Abstract
In order to adequately meet the (re) integration needs of trafficked persons, it is important to first determine how success and failure of the (re) integration process is conceptualised in post-trafficking situations. We answer this question by looking at the feedback given by service providers (N = 40) when asked what they consider to be successful (re) integration, and what they consider to be a failed (re) integration process, based on their experiences with women trafficked for the purpose of sexual exploitation in Europe. This paper first provides an overview of the different dimensions of the (re) integration process: economic, institutional and social. It also situates the concept of recovery as applied in the context of post-trafficking situations within the overall framework of (re) integration. It concludes with a discussion of particular cases of successes and failures of the (re) integration process of trafficked persons. We find that rather than speaking of definitive success of the (re) integration process, it is much closer to what happens in practice to speak of the continuum of success along different dimensions. Finally, a failure of the process is found to be when a woman returns to a situation of exploitation, or when regression or re-trafficking occurs.
Introduction
To be able to have a better understanding of the (re) integration process of women who have been trafficked for the purpose of sexual exploitation, in the short and long term, it would be helpful to have a good understanding of what constitutes successful (re) integration, and what would be considered a failure of the process.
A definition of (re) integration derived from the field of practice states it is the following: a ‘process of recovery and economic and social inclusion following a trafficking experience’ (Surtees, 2010: 24). Some of the elements of the process are seen to be ‘settlement in a stable and safe environment, access to a reasonable standard of living, mental and physical well-being, opportunities for personal, social and economic development and access to social and emotional support’ (Surtees, 2010: 24). What is identified as the key ingredient of successful (re)integration ‘is that of empowerment, supporting victims to develop skills toward independence and self-sufficiency and to be actively involved in their recovery and (re)integration’ (Surtees, 2010: 24).
Several points can be made on the basis of this definition. First, recovery is seen as being part of the overall (re) integration process. However, what exactly recovery means in the context of trafficking may need further clarification. Second, there seem to be several dimensions of success that can be derived from this definition: (1) settlement in a stable and safe environment; (2) a reasonable standard of living; (3) mental and physical well-being; (4) opportunities for personal, social and economic development; (5) access to social and emotional support; and last, but most importantly, (6) empowerment, independence and self-sufficiency (Surtees, 2010). However, when reviewing these different aspects of a successful (re) integration, one may inevitably ask whether success constitutes positive developments along all these dimensions and in addition, what would be considered a definitive failure of the (re) integration process?
This article aims to answer the above raised questions in light of existing definitions of (re) integration, through research conducted with service providers that work directly with women who have been victims of trafficking for the purpose of sexual exploitation. The article is based on the answers provided by service providers when asked what they consider to be successful (re) integration, and what they consider to be a failed (re) integration process, as well as examples of each from their own experience. The main body of this article will report on the different dimensions of success of the (re) integration process, as identified by service providers through their work. It will also discuss what is considered to be a failure of the process of (re) integration in practice. The findings will be discussed alongside existing definitions. In addition, ahead of presenting the empirical results of this research, the concept of recovery in the context of (re) integration following a trafficking experience will be clarified, using existing literature from the field of psychology. The type of trafficking this article focuses on is for the purpose of sexual exploitation, and the victims discussed are women. However, the source of information is service providers who work directly with women who were trafficked for the purpose of sexual exploitation.
The importance of this article is in trying to bring about a better understanding of what can be considered a success and failure of the (re) integration process based on reports from the field and to discuss those in the light of existing definitions of (re) integration. It has clear policy implications as it will contribute to how success is perceived and show that focusing and achieving progress along the lines of any of the dimensions of the (re) integration process is significant for the survivor. Its additional academic value is in introducing theory from the field of psychology and in discussing the concept of recovery within the (re) integration process of trafficking victims.
The next section begins with a review of the relevant literature on (re) integration, followed by discussion of the psychological literature on the concept of recovery. The researchers will refer back to this literature in the ‘Discussion’ section of this article.
Existing literature
The concept of (re) integration
The definition above was taken from practice. This section expands on existing definitions of (successful) (re) integration both from the field of migration and human trafficking.
Lietaert and Kuschminder (2021) discuss four components of (re) integration of migrants generally. The spatial component refers to a physical return to the society in which the person was living in prior to a migration experience, with an emphasis on not assuming that they were fully integrated in the past. The temporal component stresses that (re) integration is a complex and long-term process. The social component refers to the social relationships a person has developed, but also to the possibilities for new social ties in the environment in which they return. Finally, there is an emphasis that (re) integration is multi-dimensional, encompassing domains such as the socio-cultural, psychosocial, political and physical (Lietaert and Kuschminder, 2021).
