Human Trafficking Webinar for Social Workers: SOAR to Health and Wellness

Human Trafficking Webinar for Social Workers: SOAR to Health and Wellness


SOAR to Health and Wellness for Social Workers
– March 30, 2017 Webinar>>Leilani Funaki:
Hi, everyone. Thank you for joining us today on our webinar
we are grateful to have you back with us. If you cannot hear me speaking right now and
see the screen here please type no in the top box. I’m Leilani from the National Human Trafficking
Training and Technical Assistance Center. If you do find during the webinar you’re not
able to hear or you have other technical difficulties reach out to Wendy LaBrecque, her email ([email protected])
is on the screen or type any questions you have into the chat box. So today you won’t be able to speak, we don’t
have your microphone enabled so the chat box here on the right side of your screen, that’s
where you’ll communicate with us. Any questions about the training, any help
you need, please type it right there into the chat box. Today’s session is being recorded, and will
be posted on our website, shortly afterwards and one thing to point out to you here below
the chat box we have our file to download area. So there will periodically be hand-outs that
will reference in the first box here we have got the pre-work assignment that was sent
out to you when you registered, there’s also a hand out here that goes over any kinds of
financial disclosures we need from anybody involved with planning the training content
or anybody who is delivering the training. Today we don’t have anything to disclose but
so you know that information is there as recap of the requirements for earning continuing
education credits. You will also see in this file to download
box that the training slides are there, if you would like to download them and follow
along and take notes as well as the case studies we’ll reference and any of the other hand
outs that we speak of. So with that said we are going to go ahead
and get started I’m going to turn the time over to Beth Pfenning, she is from the Office
on Trafficking in Persons. Beth over to you.>>Beth Pfenning:
Thanks Leilani, good afternoon everyone as Leilani said my name is Beth Pfenning, a program
specialist with the office of tracking in persons. I, on behalf of the U.S. Department of Health
and Human Services, and the National Human Trafficking Training and Technical Assistance
Center, welcome y’all to this afternoon SOAR to train. Before we turn to the presenters I want to
briefly provide y’all with a little background on the training today. In September 2008 the HHS Office of the Assistant
Secretary for Planning and Evaluation sponsored a national symposium with trafficking experts
and medical professionals on the health needs of traffic persons. And one of the major conclusions about symposium
was that training for both healthcare and social services fields on this issue was critical. For increasing victim identification and ensuring
that our service delivery as practitioners is trauma informed. The importance of such training was further
reinforced by the Federal Strategic Action Plan on Services Specific to Human Trafficking
in the US. Recognition of the vital role y’all play and
to align with our mission to promote the health safety and well-being of the American people,
the administration for children and families and the office of women’s health designed
initial training in 2014 which is gone through piloting and enhancements that have been informed
by training evaluation feedback that we received to date and the expertise of trafficking survivors. Social service providers and healthcare professionals
through two national technical working groups. So we have four sections for today’s training
that align with SOAR, an acronym that stands for stop, observe, ask, and respond. If you have any questions throughout today’s
training I would ask you please submit them to everyone through the chat box that you
see that Leilani pointed out with the green arrow. We have administrators so they will both compile
questions for trainers who will address them at the end of each section. We will also give you two short breaks; we
know this is a lengthy webinar. So we’ll take a short pause after the stop
and ask session so ad minute straytors will come back on the line and announce what time
we’ll get started again. As a friendly reminder, continuing education
units are available for training participants who stay for the duration of today’s training
and successfully complete the online post training survey form which will be sent out
shortly afterwards. I would like to turn it over to Kathryn and
Elisabeth to briefly introduction themselves before we move on.>>Kathryn Xian:
My name is Kathryn Xian with specific alliance to stop (inaudible) it’s an honor and privilege
to present this awesome training for y’all. Thank you so much.>>Elisabeth Corey:
Hi, this is Elisabeth Corey, I’m a survivor of family controlled sex trafficking and abuse
and also a trauma expert and life coach for complex trauma survivors and I’m really excited
to be here presenting for you today. Thank you.>>Leilani Funaki:
Thanks, Kathryn and Elisabeth. Look forward to your expertise during this
training. Before we begin I was hoping to get an idea
of geographic diversity of our participants here today. So if you wouldn’t mind taking a few seconds
to look at the map here and let us know what region state and city you’re from into the
chat box. Region 7, 5, 10.4.2. Great. That’s terrific. We have a lot of people online here today. Thank you so much.>>Female Speaker:
So as Leilani mentioned we did send out some homework that you guys did not have to turn
in, don’t worry but it was really getting y’all to think through your referral networks
in your local communities. And some of the key stakeholders that we feel
are integral to having a robust safety threat as Leilani mentioned that resource is available
for download in the download pod and Kathryn will be referencing during the respond section
of today’s training so I wanted to briefly have a hat tip toward that and without further
ado I’ll turn it to Elisabeth.>>Elisabeth Corey:
Thank you so much, I appreciate everyone taking time out to complete the training today. This is such important information to have
so thank you all for being here. We’re going to start off talking about the
course objectives. It’s important to understand why we’re here
and we want to talk about what we’re accomplishing and that you should be able to accomplish
during the training. First we’ll describe the types of human trafficking
in the U.S. and then we’ll talk about recognizing possible indicators of human trafficking,
we want to demonstrate how to identify and respond to potential trafficking victims and
respond appropriately to potential human trafficking your community. Lastly, the objective today is to share the
importance of human trafficking awareness and responsiveness with others in your work
environment. So let’s start off with a pulse check. If you could, you should now see that there
are answers you can give down below, there’s a poll down there, the first question is could
you identify a potential victim of trafficking? And have you ever encountered a potential
victim of trafficking? So if you could answer that poll that should
have popped up underneath the captioning for you. That would be great. It looks like both answers agreement cooing
in with yeses and noes being close to even. That’s good, if you were all here answering
yes to this, then that would potentially mean you wouldn’t need this training. So I appreciate you being here and being willing
to learn more about human trafficking today. We do have a good number who are saying they
could identify potential human trafficking. Right now it’s coming in about 56 percent. And about 50/50 whether or not you have encountered
a potential victim of trafficking. Thank you guys so much for answering that. Next we’ll talk about the relationship between
human trafficking and public health. In the past we have typically thought of human
trafficking and really molded our response to it, from a perspective of law enforcement. And while this perspective is important we
now realize human trafficking is also a public health issue. And it affects individuals, families and communities
across generations, entire generations. This graphic here shows terms that are related
to both public health and human trafficking. Which of these public health issues relate
to your day to day work? In this case we don’t have a poll, if you
could just comment in the chat box I would love to get an idea for how — how this plays
out maybe in particular jobs you’re doing now or have done in the past. Reproductive, health, healthcare, maternal
infant health, infectious disease, social services. Prevention. Counseling, .Indiana health, community resources,
adult protective services. Mental health, Department of Children and
Families. Department of Corrections. We have a good group here today. Crisis intervention, mental health, alcohol,
women’s health prevention, trauma. Lots of great answers and very diverse juvenile
probation. Thank you guys so much for giving us an idea
of the kind of experiences that you have. One of the primary benefits of looking at
human trafficking as a public health issue is the emphasis on prevention. Looking at the systemic issues that cause
people to be vulnerable to human trafficking in the first place. Because trafficking does not happen in a silo. It is often one component in a series of traumatic
and violent experiences over the course of a lifetime. Recognizing these risk factors is critical
to prevention. From the perspective of public health prevention
and human trafficking. The primary — excuse me, for my throat today. The primary secondary and tertiary prevention
approach can be applied to human trafficking. I want to give examples at each level of prevention. So we will talk about that. The public health prevention approach does
the following. First of all, it focuses on prevention, interrupting
violence and changing social norms. So we’re getting at this from a ground level. It recognizes the social and economic determinants
of health and well-being that may lead to trafficking. It focuses on identifying protective and risk
factors and encourages culturally specific prevention and intervention efforts. It engages all essential community stake holders
who can play a role in addressing human trafficking. It builds community capacity and includes
community members in the development of policies and practices. And it recognizes human trafficking along
a spectrum of inter-related violence and systemic inequalities. I think that is so key to looking at human
trafficking in a different way. While there is a law enforcement component
that is critical, we have to expand the way we examine human trafficking today. So let’s talk about the SOAR framework. You have already heard a little bit about
how SOAR developed but this training that we’re going to be seeing today is built on
the SOAR framework can wanted by the U.S. Department of Health and Human Services. This framework provides a quick mental reference
for professionals like you to keep in mind the best way to help a potential victim of
human trafficking. So we’ll talk from four angles. First one is stop. That is focus in stop section of becoming
aware of the nature and scope of human trafficking. And we will talk observe which is the section
we work on recognizing the verbal and non-verbal indicators of human trafficking. Then we’ll discuss ask and that is identifying
and interacting with potential human trafficking victim. Then response, where we will talk about responding
appropriately to potential human trafficking victim. So the rest of this training is going to take
a closer look at each of these variables. So let’s get started with stop. Here are the objectives for the stop component
of the SOAR framework. First, we’re going to be distinguishing between
some of the most common misconceptions and realities of human trafficking. As we get into this you will see misconceptions
that you heard and maybe you held yourself. In the past. We’ll recognize the potential for interactions
with human trafficking victims on the job. You’ll leave here realizing there’s more potential
than you thought when you started. Then we will explain legal definition of human
trafficking based on the TVPA which was originally signed in 2000. And we will identify use of force fraud and
coercion against potential human trafficking victims or minors who have signs of abuse
and neglect. Then the last two things we will do is identify
common risk factors for victims of human trafficking and also identifying common relationships
between traffickers and victims. So let’s start off by talking about what your
role is. In the fight against human trafficking. I think this is important that you understand
your role from perspective of it will give you a better idea as to how to address what
you are seeing in your job. So your role is to identify potential victims
and respond appropriately including treating referring and reporting when mandated by federal
state laws and tribal ordinances. Then to work with others in your profession
to develop protocols for your workplace how to help potential victims. And I — this is really important to stress,
if you’re identifying potential victims, we are not asking you the leave here today and
become an expert identifying without a doubt a victim of human trafficking this is understanding
the science and understanding the misconceptions so you can say this person might be a victim. Next we’ll start off with a case study and
this case study is with — is about a girl named Liza. After we talk about that, we’ll discuss the
questions that you see.>>Leilani Funaki:
I’m going to be reading Liza’s case study, if you want to follow along with me, it’s
available for download in the download pod over here. Meantime, here we go. As 11-year-old I was one of six foster kids
sold into sex by my foster mother’s boyfriend. They needed money for their addiction to heroin,
no one foster system knew what was going on. The police would return us to the same foster
home. We felt we had no recourse when nobody believe
us when we were hurt. By the time I was 12 I left the house for
good. I met a guy on the street who said he would
take care of me and I believed him. He was a pimp and sold me to men for money. He had me moving the circuit, Chicago Detroit,
Indianapolis and back the o Chicago. At first he treat med nicely long enough to
get me to do what he wanted. Then he turned mean and if I didn’t make enough
money he would beat me mercilessly. I learned quickly how to keep my head down
and make my daily quota. During the time I was beaten burned raped
and assaulted, sometimes by the trafficker and sometimes by the guys buying me. Some of those wounds were treated by a grandmother
of one of pimps who had been a nurse. The pimps brought us to her place when we
were seriously injured. Sometimes I when to a local neighborhood health
clinic but no one asked what happened to me and if they did I lied because I was afraid
of my pimp. I knew he was beat me if I told anyone what
was going on. to this day I was physical mental and emotional
issues as a result of that time on the street.>>Elisabeth Corey:
Thank you so much, Leilani. Let’s talk about the questions that are here
about that particular case study. And what I’m going to do is once again ask
you guys to comment in the chat box, we will do this several times today. So first off, if Liza came to your office
or emergency department, how would you proceed? Assess for current safety. Call the police. Probing question, I explain my role and ask
what sort of help she was seeking. Open ended questions. Assess for immediate safety means. Liza would be referred to the medical unit
