A educação em direitos humanos como suporte às políticas antimanicomiais: história e memória / Human rights education as a support for anti-asylum policies: history and memory / La educación en derechos humanos como soporte a la política antimanicomial: historia y memoria

Resumo A política de saúde mental no Brasil se vê hoje ameaçada pelo retorno da lógica manicomial e isso constitui um risco aos usuários e familiares, pois o sujeito diagnosticado com transtorno mental deixa de usufruir plenos direitos. O objetivo deste ensaio é propor que o resgate da memória da barbárie manicomial seja parte fundamental de uma educação em direitos humanos; além disso, deveria estar presente na formação dos profissionais da área da saúde para fortalecer os movimentos sociais que dão legitimidade e força ao modelo antimanicomial. Parte-se de uma concepção crítica dos direitos humanos para argumentar que estes constituem a sedimentação histórica de lutas sociais em uma sociedade em conflito. A conclusão aponta que o usufruto do direito à saúde mental está intimamente relacionado à educação dos agentes de saúde, aos usuários e aos movimentos sociais.

Abstract The mental health policy in Brazil is threatened by the return of asylum logic and this constitutes a risk to users and family members, as the subject diagnosed with mental disorder no longer enjoys full rights. The purpose of this essay is to propose that the rescue of the memory of asylum barbarism is a fundamental part of human rights education; in addition, it should be present in the training of health professionals to strengthen social movements that give legitimacy and strength to the anti-asylum model. It starts with a critical conception of human rights to argue that they constitute the historical sedimentation of social struggles in a society in conflict. The conclusion points out that the enjoyment of the right to mental health is closely related to the education of health agents, users and social movements.

Resumen La política de la salud mental en Brasil se ve hoy amenazada por el retorno de la lógica manicomial, lo que constituye un riesgo hacia los usuarios y sus familiares, pues el sujeto diagnosticado con trastorno mental deja de usufructuar plenos derechos. El objetivo de este ensayo es proponer que el rescate de la memoria de la barbarie manicomial sea parte fundamental de la educación en derechos humanos; además de eso, debería estar presente en la formación de los profesionales del área de la salud para fortalecer los movimientos sociales que le dan legitimidad y fuerza al modelo antimanicomial. Se parte de una concepción crítica de los derechos humanos para argumentar que ellos constituyen la sedimentación histórica de las luchas sociales en una sociedad en conflicto. La conclusión apunta que el usufructo del derecho a la salud mental está íntimamente relacionado a la educación de los agentes de salud, a los usuarios y a los movimientos sociales.

Intervention for the comprehension of menstrual cycle, body function and pregnancy in adolescents from rural context.

OBJECTIVE: To measure the impact of an intervention on adolescents' knowledge of the phase of the menstrual cycle with more likelihood of pregnancy and identify its associated factors. MATERIALS AND METHODS: A quasi-experimental study in two rural communities. Difference-in-differences analyses was performed. RESULTS: There was a 22.1% average reduction in wrong answers on the phase of the menstrual cycle with more likelihood of pregnancy in the intervention group versus the control group (p<0.001). We founded six factors associated with this knowledge: marry and have children, right to receive education and information on sexual and reproductive health; gender equity; use of the condom; condom self-efficacy; emergency and contraceptive pills. CONCLUSIONS: There is a prevailing need to improve -among sexuality topics- basic knowledge of reproductive biology, while at the same time insisting on the benefits of using birth control methods provided for practicing responsible sexuality.

