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Tuesday, July 7th to Wednesday, September 30th

Please join us in an online, open forum on telehealth. NCB is providing an opportunity for clinicians to ask each other questions, share observations and adapted telehealth protocols for the SoT population via an online forum and technical exchange. This conversation will be a forum for peer-led informational exchange. NCB staff will assist in facilitating and monitoring the conversation.

Directions: Please watch Eugene Augusterfer’s presentation and interview Telemedicine in Mental Health first. Then feel free to join us in this open forum. All are welcome to join this forum, whether you have an account on Healtorture.org or not. For more information on using the forum, please read the directions on the first post. Please keep your comments respectful, relevant, factual, and do not share identifying information about clients per client privacy and HIPAA regulations. This forum will be open from July 6, 2020 through September 30, 2020.

Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: A literature review

This article includes an overall review of the literature about the efficacy of physiotherapy when working with clients who have pelvic floor issues, including incontinence, painful sexual functioning and other concerns.

Rosenbaum, T.Y. The Journal of Sexual Medicine, 2007; 4: 4-13.

This article was reviewed by doctoral physical therapy student from the University of Minnesota, Torey Tilahune, 2019.

Link to full text article is found below.

Background

The sphincteric and supportive functions of the pelvic floor are relatively well understood, and the specialized field within physical

Physiotherapist Day of Service: Helping Children in Amman, Jordan

For many professionals who do healing work, it is a good feeling to be able to bring your skills and experience to people who might not otherwise have access to your service. When a chance arose to bring physiotherapy work to a nonprofit organization in Amman, the CVT Jordan team was happy to step forward.

Beginning in 2015, an international group of physiotherapists (PTs) was inspired to start a project called the PT Day of Service. For one day in October, they call upon PTs around the world to engage in a day of helping within their communities, all with the mission to “Change lives. Grow community. Better the World.”

Finding the Most Effective Ways to Help Children Affected by War

At CVT Jordan, one of the most powerful and successful things that we are doing on the physiotherapy team is the children’s group sessions. During my three and a half years as a physiotherapist at CVT, I have come to understand how important it is to include the parents in their children’s healing journey. In order to get the best results, at CVT we have modified our approach as we’ve learned from the children and their parents.

Key Social Services for Refugee Survivors of Torture

In my work with survivors of torture in Jordan, every day I see how social services are an integral and extremely important element of healing. CVT uses an interdisciplinary model of care in our Jordan program, and social services represent the third angle of CVT’s services triangle, fully integrated with the other two disciplines: mental health counseling and physiotherapy. With this interdisciplinary approach, we are able to better serve beneficiaries (clients).

Creating a Safe Space for the LGBTI Community in Nairobi

At CVT Nairobi, our counseling staff has been helping LGBTI clients with mental health care for several years. Most recently, we integrated physiotherapy after clients were raising concerns about the well-being of their physical health. From the counseling group cycle, a 10-week physiotherapy cycle was developed, focused on a safe space for LGBTI clients to address functional issues such as chronic back pain, musculoskeletal disorders and pelvic floor disorders.

Physiotherapy Helps Individuals and Communities

Hope is hidden within client stories, even when those stories are full of wounds. After surviving war and torture, clients’ lives have changed, and this really affects the whole family. But after clients go through the rehabilitative care cycle with CVT, I see change and hope. I see mothers helping their children after the trauma they’ve experienced. The children become comfortable with their mother again, and the mothers have told me they feel like mothers again to their children. The whole family is once again affected, but in a positive way.

Physiotherapy Outcomes at the Center for Victims of Torture-Nairobi program

Since CVT’s physiotherapy program began in Nairobi, around 260 clients have been assessed at both intake and six month follow up on the Pain and Discomfort Inventory (PDI). On all items, clients showed statistically significant improvements in levels of pain and functionality. Approximately 130 clients have been assessed at both time periods with the Disability Rating Index (DRI) and we observe statistically significant improvements in functional ability for 10 of the 12 activities.

