Truth and reconciliation commissions

1. Introduction

Version followed: truth commissions as defined in Amnesty International's 2007 guidance Truth, justice and reparation: Establishing an effective truth commission; the psychosocial support model of the South African Truth and Reconciliation Commission as its Final Report (Vol. 1, Ch. 11, Mental Health Unit) describes it; and, for the Canadian residential-schools context, the Indian Residential Schools Resolution Health Support Program as Indigenous Services Canada publishes it. Therapist-side procedures built on these are marked [synthesis].

A truth commission is not a psychotherapy. Amnesty International defines truth commissions as "official, temporary, non-judicial fact-finding bodies" that investigate patterns of abuse rather than single events, establish facts, pass evidence to prosecutors and recommend reparation [source: Amnesty International 2007]. Amnesty prefers the term "truth commission" to "truth and reconciliation commission" because, in its view, reconciliation cannot be imposed [source: Amnesty International 2007]. Two of the best-known commissions are completed and are now historical: South Africa's TRC, established under the Promotion of National Unity and Reconciliation Act 34 of 1995 [source: TRC Final Report Vol. 1 Ch. 11], and the Truth and Reconciliation Commission of Canada on Indian Residential Schools, which issued its final report and 94 Calls to Action in 2015 under its chair, Justice Murray Sinclair [source: CBC News 2015]. The Canadian commission was officially launched in 2008 as part of the Indian Residential Schools Settlement Agreement [source: The Canadian Encyclopedia]. Other commissions named in Amnesty's critiques include Chile (1990, with a second commission in 2003), Sierra Leone, Paraguay, Sri Lanka, Morocco and Haiti [source: Amnesty International 2007].

How change is meant to happen, as the commissions and their evaluators state it: at the societal level, establishing an official, acknowledged record of violations, recognising victims, referring evidence for prosecution and recommending reparations [source: Amnesty International 2007]. For individuals, survivors interviewed after the South African hearings valued learning the truth about what happened to loved ones, being publicly heard and acknowledged, and in some cases restoring their reputations in their communities [source: Picker 2005]. These hoped-for individual effects are not guaranteed. In a cross-sectional study of 134 South African survivors, giving public testimony, closed testimony or no testimony was not significantly associated with current psychiatric status or forgiveness, while low forgiveness was associated with poorer psychiatric health; the authors concluded that truth commissions should complement, not replace, comprehensive therapeutic interventions [source: Kaminer et al. 2001]. In a randomised study of Fambul Tok community truth-telling forums in Sierra Leone (2,383 people in 200 villages), forgiveness and social capital increased but so did depression, anxiety and PTSD, with both effects still present at 31 months [source: Cilliers, Dube & Siddiqi 2016].

The psychotherapist's role is therefore not to run a commission but to help a client decide whether and how to take part, prepare for and get through statement-giving or hearings, coordinate with the commission's own support staff, deal with what follows (amnesty findings, reports, reparations or their absence), and work with what the process means in the client's life, often years after the commission has closed [synthesis].

2. Framework

The commission's own sequence [source: Amnesty International 2007; TRC Final Report Vol. 1 Ch. 11; Picker 2005]:

Establishment and mandate. A statute or decree sets the mandate, period and powers. Amnesty urges that victims' groups and civil society be fully involved in designing the commission and that mandates be broad enough; it cites Chile's 1990 commission not covering torture that did not result in death, and Paraguay's 18-month mandate being considered too short.
Statement-taking. Victims register cases and give statements. The South African TRC took about 22,000 statements [source: Picker 2005]. Its report acknowledges that statement-taking moved from storytelling to an empathetic listener towards standardised fact-finding forms, which reduced the healing potential of the encounter and stopped statement takers from assessing needs or referring people on [source: TRC Final Report Vol. 1 Ch. 11].
Hearings. Public and confidential (closed) hearings; Amnesty says commissions should be able to hold both. In South Africa only about 8% of statement-givers were selected for public hearings, usually by the commission approaching them [source: Picker 2005].
Hearing support in three phases. The South African Mental Health Unit's work: before hearings, preparing and briefing witnesses; during hearings, containing and advocating for them; after hearings, debriefing and referring them to regional service providers with local knowledge, who followed up [source: TRC Final Report Vol. 1 Ch. 11].
Findings, final report and recommendations, including reparations; Canada's commission issued 94 Calls to Action, split into Legacy (1 to 42) and Reconciliation (43 to 94) [source: CBC News 2015].
Follow-up and implementation. Reparations and prosecutions depend on governments; in South Africa, Amnesty International and Human Rights Watch jointly reported in 2003 that financial reparations remained largely unpaid [source: Amnesty International & Human Rights Watch 2003].

