Dr. Sandie Morgan and Dave Stachowiak reveal a new screening toolkit to help identify individuals that may be at risk for current, former, or future trafficking. Dr. Morgan discusses how beneficial this tool can be and how it should be used to effectively identify and help human trafficking victims.
- A screening tool is different than a list of red flags. A red flag checklist is used to identify risk factors for potential human trafficking. Screening tools are short questionnaires designed to identify potential identifiers of human trafficking.
- Prior to using the tool, the organization needs to draft and adopt a human trafficking policy, identify internal and external resources, incorporate a step by step plan of action, and train staff on how to administer the screening tool and how to follow up in response to a positive screen. Additionally, when you implement a new tool, monitor and evaluate the effectiveness of the plan and revise your procedures as necessary.
- Administering the screening tool should be done with a trauma-informed approach: establish a relationship, be prepared to respond to triggers, and safety planning.
- Westcoast Children’s Clinic Screening Tool
- Adult Human Trafficking Screening Tool and Guide
- 184 – A Toolkit for Faith-Based Communities
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Dave [00:00:00] You’re listening to the Ending Human Trafficking Podcast. This is episode number 199, A Human Trafficking Screening Toolkit.
Production Credits [00:00:08] Produced by Innovate Learning, maximizing human potential.
Dave [00:00:30] Welcome to the Ending Human Trafficking Podcast. My name is Dave Stachowiak.
Sandie [00:00:35] And my name is Sandie Morgan.
Dave [00:00:38] And this is the show where we empower you to study the issues, be a voice, and make a difference in ending human trafficking. Sandie, one of the invitations we make at the end of almost every episode is for folks to reach out to us at email@example.com with questions and comments about the show or things that have come up in past episodes. And we regularly receive questions. Thank you all of you who send them in and comments. And today we thought we’d tackle a topic that has been asked about a bit, hasn’t it?
Sandie [00:01:11] Yes and I love getting those questions, keep sending them. Lots of times we send personal answers, or we do design a content show around a question like we’re going to do today. Recently somebody asked about if it was okay to put the link to the podcast on their Website. And yes, of course, you can do that, and sharing The Five Things You Need to Know, the quick start guide. Those are all things we want you to feel empowered to do. Recently, we’ve had several questions about screening tools, and most of the content when you look for screening tools have been about screening tools for children. The West Coast Children’s cse-it tool kit or assessment tool screening tool is used. And about 25 percent of victims are under the age of 18, so it is important for us to also be looking at resources for adults. And we don’t need to reinvent the wheel, there are some great tool kits out there.
Dave [00:02:22] And Sandie, as we were preparing for this conversation, I realize I have a what I think is an understanding of what a screening tool kit is. But for those like me in our audience who may not have really heard this language very much, what is a screening tool kit?
Sandie [00:02:40] Well a screening tool is something that you use in a one on one conversation with a possible victim and it’s different than using things like a red flag checklist. Lots of times you’ll see protocols and algorithms that are based on red flags. So, the difference between red flag checklist screening tools and assessments are like this: a red flag checklist you use to identify risk factors for potential human trafficking. So if you see some of the red flags that we’ve talked about before then you would route that person for an interview where you would use a screening tool, which is a short questionnaire that is designed to identify more specific identifiers of human trafficking. And then that would then progress to a longer identification tool, but this would be the beginning of identifying it through an individual conversation through a screening assessment.
Dave [00:03:50] What would be the venues where something like this may be used vs. where a red flag checklist might be used?
Sandie [00:03:59] Well I think a red flag checklist could happen anywhere, but particularly for this you would use this in health care clinics, emergency rooms, social service offices, people who are coming in for help because they’re homeless, a lot of different social environments where people are seeking some level of assistance or have been involved in something where they’ve been identified in a marginalized community and maybe are afraid to talk to someone then you might want to see if you can sit down and ask some of these questions. I think it’s also really important that if you’re doing this as part of an organization, that you think through the strategies of what you need to have in place before you use the assessment tool. And one of the things that you want to make sure is that your agency, or your nonprofit, your organization has a plan on how to respond if the screening is positive. You want to make sure your staff has training on how to take that person to the next level, whether it’s a basic protocol that you call the 888-3737-888 Human Trafficking Hotline or you have a local task force service provider law enforcement team that are all trained, but you don’t want to identify someone and then leave them with nothing. We have to be responsible for that.
