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Ways of Coping

In response to the multi-faceted impact of victimization, this section will review forms of coping during and after the trafficking experience. As the survivors were asked what helped them to cope during the trafficking experience, the main response was descriptions of dissociation. Dissociation is also mentioned as a form of coping during the

Reintegration phase.

Types of Accessed Services:

Participant Cat Grace 3 Emerald 7 9 10 Kristine 14 15 16 Megan 18 Audrey Victoria

Shelter/Residential X x x x x x x x x x Emergency/Physical Assistance X x x x x x x x x Legal Support X X x x x x Victim Advocacy/Court Accompaniment X x x x Individual Counseling X X x x x x x x x x x x Support Group X X x x x x x Mentor/Support Person X x x x x x x Peer Support X x x x x x x x x x x x x x Case Management x x x x x x Group Therapy X x x Referrals X x x x x x x Job Program x x Survivor Leadership Training X X x x x Substance Abuse Treatment x x x Other x

Table 5 Types of Accessed Services Support

Group Mentor/Support Person Peer Support Case Management Group Therapy Referrals to other organizations Other Form of Coping % Talking/Support System ₈₀ Dissociation ₇₀ Avoidance/Faking it ₇₀ Spiritual Beliefs ₅₀ Substance Use ₅₀ Personal Strength/Perseverance ₃₅ Perception ₃₅ Writing ₃₅

Coping Skills/Techniques for trauma ₃₅ Self-Care/Exercise/Developing Interests ₃₅ Self-harm/Eating Disorder/Perfectionism ₃₅ Motivation of Children/Support of family ₃₅

Satisfaction with Care:

Throughout interviews, survivors were asked to describe their experiences with receiving services, such as accessibility, barriers and what they found helpful/not helpful. Overall, a continual theme amongst all participants is the lack of resources and the need for additional services specifically for trafficking survivors. The following sections highlight key utilized services that were discussed and considered helpful.

Counseling/Therapy: The majority of participants received therapy and described it as

helpful, specifically the demeanor, approach and commitment of the therapist, incorporating education about trauma, and providing clarity about distortions from trafficking experience. One participant mentioned her psychiatrist and medication as helpful. Megan discussed how her experience in therapy included both “traditional talk therapy” as well as a specific technique, Eye Movement Desensitization Reprocessing (EMDR), and she found both useful. This overview of her experience with therapy exemplifies these themes:

“So, I ended up going to therapy. I had a wonderful therapist and did about six months of traditional talk therapy and really stabilizing my daily routines and then six months of EMDR. And, voila, you have the half-way-functioning adult that you see before

you…That was huge. That was just another piece of that healing process. I did have an amazing therapist that I felt very comfortable with and was able to trust her and I was able to access trauma recovery therapy…she was very calm which was very nice and she taught me a lot of grounding techniques.”

Support Groups: Approximately half of those interviewed have attended support groups.

While a small portion had negative experiences going into general support groups, others expressed how helpful it was for them. Megan explained:

“She offered group therapy once and I was, like, I just don’t want to do that. It was for women who survived domestic violence in relationships and she was, like, I know that it

to come out and say that until I just went into group and I was like, yeah, I was in abusive marriage but, like, what I’m here for now is, you know, this is prostitution, like, having a pimp. And, they were very welcoming. Like, I’ve heard, like horrible things from other survivors that have tried to go to groups for domestic violence but that was a really good normalizing experience and understanding that domestic violence cycle and just some, like, coping and life skills, and communication skills.”

Shelter/Residential Programs: The majority of participants lived in a shelter or

residential program. Most found this helpful, though some commented on specific aspects of the program, such as the rules or the transition process from the program. Participants 3 and 6 described their opinions of the rules of the residential programs for trafficking survivors where they went after separation from the trafficker.

“I think they were absurd. A lot of girls, especially, got angry. You couldn’t have your cell phone on you, which I get it, like, location. And some people would stop their boyfriend or some people would want to go back to that life, so, and I get it’s for their safety but, like, I don’t know, you couldn’t have a TV in your room. So, there was one TV and sometimes I don’t want to be with them and sometimes I want to watch TV on my own” (Participant 3). “At first, I had to – I couldn’t use my phone. I felt like I was trapped at first but it really wasn’t. I got introduced to exercises. A lot of great women were there. I developed a

friendship with one of the women that was there…They really had a lot of rules. So, I wasn’t really used to rules -- I wasn’t used to, like, going to bed when they told me…Positive

atmosphere. Just the great people that they had there in general. A lot of services. Church. I really enjoyed that” (Emerald).

Emerald also commented that she did not see it as helpful to have survivors living together, showing the variety in individual needs and perceptions of services. “So they would tell me their stories and it was kind of horrible and I was thinking about my story. It was not a good idea to put us all together in the same house.”

