reactivity cluster” includes a new clinical feature, “reckless or destructive behavior.” In the experience of HBF clinicians these clinical features are often observed in survivors of trafficking and torture. DSM-5 also identifies a new clinical subtype of PTSD – “PTSD with dissociative symptoms”, which highlights the co-existence of standard PTSD symptoms and dissociation. However, Complex PTSD is still understood in DSM-5 as a sub-type of PTSD rather than a free-standing mental health diagnosis.81 This means that in cases where Complex PTSD is identified, and the victim has access to treatment at all, it is likely that the standard treatments for PTSD will be given.82 In HBF’s clinical experience of working with victims of trafficking, there is a lack of awareness in the wider mental health care sector of the need for longer term, more specialised therapy which enables the prolonged building of trust with a therapist. This is essential for the effective treatment and sustained recovery of people who have suffered repeated and/or prolonged interpersonal violence. Unfortunately such treatments are generally not provided or resourced, which means that the evidence base (in terms of controlled clinical trials) for its use and effectiveness is lacking. There is a pressing need for further international research in this area which should be conducted by clinical experts including those who work with victims of trafficking. The features of Complex PTSD, together with the work of highly regarded clinicians who have written extensively about Complex Trauma, provide a useful foundation for clinicians to learn from and build upon 83. 6.3 Effective Treatment for Victims of Trafficking who Suffer Complex Trauma Complex trauma has occurred in relation to, and with, other people. Therefore rehabilitative prospects depend upon the victim being or becoming able to build and maintain healing relationships with others. Treatment for Complex Trauma aims to stabilise individuals by building a clinical relationship of trust that can provide essential support and a gradual “gateway” into other positive relationships. With time, it may also assist effective integration into society through education and work in cases where this is appropriate. If victims of trafficking who suffer Complex Trauma do not have access to this support, they will be at risk of suffering further isolation, feelings of alienation and aggravation of their trauma symptoms. They will also remain specifically vulnerable to traffickers, whose trade flourishes from the availability of broken and subjugated people. Sharing the traumatic experience with others is a precondition for the restitution of a meaningful world. Once it is publicly recognized that person has been harmed, the community must take action to assign responsibility for the harm and to repair the injury. Recognition and restitution are necessary to rebuild the survivor’s sense of order and justice. Trauma and Recovery Current opinion in psychiatry, - Post-traumatic stress disorder (PTSD), Current opinion in psychiatry, Journal of traumatic stress, - - Psychiatric Clinics of North America, Journal of traumatic stress, The body remembers: The psychophysiology of trauma and trauma treatment - 87

Select target paragraph3

Connect to a paragraph
Connect to an entity
Disable highlights
Add to table of contents