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Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON Trauma and Resiliency of the Trafficked Child: Toward Solutions and Resolutions Julianne Duncan, Ph.D.; Margaret MacDonnell, MSW; Migration and Refugee Services United States Conference of Catholic Bishops Elzbieta Gozdziak, Ph.D.; Micah N. Bump, MA [email protected] Institute for the Study of International Migration Georgetown University Mindy B. Loiselle, MSW Child Trafficking Consultant Commonwealth Catholic Charities of Virginia Abstract This paper is based on preliminary findings from an on-going study undertaken by the Institute for the Study of International Migration (ISIM) at Georgetown University and the Migration and Refugee Services (MRS) of the US Conference of Catholic Bishops (USCCB) to: 1) examine patterns of abuse of child victims of trafficking for sexual and labor exploitation; 2) analyze the challenges service providers face in assisting child victims; and 3) identify best practices and treatment modalities used to facilitate rehabilitation of child victims of trafficking. The project is based on two primary data sources: 1) key informant interviews with service providers in the US Conference of Catholic Bishops (USCCB) and the Lutheran Refugee and Immigration Services (LIRS) refugee foster care and unaccompanied minors (URM) programs serving child victims of trafficking and 2) ethnographic interviews with child survivors of trafficking selected from among children currently in care in the United States. By analyzing patterns of victimization before emancipation as well as post-emancipation experiences of child survivors within the U.S. federal system of care, this project attempts to expand the knowledge base of the special service needs of child victims of trafficking, enhance existing treatment modalities, inform understanding of repeat victimization of trafficked children, and take steps to prevent it in the future. (Trafficking, Children, Minors, Unaccompanied, Services) Introduction Human trafficking for sexual exploitation and other forms of forced labor is believed to be one of the fastest growing areas of criminal activity. The overwhelming majority of victims of severe forms of trafficking are women and children. The particular Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON vulnerability of child victims, related to bio-physiological, social, cultural, behavioral, and cognitive phases of the maturation process, distinguishes them from adult victims and underscores the necessity of special attention to their particular needs and potential for re-victimization. There is little systematic and in-depth knowledge about the characteristics of child victims, their life experiences, and their trafficking trajectories, all of which affect the appropriateness and efficacy of the services provided and the treatment modalities used. Children are often subsumed under the trafficking of women and children heading without allowing for analysis of the special circumstances and needs of victims under the age of 18. Despite the fact that many writers use the word `children' they usually discuss girls since the research on trafficked boys is virtually non-existent. The body of

academic research on child victims of trafficking is particularly limited. Notably absent in the literature are works written by trafficked persons themselves; Jean-Robert Cadet's testimonial about his harrowing youth as a restavec in Haiti is one notable exception (Cadet 1998). In the United States, there are two major reports on child trafficking: a pioneering study by Richard Estes and Neil Weiner entitled The Commercial Sexual Exploitation of Children in the U.S., Canada, and Mexico (Estes and Weiner, 2001), and a more recent report by Mia Spangenberg of End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes-USA (ECPAT-USA) on International Trafficking of Children to New York City for Sexual Exploitation (Spangenberg, 2002). The Estes and 2 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON Weiner study is a survey of different forms of commercial sexual exploitation of children in the United States, with only a small portion of the study devoted to international trafficking of children. The ECPAT study, on the other hand, is the first report to specifically address the international trafficking of children to New York City for sexual purposes. The report is geared toward service providers, policy makers, and advocacy groups looking to gain insight into the phenomenon of child trafficking. The report lays the foundation for further in-depth studies of child victims of trafficking. These reports notwithstanding, the understanding of the dynamics involved in child trafficking is minimal. This limited knowledge impedes identification of child victims of trafficking, obstructs optimal treatment provided to the children while in care and limits prevention of repeat victimization. The Study This paper is based on preliminary findings from an on-going study undertaken by the Institute for the Study of International Migration (ISIM) at Georgetown University and the Migration and Refugee Services (MRS) of the US Conference of Catholic Bishops (USCCB) to: 1) examine patterns of abuse of child victims of trafficking for sexual and labor exploitation; 2) analyze the challenges service providers face in assisting child victims; and 3) identify best practices and treatment modalities used to facilitate rehabilitation of child victims of trafficking. The project is based on two primary data sources: 1) key informant interviews with service providers in the US Conference of Catholic Bishops (USCCB) and the Lutheran Refugee and Immigration Services (LIRS) 3 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON refugee foster care and unaccompanied minors (URM) programs serving child victims of trafficking and 2) ethnographic interviews with child survivors of trafficking selected from among children currently in care in the United States. By analyzing patterns of victimization before emancipation as well as post-emancipation experiences of child survivors within the U.S. federal system of care, this project attempts to expand the knowledge base of the special service needs of child victims of trafficking, enhance existing treatment modalities, inform understanding of repeat victimization of trafficked children, and take steps to prevent it in the future. The sample Since the passage of the Trafficking Victims Protection Act (TVPA) of 2000, a total of 63 children have been identified as victims of trafficking1 and "determined eligible" 2 for services by the Office of Refugee Resettlement (ORR) in U.S. Department of Health and Human Services (DHHS) responsible for their care. This represents eight