OBJETIVO: Medir el efecto de una intervención en el conocimiento de los adolescentes sobre la fase del ciclo menstrual de mayor posibilidad de embarazo e identificar sus factores asociados. MATERIAL Y MÉTODOS: Estudio cuasiexperimental en comunidades rurales. Se realizó un análisis de diferencias en diferencias. RESULTADOS: Hubo una reducción promedio de 22.1% de respuestas incorrectas sobre la fase del ciclo menstrual de mayor posibilidad de embarazo en el grupo intervención vs. control (p<0.001). Se encontraron seis factores asociados con este conocimiento: casarse y tener hijos; derecho a recibir educación e información sobre salud sexual y reproductiva; equidad de género; uso correcto del condón; autoeficacia del uso del condón y pastillas anticonceptivas y de emergencia. CONCLUSIONES: Entre las diferentes temáticas de sexualidad, prevalece la necesidad de mejorar los conocimientos básicos sobre biología de la reproducción, insistiendo a la vez sobre los beneficios que conlleva el uso de métodos anticonceptivos para ejercer una sexualidad responsable.

Intervention for the comprehension of menstrual cycle, body function and pregnancy in adolescents from rural context / Intervención para comprender el ciclo menstrual, funcionamiento del cuerpo y embarazo en adolescentes de contexto rural

Abstract: Objective: To measure the impact of an intervention on adolescents' knowledge of the phase of the menstrual cycle with more likelihood of pregnancy and identify its associated factors. Materials and methods: A quasi-experimental study in two rural communities. Difference-in-differences analyses was performed. Results: There was a 22.1% average reduction in wrong answers on the phase of the menstrual cycle with more likelihood of pregnancy in the intervention group versus the control group (p<0.001). We founded six factors associated with this knowledge: marry and have children, right to receive education and information on sexual and reproductive health; gender equity; use of the condom; condom self-efficacy; emergency and contraceptive pills. Conclusion: There is a prevailing need to improve -among sexuality topics- basic knowledge of reproductive biology, while at the same time insisting on the benefits of using birth control methods provided for practicing responsible sexuality.

Resumen: Objetivo: Medir el efecto de una intervención en el conocimiento de los adolescentes sobre la fase del ciclo menstrual de mayor posibilidad de embarazo e identificar sus factores asociados. Material y métodos: Estudio cuasiexperimental en comunidades rurales. Se realizó un análisis de diferencias en diferencias. Resultados: Hubo una reducción promedio de 22.1% de respuestas incorrectas sobre la fase del ciclo menstrual de mayor posibilidad de embarazo en el grupo intervención vs. control (p<0.001). Se encontraron seis factores asociados con este conocimiento: casarse y tener hijos; derecho a recibir educación e información sobre salud sexual y reproductiva; equidad de género; uso correcto del condón; autoeficacia del uso del condón y pastillas anticonceptivas y de emergencia. Conclusión: Entre las diferentes temáticas de sexualidad, prevalece la necesidad de mejorar los conocimientos básicos sobre biología de la reproducción, insistiendo a la vez sobre los beneficios que conlleva el uso de métodos anticonceptivos para ejercer una sexualidad responsable.

Conflict, Complicity, and Challenges: Reflections on the South African Truth and Reconciliation Commission Health Sector Hearing.

PURPOSE: This article describes the work of the South African Truth and Reconciliation Commission (TRC) in examining the role of the health sector in human rights violations in the protracted conflicts during apartheid. ORGANIZING CONSTRUCT: The enabling legislation contained in the Promotion of National Healing and Reconciliation Act of 1995 allowed for in-depth examination of violations and complicity in human rights abuses. We provide an overview of the process of the public hearings, soliciting submissions, examining evidence of abuse, personal testimony of conflict in situations of dual accountability, and ultimately the recommendations made by the TRC. The article also outlines the responses of various health professional training institutions to the TRC's recommendations, the implementation of university health and human rights courses, and some current challenges post-TRC. CONCLUSIONS: The health sector hearings of the TRC provided a window into the structural unequal access, racial discrimination, prejudice, and abuse in the health services under the apartheid regime. Examination of past violations perpetrated by an abusive regime and by those such as health workers operating in such a system is imperative to ensure that these abuses are not repeated in the future. CLINICAL RELEVANCE: In delivering comprehensive, compassionate, and ethical care, healthcare professionals have accountability to respect and promote the human rights of their patients. Training in human rights and its relationship to health should be incorporated into all health professional programs.

