specific needs of victims of torture. The guidelines also describe the rehabilitation procedure which
should be in accordance with the following three steps:
(i) understand the trauma that the person has suffered and its consequences on her/his mental and
physical health; (ii) identify the appropriate therapy to deal with traumatic memories; and (iii) create
and strengthen positive social relationships as additional support mechanisms.
Early identification of victims of torture is essential. The Italian guidelines provide for three progressive
levels:
1st level: Participation of non-healthcare personnel to support the identification of victims of torture
through analysis or through active and organized listening.
2nd level: Conversation with psychological healthcare personnel of hosting structures, including with
specific instruments to evaluate the level of vulnerability.
3rd level: National Health Service personnel with specialized proficiency in multidisciplinary
integrated approach that can provide for accurate clinical-diagnostic evaluations and subsequent
adequate treatment.
The guidelines give particular attention to the certification process that is essential for the asylum
applicant and for the local commissions that evaluate the application for international protection. The
medical certification, which must comply with international standards, can help evaluate the
coherence between the medical and psychological manifestations and the survivors’ accounts about
torture, violence or injuries. Another important aspect in the Italian guidelines is the emphasis on
linguistic and cultural mediation that represents an important instrument to provide assistance to
victims of torture. Linguistic and cultural mediators establish first contact and ensure mutual
understanding and proper communication between the survivor and other interlocutors, including the
rehabilitation expert team. Furthermore, the guidelines underline the importance of health protection
of service providers themselves. It foresees prompt intervention in cases of work related stress
symptoms, burnout syndrome and vicarious trauma. The guidelines also provide for training and
upgrades for service providers in order to promote the quality of rehabilitation services.
Asger Kjaerum, International Rehabilitation Council for Torture Victims (IRCT)10: Providing
rehabilitation to victims of torture and other ill-treatment – a story
Listening to survivors of torture is essential, also for experts and advocates that are working on this
issue for years, in order to fully understand not only the needs of survivors but also the impact torture
has on an individual, families of victims, the community and society as a whole. The story of a survivor
who fled his home country and received rehabilitation services in Denmark, may help to understand
the unbelievable pain and suffering and the struggle victims of torture face to rebuild their lives.
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The International Rehabilitation Council for Torture Victims (IRCT) is a health based umbrella organization
that supports the rehabilitation of torture victims, the prevention of torture and the fight against impunity
worldwide. Its members comprise more than 150 independent organizations in over 70 countries. The
IRCT is the largest membership-based civil society organization to work in the field of torture
rehabilitation and prevention.
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