Building Clients’ Trust Through Physiotherapy

Physio from CVT Jordan, Raed Jaradat, describes how trust can be built through sensitive and careful provision of physiotherapy.

Tuesday, April 5, 2016

Raed Jaradat is a physiotherapist at CVT Jordan.

Since I joined CVT in 2015, I have had the opportunity to see healing and change happen. I see torture survivors who come into the program afraid, with limited mobility and an inability to talk about what has happened to them. But by the end of the ten-week cycle, I see them talking, helping each other and increasing their movements – I believe that building trust is one of the most important things that leads to healing.

I graduated from the University of Jordan in 2008 and had experience working with a multidisciplinary organization which works with people with disabilities, including children. I worked with children with cerebral palsy and other disabilities. Then I transferred to Handicap International in the north of Jordan, working with a community of Syrian refugees. I was there for several years and then transferred to Za’atari refugee camp. There I did medical checks for physical difficulties and needs assessment for assistive devices. I worked to help ease clients’ lives, give them more mobility. I also worked at the  Azraq camp when it opened in 2014, welcoming refugees from the border from Syria and giving out primary information about our services. In the camp, I would hear about medical issues, disease, and I did screening and sometimes referred people to other organizations.

Then in May 2015, I came to CVT. CVT has given me new experience in how to deal with survivors of torture: at CVT we work on the physical and the psychological. This has been a new experience in how to deal with clients. We empower our clients and give them a chance to express their feelings.

As a physiotherapist, I’m part of an interdisciplinary team with counselors and social workers. When a counselor does an intake, he or she refers the client to me to do a physical therapy assessment – to see if the client has any physical problem or pain. This is very common after torture.

I do the assessment and discuss with the counselor what happened, especially for those cases that involve physical torture. We hear everything: torture by beating, burning, everything. In my assessment, I learn about functional difficulties, including social problems that result from these crimes. I decide if the client should go to individual or group physiotherapy. If he or she does individual at that time, he may improve and then be ready for group. Others are ready for group when they come in. To make this decision, I listen to the details of the client’s complaints and his history: medical and surgical history, medications, etc. I check for those who are the most urgent cases and look for signs of any chronic diseases.

I like my work when I see the results – those are my most happy moments. At these times, I feel like I give the client power in his life and some hope in life. I like it when the client trusts me and tells me about his case and what happened to him. I give him trust and stabilization. As an example, when I start sessions, my favorite thing is to feel the connection between the clients. I see them begin to discuss things together, start sharing their experiences with each other. I feel I give some positive energy.

One individual I assisted for six months was a survivor of torture. He had experienced the worst things: beatings, burning, broken glass, and more. When I assisted him, I found many problems. He had had many surgeries related to the torture, and he was having many difficulties. We built trust. It took three sessions to build this trust.

I discussed his case with the counselor to know about his psychology. I was nervous. I challenged myself to reach my goal for him, for his progress. After three sessions, we worked on how to decrease tension. He was constantly tensing his muscles, tensing his joints. We worked on how to relax. His mind-body connection increased. He learned how to control his symptoms.

At his 12th session, I felt his change. He could control himself; he could walk more easily. Before, he was isolated, but now he communicated with others. Now he was able to exit out the door instead of staying inside, afraid to go out. He had begun communicating with his parents again.

We continued with the plan and increased activity. His pain had lessened, and his counselor said he had improved as she observed him. He felt happy when he came to sessions.

As another example, at the group during the last cycle one man said “I can’t tell my story.” He waited, quiet, during the first session. We started working on trust and group dynamics. After Session 5, the group started to interact and laugh together. They began to tell their experiences and talk about personal issues. He started to open up. The group gave advice to each other.

I gave him some exercises for strengthening muscles. In the beginning, he told me “I cannot walk even 100 meters.” If he tried, he felt bad. But now he said, “I have more energy, I can walk a good distance.” His breathing and heart rate had improved. “I can control my symptoms,” he told me. In Session 10, we brought in musical instruments and artistic tools – it became like a celebration, and this man was at the center of it, happy and more at peace.

My job is very rewarding when I build the individual client’s trust. With another client, I told him to do exercises in the beginning, but he didn’t do them. He kept coming back, though, and he began to share some of his story, his goals and dreams with me. After he opened up about his story to me, he started to do the exercises I’d suggested and to focus on his breathing. We continued his treatment plan, and he began to get better. Trust made all the difference.

Funding for CVT’s work in Jordan is provided by the United States Department of State’s Bureau of Population, Refugees and Migration and the United Nations Voluntary Fund for Victims of Torture.