Governments and organizations worldwide provide various forms of support to people who have been trafficked, ranging from mental health services and shelter to legal aid and job training. Yet evidence on which kinds of support are most effective in helping survivors recover and avoid re-exploitation remains remarkably thin. 

The Human Trafficking Research Initiative (HTRI), a collaboration between IPA and the U.S. Department of State’s Program to End Modern Slavery, was launched in 2020 to address these and other gaps in the evidence. Over six years, HTRI has funded research in 21 countries, including evaluations testing whether protection approaches improve outcomes for survivors of trafficking.

The importance of timing and quality of case management  services

Over the years, HTRI has funded four protection-focused studies in Brazil, the Philippines, and Uganda. Three findings stand out.

Mind-body programs may have limited impacts on improving survivors’ mental health outcomes, but more research is needed. Move with HaRT, a group-based program combining breathing exercises, yoga, and guided discussion for female trafficking survivors, showed promising reductions in depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms when added to the standard package of survivor services in a Philippines pilot. But a randomized evaluation of the same program in Uganda found that while Move with HaRT participants experienced faster short-term mental health improvements, the differences between them and survivors receiving only the standard package of services disappeared within three months of the program ending. These findings suggest that mind-body approaches may have limited value in settings where robust standards of care already exist, though additional research should test whether these (comparatively low-cost) services may have more value where services for survivors are unavailable or under-resourced.

Survivor-led peer counseling shows promise when embedded at the point of rescue. In Brazil, Centro de Defesa da Vida e dos Direitos Humanos / Carmen Bascarán (CDVDH/CB) developed a peer counseling model integrated into the case management process for newly identified trafficking survivors to improve their access to social benefits and job support as well as their mental health. An exploratory pilot evaluation of the model revealed significant gaps in the operational capacity of the existing referral system, including significant delays in case reporting and difficulty locating survivors after rescue. In response, CDVDH/CB began enrolling survivors directly during search and rescue operations, reaching them at the point of identification and beginning to build trust before contact was lost. This change had a positive impact: every survivor who was offered services at the point of rescue accepted them. Notably, survivors used the peer counseling primarily to meet immediate practical needs, such as documentation and access to social benefits, rather than emotional support.

Participatory case management did not outperform traditional approaches in early recovery. In Uganda, a participatory case management tool called the Freedom Lifemap gave survivors the option to work with a case manager to complete their own needs assessment, utilizing a visually engaging stoplight-themed interface, rather than the traditional model, in which case managers conduct assessments and design case plans based on survivors’ narrative telling of their stories. Both survivors and case managers viewed the Freedom Lifemap tool positively, but the pilot research found that the tool did not produce measurable improvements in well-being compared to traditional case management. Additional research in this area could help determine whether survivor-led recovery plans might be more effective if offered later in the recovery process, once survivors’ basic needs are met.

What shaped the effectiveness of services for survivors

Across these studies, a common theme that emerged was the importance of the timing and sequencing of care. Mental health and psychosocial interventions appear to be most effective only after survivors’ immediate needs (housing, food, legal documentation, and safety) have been stabilized. The study in Brazil illustrates this clearly: survivors sought practical help before engaging with counseling and other emotional support options. These findings also pointed to the potential impact of meaningful survivor engagement in program design (particularly through survivor advisory groups), though additional research is needed that examines how survivor-led support can most effectively address victims’  needs and minimize the risk of re-traumatization. 

The bottom line

HTRI’s protection research shows that rigorous evaluation of survivor support programs is both possible and compatible with ethical care. The message running through these studies is practical: meet survivors’ basic needs first. Care providers should sequence care so that housing, documentation, and safety come before psychological support; embed services within coordinated systems and enroll survivors as quickly as possible upon identification; and involve survivors in shaping the interventions intended to help them.