Patterns of service utilization among pre-certified victims of human trafficking

Abstract

This exploratory study examined factors associated with service utilization among pre-certified victims of human trafficking. The Andersen-Newman model of service utilization guided the examination of the predisposing, enabling and need factors associated with service utilization. Tier level of country of origin was associated with the use of information and referral services; referral source was associated with the use of mental health services; and type of trafficking was associated with the use of mental health services and information and referral services. Type of trafficking predicted the total number of services utilized. Victims of sex trafficking used fewer services compared with victims of labor trafficking.

Keywords

Exploratory study service utilization social work United States victims of human trafficking

Persons who have been trafficked have multiple and wide-ranging service needs arising from complex processes involved in human trafficking such as the use of fraud, coercion and threat (Clawson, 2003; Laudan et al., 2006) and related abuse and exploitation. Service needs of trafficked persons have been widely researched (Clawson, 2003; Caliber Associates, 2007; Laudan et al., 2006; US Department of State, 2008). Existing services have been assessed in many studies (Caliber Associates, 2007; USDOJ, 2008), and experiences of both service providers (Clawson, 2003) and persons who have been trafficked have been examined (Caliber Associates, 2007; Laudan et al., 2006). However, patterns and trends of service utilization by trafficked persons have not been studied.

Services for trafficked persons

The US anti-human trafficking policy, that is, the Trafficking Victims Protection Act, 2000 (TVPA) (Public Law 106-386), provides immigration relief and social services for persons who are identified as victims of trafficking. To be eligible for social services, the person must be certified as a ‘victim’ of human trafficking by meeting the following requirements: a) the individual must have been subjected to a severe form of trafficking in persons, as defined in the TVPA; b) the victim is willing to assist in every reasonable way in the investigation and prosecution of the trafficking case, or is unable to cooperate with such a request due to physical or psychological trauma; and c) the US Department of Homeland Security (DHS) has granted Continued Presence (CP) to the victim, or notified the victim that his or her T visa application is bona fide or approved. Certification entitles non-US citizens (foreign victims) trafficked into the US to receive the same benefits and services that are available to refugees. Children (under the age of 18) are not required to be certified to receive services. Once identified as a ‘victim’ of human trafficking, trafficked persons may be eligible for services provided by various federally funded and state-funded programs.

Prior to being certified as a ‘victim of human trafficking’, a period referred to as ‘pre-certification’, trafficked persons pursuing certification can receive limited, often emergency services, which parallel post-certification services as a result of funding available from the Department of Health and Human Services (DHHS) and other federal agencies. Pre-certification services include housing, food/clothing, advocacy, legal assistance, medical/dental care, language services (e.g. interpreters/translators), mental health counseling, education, and job training (Clawson and Dutch, 2008). Services for those in the pre-certification phase are provided by various federal and state agencies. Pre-certified clients in this study were receiving services funded by a grant provided by US Department of Justice’s (USDOJ) Office of Victims of Crime (OVC) and the New York State’s Crime Victims Board (CVB).

Theoretical framework

In this study, the Andersen-Newman Model (1973) is used to examine the patterns of social service utilization among victims of human trafficking who are in the ‘pre-certification’ phase. This model suggests that a sequence of interrelated predisposing, enabling and need factors contribute to the acceptance or rejection of services, volume of service utilized and type of services utilized. This model has been used extensively to examine health service utilization by many populations including vulnerable populations such as: minorities; undocumented immigrants; children and adolescents; mentally ill, chronically ill, and disabled persons; the elderly; and impoverished and homeless persons (Aday, 1993). The Anderson-Newman Model is used for the first time with this population. In studying the patterns of service utilization by trafficked persons, this model helps identify predictors associated with service utilization. Data for each of the three factors as postulated by the model were obtained from case records of trafficked persons. For the purpose of this study, age and tier level of country of origin are conceptualized as predisposing factors; immigration status and referral source as enabling factors; and type of trafficking experienced as a need factor. Detailed information about the operationalization of each of these variables is provided in the section titled ‘Study variables’.