Tizazu et al. (2021) also focus on (re) integration of migrants more generally and in particular the economic and social aspects of the process. In their research on returnees in rural Ethiopia, in regard to the economic aspects of (re) integration, they find that having housing, owning land and the possibility to generate income are important. In regard to social aspects of (re) integration, in addition to the importance of relationships with family and friends, the research finds that participation in social events and membership in informal organisations are additionally relevant to the (re) integration process (Tizazu et al., 2021).
Moving closer to how (re) integration is conceptualised in the context of human trafficking, Okech et al. (2018) quantitatively investigate links between social support, community (re) integration and the occurrence of post-traumatic stress disorder (PTSD) in trafficking survivors. They find that community (re) integration in particular, through social support, has an indirect but significant impact on the occurrence of PTSD (Okech et al., 2018).
Bearup (2015) critiques the key definition given by Surtees at the start of this paper, by pointing out that the provided definition is overly focused on ‘empowerment’ and ‘self- sufficiency’ of victims, therefore not taking into consideration the cultural context, where such elements would not be acceptable. Bearup (2015) instead puts particular emphasis on the concept of ‘acceptance’ by the society to which a person returns, as a key element in achieving successful and sustainable (re) integration. However, what ‘acceptance’ means depends on whether a woman goes back to a ‘traditional-rural’ or a ‘modern-urban’ context. Furthermore, Bearup (2015) points out that in the traditional-rural context, acceptance is achieved through adopting a ‘traditional social role within family and village community’, while in the modern-urban context acceptance is achieved through ‘intimate relationships, market-based associations and engagement within the public sphere’, which require a ‘more individualized reflexive capacity’ (p. 120).
Pandey et al. (2013), in their study on the (re) integration process of trafficking victims in India, use the following definition of (re) integration:
Integration (and reintegration) implies long-term and multi-dimensional states of either integrating into a host country (or reintegrating into a home country setting), which are not achieved until the individual becomes an active member of the economic, cultural, civil, political life of a country and perceives that he or she has oriented and is accepted. (p. 53)
Pandey et al. find that the only way in which (re) integration of victims of trafficking for the purpose of sexual exploitation can be successful is when the causes of trafficking are addressed. What is meant by this is the situations of poverty that women who are trafficked often come from. Thus, due to economic need, even when women are identified as victims and (re) integration efforts are made, they may choose to return to situations that put them in danger of re-trafficking, because it is the only way for them to survive financially. Finally, many of the noted definitions of what (re) integration means for trafficking victims are criticised based on the reality that some trafficking victims were never truly integrated in their communities in the first place and additionally, even if they were to return to the situation of before, that may simply not be possible or even desirable in certain cases (Asquith and Turner, 2008).
The concept of recovery and the role of resilience
A multidimensional definition of recovery from psychological trauma, taking into consideration the ecological view of human development, is given by Mary R. Harvey (1996). Harvey (1996) criticises existing definitions of trauma recovery which either (1) refer ‘to the completion of a lengthy psychotherapy, and to the mastery and final resolution of psychological conflicts that may or may not have their origins in traumatic exposure’ (p. 11) or (2) focus ‘particularly on post traumatic arousal and on the intrusive symptoms characteristic of post-traumatic stress disorder’ (p. 11). This would mean that, as soon as there are no more flashbacks or nightmares that relate to the traumatic experience, recovery has been achieved.
Harvey (1996) instead introduces recovery as a ‘multidimensional’ process characterised by seven outcome criteria: (1) authority over the remembering process, (2) integration of memory and affect, (3) affect tolerance, (4) symptom mastery, (5) self-esteem and self-cohesion, (6) safe attachment and (7) meaning making. Thus, according to Harvey (1996), ‘recovery is apparent whenever change from a poor outcome to a desired outcome is realised in any one domain affected by traumatic exposure’, and further ‘resiliency is evident when one or more domains remain relatively unimpacted and when the trauma survivor is able to mobilize strengths in one domain to cope with vulnerabilities and secure recovery in another’ (p. 14). Harvey’s work is relevant to the current research on the topic of resilience as well, which will be discussed next.