Dave [00:05:40] Is that part of this toolkit of also providing that framework for if there is that positive finding what to do next or is that something that the organization really needs to create a framework for themselves?
Sandie [00:05:54] I think this is the beginning of that. This tool kit that we want to talk about today was developed by our Health and Human Services Office on Trafficking in Persons. And when you’re looking for resources, that’s a great Website to go to. And in this tool kit, the executive summary basically gives an overview of who uses it, how it’s used, and what you need to have in place in order to start making appropriate referrals. The tool kit is part of their training and technical assistance center, and it’s not something that requires that you pay for it- it’s free. It’s been well free, you know me, I like to make sure that we are good stewards of what we’ve already invested in, and our tax dollars helped pay for this. So that’s a really important piece of this. So, biggest caveat, don’t do this unless you’ve had some trauma-informed training. Trauma-informed care means that you know how to recognize when someone’s triggered when someone is having a response of anxiety, they’re shutting down but understanding and we’ve talked about trauma-informed care many times on this show. Understanding that someone’s response may not be just a yes or a no, but it may actually be what is programmed because they’ve had adverse experiences either in their childhood through being trafficked through domestic violence, but trauma-informed is going to shape how you deliver the assessment tool how you have that conversation.
Dave [00:07:46] And a quick adjunct to that for someone who is listening and has not had that and is going down this route for whatever reason. Where would be the places to look for that kind of training or that kind of mentoring?
Sandie [00:08:02] Some of the best places, while you can look here on our podcast and we’ll put some links in our show notes of other podcasts where we’ve talked about trauma-informed. Also, there are links that we can put in here on trauma-informed care and the basic principles that start with safety, and safety planning, and being trained on how to help someone who feels like they’re out of control and begins to become very anxious. And that’s what I really love about this tool kit, it actually gives you the basics for a trauma-informed approach woven into the tool kit. So, let’s look at the first step, which is relationship building tips. This is not an assessment where you hand somebody a form and ask them to fill it out. This is a very individualized screening tool and it’s designed so that first you have to create a safe space for the screening, and that means it needs to be private. If someone comes in, and there’s one of the red flags that we talk about sometimes, is there is someone else with the victim who’s doing all the talking, someone else who handles all the documents. You would never do this screening, Dave, in front of that person, that would not be a safe place so you would want to make sure that it’s private and other people are not going to be in the room. You also aren’t going to do it in a room full of even other staff because that makes it feel less personal and less safe. So, making sure that the person you’re interviewing feels safe. You may need a translator and the translator needs to be a professional or a staff translator, not someone who came with the victim. So those are really important pieces and you even need to think about their physical comfort. Maybe they’ve just come in and they may be anxious because they have low blood sugar, so offer them a snack offer tea or coffee water at the very least they may have a sense of having been homeless, they may need an opportunity to as we always say offer our guests “do you need a chance to freshen up”. So, we create those opportunities so that they have a place to make sure they feel comfortable. Then, in making this relationship building, you want to make sure that your body language is non-threatening. So, I have a friend who’s much taller than I am and so often when we are having a conversation she’ll say let’s sit down because she wants to be eye to eye. And when you’re talking to a possible victim of human trafficking, you want to be eye to eye, you don’t want to be above them, you don’t want to be towering over them, you want them to feel comfortable. You don’t want to cross your arms; we all know that when you cross your arms it feels defensive and that you don’t want to actually engage. So, we want open body language and then we want to make sure that we keep a very calm tone of voice. So, no matter what they say, you can’t really respond in an emotional way, you need to be open and accepting and just let them talk. That’s part of that.
Dave [00:11:48] A quick note on that, Sandie. You know, the last episode we talked with Belinda about empathy, if and when going through the screening process that there comes up some difficult things. Is it appropriate at that time to meet that person where they are and dive in and be empathetic and really meet the emotion that may be coming out? Or is it something from a screening standpoint that at that moment may not be the best thing to do to be asking them more questions to bring out the story and not get into the emotions so much? I’m not even sure I’m asking a question.