Hypotheses

H1. There is a relationship between predisposing factors such as age and tier level of country of origin and types and number of services utilized.

H2. There is a relationship between enabling factors such as immigration status and referral source and types and number of services utilized.

H3. There is a relationship between need factor such as type of trafficking and types and number of services utilized.

H4. Predisposing factors, enabling factors and need factor will predict the total number of services utilized.

Research design

This exploratory and descriptive study about social service utilization by trafficked persons is done by analyzing retrospective data. Case records related to service use by pre-certified clients between June 2006 and May 2010 were examined. The data were collected from Safe Horizon’s Anti-Trafficking Program, a leading anti-trafficking agency in New York City.

Sample and procedures

This study (N = 136) examined a representative sample of trafficked persons in the pre-certification phase and receiving services from Safe Horizon. The target population for this research study consists of persons who have been trafficked internationally, that is, into the United States. A purposive sample for this study is drawn from the case records of Safe Horizon after appropriate procedures for human subjects clearance was obtained from the Institutional Review Board of Fordham University. Clients above the age of 18 who received services either under a grant from the Office for Victims of Crime (OVC) or a grant from the Crime Victims Board (CVB), or both of these grants, were included in the study. Both these grants provided for services for trafficked persons in their pre-certification stage.

Study variables

Pre-disposing factors

Age: Bales and Lize (2005) indicated that younger persons who are trafficked were more likely to be exposed to risky activities and therefore would present a higher need and use of services.

Tier level of country of origin: refers to the country of origin of the trafficked person that is based on a four-tier system developed under the TVPA, 2000. Countries are placed in these tiers based on the level of implementation of anti-human trafficking policies in these countries. Governments of countries that are categorized under Tier 1 fully comply with the minimum standards set by TVPA, 2000. Governments of countries categorized under Tier 2 do not fully comply with the TVPA’s minimum standards, but are making significant efforts to bring themselves into compliance with those standards. A complete list of countries and corresponding tier levels are available at http://www.state.gov/j/tip/rls/tiprpt/2012/192363.htm.

Enabling factors

Immigration status: refers to the immigration status of the trafficked person at the time of intake. Immigration status has been cited frequently to influence help seeking among immigrants (Huisman, 1996; Lee and Au, 1998). Three categories for immigration status were: a) entered with a visa; b) no valid immigration documents; and c) ‘other’. ‘Other’ immigration statuses included those with ‘continued presence’, ‘humanitarian parole’, ‘diplomatic G-4 visa’, etc.

Referral source: is the referring agency that brought the trafficked person in contact with the service provider. Lemming and Calsyn (2004) found that social support from professionals as an enabling factor explained more variance of service utilization than the predisposing or need variables in a service utilization study. The five categories were: a) law enforcement; b) non-governmental organization; c) government agency; d) individual; and e) law firm.

Need factor

Type of trafficking: refers to the type of trafficking experienced by the client. The two types were a) labor trafficking and b) sex trafficking.

Outcome variables

Service utilization was measured in two ways. First, number of services was measured using a total count of 27 types of services used. The count was based on yes/no response to each of services used as indicated by the case workers. Each ‘yes’ was counted as 1 and ‘no’ as 0. The possible score ranged from 0 to 21. Volume of services in units or time was not calculated for inclusion in this study. These 27 services were then collapsed into the following six types of services: a) social services, b) legal services, c) health services, d) mental health services, e) information and referral services, and d) employment related services. This yielded the use or non-use of the six major types of services provided. Social services consisted of eight services including: child care; clothing/food; protection/safety planning; social service advocacy and explanation of benefit/entitlements/availability; transportation; interpreter/translator; home/hospital/offsite visit and ‘other’ services. Legal services consisted of five services including: criminal justice system based advocacy; explanation of legal rights and protections; immigration advocacy; criminal justice support advocacy and repatriation. Health services consisted of three services including: medical (emergency and long-term care); dental care (emergency and long-term) and substance abuse treatment. Mental health services consisted of four services including: in-person counseling; telephone counseling; mental health (emergency and long-term) services and emotional/moral support. Information and referral services consisted of five services including: crisis intervention or 24-hour hotline; locating providing information and/or referrals; follow-up calls and letters; clients receiving information and referrals and advocacy calls/letters in person. Finally, employment related services consisted of two services: employment assistance and literary education and/or job training.

