A Feminist Perspective on Human Trafficking of Women and Girls

Characteristics, Commonalities and Complexities

Nancy M. Sidun, Deborah L. Hume, Nancy M. Sidun, Deborah L. Hume

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9781138701755
• eBook ISBN: 9781351789417
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Focusing on the trafficking of women and girls from a feminist perspective, this book examines how social structures and gender influence human trafficking. While women and girls are not the only victims of trafficking, they tend to be disproportionally represented. Structural inequities – including poverty, gender-based violence, racism, class and caste-based discrimination and other forms of oppression and marginalization – place some individuals at substantially greater risk to be trafficked.

The contributors explore topics including trauma-informed assessment of, and therapy with, survivors of human trafficking; issues facing children of trafficked women when they are reintegrated into their communities post-trafficking; the intersection of trafficking with racial and cultural oppression; critical aspects of international sex trafficking; and commercial sexual exploitation of children. The book concludes with a discussion of how human trafficking intersects with both intracountry adoption and brokered marriages. This book was originally published as a special issue of Women & Therapy.

Trauma-Informed Psychological Assessment of Human Trafficking Survivors

Elizabeth K. Hopper

The Trauma Center at Justice Resource Institute, Brookline, Massachusetts

ABSTRACT
This article describes a framework for trauma-informed assessment of trafficking survivors that acknowledges the impact of traumatic stress while highlighting survivors’ strengths and supporting their resiliency. It identifies core content areas of a trafficking evaluation and underscores adaptations to the standard process of conducting an assessment. Feedback normalizes symptoms and offers hope, and an experiential element builds survivors’ coping skills and regulatory capacity. A trauma-informed assessment can be the first step in the healing process for many people who have survived trafficking, orienting them towards a path for change and empowering them to face future challenges.

Human trafficking is a form of modern-day slavery in which traffickers financially profit through exploitation of another person or group of people. Traffickers use force, fraud, or coercion to make money from their victims through labor or commercial sex (U.S. Department of State, 2000, 2013). Being trafficked often takes away a person’s sense of safety, ownership of their own body, and self-esteem. These impacts can be further exacerbated in situations of sex trafficking, in which the “commodity” that is being sold is the victim’s own body.

Assessment of trafficking survivors can be an essential first step in creating safety, meeting daily needs, identifying at-risk survivors and making referrals for intervention, and paving a path for recovery. I direct a program at the Trauma Center at Justice Resource Institute called Project REACH that provides mental health services for survivors of human trafficking throughout the United States, including psychological assessments. This article will discuss the Trauma Center’s assessment process with people who have been trafficked, which we approach from a strengths-based, empowerment perspective. I will review the core components of psychological evaluations of trafficking victims and will explore how assessment can lead the way to intervention. Although boys, men, and transgendered individuals are also victimized through human trafficking, this article will focus on the trafficking of women and girls and factors unique to females who have been trafficked.

Purpose of Assessment

When a girl or woman is trafficked, she is treated as an object that can be used and abused. This experience can impair her self-perception, her self-efficacy, and her relationships. Similar to victims of other forms of interpersonal violence, it is not uncommon for a survivor of human trafficking to blame herself and to internalize a perception of herself as damaged or “bad.” She may view her body as an object that is a source of pain and disconnect from her body. The experience of being trafficked might lead her to feel that she is helpless or is not in control of her own life. She might see other people as potential threats and shut down to interpersonal connection. These trauma-related symptoms have been conceptualized as “complex trauma” or “complex PTSD” (Herman, 1997; Luxenberg, Spinazzola, & van der Kolk, 2001) and can leave survivors feeling entrapped, even after they have escaped or been rescued from trafficking situations (Courtois, 2008). A trauma-informed assessment can help to identify some of these symptoms, guiding recommendations for services.

A trauma-focused psychological assessment conducted by a skilled clinician provides a space for trafficked people to have a positive experience talking with someone about their experiences and emotions, which can relieve the burden of secrecy and decrease the shame response. When the assessment process offers this type of emotional relief, along with hope for change, survivors may be less fearful of mental health care and more open to further intervention. Regardless of whether a survivor chooses to pursue therapy, a trauma-informed assessment can afford an opportunity for her to gain information and to learn and practice emotional regulation tools through this form of brief intervention.

