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MENTALHEALTHCOORDINATINGCOUNCIL

TRAUMAINFORMEDCAREANDPRACTICE‐MEETINGTHECHALLENGE

2011CONFERENCE

TraumaInformedCareandPracticeforTraffickedPeopleandCALD

Populations

LauraVidal

TheSalvationArmy‐SafeHouseforTraffickedWomen

P:(02)92115794

E:laura.vidal@aue.salvationarmy.org

Thefollowingscenarioisbasedontrueevents.

Amyisa32‐year‐oldwomanfromIndia.Amyisthemotherofthreechildrenand

hasbeenstrugglingtoprovidefoodandshelterforherfamily,asemployment

opportunitiesinhervillageareverylimited.Amyrespondedtoanadvertisementin

thenewspaperforadomestichelperinanefforttoearnmoneyforherfamily.Amy

calledthenumberlistedontheadvertisementandarrangedtomeettheemployer

inDelhiwhereheexplainedtoAmythatshewouldbetravellingtoAustraliatowork

intheprivatehomeofhisAuntandUnclewhowereelderlyandinneedof

somebodytotakecareofthecooking,cleaningandwashing.Amywasalittletaken

backbythefactthatshewouldberequiredtotraveltoAustralia,butdecidedthat

jobopportunitieswerescarceandcontinuedtolistentotheconditionsof

employment.TheemployerexplainedtoAmythatshewouldberequiredtolivein

hisAuntandUnclespropertybutwouldonlyberequiredtoworkfrom9am‐5pm

eachday.Shewastoldshewouldbepaid$20.00p/dayandwouldhavefreedomto

comeandgofromthehouseandcallherfamily.Amythoughtthiscouldbetheone‐

wayshecouldprovideforherfamilyandcreateafutureforherchildren.Amyasked

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thebosshowshewouldtraveltoAustralia,thebossstatedthathewouldarrange

Amy’spassport,VisaandplanetickettellingAmythatthiswaspartofthe

employmentpackage.ThebosssuggestedthatperhapsAmycouldtryitfor6

monthsandifitwasn’tforhershecouldreturnhometoherfamily.Whilstitwas

difficulttoleaveherchildren,sheagreedtotrythisjobopportunityfor6months

andleftherchildreninthecareofherparentsonthepromisethatthemoneyshe

wasearningshewouldsendhometoherchildren.

AmyarrivedinAustraliaunderescortofheremployer.Shewastransportedtothe

houseofhisAuntandUnclewhoseemedlikenicepeople.Theemployerstayedfora

fewhoursandthenleftthehouse.Hetoldherthatifshehadanyproblemsor

questionsshecouldcallhimandgaveherisphonenumber.Amyneversaworspoke

tohimagain.

Thefirstdayatthehousewasfine;Amycompletedthecooking,washingand

cleaningandworkedthepromised8hours.AmyenquiredtotheUncleastowhen

shewouldreceiveherpayandheinformedherthatshewouldbepaidattheendof

eachweeksheworked.Amycontinuedthisworkforaweekandattheendofthe

weekAmyrequestedherwagesfromtheUncle,hestatedthathedidn’thavemoney

topayherandshewouldhavetowait.Amyfeltdisappointedandanxiousbecause

sheknewherchildrenneededthemoney.

WeekspassedwhereAmystillwasnotpaidforherwork.WhenAmyaskedabout

herwagestheUnclebecameveryangryandstartedtoyellatAmyandtellherthat

hewasdissatisfiedwithherworksoshewouldnotbegettingpaiduntilhewas

satisfied.Amywasshockedandsurprisedbythisbecauseitwasthefirsttimeshe

hadheardthecoupleweredissatisfiedwiththeworkshewasdoing.

Shebegantoworklongerdays,andwastoldthatshecouldnotleavethehouseuntil

alltheworkwasdoneandthecouplecontinuedtoaddtaskstothelistmakingit

impossibleforhertobeabletoleave.Amyhadneversightedhertraveldocuments

asheroriginalemployerarrangedhertravelandshewasescortedtoAustralia.Amy

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triedtocalltheemployertoexplainthatshewasnotbeingpaidanditwasnot

workingoutaspromised,thephonenumberwasdisconnected.