Study limitations and strengths

There are many limitations to this study. First, the findings of the study are limited to trafficking persons in the pre-certification phase and cannot be generalized to all victims of human trafficking. There is no existing literature that suggests a substantive difference between trafficked persons in the pre-certification stage and those who are certified as ‘victims of human trafficking’. The use of secondary data from case records also made it difficult to obtain pertinent information that could be conceptualized as predisposing, enabling and need factors for use in the Andersen-Newman model (1973). Human trafficking is a complex phenomenon and in order to study the service utilization patterns of trafficked persons, it is imperative that multiple variables, measured in a variety of ways are included in the study. Because this study was based on case records, the researcher did not have the ability to gather information on a variety of factors. The sample size also presented a limitation. For this study, only cases that contained information on at least one variable from each of the three domains of the Andersen-Newman model (1973) were included in the study. This resulted in a reduced sample size which then presented another disadvantage to the researcher. The different categories in the study variables did not have a sufficient number of cases in order to conduct some multivariable analyses.

Findings

Sample description

Most trafficked persons (N = 136) in the study were trafficked for sex, 69 (50.7%), followed by labor trafficking, 67 (49.3%). The age of the study sample ranged from 18 to 62 and the mean age was 28.30 (SD = 8.85). Trafficked persons in the study originated from 47 different countries. These countries were further categorized in a four-tier system as specified by the Trafficking in Persons Report, 2010. The tier system is reflective of the range of implementation of anti-trafficking laws by different countries around the world. Countries placed in Tier 1 have strong anti-trafficking laws and countries placed in Tier 3 have the poorest implementation or absence of anti-trafficking laws. A total of 64 (47.4%) originated from Tier 2 countries, and 51 (37.8%) from Tier 2 watchlist countries. At intake, 27 (26%) clients indicated that when they were trafficked into the country, they entered with a visa, 61 (58.7%) entered without proper immigration documents and 16 (15.4%) with ‘other’ statuses. In the total sample, 44 (32.4%) were referred to the current service provider by non-governmental organizations and 53 (39%) by law enforcement agencies.

Table 1.

Sample characteristics (N = 136).

	Number of cases	Percentage of sample
Predisposing factors
Age (years)	130^a	Range 18–62
Age (years)	130^a	M = 28.30, SD = 8.85
Tier level of country of origin (TVPA Tiers)
Tier 1	8	5.9
Tier 2	64	47.4
Tier 2 watchlist	51	37.8
Tier 3	12	8.9
Enabling factors
Immigration status at intake
Entered with visa	27	26
No documentation	61	58.7
Other	16	15.4
Source of referral
Law enforcement	53	39
NGO	44	32.4
Government agency	8	5.9
Individual	17	12.5
Law firm	14	10.3
Need factors
Type of trafficking
Labor	67	49.3
Sex	69	50.7

Information on age for six individuals was not available.

Description of services utilized

Service utilization by the sample is described in Table 2. Information and referral services and mental health services were the most used services in the study. Eighty-five percent of this sample used information and referral services and 84 percent used mental health services. Only 28 percent of this sample used employment related services.

Table 2.

Description of types of services utilized.^a

Services utilized	N	%
Social services	98	72.1
Legal services	98	72.1
Health services	42	30.9
Mental health services	114	83.8
Information and referrals	116	85.3
Employment related services	38	27.9

The six types of services were not exclusive of each other. Trafficked persons in the sample used multiple services.

