U.S. Department of Health and Human Services, 

Office of the Assistant Secretary for Planning and Evaluation 

1 

TREATING THE HIDDEN WOUNDS: TRAUMA TREATMENT AND MENTAL 

HEALTH RECOVERY FOR VICTIMS OF HUMAN TRAFFICKING 

Heather J. Clawson, Ph.D., Amy Salomon, Ph.D., and Lisa Goldblatt Grace, LICSW, 

MPH 

I. STUDY OVERVIEW 

This is the third in a series of Issue Briefs produced 

under a contract with the Department of Health and 

Human Services (HHS), Office of the Assistant 

Secretary for Planning and Evaluation (ASPE) to 

conduct a study of HHS programs serving human 

trafficking victims. Funded in the fall of 2006, the 

purpose of this exploratory project is to develop 

information on how HHS programs are currently 

addressing the needs of victims of human trafficking, 

including domestic victims, with a priority focus on 

domestic youth. This project also consists of 

reviewing relevant literature, and identifying barriers 

and promising practices for addressing the needs of 

victims of human trafficking, with a goal of 

informing current and future program design and 

improving services to this extremely vulnerable 

population. 

This issue brief addresses the trauma experienced by 

most trafficking victims, its impact on health and 

well-being, some of the challenges to meeting 

trauma-related needs of trafficking victims, and 

promising approaches to treatment and recovery. 

While this issue brief touches on trauma across 

human trafficking populations, it has a special 

emphasis on trauma resulting from sex trafficking of 

women and girls. 

II. TRAUMA AND ITS IMPACT 

Recent trauma studies have deepened our 

understanding of trauma and its impact. They 

describe a complex range of post-trauma symptoms 

and identify the interactions of multiple factors as 

contributing to their seriousness (Briere & 

Spinazzola, 2005). For example, more serious 

symptoms are associated with histories of multiple 

victimizations, often beginning in childhood and 

resulting in disruptions of parent-child relationships 

(Ford & Kidd, 1998; Turner, Finkelhor & Ormrod, 

2006). More profound impacts are also associated 

with co-occurring behavioral health problems, like 

substance abuse disorders, (Acierno, Resnick, 

Kilpatrick, Saunders, & Best, 1991) and with a range 

of other issues, like limited social supports, lower 

socioeconomic status, and stigma associated with 

particular traumatic events (Brier & Spinozzola, 

2005). 

Trauma exposure occurs along a continuum of 

“complexity,” from the less complex single, adultonset incident (e.g., a car accident) where all else is 

stable in a person’s life, to the repeated and intrusive 

trauma “frequently of an interpersonal nature, often 

involving a significant amount of stigma or shame” 

and where an individual may be more vulnerable, due 

to a variety of factors, to its effects (Briere & 

Spinazzola, 2005, p. 401). It is on this far end of the 

continuum where victims of human trafficking, 

especially sex trafficking, can be placed. 

POST-TRAUMA RESPONSES FOR VICTIMS 

OF HUMAN TRAFFICKING

Most of the literature on trauma and trafficking 

focuses on the trafficking of foreign-born women and 

girls for commercial sexual exploitation. In addition 

to experiencing terrorizing physical and sexual 

violence, researchers report that victims often 

experience multiple layers of trauma including 

psychological damage from captivity and fear of 

reprisals if escape is contemplated, brainwashing, and 

for some, a long history of family, community, or 

national violence (Stark & Hodgson, 2003; Ugarte, 

Zarate, & Farley, 2003). 

Additionally, the emotional effects of trauma can be 

persistent and devastating. Victims of human 

trafficking may suffer from anxiety, panic disorder, 

major depression, substance abuse, and eating 

disorders as well as a combination of these. For 

some victims, the trauma induced by someone they 

once trusted results in pervasive mistrust of others 

and their motives. This impact of trauma can make 
the job of first responders and those trying to help 

victims difficult at best. 