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The Act defines trafficking as all acts involved in the recruitment, abduction, transport, harboring, transfer, sale or receipt of persons within national or across international borders, through force, coercion, fraud or deception, in order to place persons in situations of slavery or slavery-like conditions, forced labor or services, such as forced prostitution or sexual services, domestic servitude, bonded sweatshop labor or debt bondage 2 Eligibility determination and certification for services lay in ORR. The certification must confirm that an adult victim is 1) willing to assist in the investigation or prosecution of traffickers and 2) has either made a bona fide application for a T-Visa with the Bureau of Citizenship and Immigration Services (BCIS) in the Department of Homeland Security (DHS) or is a person whose continued presence in the United States is assured by the Attorney General in order to assist with prosecution in trafficking cases. Children under age 18 are exempt from the certification process but still need the "determination of eligibility" from ORR in order to gain access to services. The federal government uses the child's testimony as well as the dental and bone forensics for age determination.

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Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON percent of the total number of victims who have gained access to services under the TVPA provisions. Thirty-six of the 63 child victims of trafficking were unaccompanied at the time of identification and were placed in the federally-funded national network of Unaccompanied Refugee Minors (URM) programs, implemented by USCCB and LIRS. The remaining 27 were accompanied at the time of emancipation and received services as part of the emancipated family unit. On average, the unaccompanied children were older than those who were trafficked with other family member; they ranged in age from 12 to 17 at the time of emancipation. The accompanied children ranged in age from 5 to 18. The accompanied children were trafficked for labor, sexual exploitation and domestic servitude, while the unaccompanied children were trafficked for sexual exploitation or domestic servitude or a combination of both. The majority of the children in both groups are from Mexico. 13 of the unaccompanied children hail from Mexico, while an additional 13 come from Central American countries, mostly from Honduras, but also from El Salvador and Guatemala. Twenty of the accompanied children come from Peru (they are part of the same trafficking case) and four from Mexico. Three unaccompanied survivors are from China and two are from Africa. Two accompanied children are from the Former Soviet Union, and one is from Micronesia. The overwhelming majority of the children are girls; there are only one boy among the unaccompanied children and 16 boys in total. Twenty-two of the girls in the sample were trafficked for sexual exploitation and two for domestic servitude. The methodology 5 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON The study uses qualitative methodologies, primarily interviews, both telephone and face-to-face. The interviews are open-ended, but a discussion guide is used to ensure coverage of the same issues in each interview. At this point in our research, we have interviewed 16 service providers, 11 USCCB and 5 LIRS affiliates and obtained detailed information about 29 individual child victims of trafficking and gained preliminary understanding of one large case, involving 24 Peruvian children trafficked for labor exploitation. Each interview lasted between one to two hours. In addition to