Twenty-seven different services were available to the sample. However, the total number of services used ranged from 1 to 21 (M = 9.40, SD = 6.00). Trafficked persons from Tier 3 countries used an average of 11 services. Trafficked persons who were referred to the service provider by individuals and law firms used an average of 11 services, while those who were referred by government agencies used an average of seven services. Those trafficked for sexual purposes used an average about eight services while those trafficked for labor used an average of 11 services (see Table 3).

Table 3.

Description of total number of services utilized.

	N	Mean	Std Deviation
Predisposing factors
Tier level of country of origin
Tier 1	8	8.63	4.60
Tier 2	64	9.27	6.00
Tier 2 watchlist	51	9.16	5.96
Tier 3	12	11.00	7.06
Enabling factors
Referral source
Law enforcement	53	8.85	6.12
NGO	44	9.16	5.93
Government agency	8	6.50	6.52
Individual	17	11.47	4.91
Law firm	14	11.36	6.20
Immigration status
Entered with visa	27	11.19	5.45
No documentation	61	11.26	5.90
Other	16	10.56	5.73
Need factor
Type of trafficking
Labor	67	11.07	5.60
Sex	69	7.77	5.95

Total number of services utilized = range 1–21 (M = 9.40; SD = 6.00).

Results of hypotheses testing

Hypothesis 1 focused on the relationship between the predisposing variables and each of the six different types of services used and the total number of services used. Hypothesis 1 was only partly supported. Chi-square results indicated that only one predisposing factor, that is, tier level of country of origin was significantly associated with the use of only one of the six types of services utilized, that is, information and referral services (χ² (3,135) = 13.91, p < .01). Odds ratios indicated that compared with trafficked persons from Tier 2 watchlist countries, those from Tier 2 countries were less likely to use information and referral service (OR = 0.11 (0.02–0.52)). Age was not associated with the use of any of the six services used by the trafficked persons in this study.

Hypothesis 2 focused on the relationship between the enabling factors and each of the six different types of services used and total number of services used. Hypothesis 2 was also only partly supported. Only one statistically significant association emerged. Referral source was associated with the use of social services (χ² (4,136) = 10.04, p < .05) and mental health services (χ² (4,136) = 16.21, p < .01). Odds ratios indicated that compared with those referred to the service provider by individuals, those referred by government agencies were less likely to use social services (OR = 0.04 (0.003–0.45)). Compared with those referred by government agencies, those referred to the service provider by non-governmental organizations were almost eight times more likely to use mental health services (OR = 7.8 (1.47–41.42)). Immigration status of the trafficked person at the time of intake was not associated with the use of any of the six services examined.

Hypothesis 3 focused on the relationship between the need factor, that is, type of trafficking and the use of each of the six different types of services used. Hypothesis 3 was only partly supported. Type of trafficking was significantly associated only with the use of mental health services (χ² (1,136) = 13.33, p < .01) and information and referral services (χ² (1,136) = 8.03, p < .01). Odds ratio indicated that compared with those who were trafficked for labor purposes, those who were trafficked for sexual purposes were less likely to use mental health services (OR = .12 (0.03–0.44)) and also less likely use information and referral services (OR = .21 (0.07–0.67)). Type of trafficking was also significantly associated with the total number of services used (t(134) = 3.33, p < .01).

Hypothesis 4 focused on the overall effect of predisposing, enabling and need factors on the total number of services utilized. A hierarchical multiple linear regression was conducted to consider the impact of the: a) predisposing variables including age and tier level of country of origin; b) enabling factors including source of referral and immigration status at the time of intake; and c) need factors which included type of trafficking on the total number of services utilized by persons who have been trafficked. It was hypothesized that variables from all the three factors will have an effect on the total number of services used.

When bivariate analyses were conducted to test hypotheses #1–3, it was noted that not all predictor variables were significantly related to the number of services utilized. Despite this, all variables were still included in the multivariate analysis, that is, hierarchical multiple regression to test the conceptual model of the study. In the first model, predisposing factors, that is, age and tier level of country of origin, accounted for 9.8 percent of variance in the total number of services utilized, and was statistically significant (R² = .098, p < .05). When the enabling factor, that is, referral source is entered into the second model, the model accounted for 16.9 percent of variance in the total number of services utilized (R² = .169, p = .272). However, this change of 7.1 percent (R² change = .071) was not statistically significant. In the third model, when the need factor, that is, type of trafficking is introduced, it explains 21.7 percent variance in the number of services utilized (R² = .217, p < .05). This 5 percent (R² change = .048) increase in the third model is statistically significant.

