Date Presented 04/05/19
The purpose of this report is to outline the OT process for survivors of human trafficking (n=6) living in community transitional housing. After 12 weeks of intervention, all clients reported an overall improvement in performance and satisfaction in their prioritized areas of occupation. There was a significant difference in the evaluation and re-evaluation scores of performance and satisfaction (p= 0.04).
Primary Author and Speaker: Shana Cerny
Contributing Authors: Alexya Maassen, Krista Crook
PURPOSE: The occupational injustices experienced by human trafficking survivors lead to immediate occupational performance deficits and promote long-term instability (Cerny, 2016). Engagement in meaningful occupation is an effective means to regaining autonomy and agency after a trafficking experience (Cecchet and Thoburn, 2014). Helping people engage in activities of daily life despite physical or psychological barriers is fundamental to the field of occupational therapy (OT). Specifically, occupational therapists have the potential to be leaders in meeting the needs of survivors of human trafficking as their ability to use meaningful occupation as an avenue to overcome personal challenges is especially fitting for this population. The purpose of this report is to outline the occupational therapy process for survivors of human trafficking, including review of the theoretical framework and evidence guiding intervention, and the outcomes of intervention.
DESIGN: This study utilized a retrospective pre-test/post-test design. The study was retrospective as all participants had participated in an occupational therapy program at a non-profit anti-trafficking organization. The pre-test/post-test design was used to determine if occupational performance improved as a result of occupational therapy intervention.
Over an eighteen-month period, fifteen women received occupational therapy services while living at a transitional housing unit for women survivors of human trafficking. Out of the fifteen women, six of the women participated in the program for a duration of at least twelve weeks and completed outcome assessments. These women ranged in age from 22-64 years old and all had past human trafficking experience.
METHOD: Case documents including initial evaluation, intervention methods, and outcome measures were reviewed. Of the fifteen cases, only six women had participated in occupational therapy for at least 12 weeks and completed a follow-up assessment. The files were reviewed to determine themes regarding occupational performance issues and client factors influencing performance. The Canadian Occupational Performance Measure was used for goal creation and as an outcome measure. A Wilcoxon Signed-rank test was conducted to compare the evaluation and re-evaluation scores of participants’ performance as indicated by the COPM.
RESULTS: After twelve weeks of occupational therapy intervention, all clients reported an overall improvement in performance and satisfaction in their prioritized areas of occupation. There was a significant difference in the evaluation and re-evaluation scores of satisfaction and performance (p= 0.04).
CONCLUSION: This report has highlighted the damaging effects of trafficking on survivors’ occupational performance and the effectiveness of occupational therapy intervention. This study supports the role of occupational therapy as a component of the multidisciplinary team supporting a survivor’s recovery. Knowledge is very limited in the area of sex trafficking recovery and the role of occupational therapy; however, it can be concluded that client-centered, occupation-based therapy may be effective in supporting recovery.
IMPACT STATEMENT: Occupational therapy practitioners need to develop innovative community health opportunities to support this population. While at this time there is not a clear model for access and reimbursement, it is clear that the occupational needs of this population are high and that skilled intervention works. Outcomes from this study demonstrate effectiveness of intervention with a small sample; this provides the foundation to begin program development for implementation with a larger group.
References
Cecchet, S. J., & Thoburn, J. (2014). The psychological experience of child and adolescent sex trafficking in the United States: Trauma and resilience in survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 6(5), 482.
Cerny, S. (2016). The role of occupational therapy within the federal strategic action plan on services for victims of human trafficking in the United States. Occupational Therapy in Mental Health, 32:4, 317-328