interviewing service providers, the project includes interviews with emancipated children. At the time of this writing, only one child has been interviewed. However, consent has been obtained and plans are in place to interview several additional children and their family members. Not all children are available for interviews as some of them left the programs or returned to their home countries. The interdisciplinary research team includes five interviewers: two

anthropologists, a social worker, a psychologist, and a Latin American studies expert. Three of the team members are child welfare specialists. Whenever possible, two team members conduct interviews jointly to ensure breadth of perspectives. The interviews are not taped, but copious notes are taken during and immediately after an interview. The notes are typed and submitted to the interviewed service provider for review and possible additions.

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Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON The Context: Services Available to Child Victims of Trafficking Under the TVPA, child victims of trafficking are eligible for a number of services and benefits, including immigration relief (T-Visa).3 However, eligibility for services and access to immigration relief are two separate processes that may or may not intersect. Since this paper focuses on the special needs of trafficked children and the challenges in providing culturally, linguistically and developmentally appropriate social services, we will not discuss issues related to immigration relief at this point. It is, nonetheless, important to remember that immigration relief is available to these children and that unlike in the case of adult victims it is not tied to their willingness to collaborate with the criminal justice system. Brief descriptions of services available to both unaccompanied and accompanied child victims of trafficking follow. A more detailed discussion of service issues is imbedded in the presentation of preliminary findings and emerging themes. Services available to unaccompanied children Once unaccompanied children are determined eligible for benefits, they may choose to enter the Unaccompanied Refugee Minor (URM) program, a network of specialized foster care programs designed to provide culturally and linguistically appropriate care for refugee, asylee, and trafficked children. These programs are run in

Section 107 (e) of the TVPA established the T non-immigrant visa for victims of trafficking. Up to 5,000 T-visas are available annually to certified victims of trafficking who qualify to stay in the United States. The T-visas offer non-immigrant status for three years, after which the individual may apply for permanent residence.

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7 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON accordance with domestic child welfare guidelines, and are licensed in the state in which they operate. Children are provided shelter in a foster family, small group home or independent living arrangement, appropriate to the youth's developmental needs. These families and homes must be licensed by the state or county child welfare agency and the foster parents receive on-going training in child welfare matters. Foster care placements are based on the individual needs of a particular youth, with attention to the cultural, linguistic, and religious background of the youth; special health, educational, and emotional needs; as well as the personality, temperament and desires of the youth. The programs have found that while some children do well in a family setting, others are unable to adjust to the intensity of family life and do better in small group care. Once in care, the children receive indirect financial support for food, clothing, and other basic necessities. The URM program or the foster family makes arrangements to take the child to initial medical and dental evaluations and ongoing medical care. The URM program also provides intensive case management, which includes ensuring access to mental health counseling as needed and connecting the child with a pro bono attorney to provide assistance in obtaining legal immigration status. Children in the URM

program are enrolled in public schools, including enrollment in English as a Second Language (ESL) classes or other special educational services. After the initial placement period, the child is provided with independent living skills and job skills training as well as career counseling. Only children under the age of 18 can enroll in the URM program,

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Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON but they may stay in the program until they are 20 or 21, depending on the emancipation guidelines of the state where they reside. All programs continually evaluate family reunification possibilities for children in their care. Generally, trafficked children placed in these programs have not had

