Monday, May 20, 2013

Identifying and Responding to Sex-Trafficking Victims in Social Service Settings: Interview with Rebecca J. Macy, Ph.D.

[Episode 81] In today's social work podcast I spoke with Rebecca J. Macy, Ph.D., ACSW, LCSW. Rebecca is the L. Richardson Preyer Distinguished Chair for Strengthening Families and the Associate Dean for Academic Affairs at the UNC at Chapel Hill School of Social Work.

I started our conversation asking Rebecca how she became interested in identification of sex trafficking victims in human service delivery. Most of our conversation focused on how to identify and respond to victims of sex trafficking. We talked about the interdisciplinary nature of sex trafficking; how it involves representatives from law, medicine, social services, and how social workers can and should take the lead in coordinating efforts to help victims. And, as is the custom, we ended our conversation with resources for social workers, the Polaris project in particular. Rebecca was kind enough to send me a list of references and resources that I have posted to the website.

Since 2004 there has been a 150% increase in the number of searches for the term "sex trafficking." During the same period, there has been no appreciable change in the number of searches for the terms "modern day slavery" or "labor trafficking."

Download MP3 [45:49]



Rebecca J. Macy, PhD, ACSW, LCSW is the L. Richardson Preyer Distinguished Chair for Strengthening Families and the Associate Dean for Academic Affairs at the UNC at Chapel Hill School of Social Work. She has taught courses in social work practice, family violence, mental health, and statistics. Rebecca joined the faculty in 2002, after receiving her doctoral degree in social welfare from the University of Washington in Seattle. In 1993, she received her MSW from Tulane University in New Orleans. She has practice experience in community mental health where she worked with violence survivors. Her research is concerned with multiple forms of violent victimization, including child maltreatment, partner violence, sexual violence and human trafficking. Her research activities focus on the health consequences of victimization, repeated victimizations across the life span, and the development of community-based preventions and interventions to promote violence survivors’ resilience and well-being.



Jonathan Singer: In April 2012, Rebecca J. Macy and Laura Graham published an article in the journal Trauma, Violence and Abuse entitled "Identifying Domestic and International Sex-Trafficking Victims During Human Service Provision." It quickly became one of the journal's most read articles. I can't tell you why, but I suspect it is because the article promised two things: 1) Practical tips – and social workers are always in the market for practical tips, especially when they show up in peer-reviewed journal articles because, let's be honest, peer-reviewed articles are not known for being particularly practical. And 2) A wake up call. Not a wake up call to the fact that social workers are addressing the issue of sex trafficking – I know that's happening. But rather that social workers might be working with sex trafficking victims and not know it.

Yes, your client might be a sex-trafficking victim. I don't know that for sure, but it's up to you to figure out. How do you do that? I'm so glad you asked. We'll get to that in about a minute.

I learned about the article because Rebecca tweeted
My first thought was, Nicely done, Rebecca - now that's a good use of Twitter. My second thought was, even as the 2nd most read article in the journal, it is still not reaching a lot of people, and certainly not the front line social workers who are most in need of this information. I should see if Rebecca is interested in doing a podcast. Luckily she was.

In today's social work podcast I spoke with Rebecca J. Macy, She's L. Richardson Preyer Distinguished Chair for Strengthening Families and the Associate Dean for Academic Affairs at the UNC at Chapel Hill School of Social Work. Her research is concerned with multiple forms of violent victimization, including child maltreatment, partner violence, sexual violence and human trafficking. Her research activities focus on the health consequences of victimization, repeated victimizations across the life span, and the development of community-based preventions and interventions to promote violence survivors' resilience and well-being.

I started our conversation asking Rebecca how she became interested in identification of sex trafficking victims in human service delivery. Most of our conversation focused on how to identify and respond to victims of sex trafficking. We talked about the interdisciplinary nature of sex trafficking; how it involves representatives from law, medicine, social services, and how social workers can and should take the lead in coordinating efforts to help victims. And, as is the custom, we ended our conversation with resources for social workers, the Polaris project in particular. Rebecca was kind enough to send me a list of references and resources that I have posted to the website.
Throughout our conversation Rebecca uses the words "force, fraud, or coercion" when talking about sex trafficking. These three words are at the center of the U.S. Department of State's definition of sex trafficking:  "in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age." Did you get that last part. Commercial sex work for youth under 18 is considered sex trafficking. So, all you social workers that have clients under the age of 18 who engage in sex work – they are sex trafficking victims according to the U.S. Department of State.

I know a lot of you are familiar with the ideas "modern day slavery," human trafficking," "labor trafficking" and "sex trafficking." In fact, when I looked at Google Trends, I saw that there has been a 150% increase in the number of searches for the term "sex trafficking" since 2004. During the same period, there was no appreciable change in the number of searches for the terms "modern day slavery" or "labor trafficking." Clearly this is a hot topic. I think you're going to find the practical tips that Rebecca gives to be invaluable in your work in a human service setting.