Amyfelttrapped;shehadnothingtoproveheridentityortoexplainwhyshewasin

Australia,shewasunfamiliarwiththeareashelivedanddidnotunderstandhow

thingsworkedinAustralia.AmyaskedtheUncletohelpherarrangetogohomeas

shewashereona6‐monthtrialandshedidn’tfeelitwasworkingandneededto

returnhometoherchildren.Themanbecameveryangryandphysicallyassaulted

Amyandthrewherinthebedroom.Amysatcryingforhourswhiletheman

continuedtoyellatAmyfrombehindthedoor.

ThenextmorningAmypackedherbagstoleave,shedidn’tknowwhereshewas

goingtogobutshethoughtanywherewouldhavebeenbetterthanwhereshewas.

Whenthemannoticedshewastryingtoleavehephysicallyassaultedheragainand

restrainedherfromleavingthehouse.Heyelled“thiswasnotpartofthedeal,Ipaid

goodmoneyforyou,nowyouwillstayanddoasIsay”Amywasagainshockedand

wonderedwhathehadmeantbythefactthatshehadbeenpaidfor.

Amywasinthissituationfor3years,shewasphysically,psychologicallyandsexually

abusedonadailybasis.

WHATISHUMANTRAFFICKING?

So,fromthisscenariowhatcanwesaydefinesHumanTrafficking?TheUnited

NationsdefinesHumanTraffickingas“Therecruitment,transportation,transfer,

harboringorreceiptofpersons,bymeansofthethreatoruseofforceorotherforms

ofcoercion,ofabduction,offraud,ofdeception,oftheabuseofpoweror

ofapositionofvulnerabilityorofthegivingorreceivingofpaymentsorbenefitsto

achievetheconsentofapersonhavingcontroloveranotherperson,forthepurpose

ofexploitation.Exploitationshallinclude,ataminimum,theexploitationofthe

prostitutionofothersorotherformsofsexualexploitation,forcedlabororservices,

slaveryorpracticessimilartoslavery,servitudeortheremovaloforgans.”(United

NationsProtocoltoPrevent,SuppressandPunishTraffickinginPersons,2003)

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TypicallyHumanTraffickinghasthreedistinctelementsprocess,meansandend.If

werelatethesethreeelementstoAmy’ssituationwecanseethattherewasa

processofrecruitmentbywayofnewspaperadvertisement,meansbywayof

coercionandendtheuseofforcedlabour

WHATDOESHUMANTRAFFICKINGLOOKLIKEINAUSTRALIA?

TheAustralianGovernmentconsiderstraffickinginPersonstoAustraliaarelatively

newfocusarea,withapolicyresponsefromtheCommonwealthofAustraliacoming

tofruitionin2004.Inthepolicy’searlystagestherewasaparticularfocusplacedon

traffickingforthepurposeofsexualexploitation.Withthisasthefocusitwas

reportedthatlessthan100womenandmenaretraffickedtoAustraliaeachyear.

(AustralianGovernment,2004).

InpresenttimesAustraliahasbeguntolearnthatTraffickinginPersonsispresentin

morecontextsthanthesexindustry.Recently,thefocushasbeguntoshifttothe

existenceoftraffickingforthepurposeofLabourExploitation(David,2010)for

example,construction,textilesandagriculture.

Poorstandardsofliving,loweducationlevelsandimpoverishedpopulationsoften

characterizethelivingconditionsinthesourcecountriesofTraffickinginPersons

“Humantraffickerspreyonthevulnerable”(USStateDepartment,2008)Traffickers

oftenpresentopportunitiesthataddressindividual’sdesperationforanimproved

wayoflife.“Theirploysarecreativeandruthless,designedtotrickcoerceandwin

theconfidenceofpotentialvictims.Veryoftentheserusesinvolvepromisesofa

betterlifethroughemployment,educationalopportunities,ormarriage”(USState

Department,2008)

JustlikeAmy,Womenandmenareoftenpresentedwithopportunitiesof

employmentinanothercountry,butwhentheyarriveinthecountryofdestination

theyfindsituationssignificantlydifferenttowhattheyhadoriginallyconsentedto.

