Torture Survivors and their Power:

Strengths-Based Treatment

Karen Hanscom, PhD (klh@astt.org)

Faith Ray (fray@astt.org)

Advocates for Survivors of Torture and Trauma (ASTT)

Washington, D.C. and Baltimore, MD

www.astt.org

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Outline

I. Theoretical Basis

II. The Strengths-Based Model

III. Questions

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Strengths-Based Theory

A model that was originally developed at the University of Kansas in the 1980’s.

• A framework for interactions and process

• A common or shared view, a way of “seeing”

It is a way of seeing, viewing, conceptualizing,

our clients, their environment, and situation.

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Using Strengths-Based Treatment

with Torture Survivors

Torture takes away an individual’s power.

Using this model, WE do not take their power

away again. Rather, we acknowledge the

client’s power

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Learning from Research

Factors in treatment:

•The most important – the client’s responsibility for change.

•What the client brings in terms of resilience, strengths, and social

support (40% of success based on these).

•Client’s perception of worker (30%)

Quality of the relationship – Is it warm, supportive, accepting,

encouraging?

Expectancy or placebo effect (15%).

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Principles of the

Strengths-Based Approach

• Each person has an innate capacity to

improve her/his life.

• Each person is capable of making her/his own

decisions.

• Treatment is based on the whole person and

focuses on the healthy aspects of a client.

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Role of Staff

Staff can unleash the individual’s strengths by:

• Encouraging

• Assisting

• Supporting

• Stimulating

Dennis Saleebey: People are doing the best they can at the time that we see them; people have survived to this point and, change only occurs when you collaborate with the client ’ s aspirations, perceptions, and strengths.

AND when YOU firmly believe in them.

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Basic Principals

(Kisthardt, Walter)

• Initially: The helping process focuses on strengths, interests,

abilities, knowledge and capabilities of each person.

• The helping relationship is one of collaboration, mutuality, and

partnership – Power with another, not power over another.

• Responsibility in recovery: The client is the director of the helping

effort and we serve as caring consultants.

• Inherent capacity to learn, grow, change.

• The community as an oasis of potential resources.

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Why Use Strengths-Based Approach

with Torture Survivors?

In clients, trauma causes insecurity, pessimism, and a

sincere belief that one is powerless.

This model ensures that the CLIENT has the power.

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Strengths-Based

Case Study

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PROBLEM STRENGTHS RESOURCES

Client doesn’t have

employment

authorization

Client is hardworking;

desire for job once

approved for work

permit

Created a resume with

his case manager; he

has started job

searching

Homelessness;

hesitancy to ask for help

from community

Control over situation;

housing decision in his

hands

CM gave client info on

emergency homeless

shelters/advised client

to speak with

community/church

members about his

situation

Client has no access to

public transportation

Resourcefulness: asking

friends for help

Friends who can drive

him when necessary;

ASTT phone

consulations ASTT July 2012

What is Required of You,

the Care Provider?

A shift in attitude toward clients.

A change in our role with clients.

“We are at our best as helpers when we cast off the pretentious role of

expert and join with our clients as colleagues and companions in the

pursuit of all that is of consequence for a more reasonable life.”

Goldstein, Howard

1997

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The Role of the

Case Manager and Therapist

The role is to help people empower themselves.

Cowger, Charles et. Al

2004

• Helping clients: discover solutions, make their own priorities and

choices.

• What we think the client needs

vs.

What the client thinks s/he needs

• Flexibility, creativity

• Giving space for the client to take the lead.

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The Healing Relationship

Client

Therapist Case Manager

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The Strengths-Based Organization

All elements of the program are aimed at keeping the

power with the client.

• Role of the all staff

• Setting appointments

• Interactions within a session

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The Wellness Plan

I. Identifying the goal that the client wishes to

achieve.

II. Creating steps to reach the goal.

III. Behavioral Objectives

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Identifying the Goal

Assist the client in determining what s/he needs or wants

For example: Client says, “I want to go places by myself.”

GOAL: To go out in public alone.

SPECIFIC GOAL: “I would like to go to the library to use the computer.”

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Creating Steps toward Goal

What steps would be needed to go to the library to use the computer?

• Find location of library.

• Walk to bus stop. Take bus to location.

• Enter the library and look for Information Desk.

• Ask librarian for help with computer.

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The Steps as Behavioral Objectives

Each step/objective is specific, attainable, and realistic. A

clear, unambiguous description of an expectation.

The behavioral objective is:

• Written and has a target date

• Monitored at each session

Three parts:

• Behavior

• Condition

• Criteria

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The Behavior

The behavior is the action or skill that the individual will be able TO DO.

Actions:

• list choose

• search walk

• sleep go to the library

• attend listen

• call for a medical appointment

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Conditions of Performance

Circumstances or context:

• where with whom

• when using what

• how

Example: Ms. S. will walk around her neighborhood alone.

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Performance Criteria

How often (once a week)

By what date (1 week, before we meet))

How well (3 out of 7 days)

Recorded

Example: Ms. S will walk around her neighborhood alone three times a week and mark it on calendar.

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Wellness Plan

Behavior Condition Criteria Target

Date

Walk around the 3 out of 7 days 7/25

neighborhood

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Summary

• Theoretical basis of the strengths-based model.

• The shift in provider attitude and role.

• Using the wellness plan as a framework for treatment.

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Questions?

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References

Writing behavioral objectives:

1. http://ets.tlt.psu.edu/learningdesign/objectives

2. adprima.com

The Strengths-Based Model:

1. Saleebey, Dennis. The Strengths Perspective in

Social Work Practice, 4th edition, Allyn and Bacon,

2006.

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