Interventions Human Service Professionals Provide to Prevent Human Trafficking

Interventions Human Service Professionals

Provide to Prevent Human Trafficking

Chapter 1: Introduction to the Study

Introduction

The tradition of human slavery in America is not a new topic. Many would

account the beginning of America’s slavery to the arrival of enslaved Africans in 1619,

captured salves arrived in North America as early as the 1500s (Harasymiw, 2022).

Passed in 1865, the 13th amendment abolished slavery (Harasymjw, 2022); slavery,

however, continues to date. Human trafficking constitutes a contemporary form of

slavery. Modern enslavement, or human trafficking, constitutes as offenses against

human rights, encompassing the exploitation of individuals (Wright et al., 2021). The act

of human trafficking is labeled a global crisis and a crime against humanity (Talbot &

Suzuki, 2021). Human trafficking exists across the world and impacts people through no

boundaries of race, religions, or backgrounds. Opportunities arise through activities like

moving through transfer, harboring, receiving of individuals or recruitment achieved

through deceptive influence, all with the intention of exploiting them for financial gain.

Internationally recognized, majority of trafficking victims are primarily subjected to

exploitation for the purpose of sexual exploitation (UNODC, 2020); therefore

traditionally, the term trafficking is often associated with sexual exploitation of women

and girls. Human trafficking, however, also consists of forced prostitution, servitude,

forced or compulsory labor, forced marriage, begging under exploitative and coercive

conditions, organ removal, baby selling of babies, illicit adoption, and combinations of

criminal activity and exploitation (Frank, 2022). Trafficking cases are diverse and

complex with human service professionals continuing to struggle to identify and disrupt

human trafficking networkers across the United States.

The impact of human trafficking is seen across varies populations. Amongst those

most affected by all forms of human trafficking are lower income persons and families

(UNODC, 2020). Traffickers prey upon the marginalized and impoverished. Cases

reviewed by United Nations Office on Drugs and Crime (UNODC) 2018 global report

found that at least half of the victims targeted were due to their economic needs

(UNODC, 2020). Vulnerability is high for undocumented migrants and people in need of

employment. Victims of human trafficking predominately consist of women and children.

The 2018 global report indicates that for every 10 victims, approximately five adults were

women, and two were young girls (UNODC, 2020). There is an understanding that

traffickers often manipulate, force violence, and use coercion, often accompanied by

promises of a better life (Wretman et al., 2021). Human trafficking continues to be

perpetuated throughout society. Therefore, to begin the process of ever eradicating human

trafficking, the networks to support survivors must be identified and disrupt the

manifestation of trafficking throughout each community.

This chapter includes an overview of the background of the problem, problem

statement, the purpose of this study, research question, theoretical framework, the nature

of the study, definition of relevant terms, assumptions, delimitations, limitations,

significance of study, and a summary.

Background

The movement to stop modern human trafficking has confronted many

challenges, and one that is significant is that the crime is hidden. Although found in every

country, trafficking remains a hidden crime, with perpetrators often operating on the

internet and under the criminality side of the economy (UNODC, 2020). A common

misconception is that the United States does not experience an issue with human

trafficking. However, the United States is ranked one of the highest in sex trafficking

(UNODC,2020). According to the United States human trafficking hotline 2019 Data

Report, from December 2007 through December 2019, a total of 63,380 situations of

human trafficking, including sex trafficking and labor trafficking, was identified (Polaris

Project, 2020). Given the hidden nature of trafficking, these numbers are also not entirely

accurate as statistics represent documented cases.

Instances of human trafficking vary widely and involve complex situations. Cases

can lack sufficient detail to easily pinpoint methods of control, victim profiles, or

trafficker profiles. However, of those cases that service providers are aware of, there is a

clear link to the experience of many behavioral and mental health disorders. Victims of

human trafficking tackle issues such as post-traumatic stress, suicidal ideation, physical

conditions, and anxiety disorders (Burt, 2018). Even the victims known to services

experience extreme trauma experiences compounded by stigma and the feeling of shame

(Powell et al., 2018). Services that are provided are often serving multiple traumatized

population and further evaluation is needed to ensure quality of care is standard and

appropriate for human trafficking victims specifically.

This research will focus on the interventions used by human professionals

operating as directors, managers, or program directors to prevent human trafficking of

sexual exploitation also known as sex trafficking. Researchers have shown that more

literature is needed to explore how interventions could be developed to help human

services professionals within anti-trafficking better response to human trafficking

(Koegler et al., 2021). Without a change, human trafficking will continue to be a systemic

issue throughout society. Understanding the breadth of services needed and the efforts to

improve the outcome for victims will further help professionals reduce disparities and

improve quality of life.

Problem Statement

Understanding the preventative measures to human trafficking is essential to

decreasing the effects of the crime on victims. Challenges faced by human service

professionals to support human trafficking victims include streamlining services and

working more collaboratively with stakeholders and systems (Powell et al., 2018).

Victims of human trafficking often need services addressing basic needs including

physical health, trauma-focused therapy, empowering environment, and promoting skills

development. However, human services professionals note that these services are not

always easily accessible (Koegler et al., 2021), and even when they are available, the

service quality is not at the needed intensity level to make a significant impact for the

victim. Duncan and DeHart (2019) noted that the needs of victims are complex,

extensive, and deeply ingrained; therefore, long-term approaches are critical for

treatment. Service providers also express concerns that the lack of service coordination

restricts response to victims (Williamson et al., 2020). In addition, these service

provisions can be fragmented, with high rates of lost contact and disengagement with

victims and workers who lack knowledge of trafficking and trauma-informed care

(Recknor et al., 2019). Hurst (2021) explained that some survivors found difficulties

quickly building a trusting alliance or repour with professionals because of negative

interactions between them and the helping professional. Lack of knowledge and training

in identifying human trafficked victims also showed ineffectiveness in preventing future

harm to youth involved in sexually exploitive relationships (Hurst, 2021). This lack of

training further expands into first responders' inability to not only identify the hidden

nature of sexual exploitation and hinder appropriate care to victims (Hurst, 2021) but to

move away from criminalizing youth involved in the sex trades. Efforts such as this is the

shift needed toward reforming systems to respond to victims affected by the crime of

human trafficking.

International and national efforts have been put in place to prevent human

trafficking. In 2000, United Nations Protocol to Prevent, Suppress and Punish Trafficking

in Persons, Especially Women and Children was created (Victims of Trafficking and

Violence Protection Act, 2020). Also in 2000, U.S. Trafficking Victims Protection Act

(TVPA) was established as well as the Palermo Protocol (Victims of Trafficking and

Violence Protection Act, 2020). These legal instruments help support and identify victims

and create strategies to protect the individuals at risk. In the content of the law, law

enforcement initiatives and campaigns to raise awareness are reasonable prevention

strategies for human trafficking (Bonilla & Mo, 2019). Historically, a legal strategy

approach has been implemented as the primary action for managing human trafficking

(Donohue-Dioh et al., 2020). Laws are necessary to facilitate social change, demand

order, and provide protection for victims; however, laws created a little over 20 years ago

for a century old global crisis may not capture the practical context of the preventive

measures needed towards sex trafficking.

For the purpose of prevention, one way of reducing the number of human

trafficking victims is by understanding human service professionals' input on the

interventions developed. The perspective of the human service professional is, however,

limited throughout research (Koegler et al., 2021) and lacks empirical rigor

(DonohueDioh et al., 2020) The evidence-based views and recommendations of

professions is vital in prevention efforts (Donohue-Dioh et al., 2020). There is a gap in

the literature on the developed services and resources that human services professionals

provide to prevent human trafficking (Koegler et al., 2021). Researchers have not

addressed how resources could be further developed to support professionals better

respond to the prevention of trafficking.

Purpose of the Study

The purpose of this single intrinsic case study is to explore the interventions that

human service professional directors use to prevent human trafficking in Missouri.

Research Question

What interventions do human service professionals use to prevent human

trafficking in the state of Missouri?

Conceptual Framework

I will use trauma-informed care as a framework for this study. Trauma-informed

care is a framework proposed by Harris and Fallot (2001). Harris and Fallot developed a

strengths-based delivery approach of trauma-informed care based on service providers

understanding how trauma impacts an individual. There is an emphasis on delivering

services to trauma survivors in a way that prompts participation in treatment and not

retraumatizing the victim (Harris & Fallot, 2001). Harris and Fallot proposed a

traumainformed approach to enhance outcomes across operating systems to benefit both

the individuals traumatized and the professionals responsible with assisting them in

achieving stability and safety as survivors. As a framework, the trauma-informed

approach is designed not to treat symptoms related to the abuse experienced but to deliver

services appropriate to the unique needs of trauma survivors (Harris & Fallot, 2001). I

will use a trauma-informed approach in this study as it ensures the prevention services

offered to victims are welcoming and engaging for the victims while maintaining the

service provider's emotional, physical, and psychological safety. In this study, I will use a

trauma-informed approach to understand human service professionals' strategies for

creating interventions to prevent human trafficking.

Nature of Study

In this qualitative study, I will use a single intrinsic case study. Qualitative

researchers aim to understand phenomena from participants' perspectives (Merriam &

Grenier, 2019). A case study is an approach to research to analysis and investigate a

single or collective case (Stake, 1995). The case study design is completed within a

realworld context to investigate a contemporary phenomenon (Yin, 2018). In addition, a

case study is used when there are more variables of interest than data points (Yin, 2018).

Case studies differ from other approaches and therefore require several different sources

of evidence to then place data in a triangulation (Yin, 2018). The benefit of various

analysis methods and multiple data collection allows for an in-depth understanding of the

case influenced by the context and emerging data (Stake, 1995). In a case study, the

intensive study of a single unit explains the understanding of the larger unit (Yin, 2018).

The case implies a related phenomenon that is observed at a specific time frame or

overtime (Yin, 2018). The case unit identified in this study are the managers and program

directors throughout the state of Missouri. They are bound by the phenomena of creating

successful interventions to prevent human trafficking.

For this study, the goal was to choose five to seven participants through

purposeful sampling and triangulation of collected data as well as reviewing and

collecting internal and public organizational documents. The participants will participate

in a semistructured, one-on-one interview through Zoom links. In the interviews, I

explored each professional's successful strategies, components, and recommendations for

success regarding creating interventions designed to prevent sexual exploitation human

trafficking.

Definitions

Commercial sex act: Any sexual act involving the exchange of anything of value

between people (Justice for Victims of Trafficking Act, 2015).

Exploitation: The unethical or unfair use of someone for one’s own benefit in the

form of prostitution or other forms such as; sexual exploitation, labor, slavery, or organ

removal (UNODC, 2020).

Human service professionals: Human service professionals aim to serve a variety

of clients with diverse needs and concerns. Professionals work throughout service

facilities including fields of mental health, public health, and education (Neukrug, 2017).

Sex trafficking: Includes the illicit actions of hiding, enlisting, transporting,

patronizing, or soliciting an individual through that of coercion and deceptive ways with

the intention of commercial sex (Justice for Victims of Trafficking Act, 2015).

Trafficking: The enlisting, transportation, moving, harboring, or receiving of

individuals by methods of unjust exercise of authority, threat, control, abduction,

deception, or the use of exploiting vulnerability. Additionally, it involves the exchange of

money or benefits to achieve control over a person, all with the goal of exploitation

(UNODC, 2020).

Assumptions

In this study, I assumed that human service professionals will value their

profession in supporting victims of human trafficking. I also assume that all participants

will have an interest in the overall study. I assumed that all professionals will be truthful

and accurate in illustrating their experiences with the strategies they use with

interventions for victims. Lastly, I assumed that within the listed screening criteria for

sampling, each participant chosen would have had experiences with human trafficking

victims and survivors.

Scope and Delimitations

The study’s scope involves human service professional and their successful

strategies in the use of interventions against sex trafficking. Delimitations are aspects of a

study that define boundaries and parameters consciously set by the researcher; this

includes the study’s theoretical background, populations, research questions, variables,

and assumptions (Theofanidis & Fountouki, 2018). In this study, I focus solely on human

service managers and program directors who successfully create interventions for the

prevention of sexual exploitation. All questions will focus on the functions, operation,

and strategies used to create interventions. The focus in only on managers and program

directors as they hold the responsibly to create the interventions. Human service

professionals outside of these roles will not participate in this study has they would not

have a role in intervention development. Involvement with participants will not focus on

any other human trafficking type other than sexual exploitation. These parameters are

further limited to those in Missouri.

Other conceptual frameworks considered for this study included a human

rightsbased approach and a victim-centered approach. A framework such as human

rightsbased approach is used for addressing trafficking as it aligns with international

human rights standards and advocating for the promotion and protection of human rights

(United Nations Human Rights Office of the High Commissioner, 2014). Applying a

human rights-based approach requires through review of how violations happen

throughout a trafficking cycle. Additionally, the approach aims to recognize and address

discriminatory practices and unfair distributions of power that contribute to the cause of

trafficking. (United Nations Human Rights Office of the High Commissioner, 2014). The

victim-centered in the context of sexual exploitation is a way of engaging victims to not

retraumatize the victim and systematically focus on their rights, well-being, needs, and

choices, thereby giving back control to the victim where possible (Haddadin &

Alexander, 2013). Although both frameworks work effectively with victims of human

trafficking, there is no focus on specifically on the human service providers and their

actions in preventing efforts.

Limitations

Limitations, if not addressed, can affect the outcome of the study. In a study,

limitations are any uncontrollable restrictions that hinder or impact the research and its

findings (Theofranidis & Fountouki, 2018). Limitations may affect the study design,

results, and conclusion as there is an influence on how a researcher interprets the data,

causing the data to be flawed or slanted (Raskind et al., 2019). In this qualitative study, a

limitation includes the narrative data collection. I collected data from participants

providing opinions of their experiences, which may vary between individuals. As this is a

qualitative study and not proven by statistical data such as a quantitative study, to reduce

this limitation, multiple sources of information were gathered to understand the factors

that contribute to the phenomena.

Additionally, this study was in line with COVID-19 safety precautions in place.

Normal previous processes of interview style were changed due to the pandemic, which

meant no interviews were permitted to take place face-to-face. The alternative to face-

toface interviews is conducting telecommunications interviews via video, such as Zoom.

Discussions over Zoom can create barriers such as frustrations when experiencing

technical issues which can impact the participant’s engagement during the data collection

(Archibald et al., 2019). Although interview guidelines are available before the interview,

distractions are prevalent when completing interviews via Zoom. To mitigate these

challenges, I will ask participants if they have a good internet connection before starting

the interview and ensure they feel comfortable and familiar in their space. Participants

will also be aware that they can stop the interview at any time and ask for more

explanation if the question is not understood.

This study's results may apply to various forms of human trafficking. However,

applicability may be limited to sexual exploitation and the managers and program

directors functioning in the role of creating interventions. Additionally, due to the

potential variations in organizational missions, geographical requirements, and specific

intervention tactic, the results of this study could be restricted to this group of

participants. However, certain concepts still can transfer to other settings, populations,

and organizations based on specific needs.

Significance

The reviewed literature revealed a lack of research on human services

professionals' developed services and resources to prevent human trafficking. This study

aims to explore the interventions that human service professional directors use to prevent

human trafficking in Missouri. This information may help human service professionals

improve interventions focused on preventing sexual exploitation in human trafficking and

to identify best practices to create strategies in human trafficking prevention successfully.

The findings also show possible ways to enhance preparedness and provide quality

program evaluation.

This study is significant as human trafficking affects victims' physical,

psychological, and emotional development. Human trafficking further hinders the

development of a nation, promotes criminal and corrupt behavior, and undermines human

resource development (UNODC, 2020). By further understanding the interventions that

human professionals provide to prevent acts of human trafficking, appropriate outreach

can be developed throughout human service professions. Research regarding the

interventions professionals provide to prevent human trafficking will aid in additional

training for human service professionals working in critical support settings most likely

accessed by those trafficked. Results can also improve the identification and methods of

responsiveness to trafficking and guide the specialist support required. Ultimately, more

resources will create different strategies to reduce the number of human trafficking

victims.

Understanding the successful strategies used by human service professionals to

prevent sex trafficking is necessary to effect positive social change. Once more human

service professionals know what strategies are effective in interventions, these procedures

can be applied to more interventions. Expanding this knowledge to more program

directors and managers aids in the effort to address the crime of sex trafficking in the

United States.