Juventude universitária e direitos de cidadania: sentidos atribuídos à igualdade de gênero / University youth and citizenship rights: meanings attributed to gender equality / Juventud universitária y derechos de ciudadania: sentidos atribuídos a la igualdad de género

Relata-se pesquisa, realizada em 2014-2015, sobre sentidos atribuídos por universitários aos direitos de cidadania, enfatizando igualdade de gênero. Apresenta-se revisão de literatura sobre juventude e relações de gênero e mudanças nos direitos das mulheres após a Constituição Federal/1988. Indaga-se como a geração que viveu essas mudanças percebe a igualdade de gênero. Na Psicologia Social, trata-se de estudo de sentidos correlacionados ao contexto social e histórico. Foi realizado survey, estatisticamente significativo, com 423 universitários, de 18-29 anos, em três universidades. Conforme resultados, a maioria concorda com afirmações genéricas sobre igualdade de gênero, porém esse índice cai significativamente quando se trata da garantia de direitos pelo Estado. Valores tradicionais estão associados à família. As variáveis de impacto foram sexo (mulheres apoiam mais a igualdade de gênero) e religião (protestantes são mais tradicionais). Reflete-se sobre esses sentidos na sociedade brasileira, com suas crises e desafios ligados aos direitos de cidadania.

The paper relates a research, conducted in 2014-2015, on the meanings attributed by university students to the rights of citizenship, emphasizing gender equality. The literature review approaches youth and gender relations, and legal changes in women's rights after Federal Constitution/1988. It questions how the generation that lived these changes perceived the equality of gender. In Social Psychology, it is a study of meanings correlated to the social and historical context. A statistically significant survey was conducted with 423 students, aged 18-29, in three universities. Results are that most agree with generic claims about gender equality, but this rate falls significantly when it comes to the legal guarantee of rights. Traditional values ​​are associated with family. The impact variables were sex (women support more gender equality) and religion (Protestants are more traditional). The paper reflects on these meanings in Brazilian society, with the crisis and challenges related to citizenship.

Presenta-se investigación, realizada en 2014-2015, sobre sentidos atribuidos por jóvenes universitarios a los derechos de ciudadanía, enfatizando la igualdad de género. Aborda-se juventud y relaciones de género y los cambios legales en los derechos de las mujeres después de la Constitución Federal/1988. Se cuestiona cómo la generación que vivió estos cambios percibe la igualdad de género. En Psicología Social, es un estudio de sentidos correlacionados con el contexto social. Una encuesta estadísticamente significativa con 423 estudiantes, entre 18 y 29 años, en tres universidades mostró que: la mayoría aprueba afirmaciones genéricas sobre la igualdad de género, pero esta tasa cae significativamente cuando se trata de garantía legal de los derechos. Valores tradicionales se asocian con la familia. Las variables de impacto fueron sexo (mujeres apoyan más la igualdad de género) y religión (protestantes son más tradicionales). Reflexiona-se sobre estos significados en la sociedad brasileña, con crisis y desafíos de ciudadanía.

Social participation for people with communication disability in coffee shops and restaurants is a human right.

Although Article 19 of the Universal Declaration of Human Rights states that "everyone has a right to freedom of opinion and expression", for people with communication disability this may not be a reality. This commentary shares a practical example of how people with communication disabilities together with speech-language pathology (SLP) students, academics and clinical staff co-designed and co-implemented a Communication Awareness Training Programme for catering staff to enable communication access in coffee shops and restaurants. This is an example of how SLPs can embrace their social responsibility to break down barriers for people with communication disabilities. This commentary shares the reflections of those involved and how they felt empowered because they had learned new skills and made a difference. This commentary highlights the need for co-design and co-delivery of programs to raise awareness of communication disability among catering staff and how the stories of people with communication disabilities served as a catalyst for change. It also highlights the need to SLPs to move intervention to a social and community space.

