Brief Multi-Disciplinary Treatment for Torture Survivors in Nepal: a Naturalistic Comparative Study

• Published in: International journal of social psychiatry 2009-01, Vol.55 (1), p.39-56
• Main Authors: Tol, Wietse A., Komproe, Ivan H., Jordans, Mark J.D., Thapa, Suraj B., Sharma, Bhogendra, De Jong, Joop T.V.M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Associated treatments; Biological and medical sciences; Brief interventions; Comparative studies; Demography; Disability; Displaced persons; Female; Health problems; Health services; Help seeking behavior; Helpseeking; Humans; Interdisciplinary approach; Interdisciplinary aspects; Low income groups; Male; Medical sciences; Mental disorders; Mental health; Middle Aged; Nepal; Nepal - epidemiology; Patient Acceptance of Health Care - statistics & numerical data; Patient Care Team; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychosocial factors; Psychosocial intervention; Somatic symptoms; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - therapy; Survivor; Survivors; Survivors - psychology; Torture; Treatment methods; Treatments; Well being; Young Adult
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/0020764008091525

Background: Little is known about the effectiveness of treatment for torture survivors in low-income settings. Multi-disciplinary treatment is an often used approach for this target group. Aims: This study was aimed at examining the effectiveness of brief multi-disciplinary treatment for torture survivors in Nepal. Methods: A naturalistic comparative design with help-seeking torture survivors and internally displaced persons assigned to a treatment and a comparison group respectively ( n = 192; treatment group n = 111, comparison group n = 81), with baseline measurements on psychiatric symptomatology, disability, and functioning and a five-month follow-up (n = 107; treatment group n = 62; comparison group n = 45), was employed. Intervention consisted of brief psychosocial services, minimal medical services and/or legal assistance. Results: Study groups were generally comparable and non-completers did not significantly differ from completers. The treatment group improved more than the comparison group on somatic symptoms, subjective well-being, disability and functioning, with mostly moderate effect sizes. Conclusion: Treatment was moderately effective, with regards to reducing the nonspecific mental health consequences of torture, but disability scores remained high. For clients presenting with more severe mental health problems, other treatments that are realistic in the resource-poor Nepali context need to be sought.