Summary

The purpose of this qualitative case study is to explore the strategies used by

human service professionals for creating interventions for the prevention of human

trafficking. Sex trafficking remains a complex phenomenon that remains a hidden crime

worldwide. Various factors contribute to being vulnerable and susceptible to becoming a

victim of sex trafficking. There are further reasons why professionals find it challenging

to engage victims and provide prevention this crime. Therefore, it is crucial to understand

the experiences of those professionals who have successfully supported sex trafficked

victims as they have first-hand knowledge of this success. In Chapter 1, the introduction

of the study and its significance were discussed, as well as the background, problem

statement, purpose, research question, conceptual framework, and nature of the study.

Essential definitions, assumptions, delimitations, limitations, significance, and a summary

were also discussed within Chapter 1.

In Chapter 2 of this dissertation, I present the relevant literature. The literature

review includes the definitions of human trafficking, and I explore laws, human

trafficking as a crime, and preventative measures taken. I also explore human trafficking

awareness, the theoretical framework of trauma-informed approach, and the impact of

human trafficking and Covid-19.

Chapter 2: Literature Review

Introduction

Human trafficking is a human rights violation enslaving children, women, and

men across the globe. The 2021 Global Estimates of modern slavery indicated that on any

given day, one in every 150 people is experiencing a situation of modern slavery or

human trafficking (International Labour Organization [ILO], 2022). This number is an

estimate given the hidden nature of the human trafficking crime. Although human service

professionals are essential in identifying, supporting, and assisting in preventing human

trafficking, service providers have struggled to identify, prevent, and disrupt human

trafficking networks (Polaris, 2018). The purpose of this single intrinsic case study is to

explore the interventions that human service professional directors use to prevent human

trafficking in the state of Missouri.

Among the many challenges of combating human trafficking, an additional

challenge is identifying areas of improvement for human service professionals and what

strategies work well. Professionals find it challenging to identify areas of improvement

regarding the quality of victim services as there is not a nationally recognized minimum

standard of care for trafficking victims (Koegler et al., 2021). Preble et al. (2022)

revealed a consistent theme of lack of resources ranked as a barrier to service provisions

and a need for more training on the cross of human trafficking with other traumatic

events, such as domestic violence and substance misuse. Gerassi et al. (2022) noted that

training for service providers on sex trafficking often concentrated on commonly

associated risk factors, neglecting to address other structural elements, such as racial

oppression. Further research is needed to develop an evidenced-based minimum standard

of care and to develop the services that human services professionals can provide to

prevent human trafficking (Koegler et al., 2021). Scholars have exemplified the need to

understand the resources human service professionals need to prevent human trafficking

successfully.

In this chapter, I review trauma-informed care as a conceptual framework and its

relation to the current research. I further review the literature search strategy used to find

current, scholarly sources and examine the current literature relating to the phenomena of

interest, including types of human trafficking, human trafficking and whom it affects,

human trafficking as a crime, and preventing human trafficking. Finally, challenges in

human service professions and the absence of what works are examined.

Literature Search Strategy

This literature review was conducted to examine the current and empirical

knowledge base regarding the sexual exploitation of human trafficking victims and

human service professionals. The scholarly databases explored were made available

through the Walden University library and Google Scholar. Scholarly articles were

obtained using terminology related to human trafficking, modern slavery, sex trafficking,

child trafficking, human service professionals, service providers, trauma-informed care,

human trafficking prevention, sexual exploitation, and Missouri. The databases used were

SAFE Journals, APA PsycInfo, ProQuest, EBSCO, PubMed, PsycINFO, ScienceDirect,

SocINDEX, CINAHL, and Supplemental Index. Apart from the framework,

governmental legislation, and laws, the literature reviewed was published between 2017

and 2022.

Theoretical Foundation

Trauma-Informed Approach

Professionals advocate the need to establish trauma-informed care systems as it is

important to acknowledge trauma as contributors to mental health. Trauma-informed care

is a framework proposed by Harris and Fallot (2001). This framework recognizes that

understanding the impact of an individual's trauma is a fundamental responsibility for

professionals (Harris & Fallot, 2001). Understanding an individual’s trauma is not limited

to the benefit of the victim and their support but also the service providers.

Trauma-informed services have broad applications in the field of human services.

Harris and Fallot’s (2000) trauma-informed care is rooted in the service provider’s

understanding of the individual’s impact of trauma and characterized by a strengthsbased

service delivery method. There is an emphasis on delivering services to trauma survivors

that prompt treatment participation and do not retraumatize the victim (Harris & Fallot,

2001). The purpose of a trauma-informed approach is to improve outcomes across

systems for the benefit of the traumatized person and the professionals tasked with

helping achieve stability and safety for the survivor (Harris & Fallot, 2001). On an

organizational level, the changes made by trauma-informed care require an organization's

culture to have professionals emphasize appropriately in responding to the effects of

trauma by shifting the paradigm to professionals asking what happened to the individual

instead of what is wrong with the individual (Harris & Fallot, 2001). This change of

culture results in a change of outcome for the victim.

Survivors of human trafficking frequently experience extensive traumatic

episodes associated with their victimization. Trauma-informed care does not treat the

symptoms or related issues of abuse but instead provides services that support and are

accessible and appropriate to those who have undergone trauma (Harris & Fallot, 2001).

The absence of a trauma-informed approach in a service support system poses a risk of

triggering and potentially worsening an individual’s trauma symptoms (Harris & Fallot,

2001). Through the trauma-informed approach, triggering and retraumatization of the

victim are avoided.

Current use of Framework

The growing awareness of trauma has resulted in the continued development of

trauma-informed services. Services structured to understand trauma require specific

delivery from human service professionals. Fallot and Harris (2015) advocated for using

trauma-informed services within services provided by human service professionals. As

trauma can affect how people approach beneficial relationships; individuals with a history

of trauma and abuse are often reluctant to initiate or may disengaged with support and

services. The impact of trauma also affects the staff members working within these

human service programs. Secondary and vicarious traumatization are frequent concerns

within the work settings of human services (Fallot & Harris, 2015). Guided by Fallot and

Harris (2015), the Creating Cultures of Trauma-Informed Care approach (CCTIC) to

organizational change is guided into five core values: safety, trustworthiness, choice,

empowerment, and collaboration. Each guiding principle addresses the consumer's

service level needs and the staff's administrative level.

The first of the guiding principles is safety. Ensuring the safety, both physical and

emotional, of consumers and staff is a high priority. Implementing this principle includes

considering the importance of the physical components, such as building signage and safe

entry to welcoming greetings and clear explanations of the program's mission (Fallot &

Harris, 2015). The following principle, trustworthiness, goes further into task clarity,

interpersonal boundaries, and consistency. Service provided needs to be adjusted to

ensure all tasks and boundaries are clear (Fallot & Harris, 2015). For staff, service

delivery must be precise by maintaining consistency in practice and establishing

appropriate boundaries for the program (Fallot & Harris, 2015). Program directors and

clinical supervisors should comprehend the impact of services for direct staff work,

including emotional impact, high turnover, vicarious trauma, and emotional and physical

exhaustion. For the guiding principle of choice, the consumer's experience of choice and

control develops throughout their services. These choices are seen in options such as

service users deciding when, where, and by whom services are provided. For the service

provider, the choice principle focuses on the staff's experiences of choice and control,

especially in how employees met their goals. Staff members have a choice how they

choice to meet their job requirements and there are clear guidelines in job performance

guidelines (Fallot & Harris, 2015). The collaboration principle recognizes the

significance of fostering partnerships and equalizing power dynamics between staff and

clients. The understanding is that the healing process occurs in meaningful relationships

that share power and the decision making. Lastly, the empowerment principle recognizes

the consumer's strength, builds skills, and prioritizes the consumer's empowerment

throughout the services (Fallot & Harris, 2015). Prioritizing staff empowerment and

skillbuilding include ensuring all members of staff have the necessary resources needed

to complete their jobs effectively and competently. Throughout every aspect of the

program's function, there is a requirement for enhanced awareness of how service

providers understand trauma's effect on people.

The Self-Assessment and Planning Protocol and its accompanying CCTIP

SelfAssessment Scale is Fallot and Harris' (2015) attempt to provide a clear and

consistent guideline for programs and agencies facilitating trauma-informed care in their

service systems. The protocol and self-assessment tools were created for the use and

implementation of service providers, administrators, and survivors to continue developing

and evaluating trauma-informed programs. (Fallot & Harris, 2015). The emphasis is

placed on organizational culture as it embodies the broadest and most comprehensive

understanding of the program’s function. The self-assessment and planning protocol is

sectioned into six domains. Each domain is guided by key questions used to ignite

discussions and invoke indicators of a trauma-informed approach (Fallot & Harris, 2015).

The review of the day-to-day service procedures offers a starting point for organizational

change.

Each level of the protocol and self-assessment tool has specific requirements for

guidance. The first domain requires the organization to question the extent that their

activities and environment are in line with the five guiding principles of trauma-informed

practice (Fallot & Harris, 2015). The second domain is listed as formal services policies

(Fallot & Harris, 2015). This domain requires asking how the formal policies actively

reflect an understanding of a trauma survivor's or staff's challenges and or strengths.

Questions also posed include to what level the policies are monitored and consistently

implemented. The third domain of the protocol consists of asking how the program has a

consistent way of identifying individuals exposed to trauma (Fallot & Harris, 2015). This

domain focuses on the screening of trauma, the assessment planning stage, and

traumafocused services (Fallot & Harris, 2015). The following three domains are

considered system-level and administrative changes. Domain 4 focuses on administrators

integrating understanding and resources about abuse and violence throughout the

programs (Fallot &Harris, 2015). Domain 5, staff trauma training and education, accesses

the level at which staff members have received adequate training in the understanding of

trauma and the impact this may have on their service delivery (Fallot & Harris, 2015).

Lastly, Domain 6 is human resource practices. The main objective here is, inquiring the

concerns relating to trauma in the hiring and performance review (Fallot & Harris, 2015).

The assessment is intended to start the change for the organization's culture; participants

of all stakeholders, from upper-level administrators to direct service staff, must be

involved.

Techniques Developed Using Trauma-Informed Approach

Other techniques developed using a trauma-informed approach include that by the

Substance Abuse and Mental Health Service Administration (SAMHSA). Harris and

Fallot developed the first concept of trauma-informed care within health care in the early

2000s; some modern programs and initiatives surroundings trauma-informed practice are

guided by SAMHSA's (2015) guidelines. SAMHSA (2015) developed a working concept

to help facilitate communication between systems, understand the relationship and

significance between trauma and behavioral health issues, and provide guidance for

professionals in systems to adopt a trauma- informed approach. SAMHSA introduced a

framework that has the versatility to adapt to several behavioral health specialty sectors

including but not limited to the primary health field, military sectors, education, child

welfare, criminal and juvenile justice, and other professional services that have the

responsibility of care to ease or exacerbate an individual's ability and capacity to cope

with the experiences of traumatic episodes (SAMHSA, 2015). SAMHSA also lists six

key principles of the trauma-informed approach. The principles, led by safety provisions,

support through peers, push to empower, voice and choice, trustworthiness and

transparency, as well as collaboration and mutuality. These principles, along with

cultural, historical, and gender considerations, can be generally applied across different

environments. Ultimately providing a versatile yet tailored approach to trauma-informed

care.

Another trauma-informed approach is the sanctuary model. As the sanctuary

model is an organizational change model; it is built and developed specifically for

community service organizations (Bloom, 2010). This model represents a

traumainformed, organization-wide, evidence-informed approach to creating

organizational culture. The model facilitates the integration of services users in delivering

therapeutic approaches within a cohesive trauma-informed methodology (Bloom, 2010).

Galvin et al.

(2022) aimed to understand the perceived restrictors and barriers to implementation

perceived by residential care staff and specifically focus on understanding how these

perceptions influence and impact the success of the organization. Galvin et al. (2022)

found that by staff having a depth of understanding and knowledge of trauma-informed

care this fostered staff engagement at all levels of the organization. The shared

knowledge further impacted not only the staff but enabled staff to better provide service

and care to client; providing a deeper comprehensive understanding of experienced

trauma (Galvin et al., 2022). Increased trauma-informed knowledge and understanding

shifts the attitude of staff working within a trauma-informed setting and improves the

interacting environment with clients that have been traumatized.

Framework and This Study

A trauma-informed approach is a fundamental concept for this study. In this

study, I focus on the human service professionals' successes in preventing human

trafficking. Research is clear regarding the importance of the service provider

professional and the service user for using the trauma-informed approach (Fallot &Harris,

2015). Implementing a trauma-informed approach creates the opportunity to change the

experience for service providers while also understanding what works from their

perspective (Fallot & Harris, 2015). Professionals working within the field of supporting

human trafficking victims are not able to support the healing process of victims if they

operate within chaotic, stressful environments, do not recognize vicarious trauma, and are

working in unsupportive environments. A trauma-informed approach is essential for this

research as the objective is to understand the successes in preventing human trafficking;

services utilizing a trauma-informed approach will serve as a benchmark for practical and

effective steps toward prevention. The trauma-informed approach also focuses on the

actions of the human service professional themselves; professionals and their services are

primary throughout this study. For the human trafficking victim and human service

professional, a trauma-informed approach can provide a transformation experience and

efficacy of care in providing healing to those that need (Mersky et al., 2019). A

traumainformed approach is important for this study as several approaches and methods

recognize the victim's experiences; however, many fail to note the service provider's

importance in supporting the victim. The trauma-informed approach makes the service

provider's wellbeing a priority. Through the use of trauma-informed approaches in this

study, the success strategies of human service professionals will be examined, and other

organizations can implement the dissertation results.

Literature Review

Defining Human Trafficking

There are several terms used to describe trafficking. Umbrella terms used to

reference the crime of traffickers exploiting and profiting at the expense of both children

and adults include trafficking in persons, human trafficking, and modern slavery (U.S.

Department of State, 2022). In the United States, the provision, recruitment, harboring,

transportation, or obtaining of a person for labor or services while using force, fraud, or

coercion for subjection to involuntary servitude, peonage, debt bondage, or slavery

further defines forms of human trafficking in persons (Victims of Trafficking and

Violence Protection Act, 2000). Across the United States, human trafficking is

predominately acknowledged in two ways; forced labor and sex trafficking

(Understanding Human Trafficking, 2022). Human trafficking operates in various forms,

amongst several include forcing in marriage, the removal of organs, begging under force,

child soldiers, and the selling and purchasing of children (Saner et al., 2018). Second

ranked to Germany, the United States is considered one of the top destinations for victims

of human trafficking (Kim et al., 2018). In identifying the crime, the first objective is to

identify who is at risk of being human trafficked.

The comprehensive understanding of human trafficking requires an examination

of the terminology, legal protocol, and concept of definition limitations in order to

develop a multifaceted perspective on the global issue. Internationally, the Protocol to

Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children,

also referred to as the Palermo Protocol, was the first agreed definition of trafficking in

individuals (Goździak & Vogel, 2020). Before being established, the Palermo Protocol

underwent 2 years of deliberation and negotiations. Formally established in 2000, the

Palermo protocol was created at the UN Centre for International Crime Prevention in

Vienna (Goździak & Vogel, 2020). Two organizations represented opposing

perspectives; one was influenced by feminist and religious groups, while the other was

lobbied by human rights advocates. The two groups represented opposite views of

prostitution. Religious and feminist activist of the Coalition Against Trafficking in

Women (CATW), argued that the definition of trafficking should include all forms of

prostitution regardless if force or deception is involved. (Goździak & Vogel, 2020). The

opposing view of the Human Rights Caucus viewed prostitution as a legitimate service

and claimed that defining human trafficking must include the element of force or

deception (Lauger et al., 2022). However, CATW viewed prostitution as a violation of

the human rights for women (Goździak & Vogel, 2020). Defining human trafficking was

difficult during this time as one view consisted of sex work to be an act of self-decision

while another perceived prostitution as coerced. Ultimately, the Palermo Protocol refused

the definition suggested by religious and feminist organizations. Instead, it stipulated that

the definition of human trafficking requires the presence of force, fraud, or coercion

either for sexual exploitation or a particular labor (UN Protocol, 2000). The development

of the Palermo Protocol provided a significant milestone in the efforts to define human

trafficking and combat it.