The client's track alongside it [synthesis, mapped onto the phases above]:

Deciding whether to take part (information, risk and readiness). Move on when the client has made an informed, voluntary choice, including the choice not to take part.
Preparing a statement or hearing (expectations, stabilisation, a plan for the day). Move on when the client can describe what will happen, what they will and will not say, and how they will get support.
Taking part (statement, hearing, any encounter), with commission support staff present where available.
Immediate aftermath (check-in, stabilisation, referral continuity). Move on when acute distress has settled and follow-up is in place.
Waiting and outcomes (amnesty decisions, publication of the report, reparations or their absence).
Longer-term work (trauma, grief, intergenerational effects, meaning), which continues after the commission has closed.

Format and session counts. None of the sources gives a session count or duration for therapeutic support around a truth commission; plan the number of sessions with the client according to need [synthesis]. Support may be individual, family or group: Canada's health support programme offers individual, family and group counselling by registered psychologists and social workers, alongside emotional support workers and cultural support from Elders, Knowledge Holders and Traditional Healers [source: Indigenous Services Canada].

3. Guiding principles

Participation is voluntary. Never encourage a client to testify for the therapist's or the nation's sake; declining is a legitimate outcome [synthesis].
A commission complements treatment; it does not replace it. Plan for ongoing therapy rather than expecting testimony to heal [source: Kaminer et al. 2001].
Truth-telling can carry psychological costs as well as social gains. Monitor symptoms after participation instead of assuming relief [source: Cilliers, Dube & Siddiqi 2016].
Reconciliation and forgiveness cannot be imposed. Do not set forgiveness as a therapy goal unless the client chooses it [source: Amnesty International 2007; synthesis].
Accurate information prevents harm. Victims need to be fully informed about what to expect, and unrealistic expectations produce anger and a sense of injustice [source: Picker 2005].
Support is continuous: before, during and after. Match the commission's own three-phase model and close the gap where its follow-up stops [source: TRC Final Report Vol. 1 Ch. 11].
Access to support should be equitable. South African participants reported that white participants were generally offered counselling while most African and coloured participants were not; check actively who in your service is being missed [source: Picker 2005].
Safety and protection come first. Amnesty calls for victim and witness protection that goes beyond hiding identities; ask about threats before and after testimony [source: Amnesty International 2007].
Trauma sits inside social and economic reality. The South African report warns that trauma was compounded by poverty, illness and living conditions; address practical needs, not only symptoms [source: TRC Final Report Vol. 1 Ch. 11].
Five groups are affected: victims, perpetrators, families and dependants, communities, and commission personnel. Any of them may come to you as a client [source: TRC Final Report Vol. 1 Ch. 11].
Culturally grounded healing on the client's terms. Use Indigenous healing practices with Elders and healers when the client requests them (TRC Canada Call to Action 22) [source: CBC News 2015; Indigenous Services Canada].
Children and survivors of sexual violence need special measures [source: Amnesty International 2007; ICTJ 2018].
Stay in role. The therapist does not take statements, run hearings, give legal advice or facilitate victim–perpetrator encounters without that specific training and mandate; coordinate with those who do [synthesis].
Confidentiality and naming. Keep the client's identity and the identities of others out of any material you write; never pass on names of victims, witnesses or accused private persons beyond what the client authorises and the law requires [synthesis].
Dual roles. If you also work for or contract with a commission (for example as a briefer or a programme-registered counsellor), manage multiple relationships under APA Ethics Code Standard 3.05 (APA Ethics Code) and keep therapy separate from fact-finding [synthesis].

4. Intervention inventory

The commissions' published materials describe a support structure (briefing, containment and advocacy, debriefing, referral, protection, special measures for children and survivors of sexual violence, cultural support) rather than therapy techniques. The therapist procedures below put that structure into practice; where a step is not in the sources it is marked [synthesis].

