Cover: Photo by Vardan Papikyan on Unsplash
Wars, armed conflicts, and climate change are major contributors to the rising number of migrants and refugees around the world. The United Nations estimates that a significant proportion of all refugees are survivors of torture and violence. Acknowledging the growing community of survivors on Vancouver Island and the Lower Mainland as a subset of the immigrant and refugee population, the Victoria Coalition for Survivors of Torture (VCST) develops capacity for service organizations that work with survivors and their families. Through participatory action research (PAR), VCST’s Interconnectedness Initiative (I.I.) collaborates with stakeholders across the region to articulate sector strengths and opportunities to improve service delivery. This research combines stakeholder round-table discussions, case studies, qualitative interviews, and basic quantitative data sorting to inform sector growth and advocacy. By elevating the voices of survivors and their advocates and supporting cooperation between the settlement and mental health sectors, the I.I. seeks to improve long-term results for refugee communities.
The Victoria Coalition for Survivors of Torture (VCST) is a consortium of agencies and individuals responding to the needs of survivors of torture and their families by working to increase public awareness of survivors in our communities. Surviving torture can undermine a person’s social, psychological, and physical well-being; the traumatizing journey of migration can also compound these challenges (Hodges-Wu & Zajicek-Farber, 2017). We hold the vision that survivors of torture and political violence and their families will overcome this legacy of violent oppression. Our Interconnectedness Initiative (the I.I.) brings together a growing roster of community stakeholders that survivors may encounter in Canada, such as settlement, counselling, and crisis support agencies. We offer training, capacity building, and networking opportunities to foster a more collaborative service sector for the well-being of survivors. Our stakeholders group started with eight organizations in 2022; in 2025, our list of stakeholders has grown to more than a dozen community partners, including organizations outside the immigrant and settlement service sector. Furthermore, our research about the service sector informs our training, advocacy, and network building. VCST’s I.I. translates a duty of care from a global perspective to a local community-based intervention.
Together, the Vancouver Association for Survivors of Torture (VAST), Vancouver Island Counselling Centre for Immigrants and Refugees (VICCIR), and VCST are the only organizations in British Columbia dedicated to working with survivors of torture, their families, and their communities. VAST is the principal torture treatment organization in BC, offering a range of legal support and group and counselling services directly to survivors. At the same time, VICCIR is the only counselling agency with a mandate to work with survivors of torture and trauma on Vancouver Island. VCST plays a coordination, facilitation, and advocacy role across the settlement and health/wellness sector to improve services for survivors. Our organization works to enhance the capacity of settlement agencies and stakeholder organizations by developing specialized training and resources focused on supporting survivors.
Participatory action research (PAR) informs how VCST and the I.I. develop strategies for improving services for torture survivors. This research methodology positions participants as co-researchers sharing their experiences to create knowledge for their benefit (Fals-Borda, 1987; O’Mahoney et al., 2023). Using this methodology, in 2023, we conducted two round-table discussions with our stakeholders to identify sector strengths and opportunities. These consultations revealed the stakeholders’ priorities for the growth and development of a collective support network for torture survivors (Zaidalkilani, 2023). In 2024, we conducted qualitative interviews and completed data analysis of stakeholder websites as an environmental scan of standard practices, therapeutic approaches, and common programs available for survivors. This research affirmed many of the gaps identified in the 2023 research while also demonstrating how the sector uses trauma-informed methods for working with survivors (Quintero et al., 2025).
VCST is grateful to the Victoria Foundation for funding the I.I.
In our current global context, torture is, unfortunately, a significant factor in the lives of immigrants and refugees around the world. Recognizing its existence is essential for understanding the harmful physical, psychological, moral, and social effects torture has on survivors and their families living in Canada. A review of the current global situation underscores the vital need to confront this issue and promote programs like the I.I. at the local level as a plausible intervention model.
The United Nations High Commissioner for Refugees (UNHCR) estimates that by the end of 2023, there will be around 43.4 million refugees globally. Reflecting a 7% growth from the year before, this disturbing rise is principally driven by growing violence worldwide (UNHCR, 2024). The rising frequency and intensity of wars and conflicts have compounded existing vulnerabilities, with armed confrontations across the planet having increased dramatically since 2017. According to recent reports, 59 state-based conflicts—the largest number recorded since 1946—occurred in 2023 (PRIO, 2024). Conflicts and human rights violations are happening in regions of Africa, Latin America, the Middle East, Ukraine, and Gaza, to name only a few. Additionally, climate change-induced disasters have contributed to world migration, further compromising the safety of refugees and particularly vulnerable populations (Berchin et al., 2017; Carper, 2019; Uddin, 2024).
