240757 First, do no harm: Designing a model of trauma-informed care for survivors of human trafficking

Monday, October 31, 2011: 10:30 AM

Annie Fehrenbacher, MPH , Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA
     
Background: The health consequences of human trafficking pose serious challenges both for trafficking survivors and the health professionals who assist them. Although the health care system is meant to aid survivors on their path to recovery, clinical settings may also incite fear and distrust among survivors.

Objective: This exploratory study examines some of the systems-level barriers to providing comprehensive health care to trafficking survivors and offers suggestions for improving service delivery and patient-provider interactions. This project aims to create conditions in the health care setting that minimize the possibility to re-traumatize trafficking patients.

Methods: This project uses a mixed-methods approach including literature reviews, patient case studies, and key informant interviews with service providers. Case studies demonstrate the challenges posed by re-trafficking, re-traumatization, language barriers, and culturally-dependent interpretations of symptoms.

Results: Many survivors of human trafficking experience anxiety in medical settings. Some are uneasy in waiting rooms full of people they do not know and trust, while others fear that practitioners will force them to divulge details about their trafficking situations and/or will not believe their stories. Still others view medical examinations as invasive or reminiscent of past abuses. Providers must recognize the ways in which past traumas influence patients' behaviors and perceptions of their bodies.

Discussion: The findings demonstrate the need for improved understanding of human trafficking in the clinical setting incorporating training of all clinical staff that interact with patients, including clerical workers, medical assistants, and phlebotomists. Even a brief callous remark or judgmental stare can change the course of a patients' recovery, particularly if that patient decides not to return for follow-up care as a result of perceived mistreatment.

Conclusion: Creating a clinical environment in which human trafficking survivors feel safe and respected is crucial to ensuring successful recovery and reintegration.

Learning Areas:
Diversity and culture
Ethics, professional and legal requirements
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Define trauma-informed care. List 3-4 unique challenges faced by health professionals working with trafficked persons. Describe how health interventions can promote healing or lead to re-traumatization.

Keywords: Immigrants, Human Rights

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in public health with over three years of experience conducting research on human trafficking. I am the co-founder of the UCLA Anti-Trafficking and Human Rights Coalition and the Education Director for the Coalition to Abolish Slavery and Trafficking Shelter Collaboration. I am also a clinic assistant at the Saban Free Clinic Human Trafficking Program, where I work directly with survivors of human trafficking.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Barriers and Enablers that promote or impede health of immigrants and refugees
See more of: Caucus on Refugee and Immigrant Health