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By Paola M. Contreras, PsyD (Asst. Professor, William James College) and Diya Kallivayalil, PhD (Asst. Professor, Harvard Medical School)
Please note that the authors use the following abbreviations to identify themselves in the text: Dr. Paola M. Contreras uses PMC and Dr. Diya Kallivayalil uses DK.
January is Human Trafficking Awareness Month and there have been numerous developments since 2015 when I (PMC) last contributed to this blog. In the United States, some groups, such as women and young girls, remain more vulnerable to this crime yet overall, human trafficking does not have a single face. On a global scale, most concerning is the increased movement of refugees and migrants since 2014 and the recognition that within these groups are women, children, and men vulnerable to exploitation by traffickers (United Nations, 2016).
Even in the face of such setbacks, efforts to counter human trafficking in the United States and around the world have continued to evolve and come a long way in some areas. The APA's Committee for Women in Psychology (2017) released the Resolution on Human Trafficking in the United States, Especially of Women and Girls; an example of the organization's continued progress to raise awareness of a topic that is still often misunderstood and overlooked.
The APA resolution highlights that the populations most vulnerable to human trafficking in the United States are:
- women and girls;
- economically vulnerable persons,
- persons with disabilities, and
- runaway youth, with disproportionate vulnerability for youth who identify as gay, lesbian, bisexual, and transgender (GLBT);
The APA resolution encourages governments and philanthropic organizations to fund research to address gaps in knowledge related to human trafficking in several areas. Today, we (DK and PMC) will focus our thoughts on two areas where we believe psychologists in practice can be particularly helpful in anti-trafficking efforts:
- The training of professionals in information about industries where victims of human trafficking are commonly found; and
- The impact of societal biases on providing services to victims and survivors.
In our clinical work with survivors and victims of human trafficking, we hear accounts about human trafficking experiences that are riddled with complexities and, in some cases, contradictions that challenge our biases and assumptions. Before we proceed further it is important to point out that though we have both worked with people affected by sex trafficking and trafficking for manual labor â€"â€"exploitation that takes place in domestic work, agriculture, and factories among othersâ€"â€" most of our discussion today will focus on sex trafficking. Important to note is that trafficking for manual labor along with sex trafficking are the most prominent forms of exploitation noted in the United Nations' (2016) most recent report. The report also shows that trafficking can take on many other forms including: begging, forced marriages, benefits fraud, pornography production, and organ removal among others. Hence continued study of trafficking will also require researchers and policy makers to pay attention to these other, more hidden forms, of human trafficking.
I (PMC) supervise staff at RIA House, which provides a broad range of community-based services to adult women with experience in the commercial sex trade, and its associated exploitation, trafficking and prostitution. RIA House is one of many organizations that has moved towards a team model of service that includes peers with lived experience and multi-disciplinary health providers. The most important lesson that I (PMC) have learned supervising at RIA House is that there is no single pathway into trafficking. While researchers like Reid (2012) have identified trends into and out of trafficking that are important for prevention and intervention efforts, we still need to keep an open mind.
To bring our reflections into the day-to-day experience of working with victims and survivors, I (DK) interviewed Stacy Reed-Barnes, MSW, who is a social worker and peer mentor at RIA House. Ms. Reed-Barnes works with women affected by the commercial sex trade providing groups and one-to-one mentoring in shelters, substance abuse programs, in the community, prison, and any safe place where people are willing to meet with her. Ms. Reed-Barnes provided invaluable first-hand insight into some of the most pressing questions about anti-trafficking work in the United States today. I (DK) met with Ms. Reed-Barnes over the phone and as we talked, and I listened to the deep knowledge she has about trafficking. A wealth of information that she draws from her training as a social worker combined with her powerful life experiences.
As we (DK and PMC) reflected on the conversation with Ms. Reed-Barnes, we became more certain that engaging people affected by human trafficking into health services will require an approach that combines the evidence-based tools available to treat trauma, along with the invaluable knowledge that peers, like Ms. Reed-Barnes, have about the experience of human trafficking. Peers are able to establish a connection with people exiting from trafficking that, overtime, could turn into a healing therapeutic alliance. And in our experience, providers without lived experience, like us, cannot, in many cases, foster that necessary initial connection. Successful peer and professional collaborations that generate a robust outreach to victims and survivors need to be researched and evaluated to disseminate the knowledge they are producing and replicate this powerful form of engagement.