appropriate family members in the U.S. or overseas with whom they could be reunified. In one case, a child requested reunification with a family member overseas but her request was denied by the juvenile court judge overseeing her care due to concerns about her safety were she to return to a relative of the family who trafficked her. In some cases, children have chosen to emancipate from the program after turning 18 and have joined family members in the U.S. or overseas. While these family members may not have been appropriate to be the sole caregiver for a child, they may provide valuable support for an emancipated young adult. Services available to accompanied children Children trafficked with their family receive services as part of a family unit. Selfsufficiency is the hallmark of assistance provided to trafficked families. The initial services include immediate access to safe housing, medical assistance, and food. As part of a comprehensive case management, trafficked families also have access to immigration assistance. After the urgent phase of care, families are assisted in finding permanent housing and stable employment or public assistance. Children are enrolled in public schools and attend classes appropriate to their language and educational needs. Children also receive basic medical care, including necessary immunizations. Some of 9 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON the children and families experience disruptions and stress and may require mental health counseling. Trafficked children, both unaccompanied and accompanied, are eligible for mental health services to the same extent as other Americans. , however, language barriers may impede access to counseling. Emerging Themes and Preliminary Findings Although this is an ongoing research, a number of themes have already emerged. These themes will be further explored in interviews with child survivors of trafficking as well as in additional discussions with service providers. The assessments and conclusions offered in this paper are truly preliminary and it is important to bear in mind that they apply to a relatively small sample of child survivors of trafficking. Socio-economic background and family history The child survivors analyzed in this paper come both from rural and urban areas. All of the accompanied children come from the same neighborhood of Lima, the capital of Peru. Approximately half of the unaccompanied children come from rural areas or small towns. The remaining unaccompanied children are from urban areas. Family size varies greatly. The two Chinese survivors are only children. The children from Latin America and Africa come from large families, with some having as many as thirteen siblings. By Western standards, all of the children in this sample were vulnerable albeit the type and the degree of their vulnerability varied considerably. Moreover, within the parameters of their native culture and social and economic context the assessment of the 10 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON children's vulnerability and associated identity might need further modification. The

