Exit and Post-Exit Services for Victims of Human Trafficking: Ten Years of Intervention Research

Background: Human trafficking is a global problem, and its deleterious psychological, social, and physical effects have impacted the lives of an untold number of children and women.  Calls to serve the victims of human trafficking have been issued by many levels of government, non-governmental organizations, and a range of healthcare and social service professionals. While some recent reviews have examined policies to prevent or suppress human trafficking, the evidence for interventions intended to directly serve victims of human trafficking is unclear. The purpose of this review was to synthesize the body of evidence of intervention programs intended to directly serve victims of human trafficking and evaluate the effects of those interventions.

Methods: Systematic review methods were used to search, select, and extract data from published and unpublished experimental, quasi-experimental, and pre-experimental studies that assessed the effects of any exit or post-exit interventions for victims of human trafficking. All forms of trafficking (sex, labor, domestic, cross-border) were considered due to the paucity of available quantitative research on the intervention effects for trafficking victims. The authors searched eight databases, contacted authors, and reviewed the websites of NGOs serving trafficking victims to find both published and unpublished studies authored between 2005 and 2015. Two reviewers independently screened potentially relevant reports and coded all included studies using a structured coding instrument. Descriptive analysis was conducted to examine the characteristics of included studies and participants. Study quality was also assessed using Cochrane’s risk of bias tool. Meta-analysis was planned but not possible due to the small number of between-group studies that met inclusion criteria. 

Results: Nine studies, published between 2006 and 2014, met eligibility criteria. Our analysis found that most studies had major threats to internal validity. RCTs and QEDs accounted for only two studies; the remainder were pre-experimental designs. Studies were theoretically grounded in a range of models, with trauma-informed care orienting the intervention of four studies. The remainder of studies used other models (e.g. residential services, behavior modification, and medical models to justify treatment). Persons served were overwhelmingly female (98%). Two-thirds of the studies served participants that were either exclusively or predominantly under the age of 18. No trafficking victims were identified as labor trafficked; 77% of persons were sex trafficked and 23% were not reported. Authors measured a range of outcomes, with 67% measuring mental health outcomes. Other outcomes measured included substance abuse recovery, community reintegration, economic and vocational status, and recidivism rates. Study authors reported primarily positive effects of the interventions.

Discussion: This review provides the first synthesis of studies examining effects of interventions for victims of human traffickers. While many study authors recommended the interventions considered in their reports, the efficacy of these treatments remains unclear due to poor study quality and small number of studies. A continuum of trauma-informed services is slowly being developed and TF-CBT models have been tested in two studies, one of which was a high-quality RCT, with promising results. Recommendations for improving research and practice in this area will be discussed.