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Module 2 Answers
Preliminary Considerations
Toolkits > Istanbul Protocol Model Medical Curriculum > Module 3: Interview Considerations

Module 3: Interview Considerations

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Objectives

  • To understand the key role of the interview in conducting medical evaluations of torture allegations
  • To be familiar with conditions necessary for an effective interview
  • To understand and develop interview process skills such as empathy and earning trust
  • To learn effective and appropriate techniques of questioning
  • To understand the effect of the interviewing style on the interview process and the alleged victim
  • To develop the capacity to elicit a detailed narrative account of alleged experiences
  • To be familiar with possible difficulties of recalling and recounting elements of torture experiences
  • To understand how and why difficulties may arise during an interview
  • To be familiar with possible transference and counter-transference reactions
  • To develop awareness to possible vicarious traumatisation and burnout and discuss strategies to address their effects
  • To examine individual reactions to hearing a recording of an interview with a survivor of torture

Content

  • Preliminary Considerations
    • Purpose of medical evaluations
    • Interview settings
    • Trust
    • Informed consent
    • Confidentiality
    • Privacy
    • Empathy
    • Objectivity
    • Safety and security
    • Procedural Safeguards for Detainees
    • Risk of Re-traumatisation
    • Gender Considerations
    • Interviewing Children
    • Cultural and Religious Awareness
    • Working with Interpreters
    • Transference and Counter-Transference Reaction
  • Conducting Interviews
    • Types of Questions
    • Cognitive Techniques
    • Summarising and Clarifying
    • Difficulties Recalling and Recounting
    • Assessing Inconsistencies
  • Interview Content
    • Identification and Introduction
    • Psychosocial History- Pre-Arrest
    • Past Medical History
    • Summary of Detention(s) and Abuse
    • Circumstances of Detention(s)
    • Prison/Detention Place Conditions
    • Allegations of Torture and Ill-treatment
    • Review of Symptoms
    • Psychosocial History (post-arrest)
    • Assessments of Physical and Psychological Evidence
    • Physical Examination
    • Closing
    • Indications for Referral

Discussion Topics

  • Play audio (MP3 file [2] [1]) of National Public Radio interview with Sr. Dianna Ortiz (about 15 minutes) and discuss relevant interview considerations: confidentiality, informed consent, privacy, safety, objectivity, impartiality, creating a climate of trust, courtesy, honesty, empathy, the effects of interviewing style, appropriate use of open-ended and closed questioning, the risks of re-traumatisation and how to minimize the risk of re-traumatisation.
  • Discuss individual responses to the interview with Sr. Dianna Ortiz and discuss strategies for managing such reactions and limiting secondary trauma and “burn-out”
  • Discuss what you find most challenging about interviewing survivors of torture and ill treatment

Teaching Formats

  • Group Activity:
    • Listen to the audio (MP3 file [2] [1]) of National Public Radio interview with Sr. Dianna Ortiz (about 15 minutes) as a class.
    • Divide the class into several groups and have each group address the first two Discussion Topics above
    • A facilitator should be identified to moderate the discussion and rapporteur should be identified to record the group’s findings and report them when the class reconvenes.
    • After 20-30 minutes of group discussion, the entire class should reconvene
    • Rapporteurs should briefly report on their group’s findings
    • Open class discussion
  • Individual Research/Assignment:
    • Research ways in which clinicians who work with survivors of torture deal with secondary trauma. Write a series of recommendations for colleagues who conduct medical evaluations of alleged torture victims on a regular basis, but are unaware of counter-transference issues
  • Journal Entry: (Instructor to assign Write a few paragraphs — no more than a page)
    • Consider your response to the audiotape of interview with Sr. Dianna Ortiz. Provide a series of recommendations to effectivel address these reactions and possibly others.
    • Discuss what you find most challenging about interviewing survivors of torture and ill treatment

Primary Resources

  • The Istanbul Protocol
  • The Medical Documentation of Torture
  • Medical Investigation and Documentation of Torture: A Handbook for Health Professionals
  • Psychological Evaluation of Torture Allegations: An International Training Manual
  • Audio of interview with Sr. Dianna Ortiz [3]. National Public Radio. 1996.
  • Trainers’ Guidelines for Health Professionals: Training of Users
  • Torture Reporting Handbook, Part II – Documenting Allegations

Quelle

  • [1] http://phrtoolkits.org/downloads/?did=34
  • [2] http://phrtoolkits.org/downloads/?did=34
  • [3] http://phrtoolkits.org/downloads/?did=34