vulnerability of the children was exacerbated by lack of social and economic safety nets in their homelands. While there were no orphans among the cohort interviewed, one of the children was abandoned at birth. Twelve children reported that they did not have close relationships with their parents, particularly with their fathers due to a combination of death, illness, parental separation or other family problems. Eleven of the children in the sample were sent to live with relatives or family friends. With some notable exceptions, very few children report physical abuse from family members. Despite tenuous family relationships, many children remain very attached to their relatives. Her maternal grandmother raised Rosa, the eldest of five children; her parents were not married and did not live together. While both her mother and her grandmother physically disciplined Rosa, including holding her hand over an open flame, Rosa remains attached to them and continues to send money home to help her family. Economic issues, including extreme poverty and resulting hunger, affected many of the girls' desire to migrate. In some situations, parental illness compounded already dire circumstances and placed even more pressure on the children to contribute to the family's income. Irene, the youngest of three children, was born in a small town in Honduras. She describes having a close relationship with her family, including her unmarried parents as well as her eldest married sister and older brother, also married, who lived in the family home with his two children. Irene's mother never worked outside 11 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON the home due to severe case of asthma. Her father had kidney problems and worked as an itinerant farmer. Irene was a rising 7th grader and planned to go to technical school. She liked school and wanted to continue her education, but it was expensive. She made a decision to go to the U.S. to help her family. Victoria grew up with her mother. She didn't know her father. A "friend from the village" stepped in when V's mother became ill and promised to take care of her. She said that she would give V a "great opportunity". The woman brought Victoria to Chicago where she was forced to care for the woman and her husband. They didn't allow her to leave the home and they physically and emotionally abused her. Victoria stated that they made her feel "worthless". The woman informed Victoria that her mother died while she was trafficked with them. In other cases, family breakdowns resulting from death or divorce left the children vulnerable. Sue's story is particularly poignant. Sue is the youngest of four children born in a large city in Mexico. Her father who was from an upper class family married a working class woman from another country. His father disapproved of his choice and the enmity between Sue's grandfather and both of her parents never ended. Sue's father was a politician. When she was ten years old, her Dad, whom she describes as very honest became swept up in some type of political scandal. He shot himself in the head in front of her. His suicide caused a family turmoil; Sue's mother abandoned her children. The two older children went to live with her father's family and the two younger were left in the home alone. When Sue turned 17, the situation became too much for her. She contacted 12 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON her paternal uncle who lived in the United States. He told her she could come to live with him. He put her in touch with a smuggler and promised to pay the smuggling fees. In some cases, the girls were brought up in a family of traffickers or prostitutes and were pressured to join the family business or follow in the footsteps of their mothers, sisters, or aunts. Onset of Trafficking In some cases, the idea to migrate came from the girls, while in other situations, a family member, family friend, or trafficker posing as a trustworthy individual planted the idea in the child's mind. In most cases, the girls' decision to migrate resulted from their desire to help their family financially or escape a difficult or dangerous family situation. On a few occasions, girls migrated to follow "boyfriends" who eventually ended up trafficking them. When MB was about 13, she went away from home to work as a waitress in a restaurant. Within one month, a man who said he wanted to marry her wooed her. They became sexually involved and he sent her to live in the U.S. where he promised to join her later. Virtually in all cases the information on "travel" to the U.S. was obtained from known individuals: relatives, family friends or other trustworthy persons. The girl and perhaps her family would believe that the trafficker would obtain genuine work for the child or be able to ensure "safe" smuggling. When the idea to migrate came from others, it was usually presented as a favor. For example, traffickers told the children they could give them an opportunity in the U.S. 13 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON to make money for their families. They may have also engaged the parent with promises of a better life for the child. In one case involving two-dozen children, the traffickers used a simple ploy to initiate contact with the children and set up volleyball net in their yard in order to attract neighborhood kids interested in sports. There, they identified kids that they thought would make good workers in the United States and began to develop a relationship with them. The traffickers were well known in the community and most residents realized they had money from abroad. They wooed the kids with promises of trips to Disney World and told the parents they would have good jobs. They manipulated the parents into signing documents giving them permission to take the kids to the U.S. When possible, parents were also brought to the United States. In some cases, parents signed over their property to the traffickers as collateral for the trip to the US. When the idea to migrate came from a family member, it was presented as a way to help the child "pay them back" or "support their parents." When Maria finished the 7th grade at 15, her grandmother encouraged her to go to the family "restaurant" in Texas to be able to "give back to them" for raising her. Maria agreed. She was told that she would have to pay a debt of $8,000 for transportation costs and that she would be paid approximately $300/weekly for her work. It was not clear if all of this money went to pay off her debt. The trafficking journey Detailed descriptions of the children's journey from country of origin to the U.S. are difficult to ascertain. Many children withhold information about their migration 14 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON experiences, which seems natural given the stress, unease, and possible trauma. The circumstances of Josefina's trafficking history are fuzzy. Apparently, her "boyfriend" brought her to the border. She crossed the border into California successfully on the first try and was placed in a brothel. Josefina is very reluctant to share information about her trafficking experience. She makes every effort to omit details despite the fact that those details would have been helpful to the staff of the agency helping Josefina rebuild her life in tailoring their assistance. Lack of specifics notwithstanding, the journey is usually harrowing. Some survivors describe it as the worst part of the entire ordeal. Maria reported that her trip to the U.S. took six weeks and was very difficult and frightening. She traveled with 10 people, one of whom was her half sister. The rest of the people traveling may have all been adults and male. She has intimated that sexual advances were made toward her, but one of the people in the group protected her and her half sister. The group was turned back at the Texas border once and both of the girls wanted to return to Honduras, but were afraid to say this aloud. The next attempt worked and they came over the border by hanging on to the under chassis of a truck. Myrna who is from Mexico was first taken to Mexico City and then flown to a place near the US-Mexican border. From there she and the group she traveled with walked for three days and nights to Arizona. When she described her ordeal in an interview she became emotional stating how very hard and frightening the trip was. She