Certainlytheymayhaveconsentedtothetypeofwork,butnottheexploitative

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conditions.CommonexperiencesofpeopleTraffickedtoAustraliaincludepoor

workingconditions,providinglabourwithoutpay,beingforcedtoliveattheir

workplace,sexual,physicalandverbalabuse,restrictedfreedomandconfiscationof

identityandtraveldocuments.(Stanger,Pers.Comm.,2010)Itcanbearguedthat

theproblemoftraffickinginpersonsisinfactasymptomofwidersystemic

problems;comprisedlargelyofalltheelementsofglobalisedpoverty,asindividuals

inimpoverishednationscontinuetosearchforopportunitiestobettertheirlives.

VictimsusuallyenterAustraliawithvaliddocumentationunderthepromisethat

theyaregoingtobeofferedafairworkopportunity.(Stanger,Pers.Comm.,2010)

Pearson(2007)states“themajorityoftraffickedpeoplehavetendedtoenter

Australialegallyontourist,studentorworkvisas,butendedupinsituationsof

exploitationakintodebtbondageorforcedlabour”

Globallytraffickingforthepurposeofsexualexploitationiswidelyreported.The

issueoftraffickingwomenforthepurposeofsexualexploitationhasledtothe

developmentofinternationalinstruments,inparticularthefirstinstrument,The

UnitedNationsConventionfortheSuppressionoftheTrafficinPersonsandthe

ExploitationoftheProstitutionofOthers(1951)Inmorerecenttimes,particularlyin

thelasttwoyears,anecdotalevidencesuggeststhatAustraliahasagrowingrateof

traffickingforthepurposeoflabourexploitation.FionaDavidofTheAustralian

InstituteofCriminology(AIC)hasrecentlycompletedapreliminarystudywhichcalls

forgreaterresearchintotheareaoftraffickingforthepurposesoflabour

exploitation(2010)TheAustralianGovernmentAttorney‐General’sDepartmentis

currentlygoingthroughaconsultationprocesstoaddresstheirresponseto

traffickingforthepurposesoflabourexploitation.

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THEAUSTRALIANGOVERNMENTRESPONSE

TheAustralianGovernmentsharescommunityconcernaboutthewelfareofvictims

oftraffickingandhasrespondedbyintroducingacomprehensivevictimsupport

packageforthosevictimswhochoosetoparticipateinacriminalinvestigationledby

TheAustralianFederalPolice.

Acase‐managementapproachisused,andsuspectedvictimswhoaregranteda

BridgingFVisacanreceiveintensivesupportfortheperiodoftheVisa’svalidityor

untiltheywishtoleaveAustralia,whicheveroccursfirst.Thissupportincludes

temporaryaccommodation,accesstoMedicareandmedicalservices,counselling

andlegalservices,training,andsocialsupport.Victimswhoaresubsequently

grantedaCriminalJusticeStayVisacancontinuetoreceivesupport.

Additionally,victimswho,asaresultoftheircontributiontoaninvestigationorthe

prosecutionofpeople‐traffickingoffenders,aredeemedatriskofharmifthey

returntotheirhomecountrymaybeeligibleforapermanentWitnessProtection

(Trafficking)Visa.

THESAFEHOUSEFORTRAFFICKEDWOMEN

TheSalvationArmy’sSafeHouseforTraffickedWomenprovidessupported

accommodationandcomprehensivecasemanagementservicestovictimsofhuman

trafficking,slaveryandslavery‐likepractices.Theservicealsohassomecapacityto

meettheneedsoftraffickedmen,womenandchildrenlivinginthecommunity.

TheSafeHouseassessespeopleaspertheUnitedNationsdefinitionofHuman

Traffickingandprovisionofservicesisnotlimitedtotheirchoiceorcapacityto

participateinacriminalinvestigation,thisisadistinctdifferencebetweenThe

SalvationArmyprogramandtheprogramofferedbytheCommonwealth

government.

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TheSafeHouseisengagedinbothdirectandindirectserviceshoweverdirectly

relatedtothefocusofthispaperistraumainformedcare,whichspeakstothedirect

worktheservicedoeswithvictimsoftrafficking.BroadlyTheSafeHouseaimsto

upholdpeoplesrightsandinterests,achieveequitableaccesstosocial,economic

andpoliticalresources,providedirectassistanceandsupport,raiseawarenessof

structuralinequalities,promotepolicesandpracticesthathaveafairallocationof

socialresourcesandactforsocialchangetoreducesocialbarriers,inequitiesand

injustice.