4.1 Orientation to the commission's mandate and limits

Purpose: prevent the false expectations that South African survivors described, by making clear what the commission can and cannot do before the client commits. Use it at first mention of a commission, whether current or long closed [source: Picker 2005; Amnesty International 2007].
Steps: (1) Find the commission's mandate, period covered, powers and support services from its own publications or the statute, not from hearsay [synthesis]. (2) Go through with the client what the commission can do (record, acknowledge, investigate patterns, recommend) and what it usually cannot do (deliver reparations itself, guarantee prosecutions, or promise outcomes). In South Africa the commission could only recommend reparations and make some urgent interim payments, and this was poorly communicated [source: Picker 2005]. (3) Tell the client that a commission is not a court and cannot establish individual criminal responsibility [source: Amnesty International 2007]. (4) Write down the client's questions for the commission's staff or the client's lawyer [synthesis].
Example language (illustrative): "Before you decide anything, let's be clear about what this commission can do for you and what it can't, so nothing catches you off guard later."
Watch for: hopes pinned on a single outcome (compensation, an apology, a prosecution); discouragement once the limits are clear, which is useful information for the decision. It is working when the client can say in their own words what will and will not happen after they speak [synthesis].

4.2 Readiness and contraindication assessment

Purpose: decide with the client whether giving a statement, or a public rather than a closed statement, is safe now. Use before any commitment and again before a hearing [synthesis].
Steps: (1) Assess current PTSD, depression, substance use, sleep and suicidality with your usual measures; testimony can bring traumatic memories into the present, and some South African participants reported physical and psychological deterioration [source: Picker 2005]. (2) Take a suicide-risk history using current risk-assessment practice. (3) Weigh stabilising factors: support people, housing, income, ongoing treatment. (4) Note relative contraindications for going ahead now: acute suicidality, untreated psychosis, active substance crisis, ongoing threats or dependence on people linked to perpetrators, or pressure from others to testify [synthesis]. (5) Agree a decision: proceed, postpone, choose a closed rather than a public setting where the commission offers it, give written information only, or not take part [source: Amnesty International 2007 (public and confidential hearings); synthesis].
Example language (illustrative): "Saying no, or not yet, is a real choice. If you do go ahead, we can choose the setting that asks the least of you right now."
Watch for: the client agreeing to please you, family or community; dissociation when the events are named; risk rising as a deadline nears. Since the setting of testimony was not linked to psychiatric outcome in one study, avoid steering towards public testimony as more healing [source: Kaminer et al. 2001].

4.3 Protection and threat screening

Purpose: identify risks of retaliation, intimidation or exposure from testifying. Use before a statement, before a hearing, and after any publication [source: Amnesty International 2007].
Steps: (1) Ask who knows the client is considering testifying and whether anyone has warned them off. (2) Ask about officials or local figures who could interfere; Amnesty says commissions should be able to have such officials suspended or reassigned [source: Amnesty International 2007]. (3) Explain that protection measures can go beyond anonymity, for example restraining orders, police protection or, in some cases, relocation, and that the victim's own view of what they need should count [source: Amnesty International 2007]. (4) With consent, put the client in touch with the commission's protection unit or a lawyer. (5) Recheck after testimony is published; Amnesty reports that Haitian witnesses faced threats after publication [source: Amnesty International 2007].
Example language (illustrative): "Has anyone made you feel it would be dangerous to speak? Let's take that seriously and find out what protection is available before you decide."
Watch for: minimising real threats, or hypervigilance that is understandable but limiting. Follow your duty-to-protect and safeguarding procedures where a child or a third party is at risk [synthesis].

4.4 Informed choice of format

Purpose: help the client choose between a written statement only, a closed hearing, a public hearing, or no participation, and decide what they will and will not disclose [synthesis].
Steps: (1) Set out the formats the commission actually offers. (2) Go through what each format means for exposure, media coverage, family and community knowledge. (3) Have the client decide in advance which topics are off limits, and practise saying "I don't want to talk about that" [synthesis]. (4) Record the decision and the reasons, and revisit it if circumstances change.
Example language (illustrative): "You decide how much of your story goes on the record. What would you want to stay private, even if they ask?"
Watch for: the client equating more exposure with more meaning; regret after deciding. It is working when the choice feels like the client's own.

