Rehabilitation of torture survivors and prevention of torture: Priorities for research through a modified Delphi Study

Background: Research is a key element in prevention and in ensuring that survivors of torture have access to appropriate and effective rehabilitation, but it is often neglected as more pressing issues frequently come first. Methods: A modified Delphi study with three rounds of consultation was used to reach a consensus of expert panellists with respect to top research priorities in the interdisciplinary field of torture rehabilitation and prevention. Panellists included professionals (medical, psychologists and psychiatrists, lawyers, social workers and members of organizations of survivors) from 23 countries balanced by gender, geographical area, profession and area of work (country of asylum versus where torture is perpetrated). Aims were to stimulate an interdisciplinary debate, foster research and inform the future publishing priorities of the Torture Journal (the publication which led the study). Findings: The panellists came up with 174 possible lines of research from which 40 were prioritised. Some more theoretical research lines especially regarding neurobiology, evidence-based treatments or ethical debates were not considered a priority. From individual research lines, the four highest ranking were: long-term outcomes and effects of interventions (including chronicity, factors leading to re-traumatisation and implications for public health); outcomes of the Istanbul Protocol (impact of documentation of torture in the judicial system); trans-generational trauma; and, torture in the context of those disappeared and in extrajudicial killings. While there were not significant differences in priorities by gender, the analysis by geographical area showed important peculiarities suggesting that a single worldwide agenda of research might not be realistic or desirable, and that local and regional priorities must be taken into account. Discussion: Overall, the study shows a dissociation between what we know, what we would like to know and what we research. Most of the research published in medical and psychological journals is around local experiences, epidemiological data, case reports and mixed outcome studies, which were not among experts’ priorities. This points to the fact that existing research can be repetitive and that there is ample scope for other research topics in the future, particularly interdisciplinary research. Conclusion: Whilst it is accepted that global research priorities are unlikely to fully reflect research needs at every level (local/national/regional for example), some important conclusions can be drawn. The anti-torture sector is a fairly young field of academia and is interdisciplinary in nature. A wide scope of research can therefore be usefully undertaken and published for dissemination. It is hoped that the findings of this study may be a useful starting point for consideration and fundraising.