The Multimodal Social Ecological (MSE) Approach: A Trauma-Informed Framework for Supporting Trafficking Survivors’ Psychosocial Health

“There's a lot missing”: Treating survivors of sex trafficking with trauma bonds

“…Participants suggested that primary needs among this population include: healthy relationships, improved material circumstances, and education about trauma bonding. The emphasis on healthy relationships echoes previous research on the importance of new, healthy connections for survivors in treatment (Hargreaves-Cormany & Patterson, 2016;Hopper, 2017a;Hopper et al, 2018). Specifically, Margaret discussed the need to connect survivors with survivor peer support to foster healing, a recommendation in accordance with prior findings (Hopper et al, 2018).…”

“…Regardless of the chosen modality (or modalities), research advocates for pacing and regulation within trauma-informed treatment. Therapeutic needs should progress sequentially with initial phases focused on safety, support, rapport building, and skill development, before moving into cognitive and emotional processing of trauma, with survivors dictating the pace at which treatment progresses (Hopper, 2017a(Hopper, , 2017bRockinson-Szapkiw et al, 2017). Relatedly, research clearly advocates for a trauma-informed, client-centered approach (Clawson et al, 2008;Hardy et al, 2013;Hopper, 2016Hopper, , 2017aSalami et al, 2018).…”

“…Therapeutic needs should progress sequentially with initial phases focused on safety, support, rapport building, and skill development, before moving into cognitive and emotional processing of trauma, with survivors dictating the pace at which treatment progresses (Hopper, 2017a(Hopper, , 2017bRockinson-Szapkiw et al, 2017). Relatedly, research clearly advocates for a trauma-informed, client-centered approach (Clawson et al, 2008;Hardy et al, 2013;Hopper, 2016Hopper, , 2017aSalami et al, 2018). Treatment should operate from an understanding of the impact of trauma, emphasize empowerment, recognize individuality, promote collaboration and selfdetermination, and goals and outcomes should be individualized and set by the client.…”

“…Peer support also helps to normalize survivors' experiences and subsequently reduce feelings of shame (Hopper et al, 2018). Finally, in addition to therapeutic interventions, the literature widely recognizes the need for wraparound services that, in conjunction with therapy, address other prominent areas of need, to increase stability and independence and reduce vulnerability (Hopper, 2017a(Hopper, , 2017bSteiner et al, 2018).…”

“…These recommendations mirror earlier research that has suggested the use of multiple modes and components of treatment with this population due to the complexity involved. Prioritizing client self-determination (Basson et al, 2018;Steiner et al, 2018) and utilizing a trauma-informed, client-centered approach (Clawson et al, 2008;Hardy et al, 2013;Hopper, 2016Hopper, , 2017aHopper, , 2017bSalami et al, 2018) align with participants' sentiments that no one size fits all, clinicians should adopt client language, and clinicians should normalize and validate client experiences.…”