In some cases, the exposure to trauma results in a 

condition referred to as Post-Traumatic Stress 

Disorder (PTSD). PTSD is a mental health 

diagnostic category created originally for war 

combatants and disaster victims but which also 

applies to victims of other traumas, including 

trafficking victims. For those that struggle with 

PTSD, the characterizing symptoms include intrusive 

re-experiencing of the trauma (e.g., flashbacks, 

nightmares, and intrusive thoughts), avoidance or 

numbing of trauma-related, or trauma-triggering, 

stimuli (e.g. avoiding certain places, people, and 

situations), and hyper arousal (e.g., heightened startle 

response, and inability to concentrate). For both 

adults and youth, once established, PTSD is usually 

chronic and debilitating if left untreated (Feeny, Foa, 

Treadwell & March, 2004). 

Post-trauma responses like those outlined above 

reportedly contribute to problems with functioning, 

including difficulties controlling emotions, sudden 

outbursts of anger or self-mutilation (Briere & Gil, 

1998), difficulties concentrating, suicidal behaviors 

(Zlotnick, Donaldson, Spirito, & Pearlstein, 1997), 

alterations in consciousness (dissociation), and 

increased risk taking. These post-traumatic symptoms 

and problems reflect those service providers often 

identify as common among the trafficking victims 

they work with. For some victims, in particular 

victims of sex trafficking, the use of alcohol and 

drugs to escape these emotional states is also a 

problem. 

In addition to emotional problems, physical health 

problems can also predominate and result from the 

trauma of physical injury 

or indirectly through 

stress-related illnesses. 

For example, service 

providers report victims 

often complain of 

stomach pain, headaches, 

and other unexplained 

ailments. Given the 

impact of these trauma 

symptoms on the 

emotional and physical 

well-being of victims, it is not surprising that some 

victims of human trafficking experience difficulties 

obtaining and holding down a job, paying bills, and 

reintegrating back into society. 

III. CHALLENGES IN MEETING THE NEEDS 

OF TRAFFICKING VICTIMS WHO HAVE 

EXPERIENCED TRAUMATIC ABUSE

Many of the health and social needs of trafficking 

victims stem directly from their experience with 

trauma and the brutal reality of unremitting threats or 

actual physical and sexual violence. Meeting these 

needs, in particular providing mental health treatment 

and trauma-informed services, is not without 

challenges. Service providers report the following 

barriers and challenges to getting victims help in 

dealing with their trauma. 

 

Limited availability and access to 

appropriate mental health services. Issues 

of affordability and access to services, as well as 

responsiveness of those services to the complex 

needs of survivors, are common issues identified by 

service providers. Providers uniformly point to 

access to mental health services as a significant 

challenge for both international and domestic victims. 

For most victims, 

shame is seen as one of 

the greatest barriers 

preventing them from 

seeking mental health 

services. Providers 

note that the stigma 

associated with mental 

illness is an especially 

prominent challenge in 

engaging foreign-born and male victims in treatment. 

“I felt shame and wanted 

to forget what had 

happened to me. I 

needed to be strong. But 

I could not stop the

nightmares. Talking to

[therapist] helped me.“ 

Survivor of human 

trafficking

For other victims, while providers report a 

willingness to seek help for physical health 

complaints, the underlying cause of the physical 

problems or symptoms - the trauma - often goes 

ignored and untreated. 

“We can’t address issues

of employment, life 

skills, or anything else 

until we address the 

trauma. How can we 

expect someone to get a 

job when they can’t 

even get out of bed or

are afraid to leave the

shelter?” 

Case manager

For U.S. minor victims, barriers to accessing mental 

health services are linked primarily to the issues of 

confidentiality and concerns that someone will find 

out what has happened to them, lack of identification 

documents, lack of insurance, and system-related 

jurisdictional issues. For example, as one provider 

notes, it is often assumed that child welfare systems 

will provide mental health services for minors. 

