Objectives
- To appreciate the central role of psychological evaluation in medical evaluations of torture and ill-treatment
- To understand how to conduct a psychological evaluation, document psychological findings, and formulate clinical impressions and conclusions regarding torture and ill-treatment
- To review transference, counter-transference, re-traumatisation issues
- Using the Psychological Evaluations # 1 and #2, students will be asked to develop interpretations of the psychological findings and conclusions and recommendations using Istanbul Protocol standards
- To understand the value and limitations of diagnostic classifications (ICD-10 and DSM) in the evaluation of psychological evidence of torture and ill-treatment
- To understand the value and limitations of psychometric instruments (questionnaires, scales, etc) during the psychological evaluation
- To be familiar with psychological evaluations of torture and ill-treatment in children
Content
- The central role of the psychological evaluation
- Conducting the psychological evaluation
- Psychological findings and diagnostic considerations
- Components of the psychological/psychiatric evaluation
- Identifying Data
- History of Torture and Ill-treatment
- Current Psychological Complaints
- Post-torture History
- Pre-torture History
- Medical History
- Past Psychiatric History
- Neuro-psychological Assessment
- Mental Status Examination
- Assessment of Social Function
- Psychological Testing and the Use of Checklists and Questionnaires
- Clinical Impression
- Recommendations
- Treatment Considerations
- Children and Torture
- Developmental Considerations
- Clinical Considerations
- Role of the Family
- International statistical classification of diseases and related health problems, Annex
Discussion Topics
- Students should work in groups or individually on one or both of the Psychological Evaluations (#1 and #2, see Appendix I at the end of this Module). Each group should write up their interpretation of findings and conclusions and recommendations.
- Additional Discussion Topics:
- Discuss the reasons why some survivors of torture have difficulties recalling and recounting their experiences
- Discuss possible reasons for inconsistencies in the evaluation and strategies to explain inconsistencies in medico-legal reports
- Discuss how to assess the possibility of simulation of psychological symptoms
- Discuss who can/should conduct the psychological evaluations in your country (consider: qualifications, authority, official vs. non-official, etc)
- Discuss current, country-specific challenges in conducting psychological evaluations of torture and ill-treatment and their validity, or lack thereof, in medico-legal contexts
Teaching Formats
- Group Activity:
- Students should work in groups or individually on one or both of the Psychological Evaluations (#1 and #2, see Appendix I at the end of this Module). Each group should write up their interpretation of findings and conclusions and recommendations based on Istanbul Protocol standards.
- 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
- Alternative Option:
- Divide the class into several groups and assign each group with one or more (or all) of the Discussion Topics
- Follow the usual sequence for conducting group activities as outlined above
- Individual Research/Assignment:
- Individual students should assigned to read one or both of the Psychological Evaluations and write up their interpretation of findings and conclusions and recommendations based on Istanbul Protocol
- Journal Entry: (Instructor to assign; Write a few paragraphs — no more than a page)
- Respond to one or more of the Discussion Topics
- In your opinion, what are the most significant challenges in conducting a psychological evaluation of torture and ill treatment? Explain.
Primary Resources
- The Istanbul Protocol, Chapter VI
- Psychological Evaluation of Torture Allegations: An International Training Manual
- The Medical Documentation of Torture
- Medical Investigation and Documentation of Torture: A Handbook for Health Professionals
- Trainers’ Guidelines for Health Professionals: Training of Users