Trauma-coerced Attachment and Complex PTSD: Informed Care for Survivors of Human Trafficking

Author: Chambers, Ronald; Gibson, Mattew; Chaffin, Sarah; Takagi, Timothy; Nguyen, Nancy & Mears-Clark, Toussaint

Abstract: Human trafficking is a public health issue that requires a trauma-informed survivor focused response from healthcare providers. While some of the unique healthcare needs of trafficking survivors have been studied, there is still a lack of research and insight into the best approaches for the treatment of lasting psychological trauma experienced by trafficking victims. The trauma experienced within this patient population is frequently chronic and complex, and may coincide with time frames of brain development leading to specific manifestations of complex post-traumatic stress disorder (complex PTSD), intermixed with trauma-coerced attachment (TCA) – often referred to as trauma bonding- to the abuser(s). Healthcare providers need to consider incorporating both psychological and pharmacological treatments to adequately address complex PTSD with concurrent TCA. However, more research and a better understanding of effective approaches for treating trafficking-related PTSD are essential to better inform survivor-centered care. Here, we present a conceptual understanding of trauma-coerced attachment and complex PTSD in trafficking victims, as well as an approach to comprehensive, trauma-informed care used at our medical safe haven (MSH). Improving the ability of healthcare professionals to effectively treat the psychological trauma of trafficked persons in a trauma-informed manner contributes to UN Sustainable Development Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels.

Keywords: human trafficking, trauma-informed care, trauma bonding, trauma-coerced attachment, post-traumatic stress disorder, medicine, education, longitudinal care