2
Requirements to report minors to child protective 

services, however, do not necessarily result in access 

to treatment. If the abuse is not inflicted by a parent 

or legal guardian, the case is often seen as outside the 

jurisdiction of the system. In such cases the minors 

fall through the cracks and do not receive services 

they need. But there are still challenges even if a 

youth has health insurance or is served under the 

child welfare system. Most providers note that 

referral sources for mental health treatment or 

counseling are limited for youth, as well as for adults. 

In one community, the wait for a psychiatric referral 

for youth was up to seven months. 

Once access to mental health or counseling services 

is obtained, many providers are unable to maintain 

the long-term treatment that many victims require. 

Providers report that insurance and/or funding 

restrictions often limit the number of sessions that a 

victim can receive. Furthermore, traditional 

therapeutic services are often ill-designed to respond 

to the needs of transient victim populations, in 

particular U.S. minor victims, who sometimes find it 

difficult to meet expectations for weekly 

appointments. Responsive mental health treatment 

requires considerable flexibility which may not be 

supported by existing systems of care. Therefore, 

while getting services in response to the immediate 

crisis is not viewed as a problem in most cases, 

helping a victim with long-term trauma recovery is a 

significant concern. 

Difficulty establishing trusting 

relationships with victims. For both law 

enforcement and service providers, getting victims to 

trust them and accept help is a huge obstacle. They 

acknowledged that while building trust takes time, 

time is something that often worked against both law 

enforcement and providers. Many of the services 

available for victims 

are described as time 

limited. For example, 

both domestic 

violence shelters and 

runaway and homeless 

youth programs, where 

most counseling 

services are offered 

on-site to victims, 

generally provide for 

short stays that do not 

allow adequate time to 

establish trusting relationships needed in order for a 

victim to open up and begin to address their trauma. 

The mistrust of victims often is due to their histories 

of betrayal from families, service systems, and in 

some cases, law enforcement and governments. But 

in addition, a victim’s mistrust is often compounded 

by fears that connections with law enforcement 

and/or service providers can compromise their 

physical safety (e.g., the trafficker will find them, 

they will be deported, or they will be sent back to an 

abusive home). 

Mandated treatment efforts may be 

counterproductive when working with 

victims. In some communities, the only way to 

access mental health screening and treatment services 

is to be committed to a locked treatment facility. 

Having already experienced the loss of control to 

traffickers, this can make being in locked treatment 

facilities or detention centers seem particularly 

threatening, essentially re-traumatizing victims and 

frustrating their recovery. 

Secrecy is a trademark of the women and 

girls involved in sex trafficking; victims 

may not define their experience as 

abusive, or attempt to escape. A complex 

web of coping strategies and harsh realities make it 

hard for some victims to seek and receive help. The 

shame and stigma of sex trafficking may lead them to 

conceal their involvement in prostitution, even in 

therapeutic relationships where success is dependent 

on frank disclosure and “working through” the 

trauma (Herman, 2003). In addition, if a victim does 

not define her experience as abusive, no matter how 

dangerous, she will not likely seek help or engage in 

recovery (Ugarte et al., 2003). 

Foreign-born trafficking victims face 

additional barriers related to language, 

culture, and isolation. Lack of English skills 

for foreign-born victims limit their ability to access 

information about rights, services and options. 

Isolation due to these language barriers as well as 

cultural differences can be hard for any new 

immigrant but are particularly devastating for 

trafficking victims by reinforcing their captivity. (It 

should be noted that the isolation of domestic victims 

moved repeatedly throughout the country has some of 

the same effects.) Forming outside supports is 

critical in fighting the isolation and ultimately getting 

victims the help they need. Shifts in traditional 

 “Clients need time to

feel safe enough to 

overcome being scared

for their lives, to

recognize that they’re 

victims, and to build

relationships and open

up to case managers, 

counselors, therapists, 

and others trying to help

them.” 

Victim service provider 

3
Western professional treatment paradigms to more 

nontraditional interventions and support groups 

(which “recognize oppression when working with 

people of low economic status and low power”) have 

been noted as key to working with immigrant and 

refugee victims (Hotaling et al., 2003 p. 257). 