Along with the complexities of defining human trafficking, one of the most

fundamental challenges facing human service professionals and law enforcement is the

ability to identify the victims of human trafficking victims accurately. Considering the

variations of human trafficking, the problem remains hidden for several reasons; this

includes the understanding that some trafficked youth do not define their experiences as

human trafficking and fail to recognize their exploitation; therefore, victims do not seek

assistance (Haley et al., 2017). Some professionals responsible for recognizing human

trafficking indicators have limited resources, tools, and training to detect them

effectively. The lack of trust that victims bestow in these professionals can also be of

concern (National Action Plan to Combat Human Trafficking, 2021). Along with these

challenges, agencies lack consistent data collection protocols (Haley et al., 2017). Human

trafficking statistics are difficult to collect, and there is no recognized method to estimate

the number of undetected victims of trafficking (Saner et al., 2018). These challenges

continue to make identifying victims of human trafficking and those behind it difficult.

While acknowledging the challenges and limitations from the nature of

underreporting of human trafficking and lack of enforcement central data recording, the

data reports available only present a small fraction of the realistic trafficking occurrence.

According to the 2019 U.S. National Human Trafficking Hotline Data Report, over

22,000 victims and survivors were identified (Polaris Project, 2019). From this number,

14,597 was of sex trafficking and 4,934 was of labor trafficking (Polaris Project, 2019).

This is nearly a 20% increase from the previous year of individual victims and survivors

contacting the hotline directly (Polaris Project, 2019). However, the Bureau of Justice

Statistics of the U.S. Department of Justice received a total of 2,198 referral to U.S.

attorneys for human trafficking criminal offenses in 2020, this was a 62% increase from

2011’s 1,360 persons referral (Lauger et al., 2022). With such a variation in numbers,

understanding those who are at risk of human trafficking is essential.

The involvement in human trafficking is often explained by economic, social, and

political conditions. Disproportionately, the most vulnerable and underserved are affected

by human trafficking the most (Movsisyan, 2019). Societal factors play a large role in

identifying who is at risk of trafficking. There are several risk factors contributing to

human trafficking; the five highest ranking include unsafe irregular migration, substance

misuse, mental health difficulties, youth runaways or homelessness, and involvement

with children services (Polaris, 2017). A common driving force across all communities

and cultures that perpetuate risk of human trafficking is poverty (Talbot & Suzuki, 2021).

Throughout the United States, the most prevalent victim trafficked is young women

between the ages of 12 and 16 for sexual exploitation of prostitution (Basu et al., 2021).

In the United States, single mothers, young girls, and divorced women with children are

primary targets due to impoverished circumstances and traffickers offering the Idea of an

escape from poverty. Traffickers offer opportunities of love, affection, and high-paying

job in hopes of a better way of life (Bauer et al., 2019). Each reasoning for human

trafficking involvement either pushes victims out of their current predicament or pulls

them into human trafficking scenarios. This idea is understood as the push/pull concept

and it heightens the vulnerability of human trafficking victims (Kragten-Heerdink et al.,

2018). Promises often lure victims of human trafficking into trafficking relationship due

to pull factors such as stability for their families, possibilities of work, education, or other

agreements.

Human Trafficking as a Crime

Although considered an invisible crime, the presence of human trafficking is

growing. As a criminal industry that denies the freedom of over 49.6 million people

worldwide, human trafficking can generate an estimated yearly profitability of $150

billion worldwide (ILO, 2021). According to the Bureau of Justice Statistic of the U.S.

Department of Justice (2022), the criminal prosecuted number for human trafficking

increased by 84% to 1,343 from 2011 to 2020. By the end of 2020, the recorded number

of individuals in a state prison for any form of human trafficking stood at 1,564 (Lauger

et al., 2022). These numbers can appear low when comparing to the number of people

affected by the crime.

The actions of the trafficker are deliberate and skilled. Human trafficking occurs

when a trafficker uses the action-means-purpose (AMP) model (Human Trafficking,

2021). According to the AMP model, the criminal takes an action that includes

recruitment to identify potential victims. Exploiting the vulnerability of the victim, the

trafficker aims to isolate individuals, explicitly creating a divide between family and

friends (Talbot & Suzuki, 2021). This increased vulnerability makes the victim more

susceptible to the trafficker’s influence, and the trafficker then can use force, fraud, and

or coercion. The victim is then consumed in the world of the trafficker, having unrealistic

views of reality in which the trafficker exhibits their authority. The goal of the trafficker

is for the victim to experience further isolation from the outside world and continue to

play on the vulnerability of the victim, ultimately controlling the victim’s behavior

(Talbot & Suzuki, 2021). All of these actions are to compel the victim to provide

services, labor, or commercial sex acts.

Identifying what actions do not qualify as human trafficking is also essential in

defining the crime of human trafficking. A victim does not need to be transported

physically from one place to another place for the offense to consist of human trafficking

(Lauger et al., 2022). Although similar to human trafficking, it is essential to distinguish

it from migration human smuggling (Goździak & Vogel, 2020). Distant crimes apart,

human smuggling is related to but not the same as human trafficking. The action of

human smuggling typically involves the consent of a person smuggled (National Institute

of Justice, 2023). Clarification between the terms trafficking and smuggling is provided

by the Palermo Protocol. The distinction includes three entities: exploitation, the action of

consent, and transnationality (Goździak & Vogel, 2020). The action of smuggling entails

migrates who have provided consent to be transported. These actions often come with

people paying money to be smuggled across borders. In contrast, if initial consent was

initially given and subsequent alterations in circumstances occurred due to the influence

of deception, coercion, or abusive actions from the traffickers involved, it is then

categorized as a trafficked victim (Goździak & Vogel, 2020). An additional differential

factor for victims is that the act of smuggling is always transnational. Trafficking,

however, does not have to cross state lines or national borders and can operate where

initiated with the victim (United Nations, 2000). Smuggling participants typically

separate from those who assisted them to migrate once they reach their destination versus

trafficked victims are involved in ongoing exploitation (National Institute of Justice,

2023). Determining the severity of the exploitation between the two groups remains a

debate, but it is essential to note the differentiation between the two actions.

Legal Ramifications of Trafficking

While human trafficking has been referred to as the modern-day slavery, formal

protocols addressing the issue were established only a short time ago. In 2000, the

adoption of the Palermo Protocol by the United Nations General Assembly in 2000

marked a significant milestone in the global effort to combat human trafficking

(Understanding Human Trafficking, 2022). Additionally in 2000, on October 28th,

President Bill Clinton formally ratified the first comprehensive federal law aimed to

address trafficking in persons, Victims of Trafficking and Violence Protection Act,

commonly known as the Trafficking Victims Protection Act (TVPA; Goździak & Vogel,

2020). Several times over the years, authorities reauthorized the policy, starting in 2003

followed by 2005, 2008, 2013, and most recently 2019 (Busch-Armendariz et al., 2018).

The legislation provided definitions of the most common trafficking crimes: sex and

labor. TVPA's focus on sex trafficking was paralleled to international antitrafficking

efforts. The TVPA introduced the concept of the Three Ps, representing protection,

prevention, and prosecution. An additional P was later established, meaning partnerships,

a total of four Ps (Busch-Armendariz et al., 2018). Each phase represented an action;

prevention refers to the action put in place to avoid potential victims being subjected and

vulnerable of exploitation (Goździak et al., 2020). Protection entails varied assistance

programs ranging from mental health support, financial assistance, medical attention, and

securing accommodation, accessible to those who meet specific criteria

(BuschArmendariz et al., 2018). The prosecution aspect requires traffickers to be held

responsible under criminal enforcement and imposes sanctions for their actions

(Goździak et al., 2020). Lastly, partnership refers to the collaborations between various

agencies and stakeholders to prevent trafficking, prosecute traffickers, and protect victims

(Understanding Human Trafficking, 2022). The protocols established within the last 20

years represent only first steps toward combatting human trafficking. The next steps

hinge on the effective implementation of the protocols within policies and through the

service providers.

There is a substantial difference between the TVPA and Palermo protocol. TVPA

was established specifically for the United States and the Palermo protocol established

the first acknowledged international definition for human trafficking (Goździak & Vogel,

2020). The Palermo protocol extends beyond the international definition of human

trafficking, offering the community with a comprehensive legal framework that is victim

centered. This framework serves as a foundation that can be built upon and developed

(Understanding Human Trafficking, 2022). When developed, 140 countries signed on

agreeing that human trafficking is both a violation of human rights and a criminal

offense; therefore, prevention actions are required along with the protection of vulnerable

populations and the significant prosecution of criminal offenders. (Baird et al, 2021).

Reflecting on the crime aspect of human trafficking, the Palermo Protocol was not

specifically designed to address the human rights violation taking place through slavery

but rather a response to the international political need of combating organized crime

associated to human trafficking (Goździak & Vogel, 2020). There are three protocols

supplementing the UN Convention against Transnational Organized Crime. The first is

the Palermo Protocol, and the other two consist of, - Protocol against the Smuggling of

Migrants by Land, Sea and Air (Smuggling Protocol) - Protocol against the Illicit

Manufacturing and Trafficking in Firearms, Their Parts and Components and

Ammunition (Firearms Protocol) (Eurpol,2018). With this understanding of the legal

frameworks in place, efforts can expand in combating human trafficking.

Combatting Trafficking

Appropriate agencies and organizations did not always adequately address

survivors' complex and specific needs. Trafficking survivors were seen to have few

options for tailored support when the antitrafficking movement launched in the United

States in the 1990s (Baird et al., 2021). Before adopting the TVPA, victims who had

suffered from and survived human trafficking experiences were typically serviced by

service systems not fully aware and unequipped for human trafficking (Baird et al.,

2021). The absence of specialized and diverse services for human trafficked victims was

seen to marginalize further and endanger survivors. Goździak and Vogel (2020) noted

that advocates of antitrafficking and legislators consider TVPA of 2000 and the

Trafficking Victims Protection Reauthorization Act of 2003 as pivotal legislation in

tackling trafficking both internationally and throughout the United States. The passing of

the TVPA legislation initiated a government division to combat trafficking. The U.S.

Department of State officially created its Office to Monitor and Combat Trafficking in

Persons (Goździak & Vogel, 2020). This progression sparked other departments

throughout the state, such as the Department of Health and Human Services and

Department of Education, to follow with their programs to fight the acts of human

trafficking (Goździak & Vogel, 2020). All acts continue their operations to date.

With these efforts came tools to combat the crime of human trafficking

throughout the United States and internationally. The Trafficking in Persons Report

(TIP), produced by U.S. Department of State’s Office to Monitor and Combat Trafficking

in Persons, suggests it is the primary diplomate instrument used by the government to

initiate discussions with foreign governments regarding human trafficking (U. S.

Department of State, 2020). The report provides a narrative of 188 countries that

selfreport their perceived efforts to combat human trafficking (U.S. Department of State,

2018). The annual report results in a tiered rating using the standard and compliance

outlined in the TVPA of 2000s 3 Ps: prosecution, protection, and prevention (U.S.

Department of State, 2020). The three tiers used indicate how government can improve

its antitrafficking efforts based on the previous year’s ranking (U.S. Department of State,

2020). The report does not compare one country to another but measures the country

against itself based on its efforts.

The most vulnerable and underserved members of society are disproportionately

impacted by human trafficking. Amongst the extent of the 2021updated National Action

Plan to Combat Human Trafficking plan, the plan aims to address the curated needs of

families, individuals and communities underserved (The National Action Plan to Combat

Human Trafficking, 2021). The plan specifically aims to expand the efforts in addressing

the inequities of marginalized groups (The National Action Plan to Combat Human

Trafficking, 2021). These communities frequently experience social and economic

inequities, and individuals often endure several variations of abuse. The National Action

Plan reflects the commitment to equity of race and gender by actively addressing the

systemic injustices experienced by these communities (The National Action Plan to

Combat Human Trafficking, 2021). Strategic interventions can include programs that

offer appropriate support to allow communities and individuals to reduce their

vulnerability through mitigating identified risk factors (The National Action Plan to

Combat Human Trafficking, 2021). Combating trafficking efforts range from targeted

education of vulnerable population to prohibiting goods entering the U.S markets that

was manufactured under forced labor efforts (The National Action Plan to Combat

Human Trafficking, 2021). With 72% of reported calls to the National Human

Trafficking Hotline in 2019 related to sex trafficking and 11% related to labor trafficking

(Polaris Project, 2019), prevention and combat efforts often focus on sex trafficking.

However, it’s important to note that the National Action Plan is not limited to fighting

only sex trafficking. It also reflects the commitment to safeguarding worker’s rights and

endeavors to eliminate forced labor within the supply of goods (The National Action Plan

to Combat Human Trafficking, 2021). Covid-19 pandemic exacerbated these concerns

particularly due to lack of job security, significant disruptions in supply chain

availabilities, and substantial unexpected spike in demand for essential medical services

and supplies (The National Action Plan to Combat Human Trafficking, 2021). The

National Action Plan seeks to address the issue of not providing safe and human

migration. The National Action Plan aims to address the long-term drivers and acute

concerns of irregular migration (The National Action Plan to Combat Human Trafficking,

2021). There is a need to ensure legal immigration pathways provide safe alternatives for

migration.

Sex Trafficking as a Crime

Although there are several types of human trafficking, sex trafficking is often the

most recognized. The main victims of sex trafficking are women and children (ILO,

2017). Sex trafficking is a form of human trafficking in which criminals use force, fraud,

or coercion to perform commercial sex (Polaris, 2017). Sex trafficking of minors is child

abuse in the United States (U.S. Trafficking Victims Protection Reauthorization Act,

2006). Explicitly describing children, the commercial sexual exploitation of children

(CSEC) is a form of sexual abuse that entails the sexual exploitation of a child.

Exploitation involves actions conducted for the financial benefit of another person or in

exchange for something of value that is given or received by any person (Office of

Juvenile Justice and Delinquency Prevention, 2019). According to the Polaris Project

(2018), CSEC includes survival sex, kidnapping for the objective of prostitution,

exploitation of children through webcam, child pornography production and distribution

(Bird & Reitano, 2019). Further evaluation of other exploitation practices are necessary

to inform effective strategies to combat CSEC.

The rate of sexual exploitation continues to change. Globally, commercial sexual

exploitation consist of 4.9 million women and girls (ILO, 2021). In the United States,

research is sparse containing estimates of the prevalence of children who experience

CSEC (Franchino-Olsen et al., 2022). However, regardless of the method or the overall

number, when a person is younger than 18, it is considered a crime or sex trafficking of

minors (STM). If an adult initially agrees but later becomes held through psychological

manipulation or force, they are considered a victim of trafficking (U. S. Department of

State, 2018). Over the years legislation has been passed and policies created to combat

issues of STM (Baird & Connolly, 2021). Legislative changes have aimed to transform

the way victims are treated and delivery of services by law enforcement. In 2013, the

Institute of Medicine (IOM) and the National Research Council (NRC) published a report

about CSEC and STM in the United States. The report initiated reframing the legal status

of prostituted and trafficked minors (Gies et al., 2019). As requested by the U.S

Department of Justice, the report advocates for a shift, urging a transition from treating

victims and survivors of CSEC as criminals and, instead, placing emphases on the

importance of understanding and recognizing the action as child abuse and not a fault of

the child’s (Gies et al., 2019). The report provided recommendations on the development

of legislation and directives that align victims of CSE and sex trafficking from the

perception of criminals resulting in arrest and delinquent systems to services and systems

that educate and are prepared to meet their specific and tailored needs (Gies et al., 2019).

This type of legislation was referred to as Safe Harbor laws (Gies et al., 2019). Safe

Harbor laws in the United States have been enacted to change the narrative and system

response to juveniles who have fallen victim and exploited in commercial sex (Cole &

Sprang, 2020). Given that American federal consent laws are clear that those under the

age of 18 are minors and are unable to consent to commercial sex, the goal is for law

enforcement’s perspective to shift from criminalizing youth for exploitation and

recognizing them as victims of abuse (Franchino-Olsen, 2019). Victims of CSEC remain

the only child abuse victims who can be arrested and prosecuted for their own

victimization. The future of Safe Harbor laws will ensure that victims of CSE are not

involved in the juvenile and criminal justice system and receive trauma-informed care.

