A new text book, Physiotherapy in Mental Health and Psychiatry features CVT’s dynamic approach to physical therapy for survivors of torture and trauma. And if it weren’t for Jepkemoi Joanne Kibet, physiotherapist/trainer with CVT Nairobi, it likely wouldn’t have happened.
One of the book’s editors, Michel Probst, PT, PhD, had met Jepkemoi in Madrid, when she presented at the International Conference of Physiotherapy in Psychiatry and Mental Health. He was impressed with her development of a Ki Swahili version of the fear avoidance belief questionnaire and the pain catastrophization scale – two tools about pain used often by physiotherapists (physical therapists) – and with CVT by extension.
But when Michel asked Laura Gueron, CVT’s physical therapy clinical advisor, for her and her colleagues – Jepkemoi and former CVT staff members MaryAnn de Ruiter, April Gamble and Claire O’Reilly – to contribute a chapter for the book, she politely declined. She referred him to a different organization, one she considered much larger and better researched in terms of physiotherapy.
Michel wouldn’t take no for an answer. “We already have a number of European contributors,” he told Laura, “and want representation from the United States.”
As it turns out, he’d come to the right place. While the concept of physical therapy in mental health arenas is very well-developed in Europe and to some degree in Asia, Laura observes that it seems to be less common in the United States. Not at CVT, however. Headquartered in the U.S. with projects located throughout the world, the organization deems physiotherapy vital to its integrated, multidisciplinary approach to treatment.
“Our chapter, ‘Physiotherapy with Survivors of Torture and Trauma’ was rare in that some of the physios involved were from the USA,” said Laura Gueron. She and her former colleagues April Gamble and MaryAnn de Ruiter are American members of the American Physical Therapy Association.
Physiotherapy in Mental Health and Psychiatry alleges to be the first internationally relevant text book for physiotherapists, covering a range of mental health and psychiatry settings. CVT’s chapter explains that high percentages of refugees and displaced people are victims of torture and trauma. It also details the complex needs of survivors, who in addition to chronic pain often suffer from PTSD and many psychosocial issues.
“Sometimes it can be very difficult to determine if pain is caused by physical issues or emotional and psychological issues,” notes Jepkemoi. “Survivors who are suffering from depression or anxiety may have physical symptoms even though their bodies have healed. Others have ongoing physical issues.”
The physical effects of torture can interfere with even the most basic functions of daily life. Many survivors require massage or physical therapy to help alleviate chronic pain in muscles and joints, and to reintroduce them to positive touch. At CVT’s St. Paul Healing Center, volunteer massage and physical therapists offer these services to clients. CVT Jordan and Nairobi provide physiotherapy to individuals and groups on a 10-week long cycle, just as they do group counseling sessions. They’re intended to help clients regain control of their bodies and optimize everyday functioning.
The chapter also points out that a survivor’s torture can impact the severity of pain he or she experiences long after it has stopped, and that physiotherapists need to be aware of common symptoms survivors of torture and trauma exhibit in order to effectively treat them. Ultimately, the authors hope to prove that while it may be unrealistic to eliminate the physical wounds of torture, the role of physiotherapy is nevertheless indispensable to a survivor’s recovery.