4.5 Expectation management about outcomes

Purpose: prepare for the waiting, the amnesty decisions, reports and possible unpaid reparations that caused anger and a sense of betrayal in South Africa [source: Picker 2005; Amnesty International & Human Rights Watch 2003].
Steps: (1) Explore what the client hopes will follow: truth about a loved one, acknowledgement, reparations, prosecution. (2) Separate hopes the commission can meet from those that depend on government. (3) Plan how the client will get news; South African participants learned of amnesty decisions on television or made repeated calls for information [source: Picker 2005]. (4) Prepare for a perpetrator receiving amnesty and for reparations being delayed or smaller than recommended [source: Picker 2005].
Example language (illustrative): "If the outcome is slower or smaller than you hope, how would we want to handle that together?"
Watch for: the closing question "What can the Commission do to help you?" in South Africa led many to expect direct help [source: Picker 2005]; listen for similar promises the client has heard. Watch for anger turned inwards as hopelessness.

4.6 Stabilisation and narrative preparation

Purpose: build the client's capacity to tell a painful account in a formal setting without becoming overwhelmed [synthesis].
Steps: (1) Teach grounding and arousal-regulation skills the client can use in a hearing room. (2) Work out a rough outline of the account with the client, without rehearsing the full trauma narrative in detail before the commission does so. (3) Agree signals for a break with any commission support person. (4) Identify triggers in the setting; avoid intimidating settings that may re-evoke interrogation [source: Picker 2005]. (5) Plan the hours after the testimony.
Example language (illustrative): "We are not going to go through every detail today. We are going to make sure you have ways to steady yourself when you do."
Watch for: early intrusion symptoms, sleep disruption as the date nears, avoidance of sessions. It is working when the client can use the skills in session while touching on the material.

4.7 Coordination with commission briefers and support staff

Purpose: connect your work with the commission's own psychosocial support so that preparation, containment and follow-up are not duplicated or dropped. In South Africa, commission briefers supported witnesses during hearings and outside them coordinated regional services, audited providers, trained community briefers in debriefing skills and monitored referrals [source: TRC Final Report Vol. 1 Ch. 11].
Steps: (1) With written consent, contact the commission's support unit to learn the hearing process and who will be present. (2) Agree who does what before, during and after. (3) Share only what the client authorises; you are not providing evidence. (4) Confirm who the client calls after hours.
Example language (illustrative, to a support officer): "My client has asked me to coordinate with you on support around the hearing. I won't be sharing anything about the content of the account."
Watch for: each side assuming the other is following up. One South African participant was told someone would debrief her and nobody did, while her own psychologist assumed this was the commission's role [source: Picker 2005]. Settle this in writing.

4.8 Accompaniment during statement or hearing

Purpose: contain distress and advocate for the client in the room, mirroring the commission's own containment-and-advocacy role [source: TRC Final Report Vol. 1 Ch. 11].
Steps: (1) Agree beforehand whether you attend, and in what role (support person, not counsellor of record in the hearing) [synthesis]. (2) Sit where the client can see you if they wish. (3) Ask for breaks on the agreed signal. (4) Do not speak for the client about the content. (5) Stay with the client after they finish until handover to the post-hearing plan.
Example language (illustrative): "I'll be there for you, not for the commission. If you give me the sign, I'll ask for a break."
Watch for: dissociation, panic, the client continuing past their limits because of an audience. Your attending may be seen as taking a side in a small community; discuss this beforehand [synthesis].

4.9 Post-testimony check-in and stabilisation

Purpose: respond to the stress almost all South African participants reported after testifying, when most were not offered counselling [source: Picker 2005]. The South African model placed debriefing after hearings [source: TRC Final Report Vol. 1 Ch. 11].
Steps: (1) Schedule contact soon after the statement or hearing, agreed in advance [synthesis]. (2) Check safety, sleep, intrusive memories, substance use and suicidal thinking. (3) Normalise a temporary rise in symptoms without predicting it. (4) Focus on stabilisation and practical support; do not push the client to go back over the testimony in detail if they do not want to [synthesis]. (5) Agree the next steps and the follow-up plan.
Example language (illustrative): "You did something very hard. How are you sleeping, and what has come back to you since?"
Watch for: delayed reactions in the following weeks; the Sierra Leone forums showed raised depression, anxiety and PTSD that persisted [source: Cilliers, Dube & Siddiqi 2016]. Where suicide risk is present, follow your risk protocol, put a safety plan in place and give crisis resources: 988 (US), Samaritans 116 123 (UK and Ireland), and in Canada for residential-school survivors the National Indian Residential School Crisis Line, 1-866-925-4419, which offers 24-hour crisis support [source: Indigenous Services Canada].