To read a transcript of my conversation with Rebecca, please go to the Social Work Podcast website at You can connect with other social workers at the Social Work Podcast Facebook,, or follow the Twitter feed @socworkpodcast. You can follow Rebecca Macy on twitter @rebeccajmacy. You can listen to the Social Work Podcast from the website, by downloading the episodes through iTunes or BeyondPod. You're listening to the podcast right now, so I'm probably preaching to the choir, but you can also stream the 10 most recent episodes right from your smart phone using the Stitcher Radio mobile app.

And now, without further ado, on to episode 81 of the Social Work Podcast. Identifying and Responding to Sex-Trafficking Victims in Social Service Settings: Interview with Rebecca J. Macy, Ph.D.


Jonathan Singer:  Rebecca thanks so much for being here and talking with us on the Social Work Podcast about sex trafficking. My first question for you is how did you get involved in this subject?

Rebecca J. Macy:  That’s a great question and thanks for having me.  I really appreciate the opportunity to talk about this really important problem that I think is facing a lot of social workers even though we may not realize it.  I got interested in gender-based violence work and by that I mean things like domestic violence, sexual assault and eventually sex trafficking partly because of my social work career.

I started off my social work career as a clinical social worker in a community health agency and I worked with so many clients but especially women who are survivors of some type of violent victimization so a lot of times it was domestic violence or sexual assault.  And I took those interests with me when I went back to get my Ph.D. and then into my research and then all of my work has really been around working with community-based domestic violence and sexual assault service providers and agencies to see how we can develop evidence-based practices to really help survivors of violence.

And so I'm at the University of North Carolina at Chapel Hill and I work exclusively with North Carolina agencies all over our state from the east to the west and up to Virginia and then down towards South Carolina and I was finding from that work, I was talking with providers, directors of those non-profit agencies and they're saying to me, you know, Rebecca we're getting referrals to work with trafficking victims and we're just not sure how to be helpful, what to do.  We kind of feel like we're in over our heads, we're just struggling with this issue.

Jonathan Singer:  So like domestic violence shelters, rape crisis centers, they were saying we have trafficking victims?

Rebecca J. Macy:  Exactly right.  Nobody has really figured out a way to measure this.  What's the incidence?  What's the prevalence?  How big of a problem is it?  It's a very hidden problem from law enforcement, from researchers, from health and human service providers, so that’s a big challenge I think for all of us who are interested in this issue.

So, we don’t know the scope of the problem.  What we're hearing anecdotally in North Carolina is that it's a growing issue because of maybe the fact that we're kind of this central mid-Atlantic state with all these inner states coming through.  We have a lot of military bases and there might be brothels or sex work industry around those military bases. Some of the human trafficking patterns are following drug trafficking patterns and that also our I-95 corridor in North Carolina is a big emphasis there.

And then also labor trafficking is a big problem in North Carolina because of things – our agricultural industry and so labor trafficking is part and parcel sometimes of that agricultural work and there's overlap between sex trafficking and labor trafficking, so for all those reasons people are surmising that that’s why it's a growing problem in North Carolina.

Jonathan Singer:  What's the overlap between labor trafficking and sex trafficking?

Rebecca J. Macy:  That’s a great question.  So things like domestic households, so someone may bring someone in from another country to work in their house primarily as labor trafficking but maybe that there it becomes – sexual abuse becomes part of that.  Likewise, sometimes folks who are brought in to do labor trafficking might be victimized sexually or that might be part of the work, you know, maybe they're asked to work in an animal processing plant but then also because they're in such a vulnerable state or status as someone who’s been labor trafficked, also sexual violence or other types of violence become part of that, too.

So, again, we don’t have a lot of good evidence about this so I can't say okay percentage-wise, how much of these things overlap, but these are sort of what we're hearing stories from the field so to speak.

Jonathan Singer:  And so you have this experience of getting asked what do we do and so what did you do?

Rebecca J. Macy:  So, as a good researcher, I went to the literature and I said okay, why reinvent the wheel if other people have figured out how to do this and have documented it and so I went to the literature and I said okay, who’s been writing about this topic and I looked at the peer review literature and you can see from the article I wrote on aftercare services for sex trafficking survivors which I think was published in 2011, there really wasn’t a lot in the peer review literature and there's still really not.

So what we found, the student and I who worked on this project, found a lot more in what we call maybe academics who called the great literature so things like that were posted on websites, governmental reports and sometimes they were just manuals that organizations had developed.

So, the student and I, Natalie Johns, she and I contacted all any human justice or social justice type of organization that we could track down any names or contact information, all the sexual assault coalitions in the United States and said hey, have you been working on this issue, do you have a set of – do you have a manual, a set of best practices, any sort of document that we could use and then we just did a lot of Google searches to just find things and then we used those articles we systematically analyzed as in said okay what across all these different articles, we found about 20, what do people recommend in terms of providing services for this underserved population particularly when they come?

There is a global problem if they're international sex trafficking victims.  So, we identified the victim.  What sort of services should we provide this person to ensure recovery and safety and to prevent them from being re-trafficked?  So, we did that article and then that led me to thinking, you know, how do we identify these people in the first place?