Taking Up the Mantle of Human Trafficking Education: Who Should Be Responsible?

Human trafficking is a global human rights issue with long-range health consequences about which physicians are largely uneducated. Medical schools are uniquely positioned to address this gap. All future physicians, regardless of specialty, must learn to identify victims and refer them to trauma-informed treatment. Research and advocacy are needed to address the lack of rigorously evaluated curricula in this area, impact policy, and improve services for victims of this heinous form of exploitation.

Human rights in occupational therapy education: A step towards a more occupationally just global society.

BACKGROUND/AIM: Education on human rights will place occupational therapists in a strong position to address societal inequities that limit occupational engagement for many client groups. The imminent changes to the Minimum Standard for the Education of Occupational Therapists engender efforts towards social change and will require university-level human rights education. This education might enhance the profession's influence on disadvantaging social structures in order to effect social change. To contribute to the evidence base for social change education in occupational therapy, this research aims to understand the knowledge, skills, confidence and learning experiences of occupational therapy students who completed a human rights course. METHODS: Final year occupational therapy students responded to questionnaires which included listing human rights, a human rights scale measuring knowledge and confidence for working towards human rights, and open questions. Numbers of rights listed, knowledge scores and confidence scores were calculated. Responses to the open questions were thematically analysed. RESULTS: After completing a human rights course, students had good knowledge and moderate confidence to work with human rights. Three themes were identified including 'learning about human rights', 'learning about structural, societal and global perspectives on occupational engagement' and 'learning how occupational therapists can work with groups, communities and populations: becoming articulate and empowered'. CONCLUSIONS: Human rights education fosters the development of occupational therapists who are skilled, knowledgeable, confident and empowered to address occupational injustices, according to these research findings. To develop a more occupationally just global society, education that considers iniquitous social structures and human rights is necessary.

Cutting Close to the Bone: Student Trauma, Free Speech, and Institutional Responsibility in Medical Education.

Learning the societal roles and responsibilities of the physician may involve difficult, contentious conversations about topics such as race, gender, sexual orientation, and class, as well as violence, inequities, sexual assault, and child abuse. If not done well, these discussions may be deeply traumatizing to learners for whom these subjects "cut close to the bone." Equally traumatizing is exposure to injustice and mistreatment, as well as to the sights, sounds, and smells of suffering and pain in the clinical years. This potential for iatrogenic educational trauma remains unaddressed, and medical educators must take responsibility for attending to it. Possible solutions include trigger warnings or statements given to students before an educational activity that may cause personal discomfort. The authors of this Perspective assert, however, both that this concept does not distinguish between psychological trauma and discomfort and that well-intentioned trigger warnings target the wrong goal-the avoidance of distress. Exposure to discomfort not only is unavoidable in the practice of medicine but may be crucial to personal and professional moral development. The authors argue that a more appropriate solution is to create safe spaces for dialogues about difficult topics and jarring experiences. This approach places even the notion of free speech under a critical lens-it is not an end in itself but a means to create a professional ethic dedicated to treating all individuals with excellence and justice. Ultimately, this approach aspires to create an inclusive curriculum sensitive to the realities of teaching and learning in increasingly diverse societies.

Changing cultural attitudes towards female genital cutting.

As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions, and campaigns promoting abandonment have sometimes led to backlash as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights. Cutting, however, is not necessarily locally pervasive and entrenched. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions.

Revisiting global body politics in Nepal: A reflexive analysis.

Using the example of a human rights training in Nepal, the author looks at global body politics in a reflexive piece on her engagement in development practices that translate western feminist ideas on gender inequality and empowerment via UN human rights policies into non-western contexts. It firsts look at postcolonial and critical literature on feminist engagement in gender and development processes including a discussion on the concept of global body politics before examining briefly the framing of gender-based violence in Nepal. The core of the paper is a reflexive analysis and interrogation of the training in Nepal in order to bring out the tensions and contradictions around western developmental, feminist and human rights discourses. The discussion looks at how difficult it is for feminist, human rights and developmental discourses and practices to unmoor themselves from the notion of the 'expert' and those who do the rights/work/righting rights training and those who are perennially seen as requiring training. The conclusion reflects on possibilities of other epistemic practices found in intercultural dialogues.