4.10 Referral continuity and follow-up

Purpose: close the gap between the commission's short-term support and the client's longer-term needs. South Africa referred witnesses to regional service providers with local knowledge who followed up, with varying success, and ongoing counselling was beyond the commission's resources [source: TRC Final Report Vol. 1 Ch. 11].
Steps: (1) Map the services available: in Canada, cultural support, emotional support workers, and counselling by registered psychologists and social workers who must be in good standing with their regulator and registered with Indigenous Services Canada [source: Indigenous Services Canada]. (2) Make warm referrals with consent. (3) Check that the first appointment happened. (4) Address economic barriers to access, which South African survivors identified [source: Picker 2005].
Example language (illustrative): "I'll stay in touch until you've seen the next person, so nobody assumes someone else has it covered."
Watch for: drop-out after the hearing; the client being passed between services. It is working when there is a named person and a date.

4.11 Trauma-focused treatment after the process

Purpose: treat PTSD, depression and related problems with evidence-based therapy, since a commission is a complement to treatment, not a substitute [source: Kaminer et al. 2001].
Steps: (1) Reassess after the acute phase. (2) Offer the trauma-focused treatment you are trained in, in line with your national guidelines [synthesis]. (3) Include the experience of the commission itself (being heard, not being heard, outcomes) in the case formulation [synthesis]. (4) Attend to symptoms the South African report described as entrenched (emotional blunting, substance misuse, sleep disturbance, relationship difficulties) [source: TRC Final Report Vol. 1 Ch. 11].
Example language (illustrative): "Telling the commission was one part. Now we can work on what still stays with you every day."
Watch for: the client treating long-standing symptoms as simply part of life; socio-economic stress blocking progress, which needs practical help alongside therapy [source: TRC Final Report Vol. 1 Ch. 11].

4.12 Working with forgiveness and non-forgiveness

Purpose: explore the client's own stance towards those responsible without pressure. Low forgiveness was associated with poorer psychiatric health among South African survivors [source: Kaminer et al. 2001], and reconciliation cannot be imposed [source: Amnesty International 2007].
Steps: (1) Ask what forgiveness means to the client, their family and their faith or community. (2) Separate forgiveness from excusing, from reconciliation, and from giving up a claim to justice or reparation [synthesis]. (3) Work on rumination, anger and bitterness as symptoms in their own right, whatever the client decides about forgiveness. (4) Where the struggle centres on faith or moral tradition, use the Cultural Formulation Interview's spirituality, religion and moral traditions module and, if the client wishes, involve their faith leader; the DSM-5-TR "Religious or Spiritual Problem" can be recorded as Z65.8 [source: ICD-10-CM Z65.8 (Unbound Medicine)]; DSM-5-TR wording [uncertain: not verified].
Example language (illustrative): "Some people feel expected to forgive because the whole country is talking about reconciliation. What do you actually want?"
Watch for: forgiveness performed for an audience; guilt about not forgiving. A correlation does not show that forgiving lowers symptoms; do not present it as a treatment [source: Kaminer et al. 2001; synthesis].

4.13 Preparing for an amnesty finding or a mediated encounter

Purpose: support a client facing a perpetrator's amnesty application or invited to meet a perpetrator. Where perpetrators acknowledged victims' humanity, encounters were powerful, but few victims had them; the South African study recommended safe, supervised encounters where possible [source: Picker 2005].
Steps: (1) Establish who is organising the encounter and their training; the therapist does not facilitate it without specific training [synthesis]. (2) Assess voluntariness, power imbalance, ongoing contact or coercion; do not support an encounter where the client is under pressure or where the harm involves ongoing domestic or sexual violence [synthesis]. (3) Prepare the client for possible outcomes: denial, partial acknowledgement, no remorse, or a grant of amnesty. (4) Plan how the client can stop the meeting. (5) Debrief afterwards.
Example language (illustrative): "You can say yes, no, or not now. And if you go, you can leave at any point."
Watch for: hopes for a specific apology; re-traumatisation if the perpetrator minimises. It is working when the client's choice and exit plan are clear and the facilitator's process is known.

