The importance of maintaining medical professionalism while experiencing vicarious trauma when working with human trafficking victims.

Abstract

Providing health care services to human trafficking victims may negatively impact the psychological wellness and decision-making process of health care providers, especially mental health providers. This article highlights John Gregory's concept of medical professionalism and discusses how the fundamental virtues, integrity, compassion, self-sacrifice, and self-effacement can guide health care providers in managing their work with trafficked patients. Recommendations are provided to health care providers, and the leadership of their institutions, to develop and support a professional culture of prevention and intervention for health care providers who experience psychological adversities related to their work with victims of human trafficking.

The impact of working with human trafficking survivors.

“…Participant 1 defines the difference between being a “warm fire” for someone, as opposed to taking on their trauma (Cuartero & Campos-Vidal, 2019), and furthermore recognizes the importance of acknowledging their work’s positive impact on their clients to fuel compassion satisfaction against compassion fatigue (Figley, 1995; Ramirez et al, 2020):My therapist calls it being a warm fire. And it’s just like, being with the person…I can just be a warm presence, so that that person doesn’t have to go through it alone…and we’re able to, erm, see the difference and act to change it.…”

“…Previous research has defined vicarious trauma and burnout, or compassion fatigue, as a ubiquitous occurrence amongst mental health professionals who face a high level of professional contact with traumatized clients generally (Benuto et al, 2018;Bride, 2007;Fahy, 2007) and with survivors of human trafficking specifically (Ramirez et al, 2020). A study by Ting et al (2011) found that social workers experienced high levels of perceived stress initially after being confronted with client suicidal behaviour (CSB) that had the potential to develop into long-term perceived stress if not processed properly.…”

“…Previous research shows that survivors of human trafficking experience similar morbidities and comorbidities to survivors of other traumatic events, including mental health issues such as PTSD and depression (Ramirez et al, 2020) and substance misuse (Hopper & Gonzalez, 2018); however, it is important to note that trauma is not universal and different experiences result in different complexities. Crucially, recent research highlights that human trafficking survivors face a range of "biopsychosocial vulnerabilities" (Ramirez et al, 2020, pp.…”

“…This can manifest in worker’s manipulation of client decision-making to ensure the avoidance of the worker’s anticipated risks to the client’s safety and well-being. Such manipulation, or “overriding” of participant decision-making is countertherapeutic and only serves to allay the anxieties of the practitioner, rather than benefiting the service user (Ramirez et al, 2020).…”

“…Workers need to be able to discuss not only issues with clients but also how these issues affect the worker personally. Ramirez et al (2020) posited that involvement of trusted and competent colleagues is vital, as is self-reflection around knowing when to seek support and when to refer out to another practitioner, as do Kliner and Stroud (2012) who’s findings illustrated the need for organizational support and training for staff working with vulnerable populations.…”