TRAFFICKEDPERSONSANDTRAUMAINFORMEDCARE

Thereiscurrentlyonlyasmallbodyofpublishedresearchonthehealth

consequencesofanyformofhumantrafficking,andthereisanextremelylimited

bodyofresearchonthementalhealthconsequencesoftrafficking.Mosttrafficking‐

relatedhealthstudieshavefocusedonsexuallytransmittedinfectionsamong

traffickedwomenforsexualexploitation.ArecentstudypublishedintheAmerican

JournalofPublicHealth(2010)foundthatinjuriesandsexualviolenceduring

traffickingwereassociatedwithhigherlevelsofPTSD,depressionandanxiety.Italso

concludedthattheystudyservestoinformtheemergingfieldofmentalhealthcare

fortraffickedpersonsbyhighlightingtheimportanceofassessingseverityand

durationoftraffickingrelatedabusesandtheneedforadequaterecoverytime.

Forexample,wehavefoundthatsometimessomepeoplearerushedbyexternal

proceduresparticularlywithintheCriminalJusticeprocessandtheyfindthemselves

withdrawingfromthejusticesystem;realizingoncetimehaslapsed,havinghadthe

opportunitytoprocessthetrauma,theymayhavemadethewrongchoice,orregret

thechoicestheymade.

AnecdotallyworkatTheSafeHouse,showsthatthepeopleweworkwithmore

oftenthannotexperiencevaryingdegreesofPTSD,DepressionandAnxiety.People

whohaveexperiencedslaveryoftenpresentsymptomsofpost‐traumaticstress–

dissociativedisorder,anxiety,flashbacks,nightmares,intrusivethoughtsandan

inabilitytoconcentrate.Often,theydon’teatorsleepenoughandaredepressed.

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Theyexpressshameandself‐blameathavingbeenluredbythefalsepromisesof

theirtraffickers.Theyfeelthattimehasbeenstolenfromthemandtheuncertainty

ofthefuturemakescopingwithdailylivingdifficult.Someresidentsmaybebattling

addictionandsomemaybefeelingsuicidal.Theymayfeartheirtraffickersand/or

theirassociateswhomightstillbeinthecommunityorclosetofamiliesathome.

Theirfamiliesmayactuallybeindangeranddebt.Boredomcontributestodeclining

mentalhealthassomemaynotbeauthorizedtoworkorstudyandareawaitingan

outcomeregardingtheirimmigrationstatus.NearlyeveryenslavedpersonIhave

encounteredidentifiesthemselveswithareligion.Thetraffickingexperienceleaves

manypeoplefeelingabandonedbyGod.AtTheSafeHouse,andthroughour

communitypartners,wecanassistresidentstoreconnectwiththeirspirituality.Itis

apriorityofcareofferedatTheSafeHousethatpeoplehavetheopportunityto

accessappropriatementalhealthservicesandongoingpsychologicalcare,andbe

giventheopportunitytoreconnectwiththeirspirituality.

TheconclusionsbyabovementionedstudybytheAmericanJournalofPublicHealth

areparticularlypertinentinthecurrentclimateofanti‐traffickingmeasuresin

Australia.Whilstacknowledgementismadethatvictimsmaybeexperiencing

difficultieswithtrauma,practiceshowsthatthejusticeprocessislimitedintermsof

acknowledgingthefullcycleoftrauma,includingthebenefitstoaninvestigation

whentraumahasbeenprocessed.Thisispotentiallydamagingtoanindividuals

ongoingrecoveryandrehabilitation.

THESAFEHOUSEFORTRAFFICKEDWOMENANDTRAUMAINFORMEDCARE

AsestablishedearlierTheSafeHouseforTraffickedWomenprovidessupported

accommodationandcomprehensivecaseworksupportforthefullspectrumofones

needsincludingaccommodation,health,mentalhealth,legalsupport,rights

education,andeducationandemploymentsupport.Itisarightsbasedenvironment

premisedonclientdrivencasegoals,informationsharingandclearandtransparent

communication.

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WithregardthetraumainformedcareTheSafeHouseprovidesasafeenvironment

inwhichthepersoncanbegintolearnaffectcontrolandfeelsafe.Inorderto

promotesuchsafety,staffaremadeawareofpotentialtriggersandreactionsto

triggers.Staffestablishstrategieswithclientstoworkoncalmingthemselveswhen

theyhavebeentriggered.

