Human Trafficking Recovery: Conceptual and Dimensional Considerations in a Stage Model A Dissertation Submitted to the Graduate School of the University of Cincinnati in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY In the Department of Educational Studies College of Education, Criminal Justice, and Human Services 2012 by Sharon Doering B.A. Purdue University, 1998 M.A. University of Illinois at Chicago, 2000 Committee Chair: Stephen C. Sunderland ABSTRACT The devastating crime of human trafficking affects millions of individuals and communities; therefore deeper understanding of it and its psychological and social impacts is needed. Agencies are interested in strategizing methods that promote protection and assistance while individuals are interested in personal healing – both interested in recovery on various levels from the blight of human trafficking. Survivors, clinicians, and rehabilitative programmers share their ideas through semi-structured interviews about the crime, its sequelae, and important features to recovery called dimensions. This study reveals that existing models of trauma and recovery based in ecological theories are sufficient for conceptualizing the trauma and recovery from human trafficking. Stages are considered in terms of where dimensions might occur implicating practical considerations for aftercare or rehabilitative programming. ii Page left intentionally blank iii Dedication I dedicate this dissertation to Eden. You’ve sacrificed the most time at this young age to let mommy complete what she hopes will inspire you to accomplish anything you want in life. iv ACKNOWLEDGEMENTS Thank you to all my friends and family who provided overwhelming support to me throughout this journey. Ernie, you have spurred me on with your love, faith, encouragement, and endless, stimulating, intellectual insights. You’ve sacrificed to lift our family and me up in countless ways. Steve, your mentorship and example exceed academic scholarship to include invaluable life lessons, and powerful insights. You constantly helped me to see the bigger picture of learning and growth. Lanthan, your honest feedback, meticulous edits, deep understanding, and support have been remarkable. Vanessa, I have cherished and appreciated your ceaseless support, keen feminist and cultural outlooks, and faith in my studies. Roger, your theoretical understandings, creativity, and helpful feedback inspired me along the way. Sharlene, I benefited tremendously from your vast knowledge of and scholarship on this subject as well as your ability to actively and relentlessly tackle issues involving human inequalities. Thank you all for your wisdom, dedication, refreshing honesty, and commitment to social justice issues. Thank you to all the brave participants in this study who have honorably decided to share in the burden of carrying contemporary slavery’s many consequences from social marginalization and rejection to personal suffering of trauma or vicarious trauma in order to promote more peaceful world. Thank you, Dad for challenging me to consider all dimensions of an issue and sharpening my mind and heart. Mom, thanks for demonstrating how to listen to silenced populations and for giving me the courage to pursue my dreams. To my mother-in-law, Carol, my sisters, Holly, Natalie, Rebecca, and Amy, and my friends Edite, Songhay, and Mengna for loving, keeping, and entertaining my children often on short notice and without completely stocked diaper bags. Thank you, Ernie, Bill, and Rob, for your technical assistance. I absolutely could not have completed these studies without all of you. I am ever grateful. v TABLE OF CONTENTS CHAPTER 1. INTRODUCTION……………………………………………………………..….1 Problem Statement………………………………………………………….………….....6 Research Questions…………………………………………………..……………….......7 CHAPTER 2. LITERATURE REVIEW…………………………………………………….…..11 Overview of Human Trafficking…………………………………………………...……11 Overview of Human Trafficking Effects……………………………………………...…49 Overview of Recovery…………………………………………………………….……..53 CHAPTER 3. THEORETICAL FRAMEWORK AND METHODOLOGY………………..…..71 Macro theory - Ecological Systems Theory……………………………………….……..72 Micro theories of Trauma and Recovery………………………………………….……..72 Qualitative Methodology…………………………………………………….……..……74 CHAPTER 4. ANALYSIS AND RESULTS……………………………………………………90 CHAPTER 5. DISCUSSION AND CONCLUSION………………………………………......143 Results…………………………………………………………………………………..145 Research Limitations……………………………………………………………..….…148 Results Discussion and Conclusion ……………………………………………………151 Future Recommendations………………………………………………………………166 REFERENCE LIST…….………………………………………………………………………175 APPENDIX A…………………………………………………………………………………..200 APPENDIX B……………………………………………………………………………..