What I'm hearing in the field is the point of first contact is often, you know, the law enforcement maybe goes in a bust of a brothel and then they realized they have trafficking victims there and then they're at a loss, the law enforcement officers are at a loss where does a person go, maybe we want them to testify or be part of the prosecution–

Jonathan Singer:  Because people who are victims of trafficking fall under different laws and regulations and rules than people who are busted for say prostitution as sort of a voluntary endeavor.

Rebecca J. Macy:  Absolutely, although not every state in the United States acknowledges the difference and I think those are important policy things that we ought to be thinking about that, you know, certainly some people are doing sex work voluntarily, but certainly also some people are doing it because they're victims of trafficking.

So the working definition of trafficking is any sex act that produces money that’s done under coercion and some type of inducement or abuse or even just kind of misleading someone that meets the definition of sex trafficking for anyone that’s 18 years or older.  For someone who’s younger than 18, the fact that someone is involved with sex work means they are trafficking victims and those are things I don’t think we often – I don’t think about as a social worker that gosh, it's not – this is not a kid doing sex work to survive, this is human trafficking so–

Jonathan Singer:  So all those kids that we think about that are like 15, 16 runaways that are involved in what we used to say prostitution now maybe better to be thinking about in terms of sex trafficking.

Rebecca J. Macy:  Absolutely and it helps us think about them in different ways in terms of getting their needs met and in terms of the way law enforcement should interact with them and for us to see these kids or these, you know, adults who maybe are doing this work because of force, fraud or coercion as people that need services and support and don’t need just criminal justice interventions but also need comprehensive housing and safety planning and trauma and for mental health and physical health services.

So, those are things we're just not offering widespread.  Now I think there's places, outstanding places that do do that and bigger cities in the United States, L.A., New York.  I think there are services in Atlanta like that in Chicago.  We're growing some of those services in North Carolina, but you know we're also challenged by the fact that it's a world state and how do you provide these services, so–

Jonathan Singer:  So these are some of the aftercare like one, somebody has been identified–

Rebecca J. Macy:  Exactly.

Jonathan Singer:  These are the sort of things you need to do.  So in 2012 you wrote this great article–

Rebecca J. Macy:  Thanks.

Jonathan Singer:  – about how to identify victims of sex trafficking and you identified a whole host of social service agencies that – it was basically like a laundry list of everywhere social workers work–

Rebecca J. Macy:  Good point.

Jonathan Singer:  – and so one of my questions was wow, so if social workers are working in all these places and these are all places where victims of sex trafficking are showing up for services, how come we don’t know how to identify them?  How come this isn't something that has ever really been discussed?

Rebecca J. Macy:  You know and that’s exactly the question I had.  So I did the aftercare services research and then it started to occur to me, it's sort of silly because it probably should occur to me first but okay, if it's not – it's not just law enforcement seeing these people, social workers, we're seeing them, maybe it's child welfare, you know, same as CPS worker and what I think is a horrific sexual abuse case is actually trafficking.

Likewise, you know, domestic violence folks, homeless outreach youth folks are probably seeing these victims and we're not identifying these victims and getting them services before they become involved with the criminal justice system.  Is there a way that we could begin to notice some of the identifiers as social workers and intervene in a different way to at least educate folks, these potential victims about that maybe their life doesn’t have to be this way.

I think, you know, it's not like a victim of sex trafficking is going to come in to say I'm a healthcare social worker and I'm seeing this person with a terrible sexually transmitted infections, maybe indicators of physical abuse probably, you know, in my role as a social worker I might have thought of that person as maybe a victim of intimate partner violence or sexual assault, but maybe I ought to be asking questions too about trafficking.

I mean I can even think in my own community, mental health work, I work with people who might describe themselves as prostitutes and exotic dancers.  I never thought of them as maybe having had to do that work because of coercion or fraud or some type of abuse and so, you know, I even think for myself I might have worked with those people very differently had I thought of the problem differently and they're presenting problem differently.

Jonathan Singer:  So let's say you're working with a teenager and you're like oh, this teen has been sexually abused, at what point do you say oh wait no, this is trafficking?  Like what's that dividing line?

Rebecca J. Macy:  So, is there commerce?  Is someone making money off of the sex act?  So that would be for the teen and then, you know, and then also whether for an older person whether there was fraud or coercion or something that or abuse that might have been part of that.  So, I think that’s a tougher issue and there's a lot of debates probably in the literature and among also advocates for sex workers and people in prostitution you know because some of those people are doing that voluntarily and you know I think we need to respect that, too.

Nonetheless, you know, is someone there because of fraud or coercion and even if they initially voluntarily got into doing sex work, but now they're under someone’s control and they don’t feel like they can leave the situation voluntarily, again, that person would meet the definition of a trafficking victim.  So some of this gets very complex and you know and I think we need to do probably more talking with victims and survivors and people who are in these situations to see how would they describe their life and their situation themselves, you know, rather than me making a judgment about that.

But I think at the same time we want to be careful to be able to educate people especially people who may have been brought here from other countries who may not know or understand there's help available.  They do have rights.  They don’t have to live this way.  I think we as social workers can begin to play a role to at least plant seeds for folks that there are possible options and ways that they can get help and that’s maybe something we're not trained to do right now.

