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Long Term Mental Health Care for Victims of Human Trafficking

Long term mental health care for victims of human trafficking
By Ashley R. Donaldson, MA, LPC-CR

Counselors, advocates, law enforcement, and other helpers connected with victims of sex crimes such as trafficking are working with a delicate population, one that requires swift yet careful attention. While we work to positively influence many, many sectors which impact the problem of sex trafficking such as public policy and law, for example, we need to be ever-mindful of the victims to whom we are committed. Most victims are truly lost in every sense of that word and are in desperate need of loving, trustworthy help for their mere survival as well as for their mental and emotional recovery and health. Not only do we need to be mindful of the victims of these unspeakable crimes, but we also must be mindful of the criminals as they seek to maintain control and secrecy within their inner circles.

In consideration of the extent of delicacy to which we must tread, take a look at what the U.S. Department of Health and Human Services says about the nature of the impact of abuse in children:

The brain’s development can literally be altered by this type of toxic stress, resulting in negative impacts on the child’s physical, cognitive, emotional, and social growth. The specific effects of maltreatment may depend on such factors as the age of the baby or child at the time of the abuse or neglect, whether the maltreatment was a one-time incident or chronic, the identity of the abuser (e.g., parent or other adult), whether the child had a dependable nurturing individual in his or her life, the type and severity of the abuse, the intervention, and how long the maltreatment lasted.*

Are not many adult victims of sex trafficking first victims of abuse and neglect during early childhood? Commonly, victims of this type of crime have previously been subjected to abuse and neglect during childhood, therefore becoming mentally and emotionally unhealthy adults, and thus highly susceptible to further abuse during adulthood.

Children who have been abused or neglected may not be functioning at their chronological age in terms of their physical, social, emotional, and cognitive skills. They may also be displaying unusual and/or difficult coping behaviors. For example, abused or neglected children may: Be unable to control their emotions and have frequent outbursts; be quiet and submissive; have unusual eating or sleeping behaviors; attempt to provoke fights or solicit sexual experiences; be socially or emotionally inappropriate for their age; be unresponsive to affection.*

Since adult victims of sex trafficking commonly suffer first as children, we can expect similar, only louder, impairment. For example, just as a child of abuse and neglect might be quiet and submissive, an adult victim of sex trafficking might be abnormally introverted and overly submissive to her (or his) perpetrator. Such symptoms are widely understood as “codependent” (read more at and are commonly associated with, first, poor childhood upbringing including abuse and neglect, and then unsupportive and abusive relationships during adulthood. An additional common concern associated with mental, emotional, and sexual abuse is certainly anxiety (read more at, and such mental health concerns can be safely addressed in psychotherapy and with short term medication therapy, if deemed necessary.

In general, children who have been abused or neglected need nurturance, stability, predictability, understanding, and support (Committee on Early Childhood, Adoption and Dependent Care, 2000). They may need frequent, repeated experiences of these kinds to begin altering their view of the world from one that is uncaring or hostile to one that is caring and supportive. Until that view begins to take hold in a child’s mind, the child may not be able to truly engage in a positive relationship. And the longer a child lived in an abusive or neglectful environment, the harder it will be to convince the child’s brain that the world can change. Consistent nurturing from caregivers who receive training and support may offer the best hope for the children who need it most.*

Likewise, adults who have suffered from long-term abuse require similar care. So whatever sort of helper you are, whether a counselor, an advocate, law enforcement or other, be mindful of the delicacy of our work as these individuals truly need careful, trustworthy attention.


Ashley Donaldson, Mental Healthcare for victims of human trafficking

Ashley Donaldson



By Ashley R. Donaldson, MA, LPC-CR, a licensed therapist in the state of Ohio who works with children, adolescents, and adults to overcome varying mental health concerns. Ashley R. Donaldson, MA, LPC-CR is available for life coaching, too, via telephone and Skype. Visit Ashley R. Donaldson’s, MA, LPC-CR blog at