4.14 Supporting a responsible person who testifies or applies for amnesty

Purpose: perpetrators are one of the five groups the South African report found affected by trauma [source: TRC Final Report Vol. 1 Ch. 11]. A client may be a former member of the security forces or of an armed group who is giving evidence.
Steps: (1) Make sure the client has legal advice; Amnesty lists rights including being promptly informed of allegations, legal assistance and silence [source: Amnesty International 2007]. (2) Keep therapy separate from legal strategy and from any evidence. (3) Explain the limits of confidentiality under your jurisdiction's law, including any duty or court order to disclose [synthesis]. (4) Work with shame, guilt, moral injury and fear of exposure. (5) Assess risk to self and to others, including family members who learn of the testimony.
Example language (illustrative): "My job isn't to judge your case or advise you legally. It's to help you cope with what doing this stirs up."
Watch for: the client using sessions to rehearse justifications; suicidal risk when disclosure becomes public; your own reactions, to take to supervision [synthesis].

4.15 Families of the dead and the disappeared

Purpose: support relatives whose main hope is to learn what happened. South African survivors valued learning the truth about loved ones highly [source: Picker 2005].
Steps: (1) Assess grief, including prolonged grief disorder as described in DSM-5-TR and ICD-11 [uncertain: not verified]. (2) Prepare the client for findings that may be partial, distressing or absent. (3) Support mourning practices the family chooses once facts are known, including any rites that were impossible earlier. (4) Work with ambiguous loss where no remains or facts are found [synthesis].
Example language (illustrative): "Finding out may bring relief and fresh pain at the same time. Let's prepare for both."
Watch for: renewed acute grief after findings; family disagreement about whether to pursue the truth. Suicide bereavement: use safe-messaging principles and crisis resources (988 US; Samaritans 116 123 UK and Ireland).

4.16 Reparations distress and practical advocacy

Purpose: respond to the grievance that dominated South African survivors' accounts: reparations that were delayed or smaller than recommended, while perpetrators gained amnesty quickly [source: Picker 2005; Amnesty International & Human Rights Watch 2003].
Steps: (1) Recognise the anger as a response to an injustice, not only a symptom. (2) Separate what the client can influence (applications, documents, legal aid, victims' organisations) from what they cannot. (3) Refer to social work, legal aid or victims' groups for applications and advocacy [synthesis]. (4) Support the client to decide how much energy to put into the struggle.
Example language (illustrative): "You have every reason to be angry about this. Let's look at what you want to do with that anger and who can help with the forms."
Watch for: the feeling of being a petitioner rather than someone entitled to information, which South African participants described [source: Picker 2005]; hopelessness; the therapist promising outcomes.

4.17 Collaboration with cultural and Indigenous healing

Purpose: honour the client's request for traditional healing alongside therapy. TRC Canada's Call to Action 22 asks the health-care system to recognise the value of Aboriginal healing practices and use them, with Aboriginal healers and Elders, when Aboriginal patients request it [source: CBC News 2015]. Canada's health support programme provides cultural support from Elders, Knowledge Holders and Traditional Healers through local Indigenous organisations [source: Indigenous Services Canada].
Steps: (1) Ask whether the client wants cultural support and from whom. (2) With consent, connect through the local Indigenous organisation or regional office (in British Columbia, the First Nations Health Authority) [source: Indigenous Services Canada]. (3) Agree with the client how you and the Elder or healer will share information, if at all. (4) Do not run or describe ceremonies yourself; cultural authority rests with the community [synthesis].
Example language (illustrative): "Would it help to have an Elder or a traditional healer involved? I can work alongside them in whatever way you want."
Watch for: assuming every Indigenous client wants cultural services, or that none do; the client's mixed feelings where religious institutions were involved in the harm [synthesis].

4.18 Intergenerational and family work

Purpose: address effects on descendants and households. Canada's programme covers Survivors, their families and Intergenerational Survivors, including children of former students and people raised by them [source: Indigenous Services Canada].
Steps: (1) Map the family history the client knows and does not know. (2) Explore how the experiences of parents or grandparents show up in parenting, silence, substance use or relationships. (3) Offer family or group sessions where the client wants them; the programme supports individual, family and group counselling [source: Indigenous Services Canada]. (4) Respect family members who do not want to talk about it [synthesis].
Example language (illustrative): "You weren't at the school, but you grew up with what it did to your family. That counts, and it's yours to work on too."
Watch for: the client feeling their suffering does not count next to a survivor's; family conflict about disclosure.

