“Managing the client’s expectations is very important. Hope and expectation are tools of manipulation and control used by traffickers; therefore any assurances given to them which are not then carried out will repeat this negative pattern. Enabling and encouraging a client to make independent choices for themselves is much more effective in the longer term. The clinician should be wary of becoming a ‘rescuer’. “Assessment is usually easiest for the client if we begin with their immediate healthcare needs. This may be the first opportunity they have had to talk to someone about their health with the use of an appropriate interpreter. However, there is no set order to follow in assessing a victim of trafficking. An experienced clinician should be led by the circumstances of each individual case and make a judgement as to what the client is capable of discussing, and is comfortable with, at various stages of the assessment. “An initial ‘open question’ such as ‘how are you feeling?’ helps to establish my interest in the client’s well being. This can lead on to some ‘closed’ questions such as whether they are registered with a General Practitioner (GP/UK primary care doctor) and if so, what treatment they have been offered. “Many of HBF’s clients have urgent healthcare needs which may prevent them from engaging effectively in the initial assessment. These can range from a stomach infection or bedbug bites to sexually transmitted infections or severe genital injury. Sleep disorders are common and may be symptomatic of PTSD. I also see victims of trafficking who have eating disorders and substance dependencies. There is a high level of self-harm in different forms (for example, cutting and/or scratching). The client may feel nervous, afraid or exhausted; so I try to put them at their ease. them to have some simple tasks to do, such as finding their GP’s address and bringing it to the next appointment. Further sessions will increase my understanding of their functional ability, and it may then be possible to ask for more tasks in accordance with what they can manage. “In subsequent meetings, when the client is more relaxed and comfortable, a fuller history can be taken and opportunities for therapeutic intervention can be identified.” HBF Clinician “I use our standard HBF Initial Assessment Form and other recognized assessment tools which assist with questions for the particular client.94 In response to the client’s comments and questions, I provide practical information about their basic healthcare, referral to a GP and/or sexual health clinic if necessary and for their legal matters, accommodation, support and education. We then agree a list of achievable tasks that need to be carried out. “When some of the client’s practical needs are satisfied, no matter how small they are, the relationship with them can become much more positive. It can also be empowering for - 92