Occupational Therapy Intervention for Survivors of Sex Trafficking: A Systematic Review

PURPOSE: There are an estimated 15,000 to 50,000 women and children are forced into sex trafficking every year in the United States (Heinze, 2021). Sex trafficking leaves a lasting impact on survivors’ mental health and quality of life and presents these individuals with a complex set of barriers to occupational performance including various psychological challenges as well as cognitive impairments (Boyanapalli, 2020). Exposure to sex trafficking affects all aspects of a person’s life including work, community and social participation, self-care, and leisure (United Nations Office on Drugs and Crime, 2019). Occupational therapists are equipped to address these domains. The purpose of this systematic review was to describe the effectiveness of interventions to address the needs of survivors of sex trafficking in the United States. DESIGN: This systematic review described the effectiveness of interventions in the scope of occupational therapy for survivors of sex trafficking. This study included literature published between 2008 and 2023. METHOD: Researchers reviewed 58 articles from four databases. Five met the inclusion criteria. U.S. Preventative Services Task Force levels of certainty and grade definitions were used to describe the strength of evidence. RESULTS: Four level III, one-group pretest-posttest studies and one level IV case series study were included in the review. Low strength of evidence for community-based therapy, mentorship, occupation-based therapy, trauma-informed care, and coping skills. Specifically, one level three article supported each of the following: community-based interventions in transitional housing to improve readiness for community reintegration; mentorship to improve coping and quality of life; occupation-based interventions to improve occupational performance and task behavior; and trauma-informed care to improve performance and satisfaction in prioritized occupations. One level IV article supported the use of coping skills interventions to improve occupational balance and competency. CONCLUSION: This systematic review may guide occupational therapy professionals to utilize interventions such as community-based therapy, mentorship, occupation-based therapy, trauma-informed care, and coping skills on a case-by-case basis depending on their client’s personal needs. Future research should focus on developing and testing protocols for effective, client-centered occupational therapy interventions to promote quality of life for survivors of sex trafficking. To improve the strength of evidence, studies with more rigorous designs and larger sample sizes are warranted. IMPACT STATEMENT: There is emerging evidence supporting occupational therapy interventions for survivors of sex trafficking to enhance self-care, work, and leisure activities. Further research is needed to increase understanding of the effectiveness of occupational therapy intervention with this underserved population. REFERENCES: Boyanapalli, A. (2020). Occupational therapy for human trafficking. American Occupational Therapy Association. https://www.aota.org/publications/student-articles/career-advice/human-trafficking#:~:text=By%20collaborating%20with%20the%20individual Heinze, J. (2021). A snapshot of victims. National Sexual Violence Resource Center. https://www.nsvrc.org/blogs/snapshot-victims United Nations Office on Drugs and Crime. (2019). An introduction to human trafficking: Vulnerability, impact and action. https://www.unodc.org/documents/human-trafficking/An_Introduction_to_Human_Trafficking_-_Background_Paper.pdfhttps://digitalcommons.unmc.edu/cahp_ot_sysrev/1013/thumbnail.jp