and treatment services immediately. Probing questions and assess for safety. Complete a full psychosocial assessment alone
with her. Provide trauma informed care. One of my favorite phrases right there, talk
about that a little bit later. Let her know she is in a safe place. A lot of good answers here. Definitely wanting to assess for safety as
well as asking open ended questions. These are really good answers and we’ll be
honing in a little bit more on some of the techniques when you encounter human trafficking
victims today. I appreciate your answers. Let’s talk about the next one here a little
bit. What indicator would alert you that she might
be a victim of human trafficking in the first place? Definitely her self-reporting would be an
indicator. Injuries that are inconsistent with her story. Coercion, injury, affect type of wound. Guardedness, incomplete answers to questions
about her injuries. Yes, the run-away, how she presents physically,
and the way she is handling herself. So these — somebody mentioned also, if she
has no ID, that is potential truancy. These are — yes. So these are really good indicators. Absolutely. We’ll be talking about indicators today as
well. Then the last one is what questions would
you ask her? Are you safe right now? Can you leave if you want to? Is a really good question. You have somewhere safe to go. Has anyone asked you to do something you didn’t
want to do. When you felt you couldn’t say no. Where do you stay, would you like help? That’s a good question too. A lot of times we assume they do. Do you have any positive support? Anyone forcing you to do something you didn’t
want to do? These are great questions. Exactly. And we’ll be talking about questions today
as well. I think one of the critical components to
understand, they may not only be unaware of the term human trafficking but they may even
— even if they are being trafficked may not consider themselves a victim of it. So it’s really important, you guys seem to
have an understanding of that already, that you can’t usually just come out and say have
you been trafficked. And not get the answer that you want anyway. Okay. So thank you guys so much for participating. We’re going to be doing a little more participating
in this section so appreciate you staying with me there. Thank you. Next we’re going to talk about the definition
of human trafficking. To get started, basically according to the
federal strategic action plan on services to victims of human trafficking in the United
States, human trafficking is a crime involving the explication of — exploitation of someone
for compelled labor or commercial sex act through the use ofs for, fraud or coercion. According to U.S. department of state a commercial
sex act means any sex act on account of which anything of value is given to or received
by any person. Now, where a person is younger than 18, a
person younger than 18 is induced to perform a commercial sex act, it’s a crime regardless
of force, fraud or coercion. That’s the official definition. Now we’re going to do true or false. These are not going to come up as polls so
once again I encourage you guys to answer in the chat box. So starting off, we’re going to ask the question
here, trafficking must involve movement across state or national borders; is that true or
false? Seeing a whole lot of correct answers here. That is absolutely false. A person may be trafficked within his or her
own neighborhood. Although transportation may be involved as
a control mechanism, to keep victims in unfamiliar places, it is not a required element of the
trafficking definition. And I think this comes back to the idea that
human trafficking is not synonymous with smuggling or force migration widow involve border crossing. Thank you for all — your participation on
that one. The next one here is men, women, boys and
girls of any age, nationality, socio economic status, ability race and ethnicity are trafficked
and I see lots of true coming through within the correct answer. A lot of times we do focus on particularly
vulnerable populations. Especially in the media. And there are trends, we definitely see that. But it’s important to understand that trafficking
crosses so many different types of our population. Some more vulnerable than others. Next question here is victims will ask for
help if they want or need it. Right. I’m seeing a lot of falses here which is great. I may have given this away on the last slide
too because I did talk about the idea that not only did they not know what human trafficking
is, but they may also not even know that they are a victim of it. Not only that, but even if they do know, they
may be under a lot of coercion to not say anything. So they do not necessarily immediately seek
help or self-identify as victims of a crime. This could be due to a variety of factors
including fear of violence, against themselves or loved ones, loyalty to the trafficker,
lack of trust, self-blame, or they have been given specific instructions by the traffickers
regarding how to behave when talking to law enforcement or social services. There is definitely a lot of mistrust that
can come along with human trafficking victims. It is important to avoid making a snap judgment
about who is or who is not trafficking victims based on first encounters. Trust does take time to develop. Continue trust building and patience. We will talk a lot about that in the ask section. And really building that trust and having
the patients to do that is critical to determining whether or not a victim is really actually
a victim of human trafficking. The last one, healthcare and social service
professionals need to recognize signs of trafficking and respond appropriately that’s why you guys
are here today. Absolutely. It is not the — it is not the healthcare
or social services professional job to make a determination as to whether a person is
actually being trafficked. But it is important to be able to identify
potential human trafficking victims. Thank you guys so much for your participation. We will talk about identifying victims. Research has shown victims of trafficking
are likely to come into contact with someone within the healthcare system. In 2011 study interviewed attorney national
survivors of — foreign national survivors to investigate how many encountered healthcare
professionals while they were trafficked. 50 percent encountered a healthcare professional
during the time they were trafficked. And yet none of them was identified as a victim
of trafficking during these encounters. Then, in addition to that in a 2014 study
researchers interviewed survivors of domestic sex trafficking and found almost 88 percent
had encountered one more healthcare professional sometime during the period in which they were
trafficked. None of them were identified as a victim of
trafficking, as a result of these encounters. So the last thing that I wanted to mention
on this topic is coming from my own personal experiences as family controlled trafficking
survivor. Most of my interactions were with non-abusive
adults, was through the medical and teaching professions with a little bit of back lift
with social workers. While some families who trafficked dad doctors
in their own trafficking network, I believe the medical community in some form is likely
to see almost all family controlled victims at one point or another. Next one, who do they meet? As we have seen victims of human trafficking
encounter a variety of healthcare professionals while actively being trafficked. So this graph shows the result of another
anonymous national healthcare survey of human trafficking victims that came out in 2014. The respondents were victims of sex and/or
labor trafficking, a total of 173 patients were surveyed with 117 reporting they saw
physician while being trafficked. So some of the patients are — emergency department
is definitely the top percentage here coming in at 55.6 percent and that’s followed by
primary care physicians at 44 percent OBGYN at 26 percent, and dentists at 26 percent. So this is good information for us to have. Emergency department personnel are highly
likely to encounter an individual being trafficked. You can see that from these results right
here. But findings of another 2012 study indicated
that while 27 percent of staff understood human trafficking to be a problem among their
emergency department population, only 19 percent felt confident or very confident that they
could identify a victim being trafficked and less than 3 percent had been trained on potential
victim identification. That’s one of the reasons why a program like
SOAR are so critically important. So lots of training increases the chance that
a person being traffic goes unidentified or is blamed, judged or misunderstood. In addition, victims of other crimes, such
as domestic violence, child abuse and sexual assault may also be victims of human trafficking
which may not be recognized by the healthcare provider. Because very — as I said earlier, very rarely
is human trafficking something that we find in a silo. It is usually happening among other things,
as a matter of fact in my family sex trafficking was a part of the picture but domestic violence
an child sex abuse were rampant within my family. Even if I had been identified as a sex abuse
survivor that would have been at least a starting point. And certainly the human trafficking would
have come out eventually. So let’s talk a little bit more about the
TVPA and definition of human trafficking. Here is how it breaks down within the TVPA
which is trafficking victim’s protection act which was signed in 2000. And basically this TVPA says crime of trafficking
breaks down to three parts. There’s an action, there’s a mean, and there’s
a purpose. In a court of law, one of each of these elements
needs to be proven for a successful prosecution. The exception is that when minor, that’s anyone
under 18 years of age, are induced into commercial sex, it is considered human trafficking no
matter what the means. So we don’t have to prove force fraud or coercion
in that case. While we want to show you the legal definition,
we do know it’s not your role to make legal determinations; this is about identifying
potential victims. Another thing that’s important to note, while
this is an American legal definition, human trafficking is global, it is a global problem. Sometimes you may even hear it referred to
as trafficking in persons or tips, it occurs in every country in the world including the
United States. Definitions are likely going to be different
depending on what country you’re working with. Now we’ll talk a little bit more about the
means. Because this is actually going to be the most
helpful for you to understand or to help identify a potential trafficking victim. So it’s important to know that only one of
these means is required from perspective of a legal definition. And then in the case of a minor, you don’t
have to prove any of these means. A minor who is being induced to perform commercial
sex you do not have to prove any of these means. So what I would like to do now is if you could
comment in the chat box examples of these different types of means, that would be great. I would like to see how you defiant and we
have examples already up here but what is force fraud and coercion to you? Sexual assault, kidnapping. Lying about a promised job which could be
a fraud situation and withholding legal documentation often can be coercion or fraud. Promises or providing for their family that
can be a fraudulent situation. Making them think you love them. Absolutely. That’s a very, very common one, especially
in sex trafficking situations where they start off pretending to be the boyfriend. Threatening, absolutely that’s coercion. Threatening to kill family member. Absolutely. Taking someone’s passport or ID. Absolutely, that’s a huge one. And that’s something a lot of times in labor
trafficking community, promising payment but withholding payment. So great examples of what we’re talking about
with means. So thank you guys so much for answering that. So next we’re going to talk a little bit about
vulnerable populations. While we said earlier that human trafficking
can affect anybody and it does, there is also we have to consider the fact there are populations
that are more vulnerable. That is important when looking at identifying
people who are potential victims, it might be more likely they fall in one of these vulnerable
populations; it’s not always obvious they do. So we have to really be open minded about
you see this list here in front of you, I’m going to highlight a few here, children in
the United States are at particular risk for sex and labor trafficking, especially those
abused, run aways or homeless and those in systems such as foster care or juvenile detention. As a matter of fact in my own life I chose
to run away one time and I was out of the house no more than 15 minutes before I was
approached by a trafficker. And this person actually knew me and watched
me and knew that there was something going on wrong in my house, it was almost like he
was just waiting for me to walk out the front door. So I think that we really do have to look
at the run away and homeless youth as well in the foster care community when it comes
to children. We need to pay close attention there. Child labor trafficking cases have been identified
in agricultural work, restaurants, peddling and rings. So we have consider children not just trafficked
for sex, many are trafficked for labor. Another group that is important to highlight
here is the lesbian gay bisexual transgender or questioning communities. They are at high risk for exploitation. Especially come back to the homelessness,
if they are thrown out of houses for being gay by sexual or transgender. Many youth in this category reported they
had been traded sex for food and shelter and targeted for trafficking in prostitution. As we have said another important group that
I want to highlight is the Native American population that includes American Indian,
Alaska native, native Hawaiian and Pacific islanders. These populations face the same challenges
as other vulnerable populations but they have unique risk factors which include inadequate
law enforcement, so crime can go unreported. And they’re also dealing with generational
trauma. I wanted to talk about inter-generational
trauma. It’s something we need to be on lookout for
and it’s not specific to certain ethnicities and races. The trauma of war can affect families for
generations. The effects of large traumas on populations,
for example, slavery and Holocaust and other large scale traumas affect specific populations
but they have it for generations and generations, it’s not just the one trauma we’re working
with here, it can be compilation of many types of traumas added up over time. So it is important to be aware of these vulnerable
populations but also to understand you may or may not be able to fully identify whether
or not somebody falls in one of these categories. Now we’re going to talk about one of my favorite
studies, the adverse childhood experiences study. This is one — this study I can’t say enough
about what it has done gaining understanding across the immunity how trauma impacts the
person holistically. So this is critical that everyone be familiar
with the study if you haven’t taken the study I encourage you to take it. It’s a ten question test that takes five minutes
to take and it’s important we all know what our ACE number is. I have — this is what I like to say about
this, particular test, this is the only one I ever got a perfect score on; I have an ace
score of 10. If you look at the studies done on what the
ace core does in the long term to an individual from perspective of physical illness and general
function in society, I should be a hard core meth at this point. I’ll put it that way. It’s important that everybody knows their