Section Contents

  1. Preliminary Considerations
    • Purpose of Medical Evaluations
    • Interview Settings
    • Trust
    • Informed Consent
    • Confidentiality
    • Privacy
    • Empathy
    • Objectivity
    • Safety and Security
    • Procedural Safeguards for Detainees
    • Risk of Re-traumatisation
    • Gender Considerations
    • Interviewing Children
    • Cultural and Religious Awareness
    • Working with Interpreters
    • Transference and Counter-Transference Reactions
  2. Conducting Interviews
    • Types of questions
    • Cognitive Techniques
    • Summarising and clarifying
    • Difficulties Recalling and Recounting
    • Assessing Inconsistencies
  3. Interview Content
    • Identification and Introduction
    • Psychosocial History (Pre-Arrest)
    • Past Medical History
    • Summary of Detention(s) and Abuse
    • Circumstances of Detention(s)
    • Prison/Detention Place Conditions
    • Allegations of Torture and Ill-treatment
    • Review of Symptoms
    • Psychosocial History (post-arrest)
    • Assessments of Physical and Psychological Evidence
    • Physical Examination
    • Closing
    • Indications for Referral
  4. Module 3 Presentation: Interview Considerations
  5. Self-Assessment and Quiz
    • Module 3 Answers
Module 2 Answers
Preliminary Considerations
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  • Istanbul Protocol Model Medical Curriculum

