Delivering trauma-focused physiotherapy interventions for trauma-exposed refugees: a qualitative study exploring perspectives and experiences from Jordan and Kenya

Objectives: Trauma-focused physiotherapy refers to physical interventions and strategies that are used by physical therapists to address the functional and psychological impact of traumatic experiences. The aim of this study was to explore physical therapists' experiences and perspectives when delivering trauma-focused physiotherapy to trauma-exposed refugees. Methods: Six focus groups, involving 26 physical therapists working in Jordan (n = 13) and Kenya (n = 13) were conducted. A topic guide based on literature, and clinical views was used. Focus group conversations were audio recorded, transcribed and analyzed thematically, with peer checking carried out. Results: Five main themes were identified: (1) intertwined physical, social and psychological symptoms are a key feature of the clinical presentation for trauma-exposed refugees, (2) a client-centered approach that accommodates the complex clinical presentation is critical throughout the care pathway, (3) trauma-focused physiotherapy is recognized as a specialized approach with its own distinct characteristics, (4) therapists and in need of additional self-care, and (5) trauma-focused physiotherapy training gaps are evident. Conclusions: This study highlights the varied and related symptoms experienced by trauma-exposed refugees, which may be amenable to physiotherapy interventions. Specific knowledge and skills are required by physical therapists of trauma-informed care and trauma-focused physiotherapy to enable the delivery of such interventions within a client-centered biopsychosocial approach. Therapists are exposed to possible negative reactions as they are confronted daily by suffering and grief. Study findings are the first step in increasing our understanding of key processes inherent in delivering a trauma-focused physiotherapy approach.