_____________________________ Recognizing and Responding to Human Trafficking in Texas, 2nd Edition
Trauma-informed care can potentially provide a greater sense of safety for individuals who have a history of trauma as well as a space for preventing more serious consequences of traumatic stress (Fallot & Harris, 2002). While many individuals “may not identify the need to connect with their histories, trauma- informed services offer clients a chance to explore the impact of trauma, their strengths and creative adaptations in manag- ing traumatic histories, their resilience, and the relationships among trauma, substance use, and psychological symptoms (SAMHSA, 2020, p.8). Beyond utilizing a trauma-informed approach, some additional considerations when interacting with and caring for victims are: • Don’t ignore potential warning signs. Although victims do not often make explicit disclosures about their trafficking situations, many will share some indications that partially speak to their trauma. Victims may casually or jokingly reveal information that suggests their situation, such as the number of sex partners—if they are victims of sex trafficking—to provide context about their current medical situation (Richie-Zavalet et al., 2021; Stocklosa et al., 2022). If a provider notices potential signs of human trafficking, they should take time to review the patient’s/victim’s medical record to determine if that individual’s acute health concerns fit a pattern consistent with previous encounters (Richie-Zavaleta et al., 2021). • Ensure the victim feels safe and comfortable. The primary goals when interacting with a potential victim are to provide quality care, empowerment, and a safe space—not to force the patient to make a disclosure if they do not wish or are not ready to (Geller et al., 2023). Providing a secure and supportive care setting creates an environment that fosters positive relationships between victims and providers and may encourage the victim to be more willing to disclose information about their situation. In order to increase the chances of establishing a positive report and fostering trust between the victim and provider, it is imperative to allow the victim to decide if they would be more comfortable speaking with a male or female provider. Additionally, provide privacy to discuss sensitive topics; utilize interpreter services if necessary; explain the need for a private exam; and explain patient confidentiality policies, including mandatory reporting laws (Richie-Zavalet et al., 2021; Stocklosa et al., 2022).
Ask questions respectfully. Asking questions and gathering information from the victim must be done carefully and respectfully so as to not appear judgmental or dismissive of the victim’s situation, as this could irrevocably damage any established rapport and trust the victim has with individual providers or even providers in general (Palombi et al., 2019; Richie-Zavalet et al., 2021; Stocklosa et al., 2022). Examples of appropriate assessment questions are: • Do you feel safe at the moment? ‒ Where do you live? ‒ Who do you live with? ‒ What are your working or living conditions like? • Where do you sleep? Do you have access to food whenever you need to eat? ‒ Has anyone at home or at work ever forced you to do something you didn’t want to do? ‒ Have you ever received anything in exchange for sex (e.g., shelter, gifts, food)? • Has anyone at home or at work threatened you or your family? • Has anyone at home or at work ever hurt you? • Can you leave your job or living situation if you want? Are you free to come and go as you please? • Have you ever been afraid to leave or quit a work situation due to fear of violence or threats of harm to you or your family? • Have your identification documents been taken away from you? • Document the encounter thoroughly. Along with carefully asking thoughtful and respectful questions, documenting the patient/victim encounter thoroughly and using only medically relevant information with necessary supporting details is vital to providing adequate care for victims (Stoklosa & Beals, 2022; Tiller et al., 2020). It is important to state information objectively, avoid subjective phrasing or terms, and be thorough when describing relevant findings on physical exams (potential findings pointing to abuse, complete skin exams, other pertinent details; Stoklosa & Beals, 2022). Lastly, it is important to remember that medical records may serve both medical and legal purposes if the victim seeks legal justice after making a disclosure.
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