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FMR 64
44 Trafficking and smuggling
www.fmreview.org/issue64 June 2020

if you can understand the interaction in supervision. They should also consider
light of the survivor’s trauma history. It establishing co-leadership of support groups.
can also help to ask a colleague for their This allows for staff reflection and peer
insights. For example, from a programmatic supervision while decreasing the burnout
perspective, a certain housing plan or that comes from working independently
educational requirement might feel logical and holding the weight of stories alone.
and even necessary. But for a survivor of
sexual exploitation, it may feel like they Consider the WHO/UNHCR
are becoming ensnared in something with recommendation to include mental health
which they do not agree. Perhaps a survivor in primary care: The mhGAP Humanitarian
is resisting attending educational classes or Intervention Guide calls upon humanitarian
job training. Consider the possibility that actors to routinely include mental health
these situations might activate feelings of programming in primary care settings.
6
disappointment, irritability and self-blame Service providers should consider placing
related to lost time and opportunity as a mental health practitioners in primary
result of being trafficked. Take the time care or maternity clinics. Despite their
to bring empathy into the relationship need for gynecological and obstetrical
and solve problems collaboratively in care, survivors of sexual exploitation may
order to support survivors in taking the avoid routine gynaecological or antenatal
steps needed to engage in services. visits because examinations are a source
of distress. Clinicians working in this
Increase opportunities for social support: area are in a unique position to help
The strategic abuse and forced isolation survivors build positive associations with
imposed by traffickers result in shame, medical care, and maternal health clinics
learned helplessness and mistrust. The effects are ideal venues for parenting groups.
of participating in survivor support groups Jennifer McQuaid jmcquaidphd@gmail.com
cannot be overestimated. The validation, Clinical Instructor, Yale Center for Asylum
emotional connection and practical support Medicine; Affiliate Scholar, Global Mental Health
provided by fellow survivors and group Lab, Teachers College, Columbia University
leaders encourage women to explore https://medicine.yale.edu/intmed/genmed/
relying on others and building attachments. asylum/
Parenting groups enable survivors to
experience support from other mothers, 1. This article is based on the author’s work with survivors of
gender-based violence, primarily women and children, over a
to share feelings in a safe space, and gain period of 12 years at Sanctuary for Families in New York City.
information and guidance. Parenting group https://sanctuaryforfamilies.org
leaders can pay particular attention to 2. Cloitre M, Courtois C A, Charuvastra A, Carapezza R, Stolbach
processing ‘flashpoints’ – moments when B C and Green B L (2011) ‘Treatment of Complex PTSD: Results
of the ISTSS Expert Clinician Survey on Best Practices’, Journal of
interactions with children trigger feelings Traumatic Stress 24 (6): 615–627
of vulnerability or set off a cascade of re- https://onlinelibrary.wiley.com/doi/full/10.1002/jts.20697
experiencing symptoms. By working through 3. Levine J (2017) ‘Mental health issues in survivors of sex
these moments in the group, mothers may trafficking’, Cogent Medicine 4:1278841
http://dx.doi.org/10.1080/2331205X.2017.1278841
feel better understood, better equipped to 4. World Health Organization and Columbia University (2016)
manage their parenting responsibilities, Group Interpersonal Therapy (IPT) for Depression, mhGAP
and possibly more confident in moments of www.who.int/mental_health/mhgap/interpersonal_therapy/en/
intimate connection with their children. 5. World Health Organization (2015) mhGAP Humanitarian
Intervention Guide
www.who.int/mental_health/publications/mhgap_hig/en
Address vicarious traumatisation: The 6. Ventevogel P, van Ommeren M, Schilperoord M and Saxena
isolating and paralysing effects of trauma S (2015) ‘Improving mental health care in humanitarian
can transfer to care providers. Service emergencies’, Bulletin of the World Health Organization 93: 666–666A
https://doi.org/10.2471/BLT.15.156919
providers should implement group
consultation and provide staff with adequate