Module 3: Interview Considerations
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 [6]) 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 [6]) 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 [6]. National Public Radio. 1996.
- Trainers’ Guidelines for Health Professionals: Training of Users
- Torture Reporting Handbook, Part II – Documenting Allegations