Ms. Reed-Barnes discussed the complexities inherent in building trust and credibility with this population and how the experience of being exploited casts a long shadow:
My clients don't like people who come to do presentations, groups, or workshops and say stuff like, "Yeah, we're coming to help, this is what can we do for you, you guys should do this, you guys should do that, and studies show…. people with lived experience be like, are they serious right now? I run a group at the jail, it's been going on for three years for women who've experienced human trafficking, prostitution, sexual exploitation, domestic violence, and so on. They don't like outsiders coming in and trying to tell them how to heal or get better from their lived experiences. they are past the pity stage. Inmates/victims/survivors feel if people have not walked in their shoes, they have no idea of how they should come back from suffering such a life. Most survivors don't want to hear an educated opinion or as they say "that stuffâ€ . It's an honor for me to be able to go to the prison. I've done my time, I am them, they are me. We are family. As a survivor and their peer it is my duty to bridge the gap, help open up their minds, and share that not everyone is out to hurt us. Moreover, we should not bite the hands that feeds us and tell people we don't need their help. Everybody needs somebody. I tell them that if that's going to continue to be our attitude, we are going to stay stuck. I tell them even though we may feel uncomfortable with their questions, nodding, and sad faces. We get to teach people how to treat us by sharing our acceptance and experiences. I tell my peers you have to stay open to learn something from people trying to educate you about certain things, you will NEVER know it all or get better for your experiences if you are not open to "real helpâ€ . That's how we stay stuck in the system and they bypass us, we don't trust anyone because we are broken, we have to allow people in to help us that have our best interest at heart. For the most part I am successful getting peers to think differently about what professionals want and can offer, instead of thinking everyone has an agenda. I help them understand we must work together.
I (DK) asked Ms. Reed-Barnes to describe what misperceptions exist about how women and girls get ensnared into trafficking and prostitution and she responded with the following:
People think we all got there [prostitution/trafficking] the same way. That either we were molested as children or we were runaways, or we got with the wrong boy. This is true for me and many of my friends. However, everybody didn't get there the same way. People often think that we were being naive and misinformed, looking for love in all the wrong places. Some of us really were. I got there from a dark place, I come from a super dysfunctional family, was molested as a child, so when the boyfriend/pimp told me he loved me, I did whatever he asked. On my journey, I have met a lot of girls who also came from well to do backgrounds and with both parents in the house. It just depends on the person. No matter how we got there, we all suffered in similar ways, coming from every direction and background.
Ms. Reed-Barnes also discussed the barriers that societal stigma creates in anti-trafficking work. A part of the problem seems to be the anti-trafficking community's tendency to isolate the sex trafficking experience from its association to the commercial sex trade and prostitution. In fact, the APA's (2014) report of the Task Force on the Trafficking of Women and Girls found that attempts to distinguish trafficking and prostitution are probably some of the most contentious conversations in the anti-trafficking field. The report points out that some consider prostitution to be a legitimate source of income and potentially empowering work, while other scholars argue that prostitution is inherently harmful. A documentary film recently released by the Media Education Foundation, Red Light/Green Light, through in-depth interviews with prominent social science researchers exposes the incontrovertible connections that exist between human trafficking and the commercial sex trade. An uncomfortable connection to accept, perhaps because for decades people caught up in the commercial sex trade and prostitution have been pushed to the margins of U.S. society (Silver, Karakurt, & Boysen, 2015) and often persecuted by law enforcement (Williamson, Baker, Jenkins, & Cluse-Tolar, 2007).
A relevant example of the continued failure to acknowledge the connections that exist between women and girls exploited and trafficked in prostitution is Cyntoia Brown. Ms. Brown was 16 years old when she murdered a man who bought her for sex; she is currently 30 years old. Today, with Safe Harbor laws instituted in many U.S. states that automatically define minors bought or sold for sex as victims of sex trafficking and offer them protection, Ms. Brown's fate may have been very different. Instead, the Tennessee Supreme Court recently ruled that she will be required to serve a 51-year sentence for killing the man that bought her for sex before she can be eligible for release. Brown's ruling was in response to a lawsuit where her legal team argued that her sentence was unconstitutional citing Miller v. Alabama, a US Supreme Court opinion (2012) that stated that life sentences without parole for juveniles violated the US Constitution. [UPDATE: Ms. Brown was granted clemency on January 7, 2019 by Tennesse Governor Bill Haslam].
Another issue central to anti-trafficking work in the United States that Ms. Brown's case highlights is the need to continue to address the issue of the demand, from (mostly) men, to purchase, (mostly) women and girls, for sex. Related to this, the APA's (2017) resolution notes promising evidence, which suggests that addressing sex buying in the United States could reduce rates of sex trafficking (Ali, 2009; Shively et al., 2012; Shively et al., 2010). Being inclusive of the many experiences of the commercial sex trade (i.e. prostitution, stripping, pornography, erotic massage, sugar daddy) that can become a pathway into trafficking, is an area where psychologists can help the provider community through awareness raising and training to improve prevention efforts.
Another example from practice about being inclusive of the many experiences that can lead to trafficking is the importance of distinguishing between language that is comfortable for providers, versus language that is familiar to affected people. Take for instance the use of the term "human traffickingâ€ , which may not meet an affected person's experience. To this last point, we asked Ms. Reed-Barnes about her opinion regarding the use of the term human trafficking. She noted that her clients hardly ever use the term. Ms. Reed-Barnes also said that, every now and then, she used the word human trafficking to refer to her experience yet emphasized the following:
I've never heard my clients or peers use that term [human trafficking]; they use the actual word prostitution to explain their experiences. Once they have come to terms with what they have done and feel safe knowing there’s no shame among peers, they call it as they have known it. The term [human trafficking] is mostly used by professionals, doctors, social workers, etc. My clients don't say sexual exploitation, they say what is that for them? When I participate in a group or presentation at a halfway house, it is best to address the elephant in the room right away. After doing so, I will use all the words, human or sex trafficking, sexual exploitation, substance abuse, alcoholism, domestic violence and wrap up.
