Thematic Note1
July 2026
Mental health as a core component of comprehensive care for children and adolescents who are victims of trafficking for sexual exploitation
Human trafficking spans the globe and the region, devastating the lives of millions of people worldwide, and hundreds of thousands in Latin America and the Caribbean. Trafficking is not merely collateral damage of global and globalized capitalism; it is an expression of its most violent nature a historic, massive, and systematic violation of human rights (Purtscher, 2019)
Introduction
Human trafficking constitutes a grave violation of human rights and one of the most extreme forms of violence and exploitation. This phenomenon has historical roots linked to practices of forced prostitution and slavery. Toward the end of the 19th century and the beginning of the 20th century, it began to be recognized as a specific social problem that primarily affected women. In this context, the International Convention for the Suppression of the White Slave Traffic was adopted in 1904. This instrument focused on the cross-border transport of women for the purpose of sexual exploitation. Subsequently, in 1921, international regulatory frameworks abandoned the racial references present in early conceptualizations and explicitly incorporated concerns regarding the sexual exploitation of children and adolescents, thereby broadening the understanding of the phenomenon and the affected populations (Purtscher, 2019).
The Protocol to Prevent, Suppress, and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime, defines trafficking in persons as the recruitment, transportation, transfer, harboring, or receipt of persons by means of threat, use of force, coercion, fraud, deception, abuse of power, or exploitation of a situation of vulnerability, for the purpose of exploitation. Furthermore, in the case of children and adolescents, the recruitment, transportation, transfer, harboring, or receipt for the purpose of exploitation shall be considered “trafficking in persons” even when none of the aforementioned means are used (United Nations, 2000).
When trafficking is for the purpose of sexual exploitation of children and adolescents (SEC), multiple human rights violations converge, profoundly impacting the physical,
1 Note prepared by Victoria Lucas, Technical Assistant for the Inter-American Cooperation Program for the Prevention and Eradication of Sexual Exploitation, Trafficking, and Smuggling of Children and Adolescents at the IIN-OAS.
emotional, social, and cognitive development of the victims. The experience of exploitation typically unfolds in contexts characterized by control, manipulation, violence, threats, and the severing of protective bonds, creating highly traumatic situations.
The Convention on the Rights of the Child (1989) establishes in Article 39 that States must promote the physical and psychological recovery and social reintegration of every child who is a victim of exploitation, abuse, or any other form of violence. From this perspective, mental health care is not merely a clinical response but a right of children and adolescents.
Impact of trafficking and sexual exploitation on mental health
Mental health is one of the most severely affected aspects for people who have experienced trafficking. In contexts of exploitation, traffickers employ systematic strategies of coercion such as intimidation, threats, violence, and emotional manipulation with the aim of consolidating relationships of domination and subjugation. These dynamics progressively erode the victim’s autonomy and capacity for self-determination (Altun et al., 2017).
Prolonged exposure to traumatic experiences generates deep feelings of helplessness, hopelessness, and vulnerability, seriously affecting the capacity for psychological coping (Kilpatrick et al., 1989). In this scenario, some victims may form traumatic bonds with their exploiters, marked by a contradictory dynamic in which situations of violence and control are combined with attitudes that may be perceived as protective or seemingly kind. This combination reinforces emotional dependence and makes it difficult to recognize the abuse, thereby cementing relationships of forced loyalty (Dutton & Painter, 1993).
Psychological deterioration often coexists with significant physical deterioration, associated with food deprivation, grueling workdays of exploitation, lack of rest, and precarious hygiene and sanitary conditions. These conditions are further exacerbated by recurrent exposure to physical and sexual violence, resulting in a comprehensive impact on the victim’s health (Echeburúa, De Corral, & Amor, 2004).
Once victims manage to escape the situation of trafficking and return to their place of origin or find themselves in a shelter, the various symptoms and pathologies indicators of their precarious mental health become evident to those who care for them. All of these symptoms will have a very significant impact on the processes of readaptation and rebuilding their lives, both in the immediate present and for their future (Nicolás ChahínPinzón et al., 2017, p. 123).
Research from various countries shows that depression, anxiety, post-traumatic stress disorder, self-harm, and suicide attempts are common among survivors of trafficking (Altun et al., 2017).
The psychological consequences of trafficking are often particularly severe and complex, even compared to other forms of interpersonal violence. For children and adolescents, these consequences can critically affect their psycho-emotional development, identity formation, and future ability to form secure attachments.