ace score, if you’re working with people on long term basis its good know theirs as well. There’s three types of aces, those include
abuse, neglect and household dysfunction. An abuse can be physical emotional or sexual,
neglect can be physical and emotional, or emotional, and household dysfunction includes
mental illness, incarceration, mother treated violently, substance abuse or divorce. If you have never looked into the study I
highly recommend you take a look at some of the studies that have been done and some of
the issues attributed to high ace scores. So now we’ll do another quick pulse check
here. This one we do have a poll for. If you could answer the following question
here, which is, which vulnerable populations are you most likely to encounter during your
work day? Listing a lot are checking individuals with
childhood abuse and neglect. 75 percent checking that. Children involved in foster care and juvenile
justice system was the next highest number at 42 percent. Run away and homeless youth. Also coming in at 32 percent range. People with low incomes at 63 percent. Racial ethnic minorities at 50. Undocumented immigrants at 46, — 46 percent. LGBTQ at 40 percent. Those are some of the biggest ones we’re seeing
here. This is important to understand that these
are populations that are most vulnerable. Now I’m going to talk about my favorite slide
in the entire store — SOAR presentation. The reason I love this slide may be obvious
based on what you know about these thus far. I think it’s critically important for us to
understand the relationship between victims an traffickers for so, so many reasons. Identifying victims we must have this information. One of the biggest stereotypes we have is
the nature of the relationship between trafficker and the victim. Relationship of trafficker or victim varies. Yet a 2013 study by covenant house New York
shows noteworthy findings. And just to give a little background in covenant
house, they’re a service provider for homeless youth in New York. The agency often comes into contact with underage
victims of sex trafficking, these youth are also referred to as domestic minor sex trafficking
victims or DMST victims. If they’re a U.S. citizen. The study by covenant house collected data
on relationship between traffickers and DMST victims. Most striking finding was 36 percent of the
children in this study were trafficked by their parents or immediate family members. While this study is specific to the use of
covenant house, it reminds us not to discount someone as potential victim because they appear
to be with a relative. This may be a legit anytime relative. And they even have proof of that relationship
but it doesn’t mean they aren’t being trafficked. It is also important to note that boyfriends
at 27 percent, this could be a romantic partner but in many cases it is also a euphemism for
a trafficker, many traffickers do start off the relationship with their victims pretending
to be a boyfriend. This study is critically important for us
to understand the domestic relationship between victims and traffickers, because so often
we hold this belief as a society that trafficking is happening because of the white van at the
playground, the kidnappings and that just isn’t the majority of the cases we’re seeing. This, we’re going to wrap up the stop section
now. So we’ll do a quick summary. Human trafficking is the willful exploitation
of another human being. That is the action. By force, fraud or coercion, which is the
means for personal benefit. That is the purpose. ‘s important to understand that definition
and the fact that it has the different sections and is broken down into those areas. Healthcare professionals have an opportunity
to recognize signs of trafficking and become a first line of appropriate response for potential
trafficking victims. It is the TVPA which defines our — human
trafficking for us in the country. It does — trafficking does not require transportation
of victims and the victims do not usually self-identify as victims or seek help. The appearance of consent by a victim does
not disqualify occurrence of trafficking. The common at risk factors for human trafficking
include low socio economic status, familial and partner violent childhood neglect and
minority status. Traffickers often have personal relationships
with their victims prior to exploitation. With that said, I am going to turn it over
for us to take a short break.>>Female Speaker:
Thanks, Elisabeth. So y’all know we will take a five minute break
so we will get started with the observe section at 1:55 Eastern Time.>>Female Speaker:
Hi, everyone, we’re going to restart our training. I’m going to turn it to catch rip now to cover
the observe section of today’s training. Kathryn all yours.>>Kathryn Xian:
Hi, thanks. I’m a little under the weather so if I inadvertently
cough into your ears, I apologize. I had a time — ahead of time. Objectives for to SOAR framework is patient
and client related barriers to potential victim identification. They also explain include explaining provider
related barriers to potential victim identification. And identify physical and behavioral health
indicators of potential human trafficking victim. So we’ll throw the discussion point out there. We’re going to start by asking if you can
name some patient or client related barriers that prevent disclosure or identification
of human trafficking suspicions. In other words, what are some common reasons
a person who is being trafficked might not reach out for help? According to y’all? Okay. Go. There is a very big one, language barriers,
yes, absolutely. Lack Prof Provider competency. Absolutely. Constantly accompanied by abuser. For sure. Prior bad experience with provider. Uh-huh. They think they’re in love. Stockholm syndrome in other words. People not believing them. Absolutely. All good answers. So reality is potential victims are not being
recognized unfortunately. This is often due to various barriers that
hinder identification. These barriers fall into two categories. Patients or client-related and provider related
barriers. Patient or client related barriers are very
numerous. One of the most important barriers is that
clients rarely see themselves as victims. I mean, if you think about it, who wants to
identify as a victim? I don’t know anybody, survivor or not. Many have normalized their exploitation and
don’t understand that they are being victimized. Or juiced in a crime. Bay — or used in a crime, this is basic survivor
coping mechanism. They may not understand the phrase trusting
victim and/or may have no personal knowledge of what human trafficking actually is. Other barriers include fear of trafficker
or fear of deportation if they reveal what is happening to them. A distrust of those in authority including
healthcare and social service professionals, this may keep them from talking about what
is happening. This category patients or clients may have
had previous poor experience, providers which few of you already brought up in your response. A lack of knowledge of U.S. laws may also
make it difficult for people to understand what is happening to them, what is happening
to them is actually illegal or may think signed documents legitimize their victimization. Foreign born victims may have limited language
proficiency or difficulty explaining complex emotional trauma. It is also possible for victims often international
rather than domestic to be I will literate and unable to read posters about trafficking
that maybe in the office or waiting room. A language barrier is mistranslation during
the translation process or lack of appropriate interpretation. Is are want to interject, translator, access
to clean, fair good translators is also a time — a challenge in smaller communities
or in small cities, these immigrant populations use usually know one another, the trafficker
is usually involved in these communities an translators or access to translators can be
abused and manipulated by the trafficker. In other words, you may get a translator who
sympathizes with the trafficker and screw up your entire case. Keep in mind that has been an issue. So barriers, let’s move on. What are provided related barriers that prevent
identification? That prevents recognition of human trafficking? Provider related barriers include lack of
knowledge about human track trafficking, professionals cannot help something they don’t know about. That’s why training on human trafficking is
extremely important. Another barrier can be misclassification of
the case, and this can occur when for example, a sex trafficking case is seen as a domestic
violence case, particularly where the potential victim is romantically involved with the trafficker. Some domestic violence victim’s maybe human
trafficking victims. Do mental attitudes may cause providers to
view potential sex trafficking victims negatively? For example, drug addicted, dirty, quote unquote
bad kid. Some professionals dismiss them as criminals
or treat them poorly as a result of the stigma about prostitution. It is important to think about barriers that
we willingly or unwittingly create that may prevent identification of potential victims
of human trafficking. And to do as much as possible to remove these
barriers for the sake of the victims. We all have prejudices; I’m going to be blunt
here. We need to drop those prejudices at the door
when assessing and helping these survivors. As social workers, you can see potential trafficking
victims in your everyday work. Potential victims are often uncovered through
investigations into child abuse, housing code enforcement, worker safety and other problems
in which social workers are involved. Social workers can help in many ways. One, you can identify potential victims of
trafficking and help them obtain assistance, emergency services and long term care. Third, in organizes that specialize in assisting
trafficking victims and improving upon the current promising practices of reha bill tags
and reintegration. Educate vulnerable populations about the dangers
of human trafficking as a form of prevention. Provide curl curly specific and — culturally
specific and trauma informed services to victims which is extremely important. Build a correlated community response to human
trafficking, advocate for qualities that respond to human trafficking. And develop referral networks for victims
and survivors. The list goes on but I’m sure you can add
to that on your own time and get creative because it takes able age literally. That constitutes helping potential trafficking
victims or rebuild their lives are still being research tested and written. Therefore social workers have improving upon
them and reporting lessons learned with other practitioners. Social workers can encourage calling administrator’s
managers and others in their workplace to become knowledgeable about human trafficking
and to incorporate prevention and other best practices into their workplaces. Despite outlying trafficking finding and helping
potential victims is a very complex process or can be. Most trafficking victims don’t understand
their rights. And are fearful of people in law enforcement. Fear repercussions to themselves and families
and not aware of agency or community resources may advocate for them. Furthermore they may be called illegal aliens
if they refuse to testify against trafficker. Social workers serve as a key access point
to services in the social healthcare system; they also have an important role to play in
helping to identify individuals who may be trafficking victims and assessing them to
obtain needed services. Learning to ask the right questions and looking
for small clues that may suggest a person coerced into a life of sexual exploitation
or forced labor from the — forms the basis for identifying a potential victim. A victim typically experiences psychological
trauma that can upset individual’s physical and mental ability to respond to stress and
danger. So they really need advocates especially at
first contact. And this in turn leads to survival of fight
or flight or freeze, often making it difficult to diagnose an individual needs. I also like to add in that if you do have
an issue of quote unquote illegal alien afraid of deportation, if you have agencies such
as legal aid in your city or pro bono public advocacy law firm, they can protected help
identify human trafficking victims and give a layer of protection from deportation by
filing a — for trafficking victims of this. Red flags that may indicate — variety of
red flags that involve getting a patient, that can be indicator of your (inaudible)
and you can see these red slides here listed by types of services. Physical health, behavioral health, social
services and pub look health but there are — public health but there are always exemptions
to the rule. — exemptions to — exceptions to the rule. I would like to also bring back Elisabeth
to highlight one of the nuances regarding education system.>>Elisabeth Corey:
Thank you, Kathryn. I wanted to mention one thing. These red flags are fairly important for us
to understand that red flag they can be really all over the board when it comes to indicating
human trafficking victims and what we’re trying to do here is identify potential human trafficking
victims. It’s important for us to be flexible around
them. And one of the things that was certainly the
case for me as family control victim of trafficking and has been the case for many of my clients
that I work with, who also have been trafficked and sexually abused by their families is that
education was actually a bit of a safe haven and became a part of our lives where we could
excel and understand the rules when we couldn’t at home for example. So I have many, many, many examples of people
who are trafficked by their family but actually excelled in school because that was sort of
the place where everything just made sense and they could really come undone and be — be
something and someone positive. So it’s very important that if you feel like
you have potential human trafficking victims but they’re doing very, very well in school
and it doesn’t appear you’re having problems with that, it’s important to not allow that
to sway you. So I like to bring that up because I know
so often we use education or failing grades as a reason or indicator for human trafficking. So I would point that out.>>Female Speaker:
Thank you, Elisabeth; really good point. Next slide. In contradiction to what Elisabeth said, she
makes a great point of the nuances that can be exceptions to the rule, academic problems
may not be a indicator but sometimes can’t, it depends on survivor of the victim. Like to highlight there’s high risk victims
identification programs in use by law enforcement such as Dallas PD kind of red flag kids they
have seen run away three o more times in a year with a history of either sexual abuse
or addiction. It has to be one of those two factors. In addition to (indiscernible), children have
particular red flags you should be aware of the human trafficking task force in Texas
guide scores their only indicators highlights that no one indicator or group can confirm
a trafficking case and like Elisabeth said, it’s not your job to define and identify conclusively
a human trafficking victim, all you need to do is see the signs and propose that child
or adult is high risk or probably is being trafficked. It’s not upon you to define that. I would say even more so step away from any
conclusive statements that may pigeon hole or give false positive which can be very problematic
within the system especially when working with law enforcement. They don’t like being seen as working with
any agency or social worker that maybe wrong along the lines of human trafficking. The indicators are warning signs especially
the staff and education system recognize might have your score or student in addition to
the student suddenly having more expensive material possessions, often children don’t