Responsabilidad de la psicología en la conformación de los derechos humanos / Responsibility of the psychology in the conformation from the human rights

Existe cierto interés en el tema de los derechos humanos al punto que se ha generalizado su uso en diferentes esferas tanto cotidianas como académicas. Por esto, el texto hace una reflexión frente al que hacer de la psicología y la vinculación de los derechos humanos en la práctica profesional.

There is some interest in the subject of human rights to the point that has been widespread use in different spheres both every day and academic. The text reflects about which make psychology and linking human rights in practice.

[Men caretakers of life: Training in gender-sensitive masculinities for the prevention of violence towards women in Medellin]. / Hombres cuidadores de vida: formación en masculinidades género-sensibles para la prevención de las violencias hacia las mujeres en Medellín.

The training strategies targeted at men so as to reflect on the cultural patterns of patriarchy are an alternative in the promotion of human rights, the prevention of violence towards women and the mainstreaming of gender equality in public policies. With a socio-critical pedagogical approach, we conducted a Training Certification Program in gender equality and gender-sensitive masculinities, for a group of 76 male civil servants and civic leaders in the Colombian city of Medellin, for the purpose of questioning their gender socialization in the patriarchal model, directed towards the development and execution of social, educational or communications projects. The projects proposed by the participants criticize the andro-centric, sexist and discriminatory discourses regarding women that circulate in a manner predominant in their academic, workplace and family ambits, with a gender political commitment and respect for diversity.

Education on human rights and healthcare: evidence from Serbia.

Ensuring and enforcing human rights in patient care are important to promote health and to provide quality and appropriate healthcare services. Therefore, continued medical education (CME) is essential for healthcare professionals to utilize their sphere of influence to affect change in healthcare practice. A total of 123 participants attended three CME courses. Course topics covered: (i) the areas of human rights and healthcare, (ii) rights, obligations and responsibilities of healthcare professionals in relation to human rights and the rights of patients, (iii) healthcare of vulnerable groups and (iv) access to essential medical services. Evaluation of the CME courses involved two components: evaluation of participants' performance and the participants' evaluation of the teaching process. The participants were assessed at the beginning and end of each course. Each of the courses was evaluated by the participants through a questionnaire distributed at the end of each course. Descriptive statistics was used for data interpretation. Knowledge of the healthcare professionals improved at the end of all the three courses. The participants assessed several aspects of the courses, including the course topics, educational methods, the course methods, organization, duration and dynamics as well as the physical environment and the technical facilities of the course, and rated each very highly. Our results corroborate the importance and necessity of courses to heighten awareness of the state of current healthcare and human rights issues to increase the involvement of healthcare professionals both locally and globally.

As possibilidades de atuação da educação de jovens e adultos para a relação intergeracional na educação em direitos humanos / The possibilities of physical education in youth and adult education for the relationship between generations in education in human rights / Las posibilidades de la educación física en la educación de jóvenes y adultos para la relación intergeneracional en la educación en derechos humanos

A intergeracionalidade nas relações sociais é parte intrínseca da constituição das sociedades e assume diferentes contornos na história da humanidade pacificando ou tensionando estas relações em vários campos como na família, na política, no Estado e na escola. A presença preponderante de uma grande população jovem no Brasil na segunda metade do século XX, nas décadas de 70 e 90 contrapõe-se às estimativas de crescente envelhecimento da população já na metade do século XXI. A reflexão apresentada neste artigo de revisão bibliográfica discute como a questão da intergeracionalidade em uma modalidade de educação marcada preponderantemente pelas diferenças etárias entre os seus sujeitos, a Educação de Jovens e Adultos, pode ser melhor compreendida e tratada dentro das dimensões da área da Educação Física, pois este campo do conhecimento, permite a discussão, análise e vivência das discrepâncias etárias de forma integral na aprendizagem corporal, tendo em vista que todas as relações de poder da sociedade assim como a estabelecida entre a hierarquia etária se realizam no corpo.