IV. TRAUMA INFORMED AND SPECIFIC 

SERVICES 

Given this range of challenges, what do we know 

about the way systems and services can best respond 

to the complex and multiple needs of trafficking 

victims? One especially useful framework 

characterizes two broad categories of service 

delivery: “trauma informed” services, appropriate for 

all systems of care in which victims may present; and 

“trauma specific” services, designed to treat the 

actual symptoms of physical or sexual abuse in 

specialty treatment programs (Harris & Fallot, 2001). 

This framework is especially appropriate to working 

with trafficked women and girls since they are likely 

to present in a variety of systems of care for other 

than their trauma-related needs. Trauma informed 

services can promote a sensitive and relevant 

response regardless of where a victim seeks help, and 

can also improve the identification of victims. At the 

same time, trafficking victims are likely to need more 

specific and long-term trauma treatment. The 

distinction between trauma informed and trauma 

specific services can help providers better pinpoint 

where their services are located on the continuum and 

what it might take (including training, supervision, 

additional program components and networking) to 

create a more continuous and comprehensive system 

for victims of human trafficking. 

Trauma informed services encompass two 

distinctly different things. According to Harris & 

Fallot (2001), to be trauma informed means, first, to 

“know the history of past and current abuse” in the 

life of your clients. This information allows for a 

more integrated and appropriate approach to meeting 

their needs. But second, to be trauma informed 

means “to understand the role that violence and 

victimization play in the lives of most consumers 

of... services and to use that understanding to design 

service systems that accommodate the vulnerabilities 

of trauma survivors and allow services to be 

delivered in a way that will facilitate consumer 

participation in treatment.” (Harris & Fallot, 2001, 

pp. 4-5) Trauma informed services are generally 

developed to treat primary problems other than 

trauma, by building capacity within those systems of 

care where survivors of trauma may present (i.e., 

homeless shelters, substance abuse treatment 

programs, the criminal/juvenile justice systems, 

mental health programs, medical programs, etc.). 

Regardless of the agency or system’s primary 

mission, trauma informed services are committed to 

providing services in a manner that is welcoming and 

appropriate to the special needs of trauma survivors. 

Both the identification of victims, and successful 

treatment of their trauma, can be improved by having 

trauma informed services provided in multiple 

systems. 

 

Trauma specific services, on the other hand, 

are likely to be found with specialty mental health 

programs or providers, although they clearly could be 

developed in other medical settings, homeless 

shelters, or other systems of care. They are generally 

accessed by referral to those doing the clinical work. 

A variety of trauma specific techniques are in the 

repertoire of these services. Among them may be 

grounding techniques to help manage dissociative 

symptoms; desensitization therapies to help make 

painful images more tolerable; and certain behavioral 

therapies which teach skills for coping with posttrauma effects (Harris & Fallot, 2001). These 

therapies can be delivered individually or in groups, 

and are often augmented by other complimentary 

approaches, including culturally relevant material. 

V. CORE COMPONENTS OF TRAUMA 

INFORMED AND SPECIFIC SERVICES 

While the needs of individual trafficking victims with 

histories of trauma may vary considerably, the 

systems of care in which they are likely to present 

(child welfare; criminal justice; immigration; public 

health and behavioral health) can be better prepared 

to recognize their needs and help accordingly. Core 

components of a system of care responsive to the 

trauma-related needs of trafficking victims should 

include a set of core principles and practices based 

upon providers understanding that: 

 Trauma is a defining life event with a complex 

course which can profoundly shape a victim’s 

sense of self and others; 

 The victim’s complaints, behaviors and 

symptoms are coping mechanisms (their original 

4
sources of strength may no longer be effective), 

and requiring use of a relational, rather than 

individualized or confrontational, approach to 

their solution; 

 The primary goals of services are empowerment 

and recovery (growth, mastery, and efficacy) 

which are prevention-driven and limited by 

survivor self-assessment and recovery needs; and 

 The service relationship is collaborative, with 

victim and provider having equally valuable 

knowledge, the victim can be an active planner 

and participant in services, his/her safety ensured, 

a priority placed on choice and self control, and 

trust developed over time (Harris & Fallot, 

2001). 

