Potential Aftercare and Vacatur Laws for Survivors of Sex Trafficking

Sarbjeet Kaur, University of New Haven

Victims of sex trafficking often find themselves stuck in a frightful time warp from their past, even after they are rescued. The main reasons for their inability to move forward are a criminal record and inadequate mental health support, particularly in cases of prostitution. Several studies have identified the need for mental health and aftercare for the victims of sex trafficking. Many of these victims experience symptoms, including post-traumatic stress disorder (PTSD), previously identified as a contributor to criminogenic behavior. This paper reviews these issues and recommends using Cognitive Behavior Therapy (CBT) as a form of aftercare for the victims of sex trafficking, in addition to the full vacatur of criminal record in all states, for enabling a stable lifestyle and reducing the risk of criminality or re-victimization. These recommendations are intended for government task forces and criminal justice stakeholders working against sex trafficking, as these individuals hold power to enact legislation and reduce the burden placed on the victims.

Potential Aftercare and Vacatur Laws for Survivors of Sex Trafficking

Sex trafficking cases represent more than half of the reported human trafficking cases in the United States (U.S. Department of State, 2018). Human trafficking is considered a criminal offense in the United States under the “Trafficking Victim Protection Act” (TVPA), and all states have made sex trafficking illegal. However, crimes like sex trafficking are inherently concealed. Most of the U.S. laws and policies are designed to encourage punitive methods to tackle prostitution (i.e., arrests and prosecutions), rather than identifying and assisting trafficked victims who are being used for prostitution. Consequently, many of the victims (including minors) are faced with authorities who are prosecuting them for criminal offenses. This creates further traumatic experiences, not to mention causing distrust and fear toward criminal justice authorities, which often was instilled initially by traffickers.

The victims of sex trafficking charged with illegally performing commercial sex acts typically end up pleading guilty to avoid prison. They are left with a criminal record, saddling them with collateral damages, including and inability to gain employment, housing, and other benefits provided by the government (Emerson & Aminzadeh, 2016). All of these adversities committed against victims of sex trafficking necessitate measures to regain their trust in the criminal and social justice authorities. Cognitive Behavioral Therapy (CBT) as an aftercare service, in conjunction with vacatur laws (also known as “criminal record relief”) can help victims get reestablished socially and decrease their risk of recidivism and poly-victimization (Reid & Piquero, 2014). Despite an increasing enthusiasm towards mental health care for victims, these individuals tend to find effective services inaccessible due to structural and systemic barriers (Hopper, 2017).

Most of the anti-trafficking policies and legislations in the U.S. are defined by the TVPA. This federal legislation defines “severe forms of trafficking” as “recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of commercial sex acts, in which the sex act is induced by use of force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age; and/or “the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt, bondage, or slavery (Office on Trafficking in Persons, 2017). In simple words, these are the definitions of sex trafficking and forced labor; however, it is difficult to understand what it means to be “forced or coerced” in cases of commercial sex acts, especially in cases of adult victims. These two words are highly crucial in prosecuting the traffickers, because unlike minors, adult victims must prove that their involvement in commercial sex acts is purely due to force and coercion—visible or otherwise—in order to prosecute the traffickers (TVPA, 2000).

It is of utmost importance that law enforcement officials keep an open mind when arresting any individual for prostitution. The inadequacy of response and misidentification of sex trafficked victims results from society’s illusion of “ideal sex trafficked victims” derived from movies like “Taken” and Madigan and Gamble’s (1991) commentary on “good or bad rape victims.” Policies and laws should focus on victim-centered approaches instead of threatening criminal charges, in an effort to coerce cooperation with investigations (Phillips et al., 2015). As the survivors of sex trafficking are identified—especially if they were arrested initially for prostitution—they should be provided with extensive CBT to help them recover, allowing them to trust prosecutors and law enforcement during the investigation. Additionally, to help victims lead a somewhat “normal” life, the U.S. should decriminalize minor and adult victims of sex trafficking, so that no state law allows for arrest or detention of victims who have been exploited sexually by traffickers.

To achieve the latter goal, federal funding should be allocated toward training law enforcement officials to properly identify of victims and refer them to available services. Moreover, state and federal governments should encourage legislation enabling victims to vacate their criminal conviction records, including prostitution charges which occurred due to sex trafficking. The existing literature towards vacatur laws for sex trafficking victims has been supported repeatedly by international organizations and victims’ advocates, to save victims from experiencing yet another traumatic event, including arrests for a crime they committed under duress (Zabyelina, 2019).

Importance of Rehabilitation

Multiple researchers have revealed that survivors of human trafficking are likely to develop mental health problems, particularly post-traumatic stress disorder (PTSD). A multitude of women and girls who experience sexual exploitation tend to experience signs of PTSD (Hossain et al., 2010). This becomes particularly important when considering the associations between psychosocial factors and criminogenic behaviors (see Figure 1), established by various researchers (Vitopoulos et al., 2018; Van Vugt et al., 2016).