Sandie [00:12:23] No you’re really right on target because once we start going through the inventory, these eight questions, they do become triggers because we’re trying to find information that is going to help us identify if this person is a trafficking victim. And that’s where the trauma-informed training for staff becomes really important. So, you have to be prepared for that potential trauma reaction. And I love that this tool kit comes with some very basic grounding techniques that you can work through with the patient, the client right there. And I think, Dave, that we should try this right now.
Dave [00:13:10] Oh, OK.
Sandie [00:13:11] You’ve always been the man on the street ready to be the guinea pig.
Dave [00:13:15] Well truly I will be a guinea pig because I have absolutely no idea what you’re about to do.
Sandie [00:13:21] So here is what happens. The person becomes anxious, is looking away from you, and doesn’t seem to be able to focus, maybe says, “I don’t know if I can stay”, and maybe stutters, but there are tears, all kinds of little tells that show they are no longer comfortable. And so, one simple technique is a breathing technique that can calm a person’s anxiety or a panic attack. I remember when I was having some hormonal issues that my doctor taught me breathing exercises. So, this is something anybody can use as a self–soothing exercise. And here’s what you do. First, you place the tip of your tongue against the roof of your mouth. Show me. Oh, he’s doing it guys, behind the upper front teeth and keep it there. Now exhale completely through the mouth, make a “woosh” sound. Good job. Next, close your mouth and inhale through your nose to a mental count of four. So, I’m going to count: one, two, three, four. Now hold your breath and I’m going to count to seven: one, two, three, four, five, six, seven. And now exhale through your mouth making a “woosh” sound to the count of eight: one, two, three, four, five, six, seven, eight. That’s one breath cycle and you repeat that four, seven, eight three more times. And that reduces your heart rate, it calms your mind, it focuses you back on the present and brings you back from going off into the experiences that brought on that panic attack.
Dave [00:15:24] I’m reading a book right now, Sandie, by Oscar Trimboli, who I’m interviewing on The Coaching for Leaders podcast. And it’s a book about listening and a big part of the focus of the book is deep breathing. And he makes the point that really the first step of listening is listening to ourselves better and going through the breathing as being a really helpful tool to do that and to center ourselves. So, it’s fascinating, I mean, very different context from what I’m reading, but almost the exact same advice here.
Sandie [00:15:59] And focusing on the actual exhale, inhale, hold, exhale, and do that three times really centers you on who you are, where you are, and what you’re doing.
Dave [00:16:15] And so much of the traditional meditation practices too, so much focused on this as well.
Sandie [00:16:21] Exactly. The other little exercise that you can use to help a person calm down and help them stay anchored in their present surroundings, instead of getting lost in the memories of the trauma is to ask them to play the 5 4 3 2 1 Game. Do you know the 5 4 3 2 1 game, Dave?
Dave [00:16:46] No.
Sandie [00:16:46] OK. And you can use this with kids who are learning to self–regulate, you can use this for yourself when you feel really anxious, and you can do it when you’re doing an interview with someone who feels really uncomfortable. Ask the person to name five things they can see in the room. So, what can you see in this room, Dave? Give me five things.
Dave [00:17:12] I see a cup of tea. I see an iPad. I see your portfolio. There are a stuffed lion and a microphone.
Sandie [00:17:24] Now tell me four things you can feel.
Dave [00:17:29] Calm, relaxed, peaceful, relaxed.
Sandie [00:17:42] Now tell me three things you can hear.
Dave [00:17:46] You, the fan, the raindrops on the window.
Sandie [00:17:58] And two things you can smell.
Dave [00:18:05] Coffee and rain.
Sandie [00:18:07] And now one good thing about you.
Dave [00:18:10] About me? Joy filled.
Sandie [00:18:16] That’s good. Isn’t that a great exercise?
Dave [00:18:18] That is a great exercise. Let’s do that again.