Specific core components that are based on these 

beliefs and practices are listed below. 

Review of agency policies and procedures 

to identify and remove any that are 

potentially unsafe and harmful to 

trafficking victims with histories of 

trauma. Internal reviews, using a trauma lens, can 

be especially helpful in identifying policies and 

procedures (e.g., strip searches, locked holding pens) 

which can be damaging to trafficking victims 

experiencing trauma disorders. Conversely, assessing 

the degree to which policies and procedures support a 

welcoming and agency-wide trauma informed 

perspective, within an overall planning process, can 

help clarify an agency’s needs (for staff and training) 

and the role it expects to play within a comprehensive 

network of community services. 

Education and training of staff, including 

those working directly with trafficking 

victims as well as other providers in 

relevant systems of care. Education of staff 

might include training on the complex interactions of 

trauma, substance use, emotional disorders and 

physical illness; multicultural education on

specialized approaches to working with foreign-born 

victims; as well as basic safety issues in working with 

victims and approaches to treatment. Training should 

also include helping caregivers understand the 

experience of being trafficked, who is most 

vulnerable to trafficking, the techniques traffickers 

use to recruit victims, the impact on victims, and 

what a path to recovery can look like. 

Key Characteristics of a Skilled Provider Working

with Trauma-Survivors

 Understands that certain survivor behaviors are a 

response to trauma; 

 Is knowledgeable regarding the mental health [and

substance abuse] effects of violence and in particular, 

sexual violence;

 Is skilled and knowledgeable regarding trauma and

trauma treatment; 

 Is able to provide culturally competent services and

seeks supervision regarding cultural issues; 

 Is responsive to emergency mental health issues of 

clients 

Modified list from Helping Sexual Assault Survivors 

with Multiple Victimizations and Needs: A Guide for

Agencies Serving Sexual Assault Survivors (Davies, 

2007), page 40 

Screening for trauma in multiple settings. 

Identification is the first and necessary step in 

assuring victims get the help they need. In some 

cases, providers may be reluctant to ask sensitive 

questions early on in

the relationship 

building process; 

however, not raising 

those questions at all 

can be more 

detrimental. For 

victims of sex 

trafficking, culturally

sensitive screening that 

incorporates multiple 

references to sexual 

abuse has been

considered beneficial 

in reframing the abuse 

and shifting 

responsibility to the 

perpetrators (Ugarte et 

al., 2003). Staff who 

conduct these 

screening will need 

adequate skills, 

supervision, and 

supports.

“In exchange for training 

on human trafficking, we 

have enlisted help from a 

group of psychologists to

train our staff to ask 

questions that enable us to

assess mental health needs 

without directly asking if 

the client needs mental 

health services. We ask 

questions about the trauma

symptoms and then

recommend someone that

can help them, for 

instance, with the 

nightmares they are 

experiencing or the

headaches they keep

having. This helps us 

avoid the stigma

associated with mental 

health services in some

cultures.” 

Victim service provider 

5
Ensuring safety and meeting basic service 

needs. Establishing physical and psychological 

safety is considered a pre-requisite in working with 

trafficking victims with trauma histories. This may 

mean collaboratively assessing the current level of 

client safety and developing together plans to remain 

safe. It can also mean designing each component of 

service to prioritize safety. For example, an outreach 

and engagement activity under this rubric would 

prioritize safety and control by explicitly seeking 

permission to speak with a victim, asking about the 

amount of privacy he/she might want for an initial 

conversation, and following his/her lead on 

disclosure. Safety may also include working with a 

clinician who is respectful, non-judgmental, and 

allows the victim to explore his/her history in a safe 

and containing way. In addition and complementary 

to safety, providers emphasize several basic services 

that are critical components to comprehensively 

meeting the needs of individuals who have 

experienced trauma, including safe housing, life 

skills, health care, legal services, and vocational 

supports (Finkelstein et al., 2004). Developing 

multidisciplinary collaborative networks of programs 

across systems of care can help facilitate 

comprehensively addressing multiple needs. 