Ms. Reed-Barnes also called for more coordinated services with substance abuse providers. She notes that the anti-trafficking community needs to gain a greater understanding of why there are high rates of substance abuse among women and girls with histories of exploitation. Ms. Reed-Barnes explained, for instance, that presentations on human trafficking in shelters and halfway houses are most beneficial to reach people affected by exploitation. She also discussed the quick judgments and societal biases that exist towards addicts trapped in the commercial sex trade. She emphatically noted, "I really hate the double stigmas or triple stigmas or just the cold-blooded shamingâ€ and described that for most people, drugs were the only way to numb their feelings and their thoughts through the physically and psychologically painful experience of sexual exploitation.
The release of the APA's (2017) resolution on human trafficking is yet another example that APA continues to be committed to joining the scores of efforts across the United States and the globe to eradicate the terrible crime of human trafficking. The opportunity that Ms. Reed-Barnes gave us to interview her for this piece also reminded us that collaboration across disciplines and with peers is an important next step for anti-trafficking efforts in the United States. To close, we want to take this opportunity to thank all U.S. providers and those across the globe engaged in anti-trafficking work. One step at a time we will continue to build a world that can offer dignity and freedom to all.
Ali, M. (2009). Assessment of the demand-supply interface of trafficking and commercial sexual exploitation. In C. Aghazarm & F. Laczko (Eds.), Human trafficking: New directions for research (pp.73-94). Geneva: International Organization for Migration.
American Psychological Association. (2017). Resolution on Human Trafficking in the United States, Especially of Women and Girls. Washington, DC: American Psychological Association. Retrieved from: http://www.apa.org/about/policy/trafficking-women-girls.aspx.
Dakin, A. (2018, December 8). Cyntoia must serve 51-years before she's eligible for release, Tennessee Supreme Court says. CNN. Retrieved from https://www.cnn.com/2018/12/07/us/cyntoia-brown-prison-release/index.html
Miller v. Alabama, 567 U.S. 460 (2012)
Shively, M., Kliorys, K., Wheeler, K., & Hunt, D. (2012). A national overview of prostitution and sex trafficking demand reduction efforts, final report. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/238796.pdf.
Shively, M., McLaughlin, K., Durchslag, R., McDonough, H., Kliorys, K., Nobo, C., Mauch, D. (2010). Developing a national action plan for eliminating sex trafficking, executive summary. Cambridge, MA: ABT Associates.
Silver, K. E., Karakurt, G., & Boysen, S. T. (2015). Predicting prosocial behavior toward sex-trafficked persons: The roles of empathy, belief in a just world, and attitudes toward prostitution. Journal of Aggression, Maltreatment, and Trauma, 24, 932â€"954. http://dx.doi.org/10.1080/10926771.2015.1070231
United Nations Office on Drugs and Crime (UNODC). (2016). Global report on trafficking in persons. Retrieved from https://www.unodc.org/documents/data-and-analysis/glotip/2016_Global_Report_on_Trafficking_in_Persons.pdf
Williamson, C., Baker, L., Jenkins, M., & Cluse-Tolar, T. (2007). Police-prostitute interactions: Sometimes discretion, sometimes misconduct. Journal of Progressive Human Services, 18(2), 15â€"37. doi:10.1300/j059v18n02_03
Paola M. Contreras, PsyD is a licensed psychologist and Assistant Professor at William James College where she teaches in the Counseling Department and is the lead researcher of the Human Trafficking Community Research Hub. Dr. Contreras is also an advanced candidate at the Boston Psychoanalytic Society and Institute. She consults to organizations that work with human trafficking on developing and implementing relationally-focused and trauma-informed services that increase participant engagement and prevent staff burnout through effective team work. She served on the APA's Presidential Task Force on the Trafficking of Women and Girls. She has conducted research on trafficking-related issues in Central America, including trafficking trends between that region and the U.S. She provides evaluation services to international survivors of trafficking in the U.S. and has imparted cross discipline trainings and consultation nationally on trauma and trafficking to mental health and other health providers, attorneys, law enforcement, and social services providers. Her scholarship on issues that affect women and girls has been widely recognized. She was the 2014 recipient of the APA's Emerging Leader for Women in Psychology Award.
Diya Kallivayalil PhD, is the Director of Training at the Victims of Violence Program at Cambridge Health Alliance and the trauma consultant for the Department of Psychiatry. She is an Assistant Professor in the Department of Psychiatry at Harvard Medical School. Her clinical specialty is in the treatment of trauma-related disorders. She is a member of the task force for human rights and the Committee on Women in Psychology (CWP) of the American Psychological Association. She has published in the areas of complex trauma, gender-based violence, homicide bereavement and refugee health. She is the co-author of the Trauma Recovery Group (2011) published by Guilford Press and the Trauma Information Group, published by Guilford in 2018.