Sandie [00:18:19] So you could do that for yourself, for a friend. Alright, so now you’re prepared to give the interview, you’ve done your homework, you’ve reviewed trauma-informed care principles, you know that your organization has a policy on how to refer and respond. So now you’re going to say to the patient the client, “I’m going to ask you eight questions. You can answer each question in one of three ways: yes, no, or I don’t know. You do not need to provide any specific details and you may decline to answer any question if you prefer to not answer.”
Dave [00:19:07] So what we did with the 5 4 3 2 1, the breathing exercise, would you do that in every situation before starting with the questions or just a situation where there’s an indicator that someone may not quite be present or maybe having a difficult time with the emotion or the situation?
Sandie [00:19:27] It’s going to depend on the particular patient. You may start out and say, “that this is how this is going to work. You may answer yes, no, or I don’t know.” And then you may start the survey, the screening and notice that they’ve become anxious, or triggered, or start to look away, and feel anxious. Then you would say let’s do this exercise. If there is a sense that they may be uncomfortable you can start with that exercise.
Dave [00:20:02] So it’s a judgment call and there are two tools that can help to center someone, fascinating.
Sandie [00:20:09] It’s a good practice to learn and there are so many different environments where you can find it helpful. Okay, so we’re going to go through the screening tool now and ask all eight questions. And so, the first question, “sometimes lies are used to trick people into accepting a job that doesn’t exist and they get trapped in a job or situation they never wanted. Have you ever experienced this or are you in a situation where you think this could happen?” And now they can answer yes, no, decline to answer, or I don’t know. And sometimes when you’re having a conversation with a potential victim, it’s sometimes phrased in a way that you might know someone else. So, this idea of thinking through it from a third person may be easier for a potential victim.
Dave [00:21:17] And the same question on that one, Sandie, is there a time or place that would be an indicator of when you may want to phrase that in a third person versus just asking when stated or?
Sandie [00:21:27] Most of the time you’re going to just deliver this exactly the way it is, but if you sense that this particular patient is very fearful then you can use some of these questions without actually sitting down and doing the actual screening tool marking he said yes, she said no. And as part of just your professional ability to take your red flags to the next level. And so, I think that the screening tool becomes also a set of answers that you’re looking for in a general conversation with a potential victim.
Dave [00:22:11] Fair enough. Thank you.
Sandie [00:22:12] The second question, “sometimes people make efforts to repay a person who provided them with transportation, or a place to stay, money, or something else they needed. The person they owe money to may then require them to do things if they have difficulty paying because of the debt. Have you ever experienced this or are you in a situation where you think this could happen?” So that kind of scenario we’ve heard over and over again, so it would be a really clear indicator that someone is vulnerable to being exploited. The third question, “sometimes people do unfair, unsafe, or even dangerous work or stay in dangerous situations because if they don’t someone might hurt them or someone they love. Have you ever experienced this or are you in a situation where you think this could happen.”
Dave [00:23:11] And so often we hear about that is the thing that keeps people where they are is the threat against a family member, right? That gets to them.