The concept of resilience requires further exploration as it is the crucial determinant of the mechanism of recovery (Brown et al., 2012; Masten, 2007; Tummala-Narra, 2007; Ungar, 2013; Wright et al., 2005). According to Masten (2007), ‘resilience is a very broad idea referring to the capacity of dynamic systems to withstand or recover from significant disturbances’, in other words, resilience is the capacity to adapt following a shock to the system (p. 923). Tummala-Narra (2007) reiterates this definition of resilience but points out that we cannot study and look at resilience out of context, nor as a static characteristic, but as one that changes and develops with time. She notes that resilience from a cross-cultural perspective ‘involves examination of multiple phenomena, including individual development, community impact, and cultural systems of thought’, and ‘while both individual attributes and developmental transitions are important contributors to resilience and coping, both are also influenced by salient qualities of family, social support network, and community and by prevailing cultural beliefs and values’ (Tummala-Narra, 2007: 36). Thereby the concept of ‘collective resilience’ is introduced, and family support is one example of this form of resilience.
Ungar (2013) says that positive functioning can occur in the presence of trauma-related symptoms such as PTSD. He also introduces a social-ecological definition of resilience and ‘rather than defining resilience as the individual’s capacity to succeed under stress’, he defines resilience as ‘the capacity of both individuals and their environments to interact in ways that optimize developmental processes’ (Ungar, 2013: 256). According to Ungar (2013), the ‘ecological definition purposely de-centers individuals to avoid blaming them for not flourishing when there are few opportunities to access resources’ (p. 256). Thus, the study of resilience, and what we take to be indicators of resilience, depends on context and culture.
In Wright et al. (2005), resilience is approached by looking at multiple domains of functioning of mothers that have been victims of sexual abuse as children. The domains are (1) the intrapersonal (absence of depression symptoms and perception of positive physical health), (2) the interpersonal (marital satisfaction) and (3) the intrafamilial (perceived parenting competence) (Wright et al., 2005: 1177). They found that while their target group showed resilience in one domain, it might not show resilience in another. Only 16% of the 79 person sample showed resilience across all domains. But 81.9% of the mothers showed resilience in at least one domain. The authors also found that women who had spousal support, although they may have been depressed, functioned better in their role as parent.
Finally, Brown et al. (2012) look at the characteristics of early recovery from complex trauma of 20 participants, engaged in treatment in an adult outpatient clinic which focused on the care of chronically and complexly traumatised survivors. The data were gathered through in-depth interviews focused on trauma and resilience. The authors find three themes ‘preludes to vulnerability’, ‘corruption of self-experience’ and ‘paradoxical extremes of functioning’. The last theme, ‘the paradoxical extremes of functioning’, focuses on nonlinear paths and efforts towards recovery – for instance, getting a wanted job and then burning out. These types of extreme functioning were explained through what is called ‘compartmentalised adaptations to significant abuse’ that can be internal and external. External adaptations are of particular interest for the context of trafficking victims, as they report a ‘split existence’, ‘having a successful work or school life but engaging in self-destructive behaviour’ (Brown et al., 2012: 107). Thus, once again, as in the work of Wright et al. (2005), it seems that persons may show success along the lines of certain recovery dimensions and failure along the lines of others. Still, overall, they continue to ‘function’.
The above reviewed concepts of (re) integration, recovery and resilience are particularly relevant to contextualising this research which aims to provide a better understanding of success of (re) integration in post-trafficking situations, as well as when (re) integration may be considered a failure.
Methods
As the focus of this research is trafficking of women for the purpose of sexual exploitation within Europe, fieldwork was done in Albania, Bosnia Herzegovina, Bulgaria, Montenegro, Serbia, the Netherlands and Italy. A total of 40 semi-structured interviews with service providers were conducted, ranging from 20 minutes to over 2 hours in length. Interviews with service providers were mostly held in offices of assistance organisations. All interviews were recorded.
Service providers interviewed for this article were from Albania (11), Bosnia Herzegovina (5), Bulgaria (5), Italy (1), Montenegro (2), the Netherlands (6) and Serbia (10). Educational background or organisational role of those interviewed was that of case manager (2), children centre coordinator (1), clinical social worker (1), crisis unit operator (1), day centre coordinator (1), non-governmental organization (NGO) or government agency director (4), member of female NGO lobby (1), hot line operator (1), government worker (1), lawyer (2), police official (2), programme manager (3), project coordinator (1), psychologist (7), psychotherapist (1), shelter coordinator (2), shelter staff (3), social worker (2) and course teacher (1).