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Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON also mentioned Brownsville as a place she stopped on the journey to New Jersey where she was placed in a brothel along with a number of other girls. URM staff often avoid asking questions about the children's migration experience to the United States for fear that if they are subpoenaed this information might be used by the traffickers' defense team. Law enforcement also provides the agencies with limited information regarding migration and trafficking circumstances of the child survivors. Thus, the caseworkers' ability to tailor individual treatment plans is severely hindered. Trafficking experiences have significant ramifications for treatment plans. Given the fact that dealing with these experiences is essential to survivors' post-trafficking adjustment, receiving a child in care with no information as to her history or factors precipitating trafficking makes initial engagement extremely difficult. The fear, difficulty, dangerous circumstances, and mistreatment present in the stories that have been shared--either spontaneously or in court--can cause significant distress to the children. Because these experiences are not easily available to be worked through and normalized, cognitive distortions regarding culpability, generalized beliefs, self-blame, and trust may not be addressed. Treatment while trafficked The treatment of the children in trafficking situations varied considerably depending on the type of trafficking as well as other variables, including their relationship to the traffickers. Two of the girls trafficked for domestic servitude were treated very badly. One was in domestic servitude for five years and evidences significant 16 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON PTSD two years later. The other girl escaped after less than a year and also exhibits considerable PTSD symptoms. Since most of the children survived trafficking for sexual exploitation, we have reasonably good understanding of the treatment of girls trafficked to work in a bar or a brothel. Four girls in the sample were trafficked by family members to work in a family bar, however, not all of them were treated badly by the traffickers. Sarah who was a valued niece of the bar owner was allowed to keep her income and send money home. It seems that girls with kinship ties to their "employers" could keep their money and were often treated better than girls who could not claim such relationships. Reportedly, the latter group had all their income confiscated. Reports as to who was allowed or not allowed to keep their income are difficult to corroborate. However, a number of girls "knew" specifically how much of their smuggling debt they had paid off. Often times the smuggling debt kept growing since the traffickers added the cost of provocative clothing, jewelry and make up they bought for the girls to make them more engaging to the men in the bar. Some girls reported relative freedom, including having boyfriends and being able to leave their living quarters. Others reported having to endure horrific conditions of physical and mental abuse and forced prostitution. The story of Magdalena is a case in point. She and her fellow victims were treated brutally in the brothel. They were beaten for rule infraction such as talking to each other or to the clients and verbally abused and demeaned. The two women running the brothel were sisters of the two men who had 17 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON trafficked and wooed all the girls. The men were skilled at manipulation and continued to call the girls after the sexual abuse began, saying that it was just temporary. Magdalena arrived at the brothel pregnant and was forced to abort. The abortion was performed using herbs. Magdalena criticized the brothel's owners for their poor skills in performing abortions claimed that in her home country, women used better methods. Following the abortion she was given less food and forced to exercise in order to quickly regain her figure. The girls had to service 12-15 clients a day. Her traffickers closely controlled Margie's whereabouts. Margie was kept in a hotel, transported to a restaurant to entice clients and then brought back to the hotel where she was forced to have sexual intercourse and oral sex with about 20 men per day. She tried to escape, but was caught. Her traffickers tied her up and beat her, leaving her with bruises. Eventually, she and two other girls ran away from the hotel where they were kept. In other cases, it was unclear whether the girls were forced to provide sexual services to the bar patrons or just sell them inflated beer tickets. Paula reported that she was required to drink and dance with the clients and encouraged to grant them sexual favors, but was not forced to prostitute. If she did provide sexual services, she was allowed to keep half of the proceeds. Whether or not the girls were forced into prostitution, they were made to drink alcohol and in some instances smoke marihuana. All of the 20 children trafficked for labor reported having to work very long hours. However, there were no reports of physical abuse. In fact some of the survivors 18 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON wanted to continue working at the same jobs after the rescue. Perhaps the fact that many of them were trafficked together with their parents and siblings protected them from physical abuse and provided emotional support during trafficking. Perceptions of victimhood Understanding the child's perception of their trafficking experience as well as their identity as a trafficking victim plays an important role in post-trafficking adjustment. While none of the children were overtly happy in their situations, some did not see themselves as having been mistreated. Research on sexual abuse suggests that children who clearly hated what was happening to them accept treatment and advice more easily and are less likely to hold themselves accountable for their mistreatment (Hindman 1989). Children who cooperated with the perpetrators or enjoyed aspects of their experiences (e.g.; pretty clothes, freedom, boyfriends, drugs or alcohol) may have beenth more susceptible to traumatization and more resistant to treatment or therapy. Thus, their self-identity, understanding of their situation and subsequent goals may have conflicted with the goals and understanding of the URM staff and law enforcement. In addition, clear identification of someone as a perpetrator correlates with less traumatic aftermath. In situations where the perpetrator was a relative or a boyfriend or fiancée, there may be more betrayal and confusion resulting in a higher likelihood of a traumatic response. The situation was even more complex in cases where the traffickers were family members. The survivors were hesitant to speak openly of the situation for fear of

