PHYSICAL THERAPISTS DELIVERING TRAUMA FOCUSED INTERVENTIONS FOR REFUGEES IN A HUMANITARIAN SETTING: A QUALITATIVE STUDY OF EXPERIENCES

H. Khalil¹, I. Fricker², M.S. Nazzal³, A. Al-Qudah³, T. Lababneh³, S. Golden⁴, M. Busse⁵

¹Qatar University, Department of Physical Therapy and Rehabilitation Sciences, Doha, Qatar, ²The Center for Victims of Torture, Amman, Jordan, ³Jordan University of Science and Technology, Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Irbid, Jordan, ⁴The Center for Victims of Torture, Minnesota, United States, ⁵Cardiff University, Centre For Trials Research, College of Biomedical and Life Sciences, Cardiff, United Kingdom

Background: Many refugee populations are significantly affected by trauma and often suffer from trauma-related health problems. Physical therapy interventions can contribute to the management of physical and mental health problems experienced by refugees.

Purpose: To explore physical therapists' experiences and perspectives on delivering trauma focused physical therapy for refugees in a humanitarian setting as a first step to increasing our understanding of key intervention components and processes inherent in delivering a trauma-focused physical therapy.

Methods: A qualitative approach was used. Six focus groups were conducted with physical therapists who work routinely with refugees and trauma survivors. Physical therapists were recruited from the Center for Victims of Torture (CVT), an international non-governmental organization, in which physical therapists work closely with mental health and social work teams to provide complementary services that address trauma survivors’ needs in an interdisciplinary manner. A topic guide was used for the focus groups discussions. All conversations were audio recorded and were transcribed verbatim. Thematic analysis was applied; identified themes were confirmed by the research team members.

Results: Six main themes were identified: (1) Intertwined physical, social and psychological symptoms are a key feature in clinical presentation; (2) Clients experience ongoing stress; (3) Trauma-focused physical therapy interventions are dependent on the stage of recovery and the use of trauma-informed care approach; (4) A client-centred approach to assessment and treatment is critical; (5) Therapists are at risk of becoming emotionally affected and in need of self-care, and (6) Trauma-focused physical therapy academic training gaps are evident.

Conclusions: Findings from this qualitative study highlight key elements of a trauma-focused physical therapy including the need to consider stage of trauma recovery, biopsychosocial approach, client-centered approach and trauma-informed care approach. Physical therapists treating refugee populations are exposed to possible negative reactions as they are confronted daily by suffering and grief. Therefore there is a need to better equip physical therapists working in this field by providing training and education opportunities.

Implications: Findings from this study shed the light into the need to better understand key components of the trauma-focused physical therapy. There is a need to provide educational and training support to physical therapists working in this area. Training could focus on competencies that include identification of signs of the biopsychosocial sequelae of trauma; ability to demonstrate effective trauma informed practices; ability to administer client-centered trauma assessment; and ability to tailor physical therapy treatment plan according to the appropriate trauma stage of recovery.

Funding acknowledgements: Jordan University of Science and Technology

Keywords:
Trauma-focused physiotherapy
Refugees

Topics:
Mental health
Disaster management

Did this work require ethics approval? Yes

Institution: Jordan University of Science and Technology-King Abdulla University Hospital

Committee: King Abdulla University Hospital

Ethics number: MN-20200468