Service providers were selected as the target group of this research for two main reasons. First, this was due to their extensive, firsthand experience with trafficking survivors on a daily basis. Second, and importantly, the choice was made due to ethical reasons. Discussions of the trafficking experience and post-trafficking experience with survivors for the purpose of research should only be done if no other persons or target group can offer the same information, as such discussions may cause further trauma. In the case of this particular research, service providers were able to share a wealth of examples from their own experience with survivors, which provided rich data for analysis. As such, further exploration of the research questions with trafficking survivors was evaluated as not necessary by the co-authors on this particular occasion.
The interview protocol used for service providers covered a variety of questions. This article is based on the answers given to the question: what constitutes successful (re) integration, accompanied with examples of successes and failures from their experience. The first author originates from Southeastern Europe and has lived for a significant amount of time in both Italy and the Netherlands. With this background, it was possible to have a deeper understanding of social, economic, cultural and political contexts of these regions. As findings were collected, these were thoroughly discussed among all co-authors, to ensure that any newly arising topics through the research were taken into consideration and necessary methodological adjustment made, but also to allow for reflexivity on the positioning of the first author in the context of this research, considering her background, and ties to the communities of study.
Interviews conducted were either in the original language or in English. Only interviews conducted in Albanian and Italian needed the assistance of a translator, due to the language background of the first author. All interviews were transcribed verbatim and uploaded to NVivo for analysis. The approach of inductive, reflexive thematic analysis of Braun and Clarke (2006) was followed, where we began with: (1) familiarisation with the data, which entailed listening to the recordings, and reading and re-reading of the transcripts; (2) generation of codes; (3) generation of themes; (4) review of themes and exploration of relationships between themes, with regard to how they answer the research question; (5) finalisation of names of themes; and finally, (6) write up.
The study has been approved by the Ethical Committee of the Faculty of Psychology and Neuroscience of Maastricht University.
What are the elements of (re) integration success?
Interviewees were asked what they considered to be successful (re) integration, as well as to give examples of successes and failures of the process that they had experienced through their work. The following themes as components of successful (re) integration were identified: economic elements, professional assistance and institutions, and social relationships.
Economic elements
Respondents noted having a house (although it was not clearly stated if this meant owning a house or simply a place to live); the possibility to continue education if this is the wish of the woman; having a job; or an environment that would give the woman some kind of financial stability and sustainability, were important elements of success. However, there was some contradiction in responses as to whether the woman should be self-sufficient or rely (partly) on help from a partner and/or family. One interviewee defined (re) integration a success:
If she has let’s say a job, or a micro business and she is capable to provide her own income, so to afford her living cost, and not to be fully dependent on her husband, so she is economically empowered. (Service provider, Albania, 23 October 2015)
However, another respondent noted,
A lot of them stay, according to a lot of criteria, at the border of some kind of poverty, in the sense of income. But still, they have, we have to measure success, in the sense that now, financially, together with the partner, or in a community, she has some kind of sustainable financial circle. It may be through social benefits too, but also through some kind of work, formal and informal. (Service provider, Serbia, 29 October 2014)
Thus, the economic elements of successful (re) integration are (1) having a place to live and (2) having financial stability and sustainability.
The disagreement lies as to the means through which these economic goals are achieved. In some situations, such goals may be reached through the efforts of the victim (if she is financially independent) or through the efforts of her support system such as her family (if she is financially dependent). It is clearly portrayed through the above noted first quote, that service providers put emphasis on terms such as ‘economically empowered’ and seem to show preference for the ‘economic independence’ of the woman. However, this research found that, where the family environment was a healthy one, cases of (re) integration were not called a failure if the woman was financially dependent on her family. Thus, the question may be raised as to how much does this emphasis on ‘economic empowerment’ and ‘economic independence’ reflect the reality in the field, and how much does it reflect a preference for certain terminology that in some cases may not be in the best interest of the woman. If the woman makes the autonomous decision to be financially reliant on her partner and her relationship is a healthy one built on mutual trust, an emphasis on independence and ‘economic empowerment’ may make her insecure in her own choices, and doubt her self-worth, which in turn may reverse an otherwise sustainable and successful (re) integration process. This point will be briefly elaborated on in the ‘Discussion’ section of this article, contrasting independence to autonomy in the context of (re) integration.
