more likely to re-emerge and make contact for assistance than those who lack this support. It is also the case that positive legal outcomes for victims of trafficking, for example successfully providing witness testimony that results in the prosecution of their trafficker or being granted international protection, can have a paradoxically traumatic impact upon victims’ psychological health. People who have received positive news on their case after months or years of being engaged in legal procedures, may need increased therapeutic support: they may have been waiting for a long time in a state of hyper-vigilance and fear, and when they finally receive a positive outcome they can “fall apart”. There are also simultaneous practical issues that have to be dealt with which clients may find overwhelming. Emotional issues also need to be addressed as some victims of trafficking may feel overwhelmed and have difficulty processing all of the information given to them, or understanding what it means for themselves and their families. Some continue to fear reprisals by traffickers because they have, or may be perceived to have provided information about them to the authorities. For others, the continued threat from traffickers or the power of traffickers’ exploitation of belief systems (ie the threat of Juju) will continue regardless of an individual’s legal status. The temporary nature of international protection can also become a new pre-occupation for victims who fear what will happen to them when it ends. Victims of trafficking may continue to be vulnerable and in need of therapeutic support long after their legal protection status has been resolved. Our clinicians work with clients who were provided with international protection in the UK years ago, but still suffer the long-term effects of trauma. Some continue to fear for the safety of themselves and their families because of the continuation of trafficking networks and individual traffickers who still pose a threat. are helped to prepare for this in the knowledge that the offer of further assistance or support is available should they need it at any time in the future. Whether former clients take up this offer at any time is entirely their choice; but the knowledge of it travels with them and can be sustaining in itself. At HBF we respond to any signs of recovery swiftly and positively, working with the client to build and maintain it. However, in decades of work with survivors, we have found that it is not possible to assume that a person has ‘fully recovered’ or will not suffer setbacks once recovery progress has been made. The recovery of people who have suffered inter-personal violence, and particularly those who are at risk of trafficking/exploitation, needs to be sustained on a continuing basis in order to be considered to be stable and enduring by our clinicians. This means that clients who have moved on from HBF’s services are always aware that further therapeutic support is available to them if it is needed: They may at some point choose to return to having regular therapy sessions/ counselling, receive occasional phone or visit support, consult our internal GP or attend classes or activities. Over decades of working with survivors of inter-personal violence including victims of trafficking, we have learned that it is a far more effective use of resources to sustain recovery in a flexible way that is responsive to changing individual need. If treatment is restricted to a limited time period there is a risk that we may have to confront a situation some years later in which a person’s mental health has deteriorated, for example because of a situational de-stabilisation, resulting in worsening complex trauma or depression, and even, in some cases, psychosis or a serious suicide attempt. 10.4 The Meaning of “Sustained Recovery” All clients in the care of HBF are encouraged and assisted to gradually increase their own autonomy and agency from the moment that work with them begins, not only through sessions of formal therapy (in cases where that applies) but also in the course of working with them to meet each practical problem for which they require assistance. In HBF’s clinical experience, once they have the necessary tools and support to do so, clients want to move forward by themselves and establish their own lives, families and communities. Underestimating the potential risks to victims of trafficking who appear to be coping very well at particular stage of their recovery can leave them vulnerable to de-stabilisation as well as further harm, re-trafficking and exploitation. Collective statement of clinicians and staff at the Helen Bamber Foundation The majority of HBF’s clients initiate their own departure from therapy when they are ready to move forward. They 113