The regression coefficients for only the significant variables in the final model are discussed (see Table 4). Tier level of country of origin and type of trafficking significantly predicted the total number of services utilized by a trafficked person. Tier 3 country significantly predicted the total number of services used (β = .36, p = .010) and sex trafficking significantly predicted the total number of services used (β = -.27, p = .022). In the final model, sex trafficking accounted for 21.7 percent of the variance in the total number of services used.

Table 4.

Hierarchical multiple regression analysis predicting the total number of services utilized (n = 101).

	B(SE)	Beta	t	Sig.
Predisposing factors
Age	0.03 (0.07)	0.05	0.42	0.67
Country of origin (reference Tier 1 country)
Tier 2 country	2.20 (2.34)	0.20	0.94	0.35
Tier 2 watchlist country	3.70 (2.44)	0.31	1.52	0.13
Tier 3 country	8.07 (3.06)	0.36	2.64	0.01*
Enabling factors
Referral source (reference = law enforcement)
Non-governmental agency	0.32 (1.42)	0.03	0.22	0.82
Governmental agency	6.48 (3.48)	0.20	1.86	0.07
Referred by individual	2.27 (1.76)	0.14	1.29	0.20
Referred law firm	2.13 (1.78)	0.12	1.20	0.23
Immigration status (reference = valid visa)
No immigration documents	3.00 (1.71)	0.26	1.75	0.08
‘Other’ status	0.95 (2.03)	0.06	0.47	0.64
Need factors
Type of trafficking (reference = labor trafficking)
Sex trafficking	–3.04 (1.31)	–0.27	–2.33	0.02*

p < .05; **p<.01. R² = .217, p = .022.

Hypothesis 4 was only partially supported because out of the three factors tested, only one of the predisposing factors (tier level of country of origin) and the need factor (sex trafficking) had a significant effect on the outcome of total number of services utilized. When all other factors were controlled for, Tier 3 countries predicted a higher number of total services utilized compared with Tier 1 countries and sex trafficking predicted the use of fewer services compared with labor trafficking. Specific to the Andersen-Newman model of service utilization, the combination of predisposing, enabling and need variables accounted for 21.7 percent of the variance in the total number of services utilized.

Discussion

Findings from the descriptive analyses indicated that most of the sample belonged to countries that were identified as Tier 2 or Tier 2 watchlist countries including Mexico, Peru, Ecuador, Romania, Hungary and Ukraine. This is consistent with the literature which indicates that most trafficked persons originate from countries with weak economies and poor anti-trafficking laws (Clawson et al., 2006). The finding that most of the sample did not have proper immigration documents at the time of entry reflects evidence from the literature that many trafficked persons are lured into entering into the country illegally (Bales and Lize, 2005; Coonan, 2004; Dougherty, 2006; Hopper, 2004). The majority of the sample was referred to the service provider by law enforcement or non-governmental organizations (NGOs). Law enforcement and NGOs play an important role in identifying persons who are trafficked and then refer them to service providers.

An important finding from the descriptive analyses was that labor trafficking and sex trafficking were almost equally represented in this sample. This is noteworthy because it does not correspond to estimates from the literature that indicates a predominance of sex trafficking over labor trafficking in human trafficking into the US as well as worldwide (ILO, 2005; IOM, 2005; UNODC, 2008). The findings of this study is close to the ILO estimate of 43 percent trafficked for sex work, 32 percent for forced labor and 25 percent for mixed labor and sex work (ILO, 2005).