Global human rights abuses have significant consequences for Canada and its political obligations on the international scale. In 2019, the UNHCR estimated that 30% of refugees in Canada were survivors of torture (Refugee Resettlement to Canada, 2019). Despite these figures demonstrating the existence of torture survivors in Canadian society, many survivors outside and within Canada continue to be undetected and underserved. These data stress the need to understand the effects of torture and emphasize why we need policies that guarantee adequate support on the national and international scale. One action that will show Canada’s commitment to the prevention of torture would be signing the U.N. Optional Protocol to the Convention against Torture, which establishes national and international systems for inspecting detention centers (Murray et al., 2011).
The I.I., which started with two roundtable community consultations in 2023, represents VCST's dedication to understanding the needs of torture survivors. We address this gap through community-based PAR and advocacy for systemic change. Eight mental health and settlement organizations across the Lower Mainland and Vancouver Island responded to the invitation to participate in the initial I.I. participatory action research. The collaborative nature of the PAR community model reinforces our shared goal of expanding the support network for torture survivors and amplifying survivors’ voices. These dialogues were instrumental in guiding the I.I. since the participant stakeholders knew firsthand the difficulties immigrants and refugees experience in many variations. Ultimately, this inclusive participatory methodology ensured that the results were pertinent and valuable for people working with survivors and their families, promoted project ownership, and enabled more extensive participation.
This evaluation brought up critical issues and gaps. For example, the need to:
These insights have led our efforts and influenced the stages of the project.
Particular attention has been paid to conducting confidential case conferences to fulfill training needs and build community capacity. At these events, one stakeholder presents an anonymized client case that involves a history of torture; attendees sign a non-disclosure agreement as a prerequisite for participating. The presenter discusses how their organization has worked with the person, challenges, lessons learned, best practices, and recommendations for working with similar cases. Group discussion allows for exchanging ideas, experiences, and procedures in a safe, collaborative learning environment. Case conferences provide our stakeholder community opportunities to share resources and knowledge, promoting collaborative problem-solving. Our initial phase of three case conferences made clear that:
In summary, case studies have proven pivotal in refining the sector’s understanding of survivors’ needs and defining how the sector works with and for them. Further learning from our case conferences includes the need to co-create and disseminate knowledge on the long-term effects of torture on individuals, as well as develop training curricula for service organizations to promote understanding about torture. Conferencing also underlined the need to establish a thorough services resource list, spot obstacles to service access, and have specialist trauma and culturally sensitive wellness modalities. Moreover, advocacy opportunities emerged through an expanding national and international network of organizations. Through the I.I., we have also identified a pressing need to extend the operational definition of torture—for instance, viewing gender-related crimes through the lens of torture (Richards & Kapell, 2025). Many of these opportunities guided the third phase of the I.I.
The third phase of the I.I. research aimed to identify stakeholder strengths and opportunities and common practices and therapeutic approaches for working with survivors of torture. This information then informs VCST’s strategies for promoting the accessibility of services to survivors of torture and their families in our community. To reach these goals, we used a mixed-methods approach, combining qualitative interviews with quantitative data analysis of stakeholder website content.
Tool: Qualitative Interviews
We conducted 10 interviews with eight organizations (5 settlement agencies and 3 counselling agencies). Participants’ roles ranged from executive directors to frontline settlement staff and case managers. The organizations were from Vancouver Island and the Lower Mainland. Nine of the 10 respondents stated that their organization works with survivors of torture, though none of these organizations have specific mechanisms to identify survivors of torture among their client base:
1: The client self-identifies at any point in the process of working with the organization. This could be at the intake interview, during settlement work, during counselling, etc.
2: The organization watches for indicators of a history of torture while working with the client and adjusts their work with the person accordingly. Staff are trained in recognizing these indicators. This could be noted during intake, settlement work, counselling, etc.
This approach is a sector strength that aligns with the principles of trauma-informed care (TIC). TIC is an organizational framework that prioritizes the physical, emotional and psychological well-being of anyone who comes into contact with a TIC organization. TIC’s emphasis on safety, trustworthiness, and cultural responsiveness is crucial for working with torture survivors (Aroche & Coello, 2022; Torture Journal, 2022). Observing a client over an extended relationship and fostering trust for torture disclosure would be an example of TIC; asking a client outright in an intake interview or putting a box on a checklist for torture disclosure would not be TIC. Our research shows that all the organizations interviewed implement TIC into their work.