Theservicesoperatesonadonoharmpolicy,whichisakeyelementtotrauma

informedcare.Theserviceacknowledgesthattraumaimpactsoneachindividual

differentlydependingonone’spersonalhistorywithtrauma,socialandfamilial

supportsandnaturalcopingskills,forthisreasonworkwitheachpersonis

individualizedandeachpersonthattheserviceworkswithhasacustomizedand

specificcareplan.

HumanTraffickingisconsideredacomplextrauma.Itinvolvesmultipleorprolonged

traumaticevents.Itresultsinemotionaldysregulation,lossofsafety,directionand

theabilitytodetectandrespondtodangercues(Herman,1992)Itisimperativethat

theserviceoperatesonthecoreprinciplesoftraumainformedcare(adaptedfrom

theHeadingtonInstitute,2010)including:

• Understandingoftraumaand

itsimpact

• Understandingvicarious

traumaanditsimpact

• Promotingsafety

• Ensuringculturalhumility

• Supportingclientcontrol,

choiceandautonomy

• Sharingpowerandgovernance

• Integratedandholisticsystem

ofcare

• Caringandsupportive

relationships

• Ongoinghealthyboundary

analysis

• Beliefthatrecoveryispossible

Humantraffickingprimarilyinvolvesthelossofcontrol;perpetratorsinstillfearto

control.Fearisalsoincreasedbyinconsistentandunpredictableoutburstsof

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violenceandcapriciousenforcementofpettyrules.Theultimateeffectofthese

techniquesistoconvincethevictimthattheperpetratorisomnipotent,that

resistanceisfutileandthattheirlifedependsupwinninghisindulgencethrough

absolutecompliance(Herman,1993)Thisisasignificantconsiderationinworkat

TheSafeHouseinthatcaseworkandsupportservicesaredeliveredfroma

strengths‐basedandclientdirectedperspectivetoensurethatvictimsbegintobe

empoweredandtakebackcontrolovertheirownlives.Caseworkandsupport

servicesareconsideredtobeacollaborativeprocesswherebyworkwiththeperson

isapartnership.

ESSENTIALNEEDSOFTRAFFICKEDPERSONS

Traffickedpeopleareamarginalizedandvulnerablegroupofpeople.Thereare

manyessentialneedsthattraffickedpeoplehavethatincludeboththeprovisionof

practicalneedssuchasaccommodation,foodandclothingandmentalhealth

supportincludingestablishinggenuinesafetyandaddressingdeep‐seated

vulnerabilitiestoavoidfurtherexploitation;includingexperiencesoftraumabefore

traffickingoccurs.Itisnecessarythatsupportservicesandinparticularmental

healthcareprovidersspendtimeaddressingvulnerabilitiesoutsideofthetrafficking

experienceasthisinfluencesthetreatmentprocessandongoingachievementof

rehabilitation.

Asexpectedifoftentakesalongtimeforclientstoestablishtrust,theyhavehad

theirtrustabusedandhavebeentakenadvantageofasaresultofplacingtrustin

somebody.Itisoncetrustisestablishedfurtherneedsofthepersoncanbemet.Itis

importantthatvictimsareempoweredthroughouttheirrehabilitationprocess,

whichincludesencouragingtheirparticipationandofferinginformationandsupport.

Providerswhorecognisetheintersectionofphysicalandpsychologicalproblemsin

traffickingvictimscanaddressphysicalandmentalhealthneedsinanintegrated

way.

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Criticaltothesupportoftraffickedpeopleisanongoingexplanationoftheirrights,

providingchoicesandallowingthemtoestablishcontrolovertheirownlives.Thisis

achievedthroughclientcentered,rightsbasedpractice

ENGAGINGCALDCOMMUNITIES

Itisherethatoneshouldnotetheimportanceofculturallyappropriateservicesand

inparticularmentalhealthintervention.

CulturallyandLinguisticallyDiverse(CALD)communitiesareunique.Theyareunique

inthesensethatnotonlyistheirlanguageabarrierintermsofaccessingservices

buttheirculturallensorviewisdifferenttothattypicallyunderstoodbythewestern

world.

