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

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Book cover Human Trafficking Is a Public Health Issue

Abstract

Human trafficking can have devastating effects on survivors’ emotional, psychosocial, and physical health. Initial research has suggested that trafficking survivors may meet diagnostic criteria for multiple psychiatric diagnoses, including depression, anxiety, post-traumatic stress disorder, and other comorbid conditions. However, many of their reactions may be better understood within a complex trauma framework. Despite the potential benefits of mental health care for trafficking survivors, many people are not able to access effective services, due to structural/systemic barriers and the lack of adequately responsive services. Trauma-informed systems that utilize an empowerment approach may increase access to services. In addition, due to the multiple layers of stress and trauma exposure commonly experienced by trafficking survivors, intervention should be guided by a complex trauma framework. Instead of focusing solely on symptom reduction, complex trauma treatment emphasizes the development of competencies, including building regulatory capacity; developing healthy relational patterns; and developing a positive sense of self and future orientation. Treatment plans addressing mental health should be collaboratively developed with each person and may be based on their current struggles, stage in the recovery process, cultural identification, preferences, and goals. A Multimodal Social Ecological (MSE) framework is proposed to guide intervention strategies that can support trafficking survivors’ recovery and empowerment. The MSE framework incorporates complex trauma theory and uses multiple modalities to intervene at individual, social-environmental, and systemic levels.

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Notes

  1. 1.

    Running is a colloquial term that encompasses running away from home as well as elopement from treatment programs; it is a common concern for minors who have been trafficked.

  2. 2.

    A trigger is a term commonly used in the mental health field to refer to an internal experience or external stimuli that is a reminder of a traumatic experience and that precipitates an increase in trauma-related symptoms.

  3. 3.

    To better elucidate this complex issue, case examples from the author’s professional experience with trafficking survivors are shared. All the names and any other identifying information have been modified to protect their identities. These clinical case examples are identified by asterisks throughout this chapter.

  4. 4.

    Sanctuary is a model for clinical and organizational change that promotes safety and recovery from adversity through the active creation of a trauma-informed community.

  5. 5.

    Risking Connection is a relational framework that focuses on the healing potential of RICH relationships (those based in Respect, Information Sharing, Connection, and Hope), that teaches skills for working with trauma survivors, and that emphasizes self-care for service providers.

  6. 6.

    A colloquial term for a sex-buyer.

  7. 7.

    Manualized treatments are described in detail in a book or manual, with instructions for other clinicians wishing to offer the intervention.

  8. 8.

    Macro social work involves efforts to help people by intervening in large systems, such as lobbying to change health care laws, organizing large-scale activist or professional groups, or advocating for social policy change.

  9. 9.

    GLBTQ+ refers to people who identify as gay, lesbian, bisexual, transgender experienced, queer/questioning, plus people of other nontraditional gender and sexual identities.

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Acknowledgements

The author would like to express sincere appreciation to Jeff Nicklas for his administrative assistance in the production of this chapter.

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  1. The Trauma Center at JRI, 1269 Beacon Street, Brookline, MA, 02446, USA

    Elizabeth K. Hopper

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  1. Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Makini Chisolm-Straker

  2. Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Hanni Stoklosa

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Hopper, E.K. (2017). The Multimodal Social Ecological (MSE) Approach: A Trauma-Informed Framework for Supporting Trafficking Survivors’ Psychosocial Health. In: Chisolm-Straker, M., Stoklosa, H. (eds) Human Trafficking Is a Public Health Issue. Springer, Cham. https://doi.org/10.1007/978-3-319-47824-1_10

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