Faith-based programs: Another emerging theme discussed by the participants, specifically

related to shelters, were their perspectives of faith-based programs. Their feedback most often included positive experiences about it impacting their life or faith, juxtaposed with concern for

how they felt a pressure to conform to the beliefs of the program. The following quotes conveyed some of their experiences:

“…church. I don’t know. I liked it but it wasn’t an option for girls. Not everyone’s Christian where you come from. So, it’s like – there’s no other option and you have to go to church on Sundays” (Emerald).

“I was in a recovery house and I didn’t want to be there anymore. It was a Christian recovery house and they were very strict. I felt like I was in placement all over again. And, I got pregnant and they frowned upon that. I do thank that place, though, because it gave me a reason to live, like, I found God and he helped me through a lot. I started going to church. I got a mentor at the church at that place” (Participant 7).

“I received residential services and that was extremely helpful. I would also say that there are things that were done that were not helpful within that service. They’re highly faith-based and, so, if you didn’t completely comply to their way of living, or comply to certain elements, like going to church or engaging in some faith-based services, then you weren’t allowed to continue to receive services there. For me, it was, basically, if I’m not here, there’s nowhere else for me to go. So, I would say, on one hand it was very

beneficial. I needed it. It changed my life in the sense that I wouldn’t be here today if it wasn’t for them. I would have never gone to school and got my undergrad and be working on academic pursuits if it wasn’t for them. So, it’s kind of like a double-edged sword” (Participant 14).

Memorable Experiences with Providers: Some participants had specific examples of

experiences with providers, such as judges, case managers, medical providers, who cared for them in a specific memorable way. Participant 14 had medical complications as a result of the years of victimization. She described her experiences with medical care, giving an example of trauma-informed care.

“I had an amazing anesthesiologist who, even to this day, I smile when I think about her. She understood trauma and she actually called me the night before my first surgery and she talked for a whole hour. She was like, I need you to be familiar with my voice. I’m just

So, this is like incredible. Like, she would do this on her own time because she came to the hospital an hour early – so, she created her schedule so she wouldn’t have any surgeries that morning and came to the hospital a whole hour early to come into my room to meet me face- to-face, to have a conversation with me. And, she’s like, okay, I want to help you. I’m going to do your hair for you. So, she actually braided my hair which was like, just helped me feel so safe just because she was going out of her way to make sure that I was going to be okay.” “I’m having medical services that understand trauma is a resource that I don’t think a lot of victims get that I’ve been very much grateful to have and have had some incredible doctors who, in a very trauma-informed way, have met my health needs to actually get me to a place where today I am able to engage in a very healthy manner. And, compared to where I’ve been, I’m very healthy today” (Participant 14).

Participant 14 also described the value of legal services, particularly offered pro bono. “My attorney is an amazing person who is very highly invested in me. I’m completely pro bono, and I would never have been able to receive the representation that she has given me. If it wasn’t for her going, I’m going to make a difference and I’m going to use my skillset to make a difference in this area. And, so, I really believe that we need more attorneys to step up and say, hey, you know what? There’s people out there who are very vulnerable and they need legal assistance and they need representation to protect them from the system. And, so, I’m very grateful for my attorneys. I’ve had multiple attorneys for different areas. So, definitely, that has been a huge resource that has been provided that has changed my life and I believe attorneys can change a victim’s life” (Participant 14).

Descriptions of Helpful Care: Repeated themes of services that participants credited as

most helpful include: Referrals to other services (including basic stabilization needs),

development of survivor leadership and empowerment skills, incorporation of peer support, and those that understood the longevity of needs for recovery. In addition,

participants stated the most helpful aspects of services included the approach of the

provider, including those with dedication for the duration, who were nonjudgmental, loving and provided a supportive relationship. Participant 15 discussed the benefits of

participating in online survivor leadership training:

“It has been really great because I didn’t – I started to learn about trafficking shortly after I got out and recognized that, that was what had happened to me. But, I didn’t have any resources that were specifically for survivors or any kind of support from other survivors or any kind of program or anything like that. So, finding this program was amazing because it’s

a program you can do from anywhere so it’s not like dependent on a local organization and you get all the support by the survivors and you are reading this book that completely

describes so many things about what you’ve been through and, so, you know. I started it last year and that was incredibly helpful just from the perspective of having resources that spoke to the actual trauma I had been through and not something that was made for other people but that we’re like applying to this because we don’t have any other resources.”

Participant 10 described an agency devoted specifically to serving trafficking survivors that acknowledged immediate and long-term needs:

“I was working with this non-profit for sex trafficking victims and I would say those things that have been helpful where there’s the crisis call. Say I’m with my pimp and I don’t want to be with him. They get me. Like, that’s been helpful. Or, like, when I got out, just needing hygiene. Every month – we do hygiene every month – like, being able to go through a supply of hygiene and clothing or like if they’ve had a stroller or, like, when I was pregnant, they gave me a baby shower where they had – I made a list of the things I needed and they had volunteers to buy everything. Those types of services have been helpful. Or they’ll give you gift cards if I need them. Just like having that service, like, where if I’m having a crisis they can come and get me or like meetings every other week just to like follow up and check in. That’s been very helpful, too.”