Building long-term, sustaining 

relationships and providing opportunities 

for regaining valued social roles. A critical 

part of trauma recovery and building new lives for 

trafficking victims involves the development of 

trusting, long-term relationships. This often needs to 

occur well before a victim is willing to engage in 

trauma specific treatment. These relationships are 

developed in some programs with “care 

coordinators” who assist with identifying and helping 

to meet a victim’s basic needs. Care coordinators are 

sometimes the link (through gentle and respectful 

suggestion) between basic services and mental health 

treatment, where needed. Other programs, working 

especially with 

immigrant women, 

emphasize 

relationship building 

through more natural 

and culturally 

familiar supports, 

including home 

visits, sharing a 

meal, etc. Helping 

victims connect with 

valued social roles, such as providing opportunities 

for peer leadership and community action are also 

noted by trafficking survivors and providers as 

opportunities to regain or reshape a victim’s sense of 

self and capabilities. 

Access to trauma specific treatment 

services. In addition to the trauma informed 

strategies outlined above, providers working with 

trauma survivors must have access to a range of 

trauma specific interventions, including individual 

clinicians willing, available and culturally competent 

to work with victims of human trafficking, as well as 

groups designed to meet their often multiple 

treatment needs. Cognitive Behavioral Therapies 

have been most studied and therefore have the largest 

evidence-base supporting their effectiveness in 

reducing PTSD symptoms (Feeny et al., 2004; Foa 

and Rothbaum, 1998). In addition, evolving traumatheory specific to complex trauma emphasizes that 

treatment should address developmental and 

relationship difficulties in addition to PTSD 

symptoms (Pearlman & Courtois, 2005). 

Several treatment approaches have been developed 

for complex trauma specific to adolescents, using 

group therapy to address skills development, affect 

regulation, interpersonal connections and competence 

and resiliency building. These interventions all 

emphasize the relationship between symptoms and 

the traumatic experience, the development of 

concrete coping skills in managing symptoms, and 

the use of peer support groups to increase 

normalization, build healthy interpersonal 

relationship skills, and establish social supports 

(Cook et al., 2005). One program for sexually 

exploited teens emphasizes the importance that youth 

make the connection between their physical 

symptoms and mental health. Weaving mental health 

into other strategies, like art or music therapy, appear 

especially promising. 

“Interviewing techniques are

very important when working

with trauma survivors. 

Having the capacity to

empathize with the victim, 

letting her take the lead, and

treating her respectfully goes 

a long way to building trust 

and getting results.”

Law enforcement officer 

Providers also need to understand and assess the role 

that culture plays in resiliency and the importance of 

community resources as potentially mediating the 

trauma experience, especially for foreign-born 

victims. Individually-focused Western 

conceptualizations of trauma may miss the potential 

strengths inherent in culture and community to

enhance engagement in healthy relationships and 

promote recovery (Tsoi Hoshmand, 2007; ArgentiPullen, 2000; Burstow, 2003; Summerfield, 2004). 

6
Making peer models and supports 

available. Given the challenges for trafficking 

victims in developing trusting relationships with 

professionals, there was wide acceptance among 

providers that successful programs need to 

incorporate peer-to-peer counseling and supports 

among their core components. Particularly for 

victims of human trafficking, where shame promotes 

secrecy, individuals can be most comfortable with 

peers who understand, and have lived, their own 

struggles. Both service providers and victims 

highlight the critical importance of non-judgmental, 

empathic peer support that allows trauma victims to 

successfully make the transition to a new life. 