19 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON implicating their relatives or reprisals on family members left behind in the country of origin. The children's lack of identity as victims was closely related to their expectations about coming to the United States. As indicated above, almost all of the children were highly motivated to migrate to the U.S. in the hope of earning money. Many of them had compelling reasons to send money home, including extreme poverty in their home countries and parents' pleas to contribute to the family's income. In addition, they have to repay the smuggling fees. Typically, the children's desire to earn money does not change once they are rescued and in URM care. These expectations and desires might be in stark contrast with the URM programs' primary goal to ensure safety and stability. Obviously, URM programs also reflect US laws requiring children to attend school and cultural norms specifying the type of employment appropriate for a minor as well as US laws requiring a work permit and defining the age of employment and the number of hours a minor child is allowed to work per week. These restrictions may run counter to many children's expectations and goals and lead to necessary struggle as they adjust to their new daily routines. These issues have long-term consequences for the children's commitment to education and affect their desire to remain in the URM program. The children's reluctance to identify as victims stood in sharp contrast to the perceptions of program staff, who referred to the children as victims, often times simply because the law and resulting service eligibility conceptualize them as victims. However, many caseworkers interviewed in the course of this research appreciated our deliberate 20 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON use of the term `survivors' and emphasized the children's resiliency. While we recognize the necessity to use the term `victim' within the legal domain, therapeutically speaking the identity of a `victim' may be counter-productive. Trauma and treatment modalities Similarly to the concept of `victim,' the concept of `trauma' is equally ambivalent. We use it in this paper fully cognizant that a relatively small number of children in this sample--approximately 30 percent--meet the criteria of Post-traumatic Stress Disorder (PTSD) as defined in the DSM IV. In fact some children presented no psychological disturbance, while others exhibited symptoms of depression, sometimes profound. Indeed depression was the most common diagnosis and symptom. A typical presentation included somatic complaints, which were not necessarily seen as psychological. Several children had physical complaints, not responsive to medical interventions. One girl described as "doing very well" had frequent stomachaches.

Another girl, not currently in therapy said that she frequently "hurts all over". The cultural issues regarding appropriate expression of emotion are important in their treatment, but are unevenly addressed. We also subscribe to the notion that trafficking experiences and resulting psychological consequences must be viewed within the child's cultural, social, and historical contexts. Indeed, service providers may cause trauma and trauma response when bio-psychological and cultural issues of child survivors are not taken into account. Despite all these caveats, the word `trauma' adequately portrays the complex, difficult, 21 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON and very sensitive issues agencies serving child survivors of trafficking must address to responsibly direct services both at the micro and macro levels. To mitigate the psychological consequences of trafficking, children were offered a wide range of treatment options, ranging from traditional individual or group therapy, to counseling by a torture treatment specialist, to dance and art therapy. Initially, many children refused to avail themselves of psychological services, but program staff was persistent. Eventually, most children were in treatment, including one suicidal girl who remained in residential treatment for several months. Each child responded differently to the varying treatment options and it took some time to find a form of therapy that resonated with the children. A few children never really participated in any form of therapy. Some of the families trafficked for labor requested to talk to a Catholic priest and found solace in their faith and support from the local church and its spiritual leaders. The agency staff was quite adept at recognizing the survivors' spiritual needs and responded accordingly. The local community, including the Spanish-speaking

