Integrating a psychosocial rehabilitation method into standard trauma physiotherapy

Traumatised refugees face a considerable task adapting to life in a new<br/>country with multiple post-migratory stressors and reduced physical, cognitive,<br/>emotional, and social functioning. The PSoReKo project is developing and testing<br/>an integrated and balanced biopsychosocial physiotherapy approach to trauma<br/>treatment by strengthening the psychosocial aspects of the physiotherapists’<br/>competencies. The project is based on the Integrative Model of Adjustment to<br/>Continuous Challenges (IMACC), a theoretical framework based on cognitivebehavioural principles, explaining the biopsychosocial process of adjustment<br/>and recovery, seen from an intrapersonal perspective.<br/>Based on the IMACC theory and using co-creation involving researchers,<br/>physiotherapists, and interpreters, the IMACC-conversation has been developed<br/>as a clinical recovery-oriented approach supporting the individual process of<br/>adjustment and recovery. The IMACC-conversation has been integrated into<br/>standard physiotherapy practice and is now being tested using multiple baseline<br/>single-case studies. Participants are supported in making at least one adaptive<br/>behavioural change of their own choice. Behaviour changes of the categories<br/>physical activity, self-care, arousal control and social participation are aimed at<br/>strengthening activity and participation in everyday life. Change is monitored<br/>during a baseline period and throughout the intervention using a simple daily<br/>self-report (Likert scale) relevant to the chosen behaviour. Wellbeing is measured<br/>weekly during the same periods using WHO-5.<br/>Preliminary results from the pilot study show that integration of a targeted<br/>psychosocial recovery-oriented approach into standard trauma physiotherapy is<br/>feasible. Out of two completed single-case studies one shows low to moderate<br/>effect of the integrated intervention.