4.19 Children and young people giving statements

Purpose: protect young people who take part. Amnesty calls for special measures for child victims and age-appropriate procedures [source: Amnesty International 2007]. ICTJ's guide Listening to Young Voices recommends a psychosocial worker trained in social work or psychology who already has an ongoing relationship with the child, distinct from the statement taker, plus meaningful consent, support before, during and after, and follow-up, treating statement-taking as a process over weeks or months [source: ICTJ 2018].
Steps: (1) Obtain parental or guardian consent and the young person's own assent, explained in words they understand [source: ICTJ 2018]. (2) Clarify whether you are the psychosocial worker or a separate clinician; do not take the statement yourself [synthesis]. (3) Follow the child's lead on pace and support [source: ICTJ 2018]. (4) Plan follow-up after the statement [source: ICTJ 2018]. (5) Apply your safeguarding duties throughout.
Example language (illustrative, to a young person): "You can stop or take a break any time. Nothing bad happens if you do."
Watch for: pressure from adults; distress that shows later in behaviour, school or sleep. Never name a child in any record outside the clinical file.

4.20 Survivors of sexual violence

Purpose: ensure appropriate treatment of survivors of sexual violence, for whom Amnesty asks for special measures, staff trained on sexual violence and gender balance among commissioners [source: Amnesty International 2007].
Steps: (1) Ask the commission what measures it offers (closed hearings, choice of interviewer's gender, protection) [synthesis, based on Amnesty International 2007]. (2) Plan for shame and stigma in family and community. (3) Prepare for questioning that may feel intrusive and agree how to refuse a question. (4) Plan sexual and reproductive health referrals where needed [synthesis].
Example language (illustrative): "You can ask for a woman, or for a closed session. Let's find out what they offer before you decide."
Watch for: self-blame; risk of exposure in small communities; re-traumatisation through repeated retelling.

4.21 Peer and group support

Purpose: use the help South African participants found in exchanging experiences with other victims; the study recommended promoting victim support groups that were not divided by race [source: Picker 2005].
Steps: (1) Identify existing victims' groups or survivors' organisations (in South Africa, the study was co-conducted with Khulumani Support Group) [source: Picker 2005]. (2) Help the client choose a group that matches their needs. (3) If you run a group yourself, screen for readiness and agree ground rules on confidentiality and on not pressing for detail [synthesis].
Example language (illustrative): "Some people find it helps to be with others who went through the same process. Would you want to try that?"
Watch for: groups where anger escalates without containment; members comparing suffering.

4.22 Working with a completed commission years later

Purpose: most clients will meet these commissions as history: news of report anniversaries, discoveries, apologies, or their own testimony long ago [synthesis].
Steps: (1) Ask what the commission meant to the client then and means now. (2) Explore regrets about testifying or not testifying, without implying a right answer [source: Kaminer et al. 2001 (no difference in outcomes by participation)]. (3) Anticipate reactivation around public events and media coverage, and plan for it. (4) Link to current services that outlast the commission; the Canadian programme continues to be funded after the settlement process concluded in 2021 [source: Indigenous Services Canada].
Example language (illustrative): "It's been years, and the news has brought it all back. What do you make of the commission now?"
Watch for: a sense of betrayal that the promised changes did not come; collective grief in communities.

4.23 Meaning-making: personal story and national narrative

Purpose: help the client place their experience in relation to the public story of truth and reconciliation, which may not fit their own [synthesis].
Steps: (1) Invite the client's own account of what the process did for them. (2) Name tensions, such as gains for the community at a cost to the person [source: Cilliers, Dube & Siddiqi 2016]. (3) Support the client's own conclusions, which may include anger at amnesty or at unpaid reparations [source: Amnesty International & Human Rights Watch 2003]. (4) Explore what the client wants to do now: advocacy, memorial, silence or moving on [synthesis].
Example language (illustrative): "The country calls it reconciliation. What would you call what happened to you?"
Watch for: the therapist's own politics shaping the conversation; take that to supervision.

