Margarete Schauer, Konstanz Evaluation of Testimony Therapy for survivors of severe human rights violations
- In contrast to other forms of violence and psychological traumatization, most survivors of state sponsored violence and severe human rights violations have encountered not only a single stressful event but a whole series of severe traumas over an extended period of time. Such experiences can cause serious psychological and somatic distress. Thus, in addition to diverse medical diseases, a substantial proportion of the survivors suffer from chronic psychological disorders akin to Posttraumatic Stress Disorder and Depression, with symptoms persisting or developing sometimes years or even decades after the persecution.
Unaware of the impact of psychotrauma on mental health, survivors generally do not seek psychotherapeutic treatment. And even if they do request such help, knowledge about adequate treatment is scarce in health professionals. Consequently, victims remain silent about their traumatic experience and about their ongoing suffering. In addition to the advers effects for the individual, this process prevents prosecution of those who are responsible for acts of torture and genocide and complicates the fight against violations of human rights.
There are several NGOs conducting mental health programs parallel to their usual emergency relief work. They face the problem that it is still unclear to what extent psychosocial interventions are useful for the treatment and prevention of chronic psychological disorders in refugees and other victims (Summerfield, 1997). There is evidence that some acute psychological interventions in the immediate aftermath of a civil trauma may be useless or even harmful (Rose & Bisson, 1998), so caution is warranted in the implementation of ad hoc psychosocial programs in refugee camps on a large scale. Further research is necessary to develop and evaluate methods appropriate to the special characteristics of individual refugee groups.
On the other hand, medical relief organizations and their mental health professionals working with such patients are in need of information about the quality and quantity of psychological disorders that can be expected under these circumstances. Furthermore concrete instructions on how to treat survivors of severe human rights violations are mandatory.
For that reason the PT group at the University Konstanz is evaluating a short term intervention therapy, tailored to conditions that do not allow an extended series of treatment sessions or a safe and comforting environment. We are working on a procedure that has been developed especially for survivors of severe human rights violations in the immediate aftermath of the trauma.
In Testimony Therapy, witnesses to severe human rights violations are invited to report and document their traumatic experiences. In cooperation with a therapist they can restore their autobiographic memories about those experiences and regain human dignity. In this way fragmentary memories are transformed into a coherent narrative structure. This practice enables the processing of painful emotions and the construction of clear contingencies of dangerous and safe conditions, generally leading to significant emotional recovery. If the survivor wishes, the resulting documents (testimonies) can be used directly for prosecution of human rights violations.
In the current project we are evaluating the efficacy of Testimony Therapy. Our first experiences with it as an acute intervention in a Macedonian refugee camp are very promising. During the Kosovo Crisis we treated severely traumatized survivors of atrocities (acute symptoms among the survivors of severe human rights violations immediately after persecution or flight). Currently we are treating refugees who came to Germany from Kosovo and other countries. Future evaluation of Testimony Therapy will take place directly in the countries concerned in cooperation with institutions on site. Through our project we hope to promote the psychological rehabilitation of survivors and to contribute to the fight against severe human rights violations.
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Short biographical note
Dr. Margarete Schauer studied philosophy, psychology and cultural anthropology at the Universities of Munich and Tuebingen, completing her Master of Arts (M.A.) in 1990 and a Certificate in Client Centered Counselling in 1991. She received a scholarship of the State of Baden-Wuerttemberg from 1993–1996, completing her Ph.D. in Psychology at the University of Konstanz in 1998. Since May 1997, she has held a postdoctoral position as a medical psychologist and researcher at the Eberhard-Karls-University, Tuebingen. Currently she is working as well at the project described above, which is carried out at the Department of Psychology at the University of Konstanz.
Publications: Neuner, F., Schauer, M., Elbert, T., and Roth, W. T. (1999). Testimony Therapy as an acute intervention in a Macedonian refugee camp: two case reports. (submitted)
Case reports describing a pragmatic short-term treatment (a version of Testimony Therapy) of severely traumatized refugees living in a Macedonian refugee camp can be obtained upon request.
Project Collaborators
Prof. Dr. Thomas Elbert
Dipl. Psych. Frank Neuner
Dr. Margarete Schauer
Dept. of Psychology, University of Konstanz, Germany
Email Margarete.Schauer@Uni-Konstanz.de
Prof. Walton T. Roth, M.D.
Stanford University and VA Medical Center
Palo Alto, CA 94304, USA
Email wtroth@stanford.edu
(Research Supported by the DFG)
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Citation Margarete Schauer, Evaluation of Testimony Therapy for survivors of severe human rights violations. In: Trauma Research Newsletter 1, Hamburg Institute for Social Research, July 2000.
URL TraumaResearch.net/focus1/scha.htm
Copyright © 2000, Margarete Schauer and trauma newsletter, all rights reserved. This work may be copied for non-profit educational use if proper credit is given to the author and the trauma newsletter. For other permission questions, please contact via email the editor Cornelia_Berens@his-online.de
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