Occupational Therapy within the Population of Female Survivors of Sex Trafficking With History of Substance Use Disorders.

I sought to promote client centered, meaningful occupations, and holistic care within the context of a sex trafficking and substance use rehabilitation program.

Student name: Carolee Mabe
Name of Mentor: Dr. Erin Melhorn
School: University of Tennessee, Chattanooga
Setting and location: Non-profit, community based mental health
Virtual / In-person / Hybrid: In-person

Purpose: To gain insight into what makes a rehabilitative program for this population successful to thereby compare, contrast, and offer changes to promote retention.

Method/Design/Approach: The capstone began with delivery of life skills groups for women with a history of sex trafficking and addiction to promote development of meaningful occupations, assist with mental health, and encourage vocational development. The project pivoted when all the residents left the rehabilitation program. An evidence based literature review was performed on how other programs were operating and how those programs varied. The residential handbook was adjusted, OT created crisis management documents, revised household rules to be more client-led, drafted more holistic volunteer and staff training modules, and advocated for changes in staff responsibilities and dynamics to better serve the residents.

Results/Outcomes: Changes were tested upon arrival of another resident. The resident was more efficiently managed when that resident went into crisis and was more quickly referred to another organization. Deep structural long-lasting management and staff changes needed to be implemented for optimal success in the setting.

Conclusions: Occupational therapy does have a place within rehabilitation for female survivors of occupational therapy based upon existing literature and qualitative information from the 4 participant size sample group in this capstone experience. Trends were noted where non-profit programs that had more retention rates were survivor-led, had fellow survivor mentorship, had vocational opportunities within the program, and were at least a year long in length.

Ideas for next steps to build on this topic: For a program that has had graduates there could be studies done on how OT can improve client satisfaction and promote participation in meaningful occupations. Further studies could be looking at the benefit of 1:1 OT compared with group therapy with this population. Studies on how pelvic floor OT could be implemented and assist with survivors of sex trafficking, as all participants during the capstone reported some pelvic floor dysfunction.

2-3 tips for students undertaking a similar project:

  1. Do not come in expecting to change anything. Listen first and be willing to do small, seemingly insignificant work to build rapport and trust. Listen to the women and learn from them.
  2. Have a form of self-care and be aware of your own mental health. This population can be heartbreaking and hearing about the stories of pain and trauma can take a toll on any practitioner.
  3. Be very strong in documentation skill and reporting to other the participant’s behaviors and how they have been doing with you.

Incorporating Occupational Therapy in Traditionally Taboo Areas of Wellness

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