It's not something that, you know, I teach a lot of the trauma and violence classes at UNC, I haven’t been addressing this type issue in my own teaching, so I imagine it's not happening universally so I think we need to begin to think about this as an issue that we train social workers on.  You know it may – right now the estimates, kind of the conservative estimates for trafficking both labor and sex trafficking at least for international victims, people who are brought into this country conservatively, you know, I think our State Department says maybe it's probably about 15,000 a year, so it's not a lot.

Now, those estimates have been critiqued.  It may be much bigger than that.  We're just not able to capture that data, but even still, you know, even if we can identify one person and get that person help or at least offer them some services whether they availed themselves of those things or not, I think that we can potentially make a difference in the human being’s life and I think that’s worthwhile to attend to and as a part of – at the goal in professional social work practice.

Jonathan Singer:  So Rebecca what are the indicators for a sex trafficking victim that social workers, service providers should be on the lookout for?

Rebecca J. Macy:  So, is the person that you're working with are there signs of this person being controlled?  Are they under the influence of another person maybe that’s accompanying them or hovering around or won't let them be a part of a – you know, doesn’t want them to be interviewed by themselves?  Is this person – does this person not have freedom or feels like they don’t have freedom to exit their job or leave the housing situation, that they feel like there’ll be terrible consequences if they did leave a job?

Signs of physical abuse, so bruises, injuries, scars, fearful, depressed person and if this person might be an international victim of trafficking if they're not a native English speaker and likewise if they don’t have their documents with them or they don’t have access to their documents so they don’t have things like passports.  Maybe they signed a contract that they feel like they have to carry out and this could be for an international victim or a domestic victim and that there is terrible consequences to that, that they can't leave their job, that there's security at their job or there's security at their house.

They can't take breaks for their job, that they are concerned about their health and well-being if they leave the work that they're at.  Also for children, you know, the literature suggest things like, you know, and this seems sort of weird to me but does a child have a lot of hotel keys?  Are they carrying around hotel keys?  Do they seem to know language about sexual activities and sexual acts that’s not maybe typical of that child’s developmental age and stage and does the child have maybe an older guardian or a boyfriend or a girlfriend or uncle, aunt or some sort of odd caretaking relationship that doesn’t seem to add up.

So, it may not be one of those things.  There may be multiple things together or two of those or three of those things that may say to someone who’s a social worker I had to ask this person more questions about what's going on in their life.

Jonathan Singer:  So let's say somebody is in your office or you're out in the field like can you give me an example of how this might look in real life.

Rebecca J. Macy:  Yeah, that’s a great question.  I think one thing that springs to mind is like a healthcare social worker who might be asked okay, so a physician says okay I see, you know, Ms. Jones.  She’s got a lot of weird bruises.  I think she might be a victim of domestic violence.  You're the social worker and interview her to see what's going on and you know not only does she have these bruises, but she’s got maybe sexually transmitted infections.

She also may be, you know, maybe she’s not a native English speaker.  She can't talk about where her passport is.  You're asking her about that.  Maybe it's really difficult to extricate her from her boyfriend to do the interview privately.  And I should say too and maybe we can talk about strategies, but you should always talk to a suspected victim in private, so social workers should never ask questions in front of somebody else because that person even though initially it may seem like the client or the person you're working with really trust that person, that may not be the case and you may actually be putting this person in danger by asking these questions.

So really I can't underscore enough about the importance of privacy in doing these interviews but – so you know it's hard to get this, you know, maybe this Ms. Jones away from this person who brought her to the appointment to get her treated for the sexually transmitted infections.  So those things would be the chance then to ask that.  You know like is if you're a school social worker and you work in – you know, you're seeing this child who maybe shows up halfway through the year, has maybe the relationship with a guardian is unclear.

We can't get documentation from the guardian about their relationship.  You know maybe the child is coming and going at odd hours.  I mean those things might be indicators as well or especially if the child seems fearful.  You know, again, these things are maybe hard to discern initially.  It may seem like okay, is this abuse, kind of more straightforward family abuse not that that’s ever straightforward, but family abuse or is it more – is it trafficking.

I mean I think it may be sometimes it's subtle indicators to that aren't going to necessarily leap out at a social worker, but at least to kind of keep that in your mind as a social worker that that’s a possibility.

Jonathan Singer:  And I could see, you know, with the school example that you gave, if you live in certain parts of the country where there are migrant workers, right it could very well be that people show up in the middle of the year.  It could very well be that they have to leave at odd hours, that there might be questions about papers, that there might be, you know, parents who are distrustful of school officials, fearful of being deported and so it seems like it would be really important even if there are these indicators that you're able to sort of sensitively figure out what's going on, what might be legitimate migrant farm work, right as opposed to sex trafficking.

So are there strategies that you can use?  I mean you mentioned, you know, having somebody alone, are there other strategies that social workers should use to be able to tease this apart?