    • Preface
      • Copyright and Acknowledgements
      • Resources
      • Glossary
    • Introduction
      • Curriculum Materials
      • Summary of Content
      • How to Use These Educational Resources
    • Module 1: International Legal Standards (Overview)
      • Torture
        • What is Torture
        • Purpose of Torture
        • History of Torture
        • Other Definitions
        • Cruel Inhuman & Degrading Treatment & Punishment (CID)
        • Prohibition of Torture in International Law
        • The United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 1984
        • Torture in the World Today
        • Country-Specific Legal Standards and Torture Practices
        • The Perpetrators
        • Common Situations for Torture Allegations
        • Where Does Torture and Ill-treatment Occur?
        • Obligation to Investigate and Bring Justice
        • Formal Inspection of Detention Facilities
        • Official Complaints to Human Rights Bodies and Other Organizations
        • Recently Released Detainees
        • NGO Information Gathering
        • Late Allegations
      • Prevention and Accountability
        • Prevention
        • Accountability
        • Reparation
      • International Supervisory Machinery and Complaints Procedures
        • The Human Rights Committee
        • The UN Committee against Torture
        • Regional Mechanisms
        • Other monitoring mechanisms
        • The UN Special Rapporteur on Torture and other Cruel, Inhuman and Degrading Treatment or Punishment
        • International criminal courts and tribunals
        • The International Committee of the Red Cross (ICRC)
      • Safeguards Against Torture for Those Deprived of Their Liberty
        • Notifying people of their rights
        • Use of officially recognized places of detention and the maintenance of effective custody records
        • Avoiding incommunicado detention
        • Humane conditions of detention
        • Limits on interrogation
        • Access to a lawyer and respect for the functions of a lawyer
        • Access to a doctor
        • The right to challenge the lawfulness of detention
        • Safeguards for special categories of detainees
      • Module 1 Presentation: International Legal Standards
      • Self-Assessment and Quiz
        • Module 1 Answers
    • Module 2: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
      • The Istanbul Protocol
        • About the Istanbul Protocol
        • Brief History
        • International Recognition of the Istanbul Protocol
      • An Overview of the Istanbul Protocol
        • Legal Investigation of Torture
        • General Considerations for Interviews
        • Physical Evidence of Torture
        • Psychological Evidence of Torture
        • Interpretation of Findings and Referrals
        • Misuse of the Istanbul Protocol
        • Procedural Safeguards for Detainees
      • Medical Ethics
        • Introduction
        • Duties of the health professional
        • International Codes
        • Ethical rules directly prohibiting involvement in torture
        • Primary loyalty to the patient
        • Dual Obligations
        • The treatment of prisoners and detainees
        • Issues surrounding examinations of individuals in the presence of security forces
        • Abusive medical treatment
        • Consent and confidentiality
        • Security
        • Involvement of other health professionals in torture
        • Seeking further information and support
        • Country-specific legal responsibilities of health professionals for forensic documentation of torture and ill-treatment
      • General Guidelines for Gathering Evidence and Documenting Findings
        • The aims and goals of investigation
        • Multidisciplinary approach to documentation
        • Role of the health professional in the team
        • Role of the lawyer in the team
        • Role of the NGO member in the team
        • Role of judges and prosecutors
      • Documenting the allegations
        • The aim of medical documentation
        • Types of evidence
        • Medical evidence
        • Gathering of evidence
        • Essential information
        • Quality of information
        • Comparing records
      • Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
      • Self-Assessment and Quiz
        • Module 2 Answers
    • Module 3: Interview Considerations
      • Preliminary Considerations
        • Purpose of Medical Evaluations
        • Interview Settings
        • Trust
        • Informed Consent
        • Confidentiality
        • Privacy
        • Empathy
        • Objectivity
        • Safety and Security
        • Procedural Safeguards for Detainees
        • Risk of Re-traumatisation
        • Gender Considerations
        • Interviewing Children
        • Cultural and Religious Awareness
        • Working with Interpreters
        • Transference and Counter-Transference Reactions
      • Conducting Interviews
        • Types of questions
        • Cognitive Techniques
        • Summarising and clarifying
        • Difficulties Recalling and Recounting
        • Assessing Inconsistencies
      • Interview Content
        • Identification and Introduction
        • Psychosocial History (Pre-Arrest)
        • Past Medical History
        • Summary of Detention(s) and Abuse
        • Circumstances of Detention(s)
        • Prison/Detention Place Conditions
        • Allegations of Torture and Ill-treatment
        • Review of Symptoms
        • Psychosocial History (post-arrest)
        • Assessments of Physical and Psychological Evidence
        • Physical Examination
        • Closing
        • Indications for Referral
      • Module 3 Presentation: Interview Considerations
      • Self-Assessment and Quiz
        • Module 3 Answers
    • Module 4: Torture Methods and their Medical Consequences
      • Introduction
      • Torture Methods
        • Beatings/Falanga
        • Ear Trauma
        • Eye Trauma
        • Restraint, Shackling and Positional Torture
        • Suspension
        • Crushing and Stretching Injuries
        • Burning
        • Electrical injuries
        • Asphyxiation
        • Violent Shaking
        • Sexual Assault
        • Sexual Humiliation
        • Prolonged Isolation and Sensory Deprivation
        • Sleep Deprivation
        • Temperature Manipulation
        • Sensory Bombardment
        • Threats of Harm
      • Psychological Consequences of Torture
        • Introduction
        • The Paradox of Psychological Consequences of Torture
        • The Psychological Consequences of Torture
        • Social, Political and Cultural Context
        • Risk factors for Trauma and Torture-Related Disorders
        • Psychological Symptoms
      • Module 4 Presentation: Torture Methods and their Medical Consequences
      • Self-Assessment and Quiz
        • Module 4 Answers
    • Module 5: Physical Evidence of Torture and Ill-Treatment
      • Physical Evidence of Torture
        • Medical history
      • The Physical Examination
        • Dermatologic Evaluation
        • Head and Neck
        • Chest and Abdomen
        • Musculoskeletal System
      • Neurological Examination
        • Head Trauma and Post-traumatic Epilepsy
        • Nerve Damage
      • Examination of Women
        • Examination Following a Recent Assault
        • Examination After the Immediate Phase
        • Follow-up
        • Genital Examination of Women
      • Genital Examination of Men
      • Perianal Examination
      • Medical Photography
        • Assessment for Referral
      • Diagnostic Tests
      • Module 5 Presentation: Physical Evidence of Torture and Ill-Treatment
      • Self-Assessment and Quiz
        • Module 5 Answers
    • Module 6: Psychological Evidence of Torture and Ill-Treatment
      • The Central Role of the Psychological Evaluation
        • Conducting the Psychological Evaluation
        • Psychological Findings and Diagnostic Considerations
        • Components of the Psychological/Psychiatric Evaluation
      • Children and Torture
        • Introduction
        • Developmental Considerations
        • Clinical Considerations
        • Role of the Family
      • Apendix I: Sample Psychological Evaluations
        • Psychological Evaluation #1
        • Psychological Evaluation #2
      • Apendix II: ICD-10
      • Module 6 Presentation: Psychological Evidence of Torture and Ill-Treatment
      • Self-Assessment and Quiz
        • Module 6 Answers
    • Module 7: Case Example #01
      • Introduction
      • Preliminary Considerations
      • Materials
      • Module 7 Presentation: Case Example #01
      • Self-Assessment and Quiz
        • Module 7 Answers
    • Module 8: Case Example #02
      • Introduction
      • Preliminary Considerations
      • Materials
      • Module 8 Presentation: Case Example #02
      • Self-Assessment and Quiz
        • Module 8 Answers
    • Module 9: Report Writing and Testifying in Court
      • Written Reports
        • General Considerations
        • Content of Written Reports
        • Conclusions
        • Inconsistencies
      • Providing Testimony in Court
      • Appendix: Court Testimony Guidelines and Maxims
      • Module 9 Presentation: Report Writing and Testifying in Court
      • Self-Assessment and Quiz
        • Module 9 Answers
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