Self-Assessment Question 2 All of the following are potential indicators that a patient is a victim of human trafficking except: a. Presenting with frequent and repeated injuries. b. Being accompanied by an individual who frequently accompanies other individuals for similar acute illness/ injuries. c. Presenting for reproductive care with a history of several STI screenings and multiple terminated pregnancies. d. None of the above. Response and Follow-Up Victims of trafficking do not often disclose their trafficking situation in clinical settings (Alpert et al., 2014). Research indicates that up to 88% of victims interact with healthcare providers while they are in a trafficking situation (Smith, 2022. Many healthcare systems and facilities do not have policies in place that standardize screening and response protocols. One study found that only 39% of healthcare centers, departments, hospitals, and clinical settings such as dental and OBGYN offices in Michigan and Texas had screening policies in place, and only 62.5% had response protocols in place (Munro-Kramer et al., 2022). Healthcare providers must be thoughtful and careful about engaging with patients if human trafficking is suspected. Before beginning any conversation with a patient, assess the potential safety risks that may result from asking sensitive questions. Recognize that the goal of your interaction is not disclosure or rescue, but rather to create a safe, nonjudgmental place that will help you identify trafficking indicators and assist the patient (National Human Trafficking Resource Center, 2016). A trauma-informed approach is crucial in rendering aid to individuals who may have experienced trauma, and includes an understanding of trauma and an awareness of the impact it can have across settings, services and populations (SAMHSA, 2020). A trauma- informed approach involves viewing trauma through an ecological and cultural lens, recognizing that context plays an important role in how individuals perceive and process traumatic events (SAMHSA, 2020). The three key elements of a trauma- informed approach include: realizing the prevalence of trauma, recognizing how trauma affects all individuals within the health care system, and responding by putting this knowledge into practice (SAMHSA, 2020). Trauma-informed care is a strengths-based service delivery approach “that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment” (Hopper, Bassuk, & Olivet, 2010, p.82). Trauma-informed care is crucial when working with victims of human trafficking as it also involves vigilance in anticipating and avoiding processes and practices that could re-traumatize individuals (SAMHSA, 2020). 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 managing 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)?
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Book Code: PCTX1325
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