremony. The human rights activists and community workers
interviewed the survivors about how they felt after the
intervention.
Findings: After testimonial therapy, almost all
survivors demonstrated significant improvements in overall WHO-five
Well-being Index (WHO-5) score. Four out of the five individual
items improved by at least 40%. Items from the International
Classification of Functioning, Disability and Health (ICF) showed
less significant change, possibly because the M&E questionnaire
had not been well understood by the community workers, or due to
poor wording, formulation and/or validation of the questions. All
survivors expressed satisfaction with the process, especially the
public delivery ceremony, which apparently became a "turning point"
in the healing process. Seemingly, the ceremonial element
represented the social recognition needed and that it re-connected
the survivors with their community and ensured that their private
truth becomes part of social memory.
Discussion: Although this small pilot study without control
groups or prior validation of the questionnaire does not provide
high-ranking quantitative evidence or statistically significant
results for the effectiveness of our version of the
testimonial method, we do find it likely that it helps
improve the well being in survivors of torture in this particular
context. However, a more extensive study is needed to verify these
results, and better meas ures of ICF activities and participation
(A&P) functions should be used. Interviews with human rights
activists reveal that it is easier for survivors who have gone
through testimonial therapy to give coherent legal
testimony