Different Approaches to the Conversation

There are different ways to determine the needs of someone who may be at risk of trafficking or is currently experiencing trafficking. Because the evidence is still forming around these different approaches to assessment, in this training we will 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, some providers may feel more comfortable with a specific approach or a combination of both approaches depending on available services and resources, staff’s current level of comfort talking about trafficking with clients, current organizational approaches and processes, as well as 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 different stakeholders may use different terms to refer to these approaches, so it is important to clarify with your partners in delivering multidisciplinary care exactly what they mean when they say “screening,” “interviewing,” or use other related terminology. ​ ​

Additionally, neither of these approaches require disclosure. 

Universal Education


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. 


  • The provider inquires about 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

  • This is meant to be a partnership, where the individual and provider determine together which services and resources are appropriate for the individual.

ToolsSafety card image

  • CUES

    • “CUES” is an evidence-based intervention developed by Futures Without Violence that encourages providers to use a safety card to initiate the conversation and to give two cards to individuals. 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 that they can adopt a team‐based response to supporting survivors.
    • The acronym stands for:
      • C: Confideniality
      • UE: Universal Education and Empowerment
      • S: Support 
  • PEARR Tool

    • The PEARR Tool builds on the CUES intervention and was created by Dignity Health in partnership with HEAL Trafficking and Pacific Survivor Center. It is another example of a universal approach tool applied in a national, non profit health care 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 individuals, as a form of both prevention and intervention. See the resources below for more information about each of these tools.




  • The provider identifies risks and provides appropriate interventions through a standardized set of questions tied specifically to human trafficking.

Provider/Individual Relationship

  • This is a more hierarchical relationship, in which the provider determines which services and resources the individual qualifies for based on the answers to the screening questions.


Although there are general screening tools for cross-discipline professionals and specific screening tools for some professional groups, such as health care providers, no screening tools have been developed specifically for use by behavioral health professionals. The tools 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. 

  • Human Trafficking Screening Tool (HTST)
    • Developed by the Urban Institute in partnership with the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and Administration for Children and Families (ACF) to identify minor victims of trafficking. 
  • Quick Youth Indicators for Trafficking (QYIT)
    • Developed by Covenant House New Jersey to identify labor and/or sex trafficking among homeless young adults aged 18-22 years old in service provision settings. It was validated in 2018. 
  • Toolkit and Guide: Adult Human Trafficking Screening
    • NHTTAC-developed tool to screen adult victims of human trafficking that complements the HTST created by the Urban Institute in partnership with ASPE and ACF. 

Typically, screening is done in health care and behavioral health settings where red flags or indicators already indicate risk specifically to human trafficking. The provider, using a standardized set of yes/no questions, is able to identify the individual’s health risks that may link to human trafficking in order to determine which services and resources to provide. 


Additional Resources

Find a full index of health and domestic violence-related materials, including safety cards like the one pictured above, through Futures Without Violence.

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