Finally, a psychological assessment of a girl or woman who has been trafficked may be used to advocate for and empower the survivor, amplifying her voice. The U.S. criminal justice system has promoted the use of a trauma-informed and “victim-centered” approach to anti-trafficking efforts. The 2013 Trafficking in Persons Report notes that “law enforcement, immigration, and other officials who interview victims of trafficking must understand the traumatic impact of being trafficked” (U.S. Department of State, 2013). A recent update to federal anti-trafficking legislation directly acknowledged the impact of trauma, noting that victims who are “unable to cooperate with law enforcement requests due to physical or psychological trauma” may be exempted from the requirement to cooperate in order to seek immigration relief or other benefits (U.S. Department of State, 2008). A psychological evaluation report may be used to describe the traumatic impact of human trafficking on a particular person, allowing officials and service providers to understand her current psychological state and increasing the likelihood that she will be treated in a trauma-informed manner.

Assessment Approach

We view our assessment process as the first step in intervention; that is, we want it to be an experience that promotes health, versus a triggering experience. In order to be the first step in intervention, a trauma-informed psychological assessment should be an empowering process for each girl or woman. She should be approached as a human being, with unique interests, concerns, strengths, and goals, rather than as solely a survivor of human trafficking. This emphasis on personhood instead of victim status forms the groundwork for the development of a life narrative that can shift from self-blame, beyond the perception of self as a victim or survivor, to a view of herself as a person who is more than the sum of the difficult experiences in her life.

Willingness and interest in participating in the assessment are essential. Women and girls must be given information about the purpose of the assessment and what the process entails. Active consent can be a challenge because clinicians are often seen as authorities, and some survivors may have a tendency to be compliant while others may feel the need to push back against recommendations in order to feel some sense of control. Time should be devoted to building rapport and offering information so that women and girls can make informed choices about their involvement in the process and with whom information can be shared.

The assessment framework should be respectful of different frameworks and individual perspectives. The clinician should work to become culturally informed, with “culture” referring to the host of background factors that influence a person’s view of themselves and the world. A Western model of mental health, including the concept of conducting a psychological assessment, is one framework; other viewpoints are equally valid and should be elicited. For instance, one indigenous woman from Guatemala believed that her soul left her body when she was trafficked.¹ Although a Western mental health model may frame her despondency and listlessness as depression, it is important to consider that healing for her would likely include a sense of her soul’s return to her body (Castillo, 1997).

Acknowledging that freedom and self-determination are taken by the trafficker(s), a trauma-informed approach places the power of choice with each survivor to the degree possible. This means that change—anything from leaving the trafficking situation, to accepting medical or mental health care, to replacing maladaptive coping strategies with more effective tools—often occurs at a different pace and by a different route than a provider might hope. The motivation for change comes from within each survivor, and the process of making changes is typically not linear (Prochaska & DiClemente, 1984). Respecting each survivor’s viewpoint and process of change is an important step in joining with her and working together.

Because participating in a trauma assessment can be emotionally challenging for the survivor, we offer support throughout and build towards the positive, with an emphasis on resources and a future focus. A trauma-informed assessment should offer information, resources, and possibilities, as opposed to defining a person and prescribing directives. Instead of reinforcing helplessness, guilt, or shame, this process should open new avenues, build supports, and foster hope.

Core Elements of a Psychological Assessment of Trafficked Women and Girls

Elements of a psychological assessment of women and girls who have been trafficked include: rapport-building and informed consent, safety assessment, needs assessment and goal-setting, history and vulnerability factors, trafficking narrative (including elements of force, fraud, and coercion) and trauma exposure, assessment of psychological symptoms, and strengths and coping. As part of the assessment process, we include psychoeducation and an experiential element that focuses on building regulatory capacity. We wrap up the process with a future focus and an emphasis on recommendations and resources.

Safety Assessment

After building rapport and obtaining informed consent, the first element of any assessment of a trafficking survivor should focus on immediate safety needs. Progress can not be made on more complex emotional issues when a person is at imminent risk or perceived risk of harm (Maslow, 1943). A safety assessment will include information about threats from the trafficker(s), history of physical assaults and harm, known weapons, whereabouts of the trafficker, information about the trafficker’s associates, and ongoing threats to the victims’ loved ones. Attention should also be paid to any current suicidal or homicidal ideation or plans. If immediate safety needs are identified, the focus should shift to accessing resources and responding to the crisis in a concrete manner.