have the vocabulary to express or describe their trafficking system, some of those material
possessions may include jewelry and definitely cell phones or multiple cell phones. While we understand that any one of these
could be present for an individual as far as physical signs of trauma, as indicators,
another issue is indicative of trafficking but putting different pieces together should
increase our index of suspicion. Physical indicators of sex trafficking may
include dental injuries such as cavities, missing or broken teeth, trouble swallowing,
temporal mandibular joint disorder or TMJ or voice changes. Tattoos often located on the neck or lower
back really anywhere sometimes they’re not visibly seen very well like inside of the
mouth even or in the hairlinement domestic traffickers have them under control or branded
with insignia, symbol or phrase to indicate they belong to that particular trafficker. Any name such as papa or da is unusual. TB or infectious diseases normally prevented
by immunization are also red flag. This is more likely with scoring national
victims however. Scars from cigarette Burns, which are often
in inconspicuous areas such as lower back or feet, suspicious injuries such as concussions,
bruises or mutilation. Some individuals in the commercial sex industry
are beating in such a way as to preserve their physical appearance. You might not see any markings of abuse. One type of beating that is common worldwide
involves caning the balls of the feet. It’s extremely painful yet preserves appearance. Other methods include putting a victim in
a tub of ice for a long period of time or putting them in a dark room with no light,
no ventilation, sort of like solitary confinement, those are traumatic forms of torture but leaf
no mark. Neglected chronic illness or pain such as
back pain, arthritis, diabetes, hypertension, et cetera, that is not well managed, other
conditions seen may include lead poisoning heat exhaustion and silicosis especially in
factory or the farm industry where they’re exposed to extremely noxious pesticides leading
to serious health related symptoms and diseases. Certain physical indicators under the category
of — wrong slide, here we go. Sorry, I might have the wrong PowerPoint with
me, but I can go with this. Here is the case study of Janet. If I can get Leilani to read the case study
we can go into her situation and I can ask discussion questions about identifying the
force fraud coercion in this case and barriers she encountered.>>Leilani Funaki:
No problem. For those listening if you want to download
the case study, it’s there in the files to download box underneath the chat pod. So Janet’s case study reads, I am part of
the tribe of American Indians. My father was the first tribal member to go
to college and was a leader. I believe that the burden of his responsibilities
contributed to the physical abuse that my five siblings and I experienced at home. We pretended to be a model family by getting
high grades and doing extracurricular activities after school but behind closed doors we were
shamed and living in an abusive home. As a young child I was told I would be taken
away if I disclosed my sexual and physical abuse to anyone. I blame myself with suicidal and began cutting
myself by the time I was 11. After several bad relationships I got married
but I left my husband when he also became abusive. I moved back to my reservation with my children
and then to Portland, Oregon to look for work. In Portland I met a woman who offered to watch
my two small children and let us live with her while I looked for work. This woman was previous prostitute and her
brother was a leader of a local Crips gang. After arrived the brother started living in
my apartment and I was initiated into the gang by being raped by ten members. They told me I couldn’t leave them until I
died. I walked in the room let out from 8 p.m. to
6 a.m. each night to work as prostitute. I couldn’t come back to apartment each day
until I had slept with 15 men. I was never alone on the streets and if I
didn’t bring enough money back, the woman’s brother who became my pimp would beat me. My children were left at the house while walking
the streets so my pimp knew I would come back. He was paying his sister with drugs so she
would watch the children and I knew I had to get out for my children’s sake. One day a social worker came to the apartment
to perform a child welfare check. I was let out my room to talk to the social
worker who said there were reports of activity in the apartment and no food for the children. She didn’t ask if I was being abused but did
ask if I was a Native American. When I said yes she automatically gave me
a referral for drug treatment. A couple of weeks later a customer tried to
rob me and when I fought back and he stabbed me several times. I was covered with blood when I went back
to the apartment but was just told to go take a shower and get back to work. The police arrested my pimp after this and
call mid parents to come get me. I met with a treatment worker who realized
I didn’t have a drug issue but had been severely abused. He referred me to a woman support group and
that’s where I started my healing journey. My children and I entered a 14 month shelter
program and that’s where I was able to work on my post-traumatic stress disorder, gain
job skills, meet with other survivors and begin to trust myself for the first time>>Kathryn Xian:
So social workers, you have been assigned to check a report gang related activity and
children with no food in the apartment, identify force fraud or coercion use in this case. What barriers came between Janet and you? You think of barriers could be overcome and
how, go. Health professional assigned to meet with
Janet regarding other referral but quickly realize she does not have a substance abuse
problem, same question. Trust issue is number one for sure. Which is why it’s really important that
you develop skills to be able to establish trust in a safe environment which is extremely
critical for the first need and subsequent needs for that matter too? Other peep he will listening in on the conversation,
fearing the victim saying the wrong thing. Absolutely. Physically verbally abused kids held captive,
absolutely for sure. That’s a real good reason why they could give
wrong answers consistently. Paying attention to body language, keep on
responding, these are really awesome responses. I’m going to go on, you can read each other’s
responses if you have any questions feel free to put them in the question box and we’ll
address after the section. You guys are doing great by the way. Okay. So to wrap up in the socio section that’s
key points we have covered in this section. Numerous barriers prevent proper recognition
in the healthcare setting. Patient or client barriers include fear distrust,
shame, unawareness of rights and other complications. Provider related barriers include mixed classification,
unawareness of signals, uninformed attitudes, fear of professional ramification and other
challenges. When providers are aware of the common indicators
of human trafficking this understanding help generate a quicker response with potential
human trafficking cases, I would like to also add in quick that your role as a social worker
or healthcare provider elevates status in eyes of victims especially children. Your judgment, assessment, carries weight
whether you want it to or not. They will be hyper vigilant how you look at
them, how you may be judging them, so it’s always best to come in on first meet with
no judgment and a vibe of acceptance and calm. They will pick up on that. That’s extremely important. If you have had a long day, this is your 30th
case that you’re assessing maybe you want to pass it off to somebody else to actually
— for the pressure of having been on the job so many hours. That concludes our section of the observe. I think we’re taking another five minute break,
is that right Leilani?>>Leilani Funaki:
We are. Thank you very much Kathryn for that section. Once more, five minute break. Back here and ready to start again at 2:26
Eastern Time. We are back from our break with the ask section. Elisabeth will be delivering this section. We’ll turn it to her now.>>Elisabeth Corey:
Thank you so much, Leilani. So we’re going to talk a little bit about
ask now, which is really how we identify and interact with potential human trafficking
victims. The objective of the ask section are really
about we’re committing to treat potential victim using a victim-centered treatment best
practices. And one of the things we will talk a lot about
today is trauma informed care approach. Another objective is to identify the elements
needed to establish a safe environment. The third objective is to apply a victim-centered
interview technique such as those described in trafficking victim identification tool. Otherwise known as the TIZT or other tool. Let’ start off other approach, all professionals
involved in human trafficking cases must advocate for the victim. We want to avoid activities that ostracize
the victim or mirror behavior of trafficker. But not offering victims choices in recovery
process, it will require patience, empathy and compassion from you as well as from your
partners involved in the effort. One key word I like to use when described
the idea of victim centered approach is autonomy. It’s really critically important that we begin
to look at how can we provide autonomy to this victim because it may be the first autonomous
experience they have ever had. So what do we mean by trauma? In short, trauma is an experience that overwhelms
one’s ability to cope. Anyone can be affected by trauma. Individual, families or communities. Vulnerable populations especially children,
girls and women youth LGBTQ persons, persons with disabilities and older adults are disproportionately
affected by trauma. That being said, I want to reiterate something
we talked about in the stop section which is just because they may not fall into typically
vulnerable population doesn’t mean doesn’t experience trauma. A lot of time whence I’m working with clients
I refer to the phrase trauma doesn’t mean drama. Because we come to understand trauma as something
that is a massive event in somebody’s life, for example, obviously trafficking would be
one of those things. But we have to look at trauma not as an event
but as a response. Trauma is a resulting response a person has. So two people go through the exact same event
and it could create a traumatic response in one person but not the other. So we have to look at trauma as something
— a little bit different than sort of what I think is stereo typically described as trauma. So trauma informed care falls under umbrella
of victim centered care. A trauma informed approach is implemented
in any type of service setting or organization. And is distinct from trauma-specific interventions
or treatments that are designed specifically to address the consequences of trauma and
to facilitate healing. The trauma informed practice can and should
be used in an organization. Here are — I’m going to give you a few examples
ways that organizations and providers can implement a trauma informed care approach. First, reflecting the kinds of trauma informed
approach throughout the organization policies, programs designs services and spatial environment. So why would we want to do that? Let’s face it. We didn’t go into the helping profession because
our own lives had been perfect. We help because we get it. The best helpers do but that means we have
to address trauma for clients and for staff. Because as I said earlier, trauma doesn’t
necessarily mean drama. A lot of us have had traumatic responses to
events in our lives, whether or not trafficked or sexually abused or been to war or something
that horrific. All — we have almost all experienced some
kind of traumatic response in our lifetime. So if we can be looking at how we can help
staff to feel they’re safe, we will be able to provide a much safer environment for victims
of trauma coming in for services. Next thing, we want to foster the core principles
of safety, voice and choice. This comes right back to autonomy in many
ways. We want to allow victims who have come in
to get help to feel they have a voice in what’s happening, they have a choice in what’s happening
and they feel safe to also express that. This is really a critical point. Next, establishing trusting respectful and
collaborative relationships. Now, we are going to talk a bit more about
establishing trust later. But there’s one term that I really love to
use when I talk about this, that is called transformational relationships. Because when we can provide a trusting respectful
collaborative relationship with a victim, what we’re doing there is informing the way
they see relationships. More than likely many human trafficking victim
versus never had a relationship like that and now I’m hearing myself in echo. So it’s really important when we can begin
to help them to see a relationship in a different way. I know that when I was going through therapy,
this was a critical thing that happened in my relationship with my therapist, where I
began to feel like oh, look I can have a relationship very different from anything experienced before. Next point to bring up, establishing and maintaining
transparency. In actions and interactions. I want to throw out this piece of advice which
is no white lie, even when we think it’s in the best interest of the client. Because I can tell you from my own personal
experiences hypervigilance is real and those who have been through trauma, we really have
— we really know how to do that. What I mean by that is that a trauma survivor
is going to pick up on everything. Everything. So even though you may think that you have
covered yourself in that little white lie, there is a good chance that the trauma survivor
is going to figure it out because honestly they figure things out that aren’t there. They are certainly going to figure out the
things that are. So this is about being as absolutely transparent
in your actions and interactions as you possibly can be so they feel as safe as possible. The last thing I want to share from this slide,
we need to be sharing information in an ongoing and consistent manner. Many survivors carry belief that relationships
might start out okay but they won’t end that way. And when you think about the standard pimp
manipulation there, that we often hear about where it starts out really nice and lovely
and then it goes downhill very, very quickly, that’s exactly what’s happening to a lot of
relationships of trafficking survivors. This is about being in it for the long haul. So let’s talk more about the trauma informed
approach. You will see in front of you we have a list
of six principals of a trauma informed approach. Trauma informed care promotes maximized healing
and minimized re-traumatization in the delivery of a broad range of services. Those can include anything from behavioral
health, substance use, housing vocational or employment support, domestic violence and
victim assistance and peer support. This approach, I’m going to talk about different
aspects this approach helps us with. The first is it supports emotional safety
for victims and staff. And as I said before, remember that everyone
has trauma to some extent, we’re looking to provide safety on all levels. That is especially true within the helping
profession. The next thing is, providing information about
trauma to victims. This is a really critical point, something
that I face a lot within my own work because the name of my business actually has the word
trauma in it and I often hear from my clients they weren’t going to contact me originally
because they didn’t think of what they had with trauma. Being able to help trafficking victims not