The intergenerational social relationships is an intrinsic part of the constitution of societies and assumes different contours in human history pacifying or tensing these relations in various fields such as family, politics, the state and school. The preponderant presence of a large youth population in Brazil in the second half of the twentieth century, in the 70 and 90 is opposed to the estimates already growing aging population in the mid-century. The reflections presented in this literature review paper discusses how the issue of intergenerational education modality in a marked predominantly by age differences among its subjects the Education of Youth and Adults (EYA), can be better understood and treated within the dimensions of the area of Physical Education, because this field of knowledge, allows discussion, analysis and experience of age discrepancies in whole body in learning, in order that all power relations in society as well as the established hierarchy between age take place in the body.

La intergeneracionalidad en las relaciones sociales es parte intrínseca de la constitución de las sociedades y asume diferentes contornos en la historia de la humanidad pacificando o tensando estas relaciones en varios campos, como en la familia, en la política, en el Estado y en la escuela. La presencia preponderante de una gran población joven en Brasil en la segunda mitad del siglo XX, en las décadas de los años 70 y 90 se contrapone a las estimativas de creciente envejecimiento de la población ya en la mitad del siglo XXI. La reflexión presentada en este artículo de revisión bibliográfica, discute como la cuestión de la intergeneracionalidad en una modalidad de educación marcada preponderantemente por las diferencias etarias entre sus sujetos, la Educación de Jóvenes y Adultos, puede ser mejor comprendida y tratada dentro de las dimensiones del área de la Educación Física, pues este campo del conocimiento, permite la discusión, el análisis y vivencia de las discrepancias etarias de forma integral en el aprendizaje corporal, con miras a que todas las relaciones de poder de la sociedad así como la establecida entre la jerarquía etaria se realizan en el cuerpo.

Back to the future: a history of ACOG in social media's golden age.

PURPOSE OF REVIEW: To chronicle a medical professional society's adoption of innovation and to describe themes pertinent to the adoption. RECENT FINDINGS: In September 2013, the American College of Obstetricians and Gynecologists (ACOG) published a Committee Opinion on Toxic Environmental Agents that included an infographic and social media awareness campaign. To date, it claims one of the highest total audience reaches for an ACOG Facebook post reaching nearly 18 000 viewers. Despite this powerful promise, ACOG's timely and successful social media campaign did not always appear an obvious strategy. Although social media took hold of popular culture in the early 2000s, social media's professional etiquette remained uncharted and rife, with cautionary tales through the latter half of the decade. SUMMARY: Through a thoughtful and dedicated process, the ACOG Fellow and Junior Fellow leadership partnered to navigate the appropriate balance of innovation and prudence that propelled ACOG into social media's golden age, and paved the pathway for more progressive institutional changes.

Psychological, social and welfare interventions for psychological health and well-being of torture survivors.