Vulnerabilities and Risk of Sex Trafficking

There are multiple risk factors and vulnerabilities that contribute the exploitation

of victims. The intersection of technology and human trafficking has created new

challenges for identifying, intervening, and advocating for victims. When service

providers and members of the community are either unaware of the youth’s risk of

exploitation of CSEC or their actions are perceived as juvenile delinquency, this creates a

significant barrier in intervening and identifying those at risk (Cole & Sprang, 2020). A

crucial aspect of human trafficking currently is the significant role that technology plays

in facilitating and contributing to exploitation. Although access to the internet continues

to have its limitation, in 2020, the number of internet users increased to the largest it has

ever done in a decade (ITU/UNESCO Broadband Commission for Sustainable

Development, 2022). This period evidenced a 15% increase in internet use in low- and

middle-income countries (ITU/UNESCO Broadband Commission for Sustainable

Development, 2022). A contributory factor for this increase was the Covid-19 pandemic.

For criminals this shift resulted in seizing the opportunities of the pandemic to

significantly generate profits and increase criminal activities (European Commission,

2020). In particular, human trafficking operating methods changed to fit the world’s

current state and increased advertising victims on the internet or exploiting them in

private facilities (European Commission, 2020). While the full impact of the pandemic is

yet measurable, it is clear that the crisis has given rise to extraordinary challenges and

disproportionately affects the most vulnerable (European Commission, 2020). A once

hidden crime was effectively even more disguised by the impact of the pandemic through

technology.

The further development and access to the internet have increased the

vulnerability of more children to the risk of exposure to sexual exploitation and abuse.

Traffickers utilize technology throughout every stage of the human trafficking crime

(Europol, 2018). Traffickers are hiding their identities and maintaining anonymity by

creating fake social media accounts for the recruitment of their victims (Inter-agency

Coordination Group Against Trafficking in Persons [ICAT], 2019). The UNODC Human

Trafficking Report (2018) revealed that traffickers actively seek individuals on various

social media platforms; first establishing a relationship of trust with the victims before

forcing them into exploitative situations. The increased use of crypto currency creates an

anonymous arena for traffickers to make transactions and move finances throughout the

process (ICAT, 2019). The evolution of technology has had a significant impact on both

society and the crime of human trafficking.

Sex trafficking crimes occurring online pose different implications for response

versus those that are not. The expansion of the internet and its’ advances has given rise to

a new set of individuals involved in trafficking in persons. Movsisyan (2019) noted there

are several avenues of profitability with the developments through internet; internet

service providers are also profiting as they are facilitating the crime for the traffickers.

Avenues such as encrypted networks on the dark net provide a sense of anonymity for

sexual offenders, making it challenging for law enforcement to efficiently track online

activity efficiently (We Protect Global Alliance, 2021). Consequently, wide networks of

offenders have the access and ability to exchange information, contacts, and child sexual

abuse material (We Protect Global Alliance, 2021). In contrast to the previous trends and

risk of sex trafficking occurring throughout casinos, truck shops, and or other physical

locations, the exploitation is now predominantly hidden online (Movsisyan, 2019).

Providing resources to referrals to victims from online platforms to facilitate their exit is

a challenge. Identifying the traffickers is also further challenging as internet platforms

provide capabilities to hide the criminals’ identities and their locations (We Protect

Global Alliance, 2021). Access to technology has created many advantages but it has also

created new opportunities for criminals to commit the crime.

The issue of trafficking remains a significant problem, especially when those at

risk fail to identify the risk. Hornor et al. (2020) observed a lack of understanding

regarding the significance of CSEC victimization, particularly in teens. In their research,

97% disagreed with pimping and most teen participants expressed negative views toward

CSEC (Hornor et al., 2020). However, a concerning 10% of participating adolescents felt

the involvement of the teen with a pimp is the fault of the teen (Hornor et al., 2020).

Therefore, the approach to vulnerabilities, those at risk, and an approach to human

trafficking prevention matters. However, the prevention process starts with the necessity

of appropriately identifying trafficking. Heightened areas to identify sex trafficking is

also seen by nurses and medical staff as first respondents. Healthcare professionals noted

that those who have been a victim of human trafficking, they can be reluctant to

selfidentify due to fear (Recknor et al., 2018). These fears include arrest or deportation,

retaliation by the trafficker, and overall fear of police and authority figures (Recknor et

al., 2018). Some nurses fail to identify traffic victims, mistaking them for victims of

domestic victims, drug addicts, or prostitutes (Raker, 2020). Medical professionals

unintentionally inflate the issue when they fail to rescue victims (Raker, 2020).

Identification is only one step in preventing crime.

Human Trafficking and Covid

The global crisis, Covid-19, forced the world’s operation to adjust. This pandemic

exerted an impact on populations that were already deemed vulnerable and marginalized

(U.S. Department of State, 2021). Furthermore, it exacerbated these challenges, leading

to heightened vulnerabilities that, in turn, increased the risks associated with human

trafficking and exploitation (U.S. Department of State, 2021). Human trafficking does not

stop during a pandemic. The socioeconomic impacts of the pandemic exacerbated

vulnerabilities throughout communities. As individuals faced reduced access to housing,

health care, social security, finances, and the support networks, the potential for

exploitation intensified (Micallef et al., 2021). The pandemic created greater

opportunities for traffickers to conceal their activities. The pandemic increased

opportunities for traffickers to conceal their activities, including businesses exploiting

workers to remain viable and traffickers to specifically use more internet avenues,

creating higher levels of cybersex trafficking (U.S Department of State, 2020). The

circumstances rendered victims less likely to break free from the control of their

traffickers, thus compounding the trauma that they experienced (U.S. Department of

State, 2020). Notably, resources designed for trafficking prevention were reallocated to

address the needs arising from Covid-19 (U.S. Department of State, 2021). The resulting

economic instability, combined with challenges in reaching vulnerable groups and the

suspension or postponement of prevention and awareness initiatives, highlighted the

repercussions of the pandemic specifically on human trafficking (Warria, 2020). Overall,

the Covid-19 pandemic not only heightened existing vulnerabilities but also created

additional dimensions of risk for victims of human trafficking.

Throughout the pandemic, human traffickers took advantage of the declining

economy and individuals being unable to mitigate throughout countries and adapt to their

environment. Therefore, traffickers took advantage of situations where screening and

identifying victims became more challenging during the pandemic (U.S. Department of

State, 2021). Where identification and follow-up support could not be completed in

person, service providers were encouraged to create other channels of identification and

reporting such as online, use of helplines, or social media options (UNICEF, 2020).

Service providers were also encouraged to partner with law enforcement and health care

practitioners, both throughout the community and in quarantine facility-based, to ensure

they could identify the signs of trafficking and spot potential cases (UNICEF, 2020).

During the pandemic, it was also imperative that communities with high numbers of

returning migrants and targeted vulnerabilities were well informed with contact details of

organizations and how they could be of assistance. It was necessary for human service

professionals to communicate vital information through the distribution of accurate

contact details and social media platforms (UNICEF, 2020). This proactive approach

played a role in addressing the unique challenges faced during the pandemic, setting the

stage for further exploration of the difficulties encountered by human service

professionals in their efforts to combat human trafficking.

Difficulties Faced by Human Service Professionals

The role held by a human service professional is multifaceted. The role of a

human service professional is to assist communities and individuals they serve function

as effectively as possible (National Organization of Human Services, 2015). In the 1960s,

the profession of human services was developed in response to the direct need of human

problems. Human service professionals are defined as service providers and professionals

who hold a wide ranges of service providers roles (National Organization of Human

Services, 2015). These roles operate throughout nonprofit organizations and public and

private agencies in efforts to assist individuals and communities (National Organization

of Human Services, 2015). Human service professionals play a role in preventing human

trafficking by identifying, responding, and developing services for potential victims.

Human service professionals can only responsibly act to prevent human

trafficking if they are trained to do so. Early interpersonal relationships between service

provider and victims are essential in either promoting or hindering the exposure of risk

for sexual exploitation (O’Brien, 2018). However, human service professionals may not

receive human trafficking training that is adequate in first recognizing human trafficking

and then to responding appropriately (Recknor et al., 2018). Although interpersonal

relationships with professionals are important, there is inadequate training of identifying

victims can lead to missed opportunities to intervene and safeguard victims (Duncan &

DeHart, 2019). Without the adequate training, human service professionals may

inadvertently retraumatize a victim and cause more harm (Brennan et al., 2023).

Therefore, adequate training should be incorporated within organization as well as

education around the crime.

The training that is available also requires maturation and further evidence-based

research. There are no centralized training methods for human service professionals

working within the human trafficking field (Mugari et al., 2021). Human trafficking

organization and resources such as National Human Trafficking Resource Center

(NHTRC) developed categories that human trafficking education and training should

center around (NHTRC, 2016). There are four key content areas education should focus

on: definitions and problem scope, risk factors and health implications, assessment, and

response (NHTRC, 2016). Although this is suggested, nothing is required under a

governing body. Therefore, training is subject to interpterion. New developments and

adjustments in research require training adjustments. Gerassi et al. (2018) noted that the

commonly reported indicators of identifying potential victims that is disseminated at

trainings for service providers do not have a strong evidence base to support them. To

assist human service professionals with victim identification, several antitrafficking

organization describe consistent human trafficking indicators (Gonzalez-Pons et al.,

2020). Previous indicators, such as signs a person is being controlled, signs the person

lacks freedom, and signs of physical abuse may not be as sufficient as best practices for

identification (Gerassi et al., 2018). As these indicators are changing and evolving,

human service professionals are failing to recognize the shift. Professionals are also

failing to recognize victims in practice as they do not fit the image portrayed through the

media or they do not show the typically studied indicators of trafficking (Gerassi et al.,

2018). A health professional stated that, if a service user looks like a prostitute, than the

individual is indeed a prostitute (Recknor, 2020). To overcome these biases and

misinterpretations, screening tools are also needed. Similar to training on human

trafficking for professionals, there is no standard established for human trafficking screen

tools (Hainaut et al., 2022). The absence of standards results in reliance on worker’s

selfidentification or self-reference for determining the sensitivity and specifications of

screening tools (Hainaut et al., 2022). Hainaut et al. (2022) suggested that tools designed

to identify trafficking victims may not consistently undergo adequate validation, lack

adaptability for diverse human service professional settings, and fail to sufficiently

generalize for different forms of trafficking. This way of screening will lead to

inaccuracies and lack of consistencies across organizations.

Legal Barriers for Human Service Professionals

As research continues to develop around screening tools and training to identify

victims of human trafficking, the ownership of identification is dependent on the

professionals’ knowledge and insight. Without training on how to recognize victims of

sex trafficked minors, service providers may inadvertently treat victims as if they are

offenders of criminal offenses or youth involved in illegal activities, resulting in

unmerited juvenile proceedings (Cole & Sprang, 2020). Systemic responses to trafficking

can intensify the blurred boundaries between victim and offender status, particularly as

service providers contend with the distinguishing between prostitution and sex trafficking

(Duncan & DeHart, 2019). The issue of human service providers and law enforcement

not understanding the differences can result in victims not being treated and cared for

according to their needs. The actions of being treated as a criminal instead of a victim

further traps a victim in trafficking situations (Duncan & DeHart, 2019). These blurred

lines of a victim being treated as a criminal further has an impact on the lack of

recognition of the crime of human trafficking. Some human service professionals may

imply a disconnect in the underlining cause of human trafficking (Josenhans et al., 2020).

Failure in how to recognize the systemic and structural factors that contribute to

trafficking may lead to an inability to address economic and social conditions that

exacerbate vulnerabilities of those trafficked and advocation for changes in policy

(Recknor et al., 2018). One challenge involves victimizing survivors and another

challenge lays in the consequences of the trafficker. These underlining concerns are only

the start of the legal barriers in preventing human trafficking.

The lack of legal frameworks for prosecuting human trafficking makes it difficult

to provide effective interventions. Each legal framework has a focus and for the Palermo

Protocol the focus is on the purpose of exploitation in human trafficking. Exploitation is

not clearly given a definition in international law as it is subject to a variety of

interpretations and a difficult concept to define (Goździak & Vogel, 2020). Looking at

labor trafficking, exploitation occurs when workers are treated unjust, failure to be

compensated appropriately for their labor, and when traffickers exploit the situation for

their own profitable gain (Goździak & Vogel, 2020). However, legally, the real challenge

is to demonstrate to the opposing view that the harsh experiences of the victim, such as

extensive long hours without pay, deductions of pay without notice, inhabitable living

conditions, and high fees to recruitment agencies, are criminal offenses and should be

prosecuted (Goździak & Vogel, 2020). In addition, suspended sentences given as a result

of human trafficking to convicted criminals also leads to mistrust from victims and a lack

of confidence to expose their trafficker (U.S. Department of State, 2018). Given the

complexity for human service professionals in defining and law enforcement prosecuting

in the content of human trafficking, it is imperative to explore potential solutions and

policy recommendations to address these challenges.

Limited Resources Available to Professionals

Human service professionals experience further challenges after victims are

identified. Once a trafficking victim is identified (whether it is labor trafficking or sexual

exploitation), the human service professional must keep the victim safe and obtain the

appropriate resources to help the victim. This action can result in an arrest of a victim. It

can be seen as a contradictory act for a person to be underage and arrested for

prostitution. Under the federal law, the children who are arrested are considered victims,

not criminals (Duncan & DeHart, 2019). Yet, criminal justice personnel and human

service professionals may struggle with the lack of resources and with identifying

supportive services and residential care suitable for these youth (Duncan & DeHart,

2019). However, sometimes the arrest of youth ensures safety for victims from exploiters

and recruiters (Duncan & DeHart, 2019). It is possible that these actions are

retraumatizing and likely not to be the best suited for delivering services to address the

past and ongoing victimization often associated with sex trafficking (Scott et al., 2019).

The balance between keeping victims safe and providing adequate services specific to the

complex needs of a human trafficked victim is difficult.

Arresting victims and prosecuting offenders does not solve the human trafficking

problem. A victim not receiving service may be due to how and where the victim comes

into contact with their service providers (Gonzalez-Pons et al., 2020). If the initial

interactions occurs through law enforcement, it is unlikely that the victim’s needs will be

met beyond the criminal justice system (Gonzalez-Pons et al., 2020). With the

appropriate resources, primary prevention should be implemented at multiple levels

(Greenbaum et al., 2018). Therefore, there is a further need for the collaboration of the

criminal justice component and human service professionals (Judge, 2018). Correctional

staff throughout facilities require human trafficking training to unify training content as

well as determine if such trainings are improving antitrafficking knowledge, skills,

attitudes, and behavior (Rizo et al., 2022). The needs of the victims incarcerated require

critical resources and programming that identifies their victimizing and the capacity to

offer support and reentry into their communities (Rizo et al., 2022). To more effectively

address the needs of human trafficking victims, collaboration among healthcare

providers, legal avenues, researchers, and human service professionals is essential. There

is a need for screening tools to aid service care providers in identifying trafficking

victims, ensuring that victims’ overall needs can be effectively met. (Munro-Kramer et

al., 2019). Lack of resources has been a consistent limitation for human service

professionals and this results in a shortage of services available.

In addition to the challenges related to victim safety and legal complexities,

human service professionals also face limitations in terms of education and training.

Human trafficking is on the rise across the United States, making it increasingly likely

that human service professionals will encounter trafficking victims early in their careers

(Litam et al., 2021; UNODC, 2018). However, many of these professionals are not

prepared to assist individuals who have experienced human trafficking at such an early

stage in their profession (Koegler et al., 2020). To address this issue, Mays et al. (2023)

suggested that professionals can best overcome this limitation by exhibiting positive

attitudes toward sex trafficking survivors and advocating the development of

clientspecific counselor self-efficacy. The effectiveness of preparedness hinges on the

professional's belief in their own abilities when assisting trafficking survivors, along with

their positive attitudes toward clients (Mays et al., 2023). Ultimately, a survivor's

outcome often relies on the support and guidance provided by the human service

professional.