Professional assistance, institutional and legal empowerment
In certain cases, respondents noted that the cooperation of many different actors, from a variety of institutions, was necessary in order to bring about successful and sustainable (re) integration process. Speaking of a success case, one respondent noted,
I have an example of a mother with child. She was here [in the shelter] for a long time. And who couldn’t rehabilitate, because of safety reasons. The state helped. There were re-locations, the prosecution, the inspectors, they helped a lot. We moved them so many times, from one place to another, because the safety was compromised. The Ministry of Human Rights, of Security, the people that work there, other NGOs, everyone helped. It’s one shining example . . . we had a lot of mistakes in the process, from which we learned, so we had many mistakes. But we also had so many positive things, that at the end, they were re-located in a third country. And I know they are OK. Because they call. (Service provider, Bosnia Herzegovina, 2 October 2015)
The key factor that made this example a success case of (re) integration was institutional support and inter-institutional cooperation in initially keeping the victim and her family safe and thereafter assisting her in beginning a new life in a new environment. In many situations that were encountered throughout this research, it was not uncommon that victims were kept in shelters or safe houses while the police investigated their trafficking case or were in pursuit of the trafficker. However, in this particular situation, institutional support went beyond concerns about safety during an investigation or trial and succeeded in creating a sustainable life for the woman and her family beyond the reach of her traffickers. It is not clear how often this occurs in practice, but when it does, it is evident that institutional support is crucial for securing and sustaining a successful (re) integration process.
In addition to coordination and cooperation among different actors, participation in occupational training offered usually by NGOs was also considered as an important element of successful (re) integration since such participation gave tools for future job searches. An established relationship either with a service provider who the victim came to trust or with a peer – another woman who has gone through the same experience – are two additional aspects of professional assistance. Finally, knowledge sharing and assistance given by service providers was seen as important in keeping women informed about their rights, but also making it possible for them to become, what service providers referred to as ‘full citizens’, and thus, more ‘empowered’ than they were before trafficking occurred. When speaking about this topic, service providers noted that it is not uncommon for trafficking victims to lack basic documentation such as birth certificates and IDs (service providers saw this as not being a ‘full citizen’), which in turn may be necessary to be able to receive health cards, which are crucial for receiving any kind of health treatment. Access to medical treatment, whether related to issues connected to the trafficking experience or not, was seen by service providers as a basic right of the victims in these cases. Thus, providing assistance in securing documentation that would ensure that women could practice this basic right was seen as an important element of the (re) integration process. The possibility of visiting a dentist or a doctor, and in some cases women were encouraged to do so as part of the (re) integration process, meant for service providers that the woman was beginning to take greater care of herself, and thus showed more commitment to staying out of potentially dangerous situations. Although not explicitly stated by all respondents, it is believed that in these cases, service providers were often speaking of women belonging to the Roma community.
As one respondent stated,
Because in essence, if we are talking about the cause, as to why someone became a victim of trafficking, then we can ask if that person in the first place had the rights, constitutional, legislative rights that belonged to her, in the country in which she was born. Was that person integrated, and recognised as a citizen, of first, second, third, fourth, fifth order. Then, we come to the issue of integration, (re) integration. It’s a fact that most of our clients, did not have the same rights, were not included in all the systems, in the same way. They were not included in the education system, in the health system. They were invisible as subjects, as legal beings. (Service provider, Serbia, 29 October 2014)
Thus, the institutional elements of success are (1) institutional functioning, coordination, cooperation in offering support; (2) relationships built with service providers and peers; and (3) legal empowerment in acquiring documents which give access to further support and additional services. Some of the means through which these outcomes can be achieved is building a relationship with victims based on trust from the very first moments of contact, as well as continuous provision of information to victims. Exchange of information between different institutional actors is also an important means through which to achieve the above stated goals.
Functioning social relationships
Having family support and a social network to fall back on has been identified as one of the crucial elements of successful (re) integration. In certain cases, it can be the family of origin, where the trafficking survivor either comes back and is welcomed back or is successfully reconciled with the family and is thereafter offered crucial support to sustain their recovery and (re) integration. In other instances, it is considered a success when the victim forms their own family. In fact, being married has been identified as an important element of successful (re) integration by some respondents. As an interviewee noted,
Yes, well, I think that when a person . . . I am glad when they ‘marry well’. It seems to me that for some girls, who are so alone, if they find a good companion of life, they make a family, and so: the job is not enough, the job is not enough. (Service provider, Italy, 30 December 2015)
One of the issues that comes up concerning family relations is whether or not victims are open about their trafficking experience with those around them. Some women choose to not disclose their past experiences and continue to have functioning family relationships. It was noted, however, that there are cases when the woman does choose to share her past with her family and sometimes this makes the family unit even stronger.