The clinical complexity associated with trafficking requires specialized, comprehensive, and sustained interventions over time, using trauma-sensitive approaches centered on the restoration of rights.
Mental health care
Psychological care for victims of trafficking must be provided using a comprehensive approach, taking into account the impact of this experience on multiple dimensions of well-being, including physical, cognitive, emotional, social, and spiritual well-being (Monesterolo & Carro, 2013). The victim’s sociocultural context, life circumstances, age, and language must be taken into consideration.
Almanza et al. (2020) conducted a study of clinical psychologists who treat victims of organized crime and found that they begin the psychotherapeutic process with techniques designed to facilitate the victim’s engagement with treatment, promoting the therapeutic alliance, rapport, empathy, and communication with the victim.
Furthermore, Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is currently the approach that has shown the strongest evidence of effectiveness for people who have experienced traumatic events (Almanza et al., 2020)
According to Mantilla (2020), for an appropriate psychotherapeutic approach, several aspects must be taken into consideration, such as:
● creating a warm and respectful environment;
● taking into account the victim’s high vulnerability, as well as their age, gender, nationality, and ethnic background;
● respecting the victim’s silence, recognizing that it may be a coping strategy while the person gathers the emotional resources needed to verbalize highly painful experiences;
● not insisting on questions that the victim finds difficult to answer;
● adopting a flexible and respectful attitude toward the victim’s boundaries during the interview; if the person decides not to answer a specific question, their decision must be respected without pressure, prioritizing their emotional wellbeing and avoiding revictimization;
● the information the therapist provides to the victim should take into account the context in which the victim lives and be grounded in their fundamental rights.
During the interaction, it is essential to maintain anunbiased attitude, without expressing surprise, judgment, reproach, or rejection in response to the victim’s account. Furthermore, it must be kept in mind at all times that the person is a victim, regardless of their attitude, behavior, or manner of expression. Likewise, it is inappropriate to assume investigative or interrogative roles when that is not the assigned role, since persistently attempting to obtain information can generate fear and mistrust and may lead the victim to abandon the care process.
If the treatment received from mental health professionals becomes hostile toward the victim and the victim ends up suffering more from that treatment than from the crime itself, they are at risk of revictimization due to a misguided process.
Regarding revictimization, Monesterolo and Carro (2013) state that it is essential to establish aninitialbondof trust with theindividual, while avoiding assuminga therapeutic role if one lacks specialized training for that purpose.
Although there is no single standard approach to this type of issue rather, there are various paths depending on the therapeutic model adopted by psychologists in any case, treatment is concluded when the victim has achieved mental stability and relapse prevention measures are in place.
Recommendations regarding mental health care
Mental health care for children and adolescents who are victims of trafficking for sexual exploitation must be grounded in a specialized, comprehensive, and trauma-informed approach. It is essential that interventions prioritize emotional stabilization and the development of a therapeutic relationship based on trust, safety, and respect.
It is recommended that professionals create safe spaces for listening, where the victim can express themselves without pressure or demands to recount traumatic experiences before they are ready. Respecting the victim’s own timeline is central to preventing revictimization and promoting adherence to treatment.
It is important that the approach include a comprehensive assessment of mental and physical health, identifying indicators of anxiety, depression, post-traumatic stress, dissociation, self-harm, suicidal ideation, and relationship difficulties, recognizing that these manifestations are often associated with experiences of prolonged violence and subjugation.
Likewise, it is recommended to implement evidence-based therapeutic interventions, particularly those focused on trauma, that enable work on emotional regulation,
reframing traumatic experiences, and the recovery of personal resources. These interventions must be flexible and adapted to the developmental stage, sociocultural context, and level of understanding of each child or adolescent.
Another key aspect is strengthening self-esteem and rebuilding identity, since exploitation often has a profound impact on self-perception, leading to feelings of guilt, shame, and worthlessness. The therapeutic process should be aimed at promoting the recovery of autonomy, decision-making capacity, and the exercise of rights
It is also recommended to include significant support networks in the care process, provided that these networks consist of protective figures. Working with support networks can help consolidate protective factors, improve emotional support, and facilitate social reintegration.
Finally, it is essential that mental health teams work in coordination with other protection, education, and justicesystems,recognizing that psychologicalrecovery is part of a broader process of restoring rights. Coordinated and specialized care significantly increases the chances of emotional healing and of building a life free from violence for children and adolescents.
Reviewing and incorporating these recommendations into national policies, programs, and protocols presents an opportunity for protection systems to strengthen their responses.
Bibliography
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