Motivational interviewing with individuals at risk of sex trafficking

Abstract

Summary Motivational interviewing is an evidence-based practice designed to collaboratively strengthen a person’s commitment to change. Used in a wide variety of practice settings, motivational interviewing is recommended for use with individuals who are at risk of sex trafficking when discussing sex trading or relationships with potential traffickers. However, little is known about the uses of motivational interviewing with this population in practice. The current study examined whether and how social workers who encounter individuals at risk of sex trafficking use motivational interviewing. We explored perceptions of motivational interviewing use, applicability, and engagement practices by conducting in-depth, semi-structured interviews with 24 hour service providers in a Midwest region. Findings Practitioners discussed a wide variety of perceptions of motivational interviewing, ranging from completely unfamiliar, to inapplicable to their service population, to favoring its use. Those who did implement motivational interviewing described challenges to engagement with this population and provided examples in which they did not validate the clients’ perceived benefits of situations that enhanced their risk, a principal tenant of motivational interviewing. Such actions may have contributed to practitioner-client discord and ultimately reduced clients’ engagement. Applications Providers who encounter sex trafficking in practice should be trained in the use of motivational interviewing and applicability, specifically regarding how to validate the client’s internal arguments for and against sex trading and related behaviors. Future research should continue to understand whether and how motivational interviewing can be adapted for transient populations, and continue testing the efficacy of motivational interviewing with these populations.

‘Have you ever traded sex for money or drugs?’ Health care providers’ perspectives on sex trafficking risk assessments in clinics

“…Providers should begin by normalizing the spectrum of agency to victimization in sex trading before asking a question, as patients may have a range of sex trading experiences (by choice, circumstance and/ or coercion). 23 Normalizing may help providers to posit a non-judgmental attitude to patients rather than suggesting that providers are not intending to be nosy. Potential ST risk screening questions include, 'Have you ever exchanged sex for food, money, shelter drugs, hormones or anything else?…”

Trauma-informed intervention with survivors of human trafficking.

“…MI (W. R. Miller & Rollnick, 2013) is an evidence-based intervention that is highly regarded and widely recommended for work with trafficking survivors (e.g., Gerassi & Esbensen, 2021;Knott et al, 2021). A particular strength of MI in working with trafficking survivors is the set of principles ("spirit") that values autonomy and self-determination.…”