Nearly all of the clients are also receiving, or have received psychosocial counseling services as well.

Physical Therapy in Nairobi

Last November, I made my fourth trip to Nairobi to visit our CVT project. As a physical therapy advisor to our Kenya staff, I serve as a consultant, supervisor and colleague to Jepkemoi Kibet, our physical therapist/trainer in Kenya. Jep, in turn, supervises and trains our local physical therapists, Stephen, Jennifer and Collins.

We have four treatment sites where we lead physical therapy sessions: at our main offices in the Westlands neighborhood we work with young women; in the Eastleigh neighborhood we work with Somali refugees; and in the Riruta and Kayole areas we see mixed groups of refugees from Rwanda, Burundi and the Congo.

Helping Physiotherapists Examine the Ways Torture Survivors Think About Pain

Pain is one of the many problems to be addressed in survivors of torture. And in my work as a physiotherapist trainer at CVT, every day I attend to clients with chronic pain as a result of torture.

I recently had the privilege of presenting at the International Conference of Physical Therapy in Psychiatry and Mental Health in Madrid. Along with Julie Phillips, from the Department of Physiotherapy at University of the Western Cape, South Africa, I presented on the “Cross Cultural Adaptation and Validation of the Pain Catastrophizing Scale (PCS) among Victims of Torture.” The role of catastrophization in the development of chronic pain has gained a considerable amount of attention in research over the past few decades, so our topic was quite timely.

Physiotherapy to Help Survivors of Torture in Their Darkest Hours

Most people will have the experience of having a nightmare at some time. It’s not pleasant, but we deal with it. For a survivor of torture, however, a nightmare can be an extremely difficult situation. During a nightmare, the torture survivor relives his trauma. And by “relive” I mean it’s like a video he is watching of the experience. His body reflects this in his sleep. He may wake up in the same position as when he was tortured. This is one of the things I help people with in my work as a physiotherapist at CVT.

Building Clients’ Trust Through Physiotherapy

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....

Complementary and alternative medicine in the treatment of refugees and survivors of torture: a review and proposal for action

By Mckenna Longacre, MM, Ellen Silver-Highfield, Puja Lama, and Michael A. Grodin, MD. This article reviews the scientific medical literature for the efficacy and feasibility of some complementary and alternative medicine (CAM) modalities including meditation, Ayurveda, pranayama/yogic breathing, massage/body-work, dance/movement, spirituality, yoga, music, Traditional Chinese Medicine and acupuncture, qigong, t’ai chi, chiropractic, homeopathy, aromatherapy and Reiki specifically with respect to survivors of torture and refugee trauma. 

Published in TORTURE Volume 22, Number 1, 2012

Prevalence of pain in the head, back and feet in refugees previously exposed to torture: A ten-year follow-up study

This article looks at the change over 10 years concerning pain in the head, back, and feet among previously tortured refugees now residing in Denmark, and to compare associations between methods of torture and pain at baseline and after 10 years. Pain in the head, back, and feet were chosen because they are frequently reported symptoms. Conclusions were that: Pain increased, despite treatment at RCT; Treatment does not decrease risk of continuing or increasing symptoms of pain; 20 years after torture took place, increasing proportions of survivors seems to suffer from pain associated with the type and bodily focus of the torture. This presents a considerable challenge to future evidence based development of effective treatment programs.

Tortured Refugees' Expectations of a Multidisciplinary Pain Rehabilitation Programme

Refugees have often been exposed to torture in their countries of origin. Rehabilitation of tortured refugees living in Denmark is offered by the specialized Rehabilitation and Research Centre for Torture Victims in Copenhagen. After an interdisciplinary assessment eligible patients are recommended rehabilitation. In this article, it is noted that there is diversity among refugees in their expectations from pain programs and that the clients expect to have dialogue with the members of their health care team about participation in recommended activities, and to question and not just to accept professional suggestions.

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