Often,itismisunderstoodthatprovidingaculturallyappropriateorsensitiveservice

referstoprovidingaccesstoservicesinalanguagethatcanbebestunderstoodby

theserviceuser.Thisisinfactinaccurate.Culturallyappropriateorsensitiveservices

refertotheabilityofaservicetonotonlymeettheneedsofserviceusers

linguisticallybuttohaveanunderstandingofculturalvaluesandunderstandings.

Wherepossible,serviceprovidersshouldconsultwithculturallyspecificworkers

whomaybeabletogivesupporttothetherapeuticprocess.

InourexperienceithasbeenchallengingtoengageindividualsfromaCALD

backgroundwithmentalhealthservices.Theengagementisdifficultontwolevels,

1)becauseoftheirvisastatusand2)thewholeconceptofmentalhealthservicesis

foreign.

Thefirstchallengeismoredifficulttoaddressthanthesecondasitisastructural

barrierandsometimesreliesonthegoodwillofpractitionerstooffercounselingor

mentalhealthservicesatreducedratesoronapro‐bonobasis.Thesecond

challengeisaddressedatTheSafeHouseinavarietyofways.

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Firstandforemost,afteratrustrelationshipisbuilttheclientisintroducedtothe

ideaofmentalhealthsupportinanon‐confrontingmanner,alwaysemphasizingthat

itisarelationshipthattheyhavetotalcontrolover.Considerationoftraumaand

previousexperienceshereisalsoimperative.Conceptssuchasconfidentialityand

informedconsentaloneposeachallengeasagainmoreoftenthannottheindividual

maynothavehadtheopportunitytoexperiencesituationswheretheirinformation

waskeptconfidentialortheyhavebeengivenachoicetoconsenttoaparticular

activity.Infact,theconceptsofconfidentialityandinformedconsentareprobably

notconceptssuchindividualshaveeverbeenexposedto,andthusrequire

explanationoftheterms.

Thetypeoftreatmentthatisintroducedtoindividualsisofcoursedependanton

theirownindividualcareplanandtheirarticulatedneeds.Inourexperience

membersofCALDcommunitiesrespondmoreeffectivelytotherapies,whichdonot

involvetalkingasthemainbasisofintervention.Peopleoftenexperienceshame

aroundtheirexperienceanditisnotsomethingthattheyfeelcomfortabletalking

aboutinthefirstinstance.Creativetherapiessuchasarttherapyorrecreationaltype

therapiesengagemembersofCALDcommunitiesbecausetheseareactivitiesof

whichtheyarefamiliarandinvolvehealingthroughdoingratherthantalking;and

canalsobeawaytobuildtrustandworktowardmore‘talking’basedtherapeutic

interventions.

AnotherkeytoengagingCALDcommunitiesinmentalhealthsupportsand

therapeuticinterventionsiscollaborativepractice.Inourworkwithtraffickedpeople

aninvaluablemechanismiscollaboration.Asyoucanunderstand,therepetitionof

onesexperiencethroughoutthehelpingprocesscanoftencompoundthetrauma,

thepeoplewehaveworkedwithoftendiscusstheadvantageofcasemanagers

beinginvolvedintheinitialstagesofthetherapeuticrelationshipandinproviding

backgroundinformationaroundtheirsituationtomentalhealthserviceproviders.

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VIEWFROMSERVICEUSERS/TRAFFICKEDPEOPLE

Ashighlightedthroughoutthispaper,theclientbeingpositionedatthecentreofthe

helpingprocessisintegraltoongoingworkoftraumainformedservicesandthe

workofTheSafeHouse.

TheSafeHouseoftenengageswithitsserviceuserswithrespecttohowtheyfeel

aboutdifferentprocessesbothwithintheserviceandatthebroaderspectrumof

anti‐traffickingmeasuresandsupportservices.ItisthroughthisfeedbackthatThe

SafeHouseframestheiradvocacyandcontinuestoimprovetheirownservice

provision.