Education does not need to be limited to only formal education and training

throughout the human service profession. Instead, education provided by human service

professionals should hold a broader approach that encourages young people to initiate

peer-to-peer discussions about risk factors, personal experiences, and prevention

strategies related to human trafficking (Greenbaum et al., 2018). Human service

professionals, in collaboration with additional health professionals have the opportunity

to provide education to clients and their families on human trafficking, including the

associated risks and strategies operated by traffickers (Greenbaum, 2020). Therefore,

amongst the recommended peer to peer discussions, the accurate information is shared

with the vulnerable population (Greenbaum, 2020). The efficacy of this prevention

initiative will be strengthened through the training offered to human service

professionals, encompassing essential tools that can be disseminated and integrated into

awareness campaigns via social media and mobile communication channels (Greenbaum

et al., 2018).Such an inclusive approach to education not only equips professionals with

the necessary knowledge and skills but also engages the broader community in the fight

against human trafficking, fostering a more comprehensive and effective response.

Summary

The United States is not omitted from experiencing the crime of human

trafficking. Those most vulnerable to human trafficking often experience overlapping

social and economic inequities. Victims of human trafficking derive significant benefits

from access to various resources, including housing, financial assistance, medical

services, mental health support, and informed care (Goździak et al., 2020). However,

opportunities to identify trafficking victims are often missed by individuals trained to do

so. A more effective strategy for prevention services can be developed through

multifaceted partnerships involving human service professionals (Gonzalez-Pons et al.,

2020). The literature review discussed human service professionals' difficulties and needs

in defining what human trafficking is, legal ramification of human trafficking, human

trafficking as a crime, combatting trafficking, sex trafficking as a crime, vulnerabilities

and risk of sex trafficking, human trafficking and Covid, difficulties human service

professionals have accessing services for victims , legal barriers human service

professional face when working with human trafficked victims, and the limited resources

available to human service professionals. Current preventive measures present the

blueprint for combating the crime of human trafficking and the areas needed to improve

for human service professionals. Chapter 3 explains the methodology for this study.

Chapter 3: Research Method

Introduction

The purpose of this single intrinsic case study is to explore the interventions that

human service professional directors use to prevent human trafficking in Missouri. The

aim is to understand what interventions human service professionals use to prevent

human trafficking in the state of Missouri. This chapter includes a detailed discussion of

the methodological plan for this intrinsic case study. I provide information on the

research design and rationale, the role of the researcher, and information on the

methodology for the study. This chapter details the sample criteria, research affiliation, if

any, with study participants, and methods data is collected and analyzed. I conclude this

chapter by discussing trustworthiness and ethical standards.

Research Design and Rationale

For this single intrinsic case study, I used a qualitative methodology with the

purpose of understanding what interventions human service professionals use to prevent

human trafficking in the state of Missouri. Qualitative researchers aim to understand

phenomena from the participants' perspectives (Merriam & Grenier, 2019). Qualitative

research focuses on experiences, behaviors, and social issues to understand a

phenomenon (McGrath et al., 2019). The qualitative method also allows data to be

collected from extensive details through open-ended questions specific to the topic of this

study (Barrett & Twycross, 2018). This method covers a range of empirical materials that

depict aspects of a person’s life and experience through life stories, interviews,

observations, and case studies (Hussain et al., 2021). I chose to use the qualitative method

in this study to obtain an in-depth exploration of the personal experiences of prevention

strategies by human service professionals engaged in assisting victims of human

trafficking. The complexities of the experiences from the human service professionals

contribute to the understanding of each experience.

I chose to use a case study design. A case study is utilized to examine either a

single case or a collective case (Stake, 1995). A case study is based on the “why” rather

than the “what” to gain further understanding of a topic (Stake, 1995). A case can be an

item, person, or population that is complex, and it can be specified and bounded (Stake,

1995). There are various methods for collecting and analyzing data to further advance

and understand the case (Stake, 1995). This single case study is specified to human

service managers and program directors who are currently working within the role of

successfully creating interventions to prevent human trafficking. This study focuses not

on the participants’ full capacity in their role but specifically on their experiences in the

successful strategies, components, and recommendations for success regarding creating

interventions put in place to prevent sexual exploitation human trafficking.

Generic design and ethnography were other qualitative research designs

considered for this study. The generic design includes multiple approaches, and the study

does not have a specific methodological viewpoint (Kostere & Kostere, 2021). The

generic design is used to explain real world human experiences (Kostere & Kostere,

2021). I did not use a generic design as the research question is holistic, broad, and open

to an in-depth understanding and discovery of the topic (see Kostere & Kostere, 2021). I

seek to understand prevention techniques of human service professionals. Ethnography,

on the other hand, focuses on the analysis of customs, beliefs, social settings, practices,

and beliefs within a network (Jones-Hooker & Tyndall, 2023). When there is a need to

describe how a cultural group works and to explore languages, beliefs, and behaviors,

ethnography is the most appropriate design (Mohajan, 2018). In this study, there is no

need to locate a cultural sharing group and analysis a social culture; therefore,

ethnography is not the best fit. While some authors have suggested a new methodology

for health contexts by combining case study design with organizational ethnography;

however, Côté-Boileau et al. (2020) stated that the impact of qualitative research is

currently underdeveloped and not an appropriate design for this study. The choice of an

intrinsic case study was made because it is tailored to investigating a unique

phenomenon, driven by the researcher’s interest (see Harling, 2012). The researcher is

required to define the distinctiveness of this phenomenon, setting it apart from others,

which may be based on a collection of characteristics or the sequence of events.

Role of the Researcher

The role of a qualitative researcher includes several responsibilities. As the

researcher, I am a key instrument in the study (see Taherdoost, 2022). I am responsible

for collecting open-ended data to understand the participant’s thoughts, actions and

reactions, and overall beliefs about the study (see DeJonckheere & Vaughn, 2019). I

collected data through examining archival documents and conducting interviews with

participants. My role as the researcher is to analyze the data received through purposeful

sampling. As the researcher, I hold a role in finding and interviewing appropriate

participants for this study.

It was also my role to establish creditability and produce an unbiased analysis. A

researcher’s perceptions and biases have the potential to influence questionable and

unethical research practices, ultimately impacting the end results of the study (Baldwin et

al., 2022). To mitigate any potential bias, I used bracketing. Bracketing is the attempt to

set aside my personal preunderstandings and assumptions and to be more open to the

phenomenon (Dörfler & Stierand, 2020). During the interview process, I built rapport yet

maintained professionalism and established boundaries by stating my role as the

interviewer. The topic of exploring prevention strategies had the potential for participants

to discuss trauma events. Completing qualitative research interviews can create emotional

challenges for some researchers. Therefore, being mindful of emotional impact and

disturbances during these procedures are important (Dickson-Swift, 2022). I put

mindfulness in practice by completing memos after each interview as well as while I’m

reviewing the recordings. I used this process to ensure I am setting boundaries between

myself and the participant while continuing to maintain a rapport.

The potential for the presence of bias is inevitable in any study. My role as the

interviewer requires the need to be reflexive, conscious, and aware of the impact the

conversation between myself and the participant will have on the interview (see McGrath

et al. 2019). McGrath et al. (2019) suggested that the interviewer should be seen as a

cocreator of the data along with the participant, avoiding introducing bias or

contaminating the data. My previous experience in the field of human services may led to

a potential bias when collecting analyzing data. My preconceived ideas of human

trafficking and its prevention methods are based on my 15 plus years working in child

protection. However, my previous knowledge of human traffic may aid in understanding

the context of the subject and the experience of the participant. Potential bias is also

mitigated by constantly being self-aware of my potential bias and managing this

throughout the data collecting process.

To show appreciation for participant’s involvement in my study, each participant

received a token of appreciation after completing the interview. Participation token is

often given to offer reimbursement to cover any cost participates may encounter (UK

Statistics Authority, 2022). In this study, participates received a Visa gift card of $10 for

volunteering and sharing their experiences of creating prevention strategies. This token of

participation was given to show an appreciation of their time. Within 3 business days of

completing the interview session with the participate, they received the token of

participation as well as an emailed letter of appreciation.

Methodology

Participant

For this qualitative study, I selected an intrinsic single case study to explore the

interventions that human service professional directors use to prevent human trafficking

in Missouri. The population for this study consists of human service managers and

program directors who currently or previously created successful interventions for the

prevention of sexual exploitation. There is a requirement of homogeneity within the

sample pool; this will relate in a better understanding of the overall perceptions of similar

individuals that have insight in their experiences (Clark & Vealé, 2018). The

requirements set for this sample include human service professionals working in the

human service field for a minimum of 5 years. These human service professionals must

have worked directly with sexually exploited victims for a minimum of 4 years. The

requirement for a minimum of 5 years of experience in the field signifies the importance

of substantial professional knowledge and establishes eligibility for managerial roles.

In this study, I use purposeful sampling. Purpose sampling is used in qualitative

research when the researcher selects individuals who are a good match to the aim and

objective of the research (Campbell et al., 2020). Case study researchers often use

purposeful sampling with the goal to illustrate the phenomenon of an interest with an

indepth understanding (Patnaik & Pandey, 2019). I chose to use a purposeful sample

because this sampling allows me to specifically select human service manager

participants located in the state of Missouri. The highly subjective choice ensures that the

information provided by the participants is resource-rich specifically regarding

prevention strategies.

I obtained six participants for this study. The number of participants in qualitative

research depends on the problem being studied. I chose a small number of participants as

this develops a more in-depth understanding of the topic. A smaller sample size is chosen

to carefully assess the insights and precision of participants about the topic (Taherdoost,

2022). Sample size play a role in maintaining the research’s reporting accuracy (Subedi et

al., 2021). Unlike quantitative studies, the goal in qualitative studies is not of statistical

representativeness; therefore, a large sample size is not necessary (DeJonckheere &

Vaughn, 2019). The purpose of qualitative methods is not to generalize the results to a

larger population (DeJonckheere & Vaughn, 2019). The focus is on in-depth

understanding of the topic, derived from a comparatively smaller cohort of participants.

The researcher seeks to achieve data saturation, in which no new relevant information is

contributed (Alam, 2020). I determined that I achieved data saturation when there were

no new pertinent information from participant interviews and the information received is

redundant. Once data saturation was achieved, I terminated participant interviews.

I recruited participants for this study by word of mouth and social media

platforms including LinkedIn, Facebook, X, and Instagram. Flyers were posed throughout

these social outlets. I communicated the requirements of study with the participants along

with the interview duration, data collection process, and data privacy procedure.

Instrumentation

I created an interview protocol for this study. Interview protocols include the

guide for the interview component of the study (Yeong et al., 2018). The interview

process is supported by the interview protocol. The interview protocol ensures the

interview is efficient in gathering comprehensive details within the time constraints

(Yeong et al., 2018). I used the interview protocol refinement (IPR) framework. This

framework comprises of a four-phase process for creating and enhancing an interview

protocol (Castillo-Montoya, 2016). The first phase of the four-step process involves

ensuring that the interview questions are in line with the research question

(CastilloMontoya, 2016). The second phase includes developing an interview protocol

promoting a conversation that may include asking interview questions differently from

how it is initially written (Castillo-Montoya, 2016). This phase may include drafting a

script for direction. The third phase involves receiving committee response on the

finalized interview protocol (Castillo-Montoya, 2016). Lastly, the fourth phase is to

implement any changes received (Castillo-Montoya, 2016). The feedback received

improves the interview protocol’s reliability and trustworthiness.

Following the guidelines of the interview protocol, my interview questions

include six open-ended questions that aim to understand the procedures human service

professionals successfully completed to aid in preventing sexual exploitation. Questions

have a follow-up probing question to allow for further understanding. The interview

questions are based on professional experiences whilst carrying out prevention measures.

Expert Panel Review

I have conducted an expert panel review to enhance the validity of the interview

protocol. The expert panel review helps enhance the practicability and credibility of the

interview protocol (McGrath et al., 2019). The expert panel review takes place before the

interviews takes place.

For the expert panel, three experts were chosen. The interview protocol was sent

to each panelist via email after a telephone call to review the interview questions. Two of

the three experts were selected because of their managerial role in corporate social

responsibility and their direct experience in human trafficking victims' program

initiatives. Expert 1 had 17 years of experience in the field. Expert 2 had had 7 years of

experience. Expert 3 was chosen for their role as a human service professional who has

worked with programs dealing with victims of human trafficking. Expert 3 had 25 years

of experience in this field. Expert 1 corrected grammar in the introductory paragraph and

suggested I ask what human trafficking is defined for their organization. Expert 2 added

probing questions about funding to operate interventions that combated human trafficking

and where the funding came from. Expert 3 suggested changing the wording of one

question. Each suggestion was reviewed and taken into consideration for the final

interview questions. As a result of the panel review, I added probing questions about

funding to operate interventions, changed grammar, and changed the wording of one

question. The expert panel interviews enable me to gain skills before embarking on data

collection (McGarath et al., 2019). The process has clarified the questions I will ask in

the final interview.

Procedures for Recruitment

I recruited participants for this study through multiple channels, including word of

mouth and social media platforms, including LinkedIn, Facebook, X, and Instagram.

Those who expressed interest were instructed to contact me via email or phone. To

participate, each individual was employed in Missouri and met specific qualifying criteria

established prior to the recruiting process. Prior to involvement, I received informed

consent from all participants, and comprehensive study guidelines provided. Interview

questions regarding their involvement with human trafficking victims was discussed and

explanation and guidelines of confidentiality given.

All interviews were completed using the Zoom platform and securely recorded

through a recording system. It is important to note that Zoom interviews may have

presented certain challenges, such as limited visibility of participants (Parsons et al.,

2023). This limited view can result in the loss of nonverbal cues and engagement during

the interview. To mitigate this challenge, I paid close attention to less obvious cues, such

as eye contact and vocal inflection. Additionally, I actively engaged with participants to

maintain their comfort throughout the interview (see Parsons et al., 2023). These recorded

interviews were subsequently transcribed for the purpose of data collection. Each

participant received transcriptions from me by email following their interview.

Interviews were be scheduled for a duration of about 60 minutes. While the

allotted time has not guaranteed to be used in full, it did not exceed 90 minutes. At the

start of each interview, I explained the study's objectives and context to the participant.

Rapport was established through introductory questions, followed by the questions they

received beforehand. Pending each answer, where needed, participants were prompted for

further elaboration and in-depth insights. Participants will also be encouraged to provide

any additional information they believe is pertinent, given their familiarity with the study

and its purpose.

Data Analysis Plan

In this qualitative study, I used a single intrinsic case study. This study followed

Yin’s (2018) five components of data analysis. The first step of compiling consists of

gathering and organizing the collected data (Yin, 2018). For this study, I administered

one-on-one semistructured interviews and collect data from internal and public

organizational documents. The purpose of this step is to gather as much information as

possible for the study (Yin, 2018). Disassembling is the next stage, which is breaking the

data down into smaller units in order to understand and gain further details (Yin, 2018).

In this study, I dissected the details given and placed them first into categories. Following

disassembling is reassemble, which is grouping the smaller units into meaningful

categories (Yin, 2018). For this step I looked for patterns, insights, or concepts

throughout the data collected (see Yin, 2018). These patterns or concepts may emerge

following my examination of the data in different ways such as reflecting on different

themes or creating a matrix or visual diagrams and charts. Another way I accomplished

this step is by writing self-memos taken while observing data (Yin, 2018). The next step

requires a deeper exploration of the data in the interpreting stage (Yin, 2018). In this

stage, I analyzed the data to identify relationships and trends that develop explanations or

theories based on the findings. The final step in Yin’s steps is concluding. Concluding

draws an overall generalization based on the evidence provided by the data (Yin, 2018).

In this stage, I synthesized the findings from data collected categories. The findings

provided a clear and coherent understanding of the topic.

Issues of Trustworthiness

Credibility

To confirm trustworthiness, credibility must be present. Credibility provides the

confidence in a study’s findings. Credibility serves as a measure to understand and

confirm if the results accurately represent the information received from the received data

(Korstjens & Moser, 2018). Credibility is rooted in honest and transparent reporting

(Johnson et al., 2019). I promoted credibility in this study through triangulation.

Triangulating refers to using different information sources and or procedures to

consistently establish connections and patterns. (Stahl & King, 2020). There are various

triangulation processes; for this study, the best fit is methodological triangulation.