Figure 1: Psychosocial factors and lack of mental health services influencing sex trafficking

Becker et al. (2012) indicate that young adults with a history of traumatic experiences are likely to recidivate when PTSD symptoms are present, especially in cases of young African American girls. They also recommend using trauma informed mental health services to reduce youth recidivism, as the incarceration experiences can present iatrogenic effects, exacerbating the symptoms of PTSD. The probability of mental health problems becomes greater when criminal justice authorities treat victims as mere instruments for “criminal investigations,” instead of helping them retrieve their autonomy.

The emotional consequences of physical and mental trauma can increase survivors’ chances of harming themselves or others. Basson et al. (2012) found that commercially trafficked youths tend to succumb to substance abuse, self-harm, and other maladaptive behaviors to cope with their experiences. Use of drugs or selling drugs are used as numbing agents by these survivors, while many victims choose to avoid law enforcement officials, as they are under the assumption that they will face charges if and when they choose to come forward (Reid & Piquero, 2014). Additionally, some researchers have suggested that maladaptive coping can explain the link between delinquency and victimization (Hopper, 2017; Turanovic & Pratt, 2013). It is apparent from these studies that we need early interventions for the victims of sex trafficking, to help them refrain from continued exploitation and recidivism. A step in that direction would be the enactment of vacatur laws on federal and state levels. This would allow survivors to appeal to the courts to clear their criminal record, so they can lead a normal life by acquiring suitable jobs and stable housing (Emerson & Aminzadeh, 2016). This also would allow survivors to build trust in law enforcement, despite their belief that criminal justice approaches prioritize prosecution over the protection of victim rights.

How Can Cognitive Behavioral Therapy Help?

The empirical evidence has shown consistent positive results in the treatment of PTSD using CBT. CBT is a mixture of different types of behavioral interventions, such as cognitive restructuring, exposure therapy, barring thought processing, and using breathing techniques to achieve desired results. Exposure therapy uses anxiety provoking stimuli for survivors to confront their trauma repeatedly until habituation is reached (Williamson et al., 2010). It can involve imagery exposure, imagination, and in-vivo exposure (confronting actual stimuli), to invoke anxiety related to the survivor’s traumatic experiences for confrontation. Exposure therapy relies upon acting and engaging in challenging and fearful assumptions rooted in previous trauma, followed by an objective assessment of what results from exposure to those fearful assumptions. It has been found that CBT has a higher success rate in preventing development of chronic PTSD, in addition to speedy recovery from PTSD in cases of female sexual violence victims (Van Vugt et al., 2017).

Figure 2: Psychological mechanisms in addressing experiences and trauma
(Adapted from Council of State Governments, 2020).

CBT also utilizes cognitive restructuring, or identifying and changing negative thoughts (see Figure 2). The core premise of CBT lies in a common theory: our actions and behavior are derived from how we think and feel about a particular situation. Depending upon the situation, those thoughts and behaviors can be maladaptive, creating destructive behavior towards others or oneself. CBT focuses on changing those maladaptive thoughts and attitudes, instilling pro-social behavior, and helping victims lead a healthy way of life (Feucht & Holt, 2016).

CBT is also considered an effective long- term intervention for sex trafficking victims, especially trauma-focused CBT (TF-CBT). This typically involves 12-20 structured therapy sessions teaching the survivor to cope with traumatic experiences through “coping skills, trauma narration, trauma processing, treatment consolidating, and finally closure” (Levine, 2017, p. 7). The common finding from assessing trafficking survivors is that they experience extreme emotions, including anger (usually channeled inwards), fearfulness, shame, memory loss, emotional numbing, being startled by sudden movements, criminogenic predispositions, and suicidal thoughts (Altun et al., 2017). All of these emotions—some being symptoms of PTSD—collectively make it harder for the victim to aid in criminal investigations after they have been rescued. CBT allocation as a primary mental health service for the survivor eventually can help in conducting investigations in an efficient manner.

How Can Vacatur Laws Help Victims of Sex Trafficking?

Sex trafficking victims often are arrested for prostitution, substance abuse, and, in some cases, possession of a deadly weapon; however, these crimes are committed under duress propagated by traffickers. Court databases hold information on conviction record, communicated via state agencies to federal repositories. However, law enforcement databases maintain arrest records that frequently change depending upon subsequent court proceedings. Additionally, the waiting times related to these relief options require stern eligibility requirements, money, and an enormous amount of patience. An “eligible” survivor needs to wait a minimum of 8 years for the government to seal a criminal record (Marsh et al., 2019). Having full vacatur of a criminal record for sex trafficking victims can help them recuperate and reduce the chances of becoming vulnerable again.

As mentioned previously, criminal records can affect survivors’ ability to get a job or secure stable housing. Over 70% of the survivors of human trafficking struggle to gain stable employment, while nearly 60% are unable to find safe housing (Marsh et al., 2019). This creates barriers for them to indulge in a positive lifestyle and decrease the risk of re-victimization. Similarly, survivors who intend to continue their education face additional financial burden, as they are not “qualified” enough to get financial aid or loans (Scott-Clayton, 2017). As we move towards an era where offender re-entry programs like “ban the box” are becoming increasingly popular, creating full vacatur laws for survivors who have been victimized through circumstances that can only be described as “horrendous” only seems fair.