Thus, the social elements of successful (re) integration are (1) reconciliation with the family of origin or the family created before the trafficking experience and (2) creation of a new family. Considering the means necessary to achieve this, two conditions would have to be fulfilled for the above outcomes to materialise – first, that the victim regains her ability and wish to rebuild or create new relationships, and second, the willingness of the family members to form relationships with the victim. It is in this context that service providers spoke about whether or not victims reveal their past to their families and those closest to them. It seems that what is a sign of a healthy relationship is not whether or not the past is revealed, but that the decision to reveal or conceal the past is made solely by the victim. Thus, whether or not the past of the victim is known to those closest to her does not seem to have a clear influence on her ability to form relationships. What does seem to have influence is that she is the one who makes the decision to disclose or not.
A continuum of success
So far, various economic, institutional and social elements of successful (re) integration have been noted and briefly related to the means necessary to achieve them. However, the next question to ask would be, for (re) integration to be marked as a success, do all of these outcomes need to be achieved? Based on the results of this research, the answer would be no. In fact, rather than speaking of successful (re) integration along each element discussed, we would emphasise the continuum of success. And even when (re) integration succeeds along some dimensions, but fails along others, the overall process may still be seen as satisfactory, in practice.
For instance, respondents noted that women with some addiction issues may be considered success cases. As one interviewee pointed out,
Yes, for instance, what is successful (re) integration? We have a woman that was for years a heroin addict, has hepatitis etc. She speaks 4 languages, works in a foreign firm, makes much more money than all of us combined. She drinks. So what? That is nothing, compared to what she was in the past. If you ask me, it’s a triple success. She went through rape, through the life of an addict, drugs . . . and from that into human trafficking. Then, she went into drug addiction therapy. She was on different types of drugs, over 3 years. Now, finally, she found employment, she is working . . . she drinks. But so what? She is functional, every day she is at work. She is doing very complex tasks, she has knowledge, she cooperates, lives normally. She has no connection with the people of the past. If you ask me, that is successful (re) integration. (Service provider, Serbia, 2 November 2015)
Thus, it seems that in measuring and looking at success, we should clearly consider the starting point. When a person comes from a severely disadvantaged position, independently of the trafficking situation, and has made such economic progress that would be considered for any individual a move up the social ladder, the outcomes outlined above should be considered as significant success. In this context, however, the progress that she has made comes with the trade-off of showing dependency on alcohol. This was clearly stated by the respondents:
Successful (re) integration? Well, when I began working, I thought that I have to satisfy a lot of needs, to call a situation successful, that the quality of life should be significantly better. So someone that has no education, has to be enrolled, etc. But with time, I realised that the capacity for change, is not the same in everyone. And that not everybody has that need, that we often have in the head, that they have to be like this, this and this, and that they have to live a perfect life, without problems. I understood that even a small step of progress, makes their life better, and betters their quality of life. (Service provider, Serbia, 3 November 2015)
The same interviewee further noted in regard to addiction that:
With time, I learned that when we have a collection of bad factors, if the person is an addict, someone that does not have good contact with family, no education, no job, no place to live, no basic subsistence. I decrease the demands, in front of myself, and also in front of the person. When we do even small steps, then I am happy with the person and myself. At the beginning, I was always putting very high goals, and then I would be very unsatisfied, myself and also the victim. I would feel a failure. But now, I can see the risk factors, the strengths, the potential for which I can get a grip. I need to do a good diagnosis, evaluation. (Service provider, Serbia, 3 November 2015)
During this conversation, the above respondent remarked that when she began working in this field, she would actually have had the same very high expectations for each of the persons she encountered, but high expectations as to what is desirable in her opinion. Thus, she would have been disappointed if every person she took on would not have continued or completed their education. In the period of the interview, the organisation was actually dealing with the loss of life of one of their beneficiaries. The person was a victim of trafficking and a former addict who was recently doing very well, but her body had suffered too much in the past, so although the exact cause of death was still under investigation, it was assumed that it was due to past physical traumas. Thus, taking all of this into consideration, in certain cases, finding ways of keeping the person alive, away from drugs, and out of situations of exploitation, would be considered a success.