Methodological triangulation uses multiple methods of analyzing and collecting data

(Stahl & King, 2020). For this study, I used triangulation by collecting data through the

analysis of interviews and reviewing and collecting internal and public organizational

documents.

Transferability

An additional component of trustworthiness is the assertion of transferability.

Transferability notes that descriptions and patterns identified in one context may exhibit

applicability in another (Stahl & King, 2020). In qualitative research, transferability

occurs when the same circumstances apply to diverse participants sharing similar

backgrounds (Stahl & King, 2020). Transferability is possible when the findings of this

study will be helpful to other similar groups. Transferability is promoted in several ways;

one way transferability is promoted is through triangulation. Triangulation further

supports researchers in grasping the understanding of the phenomena researched (Moon,

2019). Data triangulation can help strengthen the transferability of the findings by

providing multiple perspectives and evidence that supports (Moon, 2019). For

transferability from this study, I thoroughly describe the techniques for data collection

and the criteria will be evidenced and available to review.

Dependability

A further element of trustworthiness is dependability. Dependability pertains to

the study’s reliability and the thorough documentation of its logical processes (Stahl &

King, 2020). Stahl and King (2020) stated that an aspect of dependability is the

researcher’s anticipation of review by a peer. The researcher presumes that the work is

inspected. The researcher ensures that facts are separated from the researcher’s

interpretation (Stahl & King, 2020). To ensure dependability for this study, I used

bracketing, which is the process of ensuring that data are separated from my observation

and interpretations (Stahl & King, 2020). The practice of bracketing requires a review of

bias and reflexive analysis by the researcher. Bracketing helps the researcher to recognize

and temporarily suspend their personal bias and preconceived notions (Stahl & King,

2020). This approach reduces the potential impact of biases on the research and

influencing the outcome (Stahl & King, 2020). A part of the bracketing process can

involve debriefing with peers to validate findings and interpretations. I ensured to follow

this procedure by engaging two educational peers with my research. Allowing multiple

reviewers examine my work has ensured that different perspectives are considered, and

potential biases are identified.

Confirmability

To further minimize bias, the concept of confirmability needs to be considered.

Confirmability aims to align with objective reality as closely as possible (Stahl & King,

2020). Confirmability entails providing a detailed and comprehensive picture of the

methods used in this study. Data accuracy is necessary for the researcher to maintain

impartiality throughout the study (Stahl & King, 2020). The confirmability of the results

of this study is influenced by explaining any influence I may have had as the researcher

during the interview and detailing this through peer review and triangulation.

Ethical Procedures

This research adhered to all ethical considerations. I provided potential

participants with comprehensive information that facilitated participants in making

informed decisions concerning their participation throughout this study. The selection of

participants adhered to the recruitment plan, which includes self-selection, participant

criteria, and obtaining informed consent. Informed consent preceded the Zoom

interviews. Study participants were notified that they have the right to withdraw from the

study at any stage. Additionally, participants are protected under Walden University's

Institutional Review Board (IRB) oversight, with approval granted before data collection

commences. All data acquired during the study was maintained securely under a

password protected computer and treated confidentially. All paper forms collected is filed

under lock and key. To further ensure participant confidentiality, all information collected

is stored on my computer in a file which is password-protected. These protective

measures collectively add to data privacy. All data gathered will be securely and safely

disposed of 5 years following the conclusion of the study.

Summary

Chapter 3 addressed the methodology used in this study exploring the

interventions that human service professional directors use to prevent human trafficking

in Missouri. This chapter discussed research design and rationale, role of researcher,

participant population, instrumentation and procedures, expert panel review, procedure

for recruitment, data analysis plan, trustworthiness, creditability, dependability,

confirmability and ethical procedures.

Chapter 4 provides the results of the study, including the setting, demographics,

data collection and data analysis, and evidence of trustworthiness.

Chapter 4: Results

Introduction

This single intrinsic case study aimed to explore the strategies used by human

service professionals to create interventions to prevent human trafficking. I completed

this study to answer the following research question: What interventions do human

service professionals use to prevent human trafficking in the state of Missouri?

In this chapter, I provide the evidence of trustworthiness by highlighting

confirmability, dependability, and transferability. This chapter further discusses the

development of themes. The results of this study are also presented in this chapter, along

with interview responses from participants sharing their experiences as human service

professionals working with victims of human trafficking. The chapter concludes with a

summary of the information presented.

Setting

I conducted all interviews with participants virtually using the Zoom platform.

Virtual interviews provided convenience as I was located in a different country from the

participants at the time of these interviews. Although video communication has

limitations, such as a restricted view of the participant's environment and some difficulty

in reading body language, Zoom enabled effective face-to-face communication despite

the distance and time difference. All interview appointments were scheduled via email.

Due to an unforeseen circumstance, one participant missed the scheduled interview,

which was then rescheduled to the next convenient day. All interviews utilized Zoom's

camera and audio features. To ensure protection and compliance, confidentiality forms

were sent to participants prior to the interviews to confirm their consent for audio

recording.

Demographics

A total of six people participated in this study. Interviews did not result in the

collection of any demographic data because they were not relevant to answering the

research question. However, all participants met the participant criteria. As required, all

participants currently worked in the state of Missouri during the time of these interviews.

Participants also held a manager or supervisor role as a human service professional and

worked directly with sexually exploited victims for a minimum of 4 years.

Data Collection

A total of six participants were interviewed for this study. Each participant

engaged in one semistructured interview. As outlined in Chapter 3, participants received

consent forms prior to the start of the interview. These consent forms were emailed

before the interview, and verbal compliance was confirmed during the interview.

All data from participants were gathered through Zoom interviews. To my

knowledge, no other persons were present besides the participant being interviewed.

Interview times varied for each participant, with the average interview length being 43

minutes. During all interviews, I took detailed notes in a notebook, which was securely

stored in a locked drawer. The Zoom interviews were audio-recorded using my mobile

device, and the recordings were subsequently transcribed and documented. Additional

data were collected from six archival documents, retrieved from public domains and

organizational websites.

One variation in data collection involved a participant missing the scheduled

interview due to a workplace crisis. After waiting for 15 minutes during the Zoom

session, I reached out to the participant regarding their participation. I signed off after not

hearing from them for 20 minutes. The participant later messaged to apologize for their

absence. We rescheduled for a convenient time, and the interview was successfully

conducted within 2 days. There were no other variations in data collection as described in

Chapter 3.

Data Analysis

While using Zoom to conduct the interviews, I audio recorded the sessions with

my mobile phone. During each interview, I also took detailed scripted notes. After the

interviews, I utilized Microsoft Word Transcribe to convert the audio recordings into

transcripts. I meticulously listened to the audio and reread the transcripts multiple times

to ensure accuracy, correcting grammatical issues occurring from the transcribe, and any

other mistakes noted throughout the transcription process. After completing this review,

the participants received their respective transcripts in accordance with the informed

consent form they had received before the interview. This process allowed the

participants to review their transcripts for accuracy and confirm their interactions during

the interview. It also provided an opportunity for participants to alert me to any errors and

request corrections if needed. No feedback indicating transcript inaccuracies was

received.

Each stage of data analysis followed a process. The process adhered to Yin’s

(2018) five components of data analysis. The initial step involved compiling as much

information as possible during the interviews and recording it on an Excel sheet. The

Excel sheet was organized into sections for each participant, interview question,

response, codes, categories, themes, and notes. Throughout the review process, I

repeatedly read the transcripts and listened to the audio recordings. I compared my

scripted notes with the transcripts and incorporated my notes into the memo section of the

Excel sheet. Probing questions were asked during the interviews to avoid assumptions.

The next stage consisted of Yin’s (2018) disassembling stage, which entails

breaking the data down into smaller units to further gain insight. The initial stages of

coding included first descriptive coding and content coding. Examples of these codes

included collaboration across different organizational sectors, survivor insights, and

concerns of revictimization of human trafficking victims. Following this stage, the data

underwent a second coding cycle, allowing for review from a different perspective and

facilitating the disassembly and reassembly of the data. The codes were then organized

into Yin’s reassemble phase, which involves category development using mind map

visualization and matrix creation. For this study, some identified categories were

continuous improvement and feedback, preventive education and relationships, and

coerced involvement in the justice system. From these categories, I activated the

subsequent stages of data analysis as outlined by Yin and identified emerging themes. For

example, the categories enhanced collaborative efforts and integrated understanding

across sections contributed to the development of the theme: the need for multiagency

human service collaboration to prevent human trafficking. These developed themes were

then able to answer the research question.

Through the data analysis, I identified seven themes from the interviews. Theme 1

was need for multiagency human service collaboration to prevent human trafficking.

Theme 2 was the need for education on defining human trafficking for middle and high

school youth. Theme 3 was to use human trafficking survivor’s insight and strategies to

prevent future human trafficking. Theme 4 was to address the stability needs of victims to

avoid returning to traffickers. Theme 5 was human service providers using strategies that

do not apply an overemphasis on criminal justice is more effective for prevention. Theme

6 was human service professionals need continuous education on ever changing human

trafficking trends. Theme 7 was community engagement is necessary for prevention.

Evidence of Trustworthiness

Credibility

Credibility in this study provides confidence in the truth of the findings.

Credibility is concerned with whether the results of the study accurately represent the

perspective of the participants involved in the study. To ensure the best reflection and

clarification during the interview, I asked open-ended questions and probed to reflect the

participants' responses. Interviews were transcribed by Microsoft Word Transcribe

software and then listened to and reviewed for any needed corrections. Each interview

transcript was sent to the participant via email to ensure the accuracy of the interview's

content. To further confirm creditability, I analyzed the open-ended questions of the

interview and reviewed public organizational documents as a triangulation strategy.

Transferability

For this study, the success of transferability is ensured during data collection and

data analysis. The process of transferability notes that information identified in this

context may be applicable in another (Stahl & King, 2020). Transferability is also

promoted through data triangulation. To achieve this, I provided a comprehensive

description of the research process and data collection methods, ensuring that the findings

are understandable and transferable. This approach allowed for multiple perspectives and

provided evidence to support each step of the research. By offering accurate, supportive,

and robust information, future researchers can expand upon this study. The strategies

followed in this research contribute to the discipline by providing human services

professionals with effective measures to prevent human trafficking.

Dependability

Dependability refers to reliability as well as the thorough documentation of the

study’s logical processes. This process involves maintaining the detailed written

procedure of data collection. In this study, all standards were followed and provided

guidance for ensuring there were no deviation. The data collection process was approved

by Walden IRB prior to data collection and analysis. During the data collection process, I

ensured dependability by using bracketing. Bracketing was employed during data

collection. This technique required the suspension of personal biases and preconceived

notions to maintain impartiality. The process involved journaling, making memos of my

thoughts, and enlisting peers for a peer review. This approach allowed for multiple

examinations of the work and consideration of different perspectives.

Confirmability

Confirmability aligns with objective reality, integrity, and authenticity. It involves

providing a detailed picture of the methods of my study and only using the information

provided by each participant. Throughout the study, the exact words of each of the

participants were used when analyzing and coding the data to ensure confirmability. Each

interview was verified with the participant, and I bracketed my knowledge from previous

work history, which might have influenced the study topic using a journal. Any

influences challenging confirmability would have been disclosed. Additionally, audio

recordings, journaling, and peer review further ensured confirmability.

Results

To answer the research question, I asked six questions during the semistructured

interviews. I also included probing questions for clarity and exploration when needed.

The data collection process concluded seven major themes. Theme 1 was need for

multiagency human service collaboration to prevent human trafficking. Theme 2 was the

need for education on defining human trafficking for middle and high school youth.

Theme 3 was use human trafficking survivor’s insight and strategies to prevent future

human trafficking. Theme 4 was address the stability needs of victims to avoid returning

back to traffickers. Theme 5 was human service providers using strategies that does not

apply an overemphasis on criminal justice is more effective for prevention Theme 6 was

human service professionals need continuous education on ever changing human

trafficking trends. Theme 7 was community engagement is necessary for prevention.

Need for Multiagency Human Service Collaboration to Prevent Human Trafficking

The participants noted the need for working in partnership and collaborative

efforts across human service sectors such as antitrafficking coalitions juvenile justice,

child protective services, therapists, service providers working in drop-in centers, and

youth serving organizations to improve the overall response to human trafficking. This

collaboration fosters an integrated understanding of each sector's functions and

contributions, and it facilitates communication on successful strategies for preventing

human trafficking. Additionally, these partnerships aid in continuous feedback,

emphasizing the importance of ongoing feedback and adaptive practices. Participant 1

shared,

I think that collaborative models work pretty well, and especially when you've got

different people in different organizational sectors that are. You know,

contributing to increasing a better response to the issue. So I think anti trafficking

coalitions can be really useful to sort of facilitate that collaboration.

Participant 1 further went on to state,

But I think when people better understand each other’s areas and what they can

do and what they can't do and. Maybe provide some feedback on things that they

could be doing like differently or better as well as sort of affirmations about here's

what's working well. Hmm. I found that to be really useful.

When discussing what strategies do not work, Participant 3 explained,

Scare tactics. Oh, my God. Scare tactics and like. This focus on criminal justice

exclusively doesn't work. As human trafficking, so the trafficking survivors don't

often see themselves as survivor. As you know, victims, so they're not going to,

like, run to the nearest police station and be like, hey, I'm a victim. So you really

need to have like a a much more interdisciplinary kind of approach. Participant 3

illustrated what was not productive in strategies for preventive work and followed

up with the importance of interdisciplinary work between human service

professionals and criminal justice system. Archive data 2 discussed the

importance of collaboration in their organization and further stated “our

collaborative partnerships include trafficking survivors, service providers, faith-

based groups, legislators, the Supreme Court and Attorney General of Missouri.”

The insight from the interviews and the archival documents highlighted the

importance of integrated and interdisciplinary approaches to addressing human

trafficking. This mutual understanding of each profession’s function and its

contribution is crucial for developing successful strategies to prevent human

trafficking.

Need for Education on Defining Human Trafficking for Middle and High School

Youth

The participants outlined that early education on healthy relationships and

defining human trafficking for middle and high school youth enhances prevention

strategies. This approach, while acknowledging the controversial elements of such

education from community and school officials, fosters better understanding and

awareness among young people, thereby contributing to the early prevention of human

trafficking. Participant 3 stated,

And the other things that are really effective are things like healthy relationship

curricula in schools. That's pretty controversial. So and it's not just about safe sex,

like, that's that can be part of it, of course. But it's, you know, like. It's about the

anti-bullying, it's about and you know, coercive relationships and dating

relationships, it's, you know, how you know when you have friends that aren't

treating you quite right. You know, it's life at home and helping you realize that,

you know, things that might be happening at home may or may not be all that

healthy. That's part of it. Right. So those are tools that kids need in order to

understand that future relationships they encounter. Are they feel good or not.

And so I mean, that's like I said before, that's controversial because part of that

conversation is about consent and sexual relationships.

Participant 4 detailed,

Using experts in the field to educate youth and definitely intervening at a younger

age. I would say like middle school level seems to be more more effective. I

know there's a lot of, like, you know, red tape around there, like introducing

certain things to the younger kids. However, these younger kids are being

exposed. Quicker than we can tell them about things.

Participant 5 also explained from their experience why early intervention is necessary.

Early early intervention, obviously, social media has really driven this. Yeah, it's.

I would say hit them, hit start hitting kids, age appropriate awareness, knowing

when you send. When you send pictures to your boyfriend, you know and he sells

them. Now you've now you've been a victim, right?

Education at this stage was also recognized in the need for building a rapport and

teaching healthy relationships as a preventive measure. Participant 6 noted her current

position in activating this need:

We would go out, and the main thing was just building the rapport with them and

teaching them healthy models of relationship, but really breaking down the whole

aspect of what love is. And. What is healthy love, What is a facade of love, And

then what does love mean to them? That was the perspective that I usually took

and I started with just building a relationship with them and then we would just

break down the cognitive distortions and say what was different from their old

response to their new response and going out and things.

Incorporating early education on health relationships and human trafficking into school

curricula can play a role in preventative efforts. Despite potential controversies, this

education is vital for equipping the youth in human trafficking awareness and prevention.

