Familes and children
The effects of torture go far beyond the sphere of the individual who has directly suffered violence or witnessed such acts being perpetrated on others. Torture affects whole communities and in particular the survivor's family.
Children may suffer from chronic psychological stress as a consequence of violence, death and loss. There are cases in which children have witnessed the violation of their parents, their homes and their neighbourhoods. Some have been imprisoned, raped and tortured so that they too can become emotionally detached from their families and peers.
The Children & Family Team of the Medical Foundation for the Care of Victims of Torture (MF) works with families, couples, children and young people, who may be either accompanied or unaccompanied.
The team includes family and couple psychotherapists, a child psychiatrist, an art therapist, an outreach worker, an interpreter, a music therapist, an education counselling specialist, counsellors, group workers, paediatricians, a social worker and a health visitor.
Therapeutic approaches used with this group of clients include individual work, music therapy, art therapy, group therapy and family therapy.
Sessions adopt a holistic approach, with clinicians attending to a client's protection needs, writing reports for asylum applications, tackling issues around housing, health, education or safety. At a deeper level, rehabilitation focuses on intensive psychotherapy.
Group therapy is also used, with a particular focus on younger adolescents, older adolescents, a friendship group, a mother and toddler group, an Albanian women's coffee group, and the Unity of Hope group, which brings together children with mixed Eritrean and Ethiopian parentage.
Referring to the team's work with families, Jocelyn Avigad, team manager, likens family therapy to heart surgery - facilitating healing in one part of the system has the potential to heal the whole: "If one person in a family has been hurt or killed, the whole family suffers. Through family therapy, those who remain can be brought together to talk and redevelop their lives as individuals and as a group."
The extreme trauma suffered by torture survivors can undermine a parent's ability to function in their role, so that while they may be physically present, they can be rendered emotionally unavailable to the rest of the family.
The systemic therapeutic process starts with a careful assessment of the family to consider what type of intervention will best suit their needs. The team works on the principle of minimal intervention - to provide sufficient support to galvanise the family's existing strengths and uncover its vulnerabilities, and to help them rebuild trust and intimacy.
As part of the Government's Gateway project, many refugee families have been resettled in communities throughout the UK, including Leeds, Glasgow and Bolton. Family therapists from both the MF London, Scotland and Manchester centres have been involved in training Gateway workers in how to deal with families who were broken up when they arrived in the country.
Senior systemic and family therapist at MF Scotland, Kathleen Van de Vijer, said: "It's important to work therapeutically with parents so they can reconnect with their strengths and skills as parents. That enables them to again become available to their children while also processing their own torture experiences into who they are now."