Rebecca J. Macy:  Great question.  So interviewing folks when they're alone, I think even thinking about your office or your building that you work in, like maybe you want to have a poster up about human trafficking that indicates to someone oh, maybe this is someone I can get help from or this is a place that understands my situation.  You know some of the strategies we use to help domestic violence victims to get information, you know, only having pamphlets and posters in women’s bathrooms or in bathrooms and stalls where someone can, you know, secretively pull down this information or a number that they could call later.

I think those type of strategies – I mean, you know, signaling too that this is a place where I could potentially get help or that, you know, I – this is a person I can trust I think is a good place to start.  I think too social workers need to have some training on this issue.  You know there’s more and more continuing education opportunities.

Polaris project, they have a lot of great information on their website.  They also run the trafficking hotline.  I'll give that number in a little bit here or maybe before we wind down.  I think there's growing interest like in North Carolina we have a coalition against human trafficking and they do a lot of education around this topic.  So, I think social workers to be prepared so that you feel confident to ask the questions, to explore things and then to do follow-ups so that those are kind of laying the groundwork I'd say.

So beyond that, you know, talking with the victim or potential victim by themselves in private, whenever possible and as much as possible, you know, conducting interviews with linguistic in cultural confidence, you know, so and then ensuring if you're going to have a translator in the room, if you're going to have someone helping you that that’s a trained person who’s sensitive to asking questions of clients and is not someone that’s involved with the trafficking.

Sometimes communities can be – you know, immigrant communities can be quite close knit and if you know your translator is related to one of the traffickers that could be a real problem for that victim.  You're not going to get answers.  So ideally and this is, you know, I know this is kind of maybe the Cadillac model of interviewing, but ideally you would have a translator who’s also trained in human trafficking and you feel you know that person well that they're not going to be putting victims at risk, too.

Jonathan Singer:  That would be kind of amazing.

Rebecca J. Macy:  Yeah, I know.

Jonathan Singer:  I mean, first of all, to have you know people who are interpreters and then to have one who’s trained in sex trafficking, that – yes, Cadillac.

Rebecca J. Macy:  That’s it.

Jonathan Singer:  Good word.

Rebecca J. Macy:  So, you know, so it's not the Honda Civic which I drive a Honda Civic model of interviewing, so I recognize that.  I want to throw Cadillac versions out there because I think that’s where the field ought to go.  We ought to be moving in that direction, so I just really want to acknowledge.  I mean as someone who’s done social work practice on a shoestring budget, I know the realities of working on the field then you do the best you can.

But as you can, you know, as we're beginning to build infrastructure and capacity in this area, those are things that we ought to be thinking about and shooting for potentially.  So other things, you know, the literature says maybe not ask questions trafficking directly.  You know as social workers a lot of times we get trained to say okay, let me ask this question directly so people understand what I'm asking, but they say more ask indirect questions and maybe more situational questions particularly around employment.

Things like, you know, do you have the power – can you leave your job if you want?  Well, what do you think would happen if you left your job?  Can you take breaks when you want?  Can you go to the bathroom when you want?  Do people let you sleep?  Can you, you know, or your house, tell me about where you live.  Do you have a bed?  Just kind of basic daily life questions to indicate whether or not this person has freedom to make decisions over their own life or not.

Jonathan Singer:  Yeah, it's really like paint me a picture of your life because if you said are you a victim of sex trafficking?

Rebecca J. Macy:  I mean who’s going to say yes, probably not very many people, you know, that’s – and they may not self identify that way either.

Jonathan Singer:  Right.

Rebecca J. Macy:  You know, they may feel like well, I got into this situation because you know, I ran away from home or I came, you know, I came across the border somehow and I didn’t go through immigration.  I signed these contracts and then someone else has my passport or my driver’s license or–

Jonathan Singer:  Or my parents got money–

Rebecca J. Macy:  Exactly.

Jonathan Singer:  – for me to come and work and I'm doing work I don’t like to do, but this is what I do for my family and…

Rebecca J. Macy:  And some traffickers even allow victims to send back a little money to their family, so if the victim says oh well, I know this is making the difference between whether my family eats or not or if my family is threatened, if I'm the victim and my – and the traffickers are threatening me with things like deportation or my family or if I got younger siblings at home I'm trying to protect, whether I'm an international or domestic victim.

I mean all of those things can come into play and whether those are accurate or not, you know, maybe the trafficker doesn’t have that much power but if I believe that as a victim, I'm not going to probably trust a social worker with that information.  As a social worker, you can ask me questions I am the hypothetical victim about my working situations, my living situations.

You can begin to say okay, this young woman doesn’t have control over her life to make decisions so maybe this is trafficking situation.

Jonathan Singer:  So if I'm talking with somebody and they say well, you know, I don’t have my own bed and you know, it's really – you know, they lock the doors at night.  I don’t know where my papers are, I mean you know, and after listening to this interview, this is possibly a victim of sex trafficking.  What do I do?