immigrants, also embraced the survivors and provided a lot of community-based support. Many URM programs clearly wanted all the children to participate in therapy and were convinced about the efficacy of this treatment for child survivors of trafficking. Some programs followed their agency's protocol as to the appropriate use of therapy and the children's interest and willingness to attend sessions. Other programs' decisions depended on the availability of resources, both psychotherapeutic and psychiatric. In most instances, decisions were influenced by what services were reimbursed. 22 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON Many social workers reported that the children in their care took a significant amount of time to bond, even when matched with linguistically and culturally competent caseworkers. Experienced staff reported that it was not uncommon to take six months to a year of sensitive listening, supportive interventions and not reacting to provocative behavior to begin to build mutual trust. The consistency of effort and the amount of time needed during the adjustment period is also greater than the norm. Once established, the relationship was often more intense than is typical. Many of the children imbued the social worker with powers and knowledge that they did not (and could not) have. The concept of in loco parentis was often exacerbated. The social worker had to be an extraordinary advocate with complex and encumbered systems, including in many cases the immigration authorities, social security and public assistance services as well as attorneys for both the child and the prosecution. Conclusions and recommendations We offer the following recommendations to enhance existing assistance to child survivors of human trafficking fully cognizant that they are truly preliminary and warrant further research.

Place children in stable care as soon as possible. Child survivors of trafficking should be placed in stable care as soon as possible since the period of bonding is much longer that for other populations. As with many troubled and traumatized children, patience and consistent presence of the caseworkers were crucial to bonding with the child. Many caseworkers emphasized the need simply 23 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON to be available to the child, including after-hours. The feasibility of the latter suggestion depends on the number of children in care and available resources. Ensure flexibility of treatment. In the United States, specialized care for child survivors of trafficking is still in its infancy. Programs have limited experience in serving trafficked children and even the best ones struggle how to maximize their resources and experience to ensure the most efficient care. Treatment plans need to be flexible and programs need to recognize that the individuals' path in and out of trafficking varies highly and may impact the child's willingness and readiness to engage with the helpers. The children's perception of their situation may be at odds with the perception at of the service providers and their plans for the child's life trajectory. Ensure small caseloads and consistent care. Make every effort to ensure that caseworkers work with as few children as possible at any given time and when ever possible make sure that the staff member who made the initial contact with the child remains her or his caseworker. Provide supportive family counseling. For children who had been trafficked with other family members, provide supportive family counseling to assist both the children and the adults--parents or other adult relatives to repair relationships, which have been stressed by the trafficking experience. Use culturally competent therapists willing to work closely with the agency staff. The psychological presentation of the trafficked child is often culture-bound and may vary considerably as well as change over time. When making the decision to refer to therapy, use culturally competent--preferably bilingual and bicultural--therapists. Culturally competent caseworkers that respected the 24 Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON cultural and personal identity of their clients and were able to recognize their strengths were very successful in forming strong relationships. with staff therapists appear to manage case complexities more easily. Balance the conflicting needs of law enforcement and service providers regarding information sharing. The need of law enforcement to protect their cases should to be balanced with caseworkers' need to know salient details about the child's trafficking history. Law enforcement can train caseworkers about the type of information that is likely to be subpoenaed and used against the child as well as how to ask and record sensitive information without jeopardizing the child's safety, while caseworkers can train law enforcement regarding the importance of the child's history in order to maximize placement stability. It is also important to use therapists willing to work closely with agency staff. Agencies

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Segundo Coloquio Internacional sobre Migración y Desarrollo: Migración, Transnacionalismo y Transformación Social DO NOT CITE WITHOUT AUTHOR'S PERMISSON

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