even understand they were trafficked, but to understand that they may have a traumatic
response to the trafficking, is so important. They may not even realize what’s happening
to them is actually because they’re having a traumatic response. Also another key point of trauma informed
approach is you are — you can — — connect potential victims to crucial support networks
to foster supportive interpersonal — I think it is also very, very valuable to
connect victims with peers in one — peers in one perform form or another. Will it always go smoothly? No, it’s not going to. I run support groups via churl support groups
for survivors of trauma now and people trigger each other. It happens. But having the ability to connect with people
actually know what they have been through on a very deep personal level is critical
to that survivor acceptance and being able to drop the shame carrying around what happens
to them. Another thing it does is help people with
history of trauma to manage feelings — feel in control of situations and get input on
the programs services they want to be a part of. Let’s get back to this idea of autonomy but
also important for trauma survivors to understand many times they’re having a trauma response
to something happening and them and makes them feel out of control, so part of learning
how to address their own traumatic responses is to recognize that’s what happening so they
can begin to address things from the perspective of empowered autonomous adult or older child
if that’s what happens to be. That can be a very powerful learning for a
trafficking victim. Another thing trauma informed approaches do
for us is it changes the paradigm from what is wrong with you to one that asks what has
happened to you. I can’t stress the difference in that. More. I could spend an hour talking about just that
and how critically important it is for survivors of trafficking and trauma to understand their
response to life right now is not something that’s wrong with them. But it’s how they have responded to what has
happened to them. And then the last one I want to bring up here
around trauma informed approach is that it engages people with histories of trauma in
a manner that recognizes the experience of trauma. And now the impact of trauma on development
and coping strategies. Because the impact of trauma is incredibly
holistic. Studies are showing the inextricable tie between
physical difficulties and traumatic experiences. This is especially true when the trauma has
been prolonged. That is the case with most trafficking victims. They have been through prolonged trauma, sometimes
we refer to it ads complex trauma. That is what their experiencing. If we can help them to understand how that
trauma is potentially impacting all aspects of their life and not just their therapeutic
life that can be incredibly helpful for them in their own healing. I know that’s something focused with a lot
in my clients in virtual group is how has your entire life being impacted by your traumatic
experience because they can understand that then they can also begin to make changes to
that. And they can feel empowered to make changes
to that. So it’s not just that they’re having a random
response to a random event but that it is actually a holistic response to trauma. The ace studies help a lot with this actually
because they’re showing these connections that we have never known were there before. So another reason to go and do some research
on the ace site as well. Then a little side note. When organizations are working with peers,
and bringing those peers in to support potential victims, there are a few things that are really
important to consider. This is very near and dear to my heart because
I work with organizations as a peer and a coach and mentor of trafficking victims and
other trauma survivors. So I have seen these things play out directly
and we need to make sure we engage peers with empathy respect and support. We want to come at this treating these peers
with as much respect as we can. We need to provide meaningful opportunities
for pierce to facilitate organize and coordinate activities so it isn’t that the peer is sitting
there, while somebody else is doing the work but we are engaged with these peers and allowing
them to be part of the process. And we want to offer peers choices and hon
thaw nor their decision like we would with somebody who is coming directly out of a human
trafficking situation. We want to be treating those peers similarly,
back to earlier point, we want to treat staff, herb in our organization like this and — everybody
in our organization like this and not just people coming out of a traumatic situation. The last thing I want to say on this slide,
I know talking a lot on this slide but it’s important, to do your research on what works,
what is available for trauma victims in your area. Talk with survivors what works for them. Just because somebody or something is claiming
to be trauma informed, doesn’t mean that its survivor informed. It may not be avoiding re-traumatization,
there’s been trauma informed approaches that when I looked further, they weren’t really
promoting the autonomy and healing needed after complex trauma. Do your research and involve the survivor
in your discussion on what really works for trauma. Thank you for listening. Before we get to the video, I just wanted
to mention quickly a little bit about my story. Now, my story and the story you’re about to
hear are actually not that different and interestingly enough, we are — this is actually not a normal
story that you hear in the media or the news at all. So you kind of get two perspectives that you
might not hear a lot of. But I wanted to talk about my story. You know I am a family controlled survivor
of sex trafficking. When I was growing up, yes my parents were
my primary traffickers, I went to many medical doctors and my parents would go with me and
make excuses for what was happening to me. I had a ton of — it was suggested by my mother
that they were caused by bed wetting and the nurses who were working at the doctor’s offices
would — believed her. Now I know that in many cases that wouldn’t
happen today but my mother is an extremely persistent person so important point to make. My parents wouldn’t allow pelvic exam or anything
that might show I had been through any type of sexual abuse but when I was eight I was
taken to a doctor by a neighbor where when my parents were out of town and the doctor
did a pelvic exam and called the police and while that sounds like a really good thing,
what actually happened next was actually added to my traumatic experiences. Basically everybody was standing in a room,
they were all very concerned, they were all adults, and I was the only child in the room. And what I gathered because I was a child
at the time was that everybody in the room was mad at me. Because I had been living in such a punitive
household that was, what, came across. So I was immediately taken into foster care
because of this experience. And in foster care I was placed in a very
neglectful foster care which was more like a hotel for kids, they didn’t make meals for
us, we were basically on our own and I ended up being raped by a foster care brother. So in the process I decided the best choice
was for me to go home, I changed my story and I said everything at home is fine. And that basically what the result of that
was is that my CPS workers were very disappointed in me, once again, I interpreted their reaction
as angry with me. And I had a judge who actually — me because
he decided the reason for my physical injuries was because I had decided I wanted to. Now, remember, I was eight and nine years
old at the time this happened. So I think what and unfortunately what happens
for a lot of survivors and in family controlled situations, is that the experiences we have
with adults outside of our family can be scary and we don’t necessarily trust them because
we have been told not to. And then we can get in situations where we
feel like our parents were right all along because the experiences don’t turn out to
be good for us. So I’m going to turn it over now to the video
where a good survivor friend of mine is going to tell her story.>>Female Speaker:
I was trafficked beginning as a young child; it was pretty much almost a part of my life. All of my life up until I escaped when I was
18. My trafficker was somebody that had my complete
trust and complete trust of my family. Therefore, it made it very easy to gain access
to me to exploit me. There are moments in time when I was trafficked
that the opportunity for intervention arose. When I was a young child I had chronic reoccurring
vaginal infections that were treated by my pediatrician. Then in middle school, I contracted oral — sexually
transmitted disease and which I was treated by ear nose and throat doctor, both physicians
were wonderful and very caring. But not one physician or healthcare worker
ever asked whether I was being sexually exploited. Not once. Both doctors knew my family so they may have
dismissed that thinking no way could a child from a middle class home be exploited. Another case I see an opportunity that was
missed for an intervention was I was in middle school, somebody reported that I was being
sexually abused. I had to go down to child protective services
prior to going to my interview I was coached by my trafficker what to say and how to deny
the abuse. He told me not to talk too much and to know
that the CPS was not my friend. I distinctively remember him saying do you
know what they want to do? And I said no. And he said that they want to take you away,
if you say anything for good, you will be locked up, taken away from your family, your
friends and your pets. You will go to jail and everybody will know
what you did. By the time I got there and walking in to
the office which I was interviewed by CPS worker, I walked in there, feeling guilty,
feeling ashamed, and not at all seeing the social worker who was interviewing me as somebody
that could help me who was there to rescue me, bring me to safety. I saw her as the enemy. I answered her questions, denying that I was
being abused. And left there with no — there was no follow-up. And my trafficking continued.>>Elisabeth Corey:
All right. What we’re going to do now is talk a couple
of questions here. I like for everyone to do is come back to
your chat box and answer a few questions we have here. The first one when it comes to the stories
you saw in the video, what red flags should the provider had seen? STI, frequent vaginal infections. Yes. No child should have STDs, physical symptoms
fearfulness, and timidness. Yes. Absolutely. Thank you guys for responding to that. What questions could the providers or social
workers have asked? How are things at home, open ended questions. Absolutely. Do you feel safe? Next one says ask if comfortable, what is
happening to you. Are you safe? Do you know we are here to help. And then this next question is I think really
important one, is about do you know what my role is. I think that that’s a real critical question
because people may have told her — people did tell her to be — to believe that the
role of this person was to cause her harm and difficulties in her life by arresting
her, what not. You know what my role is. Seeing also are you afraid of anyone, tell
me what is — day in your house is like. These are all good questions. They’re scrolling by so fast I can’t get to
all of them here. Assure you — that’s a good one. So the next question for you guys is what
should the social worker have done differently here? Explain their role. That’s one of the most critical things. Followed up the other critical thing here. Really helping the child to understand the
role of the social worker, they’re not there to retaliate or arrest the child. Then also, yes, the following up, not allowing
this to be a one contact situation I think is critically important. Someone saying give her a phone number and
tell her she can call any time. Yes. And get back to that whole building a longer-term
relationship with the child can be very helpful. Gang her trust which takes time as we were
saying. Asking open ended questions. Yes. Thank you guys so much for these really awesome
answers. This is exactly the discussion we need to
have. Another person said visit her home. I think that’s a really good one. It’s also important to note that in some cases
where there’s sexual abuse trafficking in the home, visiting the home won’t give you
obvious indicators. It won’t look lick you might think it’s going
to look like. My parents were absolutely famous for what
I call their perfection mask which is everything in the home looked perfect and great and beautiful. And you would have never known anything was
wrong up in that house ever but it’s critically important that CPS workers go to the home
because that may or may not be the case. Thanks for your answers. And you’re welcome, Beth. I’m glad I could share this story. Okay. So we’re going to talk about trust building. Because if there’s anything that’s the hardest
to do is probably this. It’s one of the most important points about
trust, is that it will take a long time to build it. And it will come in phases. You can lose trust at any time for any reason,
remember the victim expects you to betray them, they are waiting for it, that’s why
it’s critical that you don’t and when I mention earlier this idea of little white lies, don’t
tell them not even the littlest ones that may seem like you’re protecting them because
they are just looking for you to do something to hurt them because that’s what they’ve experienced
probably over and over and over again. So we have to go into the relationship understanding
that. We need to see the potential victim as an
individual and treat him or her with dignity and respect. This comes to a point that I think is critical
to make here. You are not a savior and they are not your
problem to solve. I know I have social workers, I have my NSW
and I’m also a survivor and life coach but I can tell you that it is really easy to fall
into the trap of wanting to save this person. That is not where we want to go. We need to treat them with dignity and respect,
we need to treat them as an equal to us and they need to be able to feel that. They need to feel that we respect them. And not be thinking oh, I’m just somebody
this person is trying to save here today. Foster honesty trust and respect to the victim,
definitely. Understand that incremental disclosure is
how most cases unfolded. Give you guys maybe more information than
you wanted right here but not only does the narrative change as victims heal, but memories
may actually be repressed in addition to that. So not only are we dealing with a situation
where the person will over time begin to translate that memory differently, when they first say
it they may not consider it rape but later on as they begin to heal and begin to see
the trafficker for who they really are, the words might change and suddenly it becomes
rape instead of sex. These are very typical interpretations of
their story that shift over time. In addition to that you may also be dealing
with the fact that memories of traumatic situations don’t show up at first. They may never show up but in a lot of instances
they come later on in the process. So we do have to make sure we understand incremental
disclosure happens. There will also be instances they tell you
a part of the story because they want to see if you’re trustworthy then tell you the rest
of the story later when they feel better about trusting you. That absolutely happens too. There’s a combination of things that are going
on here that contribute to incremental disclosure. It’s very important that as social workers,
we understand that. I talk an awful lot with law enforcement about
this. And trying to encourage them to understand
how disclosure works and why of potential victim of human trafficking will disclose
