In considering who may be at heightened risk for developing psychological problems, one must evaluate both general/overall risk factors as well as those risk factors specific to traumatised populations including how trauma affects family and social relationships and other natural supports. The general risk factors for developing mental illness are based on age, sex, education, social class, divorced/widowed status, history of mental illness, and family history of mental illness. Additional risk factors for torture survivors include torture, war, political oppression, imprisonment, witnessing or experiencing atrocities, loss of family and/or separation from family, and distortion of social relationships. If the torture survivor is also a refugee or asylum seeker, he/she has the further risk factors of migration (loss of home, loved ones, possessions, etc), acculturation, poverty, prejudice, cultural beliefs and traditional roles, cultural and linguistic isolation, absence of adequate support systems, and unemployment or underemployment. The multiple layers of increasing risk present a clinical picture that has been described by as one of “cumulative synergistic adversity.”
Search
-
- Preface
- Introduction
- 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
- 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
- Torture
- Module 2: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
- The Istanbul Protocol
- An Overview of the Istanbul Protocol
- 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
- Documenting the allegations
- Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
- Self-Assessment and Quiz
- 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
- 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
- Preliminary Considerations
- 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
- Module 4 Presentation: Torture Methods and their Medical Consequences
- Self-Assessment and Quiz
- Module 5: Physical Evidence of Torture and Ill-Treatment
- Module 6: Psychological Evidence of Torture and Ill-Treatment
- Module 7: Case Example #01
- Module 8: Case Example #02
- Module 9: Report Writing and Testifying in Court