Torture disclosure is more likely in environments where survivors feel safe and supported in a trusting and non-judgmental atmosphere (Duffy & Kelly, 2015). Examples of trauma-informed methods for identifying survivors of torture shared in our participants’ interviews include:
When asked about operational resources which contribute most to their organizations’ success, nine of 10 respondents cited staff cohesion and training as a key strength. Some of the staff strengths noted by
respondents include:
When we asked the respondents what their organization does best, all touted their organization’s client-focused culture. Similarly, when asked what each person was most proud of within their organization, nine of 10 people said their team. One response said simply: “Our people. Absolutely.” It is clear that the people working within the sector and the working culture are two of the sector’s greatest strengths.
Six respondents cited funding as a major growth opportunity in the sector. Lack of reliable funding created a sense among respondents that if only there was more funding, the organization would be able to work with more people. After funding, staff training and capacity building were other important opportunities mentioned by four respondents.
Staff burnout is also a concern among these stakeholders and could represent an opportunity to develop resources to support staff who may experience vicarious trauma through their work with survivors. One respondent expressed frustration that a settlement worker cannot change systemic barriers, while another mentioned “compassion fatigue” or burnout. Furthermore, many settlement workers and interpreters who support refugees and newcomers also have the added challenge of being survivors of similar stressors themselves. As a result, their clients' experiences can sometimes retraumatize them, compounding the emotional toll of their work.
We closed our survey by asking respondents what they thought about working with survivors of torture. Their self-reflective answers were inspiring. Respondents shared their personal stories of immigration, family histories, and passion for helping people on their settlement and wellness journeys. One respondent told us that working with survivors of torture aligns with his personal core values, while another cited her intention to use her privilege of being born in Canada to navigate the Canadian system with and for her clients. There was a sense among respondents that it is an honour to be trusted with people’s stories and to accompany newcomers on their journey.
Tool: Website Content Analysis
We collected content about programs and services from the websites of the organizations we interviewed. This information populates a catalogue of the respondents' offerings. Using Maslow’s Hierarchy of Needs as a framework, we sorted the data into the hierarchy, giving us an integral perspective on how the services available for survivors of torture and their families meet their universal human needs.
Abraham Maslow published his psychological theory of the Hierarchy of Needs in 1943 with the intention of understanding human happiness and fulfillment. His framework has six levels (physiological, safety, love/belonging, self-esteem, self-actualization, and self-transcendence), often depicted as a pyramid with lower levels supporting the levels above. O’Brien and Charura (2024, p 1,613) emphasize that Maslow’s hierarchy speaks to the multifaceted nature of human needs—a person may have simultaneous needs across categories and flow between the levels, demonstrating the systemic and interconnected nature of these needs. A systemic, biopsychosocial framework is essential to address these interconnected issues effectively (Aroche & Coello, 2022; Mitchell & Correa-Velez, 2009). Lonn and Dantzler propose that the hierarchy is a robust framework to work with “the multiplicity of refugee needs” (2017, p. 5), which range from basic housing and food security to psychological trauma recovery. As the lower levels of the pyramid become more established, the upper levels develop through stability.
As one of our interview respondents put it, refugees living in an uncertain world are mostly concerned with their own and their families’ survival. Only once stability comes to the survival level can people slowly start to reconnect to and meet their needs for social connection and personal fulfillment. In meeting these needs, survivors of torture face unique challenges stemming from trauma, exile, and systemic barriers.
Using basic data sorting analysis, we sorted the interview participants’ website content about programming into Maslow’s Hierarchy. This demonstrates how stakeholders’ programs are working within the hierarchy to meet a variety of needs of survivors of torture, a subset of immigrant and refugee clientele. Many programs fit into multiple levels, while others fulfill specific needs; the findings illuminate where offerings overlap and where gaps exist.
First Level: Physiological Needs
This level addresses physical needs, such as food, water, and shelter. All five settlement agencies have programs which address these needs. This is generally included in the bundle of settlement and case management services, such as the BC Newcomers Services Program (BCNSP) or Immigrant Welcome Centre (IWC). Elements of these programs which meet physiological needs include support in finding and accessing medical care and housing.
