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:
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:
Torture. 2020;30(1):23-39. doi: 10.7146/torture.v30i1.113063.
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.
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.
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.
酷刑是对个人身心健康的侵犯，影响幸存者及其家人的生活。幸存者的人际关系、社会生活和职业功能可能会受到影响，精神和其他存在问题可能会出现。文化和历史背景将塑造酷刑经历和后果的意义。为了有效地治疗酷刑幸存者，提供者必须理解并解决这些因素。复杂护理模式（CCM）旨在通过有效的团队护理来改变慢性病患者的日常护理，并改善健康结果。
我们对 CCM 进行了文献回顾，并提出了一种改编的复杂护理方法（CCA），该方法借鉴了哈佛难民创伤计划的五个领域模型，涵盖创伤故事、生物医学、心理、社会和精神领域。我们将 CCA 应用于“约书亚”的案例，他是一名前受酷刑的儿童兵，并讨论了在五个护理领域的诊断和治疗。
CCA 被描述为一种与酷刑幸存者合作的有效方法。我们阐明了如何根据酷刑幸存者所经历的独特历史和文化背景来调整 CCA，以及它的五个领域如何有助于整合诊断和治疗方法。强调了治疗提供者之间沟通和协调护理的好处。讨论/结论：酷刑幸存者的需求非常适合 CCA 的应用，由一支能够有效沟通并全面整合幸存者生活所有领域护理的提供者团队提供。