incrementally because there really is a lot going on when there’s been trauma in this
way. It’s very important we change our understanding
how that narrative is coming forward for us. Next one, use open ended questions. Because one of the things I know that I did
for many years is I always looked to give the right answer. And I did this in school too, which is one
of the reasons I got such great grades but in reality, I was always looking to see what
does the person want me to say here? Because I wanted their approval and I wanted
them to like me and I wanted all these things and I also sort of wanted them to not get
mad at me. I had been in all these situations that were
violent and critical, all my life and so I certainly didn’t want to give anybody an answer
they didn’t like. So we have to keep our questions open ended
as possible because that eliminates the possibility hopefully eliminates the possibility they’re
just telling you what you want to here, doesn’t eliminate it fully, I understand that. They can still find way to try to tell you
what you need. So but I think we have to keep that in mind. Also practice reflective listening. So many times survivors are not used to being
heard, victims are definitely not used to being heard and so if you can point out that
you are listening. That’s critical. Couple more points on this, when asked what
might have made a difference in telling the truth about what happened to them, many victims
said indication that the provider cared or saw him or her as an individual and treated
him or her with dignity and respect would have made a difference. Victims said that finding a way to connect
with them was so important. Asking them personal questions, showing concern
for them as a whole person, not just maybe the medical condition they have on that day. Is important to be doing. You can — some sample questions might be
where at your home are you in school, are you working? Is work okay? Beginning to build that type of conversation,
I think really makes a difference, it can start the process of creating trust between
you and the victim and so it’s something to do. I’ll leave this, there’s this piece that came
out specifically from the healthcare provider and I think that it’s worth noting what she
had to say here. When I see a patient or client, I let him
or her talk about whatever he or she wants to discuss. I don’t force a series of questions or ask
from a list. I engage the patients to clients and let them
tell me why they are in my office. Excuse me my throat is acting funny. Part of this process is patience; incremental
disclosure is a huge part of the way these cases unfolded. More so than any other kind of trauma. The potential victim may tell you one story
on week one then another week two and still another week 3. But listening is important because this is
how you will start bonding with these patients or clients. Often they have bonded with their trafficker
because of instead of complex emotional reasons, circumstances in their past such as adverse
childhood events, repeated exposure to physical abuse and trauma. This bonding must be broken and new bonds
formed. Potential victim is asking herself how I survive
now that I don’t have him around me. And the setting has to be safe, secure and
trust must develop in order for potential victim to tell what has really happened to
them. So let’s move to the next slide here. Cultivating trust in creating a safe space. So let’s talk about this. The first one here conducting the interview
in a safe comfortable environment. Privacy. This is hard stuff to talk about. And we want to make sure that they feel when
they’re talking to you they’re not also being overheard or listened to by other people. Really looking at is this a trauma informed
face. For example, can they see the door? To this day when I sit in a restaurant I have
to sit in a way I can see the door. Certainly when somebody is just coming out
of the victim — or just coming from being potentially a victim of something this traumatizing,
they are going to need to feel their safe in the space and one of those ways is can
they see the door. Are there triggering items in the room? You can even ask them, is there anything in
the room that feels like a distraction to you or is triggering something from your past
or your traumatic experiences? Remove the item. But if you don’t ask they may sit there and
fixate on it and not tell you. I know when I first started going to therapy
that was certainly my approach. Trust is compromised when an interviewer appears
judgmental. It’s really important, it isn’t your — is
it your place to have an opinion about what happened to them? It isn’t your opinion, and I know you know
that but it’s easy when you get in situations especially sharing something that’s very difficult
to listen to, to want to have an opinion. The next one, presses too hard for disclosure. This is traumatizing. I know that this is a common thing in law
enforcement and they need to know in other settings they are not going to also be experiencing
that. I worked with family experience in trafficking
now for many, many years and they may have been working on their own recovery from trauma
for 20 years or so. They still haven’t disclosed to anybody beyond
therapeutic community. That’s their right. So we have to respect that. The next one fails to promote informed consent. Once again, coming back to this idea of autonomy
and choice. It needs to be their choice. And the meeting infrequently with potential
victim. I’m going to change this a little bit to making
yourself available to meet infrequently. Let’s face it, potential victims can sometimes
have trouble convincing themselves to meet with you, or maybe facing their own defenses
against meeting with you, maybe other barriers in place, but they have flex — be as flexible
as you can when meeting with potential victims because if you’re available, even if they
can’t make it they will take note of that. Take note you made yourself available. So trust is promoted when an interviewer clarifies
his or her role supporting a potential victim. That’s something a lot of people brought up
when talking about the earlier case, that for example, I’m not a cop and what you’re
it willing me is confident able unless I feel you’re in immediate danger. That’s great information to provide, especially
dealing with children; a little bit more about details of who you are and why you’re not
a threat is really important. Also, define what he or she can do for potential
victims without unrealistic promises. Definitely they need to know how are you going
to help them. Ask simple questions, listen to potential
victim’s answers emphasizes what he or she is not guilty or — or that she is not guilty
or at fault. And I’m going the talk more about that in
a second. Finally demonstrate cultural competency. I want to add to this section there’s three
really important phases in relationship building with survivors of trauma. The first one is, maybe none of these will
surprise you much but the first one is, it’s not your fault. That’s a critically important phrase. We don’t want to be judging them, we also
want to be helping them to see where they may be blaming themselves but it isn’t their
fault. The next one is I believe you. — phrase is I believe you. Their story is going to change, keep believing
that are story. Be careful not to use phrases like you don’t
seem like you went through all of that. Because heard that many times in the therapeutic
community and while I got that it was meant to be a compliment and they were saying look
how strong you are, you went through all of this and you don’t seem like you went through
any of it, but what that sets through sort of indicates is a slight bit of invalidation
of what they went through, like oh you don’t believe me because I don’t look like I went
through that. Stay away from well-meaning phrases like that
even though I know they sound good. And the last phrase is so important in relationship
building is something I refer to as me too. Share a bit about who you are, when it is
appropriate, if you can relate and you can go there and go there in a professional sense,
let them know it. I’m not suggesting that you should say something
happened to you that didn’t happen to you, not at all. But if you can relate to their pain, if you
can relate to some level of their experiences, let them know, this is another reason why
peer relationships are so critical. Because there is so much healing in being
able to hear from others that they understand, they experience it themselves even. Next slide. Going to talk the next couple of slides a
little bit more about the procedural side of things. We’re going to start off with separating the
patient or client from possible controller. It is critical for every provider to have
a separation protocol; this plan must be established ahead of time. A separation plan allows provider to examine
or question the patient or client privately in a safe environment. The plan needs to cover who will carry out
the actual separation process and what occurs in the person accompanying the patient refuses
to leave their site. Strict criteria should be set for when and
when not to intervene once a patient or client had been identified. If a descendent is made to proceed with an
intervention, a clear — a decision, a clear determination must be in advance, including
notification of internal and external security officials. Informed consent is obtained from — and local
child protective services will need to be contacted for a minor. Remember the victims may not understand the
term human trafficking and maybe reluctant to leave their trafficker at this time. Human trafficking is a criminal activity. That means that the traffickers may be armed
and violent. This means that there is inherent danger involved
with any type of intervention. Most danger centers on the patient who has
now been identified as potential victim of human trafficking. If an intervention is planned and fails a
victim may suffer additional abuse and trauma from his or her trafficker. In addition, staff or agency maybe exposed
to some level of danger so is it’s critical to work through the safety component of intervention
before carried out using input from local and federal law enforcement and hospital security. If that’s applicable. And it’s also important to note here if you
are already working within the domestic violence community, you may have a good idea of what
this looks like. But it’s critical that you make sure if you
do have a protocol in place already for domestic violence situations that you update that so
that it includes what to do when you’re faced with human trafficking. So if you could now go to the chat box one
more time and share any experiences you have had with separating potential trafficking
victims. I see we have multiple attendees typing. None. Worked in a medical clinic where clinic protocol
was to room patient alone before allowing anyone in room with him or her. Degree. Great example. If someone comes to our office with a client
I explain it’s our policy to meet with everyone alone and they’re happy to wait in the front
waiting area. Another great example. Very challenging when separated especially
when the situation has been long term and there’s pregnancy and young children involved. Absolutely. Separation is a step but honest, sprayings
doesn’t necessarily mean we have in beautiful glorious relationship with the trafficking
victim and everything is great. It is a step in the process. Nothing is assured just because of the step. I see there are several other people typing. Give it just another minute here. DV cards with phone numbers made small so
could fit in the shoe that is a great one, there are really good tactics also out there
for how to give contact information to victims so they can contact you later. When they are in a place where they’re not
with their trafficker. So absolutely, that’s another technique. Ask to speak with insurance person or billing
matter. Great one. Thank you guys, thank you for the answers. We are going to talk a little bit more about
the separation process in the final section too. Let’s talk about a particular tool for action. We will start out by focusing on safety, it’s
necessary to ask trafficking specific questions if red flags are raided. However, — raised. But you need to make sure it’s safe to conduct
assessment. We discussed one aspect which is separation. When you’re conducting a safety check in person
you need to ask the following question: Is it safe for you to talk with me right now? Do you feel like you are in any kind of danger
while speaking with me at this location? Is there anything that would help you to feel
safer while we talk? There’s really good examples of things you
could ask to assess whether or not it’s safe to continue. When conducting safety check by phone remind
individuals he or she is free to hang up any point during the conversation if he he or
she believes one is listening in. Then ask the following question. How can we communicate if we get disconnected,
would I be able to call you become or leave a message — back or leave a message? Someone comes on the line what would you like
for me to do? Hang up? Identify myself as someone else? A certain person or friend? Are you in a safe place? Can you tell me where you are? Would you prefer to call me back when you
are in a safe place? And then are you injured would you like me
to call 911 or an ambulance. So these are examples of questions you can
ask that can help you determine if it is safe to continue with assessment. So now we’re going to discuss one example
of assessment tool called the trafficking victim identification tool. It can help you in the actual process of identifying
trafficking victims. The institute of justice recently completed
studies in which they created field tested and validated. But first screening tool that can reliably
victims of sex and labor trafficking including U.S. and foreign born victims. The tool was value dated in — validated in
similar service agencies and not in healthcare settings. So depending on what your environment is,
it may or may not have been validated in that environment. However, in the work that I’ve — the people
I discuss in this particular tool with, what I found is they have been able to take pieces
and parts of this tool and incorporate it into their existing assessment tool especially
in the case of medical communities in order to really gain more integrated process to
identifying human trafficking. So the questions cover the following topics. Personal background and demographics, migration
in the United States, and work and living conditions. So this is something to look into. By the way trafficking victim identification
tool is something available to free and I see the link is in the chat where you can
go and grab that. To wrap up, we’re going to do — or ask a
couple of questions that are what you would do. And I would love to see you guys answer in
the chat. Here. Where we’re probably going to not focus the
last question because we sort of already talked about that a little bit but what would you
do if you see that the patient or client has bruises on her face and arms in an unusual
brand at the top of her breasts. Ask open ended questions. Definitely. Don’t ignore it; ask her what happened or
the meaning behind the tattoo, find way to speak to her alone. Make a general comment bruise are painful
and open and talking about them. Good one there too. Build trust and rapport. We are providers who can assist her. How did you get those bruises? What is a significant — significance of your
tattoo? Would you like to tell me something? Yes. So great responses, it’s obvious you guys
have been paying attention. Thank you for those great answers. So next what would you do or ask next? Say you ask these questions, they have given
