Survivors of Trafficking Deserve Ethical therapists

From January 2020 - April 2021, YAMT conducted a mental health survey to learn more about the ways in which survivors of trafficking and the commercial sex industry are receiving and accessing mental health services throughout their local community. Of 100 participants, 82% of survivors found that they were unable to access therapeutic services after exiting, and many expressed not seeking out mental health treatment on average between 2-4 years due to fear, shame, guilt, and therapists lack of knowledge that they could talk about this in a therapy setting.

When asked, “What did you find lacking in the mental health services offered to you?” many indicated the following:

• Unethical Therapist (Folx who violated HIPPA, My personal Boundaries or Re-exploited me in treatment)

• Lack of clinicians with knowledge about human trafficking

• Lack of clinicians with the knowledge to affirm and treat LGBTQ+ survivors

• Lack of financial accessibility to treatment

• Lack of clinicians who took racial trauma seriously

On an individual level, the survey revealed survivors impacted by unethical therapists were impacted by the following:

• Therapists who would try or pressure survivors to engage in sexual conduct with them.

• Psychiatrist who would over-medicate and misdiagnose them

• Impose their personal values on them (which further enhanced the shame and guilt that they felt

• Therapists would break confidentiality

Shobana Powell, the Founder of Shobana Powell Consulting, recently provided an excellent webinar on Clinical Ethics and Boundary Setting when working with commercial industry survivors throughout You Are More Than’s Nurture Forward Directory. This webinar breaks down the National Association of Social Workers Code of Ethics and relates it back to how to treat survivors ethically within the clinical setting.

5 Recommendations from You Are More Than Inc:

1. Treat clients with dignity and respect:

   1. At no point ever is it alright or safe for you to have a personal, sexual relationship with a client, especially if they are survivors of sexual violence. Our jobs are to show up in those rooms as unbiased, supportive, not predatory.

   2. Survivors feel more shame and guilt when clinicians cannot take an unbiased approach to the work. When we ask questions like “Well, why would you do something like that? How come you never told anyone? “That specific trauma or sexual act could not have happened, it seems that you are having delusions” How many people did you have sex with? Don’t you think it would have been better if you just asked for help rather than doing it on your own?” Not realizing questions along these lines causes survivors to feel shame and more isolated.

   3. Religion has no place in the therapeutic setting unless that is what the client wants. It’s difficult for survivors to show up fully when a therapist imposes their religious views on them.

2. Recognize that survivors of trafficking are not too traumatized to treat, too traumatized to have effective mental health treatment.

3. Informed consent is crucial to making the therapeutic relationship work. Informed consent goes beyond reviewing paperwork with your clients and having them sign off. Informed consent means that survivors are:

   1. Apart of their treatment planning and goal setting.

   2. They are allowed to speak up when a rupture occurs and you make space to hear how they’ve been harmed by you.

   3. They are allowed to say no to something in treatment not working. They are allowed to want a different approach and should be given different options to understand and explore their trauma than just traditional talk therapy. Are you trained in EMDR? Are you good at utilizing art as therapy to integrate into treatment. Can you use hip hop/music as means to understand how a client is feeling rather than having them express it verbally.

   4. Language access is really important in this discussion as well; informed consent for survivors who do not have English as their first language need access to trauma-informed interpreters and translators who are NOT family members or young children.

4. Make therapeutic settings accessible to survivors of trafficking by offering low-cost to free clinical slots a year.

   a. Many survivors of trafficking will go years without access to health insurance, stable employment, or a stable family/community, limiting their access to traditional avenues of mental health care. On average, a trauma therapist in the state of NJ who is highly skilled in treating trauma will charge $150.00 per session. For many survivors, that is not accessible, especially when they do not know where their next meal will come from.

   If we want survivors to have access to long-term exits out of the commercial sex industry, to maintain employment and healthy community relationships, and to go back to school, their mental health needs to be prioritized.

5. Get specialized trained in treating survivors of trafficking! Join YAMT’s Nurture Forward Directory. A directory geared towards bridging the gap in mental health services for survivors of trafficking nationally. With this directory, clinical providers gain access to bi-monthly trainings, yearly provider meet-ups, and an increase in your clinical network and more.