4.24 Self-care and supervision for clinicians and staff

Purpose: commission personnel and some family members experienced trauma vicariously [source: TRC Final Report Vol. 1 Ch. 11]. The same applies to therapists doing this work, and to staff who become clients.
Steps: (1) Arrange regular supervision with someone experienced in political violence or collective trauma [synthesis]. (2) Monitor your own symptoms of secondary trauma. (3) If you also work for a commission, keep that role clearly separate from your therapy clients [synthesis]. (4) If a commission staff member is your client, treat their exposure as a work injury.
Example language (illustrative, to a staff member client): "Listening to hundreds of statements is exposure too. It makes sense that it's affecting you."
Watch for: emotional blunting, irritability or avoidance in yourself; over-identification with clients.

5. Handling problems

The commission sources describe systemic problems (unmet expectations, absent follow-up, unequal access, delayed reparations, threats to witnesses); the clinical responses below are [synthesis] unless a source is given.

The client feels pressured to testify (by family, community leaders, activists or the therapist's own enthusiasm). Go back to voluntariness; explore whose wish it is; remind the client that one study found no psychiatric difference between those who testified publicly, privately or not at all [source: Kaminer et al. 2001]. Support a "no" as fully as a "yes".
Overwhelm before or during testimony. Postpone or switch to a closed or written format where the commission allows it [source: Amnesty International 2007 (public and confidential hearings)]; return to stabilisation (4.6); ask the commission's support staff for breaks.
Symptoms worsen after taking part. Expect that this may happen; the Fambul Tok study found raised depression, anxiety and PTSD that persisted [source: Cilliers, Dube & Siddiqi 2016]. Reassess, review suicide risk with current practice, add sessions and move to trauma-focused treatment once stable (4.11). Crisis resources: 988 (US); Samaritans 116 123 (UK and Ireland); National Indian Residential School Crisis Line 1-866-925-4419 (Canada) [source: Indigenous Services Canada].
Nobody followed up. This happened in South Africa when the commission and the client's own psychologist each assumed the other would debrief [source: Picker 2005]. Prevent it with a written plan (4.7, 4.10); if it has already happened, acknowledge it as a failure of the system, not of the client.
Anger at amnesty or unpaid reparations. Validate it; separate advocacy from therapy; refer for legal or practical help (4.16) [source: Picker 2005; Amnesty International & Human Rights Watch 2003]. Do not defend the commission or government.
The client feels the commission was biased or exploitative. Some South African participants said so [source: Picker 2005]. Listen without correcting; explore what the experience confirmed about power and trust; consider how this may play out in the therapy relationship.
Unequal access in your own service. South African participants reported that counselling was offered unevenly by race [source: Picker 2005]. Audit who you offer support to and remove barriers such as cost, language and travel.
Threats or intimidation after testimony. Treat as a safety emergency: contact the commission's protection unit, the police or a lawyer with consent, and follow safeguarding duties [source: Amnesty International 2007 (protection measures; threats to witnesses in Haiti)].
Rupture: the client links you with the state or the institution that harmed them. Name the possibility early, be clear about whom you work for and who pays, and repair by acknowledging real power differences rather than defending yourself. For Indigenous clients in Canada, the client's mistrust may extend to churches and governments that ran the schools; offer cultural support on request (4.17).
Stuck in rumination or bitterness. Work on rumination as a process, not on whether the client should forgive (4.12) [source: Kaminer et al. 2001 (association only)].
Non-attendance or avoidance. Often avoidance of trauma reminders or of a process the client distrusts; reduce pressure, offer flexible contact and practical help, and keep the door open.
Responsible person seeking absolution from the therapist. Keep the therapeutic frame; work with guilt and responsibility without pronouncing judgement or forgiveness; refer legal questions to counsel (4.14).
Request for information or records from the commission, police or a court. Get legal advice; disclose only what the law requires and the client has been told about; keep clinical notes free of names of other victims, witnesses or accused persons [synthesis].
Dual role conflicts (you are also a commission briefer, statement taker or programme-registered counsellor). Keep roles separate, consult, and consider referring the client on if roles clash under APA Ethics Code Standard 3.05 (APA Ethics Code).
Vicarious trauma in the therapist. Increase supervision and reduce caseload exposure (4.24) [source: TRC Final Report Vol. 1 Ch. 11 (personnel affected)].
Contraindications for victim–perpetrator encounters: coercion, ongoing contact or control, domestic or sexual violence with a continuing power imbalance, or a client who cannot leave safely. Do not support the encounter and tell the organising facilitator, with consent [synthesis].

Sources

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