answers and maybe found suspicious, what would you do or ask next? Do you want help? Ask if she has a safe place to stay or who
she turns to for support. Try to get her to talk about it, offer phone
number and explain your role and let her know she can call you. Is someone hurting you? Are you concerned, can I tell you more about
possible things we can do to help you. These are good. Thank you guys. And the final question is who would you what
would you do if she tried the leave the room in the middle of meeting? Offer to meet with her again. Try to give her a card as she’s walking out. Tell her she is also welcome back. That’s so important for everybody the really
focus in on, it’s unlikely you get disclosure the first time you meet a human trafficking
victim but if they feel like you are open, them reaching out to you at other times that
may be a way to get them at least thinking about the possibility that they can get help. Always remember I am here. I love that. Thank you guys so much. To wrap up, section summary here, what we
have learned today is applying trauma in foreign techniques and how to improve your ability
to work with victim of human trafficking. Building trust is essential in working with
potential victims. I think I probably over talked about that
particular topic because it’s so critically important. Next, conduct a safety check with a patient
prior to starting the interview and then you do have opportunity and ability to use the
trafficking victim identification tool otherwise known as TBIT. To assist with interviewing. I think that sums up the ask section. If you have any questions feel free to put
them in the chat box and if we don’t address them now we can address them later. I think we’ll be going into a break now.>>Elisabeth Corey:
We have one final five minute break. So let’s go ahead and take that now, back
here to begin the last section of the training at 3:28 Eastern Time. Five minute break, back at 3:28 and feel free
to continue typing any questions we have, we’ll be sure to address them before we wrap
up the training today. Thank you.>>Leilani Funaki:
Okay everyone welcome back from the break, here we are with Kathryn one more time to
deliver the response section of our training. Kathryn over to you.>>Kathryn Xian:
Thanks, ALOHA, everybody, thanks for sticking with, the respond objective of our training
include referring potential victim based on available local resources and your profession,
apply culturally linguistically appropriate services standards and exhibit cultural awareness
when interacting with potential victims of human trafficking. Define role governmental and non-governmental
organizes play in addressing the issue of human trafficking. Apply to real world case study. Communicate the basic elements necessary for
human trafficking response protocol and communicate the qualities of advocate for human trafficking
awareness who can more effectively work with management and peers. Use your referral networks to help human trafficking
victims get the help they need because we can’t do this alone. No one agency can. Decide where to refer a potential victim;
this should be based on agreement and discussion between you and potential victim always. Some things to keep in mind good clothing
basic needs, interpretation, clean interpretation as mentioned before can be problematic. Several legal assistance to stave off deportation
fear, identify local service providers to help with that. Dental substance abuse treatment needs, behavioral
health treatment referral, identify those service providers. Anonymous reports if any can be made to NTRC
and ACRC human trafficking hotline. It is important to connect potential victims
to ensure you are providing holistic care, the response to these surviving require a
holistic approach not just one agency can fill the need. Human trafficking is a crime, if you believe
its committed contact law enforcement after you get the consent of your client. Never before because as Elisabeth said it
can be very re-traumatizing once law enforcement comes in because they don’t have sensitivity
training at all, they’re not required to. If potential victim is minor follow agency
reporting protocols which I believe most of us are in fact all of us are mandatory reporters
in that area. If you choose to report this crime works with
local anti-trafficking network and diversity it. Don’t just go to one, go to multiple because
you never know level of training one agency has, it is an evolving process and will continue
to evolve, never take for granted that one agency or one person is to go to for all trafficking
cases. Peer support is absolutely critical, engage
local survivor networks; survivor networks are absolutely beneficial to the healing process. Identify other networks the potential survivor
identifies as safe places, houses of worship, hobby volunteering for cause, reunification
of loved ones, support groups and athletic activities. Also alternatives from care and healing like
acupuncture or massage or yoga can also be helpful outside of our budget plan but effective. We can draw on lessons learned and tools to
public health responses to intimate partner violence or sex abuse under — the national
referral mechanisms ensure providers can participate in a network with well prepared and trustworthy
services for example shelters, legal aid law enforcement social work. Medical and health education recognizes human
trafficking health concern is a fundamental component of a public health strategy. Paraprofessional community health workers
can assist in identification and support of trafficking victims because of their presence
in vulnerable communities. Community health workers are typically trusted
and respected community leaders making it easier to offer more effective and sensitive
education and intervention results in better outcomes. So for those who have populations of natives,
really utilize native centered NGOs that really help open dialogue and establish trust and
network to be able to become more culturally sensitive, they definitely know human trafficking
is a big problem and community wants some help in combating it. So always underscore relevance of the native
population and urge them to reach out those groups doing this work. We have seen healthcare professionals play
major role in identifying potential victim of human trafficking however utilizing the
larger referral network to provide services needed to protect the potential victim help
them recover and prevent further trafficking and recidivism. If you think you have encountered a victim
of trafficking, it is important to collaborate among key service providers including law
enforcement service providers and others mentioned on this slide. Helps to ensure that survivors receive the
help they need, local law enforcement and social service providers also supply valuable
information about types of trafficking occurring in your area. This may help when compiling a list of red
flags and indicators specific to your local population. Local bike offices maybe aware of common street
names and tattoos used by traffickers working in your area. And specific types of trafficking present. Reporting requirement do you know what state
reporting requirements are? States vary frequently since definition of
trafficking allows — the patient or client must be reported if that is the case. Mandatory reporting requirements can get a
little complex in tribal law jurisdiction so important to know requirements areas and
continue to work with the health insurance portability and accountability act of HIPAA
guidelines. State laws also suspect child abuse domestic
violence, populations abuse may apply, even if you’re not sure that this is a trafficking
case. You cannot physically restrain such child
or prevent him or her from leaving. You should offer both child and adult referral
call line number, et cetera but make sure giving written materials does not jeopardize
potential victim safety, also let victim know he or she chooses to come back you and your
organization would like to see him or her and offer services. If possible schedule follow-up visit and while
crucial to document the patient’s injuries and treatment well, sometimes information
can be used as victim of trafficking in court proceedings. There should be guidelines in place how best
to document so you should be concerned about protocol and downloading assessment tools
and I would like to remind you if you didn’t see it already there are assessment tools
and protocols available to download in the files to download pod on your screen. In addition to following state reporting requirements
make sure the organization are meeting organizations are meeting the class standard so victims
receive cultural hi competent care. Enhanced national class standard are intended
to advance health equity, improve quality, and help eliminate healthcare disparities
by establishing a blueprint for individuals as well as health and healthcare organizations
to implement culturally linguistically appropriate services. Enhance standards are comprehensive series
of guidelines and inform guidance those practices related to culturally and linguistically appropriate
health services, refer to the hand outs for further information. Though the class design for healthcare settings
they can and should be applied to social service settings as well. So offer to individual’s proficiency or
other communication needs at no cost to them to facilitate timely access to all healthcare
and services and show competence of individuals providing language assistance, recognizing
that the use of untrained individuals or interpreters should be avoided. Provide easy to understand (indiscernible)
and language commonly used by population in the service area. The national human trafficking hotline. NHTH is a national anti-trafficking resource
center hotline. Serving potential victims to trafficking and
the anti-trafficking community across the nation. 24 hours day, 7 days a week, every day of
the year. This resource is a non-profit non-governmental
organization funded by Federal Government that works exclusively to combat all forms
of human trafficking. It is not a law enforcement or immigration
authority. Mission of NHTH is to provide trafficking
victims and survivors with access to critical support and services to get help and stay
safe and equip the anti-trafficking community with tools to effectively combat human trafficking. The NHTH offers confidential round the clock
access to a safe space to report tips, seek services and ask for help. With extensive service referral directory
of over 3,000 local service providers across the country NHTH is able to provide live information
and referrals. The NHTH also maintains case records to provide
continuous care when callers move or need ongoing assistance over time. Anyone can call the hotline at any time. Be it provider patient or client service provider’s
not great confidentiality or HIPAA guidelines to access services to the hotline. Service providers not break confidentiality
or HIPAA guidelines access to service. The men and women in the information that
healthcare or social service provider should have when calling the hotline includes one,
age of patient or client, two, any physical or emotional injuries note and documented
three detail regarding patient or client work or living situation. Moving right along. So going to a final group exercise. We through the case study provided and on
your own to develop a response. Using the four areas that we have covered
in the training. What common risk factors for human trafficking
individually exhibit, observe, what are physical and mental indicators of human trafficking,
ask how would you apply the interview techniques to this case.Respond.What service providers
would you refer potential victim of human trafficking>>Leilani Funaki:
Okay this is Leilani again, so we’re going read one more case study. This one is about Barbara and it’s listed
in files to download if you would like the follow as I read. To reiterate what Kathryn just said, if you
could be thinking, about how you would respond to this person to Barbara if you were part
of this case study as I read then ask you to answer the questions that Kathryn read
off for us. So Barbara case study that reads, I grew up
in suburb in north Virginia; I was molested for first time by my father at eight years
old. Starting running away to get away first when
I was 12 years old. The police were catching me and bringing me
back and my parent didn’t seem to know what to do with me. I spent time in a detention center and reform
schools and hospital centers for children with problems. My mother was in complete denial. I tried to tell her what was happening but
she couldn’t belief or didn’t want to. They put me into the juvenile justice system
and child welfare system and eventually parents’ rights to me were taken away. I kept running to Washington D.C. and before
long noticed me there. One lady picked me up at 13.She took me to
the apartment and told me I could stay there. She groomed me for prostitution. She told me the man in the apartment was boyfriend
but now I believe trafficker. One day when I was 14 they sold me to another
pimp named Moses, vicious by smart and had many women under his control. He sold me to anyone and everyone he had a
quota to make if I didn’t make it he would take a wire coat hanger and whip me mercifully
.I did what he wanted me to do for fear of beating again. I walked the tracks around certain hotels
and arrested many times but my pimp never bailed me out, he didn’t want to spend the
money so I would sit? Jail until they finally let me out. Around that time I started using drugs that
were given to meat first I used them to numb the pain but I became addicted to heroin. With the beatings violence and abuse I became
tough but somewhere inside me I was able to protect a small little place, place that loved
life, loves animals an years later when helped to leave the life I told her what happened
to me, she couldn’t believe it she kept saying you don’t seem like all that happened to youth
emergency department was my doctor during the years I was on the street. Even though I was obviously a minor during
the first years no one asked me what happened to me or what was wrong. Ultimately one caring concerned person in
drug rehab center I went for methadone saw I was sick and addicted and realized there
was something more going on. She said I needed help and took the time to
ask me questions and get plea to tell my story. She was the one who fund found me the right
services for what happened to me. But it wasn’t until years later I really understood
that I was a trafficking victim. Okay, and so I think if I could just –>>Kathryn Xian:
[inaudible]>>Leilani Funaki:
— I’m sorry, go ahead Kathryn>>Kathryn Xian:
If this was your client, what would you do? Walk through the SOAR steps keep up the slide,
what common risk factors of human trafficking, where this physical and mental indicators. Go ahead and start responding while I’m reading
this off. How would you apply victim centered interview
techniques? What service providers would you link up with
to refer this potential victim of trafficking?>>Leilani Funaki:
Okay one response we have is frequent run away, I see more response coming in Coming
in — early sexual abuse by a family member running away without support from parents,
run away history of juvenile services, early trauma. These are all good examples of common risk
factors for this case. Engagement with the system, a high ace score
referring back to what Elisabeth covered that was definitely an indication or risk factor
here. Let’s see. Other responses are trust vulnerability issues,
childhood sex abuse, substance abuse, time in jail. [inaudible]>>Kathryn Xian:
Let’s hear how many — how you would you ask, apply the interview techniques to this case?>>Leilani Funaki:
