The complex care of a torture survivor in the United States: The case of Joshua.

Autor:	Berthold SM; Associate Professor and Director of Field Education, University of Connecticut School of Social Work (and Co-Chair of the NCTTP Research and Data Project) Correspondence to: megan.berthold@uconn.edu., Polatin P; Faculty, HPRT; Psychiatric consultant, IRC/Dallas; Adjunct Associate Professor of Global Mental Health, George Washington University; Associate Professor of Anesthesia/Pain and Psychiatry (retired) UTSW; Health Program Consultant, DIGNITY Institute Against Torture (retired). Correspondence to: peter.polatin@gmail.com., Mollica R; Director of Harvard Program in Refugee Trauma, Massachusetts General Hospital Professor of Psychiatry, Harvard Medical School. Correspondence to: Rmollica@partners.org., Higson-Smith C; Director of Research, Center for Victims of Torture. Correspondence to: chigsonsmith@cvt.org., Streets FJ; Associate Professor (Adjunct) Pastoral Theology, Yale University Divinity School., Kelly CM; Massachusetts General Hospital., Lavelle J; Co-Founder of Harvard Program in Refugee Trauma (HPRT).
Jazyk:	angličtina
Zdroj:	Torture : quarterly journal on rehabilitation of torture victims and prevention of torture [Torture] 2020; Vol. 30 (1), pp. 23-39.
DOI:	10.7146/torture.v30i1.113063
Abstrakt:	Introduction: Torture is an assault on the physical and mental health of an individual, impacting the lives of survivors and their families.The survivor's interpersonal relationships, social life, and vocational functioning may be affected, and spiritual and other existential questions may intrude. Cultural and historical context will shape the meaning of torture experiences and the aftermath. To effectively treat torture survivors, providers must understand and address these factors. The Complex Care Model (CCM) aims to transform daily care for those with chronic illnesses and improve health outcomes through effective team care. Methods: We conduct a literature review of the CCM and present an adapted Complex Care Approach (CCA) that draws on the Harvard Program in Refugee Trauma's five-domain model covering the Trauma Story, Bio-medical, Psychological, Social, and Spiritual domains.We apply the CCA to the case of "Joshua," a former tortured child soldier, and discuss the diagnosis and treatment across the five domains of care. Findings: The CCA is described as an effective approach for working with torture survivors. We articulate how a CCA can be adapted to the unique historical and cultural contexts experienced by torture survivors and how its five domains serve to integrate the approach to diagnosis and treatment. The benefits of communication and coordination of care among treatment providers is emphasized. Discussion / Conclusions: Torture survivors' needs are well suited to the application of a CCA delivered by a team of providers who effectively communicate and integrate care holistically across all domains of the survivor's life.
Databáze:	MEDLINE
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