Use Human Trafficking Survivors’ Insight and Strategies to Prevent Future Human

Trafficking

The participants emphasized strategies that consider long-term impacts and

incorporate survivor insights to enhance the effectiveness of antitrafficking efforts.

Highlighting the importance of survivor experiences and perspectives ensures that

longterm plans are informed by those who have experienced human trafficking.

Participant 1 noted,

Having professionals who are involved in that collaboration as well as survivors

is also very helpful because survivors of course understand you know what

they've experienced and they have unique insights. Especially when you're

thinking about consequences of responses long term, survivors tend to be really

helpful in helping people think out long term consequences.

Although Participant 1 was clear about the positives of gathering victim’s insight,

Participant 2 shared the opposition in not receiving survivor insight and stated, I think

human trafficking has really become like a hot button issue for lots of different

political things all across the spectrum, and it does seem like lots of people want

to help, but everyone is picking a different way to do that. And so, you know, you

have, like, conservative politicians that are passing bills that I don't find

particularly helpful, but I also see Democratic politicians doing that too. So I

guess for me, my stumbling block is lawmakers, not taking a second to learn from

providers or from survivors themselves, and instead just deciding like, well, this

will help and like, pass a bill that actually doesn't.

Participant 6 stated,

Well, just from my perspective, my own perspective, I'm a survivor as well. So

working with the individuals that were survivors, I had another way to relate with

them and, I say relate with them, but it's also on the other hand of that is to call

them out and to be able to say “hey, like, you're not going to play me, I've been

there” and cause we have the skill set and we're taught the skill set on how to

manipulate situations and don't even know that we're doing it. So whenever you

have another survivor there, it's kind of like I know what you're doing, you might

not know that you're doing it but I'm gonna call you out and we have that

relationship that we can do that. I would say that was the most helpful part.

Victim insight was seen as vital in illustrating past experiences. By obtaining

information and future planning, this leads to more effective and empathetic

strategies for combating human trafficking.

Address the Stability Needs of Victims to Avoid Returning to Traffickers

The participants noted that there are benefits in addressing needs for victims and

vulnerable individuals that contributes to their stability and security. By meeting these

immediate needs, the dependency on traffickers for basic necessities is reduced,

ultimately enhancing the effectiveness of human trafficking prevention efforts. This

theme also delves into the need to understand the root issue of trafficking. Participant 2

shared,

So in combating it, I would say some of the most useful. Strategies have been

around meeting the needs of people through our own services so that they don't

feel like they need to fall back onto sexual exploitations. A lot of the people that I

work with, I wouldn't call it voluntary because there's a lot of manipulation

around it, but a lot of them, were kind of preyed on and manipulated because they

had some big need that wasn't getting met. Housing, money, income, food, things

like that. And so if we're able to meet those needs, then a lot of the time the

traffickers don't have the tools to kind of manipulate or coerce someone into

trafficking to begin with. because a lot of the people we work with, it starts out

because they need something.

Participant 3 stated,

So what's really effective is things like, you know, ensuring that people have

adequate access to like, you know, housing, employment, things like, you know. The

social determinants. that will stabilize communities and individual, you know, lived

experience. And those are often things that are not really funded very well, OK. Or, you

know, they're kind of often the last things that are thought of. Participant 5 echoed this

need and illustrated their experience with examples demonstrating the benefits of

addressing stability needs,

You know we, we meet them where they're at and we just love on them. We just

try to prepare them right. We try to pour into them their value, you know, a

relationship that's not transactional. We help them get their birth certificate and

their drivers license and you know, social security card. Things that will put them

in a better position when they recognize this is a situation that I don't want to be

in. Life skill groups, pro social activity, how to have healthy boundaries, how to

have a positive relationship with another human being that isn't transactional,

that's based on a mutual care care and respect. That's honestly, that's what's

worked for us

Participant 2 gave examples of these situations as well,

A woman who she had successfully gotten away from her trafficker. She was

working with us, but she found that working an entry level job, the income that

she was making was not enough to pay for all of her needs. She couldn't pay for

her car, and her childcare, and her job;. I'm sorry and her rent all with that job.

And so she ended up reaching out to her trafficker again to say like, what income

can you offer me? Which makes sense. Like if you're trying to survive. I

completely understand. Reaching for whatever you need. But we were able to

secure her a space in an apprenticeship program with one of the local labor

reunions, and so then she was able to make more money and learn a trade at the

same time. So that kind of long term then, you know, she's not gonna need to fall

back with that trafficker in order to get her needs met. and also she was just

psyched to be able to, like, learn something new.

Participant 1 further detailed their concerns and expressed the need to not only address

stability needs but the root sources of these needs,

I think a lot of our attention is focused on responses after the fact, which are

definitely needed, but I think that if we did a better job of addressing root sources

of the problem, then we would be in turn ameliorating trafficking before it

happens. I don't think you're ever going to entirely eradicate the problem, but you

can certainly reduce its likelihood and I think you can better do that through big

picture responses so you know, we know that there's a very strong association, for

example, between poverty and sex trafficking, exploitation. So, you know,

poverty alleviation programs such as expanding Medicaid, expanding Medicare,

you know those healthcare responses I think would be beneficial, continuing to

increase the minimum wage would be beneficial. Increasing access to safe and

affordable housing, you know, all of these things that are sort of macro level

responses that might seem like well, that's not related to sex trafficking or that's

not sex trafficking specific. Well, it is because they're the social conditions that

more or less produce, not just like vulnerability to trafficking but traffickers. You

know, like, if you look at a lot of traffickers, they're coming from the same

backgrounds as people who are trafficked. So you know, how can we prevent that

desire for economic livelihood? That means that people will exploit others in

order to get it.

By meeting basic needs such as housing, employment, and access to essentials, the

dependency on victims’ traffickers is reduced. Long-term solutions, such as

apprenticeship programs and poverty alleviation initiatives, can further create an avenue

and prevent victims from returning to traffickers. Addressing the root causes of

trafficking, such as poverty and lack of access to resources, is crucial for preventing

exploitation and reducing the likelihood of trafficking.

Human Service Providers Using Strategies that do not Overemphasize Criminal

Justice is More Effective for Prevention

The participants noted that the use of law enforcement using criminalization as

leverage to force cooperation amongst victims does not aid towards prevention.

Participant 1explained,

So there's a law enforcement person who I've worked with also who, He’s very

anti decriminalization of young people involved in commercial sex. So yeah. And

you know, I asked him well, why? Because isn't that re victimizing? If you have

somebody who's a victim of trafficking and then they're treating them, you know,

as a, as a criminal. Then he said, well, we try not to treat them as a criminal, but

you've got to have some kind of leverage in order to get them to, you know,

report. And the traffic occurs and if you don't then it if you decriminalize, then

basically it's like a free run for traffickers to do whatever they want to.

Participant 2 illustrated,

I have not had a lot of luck working with law enforcement in my area. We've had

a lot of prevention efforts thwarted a little bit like as an example, if I'm working

with a client that I know has recontacted her trafficker or has kind of fallen back

into the life in some way. And then I found out she was arrested for drugs. Even if

I go into the police officers like area and I say like I I realized she was arrested for

drugs we're working with her, she’s a trafficking victim. I get very little give on

that and so that system seems very focused on penalizing anything they can rather

than rehabilitating.

Police officers specifically were frequently mentioned throughout this theme. Participant

2 also stared their experience and stated,

We also have a lot of police officers, unfortunately that are the traffickers

themselves. We've seen that happen a lot. And so that also adds another layer of

safety questions like are you even safe calling 911 if your trafficker as a cop?

Absolutely not like you don't want to. Be involved in that system. So those are big

stumbling blocks and then.

Participant 6 shared,

I have not found it very effective, law enforcement side. It does not work to

discipline them. Typical therapy does not work. Structure therapy does not seem

to work very well right off the bat. It's more of meeting than where they're at. I've

seen a lot of people, they just they give up right in the beginning because they

can't get a hold of that. But whenever you're working with an individual that

population, you're kind of working backwards. You can't get anything done until

you have that relationship, so you're spending an immense amount of time in the

beginning just building that trust and then you can help them bridge over into

whatever else they need.

This theme highlighted that strategies that prioritized the holistic needs of trafficking

victims outweighed those that focused on the criminal justice factor. Participants

highlighted the ineffective and potential harm of using forced cooperation with victims.

Human Service Professionals Need Continuous Education on Changing Human

Trafficking Trends

During the interview, the participants illustrated the need for continuous education

and development amongst the profession. Participant 4 shared the view that, “I think

early intervention strategies have been have proven to be incredibly helpful in combating

that and community engagement like I said, and. And continuous training, continuous

life?” Participant 3 articulated,

So for practitioners, I think the coalitions and task forces really need to place

emphasis on having regular and periodic discussions, trainings, whatever. On you

know if they're going to be using like an indicator scale of some sort to help them

figure out what it is that they're looking at because they need to have regular

discussions around those scales and to be up to date on because there are so many

limitations, OK. And they're going to change. All the time. Is just a very variable

place that we're in right now around that and there's a lot of work being done

around it right now. So like that needs to happen. And then also along with that

discussion, those coalitions and task forces need to, not sure how to say this, but

they need to have conversation around working with researchers

Participant 5 also shared similar thoughts with Participant 3 around training and shared,

So for me, I think that there should be training for all like human service workers,

you know, like mandatory, mandatory training for all human service workers.

Anyone. Because it's there. It's so in our faces all the time. So yeah, that is

definitely something that, you know, in my opinion I would implement.

Participant 3 also discussed the use of tools, scales, and education in human trafficking.

The challenge of the maturity of defining human trafficking was illustrated and how this

impacts the continuous education and develop for human professionals. Participant 3

stated,

Not all of them are going to be culturally appropriate for the population they're

being used for so. And so like, I want to back up a little bit, so. So it takes like 17

years to come up with evidence based anything right for clinical practice. And if

the TVPA was passed in 2000, that means we've had 24 years of working in this

space. So we're just now to the point where we're likely to be able to start. Saying

that anything is evidence based, right? So I mean, we've just been doing the best

we can with what we've got up to now. So yeah, in certain spaces with certain

populations, there have been scales developed, right? How validated and reliable

they are.

Participant’s 3 views were taken into consideration, especially when Participant 6

acknowledged “ that your trafficker is 10 steps ahead of you.” The participants illustrated

the need for education through the profession, along with the challenge in slow

development of evidence-based methods in the field. Implementing regular mandatory

training for all human service professions will better equip them in combating human

trafficking as human trafficking evolves.

Community Engagement is Necessary for Prevention

The requirement of community engagement was consistently present throughout

the interviews. Participant 4 clearly stated that “Community engagement. Absolutely.

Spreading awareness” were the strategies that they found personally effective in

combatting human trafficking. Participant 1shared,

I guess I immediately go back to community support. Yeah, that supportive

service providers and survivors just to better increase our understandings about

not just human trafficking itself, but also about, you know, better responses and

also challenges that we see in the Community.

In a further question, Participant 1 went on to say,

Well. I think sometimes there's like larger community misunderstandings of the

issue, and I think that can pose a barrier. Especially when that translates into, you

know, professionals who are likely to encounter people who experience human

trafficking. So if they think that trafficking looks like it does on TV or in the

movies or those things that make the news. Then you know they're prepared to

identify and work with a very small corner of what human trafficking looks like

in the United States, and then they're much less prepared, you know, to work with

or address trafficking that happens, you know, sort of outside of that. Really

lesser lesser experience type of traffic and then of course service gaps, that's a big

one. Participant 4 elaborated on the level of support and the occasions where there

are limitations. They described that support is available from those

knowledgeable of human trafficking, however, Participant 4 stated,

I find that we get a lot of support from people who already are aware. It's so hard

to talk to someone new and they and they're just like all in with like, we'll give

you what you need. We'll let you talk to our kids. And I'm particularly talking

about like maybe the school systems. They're not like. There's a barrier there, and

you know, and it's really hard for us to receive the support and the backing to go

in and educate these children inside of schools.

Participant 4 also stated,

Yeah. Yeah, it's the resistance from the school. It's the resistance from, you know,

the public. We go when we speak at churches, you know, and it's that it's that kind

of a lot like closed mindedness is what we see inside of churches. So we have that

barrier and the resistance from the schools. When we go into churches, we see

maybe you know close the mines and they're like oh, that's like a their problem.

It's not a US problem, you know, that happens in that country not this country or

it happens in single parent homes, you know, not two parent homes and you

know. And those are both right and wrong answers, you know, because it does,

but it but it also happens in other ways. And so it it's really hard to to get people

to see the other side of it when they don't want to.

The “their problem” referenced by Participant 4 illustrated what Participant 6 also

disclosed regarding the need for community education. Participant 6 stated,

I think in prevention we first have to take a step back and educate the community.

And educate professional. I think that is the biggest missing piece is people think

that it's a choice and they think that they're going out and doing these things

because they want to and that is not not at all the case. It's what they've learned.

It's learned behavior. So I would say we would definitely have to teach

everybody, one how to spot it,

Although overcoming resistance and misconceptions was a component of this theme,

during the interview, the participants emphasized the importance of spreading awareness,

educating the public and professionals. Effective community engagement can bridge

service gaps and allow linkage in the interdisciplinary work as well.

Summary

Chapter 4 outlined the setting of the study, demographics, data collection

methods, and data analysis processes. This chapter also presented evidence of

trustworthiness, including credibility, transferability, dependability, and confirmability.

Lastly, it provided a thorough outline of the results, which consisted of seven themes.

These themes, discovered during the data analysis process, answered the research

question.

Chapter 5 presents a further explanation of the findings, discusses the limitations

of the study, and offers recommendations for future research on successful strategies that

human service professionals can use to prevent human trafficking. Additionally, I will

discuss how the implications of this study can encourage social change. Finally, the

chapter will conclude with a summary of the study.

Chapter 5: Discussion, Conclusions, and Recommendations

Introduction

The purpose of this single intrinsic case study was to understand what

interventions human service professionals use to prevent human trafficking in the state of

Missouri. The results of this study may play a role in guiding future research, supporting

human service professionals in improving interventions focused on preventing sexual

exploitation in human trafficking, and identifying best practices to create strategies for

human trafficking prevention successfully. The findings also demonstrated ways to

enhance preparedness and provide quality program evaluation.

The main themes that developed from this study included the need for

multiagency human service collaboration to prevent human trafficking, the need for

education on defining human trafficking for middle and high school youth, using human

trafficking survivor's insight and strategies to prevent future human trafficking,

addressing the stability needs of victims to avoid returning to traffickers, human service

providers using strategies that do not apply an overemphasis on criminal justice is more

effective for prevention, human service professionals need continuous education on ever

changing human trafficking trends, and community engagement is necessary for

prevention.

In this chapter, I present an interpretation of my research findings, limitations,

recommendations, and implications. Finally, I provide a conclusion of the study.

Interpretation of the Findings

Need for Multiagency Human Service Collaboration to Prevent Human Trafficking

One of the primary themes that emerged from the findings was the need for

multiagency human service collaboration to prevent human trafficking. This theme was

present in the literature examined in Chapter 2. Specifically, the TVPA legislation

introduced the concept of the Three Ps, with the fourth additional P being partnerships

(Busch-Armendariz et al., 2018). Each phase represents a needed action, and partnership

refers to the need for collaboration between various agencies and stakeholders. This joint

working and collaboration not only operate in preventing trafficking but also in

prosecuting traffickers and protecting victims (Understanding Human Trafficking, 2022).

For some human trafficking victims, law enforcement becomes the initial interaction, and

it is unlikely that the victim's needs are met through the criminal justice system

(Gonzalez-Pons et al., 2020). Therefore, there is a further need for collaboration between

services such as criminal justice and human service professionals to apply multiple levels

of engagement and support for the victim (Judge, 2018). Collaboration promotes an

understanding between agencies to comprehend each sector's function and emphasize

communication.

The theme also aligned with the theoretical framework of this study, the

traumainformed approach. Fallot and Harris (2015) guided the CCTIC to organizational

change into five core values: safety, trustworthiness, choice, empowerment, and

collaboration. Each guiding principle addresses the different needs of the consumer and

the staff's administrative level. The principle that applies to this theme is the collaboration

principle, which recognizes the significance of fostering partnerships and equalizing

power dynamics between staff and clients. The significance of this relationship is in the

understanding that the healing process occurs in meaningful relationships that share

power and decision making.