The significant relationship between tier level of country of origin and service use is important. The reasons for low utilization of services by those who belong to countries where anti-trafficking laws are not strictly enforced are unclear. A possible explanation for this could be lack of information about the services, fear or confusion about the implications of using these services and a general lack of trust about service providers (Logan et al., 2009; Srikantiah, 2007). However, further research is required to understand the implications of these findings. There is also a statistically significant relationship between tier level of country of origin and the total number of services utilized. Compared with Tier 1 countries those trafficked from Tier 3 countries were found to be using more number of services. An explanation for this could be in favor of the anti-trafficking policy. It is possible that service providers and civil society are more focused on individuals trafficked from Tier 3 countries which is reflected in the high number of total services used by those from Tier 3 countries.

Referral source has been identified as an important enabling factor for service utilization and has been the strongest predictor of service utilization in at least one study (Lemming and Calsyn, 2004). Government officials who interact with trafficked persons might not be trained to assess their social service or mental health needs. This is just one possibility. The nature of the relationship between the trafficked person and the official of the government agency in their home countries as well as at the time of intake might have an impact on the use and non-use of the service.

Those trafficked for sexual purposes had lower odds of using mental health services and information and referral services compared with those trafficked for labor. They also utilized fewer services than those trafficked for labor. This is an important finding indicating possible differences in service needs based on the type of trafficking experienced. Provision of mental health services and of information and referral services are essential functions of social workers. The findings of this study suggest a significant role for social workers in identifying victims of human trafficking and creating awareness among the victims of human trafficking about existing available services. It is also important for the social workers to examine the reasons for the differences in service utilization between those trafficked for sex and those trafficked for labor.

This sample of victims of human trafficking in the pre-certification phase might have recent experiences of severe abuse and exploitation that could act as barriers resulting in lower levels of service utilization. This study provides evidence supporting the need for service providers to establish a relationship with trafficked persons in what might probably be their first interaction with the service delivery system consequent to being identified as potential victims of human trafficking.

Implications and recommendations

The most important findings from this study that have implications for social work practice are the following: b) most of them are undocumented; c) most of them belong to countries that have poor anti-trafficking policies and might be unaware of the fact that the US provides protection to victims of human trafficking; d) most of them are referred to service providers by law enforcement agencies and non-governmental organizations; and e) labor trafficking and sex trafficking cases are almost equally represented.

All of these findings confirm that trafficked persons are characterized by multiple vulnerabilities when they come in contact with service providers. Since the study sample consists of trafficked persons in the pre-certification phase, social worker practitioners informed by the findings of this study should consider ways in which they can develop strategies that would assure that all these levels of vulnerabilities are addressed and the service needs of those who were trafficked, are properly identified. These strategies should include specific assessment of service needs based on the trafficking experience of the clients. Social workers need to understand that the trafficking experience of the client will play a crucial role in their ability to utilize services. At a macro-level, the service provision approach to this population must be multicultural and interdisciplinary while taking into consideration the unique characteristics and experiences of trafficked persons. The development of this service provision approach can be grounded in the larger framework of social work practice with immigrants. Social work practice with immigrants has gained much ground in recent times as the immigrant population in the United States has been on a steady rise. The social work practice with immigrants discourse has consistently stressed the complexity of the immigrant experience, the impact of cultural factors in service utilization and the need for an interdisciplinary approach to meet the service needs. Added to this is the acknowledgement by NASW of the impact of globalization and the emergence of global problems that now have to be addressed at a local level (Finn and Jacobson, 2008; Healy, 2001).

Footnotes

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author biography

Smita Ekka Dewan, LMSW, PhD, is an administrator at Fordham University, New York, USA.

References

Aday

L.A.

(1993) ‘Indicators and Predictors of Health Services Utilization’, in Williams

Torrens

(eds) Introduction to Health Services, pp. 46–70. Albany, NY: Delmar Publishers Inc.

Andersen

R.M.

Newman

J.F.

(1973) ‘Societal and Individual Determinants of Medical Care Utilization in the United States’, Milbank Quarterly 51(1): 95–124.