According to other service providers, a successful (re) integration is:
To be able to say no, to things that are not fitting to her. To be able to make choices that according to some standards could be good or bad. That she does not enter into, that is, that she recognises violence, not just physical, but also in the sense places that make her feel good, and make her feel bad. So she is able to stay away from violent relationships. (Service provider, Serbia, 29 October 2014) That in a way, they get back to normal life, normal things in life. That they stand on their own two feet. That they connect with those people, whether it’s family or friends, that are for them real support. And not find people who may again introduce them to some problems . . . To find a job, to start living independently. Not to live in a situation of violence. To have some healthy, functional relationships. Whether with romantic partners, with family or something similar. (Service provider, Serbia, 30 October 2014)
As one interviewee summed it up,
What I think is a successful case is sometimes a miracle because you never can . . . It is very rare that you can reach these . . . It’s a woman that can have her autonomous and independent life, without violence. (Service provider, Bulgaria, 9 July 2014)
Failed (re) integration
In the previous section, it was stated that the (re) integration process may be considered a success, even if a woman is still, for instance, struggling with issues of addiction. In fact, drug and substance abuse problems were often mentioned by service providers as some of the most significant challenges for victims following a trafficking experience (that may or may not be a direct consequence of the trafficking – as in some cases, addiction issues predate the trafficking experience). But nonetheless, addiction was not seen as an outcome which would mark a (re) integration process a failure. However, it should be noted that this reference is to alcohol addiction only. Drug addiction, which as described in one of the paragraphs above, could lead to loss of life and would not in any situation be considered a success. In addition, outcomes such as permanent institutionalisation and continuous dependence on institutional help by certain victims dealing with mental challenges were also not seen as a failure of the (re) integration process. An example was given of a victim with significant mental challenges who was permanently placed in an institution, as she was seen as incapable of living independently. However, although institutionalised, it was recommended that she retain custody of her underage son, who was to live with her in the institution. This was not considered a failed (re) integration process.
Thus, this leads to the question, what is the bottom line outcome which if present, would clearly signal a failed (re) integration process? Based on this research, a failure of the (re) integration process is when a woman would return to a situation of exploitation, when regression or re-trafficking occurred and the woman was again under threat or in a situation of violence and exploitation. It was in this context that some service providers would note that they strongly discouraged return to sex work, as it would again place the victim in potential situations of exploitation – physical, mental abuse or financial exploitation.
Discussion
The overall (re) integration process, of which recovery is a part (as discussed at the beginning of this article), has three distinct dimensions along which success can be measured, which correspond to the empirical findings of this article. All of the dimensions already discussed throughout this article thus fall within the following three elements and their subgroups: the economic dimension: (1) having a place to live, and (2) having financial stability and sustainability; the institutional dimension: (1) institutional functioning, coordination, cooperation in offering support (2) relationships built with service providers and peers, and (3) legal empowerment in acquiring documents which give access to further support and additional services; and finally, the social dimension: (1) reconciliation with the family of origin or the family created before the trafficking experience, and (2) creation of a new family. Considering the concepts of recovery and (re) integration, success in regard to the social dimension of psychological recovery would mean the ability of the victim to form safe attachments, whereas success in regard to the social dimension of (re) integration would mean acceptance of the victim from the side of the family, whether family of origin or newly formed. Thus, social psychological recovery could be understood from the perspective of the survivor and falls within the wider umbrella term of overall (re) integration, whereas social (re) integration could be understood from the perspective of the ‘others’, which most often in the case of trafficking victims is family members.
The findings of this research are not an exhaustive list of elements of success. These are the outcomes that were identified by service providers when defining what they see as successful (re) integration. These particular outcomes are not contrary to the outcomes identified in existing definitions of successful (re) integration. As already noted, Surtees (2010), as well as Tizazu et al. (2021), identify elements of success such as living in a stable and safe environment, a reasonable standard of living (economic), access to emotional and social support (social), and opportunities for personal, social and economic development.