……206 vi List of Tables and Figures Figure 2.1. Sex Trafficking…………………………………………..…………………..………11 Figure 2.2. Child Soldiering……………………………………………………………………...16 Figure 2.3. Chattel Slavery……………………………………………………………..………..19 Figure 2.4. Domestic Servitude………………………………………………………..………...36 Figure 2.5. Human Trafficking as a Process embodying other Crimes……………………….…40 Figure 2.6. Labor Trafficking………………………………………………………..…………..42 Figure 2.7. Urie Bronfenbrenner’s Ecological Systems Theory Model…………………………44 Figure 2.8. Adapted from Mary Harvey’s Four Recovery Outcomes………………………...…62 Figure 2.9. Maslow’s Hierarchy of Needs…………………………………………………….…66 Figure 3.1. Phase III Participant Roles………………………………………………………..…80 Figure 3.2. Phase III Area of Expertise of Participants……………………………………….…81 Figure 3.3. Phase III Participant Demographics: Sex……………………………………………83 Figure 3.4. Phase III Participant Demographics: Traditional Educational Level………………..84 Figure 3.5. Phase III Partic152ipant Demographics: Race……………………………………....85 Figure 3.6. Phase III Participant Demographics: Ethnicity…………………………………...…86 Figure 3.7. Phases of Research…………………………………………………………………..89 Figure 4.1. Results Showing the General Progression of Recovery Dimensions in Stages……142 Figure 5.1. Human Trafficking Recovery Wheel………………………………………………159 Table 2.1. Practices Defined as Forms of Slavery in International Conventions………………..23 Table 4.1. Phase II Research Results………………………………………………………….....94 Table 4.2. Microsystemic Inhibitors and Promoters to Recovery after Human Trafficking…...109 vii Table 4.3. Macrosystemic Inhibitors and Promoters to Recovery after Human Trafficking…..110 Table 4.4. Important Dimensions to Human Trafficking Recovery: Results from Survey and Content Data……………………………………………………………………………………116 viii List of Acronyms APA: American Psychological Association ATIP: Anti-Trafficking in Persons BBC: British Broadcasting Corporation CATW: Coalition Against the Trafficking in Women CBO: Community-based Organization CDC: Centers for Disease Control and Prevention CEDAW: Convention on the Elimination of all Forms of Discrimination against Women CNDP: National Congress for the Defense of the People CPTSD: Complex Posttraumatic Stress Disorder CRC: Convention on the Rights of the Child CTOC: Convention against Transnational Organized Crime DESNOS: Disorders of Extreme Stress Not Otherwise Specified DRC: Democratic Republic of Congo DSM-IV: Diagnostic and Statistical Manual of Mental Disorders Fourth Edition ECPAT: Elimination of Child Prostitution, Child Pornography and Trafficking of Children for Sexual Exploitation FARDC: Armed Forces of the Democratic Republic of Congo FBO: Faith-based Organization EU: European Union FBI: Federal Bureau of Investigation ICD: International Classification of Diseases ICE: Immigrations and Customs Enforcement ix ILO: International Labor Organization IPEC: International Program on the Elimination of Child Labor IOM: International Organization for Migration IPSOFA: Psycho-social Institute of the Family (Institut Psycho-Social de la Famille) LRA: Lord’s Resistance Army NGO: Non-Governmental Organization OSCE: Organization for Security and Cooperation in Europe PTSD: Posttraumatic Stress Disorder ROMHP: Recovery-Oriented Mental Health Programs TVPA: Victims of Trafficking and Violence Protection Act of 2000 known as the “Trafficking Victims Protection Act” TIP: Trafficking in Persons UN: United Nations UNICEF: United Nations Children’s Fund UNGIFT: United Nations Global Initiative to Fight Trafficking in Persons UNODC: United Nations Office on Drugs and Crime UPC: Union of Congolese Patriots USAID: United States Agency for International Development USDHHS: United States Department of Health and Human Services USDOS: United States Department of State USDOJ: United States Department of Justice VBP: Values-Based Practice WHO: World Health Organization x Chapter 1 Introduction The world is full of suffering; it is also full of overcoming it. -Helen Keller Tears stream down my face as I hear the international news today. Yesterday, March 13, 2012 in the Hague, the International Criminal Court (ICC) sent a strong message that it would not stand for the impunity of leaders who traffic children through its very first conviction since its inception ten years ago. "The prosecution has proved beyond reasonable doubt that Mr. Thomas Lubanga [Dyilo] is guilty of the crimes of conscripting and enlisting children under the age of 15 years and using them to participate actively in hostilities," said Presiding Judge Adrian Fulford (National Public Radio, March 14, 2012). Lubanga kidnapped, coerced, and forced more than 42,500 children to fight, kill, mutilate, cannibalize, rape, and be raped, under his leadership in the Union of Congolese Patriots1 (UCP) between 2002-2003 (British