Second Level: Safety Needs
This category concerns the human need to feel safe in one’s environment. Again, all five settlement agencies offer services to meet safety needs. LINC (Language Instruction for Newcomers to Canada) is a prime example of a program which can fulfill safety needs: Being able to speak English is a significant skill for someone to navigate life safely and confidently in Canada. All the settlement agencies provide language classes. Other offerings in the safety category include Settlement Works in Schools (SWIS), which tracks children moving through the school system, and employment services, which helps people secure work for a stable income.
Third Level: Love & Belonging Needs
This category, which is the start of building networks of personal and familial connections, has the greatest overlap across all the organizations. This suggests that the sector’s strength is in fostering love and belonging. Research by Rojas, Méndez, and Watkins-Fassler (2023) demonstrates that love, belonging, and esteem play a crucial role in well-being and can have a greater impact on long-term well-being than material stability alone. For survivors of torture, social disconnection, loss of identity, and diminished self-worth often exacerbate trauma, making community and psychological support critical for their well-being. This is where the settlement agencies’ social connection programs reflect some of the counselling agencies' group services. Volunteer programming, social groups, youth programming, and peer-to-peer support, all combine to build on security and safety gained in LINC and IWC/BCNSP. This is also where the organizations begin to build stronger connections with the community beyond the agency.
Fourth Level: Esteem Needs
All agencies offer multiple programs that fit into this category, which encompasses self-esteem and sense of self-worth. Carrying through from the previous levels are employment services, language classes, IWC/BCNSP, and counselling. The community programs under “love and belonging” also apply here.
Fifth Level: Self-Actualization Needs
This category refers to someone reaching their full potential. We categorized employment services for developing job skills and networks here; counselling and group programming are also key offerings that support self-actualization.
Sixth Level: Self-Transcendence Needs
This final category refers to a level beyond self-actualization in which a person can begin to understand the world holistically. In posthumous writings, Maslow describes this as “the very highest and most inclusive or holistic levels of human consciousness, behaving and relating, as ends rather than means, to oneself, to significant others, to human beings in general, to other species, to nature, and to the cosmos” (Maslow, 1969, p. 66). In our data sorting, it appears the counselling agencies’ services are best aligned with this category. However, a case could be made that group circles, community connections, and volunteering programs offered by all agencies could also contribute to a sense of self-transcendence and interconnectedness.
Our qualitative interview research revealed many sector strengths and opportunities. The service and counselling sector is implementing TIC and exercising ethical precautions when working with survivors of torture. Strong, dedicated teams of people are guiding their organizations to work with immigrants and refugees to grow their new lives in Canada. However, it remains difficult to define and even identify survivors of torture among the clientele. Organizations need more staff training and support for working with survivors, as well as sustainable funding to provide reliable programming for this growing community.
Our website data analysis demonstrates how services offered build on each other to support people as they move up and down Maslow’s Hierarchy of Needs. Sorting these agencies’ programs into the hierarchy shows that programs for Newcomers fill the hierarchy from the bottom up. The settlement sector has a strong overlap with the counselling agencies in the love/belonging and esteem categories. Referring clients to counselling and connecting them with community-based and social programming helps send newcomers further up the pyramid, as they access services that are more focused on mental well-being.
Next Steps: Strategies to Promote Service Accessibility for Survivors and Their Families
By looking at the opportunities, strengths, and gaps identified in the I.I. research, VCST outlined some strategies that can help promote the accessibility of services for survivors of torture and their families. What follows are highlights from our full I.I. Research Report (Quintero et al., 2025).
Opportunity: Identifying Survivors among Clientele
Opportunity: Secure Sustainable Funding for All Aspects of Settlement Work
Opportunity: Expanding VCST’s Model
Much of VCST’s work, in close collaboration with stakeholders VAST, VICCIR, and others, could serve as a strong Canadian example of a functional support framework for survivors of torture worldwide.
VCST, with VAST coordinating the Canadian Network for Survivors of Torture and Trauma (CNSTT), could expand stakeholder connections to include organizations in Toronto, Montreal, and Calgary (for example). These connections would map where and how other immigration centres are already working with collaborative models similar to VCST. This mapping could demonstrate a Canadian approach to supporting survivors and the start of a more unified, national framework. The development of a Canadian framework supports the exploration of sustainable federal funding, upscaling models to reach more clients, and more effective advocacy on the national scale.