Need for Education on Defining Human Trafficking for Middle and High School

Youth

This theme aligns with the components of the existing literature review presented

in Chapter 2, which emphasizes that early relationships between service providers and

victims are essential in exposing potential risks and identifying sexual exploitation. The

UNODC (2020) recognized that raising public awareness and understanding of

trafficking through school education serves as an effective preventive strategy.

Counselors, teachers, and school administrators who regularly interact with victims can

not only identify those being trafficked but also aid in preventing trafficking (Albert,

2021). Educators trained in human trafficking education and schools who provide this

training to students play a role in preventing, detecting, and addressing child trafficking

crimes (Zhu et al., 2020). Teachers, in particular, have the opportunity to observe

vulnerabilities and accurately identify and report suspicions of abuse or human trafficking

due to the significant time they spend with students (Albert, 2021). Early education

fosters a better understanding and awareness of human trafficking among young people,

contributing to early prevention.

The theme also aligned with the theoretical framework. Harris and Fallot’s (2001)

trauma-informed care is rooted in the service provider’s understanding of the individual’s

impact of trauma and characterized by a strengths-based service delivery method. There

is an emphasis on delivering services to trauma survivors that prompt treatment

participation and do not retraumatize the victim (Harris & Fallot, 2001). Incorporating

these practices while educating children reduces the risk of retraumatizing. Despite

potential controversies, education at this stage is vital for equipping youth with awareness

and prevention strategies against human trafficking. Several participants highlighted the

need for education to occur at the middle and high school levels, despite resistance from

the community or schools. During my interviews, one participant noted that the fear

surrounding human trafficking education often stems from the misconception that it is an

introduction to sex education. The delivery of human trafficking education is as important

as the content. Integrating education on healthy relationships and human trafficking into

school curricula can significantly contribute to preventive strategies.

Use Human Trafficking Survivors’ Insight and Strategies to Prevent Future Human

Trafficking

Existing research noted in the literature review aligns with Theme 3. Hurst (2021)

highlighted the importance of incorporating the perspectives of human trafficking

survivors in the development of prevention programs. Appropriate agencies and

organizations did not always adequately address the complexity of survivors' needs,

leaving them with limited options for tailored support (Baird et al., 2021). Insights from

victims are vital in illustrating past experiences, enabling human service professionals to

tailor care, services, and treatment for survivors based on their expressed needs. The

absence of specialized and diverse services for human trafficking victims further

marginalizes and endangers survivors. By obtaining their input and planning for the

future, more effective and empathetic strategies for combating human trafficking can be

developed.

The theoretical framework also aligns with this theme. There is an emphasis on

delivering services to trauma survivors in a way that encourages participation in

treatment without retraumatizing the victim (Harris & Fallot, 2001). Victim insights

indicate that friction in the client-professional relationship can deter victims from seeking

support and assistance, prolonging their interaction with traffickers and impacting trust in

professionals. Harris and Fallot (2001) proposed a trauma-informed approach to enhance

outcomes across systems, benefiting both the traumatized individuals and the

professionals responsible for assisting them in achieving stability and safety. Insights

from survivors guide human service professionals in incorporating the best practices to

prevent future victimization.

Address the Stability Needs of Victims to Avoid Returning to Traffickers

This theme aligns with the existing literature reviewed in Chapter 2, which

recognizes that the most vulnerable populations are subject to human trafficking. Given

that the most underserved members of society are disproportionately affected by human

trafficking, prevention programs must acknowledge this disparity and adjust accordingly.

The National Action Plan to Combat Human Trafficking (2021) aimed to address the

needs of these underserved families, individuals, and communities underserved. It seeks

to expand efforts to address inequities faced by marginalized groups, thus supporting the

efforts of trafficking prevention. There is also a need to enhance support services for

victims. One of the Ps of the TVPA legislation is protection (Busch-Armendariz et al.,

2018). Protection includes various assistance programs such as mental health support,

financial aid, medical care, and secure housing for those who meet specific criteria

(Busch-Armendariz et al., 2018). These support mechanisms are crucial in ensuring that

victims have access to necessary services, thereby reducing their dependency on

traffickers for basic needs.

Theme 4 aligns with the theoretical framework. Trauma-informed care aims to

understand the impact of trauma on human trafficking victims and the circumstances that

lead to their vulnerability (Harris & Fallot, 2001). This framework emphasizes a holistic

understanding of victims' needs, ensuring that immediate and basic necessities are

prioritized (Harris & Fallot, 2001). Such an approach helps reduce dependency on

traffickers by providing stability and security through supportive services.

Traumainformed care involves recognizing the relationship between trauma and

behavioral health issues while guiding professionals to adopt a trauma-informed

approach. One key principle is safety provisions, which includes safe housing, financial

assistance, and access to essential resources. Ensuring victims can access appropriate and

effective services aligns with findings that stability is crucial in preventing human

trafficking.

Human Service Providers Using Strategies That Do not Apply an Overemphasis on

Criminal Justice is More Effective for Prevention

Theme 5 aligns with the literature presented in Chapter 2 in stating that arresting

victims does not solve the human trafficking problem. If the initial interaction by a victim

occurs through law enforcement, it is not likely that their needs will be met beyond the

services of the criminal justice system (Gonzalez-Pons et al., 2020). This theme showed

that the use of law enforcement using criminalization as leverage to force cooperation

amongst victims does not aid towards prevention. The needs of the victims incarcerated

require critical resources and programming that identifies their victimizing and the

capacity to offer support and reentry into their communities (Rizo et al., 2022). To more

effectively address the needs of human trafficking victims, collaboration among

healthcare providers, legal avenues, researchers, and human service professionals is

essential. Specifically concerning CSEC, as requested by the U.S Department of Justice,

a shift urged a transition from treating victims and survivors of CSEC as criminals and,

instead, placing emphases on the importance of understanding and recognizing the action

as child abuse and not a fault of the child’s (Gies et al., 2019). This theme highlighted

that strategies that prioritized the holistic needs of trafficking victims outweighed that

that focused on the criminal justice focused strategies.

The theorical framework also aligns with this theme. The purpose of a

traumainformed approach is to improve outcomes across systems for the benefit of the

traumatized person (Harris & Fallot, 2001). On an organizational level, the changes made

by trauma-informed care require an organization's culture to have professionals

emphasize responding to the effects of trauma by shifting the paradigm to professionals

asking what happened to the individual instead of what is wrong with the individual

(Harris & Fallot, 2001). During some circumstances, within the criminal justice arena, the

earnest is placed on what did the victim do instead of what happened towards the victim.

With trauma-informed practice involved, there can be a more positive change of outcome

for the victim.

Human Service Professionals Need Continuous Education on Changing Human

Trafficking Trends

This theme aligns with literature illustrated in Chapter 2 in that human service

professionals can only responsibly act to prevent human trafficking as they are trained to

do so. However, human service professionals may not receive human trafficking training

that is adequate in first recognizing human trafficking and then to responding

appropriately (Recknor et al., 2018). There are no centralized training methods for human

service professionals working within the human trafficking field (Mugari et al., 2021).

The training that is available also requires maturation and further evidence-based

research. Human trafficking organization and resources such as National Human

Trafficking Resource Center (NHTRC) developed categories that human trafficking

education and training should center around (NHTRC, 2016). Similar to training on

human trafficking for professionals, there is also no standard established for human

trafficking screen tools (Hainaut et al., 2022). The absence of standards results in reliance

on worker’s self-identification or self-reference for determining the sensitivity and

specifications of screening tools (Hainaut et al., 2022). Therefore, the need for continuous

education in practice is critical to development and consistency of practice across

professions.

The theorical framework also aligns with this theme. Without the adequate

training, human service professionals may inadvertently retraumatize a victim and cause

more harm; the trauma-informed approach prevents this traumatization (Harris & Fallot,

2001). The trauma-informed approach aims to equip staff with adequate trauma training

and education, which will support their service delivery (Fallot & Harris, 2015).

Therefore, it is essential that continuous, comprehensive, and evidence-based training be

prioritized to ensure that human service professionals are equipped to recognize and

respond to human trafficking effectively, while also minimizing the risk of further harm

to survivors.

Community Engagement is Necessary for Prevention

The last theme also mirrored literature throughout Chapter 2 in the recognition

that raising public awareness about human trafficking serves as an effective preventive

strategy. Human service professionals undertaking community sensitization equips

community members with knowledge on how to guard themselves against potential

traffickers (Mbamba et al., 2022). Community engagement also helps the community

identify what trafficking is, in order to safeguard appropriately. The need of engagement

and awareness also extends to educating the community of variations of human

trafficking as opposed to what the media portrays as human trafficking. Without the

appropriate education, professions may fail to recognize victims in practice as they do not

fit the image portrayed through the media and do not show the typically studied

indicators identifying trafficking (Gerassi et al., 2018).

The theorical framework approach also aligns with this theme. The growing

awareness of trauma has resulted in the continued development of trauma-informed

services. The purpose of a trauma-informed approach is to improve outcomes across

systems for the benefit of the traumatized person and the professionals tasked with

helping achieve stability and safety for the survivor (Harris & Fallot, 2001). This includes

the actions human service professionals engage in throughout the community to bring

awareness and educate.

Limitations

Limitations of this study need to be considered. Some noted limitations of the

study are a result of the criteria that was in place for each participant. This included

experience level, experience type, and geographical location of participants that

inherently restricted the diversity and inclusivity of the sample, potentially affecting the

generalizability and applicability of the findings. No demographic information was

collected for this study because all of the participants were currently working in Missouri.

The decision to collect data exclusively from professionals currently working in Missouri

limited the transferability of the results, as the data reflects experiences and conditions

are specific to that region. Consequently, this regional focus restricts the broader

applicability of the findings to other populations and contexts.

The criteria for this study also consisted of human service professionals having an

experience with sexual exploitation. Although critical in the findings of this study, types

of human trafficking are vast and varied across populations and forms. Other forms of

human trafficking and their prevention methods and successes may vary. The absence of

data on these other forms limits the study's comprehensiveness.

Gender, age, and experience level were also not disclosed throughout this study,

contributing to limitation. Data were only collected from professions working within the

human trafficking field over 5 years. The inclusion of only those with over 5 years of

experience in the human trafficking field may have excluded perspectives from newer

professionals who could offer different insights based on their more recent education and

exposure.

A semistructured Zoom interview was used to collect the data from all

participants and also presents limitations. Using Zoom for interviews provides

convenience to interview across boards and time zones, but it may have limitations. By

completing interviews through Zoom, I could have missed out on pertinent information.

Full assessment of their environment, nonverbal signals, body language, technical issues,

and connectivity issues could affect the details and quality of the collected data.

Recommendations

The development, implementation, and teachings of human trafficking

preventative strategies remain a topic of exploration. The wide variation in human

trafficking highlights the need for diverse approaches to prevention and a deeper

understanding of the effectiveness of these strategies. Therefore, administrating

additional research in this area is necessary. Future studies could benefit from using an

experimental design with a quantitative methodology to assess the impact of specific

prevention strategies. Quantitative data would allow for the testing of relationships

between variables and examine cause and effect associations (Bloomfield & Fisher,

2019). Researchers could use data to evaluate the effectiveness of antitrafficking policies

and interventions by analyzing changes in human trafficking statistics. Comparing the

implementation of different prevention strategies would show measurable data to assess

their effectiveness.

An additional recommendation for future research involves exploring different

topics. It would be beneficial to examine the methods human service professionals use to

collect data on the prevalence of human trafficking. Human trafficking is a hidden crime,

and numbers rarely reflect the true reality due to misrepresented or underreporting and

inadequate documentation. Although modern day slavery has persisted for centuries, the

TVPA was only established in 2000. This relative infancy in legislation leaves room for

improvement, especially in developing successful prevention strategies. Expanding

documentation and data collection practices is crucial for human service professionals.

During data collection for this study, it was noted that, apart from one participant,

no other participants discussed the use of scales, human trafficking indicators, or

screening tools. This could be due to various reasons, such as their level of engagement

does not require indicators or there is a lack of need for them. As there is no standard

training on human trafficking for professionals, there is also no established standard for

human trafficking screen tools. Further research to contribute to development is critical.

Lastly, the concept of human trafficking is not bound to a state, region, or country. The

epidemic is a worldwide issue. The implication and understanding of human trafficking

vary across cultures. Future research could explore how cultural influence impact human

trafficking. For example, the practice of forcing children into fishing communities in

Ghana or child labor in agriculture in Guatemala highlights the cultural factors that

impact the community’s human trafficking problem. The actions of the adults in these

circumstances are often based on cultural norms, which challenge tackling the crime of

human trafficking. Understanding these cultural influences and developing culturally

appropriate education and prevention strategies would be a valuable recommendation for

future research.

Implications

This study promotes positive social change as it provides a better understanding of

the strategies used by human service professionals to prevent human trafficking. This

understanding may directly impact human traffic victims. Risk factors leading to human

trafficking vulnerability will be able to be reviewed and a focus on prevention applied.

This study may lead to positive social change by bringing awareness to the impact of

human trafficking trauma and the appropriate way to administer care. The findings of this

study can also inform policies and shape community responses to the evolving nature of

human trafficking, ensuring that the needs of victims are prioritized and that the process

of decriminalizing victims is facilitated.

The social determinants of health are crucial in understanding and developing

prevention strategies for human trafficking. Therefore, applying this study to key social

determinants, such as economic stability, is critical. The focus on economic stability is

directly related to the outcomes of this study, emphasizing the need to address victims'

stability needs to prevent their return to traffickers. This can be achieved by meeting

basic needs such as housing, employment, and access to essential services. A multiagency

approach, involving collaboration between human service professionals and other

agencies, is essential for providing holistic care and services to victims. Access to

healthcare, a critical social determinant, can also be improved through collaborative

efforts, thereby enhancing prevention efforts. Another social determinant is community

and social context. This study’s results highlight a need for the community to be educated

around human trafficking and its elements in order to find success in prevention of

human trafficking. Educating the community enhances its ability to recognize and define

human trafficking, as well as identify the most effective prevention strategies.

Further recommendations for human service professional include practice

implications from the results of this study. Human service professionals can use the

results from this study to implement changes to their practice such as integrating

feedback from human trafficking survivors into their practice. Human trafficking

survivors offer unique insights that human service professionals without direct experience

cannot provide. The information provided in this study may also encourage human

services professionals to create effective treatment plans and use the trauma-informed

approach, as this will treat appropriately and not cause further trauma.

Conclusion

The purpose of this single intrinsic case study was to understand what

interventions human service professionals use to prevent human trafficking in the state of

Missouri. Successfully tackling human trafficking is a challenge as the act is labeled as a

global crisis and a crime against humanity. It is a hidden crime that impacts and affects

all cultures. The crime of human trafficking is not to be limited to that of only sexual

exploitation. Further research is needed around other forms of human trafficking.

Although this study has resulted in identifying successful strategies to prevent human

trafficking; preventive strategies need to be specifically catered to the type of human

trafficking. Human trafficking such as forced prostitution, servitude, forced or

compulsory labor, forced marriage, begging under exploitative and coercive conditions,

organ removal, baby selling of babies, illicit adoption, and combinations of criminal

activity and exploitation each require targeted interventions that address their unique risk

factors and outcome.

Ongoing research is essential in this area. Despite relatively new legislation and

processes that are continually under review, the crime persists, and the number of victims

continues to rise. Immediate actions are necessary to bring about change and protect

those vulnerable to this crime. Victims rely on change agents, such as human service

professionals, to know what is best to protect them, provide adequate services, and

implement successful interventions. For human service professionals to fulfill this role

effectively, more information and evidence-based research must be readily available.

Unlike other professions such as law enforcement, teaching, or doctors, where there are

standardized educational and training requirements, there is no established standard for

those protecting and serving victims of human trafficking.

This study contributes to improving polices, procedures, and the working environments

for human service professionals. In conclusion, the findings emphasize that working in

collaboration, applying insights from survivors, educating the youth and the community

about human trafficking, avoiding criminalization to victims, understanding the stability

needs of victims and continuous education to service providers are crucial.

Successful prevention strategies cannot occur without these elements.

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