Bales

Lize

(2005) ‘Trafficking in Persons in the United States’, final report to the National Institute of Justice, available online at: http://www.ncjrs.gov/pdffiles1/nij/grants/211980.pdf

Caliber Associates (2007) ‘Evaluation of Comprehensive Service for Victims of Trafficking: Key Findings and Lessons Learned’, final report submitted to the National Institute of Justice, US Department of Justice, available online at: http://www.ncjrs.gov/App/publications/Abstract.aspx?id=240518

Clawson

H.J.

(2003) Needs Assessment for Service Providers and Trafficking Victims. Fairfax, VA: Caliber Associates.

Clawson

H.J.

Dutch

(2008) Addressing the Needs of Victims of Human Trafficking: Challenges, Barriers, and Promising Practices. Fairfax, VA: ICF International.

Coonan

(2004) ‘Human Trafficking: Victims’ Voices in Florida’, Journal of Social Work Research and Evaluation 5(2): 207–16.

Dougherty

M.E.

(2006) ‘Preying on the Margins: Trafficking in Human Beings is Much Closer to Home Than What Most People Think’, America 194(3): 18–20.

Finn

J.L.

Jacobson

(2008) Just Practice: A Social Justice Approach to Social Work, 2nd edn. Peosta, IA: Eddie Bowers Publishing.

10.

Healy

L.M.

(2001) International Social Work: Professional Action in an Interdependent World. New York: Oxford University Press.

11.

Hopper

(2004) ‘Underidentification of Human Trafficking Victims in the United States’, Journal of Social Work Research and Evaluation 5(2): 125–36.

12.

Huisman

K.A.

(1996) ‘Wife Battering in Asian American Communities. Identifying the Service Needs of an Overlooked Segment of the U.S. Population’, Violence Against Women 2(3): 260–83.

13.

International Labour Organization (ILO) (2005) Human Trafficking and Forced Labour Exploitation: Guidance for Legislation and Law Enforcement. Geneva: ILO.

14.

International Organization for Migration (IOM) (2005) ‘Data and Research on Human Trafficking: A Global Survey’, International Migration 43(1/2): 1–355. Available online at: http://www.iom.int/jahia/webdav/site/myjahiasite/shared/shared/mainsite/published_docs/books/data_res_human.pdf

15.

Laudan

Y.A.

Janine

M.Z.

Newman

L.C.

(2006) ‘Comprehensive Services for Survivors of Human Trafficking: Findings from Clients in Three Communities’, available online at: http://www.urban.org/publications/411507.html

16.

Lee

(1998) ‘Chinese Battered Women in North America: Their Experiences and Treatment’, in Roberts

(ed.) Battered Women and Their Families: Intervention and Treatment Programs, pp. 448–82. New York: Springer.

17.

Lemming

M.R.

Calsyn

R.J.

(2004) ‘Utility of the Behavioral Model in Predicting Service Utilization by Individuals Suffering from Severe Mental Illness and Homelessness’, Community Mental Health Journal 40(4): 347–64.

18.

Logan

T.K.

Walker

Hunt

(2009) ‘Understanding Human Trafficking in the United States’, Trauma, Violence, and Abuse 10(3): 3–30.

19.

Srikantiah

(2007) ‘Perfect Victims and Real Survivors: The Iconic Victims in Domestic Human Trafficking Law’, Boston University Law Review 87: 157–204.

20.

United States Department of State (2008) Trafficking in Persons Report. Washington, DC: Office to Monitor and Combat Trafficking in Persons. Available online at: http://www.state.gov/g/tip/rls/tiprpt/2008/

21.

UNODC (2008) ‘United Nations Office of Drugs and Crime, Human Trafficking: An Overview’, available online at: http://www.ungift.org/docs/ungift/pdf/knowledge/ebook.pdf

22.

USDOJ (2008) United States Department of Justice, Assessment of U.S. Government Efforts to Combat Trafficking in Persons in Fiscal Year 2007’, available online at: http://portugal.usembassy.gov/root/pdfs/2008usg_effortsdojassessment.pdf