There are more than three million trafficked women, many of who are children. This population has been largely forgotten because the victims are geographically transitory and exist within an illegal framework. Research, often conducted using invalid techniques, suggests that most survivors of sex trafficking (i.e. those evaluated in shelters), have mental illness. The majority of survivors have depression, anxiety, posttraumatic stress disorder or a more severe diagnosis: Disorders of Extreme Stress (DESNOS). In addition to these diagnoses, many victims of sex trafficking also have secondary psychological issues such as alcohol and drug abuse plus concurrent medical illnesses, which add to the psychological burden that sex trafficked victims endure. Mental health interventions often focus on identifying potential victims in healthcare centers and public places such as shopping malls or at truck stops. The problem, however, is that once a sex trafficked person is rescued there are no prospective clinical trials to guide therapy; oftentimes by default, trauma-based cognitive behavioral therapy is used; such approaches may not be effective for those with DESNOS. Considering the number of women and children who have been victimized by sex trafficking, it is astonishing that so little is known about the natural history of mental health issues and almost nothing is known about how best to treat these victims.
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