However, what we would additionally like to stress from this research is that success does not necessarily mean positive outcomes along every dimension identified. In this regard, the findings here are particularly able to be related to the literature on recovery (Brown et al., 2012; Harvey, 1996; Masten, 2007; Tummala-Narra, 2007; Ungar, 2013; Wright et al., 2005). Namely, success can be seen whenever there is progress in regard to any of the dimensions of (re) integration. Thus, instead of speaking of definitive success of the (re) integration process, it is much closer to what happens in practice to speak of the continuum of success along different dimensions. Similarly, what Brown et al. (2012) coined ‘paradoxical extremes of functioning’, particularly in the context of recovery from complex trauma, are not uncommon in the context of (re) integration following a trafficking experience. As already noted in some of the examples given, a woman may be addicted to alcohol, but still hold a steady job, which was seen by her service providers as significant positive progress (which should not be taken to mean that all the assistance needed should not be given in regard to the challenges with alcohol). This was particularly when compared to her initial starting point of being a heroin addict, with various physical health problems, and who suffered rape even before entering a situation of trafficking. Thus, one of the crucial points to be made from this research would be to say that the focus should be on the continuum of success, in particular considering the starting point of many of the victims, rather than expecting clear success along all dimensions identified as relevant. The one condition, which if present would mark the (re) integration process as a failure, was if a woman was still in a situation of violence and exploitation.
Another contrast of the current research with existing definitions of (re) integration success has to do with the issue of empowerment, independence and self-sufficiency, which were identified as key ingredients of a successful (re) integration process (Surtees, 2010). What this research has found to be crucial is autonomy in decision making, rather than independence. As previously acknowledged, it was not seen as a failure of the (re) integration process if a woman was financially dependent on her social network – be it her family of origin or her husband. Marriage, rather than a woman being ‘independent’, was seen as one of the elements of success that gives stability and sustainability to the (re) integration process. The partial explanation as to the divergence of existing definitions of success and their emphasis on independence, with practices outlined by this research, where marriage is seen as a positive element, may have to do with differences between the concepts of ‘independence’ and ‘autonomy’. According to Ryan et al. (2016), confusion between the two concepts in the psychology literature is not uncommon. Where independence means ‘not relying on others’, autonomy implies ‘willingness or volition’ (p. 389). Thus, as the study of Ryan et al. (2016) goes on to say, when a teenager willingly asks for help from a parent, this is considered as an occurrence that may positively contribute towards the development of the teenager. Nonetheless, he or she would in this case be making an autonomous decision to be more dependent on another (in this case the parent). Along the same lines, what this research found to be crucial is the autonomous decisions of women to enter healthy relationships, even if those relationships may mean financial or other types of dependence (dependence for emotional support for instance). In this regard, a new marriage was found by this research to be equally important as healthy relations with the family of origin. Wherever the emotional support, which may translate into financial support, is coming from, the important element is that it is derived from healthy relationships that women entered into through their own autonomous decisions – independence and self-sufficiency in this context were found to be less relevant.
Implications for the work of service providers
Based on the findings of this research, the following implications for service providers working directly with survivors of trafficking for the purpose of sexual exploitation can be drawn:
This research has found a distinction between ‘autonomy’ and ‘independence’ in the context of post-trafficking situations, with the former being particularly important to survivors. Service providers should ensure that women under their care are able to make their own healthy choices and implement their decisions, even if that would mean reliance on social support from the network of friends, family and community.
Components of successful (re) integration were found to be linked to the economic situation of survivors, their social relationships and environment, as well as the professional assistance they receive and their institutional and legal empowerment, post-trafficking. When overall success of the (re) integration process is considered by service providers, progress along any of the components should be viewed as positive, in particular considering the starting point specific to each survivor. However, this should not mean that persisting challenges (e.g. alcohol addiction) should not be further treated.
Inter-institutional cooperation among all professional actors involved in the life of survivors post-trafficking is key in assisting the recovery and (re) integration process.
Finally, a return to a situation of exploitation was identified as a sign of failure of the recovery and (re) integration process, as it draws again on the vulnerabilities of survivors, which they have tried hard to overcome and puts them in situations of danger. In this regard, building trust among survivors and service providers, which would ensure that women always know they have someone to turn to in times of hardship, and when in need of advice, is one way of preventing the reversal of the recovery and (re) integration process.
Limitations and strengths
This research was based on the experiences shared by service providers who work with trafficking survivors firsthand. As such, the views of survivors themselves as to what they consider as successful components of the process of recovery and (re) integration were not included. Nonetheless, key aspects of the recovery and (re) integration process were explored, in particular, elements of successes and failures. A particular contribution of this research is the link made between the concepts of (re) integration and recovery from the field of psychology.
Conclusion
Key aspects of the recovery and (re) integration process of survivors of trafficking for the purpose of sexual exploitation were identified, linked to: (1) their economic situation; (2) professional assistance, institutional and legal empowerment; and (3) their social relationships and environment. Progress along any of the three dimensions of the process should be considered as positive and a step closer to success. A return to a situation of exploitation is considered as a failure of the process of (re) integration.
