Testimonial therapy: a pilot project to improve
psychological wellbeing among survivors of torture in
India.
Authors: Inger Agger, Lenin Raghuvanshi, Shirin Shabana Khan,
Peter Polatin, Laila K. Laursen
Torture, vol 19, no. 3
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Introduction: 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. 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 measures 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.