Rebecca J. Macy:  Great question.  And so one of the key recommendations from the literature is to call the National Human Trafficking Resource Center hotline which is run by the Polaris Project, so that number is 1-888-3737-888 so, again, that’s 1-888-3737-888 and Polaris Project which is based in Washington D.C. does a lot of great work with human trafficking, labor/sex trafficking, so that’s a great resource for social workers or if you're just beginning to get up on this issue, I suggest checking out their website.  So, Polaris P-O-L-A-R-I-S, just Google that and you can find it, but–

Jonathan Singer:  Do you know what they do when you call the number?

Rebecca J. Macy:  Absolutely.  So you call and they can give you information about trafficking services in your area.  So, is there a shelter particularly ideally, maybe a shelter devoted to trafficking victims and we can talk about a little bit more why that’s preferable but our services both for domestic trafficking victims or international trafficking victims.

So in North Carolina I know we're having a growing number.  We created these regional rapid response teams so that when a trafficking victim comes to light we have a group of professionals in an area whether that’s Charlotte or the triangle area where I live or out east or out west in actual area so that, you know, you can call that group and then they’ll put together a group of professionals to help address the needs of a trafficking victim.

So, it varies from state to state, you know, so – and in fact, if you're in a social work center where you think you might see a trafficking victim, you might want to call Polaris ahead of time and say what are the services in my area and what things should I know about and what might be available wherever I'm at and then you are – begin to know what's there and maybe, you know, take that director or that advocate or case manager from that agency out for coffee or lunch just to see what the services they can provide.

Jonathan Singer:  It's a great idea.  Okay, so anybody who’s listening to this podcast, call that number and check it out informationally.  I mean don’t all do it at the same time–

Rebecca J. Macy:  Right.

Jonathan Singer:  – because we don’t want to overwhelm this way–

Rebecca J. Macy:  I know then they’ll hate me.

Jonathan Singer:  Oh yeah, but check it out, so that’s just good social work to know what resources are available.  Okay.  That’s a great recommendation.

Rebecca J. Macy:  And we have – in North Carolina we have a coalition against human trafficking, so you know, again, I suggest people just maybe Google that for their state because those folks may know.  Not every – Polaris doesn’t know about every service provider, so you may want to begin to establish some contacts wherever you live and one way to do that to see if you’ve got a coalition against human trafficking or a lot of times I'm finding too the coalitions against sexual assault in many states are working on this issue. So that might be also point of contact and most states have either a coalition against sexual assault and/or a coalition against domestic violence sexual assault.  So that might be another good place to contact to see are they working on this issue, who else in your state is working on this issue because it's never going to be just about social work.  So if we identify these victims, in the end it's going to take an interdisciplinary team of folks to really work with victims whether they're international or domestic trafficking victims you know because there are criminal justice issues.  There's legal issues.  There's mental health and physical health issues.  There's housing issues.  So, it's really going to take a team of folks to begin to help this victim.

Jonathan Singer:  You know, as you were talking I was thinking if you identify somebody that seems to fit the bill for sex trafficking, what you’ve identified is something that is illegal and it might not be that the laws in that state would put the victim as somebody who would be sanctioned legally, but somebody would be and so that opens up a huge can of worms.  It's like are there responsibilities for the social worker at that point knowing that you have sort of stumbled into or uncovered this illegal activity?

Rebecca J. Macy:  Well and I should underscore the fact that if we're talking about someone under the age of 18, we also have an obligation as a social worker in most states to call child protective services too and to let them know about what's going on.  So, it does become complicated.  You know giving someone help might necessitate, you know, maybe important to call law enforcement.

Law enforcement may be someone that can help the victim and provide safety, you know, so re-trafficking so once someone begins to take safety steps and maybe say you're the social worker working and you’ve call up the hotline and you found some place to make a referral and now you're helping that person to get into, you know, trafficking like crisis housing or something. You know, it may be good to involve law enforcement if that makes sense in your community, if that makes sense for the victim because they may provide extra protection and safety services. And not, you know, just that all social workers aren't educated about human trafficking. Not all law enforcement folks are either.  Not all physicians will be.  Not all mental health providers.  The other thing that you may want to think about as a social worker is getting a relationship with your local legal aid.  So in North Carolina our legal aid has been very very active in dealing with the problems of labor trafficking and sex trafficking and trying to provide victims with appropriate legal representation and legal services, likewise immigration services and so those can be intertwined so much too. The legal issues can be so intertwined with the immigration issues. And if someone is an international victim of trafficking, of sex trafficking, there are these T visa options. So they can apply, if the victim is willing to cooperate with law enforcement, a trafficking victim can work with – can apply for these T visas.  Now it can take a while and there's a process, but that is something that could be done and once they get the T visa and sometimes while they're in the process of applying they can also get support, so like Medicaid support or funding support to help with housing and healthcare and those types of things so.

Likewise, there's more and more grant opportunities, so for example the Salvation Army in Raleigh right now has a group of case managers that are providing services for trafficking victims and that grant has come from the Office of Crime Victims National Grant.  I know National do suggest this as it has done some work in this area.  So, I think there's growing opportunities for grant funding to provide these services and that’s something social workers who are really passionate about this or committed to this issue might want to think about, too.