Forexample,whenoneresidentwasaskedabouthowtheyfeltafteraninterview

withanagencyabouttheirtraffickingexperiencethefollowingresponsewasgiven:

“theyhavetounderstandthatwecomefromdifferentbackgroundsandunlikeinmy

countrywedohaveoptions.Soit’skindoftheyhavetogiveustimenottopushus,

everythinginarush…whenyoutakeeverythinginarushIdon’thavesay,Idon’t

haveanythingthatIcando,orsuggestionsIcanraise.Thereisnowayout.Youjust

continuepushingme;andyouhavetoleave.Iftheydon’twanttolistentowhat’s

mademebehere,it’sliketellingsomeoneyouhavetoenterintoaholeandyou

don’tknowtheriskyouwillfaceifyouenterintothathole.Sothebestthingtogive

istimeandachancetoexplain,puteverythingintheopen…atleasttohavetime”

(SafeHouseResident,2011)

Thisoneviewalonehighlightsjusthowimportantitistoconsidertheimpactof

traumainallinteractionswithvictimsoftrafficking,andtoalsoconsiderthe

elementsofchoice,timeandculturalperspective.

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WAYSFORWARD

Asawayofsummary,Inowsuggestwaysinwhichservicescanmovetowardtrauma

informedcare,aspremisedbyourworkwithvictimsofpeopletrafficking‐

1. Createsafeandrights‐basedenvironments;

2. Donoharm;

3. Promotetheachievementofequality;

4. Createclient‐centeredenvironmentswithindividualizedcareplans;

5. OperateontheEmpowermentprinciples,creatingpartnershipswithservice

usersandallowingserviceuserstotakecontrolovertheirownlives;

6. Considertheseverityanddurationoftraumaasameanstoassesstheimpact

oftrauma;

7. Informationsharing,withclearandtransparentcommunicationatalltimes;

8. Ensurestaffarealltrainedinelementsoftraumaandareawareofservice

usertriggers,andstrategiestoaddressreactionstosuchtriggers;

9. Introducealternativetherapies;

10. Createculturallycompetent,sensitiveandawareservicesand

11. Promoteandengageincollaborativepracticeasawayofreducingtherateof

re‐traumatisation.

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References

CommonwealthofAustralia,(June2004)AustralianGovernmentsNationalAction

PlantoEradicateTraffickinginPersons,Canberra,ACT

David.F(2010)‘LabourTrafficking’,AICReportsResearchandPublicPolicySeries

108,AustralianInstituteofCriminology,Canberra,ACT

DepartmentofState,UnitedStatesofAmerica(2009)‘Australia’inTraffickingin

PersonsReport,Publication11407,OfficeoftheUnderSecretaryforDemocracyand

GlobalAffairsandBureauofPublicAffairs

DepartmentofState,UnitedStatesofAmerica(2008)‘Introduction’inTraffickingin

PersonsReport,Publication11407,OfficeoftheUnderSecretaryforDemocracyand

GlobalAffairsandBureauofPublicAffairs

HeadingtonInstitute(2010)CorePrinciplesofTraumaInformedCare,

http://www.headington‐institute.org/

Herman,J(1992)TraumaandRecovery,BasicBooks,NewYork

HossainM.Zimmerman,C.Abas,M.Light,M.Watts,C.TheRelationshipofTrauma

toMentalDisordersAmongTraffickedandSexuallyExploitedGirlsandWomen,

AmericanJournalofPublicHealth,2010;100(12):2442‐2449

Pearson,E.(2007)‘Australia’inCollateralDamage:Theimpactofanti‐trafficking

measuresonhumanrightsandtheworld,TheGlobalAllianceAgainstTraffickingin

Women,AmarinPrintingandPublishingPublicCompany,Thailand

Stanger,J(2010),TheSalvationArmy‐SafeHouseforTraffickedWomen,Personal

Communication

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UnitedNations(2000)ProtocoltoPrevent,SuppressandPunishTraffickingin

Persons,EspeciallyWomenandChildren,SupplementingtheUnitedNations

ConventionAgainstTransnationalOrganisedCrime,UNDoc.A/45/49,

http://www.uncjin.org/Documents/Conventions/dcatoc/final_documents_2/conven

tion_%20traff_eng.pdf,Accessed9October2009

DISCLOSURE:ThispaperexpressestheviewofLauraVidalonbehalfofTheSalvationArmy

SafeHouseforTraffickedWomen.TheintendedaudienceistheMentalHealthCoordinating

CouncilofAustralia,conferenceonTraumaInformedCare.Nopartofthepaperis

authorizedforreproductionwithouttheexpresspermissionoftheauthor.