Research Policy

• Target 1: By the year 2015, based on an improved understanding of the physical, psychological and social consequences of torture, new knowledge has been produced that affirms or disconfirms the validity of at least 10 methods or approaches to rehabilitation of torture survivors
• Target 2: By the year 2015, based on an improved understanding of the practice of TOV, the crucial elements for effective organisation of community mobilisation for rehabilitation and prevention in relation to TOV have been identified, and models from at least 2 different parts of the world have been tested
• Target 3: By the year 2015, RCT is able to provide new knowledge as to which models or approaches offer the best access, quality and possibilities for sustainability in the work against TOV in different political and socio-economic environments
• Target 4: By the year 2015, approaches for eliminating torture within law enforcement institutions, particularly in places of detention, have been developed and tested, and the impact assessed in at least five countries
• Target 5: By the year 2015, relevant sources are routinely monitored/consulted for information on all aspects of TOV, and regularly updated reviews of knowledge in key areas are made easily accessible for global use

These targets will be pursued partly by the systematic gathering and documentation of current knowledge and practice with regard to the effect and methods of rehabilitation and prevention, and partly by carrying out research - or stimulating others to do so - in order to fill gaps in this knowledge.

The research is organised in clusters comprising senior researchers, post-docs and Ph.D. students.

An essential component of both rehabilitation and prevention research is the development of valid, reliable and context-specific data-collecting instruments. This work will, among other things, include the identification, development and testing of instruments which are relevant to populations who have been exposed to TOV in developing countries and transitional societies.

RCT's research observes international guidelines for scientific practice, including scientific ethical rules, and utilises methods accepted by the international scientific community. The primary output is publications in international scientific peer-reviewed journals, indexed in relevant databases. Furthermore, researchers at RCT present their results in books, book chapters and review articles as well as through lectures, participation in scientific networks and at conferences etc.

Rehabilitation Research
To date in both Danish and international health systems, the rehabilitation of torture survivors has been based on experience rather than on scientific evidence. The rehabilitation activities conducted at RCT's rehabilitation clinic and at RCT's partners in the South do, however, provide ample opportunities for carrying out research projects with a view to a more systematic gathering of knowledge. RCT has recently concluded two longitudinal studies among clients who have undergone rehabilitation. These studies indicate that torture poses significant mental and physical strain, with a tendency to chronic impairments, also many years after torture has taken place. The next necessary step will be to carry out effect trials in the form of controlled clinical trials. To facilitate this, RCT is planning to establish a controlled clinical trials unit (CCTU) with fixed routines for single and multi-centre trials, partly with regard to design and analysis and partly with regard to clinical monitoring. The point of departure is controlled trials of the efficiency of different rehabilitation processes. The few attempts made to investigate treatment effects in developing countries will also be studied.

Rehabilitation research is multi-dimensional per se and will thematically be organised in relation to the World Health Organisation's International Classification of Functioning, Disability and Health (ICF). ICF consists of a context-sensitive classification of domains for a person with a given state of health classified with regard to functioning and impairment, activity and participation as well as contextual factors.

In order to alleviate TOV-related sequelae, knowledge must be gained about the mechanisms underlying them. This knowledge will be gained partly through analogies to well-known conditions and partly through new research in for example mechanism analysis of somatic (pain, stress) and mental (cognition disorders, stress) symptoms. The rehabilitation research will also focus on the development and testing of interventions in connection with TOV-related impairments, limitations of activity and participation as well as contextual factors. TOV often takes place in developing countries where the need for rehabilitation is great given the lack of basic resources. Therefore, RCT prioritises contributing to the development of cost-effective rehabilitation interventions comprising the core elements of progressive rehabilitation programmes. These interventions should also be tested in clinical trials. Clinical relevance is of utmost importance in connection with rehabilitation research, and it is therefore paramount that researchers have a professional background as well as practical experience of rehabilitation processes.