Jonathan Singer:  It's interesting, so if you're working in an agency and you recognize this is going on that agencies are always strapped for cash, but it sounds like there are possibilities for sources of external funding that might support efforts to identify or provide services for that sort of thing.

Rebecca J. Macy:  Absolutely, so this has become kind of a hot topic.  You know we see in the media.  We see it all over the place, but so I think the funding and the recognition of this issue is beginning to grow and funding is beginning to grow along with it.  Now that’s not to say that maybe there's enough to provide sort of the Cadillac interventions for it but at least that’s something that social workers who want to make a difference in their community can pull together these other folks and apply for these grants because there are funding opportunities out there and that’s a way to provide services for this really underserved population.

Jonathan Singer:  So, as you were talking, as we're talking about the complexity of immigration and police officers and social workers and doctors and all these sorts of things, it strikes me that this is – this becomes a messy situation very quickly and it sounds like we are just in the very beginning stages of understanding it and addressing it so what do you think are the next steps?  Where do you think social workers should be going?  What do you think they should be advocating for?  What do you see us doing?

Rebecca J. Macy:  That’s a great question.  Off the top of my head, I think one thing we ought to be thinking about is really ensuring that all social workers have some sort of basic training and identifying human trafficking at least–

Jonathan Singer:  In other than this podcast.

Rebecca J. Macy:  Right, in probably more than the podcast.  This is a start.  You know read the article I guess and you know, I'll tell you if you need a copy of the article, feel free to contact me and I can always, you know, I know not all social workers have access to peer review journals and that’s something I'm happy to provide people with or PowerPoint presentations.

I've got PowerPoint presentations of the articles I've written about this.  I'm happy to share those with folks, so feel free to send me an email.  It's rj – well you'll probably put my contact information up.

Jonathan Singer:  Yeah, yeah.

Rebecca J. Macy:  Okay.  All right.

Jonathan Singer:  They’ll be able to contact you.

Rebecca J. Macy:  Okay, no worries.  So that’s something to look at, that’s kind of a first step to look for training opportunities and then I think what I'm hearing is more – the need for more in depth training for across all professionals that might like, so lawyers, physicians, mental health workers.

In North Carolina, we have an acute shortage of trauma informed mental health workers particularly bilingual ones who can work with victims from different backgrounds, so that’s something, you know, we need people trained in trauma therapies and you know, and this is something where people haven’t done a lot of work in this area, so you know, if you are someone who has done work in this area maybe to offer us continuing education and offer training opportunities because I think we're – just as you say, we're just beginning to figure out how to address this issue.

And so once more folks are trained and aware, I think the next step is also to bring about, you know, these interdisciplinary teams that could work together in a community to address trafficking comprehensively because it's such a complex issue.  No one professional is going to be able to do it by themselves.  Now that’s asking a lot of folks, you know, to asking a lot of legal weight and social workers and physicians and law enforcement to all come together.

Nonetheless, some communities have been very successful and just to go back to some of the examples in sexual assault and domestic violence of starting like sexual assault response teams, so our kind of a model I think which could be useful for the problem of human trafficking in communities too and some cities have developed those type of community response teams so that we're really working on these issues across disciplines and trying to get services for victims, but also trying to prosecute perpetrators.

And that’s probably one of the next issues where kind of at an advocacy level if you're in a state where the laws are such that, you know, perpetrators aren't held responsible for human trafficking, you know, advocating for changes in those laws, also advocating for changes in laws so that trafficking victims can be protected and provided services and not just, you know, processed through the criminal justice system I think is something and then asking folks in your community to avail themselves of those policies because I think, you know, we have some of those policies in North Carolina, but it can be risky for a prosecutor to implement those.

So, you know, supporting prosecutors to go after trafficking perpetrators as ring leaders and to provide services and support to victims, those are things that we as social workers could do, you know, to speak for these really underserved, vulnerable population that may not get services or help otherwise.

Jonathan Singer:  So I think it's really interesting that you're saying that, you know, it's such a new field that maybe some of the things from sexual assault and sort of the victim response that’s already been created could be transferred or translated for this purpose.  Are there things, are there other places the field you think should be going or other things that – specifically that social workers should be doing or taking a lead on?

Rebecca J. Macy:  You know I think in terms of this interdisciplinary work, getting teams together and really ensuring that we're doing victim-centered practice when it comes to human trafficking, is something that social workers are very well prepared to take the lead on because we're so good at working on cross-cutting issues and bringing people – brokering relationships and working across agencies.

You know each of these different professions has their own perspective.  Law enforcement has its own set of goals.  Healthcare professionals, mental healthcare professionals, attorneys all have their own set of goals so it can be really tough to get people in the same room talking in a productive way and I think social workers can be really good at that and play a lead role.

So I hope in communities, you know, social workers will first take a lead at the community level to work on this issue in an interdisciplinary team-based way and I also think social workers could take the lead in prevention.  Prevention of sex trafficking is something that’s really not being attended to fully right now.  I think we really need to think about what are the programs and policies that may end trafficking like what helps to reduce people’s vulnerability and certainly there's criminal justice solutions, but likewise are there things like family violence prevention when you think about domestic minor trafficking or help for a homeless runaway youth.

