Psychological support and therapeutic services
In addition to any immediate physical injuries, some children may experience longer-term emotional and psychological problems. Although most children will respond quickly to the care received, some will have developed long-term illnesses and health complications while others who have experienced horrific ordeals may be profoundly affected.
Living in an unpredictable world
Although children all have very different experiences of exploitation, a number of children may have witnessed murders, rape, physical attacks and torture and may have themselves experienced prolonged physical, sexual and emotional abuse and deprivation of sleep, food and light. Some children will have been living in an unpredictable and uncontrollable world experiencing fear, threats, intimidatation, manipulation and isolation. In some cases the child may have had to develop a dependency on their abuser, and their understandings of relationships and their ability to trust are likely to be damaged or confused.
The child may have experienced many losses during this time, losses of friends, family members and the loss of childhood and opportunities to play and learn.
Responses
Children who have experienced sexual violence may suffer from depression, anxiety, sleeping difficulties, flashbacks and nightmares, low self-esteem, sexualised behaviour, eating disorders, suicidal thoughts and substance misuse. Although many children can go on with their lives and function effectively, others will require specialist support. However, in most cases the demand for therapeutic services far outstrips the supply. For those children living in rural areas or who have additional needs such as learning difficulties or disabilities, access to suitable service provision is even more limited.
Types of support
Some but not all children who have been exploited may benefit from different therapeutic treatments delivered individually, in a group or with the family. The nature of provision may include counselling, play therapy, narrative therapy, art therapy, music therapy, nature therapy, cognitive behavioural therapy, eye movement desensitisation and reprocessing (EMDR), psychotherapy, anger managment or conflict resolution work.
It is also equally important to focus on the child's resilience, strengths and skills and develop opportunities to build on these foundations and acknowledge these positive aspects.
Therapeutic interventions need to be grounded in safe and trusted relationships and must be based on the child's developmental age, be culturally relevant, flexible, appropriate and carried out by a trained professional.
Key texts:
- Research to action: sexually exploited minors (SEM) needs and strengths: WestCoast Children's Clinic, 2012
- A multi-method study identifiying the barriers and solutions to meeting the physical and psychological health needs of young people involved in or vulnerable to sexual exploitation: Gabrielle Tracy McClelland, 2011
- Community counselling: How trained survivors become trusted and empathetic counsellors, ILO
- Implementing Trauma-Focussed Cognitive Behavioural Therapy (TF-CBT) among formerly trafficked- sexually exploited and sexually abused girls in Cambodia: A feasibility study: Judith Bass et al, 2011
- Application of yoga in residential treatment of traumatised youth: Joseph Spinazzola, Alison Rhodes, David Emerson, Ellen Earle and Kathryn Monroe in Journal of the American Psychatric Nurses Association 17, 431-444
- Aggression in sexually abused trafficked girls and efficacy of intervention [Abstract available]: Sibnath Deb, Aparna Mukherjee and Ben Mathews in Journal of Interpersonal Violence, Vol 26, 745-768, March 2011
- Assessment of trafficked and abused girls living in shelters in Cambodia: Development and testing of a locally-adapted psychosocial assessment instrument: Judith Bass, Paul Bolton and Luke Bearup, 2010
- Evidence-based mental health treatment for victims of human trafficking: Erin Williamson, Nicole M. Dutch, and Heather J. Clawson for the US Department of Health and Human Services, 2010
- The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women [Abstract available]: Mazeda Hossain et al in American Journal of Public Health, Vol 100, Number 12, 2010
- Yoga therapy in practice. Trauma-sensitive yoga: principles, practice and research: David Emerson, Ritu Sharma, Serena Chaudhry and Jenn Turner in the International Journal of Yoga Therapy, 19, 123-128
- Psychosocial and mental health service provision for survivors of trafficking: Baseline research in the Greater Mekong Subregion and Indonesia: Sean Devine for IOM, 2009
- Cultural perspectives on child trafficking, human rights & social justice: A model for psychologists [Abstract available]: Rita Chi-Ying Chung in Counselling Psychology Quarterly, Vol 22, 1, March 2009
- Human trafficking: A review for mental health professionals: Oksana Yakushko in the International Journal for the Advancement of Counselling, 31, 158-167, 2009
- Sexual abuse and therapeutic services for children and young people. The gap between provision and need: Debra Allnock et al for NSPCC, 2009
- The impact of trafficking on children:Psychological and social policy perspectives: Yvonne Rafferty in Child Development Perspectives, Volume 2, Number 1, pages 3-18, 2008
- Treating the hidden wounds: Trauma treatment and mental health recovery for victims of human trafficking: Heather J. Clawson et al for US Department of Health and Human Services, 2008
- Physical and mental health aspects of rehabilitating children freed from slavery: Judith Hyde et al for Free the Slaves, 2006
- Psychosocial rehabilitation of children who have been commercially sexually exploited. Training guide: ECPAT, Thailand, 2005
- Psychosocial support to groups of victims of human trafficking in transit situations: IOM, 2004
- Specialised training manual on psychosocial counselling for trafficked youth: Handling the trauma of sexual exploitation: Mark Jordans for ILO/IPEC Nepal, 2001
Also see texts on the health and spiritual, cultural and religious connections pages
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