Human trafficking

Here on The Psychologist we receive quite a few submissions from assistant psychologists who are not that happy with the process of getting such a post, or with the work they find themselves doing. But you want to share your story because you're so passionate about the area. 
Yes, very much so. Although  I understand the frustrations of many others, I believe that through the experiences we gain as assistant psychologists, and in the process of getting these posts, we begin to learn the insights and skills that will ensure we are better practitioners in the long run.

While working as an assistant psychologist I got involved in the TARA project, working with women who have been trafficked for sexual exploitation. It's a national project but part of Glasgow Community and Safety Services. In November 2011 a pilot was set up in conjunction with NHS Greater Glasgow and Clyde to provide psychology services to the TARA Project to discover what psychology could offer to improve the outcomes for the victims, and to ensure the process of gathering evidence by the UK Border Agency and the police is one which is sensitive to the psychological impact on the victims of both their prior experiences and the process of disclosing them in order to provide evidence.

Is human trafficking a big issue in Scotland?
It has recently received increased awareness, with the publication of an inquiry into human trafficking in Scotland led by Baroness Helena Kennedy QC, and the first conviction (in April 2012) of two individuals within Scotland for trafficking offences. Human trafficking comes in many forms, including sexual exploitation, domestic slavery, or bonded labour. It frequently involves unspeakable acts of violence and torture to the victims, where traffickers strive to gain complete control through physical and emotional abuse (see Cathy Zimmerman's report at tinyurl.com/cy8cxxd).

These women must feel very trapped and afraid.
Yes. The process of being trafficked is built on a relationship of power and control, both emotional and physical. The victim is misled or coerced into the belief that they are being taken to a better life, and that the trafficker is a person that they can trust and who holds their best interests. However, once they reach the destination country this façade is lifted and the victim is subject to violence, torture, threats to themselves and their family, and sexual exploitation.

In most cases, the traffickers seek out already vulnerable individuals who are more easily exploited, with 60 per cent of women experiencing physical or sexual abuse before trafficking. Women being trafficked from African countries may be led to believe that, due to 'black magic', betraying their trafficker would cause themselves or their loved ones to become seriously ill, 'go mad' or die. It can be very difficult for professionals in Western countries, or indeed in their home countries, to develop therapeutic relationships with them and to break down the secrecy.

So how do psychologists even begin to treat such women? 
Trafficking is considered to be a complex trauma and we can treat the psychological impact as such, for example by using Judith Herman's model of complex trauma. Cathy Zimmerman uses the Brief Symptom Inventory to discuss the wide range of psychological symptoms exhibited including anxiety, depression, hostility and PTSD symptoms. But it is also important to be mindful of the effects of culture, and to amend our interventions accordingly. In terms of Judith Herman's model, it is important to consider doing some stage three work on identity and self-esteem along with the stage one safety work, as establishing these connections is essential before an individual can feel 'safe' in a host country.

And does the system foster that feeling of safety?
Once an individual has been identified as being a possible victim of trafficking they are asked to consent to taking part in the NRM (National Referral Mechanism) process, as well as applying for asylum. After giving an initial statement detailing their experiences, if it seems likely that they may have been trafficked, they are given a 45-day recovery period, after which they are expected to provide a detailed account of their experiences and to disclose the full extent of their trauma. Many women speak about feeling 'undressed' by even gentle questions around the events.

We can strive to ensure these women are given an element of choice to their disclosure and that they are mentally able to participate in the process. Ensuring that the professionals involved in the disclosure process have sufficient training in responding to emotional distress, and are able to help individuals who experience dissociation or suicidal ideation, is also key. Services such as the TARA Project are highly experienced in working with trauma, and it is important to ensure that all agencies and statutory services have the same psychological awareness.

Can you tell us a bit more about your own personal involvement in the study?
As Assistant Psychologist my role included some direct clinical work, with the opportunity to formulate and plan my sessions under supervision; the conduct of audit, where I collected and analysed information from the TARA staff to present a picture of the experiences of the women and to provide an indication of the outcomes of pilot project; and the development of training, which included sourcing resources and literature to input into training programmes conducted by the Consultant Clinical Psychologist. Through all of this, I gained a huge amount of knowledge about the practical applications of psychology, and had the opportunity to work therapeutically with clients using a psychological approach. I learnt about working in collaboration as part of this multidisciplinary team, and about the impact of cultural differences and the skills required to work with interpreters. Also, importantly, I experienced directly the positive impact that psychology can have.

So are these women getting the help they need?
The majority of women TARA support show psychological distress within the first few weeks of referral, and prior to the pilot project there was no form of mental health screening by a specialist service at initial contact, or any direct psychology input available to the women. However, with the addition of much-needed government funding the pilot project has been able to continue and psychology input is available to the women supported by the TARA project. Services like the TARA project do a fantastic job in supporting these women; they are hugely committed and very inspirational.

What was the main thing you took from your involvement?
The sheer resilience and human strength shown by these women. With the input of psychology these women could have the opportunity to move forward, which is an opportunity that everyone deserves. The passion I have for psychology comes from the values I believe psychology as a profession holds – equality, justice, empathy and open-mindedness. When we remember where our passion comes from, and the values we believe in, it is easy to see the importance of a human rights context in all our work. Psychology as a profession is in a position to stand against violations against human rights and to show from an evidence-based framework the effects that these violations have on the mental well-being of individuals.