Likewise in developing countries, are there things like anti-poverty programs, gender empowerment or education programs that really might help, you know, reduce the likelihood of people being trafficked in the first place.  I mean I think this is a really expensive problem to solve once it happens.  You know this is really the case of we need to stop pulling people out of the river downstream.  We need to go upstream and you know, prevent them from being pushed in the river to use that – overused prevention metaphor, but I think prevention is a really important area.

Likewise, I think social workers can take the lead on the research in this area because it's so complex, but also I really think this is an area where we need to make sure what we're doing works because this is a place we as social workers, law enforcement officers, healthcare professionals, we can make things much worse for these people without even realizing it.

We could have very very good intentions and we think we're helping them.  We think we're doing the best when actually what we're doing is making their life worse or putting their families in danger or increasing their risk of re-victimization or re-trafficking, so I think we – you know, I really encourage people – if you're developing a novel, innovative program to address trafficking whether it's, you know, to work in terms of aftercare services, whether it's to prevent trafficking, document and evaluate it because every time we develop a new program and it goes away because of funding and no one’s documented it, no one’s tried to evaluate it, we lose that information that could be really generalizable and be helpful in terms of building a knowledge base for what works in this field.

And it's a tricky challenging issue and I think social workers because of our commitment to social justice, because of our commitment to ethical social work practice, because of our care of vulnerable populations, we could really make a difference in the research in these areas, so whether I think you're a practicing social worker or a researcher, you know, it's going to take collaborations among those groups to make this really work and to figure out what makes a difference for trafficking victims.

Jonathan Singer:  Rebecca, this has been tremendous talking about the indicators, talking about strategies for intervening sensitively, right and also for thinking about doing this interdisciplinary, next steps, prevention, it's been a real wealth of information.  Thank you so much for taking the time to talk with us about sex trafficking.  I really appreciate it.

Rebecca J. Macy:  Thank you for this opportunity.  It's great to write in a research article, but you know it ends up in a journal and I don’t know if anyone ever reads it.  So the fact that you were interested enough to ask me to do this interview, I was just delighted and it was great having such a great interview, so thank you for the podcast.

Jonathan Singer:  My pleasure.

-- END --


  1. Clawson, H. J., & Dutch, N. (2008b). Identifying victims of human trafficking: Inherent challenges and promising strategies from the field. Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Retrieved from
  2. Macy, R. J., & Graham, L. (2012). Identifying domestic and international sex trafficking victims during human service provision. Trauma, Violence & Abuse, 13, 59-76. doi:10.1177/1524838012440340
  3. Polaris Project. (2010). Identifying victims of human trafficking. Washington, DC: Author. Retrieved from
  4. U. S. Department of State. (2012). Trafficking in persons report. Retrieved from
  5. U. S. Department of Health and Human Services. (2008a). Resources: Identifying and interacting with victims of human trafficking. Washington, DC: Author. Retrieved from


  1. Boxill, N. A., & Richardson, D. J. (2007). Ending sex trafficking of children in Atlanta. Affilia, 22, 138-149. doi:10.1177/0886109907299054
  2. Busch-Armendariz, N. B., Nsonwu, M. B., & Cook, H. L. (2011). Human trafficking victims and their children: Assessing needs, vulnerabilities, strengths, and survivorship. Journal of Applied Research on Children, 2(1), Article 3. Retrieved from
  3. Clawson, H. J., Dutch, N., Salomon, A., & Grace, L. G. (2009). Human trafficking into and within the United States: A review of the literature. U.S. Department of Health and Human Services. Retrieved from
  4. Logan, T. K., Walker, R., & Hunt, G. (2009). Understanding human trafficking in the United States. Trauma, Violence & Abuse, 10, 3-30. doi: 10.1177/1524838008327262
  5. Fong, R., & Cardoso, J. B. (2010). Child human trafficking victims: Challenges for the child welfare system. Evaluation and Program Planning, 33, 311-316. doi:10.1016/j.evalprogplan.2009.06.018
  6. U. S. Department of Education. (2009). Human trafficking of children in the United States: A fact sheet for schools. Washington, DC: Author. Retrieved from 
  7. Zimmerman, C., &  Watts, C. (2003). WHO ethical and safety recommendations for interviewing trafficked women. Geneva, Switzerland: World Health Organization. Retrieved from 

APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2013, May 20). #81 - Identifying and responding to sex-trafficking victims in social service settings: Interview with Rebecca J. Macy, Ph.D. [Audio Podcast]. Social Work Podcast. Retrieved from


DrBarrettBonella said...

I haven't had a chance to hear this podcast yet, but I noticed something while going through the Google Analytics: The spikes and Valleys all occurred at regular intervals! It tended to spike in April and November and tended to Lull in January, July and August. I'd be interested in hearing your thoughts on this.

Cherra said...

Would you consider doing another podcast along these lines, with further information for social workers ideally around prevention and education, and maybe something with the role of international social work in prevention in home countries around poverty and social changes that professor Macy mentions?