Empirically Tested Interventions for Torture Survivors: A Systematic Review Through an Ecological Lens

Torture has been documented to occur in 81 countries (Amnesty International, 2008) resulting in 2-15 million torture survivors worldwide (Physicians for Human Rights, 2010). The problems torture survivors experience are best understood from an ecological perspective (i.e., understanding human behavior as contextual), but the solutions offered are rarely ecological in nature. Rather, most empirical literature on interventions for torture survivors discuss individually focused interventions only. This article is a critical review of the literature on interventions for immigrant survivors of politically sanctioned torture from an ecological perspective (Bronfenbrenner, 1977). A systematic literature review was conducted. The review included 22 articles, covering 13 interventions. Each article was coded to capture ecological intervention components. All interventions targeted individual-level change. Eleven interventions targeted additional ecological-levels surrounding survivors in the microsystem, macrosystem, and/or chronosystem levels of ecology. Interventions targeted several life domains, such as the legal, social, and occupational domains. Interventions included cultural adaptations such as using interpreters and designing interventions to be more congruent with the survivors' cultures. The current body of literature on empirically tested interventions for torture survivors is limited, with few interventionists testing their work empirically and fewer sufficiently addressing the ecological needs of torture survivors. More intervention development is needed to address the ecological needs of survivors and make interventions that are multilevel, community-based, and culturally situated (Trickett, 2009). Future research should aim to involve torture survivors through community-based participatory research and seek suggestions for research from within the survivor community, so that interventions can be situated within their cultural context. What is the significance of this article for the general public? It is important to consider the context surrounding an immigrant survivor of politically sanctioned torture when implementing psychosocial interventions, because failing to do so could mean the intervention is ineffective or harmful. This study shows that out of all relevant published interventions, many consider the environment immediately surrounding survivors (such as their family), but few go beyond that to address the role culture or society has on s