BACKGROUND: Torture is widespread, with potentially broad and long-lasting impact across physical, psychological, social and other areas of life. Its complex and diverse effects interact with ethnicity, gender, and refugee experience. Health and welfare agencies offer varied rehabilitation services, from conventional mental health treatment to eclectic or needs-based interventions. This review is needed because relatively little outcome research has been done in this field, and no previous systematic review has been conducted. Resources are scarce, and the challenges of providing services can be considerable. OBJECTIVES: To assess beneficial and adverse effects of psychological, social and welfare interventions for torture survivors, and to compare these effects with those reported by active and inactive controls. SEARCH METHODS: Randomised controlled trials (RCTs) were identified through a search of PsycINFO, MEDLINE, EMBASE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Depression, Anxiety and Neurosis Specialised Register (CCDANCTR), the Latin American and Caribbean Health Science Information Database (LILACS), the Open System for Information on Grey Literature in Europe (OpenSIGLE), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and Published International Literature On Traumatic Stress (PILOTS) all years to 11 April 2013; searches of Cochrane resources, international trial registries and the main biomedical databases were updated on 20 June 2014. We also searched the Online Library of Dignity (Danish Institute against Torture), reference lists of reviews and included studies and the most frequently cited journals, up to April 2013 but not repeated for 2014. Investigators were contacted to provide updates or details as necessary. SELECTION CRITERIA: Full publications of RCTs or quasi-RCTs of psychological, social or welfare interventions for survivors of torture against any active or inactive comparison condition. DATA COLLECTION AND ANALYSIS: We included all major sources of grey literature in our search and used standard methodological procedures as expected by The Cochrane Collaboration for collecting data, evaluating risk of bias and using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods to assess the quality of evidence. MAIN RESULTS: Nine RCTs were included in this review. All were of psychological interventions; none provided social or welfare interventions. The nine trials provided data for 507 adults; none involved children or adolescents. Eight of the nine studies described individual treatment, and one discussed group treatment. Six trials were conducted in Europe, and three in different African countries. Most people were refugees in their thirties and forties; most met the criteria for post-traumatic stress disorder (PTSD) at the outset. Four trials used narrative exposure therapy (NET), one cognitive-behavioural therapy (CBT) and the other four used mixed methods for trauma symptoms, one of which included reconciliation methods. Five interventions were compared with active controls, such as psychoeducation; four used treatment as usual or waiting list/no treatment; we analysed all control conditions together. Duration of therapy varied from one hour to longer than 20 hours with a median of around 12 to 15 hours. All trials reported effects on distress and on PTSD, and two reported on quality of life. Five studies followed up participants for at least six months.No immediate benefits of psychological therapy were noted in comparison with controls in terms of our primary outcome of distress (usually depression), nor for PTSD symptoms, PTSD caseness, or quality of life. At six-month follow-up, three NET and one CBT study (86 participants) showed moderate effect sizes for intervention over control in reduction of distress (standardised mean difference (SMD) -0.63, 95% confidence interval (CI) -1.07 to -0.19) and of PTSD symptoms (SMD -0.52, 95% CI -0.97 to -0.07). However, the quality of evidence was very low, and risk of bias resulted from researcher/therapist allegiance to treatment methods, effects of uncertain asylum status of some people and real-time non-standardised translation of assessment measures. No measures of adverse events were described, nor of participation, social functioning, quantity of social or family relationships, proxy measures by third parties or satisfaction with treatment. Too few studies were identified for review authors to attempt sensitivity analyses. AUTHORS' CONCLUSIONS: Very low-quality evidence suggests no differences between psychological therapies and controls in terms of immediate effects on post-traumatic symptoms, distress or quality of life; however, NET and CBT were found to confer moderate benefits in reducing distress and PTSD symptoms over the medium term (six months after treatment). Evidence was of very low quality, mainly because non-standardised assessment methods using interpreters were applied, and sample sizes were very small. Most eligible trials also revealed medium to high risk of bias. Further, attention to the cultural appropriateness of interventions or to their psychometric qualities was inadequate, and assessment measures used were unsuitable. As such, these findings should be interpreted with caution.No data were available on whether symptom reduction enabled improvements in quality of life, participation in community life, or in social and family relationships in the medium term. Details of adverse events and treatment satisfaction were not available immediately after treatment nor in the medium term. Future research should aim to address these gaps in the evidence and should include larger sample sizes when possible. Problems of torture survivors need to be defined far more broadly than by PTSD symptoms, and recognition given to the contextual influences of being a torture survivor, including as an asylum seeker or refugee, on psychological and social health.