An evaluation of combined narrative exposure therapy and physiotherapy for comorbid PTSD and chronic pain in torture survivors : a case series

Torture is associated with adverse health consequences, with especially high rates of PTSD, depression and chronic pain. Despite the growing evidence base of the treatment for PTSD, increased awareness of the relationship between pain and posttraumatic symptoms, and the accompanying need for effective treatment strategies, few studies have examined an Integrated treatment of both. In this study, using an A-B case series design with 3 and 6 months follow up, six refugee torture survivors with comorbid PTSD, depression and reported pain received 20 sessions of Narrative Exposure Therapy (NET) and 10 sessions of physiotherapy. Outcome variables included symptoms of PTSD and depression, pain intensity, physical functioning and quality of life. At the group level, medium and large effects were found for symptom reduction of PTSD and depression, while the individual results reflected variable outcomes. We conclude that this treatment could be effective for some, and partly effective or not suitable for others. Directions for future research regarding the improvement of rehabilitation approaches of torture survivors are discussed, highlighted through descriptions from the six therapy cases