Human Trafficking: A Treatment Guide for Mental Health Professionals

by John H. Coverdale MD, Mollie R. Gordon MD, Phuong T. Nguyen PhD

Overview

Human Trafficking: A Treatment Guide for Mental Health Professionals is the first book on human trafficking and mental health. The editors have marshalled their considerable experience developing resources and interventional programs for this patient population, as well as expertise in research and scholarly writing, to create a unique—and uniquely useful—guide for clinicians likely to encounter trafficked patients. Foundational to the effort is recognizing that their numbers are legion, and growing, and that their safety and well-being depends on the ability of clinicians to screen, assess, and identify them in a system that often constructs barriers to care. Epidemiological data is provided to help clinicians understand the factors that contribute to being trafficked, the associated consequences, and the role of health professionals in combatting it. Screening processes are discussed, and potential barriers, both organizational and provider-based, to the identification of trafficked persons are explored. The next section addresses sensitive, trauma-informed, and integrated patient management in different settings, including emergency departments, primary care, and substance abuse facilities, since both medical and substance abuse comorbidities are common in trafficked patients. The trauma-informed concepts of asking, respecting, and responding are vital components to the survivor-centered care emphasized by the authors, and psychotherapeutic considerations and cultural aspects in the assessment and treatment of these patients—topics that have been neglected heretofore—are discussed in-depth. Finally, advocacy, confidentiality, and reporting requirements for adult and child patients are addressed, providing a much-needed legal and ethical framework.

The chapters have clearly outlined objectives that are achieved through a number of useful features: • Each chapter includes clinical cases that encapsulate the trauma and horror of the real-life fallout from human trafficking. These vignettes deftly illustrate and contextualize the chapter's topic, such as managing co-occurring substance use disorders or identifying the trafficked person who presents in the emergency department.• Chapters are equipped with "pearls and pointers" that summarize key points and highlight the most important take-aways.• Contributors make ample use of visual aids, such as tables and figures, that enhance understanding and consolidate information into readily accessible formats.• Ten vivid, real-life case scenarios are offered in the final chapter, providing the clinicians with insights into trafficked persons' health care interactions, questions to increase sensitivity and help identify these patients, and counsel on managing their care with empathy and patience.

Often shocking, frequently poignant, and always useful, Human Trafficking: A Treatment Guide for Mental Health Professionals teaches clinicians to look at their patients with fresh, informed, and compassionate eyes.

Product Details

ISBN-13:	9781615372485
Publisher:	American Psychiatric Association Publishing
Publication date:	06/11/2020
Pages:	284
Product dimensions:	6.00(w) x 9.00(h) x 0.50(d)
Age Range:	18 Years

About the Author

John Coverdale, M.D., M.Ed., is professor of psychiatry and medical ethics at Baylor College of Medicine in Houston, Texas; serves as deputy editor of Academic Psychiatry and associate editor of Academic Medicine ; and co-directs the anti-human trafficking program at Baylor College of Medicine.

Mollie R. Gordon, M.D., is an associate professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston, Texas, where she is a co-director of the Anti-Human Trafficking Program. She is a co-chair of the American Medical Women's Association Physicians Against the Trafficking of Humans, is on the HEAL trafficking speakers bureau, and has opined for the Office of Trafficking in Persons.

Phuong T. Nguyen, Ph.D., is an associate professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine. He is director of psychology services at Ben Taub Hospital and the program director of the BCM Anti-Human Trafficking Program. Additionally, he serves as the training director for the BCM Psychology Internship Program and the Ben Taub Hospital/BCM Psychology Postdoctoral Fellowship Program, which includes the country's first formal psychology postdoctoral fellowship track specializing in anti-human trafficking work.

Table of Contents

Chapter 1. Becoming a Trafficked PersonChapter 2. Epidemiology of Human Trafficking: The Complexities and Intersections of Vulnerability, Risk, and ExploitationChapter 3. By the Right Name: What Does It Actually Mean to "Screen" and "Assess" for Trafficking in Health Care? Chapter 4. Barriers to Identification of Trafficked Persons in Health Care SettingsChapter 5. Emergency Department Management of Trafficked PersonsChapter 6. Managing Trafficked Persons With Comorbid Medical ConditionsChapter 7. General Principles of Care for Trafficked PersonsChapter 8. Responding to Trafficked Persons in Heath Care Settings: Patient-Centered, Survivor-Centered CareChapter 9. Care Management of Trafficked Persons With Substance Use DisordersChapter 10. General and Specific Psychotherapy Considerations for Managing Trafficked AdultsChapter 11. Child Sex and Labor TraffickingChapter 12. Cultural Aspects in the Assessment and Management of Trafficked PersonsChapter 13. The Clinician as Advocate: Confidentiality and Reporting RequirementsChapter 14. Survivor Voices: Case Scenarios of Labor and Sex Trafficking

Editorial Reviews

The International Labour Organization reportedthat, in 2016, 24.9 million people were trafficked,20.1 million as forced labor and 4.8 million forcommercial sex. These numbers are probably anunderestimate but they indicate that human trafficking is a huge problem that psychiatry hasneglected. The editors of Human Trafficking: ATreatment Guide for Mental Health Professionalshave put together a very experienced group ofauthors who provide a rich and comprehensivereview of this human tragedy. In their preface, theeditors state that their goal was to create "aneducational and clinical resource for mental healthpractitioners as well as clinicians from any discipline who might encounter trafficked persons(which is essentially all of us in the health carefield)." The 25 authors include internationalexperts in multiple disciplines, 14 of whom arephysicians. Each chapter is concisely written andincludes diagrams and charts as well as "Pearlsand Pointers" at the end to emphasize the mainpoints. As the editors' goal was to create a reference source, each chapter also includes an extensive bibliography.For clinicians, I single out some particularlyhelpful information. There is an excellentdescription of signs and symptoms that may present in a trafficked person in the emergencydepartment. The discussion of comorbid medicalconditions covers sexually transmitted diseasesand the need to coordinate interventions for bothphysical and mental health. Trafficked individualsface many difficulties accessing medical care,including especially being able to pay, languagebarriers, safety concerns, and chronic illnessesthat require long-term care that is not usuallyavailable to someone who is trafficked. Specialchapters deal with sexual abuse and child trafficking for labor and sex. Since many traffickedpersons in the United States come from foreigncountries, cultural issues and the need for culturally appropriate assessment is very important andthese topics are well covered.When discussing management, all of theauthors emphasize the need for trauma-informedcare that is characterized by empathy, trustworthiness, and collaboration; however, this stresson the need for "trauma-informed care" may seemlike an overused platitude. Although there are nodata or evidence to guide treatment, the use ofcognitive-behavioral or exposure therapies to treattrafficked individuals does not seem to be a goodidea. These patients come from different culturesand have massive traumas that greatly impairtheir ability to process information. Providingexposure therapy to people who suffer from frequent nightmares and startle reactions seemsalmost harmful. For long-term treatment, gentleconsistency and judicious use of medicine in asupportive relationship seems likely to be themost helpful method for reducing suffering, eventhough firm evidence is lacking.The last chapter "Survivor Voices" presentsaccounts by those who escaped and were able torecover and write about their traumatic experiences. These are truly inspiring stories by remarkable people who have triumphed. However, Iwonder about the hundreds of others who were notable to escape, who live out a life of humiliation,fear, drug addiction, and struggles with depressionand suicidal thoughts.In summary, this is an excellent book about aneglected and underreported group. People who aretrafficked have multiple psychiatric and other healthdisorders and clearly need medical approaches toalleviate their suffering.

Journal of Psychiatric Practice - J. David Kinzie