Participant 7 explained the prioritization of stable housing to protect vulnerability as well as to provide physical stabilization prior to receiving counseling. She also described the role and relationship with her caseworker:

“I haven’t really gone to counseling yet because I’ve been so busy. But, like, housing for me has been the biggest thing for me…It’s transitional living but it’s still my own apartment. You still pay rent. There were these people. And, they’re really trying to make human trafficking a big deal. I think my caseworker does a really good job at her job and

advocating for me and they pushed to get me into that apartment. And, they also have this rapid rehousing where they pay your rent for a year. That’s an important part, not letting them down and not putting them on the streets. If we’re on the streets, then what other choice do we have? Without a car to get – you know. It’s what else do you have to do? Go get a hotel room and go make some money to have a place to sleep.”

Participant 9 described the value of the attitude and demeanor of the staff and program: “The place that kinda helped build me up mentally, you know. You know, like, just giving me encouragement and trying to motivate me and just, like I said the

three times, I do believe. And, so, I stayed and went through the process. And, it was there to help me through the tears, through the hugs, through everything.”

This quote gives insight into the value she placed on their interaction with her, including when she was not quite ready for receiving help.

Descriptions of Dissatisfaction with Care: When survivors spoke about what was not

helpful, continual themes from the majority of participants were lack of understanding of human trafficking, services that do not listen or offer choice, unfulfilled promises, lack of resources, and experiences where they were re-traumatized or re-exploited, including using a participant for organizational gain. Participant 14 explained this idea of re-exploitation:

“I’ve experienced some very horrific experiences with service providers that has actually deeply wounded me and has made it even harder to trust -- organizations that might actually be very well-intentioned and actually really be able to help me -- and, so, I think really listening…I get concerned about re-exploitation and I definitely was re-exploited and I feel like, right now, human trafficking is this hot social justice topic issue and it is easy for victims to have been victimized, to be re-exploited in whatever means – it might be financial means. It might be being the poster child of the organization but not receiving compensation for what they’re being asked to do or the story that they’re being asked to share or they could be re-exploited in the sense of them not being treated like a human being should be treated and them not being given the resources that they actually need…I think that is something that I am supersensitive to because, under the name of an organization that was supposed to help me, that promised to help me that I thought was legit, did not.”

Participant 15 described the value of having a therapist who has training to understand trauma and the specific needs and experiences of trafficking victims:

“The therapy was really helpful. I don’t think that they were really equipped to deal with trafficking survivors. Like, my therapist did not bargain for that when she first met me, and she was a great therapist but kind of approached it as like a child abuse situation or like a domestic violence situation because that was like the whole analogy she had for it…I went through a few different therapists here trying to find a new therapist because I go to someone and they’d be like, oh, I know what trafficking is but, like, the vision they had in their head was, like, the person kidnapped from overseas and chained up in a basement and, like, they had no understanding of domestic sex trafficking and weren’t really willing to learn. I am willing to teach people if they’re willing to learn. But, running into that, misconceptions about trafficking and people just not being very

educated about it has been a really, a tough thing just in accessing health care in general and, particularly, like, mental health care and primary care physicians and, for a while there before I found my current psychiatrist, I went through hell with that psychiatrist who didn’t know what they were doing with trafficking. And, so, that’s probably one of the biggest barriers as well.”

Participant 15 also described her experience with a shelter, the lack of understanding and the demeanor that hindered satisfaction. In addition, it is an example of the need for long-term stabilizing support:

“When I was in the shelter after I got out of the hospital, my experience was primarily negative with that organization and they, like, rushed me out of transitional housing really fast and I haven’t had stable housing in a few years since I got out of the last relationship I was in because they kind of rushed me out of transitional housing and they have this mindset that – well, first of all, supposedly they work with trafficking survivors but nobody that I worked with there had any real knowledge of trafficking or understood anything about my situation. And, primarily, all the other people in the program were domestic violence survivors. And, they had this mindset that all their clients were trying to take advantage of the program and get free stuff and not have to work, and were not shy about telling us.” Cat described the need for survivor’s to be offered choice, yet the complexity for navigation of offering choice while also providing protection and structure:

“The only time I didn’t feel that way was when I was in a residential home. That was the only time that I felt like I didn’t have choices, you know, and that’s not a really good place to be with a survivor because she didn’t have choices before she came – before she got out of the life. She had no choices. I felt that way. But, for the majority -- that was probably in the beginning. And, I think, you know, that it wasn’t intentional – I don’t feel that it was

intentional. I just feel like sometimes people don’t know what to do, and they want to protect you and they want you to be safe and they feel like almost – they’re keeping you safe from