Sandie [00:23:19] Exactly. And do you notice how the responses to this do not require elaboration? There’s no digging for the next level. It’s just an assessment, this is a screening tool, and we just want a yes or no. The fourth question, “sometimes people are not allowed to keep or hold on to their own identification or travel documents. Have you ever experienced this or are you in a situation where you think this could happen?” The fifth question, “sometimes people work for someone or spend time with someone who does not let them contact their family, spend time with their friends, or go where they want when they want. Have you ever experienced this or are you in a situation where you think this could happen?” And questions like that, we sometimes see some overlap between other kinds of situations besides human trafficking. So, this is a screening tool, not a diagnostic tool. If they answered yes to someone not letting them contact their family, this could be isolation as a result of domestic violence as well. So, this is a screening tool, not a diagnostic tool. Number six, “sometimes people live where they work or where the person in charge tells them to live and they’re not allowed to live elsewhere. Have you ever experienced this or are you in a situation where you think this could happen?” And again, we’re only asking for a yes, no, I don’t know or decline to answer because we’re not digging for more information, we just want the surface information. Seven, “Sometimes people are told to lie about their situation including the kind of work they do. Has anyone ever told you to lie about the kind of work you’re doing or will be doing?” I saw Shyima Hall last week and I remember when I first heard her story that they had told her if someone comes to the door, this is what you’re supposed to say. So, this is such a common aspect of a trafficker’s way of controlling their victim. The last question, “Sometimes people are hurt or threatened or threats are made to their family or loved ones or they are forced to do things they do not want to do in order to make money for someone else or to pay off a debt to them. Have you ever experienced this or are you in a situation where you think this could happen?” Yes, no, decline to answer, don’t know. So, in each of these questions, we have a scenario and we’re not saying this happened to you. We’re just asking them if you might have had a similar experience or if you think it could happen to you. Then, and here’s the easy way to evaluate the results, if the client or patient answered yes to any of the questions this may indicate a risk for current, former, or future trafficking. And if you feel this individual is at risk you can discuss referral options including reporting to appropriate authorities trained on human trafficking and you can ask, “Do you want additional resources or information?” And that’s when the easiest thing is to contact the Human Trafficking Hotline. So when our listeners are looking for screening tools, it’s not just getting eight questions to ask but it’s getting the whole tool kit that sets you up to make sure your organization has all the pieces in place that your staff has trauma-informed training, that you understand mandatory reporting as well, and that you have a list of how you will respond and refer. You may find that someone is in immediate danger, you need to know how to find resources for them for emergency housing, for law enforcement possibly, and that will take making sure that your staff has those resources identified ahead of time.
Dave [00:27:46] And since this is a U.S. government document available to anyone really to resource and use, right?
Sandie [00:27:52] Absolutely, this is totally free.
Dave [00:27:55] Yeah, we’ll link to it of course in the notes here and of course, as every document, we reference on the show. A lot more detail here that’s in the document itself than we’re going into in this conversation. But, Sandie, it really strikes me listening to those questions, I haven’t heard them previously. How many of the things we talk about on the show and all the different aspects of trafficking the economic, the human aspects of our reflected in those questions as you pointed out as we went. A lot of thought was put into this list, clearly.
Sandie [00:28:24] It’s well done. And just as kind of a summary for your organization, these are the considerations that you need to make your checklist before you start using this screening tool. First of all, you need to draft and adopt a human trafficking policy that is going to reflect survivor-centered, trauma Informed, cultural and linguistic responsive policies, and best practices. So, you don’t want to use the tool before you have those policies in place. Secondly, you want to identify internal resources and external resources and agencies for cross-sector partnerships. Third, you want to incorporate a step by step plan of action, and there is an example in the tool kit. And fourthly make a plan to train your staff on how to administer the screening tool and how to follow up in response to a positive screen, including mandatory reporting. And then as always, when you implement a new tool, monitor and evaluate the effectiveness and the impact of the plan and revise your procedures as necessary. And that’s a wonderful tool kit that I think anybody can use.
Dave [00:29:51] Well, thank you so much, Sandie, for bringing this to us. And of course, as we mentioned up front, we would love to respond any questions you have that have come out of this conversation and/or other topics that are coming up for you around this because we’re here to help provide resources or perspective. As we say upfront in every episode, Sandie, it’s really about studying the issues so we can then be a voice and make a difference in ending human trafficking. And one of the key reasons for that studying the issues is there first is so that we are relying on, and at least knowledgeable about, the partnerships that are out there and all the wonderful work that’s already been done versus trying to reinvent things ourselves. And I would invite you as well to take the very first step. If you’ll go online and download a copy of Sandie’s book, it’s absolutely free, The Five Things You Must Know, a quick start guide to ending human trafficking is a wonderful place to start especially if you’re beginning to study the issues and want to help. It’ll teach you the five critical things that Sandie has identified in her work, that you should know before you join the fight against human trafficking. You can get access to it by going over to endinghumantrafficking.org. And that’s also a wonderful place to go in order to join our regular update and newsletter. You can learn more about Sandie’s work and all the work we’re doing to support ending human trafficking here on the podcast and through the Global Center for Women and Justice here at Vanguard University. And Sandie, I’ll see you again in two weeks.
Sandie [00:31:30] Thank you, Dave.
Dave [00:31:31] Take care, everyone.