8 The Foundations of Therapy for Victims of Human Trafficking The ability to express their subjective feelings and be heard is positive and re-affirming for people who have suffered interpersonal violence in trafficking. This is a matter of the clinician sensitively gauging the points at which to explore expression of feelings, and asking questions which confront those feelings without causing re-traumatization. Damage from interpersonal violence is profound and there are no easy routes to recovery. Trauma symptoms often endure for a long time before there is any single sign of progress. However, the continuation of therapy should be considered as progressive development in itself. In HBF’s clinical experience, victims of trafficking who engage with regular therapeutic support are far less likely to be at risk of danger from self-harm/destructive behaviour than those who are without it, and those who succumb to it know that they can always find a way back. HBF’s therapeutic work varies according to the discipline/ training of each clinician, and is adapted to the specific needs of each client. A wide range of therapies for survivors of interpersonal violence are catered by HBF therapists to meet the specific needs of victims of trafficking.111 In keeping with the scope of this study, we do not explore each therapy in detail, but encapsulate the core ethos of approach which is taken by all HBF clinicians. We focus upon elements which may assist those who come into contact with victims, and which support a wider understanding of effective routes for their sustained recovery. At the initial assessment stage or during the earliest stages of contact with HBF clinicians, some clients are identified as having acute mental health needs that require immediate referral to National Health Service (NHS) mental health services. This referral work can be problematic and time consuming, but it is essential to limit the damage of acute mental health problems as soon as possible to avoid further deterioration, vulnerability, isolation and distress. Some people may be too overwhelmed or distressed to communicate, and may therefore be unable to engage with a formal programme of therapy. These clients often benefit from the provision of therapeutic support from a trained person whom the client comes to understand as being proactively “with” them on a regular basis and who can assist them in various practical ways, helping them to meet tasks and challenges which they feel unable to cope with on their own. It can therefore be considered as an “accompanying” function which helps to build clients’ confidence by gradually establishing a relationship of trust. “In providing therapeutic support, I assist clients to improve their most immediate social problems, knowing that other HBF staff will work with them on their legal/ welfare and medical needs. For example, I may help them to negotiate with a difficult neighbour in a shared house or, in the case of a young person, to help them to explain their feelings and daily habits to a new foster carer (for example, telling them why they feel unable to eat a certain food they are being given, perhaps because it is strange to them or gives rise to unpleasant memories). I also help clients to discuss their own needs with accommodation and support providers. “Learning how to negotiate is a useful, practical skill, and a new experience for many victims of trafficking who are habituated to systems of domination and violence within human relationships. If a trusting relationship can be established through the solving of such problems, longer term programmes of therapy may then be introduced.” HBF clinician 111 99