Mental health treatment for victims of trafficking

What is trafficking?

Sex trafficking is defined as the recruitment, transportation, provision or obtaining of an individual for the purpose of a commercial sex act. These can include prostitution, pornography, mail order brides, live sex shows and sex tourism according to the HHS Report.

Labor trafficking is done for the purpose of domestic servitude, restaurant work, janitorial work, factory work, migrant agricultural work, construction and peddling (illegal selling of drugs or items of theft).

How victims are identified and the challenges to identification

Often, they are identified by the police, through tips from people, investigations into other problems, raids and referrals from NGO’s (Clawson, Dutch, Salomon, & Grace, 2009). Others are identified through religious institutions, immigration services, health or social service provides and domestic violence shelters.

Before being identified as victims of human trafficking, they are often charged with crimes which could range from anything like shoplifting, solicitation (offering money or inducing another to commit a crime), prostitution and others. It is only in counseling sessions that victims disclose that they were trafficked.

What makes it difficult to identify victims is due to the lack of awareness by the victims that this is a crime and that they are eligible for protection and services. In other cases, the victims do not consider themselves as being victims. Women and girls trafficked for sex work often see their pimps as their boyfriends, which is a tactic used by traffickers to control the girls. Another difficulty is because the victims are afraid of getting caught by local law enforcement officials for being an illegal in the country and fear deportation or abuse at the hands of officials. Others hide due to feelings of shame and disgrace and keep silent about their situation.

Who are the victims?

According to the report, victims are usually those who live in poverty, are young, have had limited education, lack work opportunities in their region, don’t have family support due to being an orphan, runaway, homeless and having family members who work with traffickers. They may also have a history of sexual abuse, have physical or mental disabilities and live in places where corruption and crime is rampant. It is also usual for victims to come from places where there is civil wars or economic crises. According to the International Labor Organization (2002), girls and women are likely to be trafficked for commercial sexual exploitation and domestic servitude, while men and boys are trafficked for forced labor in farming, petty crimes and drug trade (as cited in Clawson, Dutch, Salomon & Grace (2009).  

Victim needs

The immediate safety of the victim is paramount. This includes giving them emergency shelter, basic medical services, food and clothing, legal services, translation for certificates and other legal documents, life skills training, job training, mental health services, child care and getting them in contact with family.

They may need therapy for trauma (PTSD) especially if they had been tortured and show signs of Stockholm syndrome (feelings of trust or affection felt in certain cases of kidnapping or hostage-taking by a victim toward a captor). Others may need help with drug abuse which may have begun before or after being trafficked due to drugs being forced upon them or to help them deal with their situation. Co-occuring disorders are highly likely among victims of trafficking. Victims have found to have greater risk for developing major depressive disorders, dissociative disorders, panic disorders, OCD, anxiety disorders and so on.

According to the HHS report, trafficked women had recurring thoughts of terrifying events, nightmares, feelings of the traumatic event happening again, are unable to feel emotions, are withdrawn, have anger issues and have trouble sleeping.

Victims of trafficking often develop complex trauma. They would suffer from such feelings of anxiety, self-hatred and despair and have difficulty with interpersonal relationships and intimacy. They are great risk of suicidal ideation and other self-destructive behaviors.

Evidence based treatment

The authors cite evidence based treatment recommended for use with trafficked victims include:

1. Cognitive Therapy
2. Cognitive Behavioral Therapy - which includes exposure therapy and breathing techniques
3. stress innoculation training - this combines psychoeducation with anxiety management techniques like relaxation training, breathing techniques and thought stopping.

Victims of trafficking will have a completely different and negative view of the world and people in it so they will need much cognitive restruction apart from help with PTSD symptoms and other co-occuring mental health disorders as mentioned before. They will need much help with “resocializing” back into society.

Since most victims may have come from other countries, the counselor must take into consideration their ethnicity, worldview and religion. Their beliefs about treatment and about their experience will differ based on their culture, religion and history. The counselor should arm themselves with knowledge about the client’s beliefs, values and practices so as to give them the best possible care.

Extracted from:

Clawson, H., Dutch, N., Salomon, A., & Grace, L. G. (2009). Study of HHS Programs Serving Human Trafficking Victims. US Department of Health and Human Services.