The Multimodal Social Ecological (MSE) Approach: A Trauma-Informed Framework for Supporting Trafficking Survivors’ Psychosocial Health

  • Elizabeth K. Hopper


Human trafficking can have devastating effects on survivors’ emotional, psychosocial, and physical health. Initial research has suggested that trafficking survivors may meet diagnostic criteria for multiple psychiatric diagnoses, including depression, anxiety, post-traumatic stress disorder, and other comorbid conditions. However, many of their reactions may be better understood within a complex trauma framework. Despite the potential benefits of mental health care for trafficking survivors, many people are not able to access effective services, due to structural/systemic barriers and the lack of adequately responsive services. Trauma-informed systems that utilize an empowerment approach may increase access to services. In addition, due to the multiple layers of stress and trauma exposure commonly experienced by trafficking survivors, intervention should be guided by a complex trauma framework. Instead of focusing solely on symptom reduction, complex trauma treatment emphasizes the development of competencies, including building regulatory capacity; developing healthy relational patterns; and developing a positive sense of self and future orientation. Treatment plans addressing mental health should be collaboratively developed with each person and may be based on their current struggles, stage in the recovery process, cultural identification, preferences, and goals. A Multimodal Social Ecological (MSE) framework is proposed to guide intervention strategies that can support trafficking survivors’ recovery and empowerment. The MSE framework incorporates complex trauma theory and uses multiple modalities to intervene at individual, social-environmental, and systemic levels.


Human trafficking Trauma Mental health Psychological Complex trauma Intervention Treatment Trauma-informed Survivors Multimodal Social ecological Framework 



The author would like to express sincere appreciation to Jeff Nicklas for his administrative assistance in the production of this chapter.


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Authors and Affiliations

  1. 1.The Trauma Center at JRIBrooklineUSA

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