Needs Assessment and Goal-Setting

Without basic necessities, it is difficult to turn attention to emotional needs; conversely, unmet needs often have a significant mental health impact on trafficking survivors. Therefore, a basic needs assessment is often an initial step in assessment of women and girls who have been trafficked. A needs assessment reviews a wide variety of current needs such as the need for shelter or housing, lack of basic necessities (clothing, food, and personal care items), medical or dental problems, communication barriers, transportation issues, and immediate financial needs. It should also assess ongoing stressors, including legal stressors (involvement in the immigration, civil, or criminal justice systems), cultural barriers, parenting stress, lack of contact with family, illiteracy, lack of education or job skills, poverty, social isolation, and other longer-term stressors (Clawson, Small, Go, & Myles, 2004). Attending to and meeting some of these basic needs can contribute to the development of a trusting relationship.

Goal-setting involves working with a woman or girl to identify her priorities and set short-term and long-term goals. By beginning and ending with a positive future orientation, we provide emotional containment to assessment of topics that are typically more intense, such as the trauma narrative and post-traumatic reactions to the trafficking experience. Using an empowerment approach, a woman’s goals are often translated into recommendations to service providers or the criminal justice system. Goal-setting is a way of amplifying the voice of each survivor, highlighting her main concerns, and helping her to advocate for herself.

History and Vulnerability to Trafficking

After safety and basic needs have been addressed, attention may turn towards the trafficking situation within a larger context, including history and vulnerabilities. Traffickers typically target people who are vulnerable in some way, whether that is due to poverty, lack of access to education, lack of resources and opportunities, chronic unemployment, discrimination, displacement or unstable living conditions, youth or naïveté, history of trauma exposure, lack of a supportive care giving system, responsibility for dependents, limited awareness of the crime of human trafficking, or other reasons (Logan, Walker, & Hunt, 2009; U.S. Department of State, 2000). Experts indicate that women and girls are disproportionally targeted for human trafficking schemes (U.S. Department of Justice, Bureau of Justice Statistics, 2011; U.S. Department of State, 2000, 2009). This increased risk is particularly notable for sex trafficking, with an estimated 98% of reported cases involving female victims (International Labour Organization, 2012). Females have unique vulnerability factors that may contribute to these different rates of human trafficking. When evaluating a girl or woman who has been the victim of human trafficking, it is important to understand her perception of the situation and what drew her into the scheme, in order to provide her with education and promote secondary prevention by reducing her risk of being re-trafficked.

Gender Inequality

Women and girls in many parts of the world hold disadvantaged social and economic positions, which has “contributed to a burgeoning of the trafficking industry” (U.S. Department of State, 2000, Division A, Sec. 102b). The assessment should consider gender-based disparities that left each girl or woman vulnerable to trafficking (La Strada International, 2008). For instance, girls and women in some communities are relegated to the domestic spheres, preventing them from engaging in ongoing education and employment and creating social and financial dependence on men (Chung, 2009). Concrete recommendations regarding immigration status, education, job skills training, or child care may reduce the vulnerability to re-exploitation. The assessment should also evaluate gender stereotypes held by the survivor’s community, family, or internalized by the survivor herself. Some gender stereotypes present men as powerful and in control and women as passive, leaving decision-making in the hands of men (D’Cunha, 2002); when these perceptions are internalized, they may reinforce feelings of helplessness and dependency. By considering psychological factors such as each survivor’s view of her social roles and her sense of self-efficacy, the assessment can make mental health recommendations that address gender-based barriers. Myrna’s story is a prototypical narrative of recruitment shared by numerous young women from Latin America who were vulnerable to trafficking due to poverty, gender inequality, and lack of opportunities for improving their lives.

Myrna (23 year ol...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Citation Information
• Notes on Contributors
• Introduction—Human Trafficking of Women and Girls: Characteristics, Commonalities, and Complexities
• 1. Trauma-Informed Psychological Assessment of Human Trafficking Survivors
• 2. Psychotherapy in the Aftermath of Human Trafficking: Working Through the Consequences of Psychological Coercion
• 3. Survivor: A Narrative Therapy Approach for Use with Sex Trafficked Women and Girls
• 4. What’s Home? (Re)integrating Children Born of Trafficking
• 5. International Sex Trafficking
• 6. Sex Trafficking and the Commercial Sexual Exploitation of Children
• 7. Cultural Oppression and Human Trafficking: Exploring the Role of Racism and Ethnic Bias
• 8. Human Trafficking and Intercountry Adoption
• 9. Global Love for Sale: Divergence and Convergence of Human Trafficking with “Mail Order Brides” and International Arranged Marriage Phenomena
• Index