Only a minority of the world's TOV victims are treated for their trauma, and the number of those in need of rehabilitation is unknown. The majority have to take care of themselves or manage with the support they can get from their immediate surroundings. In order to develop cost-effective interventions aimed at limiting the social, economic and health-related problems of TOV survivors and their families, RCT's rehabilitation research will furthermore include studies of the way in which people from different cultures and life contexts cope with their traumatic experiences. The focus of this research will be on the factors predicting positive and negative coping and development.

Prevention Research
During the past decade international development assistance (human rights and health-related) has focused increasingly on the prevention of TOV. This work has contributed to the development of preventive programmes and interventions (e.g. post-conflict demobilisation and human rights training of the police). The work is, however, often based on the assumption that conditions of TOV are transitional deviations from normality, i.e. peace. This assumption is problematic in relation to both empirical and theoretical considerations since TOV is often a permanent element in people's lives in many developing countries, transitional societies and even in democratic states. The effect of this on people and communities is often very complex and poorly documented.

Taking this insight as point of departure, RCT will contribute with research in the form of descriptions and analyses of complex and often global, social and historical relations. Furthermore, the ways in which these relations form the basis for the continued existence of TOV and the effects this has on local communities will be investigated. In connection with this, RCT will actively contribute to the development of more efficient intervention forms. Thematically, prevention research will be centred around two axes. Firstly, institutions and networks practicing TOV will be analysed. Secondly, interventions as well as the ability of local communities to cope with and survive periods marked by TOV will be described and analysed as will the effects of TOV on social, political and economic structures.

TOV takes place in a number of different institutions and networks. Practices of TOV influence the possibility of living worthy and productive lives for a large number of populations, communities and individuals. At the same time TOV affects those who voluntarily, unknowingly or unwillingly carry out the atrocities. Both victims and perpetrators - as well as the institutions within which they operate - have been objects for analysis. Rarely is focus put on the relation between perpetrators and victims or on why they end up in one category or the other. It is of utmost importance to understand this complex relation and the way in which it is played out in concrete contexts if the structures that lie behind the continuous existence of TOV are to be identified. Only on the basis of this understanding can suitable interventions be designed.

Both research and interventions are increasingly focussed on the suffering inflicted on local communities during periods marked by TOV. In contrast to the often individual-focussed initiatives practiced in the North, focus in developing countries and transitional societies is directed towards collective experiences in connection with TOV and towards preventive community-based interventions. In particular, RCT will be concerned with the culturally determined livelihood and coping strategies utilised under living conditions characterised by TOV. The primary focus of this work will be on civilians during intra- and inter-state conflicts and on persecuted populations in weak as well as strong states. The main task will be to document, describe and analyse the following: 1) the prevalence and forms of TOV inflicted on these populations; 2) the way in which TOV is integrated, interpreted and understood in each populations' life worlds (including the significance of political and social identities); and 3) the way in which the populations act upon it. In addition, the aim is to understand how classic rehabilitation tools and more recent ones (community-based interventions) are integrated in or used in opposition to local healing strategies.

The development of methodologies will be central to prevention research which is per se interdisciplinary. Furthermore, it is an aim to establish comparative methods that do not compromise the local contexts in which research is carried out.

Capacity Building and Networking
Both within the rehabilitation and prevention clusters we seek to establish national as well as international networks within strategic research areas. Furthermore, we aim to increase/widen the research capacity in the South. In line with Danish development assistance given to partner countries, RCT's partners are also to be involved in the research process. Besides ensuring an improved quality of research, capacity building also aims at providing partner organisations (RCT's and others working with TOV-related conditions) with tools for analytical reflection on their own practice which will hopefully lead to better interventions. RCT will facilitate research processes that complement to RCT's own research efforts.

In Denmark contributions to the construction of research competence are made through supervision of Ph.D. and Masters students and full cooperation with the universities is striven for. Expanding the cooperation with universities will contribute to better research and to the dissemination of RCT's research and intervention agenda. RCT will furthermore facilitate connections between partner organisations and universities in such a way that the universities can, for example, contribute to the training of employees in partner organisations.

RCT will strive to both participate in and organise international conferences within relevant research areas and to accommodate guest researchers for limited periods of time.