Furthermore, peer led services can reduce or remove 

the cultural and language barriers that can get in the 

way of successful recovery. Structured peer support 

additionally offers the opportunity for survivors to 

“develop a new identity as a valued and responsible 

member of a community.” (Herman, 2003 p.11) 

SAGE is a human rights non-profit survivor-run drug, 

mental health, and trauma treatment center in San 

Francisco, California. Its peer counseling model

avoids a traditional approach to trauma treatment that 

positions service providers as clinically neutral 

authority figures. Rather, SAGE provides client

centered supportive partnerships which address the 

social, political and economic contexts of client

difficulties. SAGE combines the peer counseling with

a host of other services, including alternative trauma

treatments, such as acupuncture, art therapy, massage, 

healing touch, movement, and drama. SAGE also has

a broad referral network which includes therapists

specializing in Eye Movement Desensitization and

Reprocessing (EMDR), an information processing

therapy that integrates elements of many effective 

psychotherapies (psychodynamic, cognitive 

behavioral, interpersonal, experiential, and bodycentered therapies in structured protocols that are 

designed to maximize treatment effects (Shapiro, 

2001), and willing to provide pro bono services. 

More and more programs for victims of human 

trafficking are starting to engage survivors in 

programming. This includes peer counsels assisting 

in program decision-making and peers providing 

group-mentoring/support to current clients. Peers are 

often individuals who graduated from the program. 

Interviews with survivors suggest that, when they are 

ready, involving them in the care of others can be 

beneficial to both the survivor and the victims they

work with. Other programs have formed 

“communities” of survivors to serve as peer groups to

assist other victims in rebuilding their sense of 

personal efficacy. Part of the success of these groups 

involves allowing the victims to set the agenda for 

meetings and focus on what is most important to 

them; which have included computer training, 

language classes, ethnic celebrations, and writing 

plays about their experiences. 

Developing alternatives to traditional 

therapies. Alternatives to traditional therapies, 

especially those that build self-esteem, 

empowerment, and re-connection with self, are 

considered important adjunct services for this 

population. Art therapy, journaling, poetry and song

writing, yoga, body work, drama, and outdoor 

physical activities are some examples of this strategy. 

Given the difficulty some victims have with selfsoothing (an impact of trauma), it is not surprising 

that several programs use music as part of their 

therapy. Some programs report offering organized 

religious or spiritual activities to help victims connect

to something that will last beyond the program

timeframe. For several of the youth programs, 

engaging victims in decision making, providing

leadership opportunities, and helping youth develop 

valued social roles is part of therapy. For adults, 

programs offered acupuncture, meditation, and a 

variety of other alternatives to traditional therapy

within their agencies. 

V. SUMMARY

Victims of human trafficking are especially

vulnerable to the debilitating physical and 

psychological symptoms of trauma resulting from

their repeated, intrusive, and long-term abuse. 

Providers working with this population, in particular 

with sexually exploited women and girls, emphasize 

that trauma recovery is critical to a victim’s ability to 

repair and regain her life. However, there are many

challenges to meeting the trauma-related needs of 

trafficking victims, especially since a comprehensive 

approach, which includes building basic supports and 

safety as well as treatment, often crosses multiple 

systems of care. Building trauma-informed and

trauma-specific services offers the promise of 

identifying and responding to victims where they

present (i.e., in other than the mental health system) 

with services that cover the spectrum of their needs. 

Building long-term, trusting relationships is at the 

7
heart of this work, which requires time and flexible 

models of engagement and treatment, including peerto-peer work. In addition to group and individual 

trauma-specific counseling, a range of alternative 

therapies offer promise in helping victims build selfesteem, empowerment and re-connection with 

themselves and society. For foreign-born victims, 

promising models that recognize the limitations of 

individualized Western treatment and the healing 

potential of culture and community resources show 

promise. 

The issue briefs in this series and the final study 

report can be downloaded from the following Web 

sites: 

http://aspe.hhs.gov/hsp/07/HumanTrafficking/

http://www.icfi.com/markets/social-programs/

8
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