There are different ways to identify the needs of someone who may be at risk of trafficking or is experiencing trafficking. Because evidence is still forming around these different approaches, we talk about both universal education and screening and provide tools for each without recommending one over the other. While these approaches can be used in any setting, providers can use universal education to provide information and resources to anyone, whereas screening tools are created and intended for use in a specific setting with a specific population (that may be a subset of the population you serve). Some providers may feel more comfortable with a specific approach or a combination of both approaches depending on available services and resources, current level of comfort talking about trafficking with clients, current organizational approaches and processes, and length of time with a patient or client. Providers that typically see a client once and/or for a short period of time (i.e., emergency department) may find it more helpful to use a screening tool, whereas providers that have longer or recurring appointments with patients (i.e., behavioral health), may prefer a universal education approach.
It is also important to recognize that your partners may use different terms to refer to these approaches, so it is important to clarify when delivering multidisciplinary care what is meant by “screening,” “interviewing,” or other related terminology.
Additionally, neither of these approaches requires disclosure.
Remember:
Neither universal education nor screening approaches require disclosure . It is more important to identify and understand the individual’s needs when developing an appropriate response than to secure a disclosure.
Goal
- To determine the individual's needs while simultaneously educating the individual on the ways that interpersonal relationships, work environment, or other socioecological risk factors may inform and influence that individual's situation and presenting issue.
Provider/Individual Relationship
- Based on partnership, where the individual and provider determine together which services and resources are appropriate for the individual.
Tools
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CUES
- “CUES” is an evidence-based intervention developed by Futures Without Violence that encourages providers to initiate conversations about domestic and sexual violence by offering individuals two safety cards (specifying that one is for the individual to take for a friend or loved one). If there is a disclosure of violence, providers can offer to make a referral to their local domestic violence agency. The “CUES” intervention is centered on partnerships between domestic violence agencies and health settings so they can adopt a team‐based response to supporting survivors.
- The acronym stands for:
- C: Confidentiality
- UE: Universal Education and Empowerment
- S: Support
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PEARR Tool
- The PEARR Tool, provided by CommonSpirit in partnership with HEAL Trafficking and the Pacific Survivor Center, builds on the CUES intervention. It is another example of a universal approach tool applied in a national, nonprofit healthcare system.
- The acronym stands for:
- P: Privacy
- E: Education
- A: Ask
- R: Respect
- R: Respond
By using a universal education approach, providers can reach more people as a form of both prevention and intervention. See the resources below for more information about each of these tools.
Goal
- To identify risks and provide appropriate interventions through a standardized set of questions tied specifically to human trafficking.
Provider/Individual Relationship
- Hierarchical, where the provider determines which services and resources the individual qualifies for based on the answers to the screening questions.
Tools
There are general screening tools for cross-discipline professionals and specific screening tools for some professional groups, such as healthcare providers. Determine whether a validated screening tool exists for your setting and target population. Because of the time and resources needed to validate screening tools through longitudinal research, there are few validated screening tools available. If there is no validated screening tool for your setting, you may wish to consider using an evidence-based tool. If using an evidence-based tool, conducting universal education becomes especially important.
The tools and resources listed here help professionals apply trauma-informed principles to identify individuals who have experienced trafficking and provide appropriate referrals to supportive and culturally competent services.
- Quick Youth Indicators for Trafficking (QYIT)
- Developed by Covenant House New Jersey to identify labor and/or sex trafficking among young adults experiencing homelessness aged 18-22 years old in service provision settings. It was validated in 2018.
- Rapid Appraisal for Trafficking (RAFT)
- Four-item screening tool designed to identify labor and sex trafficking in healthcare settings. It was validated in 2021.
- Short Screen for Child Sex Trafficking (SSCST)
- Tool designed to identify adolescents experiencing sex trafficking. It was developed and validated for use in healthcare settings in 2017.
- Toolkit and Guide: Adult Human Trafficking Screening
- NHTTAC-developed guide designed to train public health, behavioral health, healthcare, and social work professionals to use a trauma-informed, person-centered approach to assess adult clients and patients for trafficking or risk of potential trafficking. It is not validated.
Screening is most frequently done in healthcare and behavioral health settings where red flags or indicators already indicate risk specific to human trafficking. The provider, using a standardized set of yes/no questions, can identify the individual’s risks that may link to human trafficking to determine which services and resources to provide.
- Chisolm-Straker, M., Sze, J., Einbond, J., White, J. & Stoklosa, H. (2019). Screening for human trafficking among homeless youth. Children and Youth Services Review, 98, 72--79. https://doi.org/10.1016/j.childyouth.2018.12.014
- CommonSpirit. (2019). PEARR tool: Trauma-informed approach to victim assistance in health care settings. https://commonspiritpophealth.org/wp-content/uploads/2020/10/CSH-PEARR.Tool-Tel-Field-FA4-Protected.pdf
- Futures Without Violence. (2019). Project catalyst: State-wide transformation on health, IPV, and human trafficking. https://www.futureswithoutviolence.org/health/project-catalyst/
- Futures Without Violence. (2018). CUES: An evidence-based intervention. http://ipvhealth.org/health-professionals/educate-providers/
- National Human Trafficking Training and Technical Assistance Center. (2018). Adult human trafficking screening toolkit and guide. https://nhttac.acf.hhs.gov/resources/toolkit-adult-human-trafficking-screening-tool-and-guide
- Office of the Assistant Secretary for Planning and Evaluation. (2017). Pretesting a human trafficking screening tool in the child welfare and runaway and homeless youth systems. https://www.urban.org/sites/default/files/publication/93596/pretesting_tool_1.pdf
Find a full index of health and domestic violence-related materials, including safety cards like the one pictured above, through Futures Without Violence.