There are a few people typing in their responses. [inaudible] Tell them they can trust you and ask them
the if they’re okay. Another suggestion, explain my role how I
could help them. Create safety and allow the victim to tell
story and identify needs.>>Kathryn Xian:
Great all great responses. I would like to also throw out there that
you never want to — I hate using the word never but I’m going to say it anyway. You never wants to see information to a victim,
depending on age and how long they were trafficked, they may not know the lingo associated with
prostitution and trafficking but that helps build your profile of this victim, you never
want to teach them what these terms are, they don’t know what they are, then you know that
they haven’t been in their situation for very long or it may tell you a little bit more
about the trafficker that he or she is involved with. So let them speak, let them fill out the terms
if they know them and know what they are. Don’t teach them what prostitution is in other
words through vernacular. Okay? Great. So let’s move along.You guys are absolutely
wonderful in your responses. So, protocol components, developed for human
trafficking should include this very important elements to be able to apply in your workplace,
you need a protocol, for working with these potential human trafficking victims. Protocols can be extremely helpful in interacting
with the potential victims and can be developed by using current systems for protocols that
respond to victims of domestic violence or child abuse. For example, child abuse sex assault, substance
abuse, domestic violence all weave into this dynamic that creates human trafficking environment. The components of human trafficking protocol
within the healthcare system should include many of the things we have just talked about,
such as a list of red flags, based on local trends in trafficking in your area, a separation
procedure. Interview procedures. Once the patient is separated ready to be
interviewed the protocol should address the following item, A, who design interviewer
will be and if interpreter is needed. B, trauma informed care techniques will be
utilized during the interview. C, what translators will be used and how to
contact them. — will be used and how to contact them, very
important not to take that for granted. Make sure your translator is clean. We in Hawaii had such a bad problem with translators
being connected to the traffickers we actually had to get a federal agency to help us get
a translator from out of state. That’s how important communication is and
language control is, and the traffickers know that and they use it. D, specific questions about to be asked and
the order to ask them and how to incorporate a tool such ads the VERA tool that that you
have in in your download box pod and E, the appropriate procedure if the patient is confirmed
ads a victim of trafficking — as a victim of trafficking. Which is not your job, you’re just there to
identify potential victim. A safety planning for potential victim and
medical staff needs to be considered with the intervention. Advance preparation for certain scenarios
should also be considered such as what occurs if trafficker refuses to be separated from
the patient. Think about these things. How would the response be? How should you respond when you reach a level
of certainty that the patient is victim of trafficking but this patient refuses intervention? Mandatory reporting. What are your state and local requirements? Your referral network. It is critical to partner with local state
tribal law enforcement and social service providers shelters, NGOs and legal service
providers to name a few. Federal law enforcement may need to be involved
with other federal agencies depending on the case. For instance, I mentioned this in the chat
box, even though federal definition of human trafficking incorporates that anything given
in exchange of value for the labor or services is defined as trafficking. Doesn’t necessarily need to be money, many
states require there’s cash exchange. That means trafficking exchange for drugs
will not legally fly as a technically a labeled human trafficking case for that particular
state. However, the federal law enforcement does
include that broader definition. The caveat with that is federal law enforcement
usually takes between one and two years before a case goes to indictment if at all. Local law enforcement tends to be very much
quicker with their response. In various different crimes. So things to consider, lots to know. To be well informed. Now that you have properly identified a potential
victim of human trafficking, it is very important you receive buy-in by potential victim. Trust. Once trust is established you will want to
pass off such relationship to the next provider and all providers need to be on the same page. Communication between providers is really
important so whatever your protocol is about interagency communication and confidentiality
need to be established because when providers don’t know what’s going on with their shared
clients or former client, that can be very, very problematic. Why? Victims tend to even if a stable setting or
in family of a trafficker, miscommunication is used and manipulation of miscommunication
is used to advantage of the person trying to survive under abuse and duress. So that’s what they’re used torment so they
will often create opportunities for miscommunication between provider and people get confused trying
to provide with holistic care. That is why we recommend that you also have
a clear up to date constantly on the same page communication with the providers who
refer the survivor to. By engaging the potential victim at every
step of the follow-up process for services you also be able to ensure the delivery of
these services, sometimes other providers will drop the ball but you need the follow-up.You
really do. It’s worth it. Maintain a high level of confidentiality while
continuing to develop their after care plan with potential victim involved. Need to be okay with where they’re going. And take back control of his or her life will
help him or her to feel empowered by the process and avoid abandonment or situations or feelings. So whenever there’s a potential opportunity
to teach environment in this way can have them regain their sense of agency and individuality,
take it and encourage that. So protocol development in school, information
for social workers, social workers can help support protocol development in school and
that’s an area where I see it is large room for improvement, protocol for interacting
with potential victims of human trafficking can be developed by adapting and using current
systems the protocols response to victims of domestic violence or child abuse, social
workers can play a key role in development of these patrol protocols within the setting. Develop adopt implement and implement and
enforce culturally specific trauma-informed policy and protocol to address trafficking. Make sure all personnel are properly trained
on the protocol; make sure that they’re not there to make category judgment of who is
victim, and who isn’t. Make certain campus security is in place and
trained so all visitors are screened. Partner with services and law enforcement,
develop programs and list of parents and guardians to make them part of their children safety,
if that does yield really well with prevention. And assess environmental structure and take
every possible step to help make that school safe. Identifying champions for protocol development. Look at your own agency. And develop a protocol that requires at least
one person who has the authority to move this protocol process forward, who has that authority. Subset we just covered are components of a
basic human trafficking protocol. In order for the protocol to be successful
you need to find a champion in your agency to work effectively within your senior management
and other levels of management. Or not even management. There needs to be a person who has authority
to move process forward within your agency in perpetuity, not just one time. In developing a protocol consider reaching
out to stakeholders or victims’ advocates to assist in development of healthy protocol
and might also want to talk to survivor whose are willing to help you develop protocol if
you have access to them. That’s also really highly recommended. We get that for the core training. Whether your facility is a hospital clinic
school or non-profit, identifying your champion and calling them with protocol is critical
to helping victims of trafficking. And your agencies for that matter. To wrap up, the response section, key points
we covered in this section. One, strong advocacy for victims such human
trafficking begin business using the full extent with potential victims an encouraging
comprehensive adoption of such awareness with all employees to make sure you know your local
referral network. Networks vary by region and local knowledge,
one quickly connecting potential victims with the help they need in the best interest of
the victim, not the agency so much. I think that happens by default but really
is the victim. Have horror stories about other agencies that
work in a solid behavior and cases fail, cases get thrown out in court. Horrible things. Really trust that network to develop the trust
needed within your own environment. And community to work together to help these
survivors. Three, non-governmental organizations law
enforcement agencies legal service providers and social services work collaboratively with
healthcare professionals to best assist identify victims of trafficking. It takes a village once again. It is important to identify elements needed
for the development of protocols potential victims and ads well as appropriate advocate
with the authority and appropriate training underscore underscore to see that protocols
are developed and implemented. So to wrap up, the training as a whole, let’s
see if we have covered all the course objectives. The training decides reality of human trafficking
in the U.S. in terms of why it is a critical concern to your work. The course objectives were describe types
of human trafficking in the United States, recognize possible indicators of trafficking. Demonstrate how to identify and respond to
potential trafficking victims. Respond appropriately to human trafficking
in your community. Share importance of being aware and of and
responding to potential human trafficking with others in your work environment and greater
community. Do you feel like you can do all in these? If not or if you do feel that way, please
pose your statements or ask any questions.>>Leilani Funaki:
We did have one question that we can answer here. How do you approach a victim who is identified
but is actively denying involvement or abuse or danger even when they’re alone with provider? So, I don’t know Kathryn or Elisabeth, either
want to try to answer that question?>>Kathryn Xian:
Elisabeth you want to try to give it a shot?>>Elisabeth Corey:
Yeah. This question is probably one of the most
common and one of the most complicated questions when it comes to human trafficking and working
with victims of trafficking. Especially when you are working with youth. I notice the word youth is part of the question
as well. There’s so many things going on here, of course
there’s intimidation that we’ve talked about, there can be threats, there can be all sorts
of different forms of coercion that are terrifying this person and not wanting — not allowing
them to speak up. In my situation when I was growing up I actually
dissociated and repressed majority of memories of my trauma, it’s fair to assume in the case
of — many cases they don’t even consciously remember the worst of their trauma. It has been dissociated away. And so I think the best place is for you to
get an understanding for what’s happening to them would be in the long term trustworthy
respectful relationships where they can over time learn that they’re in a safe place so
they cannot only begin communicating with you about what happened to them but they can
start to understand their truth as well. That’s a serious issue that doesn’t get a
lot of air time, what if — they’re not consciously lying to you, they don’t even remember the
experience they’re having. So I would say in this case of this victim,
this is building a long term relationship with them, a safe respectful relationship
that they can come to you at any point. They may stay in denial for some time and
unfortunately there isn’t a whole lot you can do to get them to tell you what they aren’t
ready to tell you yet unfortunately. But as I said continuing to keep the line
of communication open with them, possibly even for years. Get them to come forward and tell you what’s
happening.>>Kathryn Xian:
I would like to also add if I may, I’ll leave this example one of my juvenile client that
took her two years to actually want to talk about what happened to her and actually want
to talk to law enforcement for that matter which was never pressured on her at all. But she came to her own understanding what
justice was, what we can do as social workers and healthcare providers professionals is
provide ground work of what a healthy relationship is or should be. What justice looks like? What potential every survivor has in healing
panned being a whole person. And they look for that, they look for a connection,
they look for representations in the other human beings that this life is a better life
as possible. All you can do is plant the seed and hope
it will germinate if you don’t get disclosure right away. This one kid took two years. From 14 to 16 to finally get it and these
victims, basically point highly transferable. Transferable issues with the survivors especially
the kids. So any male providers should take that into
consideration because if that comes up, these lines can be very blurred with regard to the
victim. You take that responsibility upon yourself
to teach you about healthy friendships and draw that boundary that they have had erased
from their definition of drawing up. No boundaries is like the golden rule
of these victims while they’re in a victimized state. They don’t know — they’re desperately looking
for that. Either role model, boyfriends, that’s what
makes them vulnerable so keep that in mind, there’s opportunity to plant seeds there. You not necessarily won’t be there to watch
them grow and flourish. You might be, you might get that call at 2
in the morning two or three years later. To let you in on what’s going on with your
former client. And that’s a great thing. But keep all those things in mind.>>Leilani Funaki:
Great. Thank you both. So as to wrap up our webinar today, two pieces
of information I want to share with you. First is that we don’t just offer this training
we provide free technical assistance, if you heard something today you feel your organization
could benefit from knowing more about or you would like to talk about customized solutions
we can offer for you, please do reach out. Our email address ([email protected]) phone
number (844-648-8822) and website (https://www.acf.hhs.gov/otip/training/nhttac) are in the chat box. Also email me directly, this is Leilani Funaki
([email protected]), if you would like to hear more about ways we can help you, we would
love to be able to do that for you. The final piece of information is that we’ll
be sending out an email this afternoon with the link to our evaluation for this training. So if you are interested in receiving CEs
or CEUs you need to complete the evaluation and they’ll have until April 6th to do so. Once again, thank you, very much for attending
the training today. We appreciate your presence here and hope
we were able to provide you with information that you can take home to
your organizations. So thank you very much.

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