Previous Policies and Recommendations

Practitioners in the field of criminal justice use CBT not only to reduce recidivism, but also help victims confront and overcome the psychological aftermath of crimes committed against them. Sex trafficking survivors often experience symptoms of PTSD. It is apparent that these survivors should be provided with trauma-informed care, along with safety nets and empowerment. CBT generally is considered the most evidence-based therapeutic treatment in criminal justice systems around the world (Williamson et al., 2010). Moreover, CBT in conjunction with prolonged exposure therapies have shown promising results (Salami et al., 2018). Empirical evidence suggests that psychiatric sequelae caused by traumatic experiences, including PTSD, depression, psychotic symptoms, disassociation or memory loss, and substance abuse can be dealt with using cognition and exposure-based therapies.

Feucht and Holt (2016) conducted a meta-analytic review of individual CBT programs (n=50) and practices (n=8) utilized to treat clients experiencing victimization, substance abuse, sex related offenses, domestic violence, and other behaviors. Based on this review, most of these programs and practices are promising or effective at reducing the issue at hand and subsequent recidivism. Additionally, programs which used CBT as their primary element generated much better results than those using it as a secondary component of the program or practice.
To further restore a survivor’s dignity and positive attitude, it is necessary that they are not faced with hinderance in terms of finding a stable lifestyle, housing, education, and employment. There are different types of criminal relief record, including sealing records, expungement, and full vacatur of criminal record from the system. Criminal record expungement and vacatur are frequently witnessed in cases of underage sex trafficking; however, the scarcity of such laws in cases of adult victims is striking. In contrast, some states have taken steps towards creating “safe harbor laws” for victims of human trafficking. Safe harbor laws provide affirmative defense against prosecution of crimes, which can be one by-product of human trafficking. Some states have created extensive safe harbor laws for the survivors of sex trafficking, while others have taken a narrower approach by creating such statutes only for minors. Some states, such as California, still do not have any safe harbor statutes, despite having many human trafficking cases. As of 2016, 31 states have developed provisions of some sort to help survivors of sex trafficking in expunging, sealing, or vacating their prior criminal record (Castillo, 2016).

Critique of the Policies

Despite the established effectiveness of CBT programs, it is important to recognize no program or practice works the same for every survivor. The analogy “one size fits all” rightfully resonates with research related to CBT interventions. CBT is a cost-effective and evidence-based practice; however, it has a greater success rate in cases of minors who have been subjected to sex trafficking, as compared to adult victims, which seems logical since adult victims may develop more deep-rooted maladaptive attitudes. CBT programs work best when used in a multipronged approach along with other behavioral therapies. Nevertheless, trauma-focused CBT inventions have shown effective results in cases of victims and victimization. There have been evaluated CBT programs that have yielded no beneficial results, but rather than victimization, they tended to focus on crime prevention and substance abuse (Feucht & Holt, 2016).

Combined, research suggests CBT in conjunction with criminal record relief will help survivors get back to living a productive life. Myatt (2016), however, speculates that remedies for victims will be still inadequate. Even though each state has their own versions of safe harbor and criminal record relief programs, procedural hurdles and requirements to be met makes these laws unsatisfactory. For instance, some pretrial diversion programs need survivors to admit that they are guilty, or they use conditional plea bargaining to qualify individuals for the program.

The state of New York has been praised repeatedly for its safe harbor laws and criminal record relief. However, to qualify for the “Person In Need of Supervision” (PINS) certification, survivors must prove they were subjected to “severe” forms of trafficking, have not been previously convicted of prostitution, have not previously received PINS certification, and prove they are willing to cooperate with services. After all these requirements are met, survivors still can be denied if they are under the age of 18 years. Expungement and vacatur laws are only available in 39 states, and to file petitions for vacating a criminal record, one typically must file a different petition for each arrest, with additional filing costs (Myatt, 2016). In sum, it appears that expungement and vacatur laws alone are not ideal instruments to avert re-victimization, but when used along with CBT programs, they can help survivors cover some distance on their road to recovery.
Final Recommendations

After assessing multiple CBT programs and safety nets, including safe harbor and vacatur laws, it is apparent that both approaches individually are at least somewhat effective, but when used together likely will yield long term positive effects for survivors of sex trafficking. To test the effectiveness of any program, it is important to conduct multiple experimental studies or randomized controlled trials (Feucht & Holt, 2016). There is a substantial amount of research conducted on CBT programs, but it will be beneficial to investigate its effects by studying it in combination with safe harbor/vacatur laws in the case of sex trafficked adult women.

Research suggests that a majority of sex trafficking victims are female (not to diminish the victimization of male victims), however, most existing research is on underage female sex trafficking. It is equally important to focus on adult victims as well, since they are also on the spectrum of poly-victimization (Levine, 2017). It is possible that adult victims are more prone to re-victimization, since they are required to adhere to additional procedural hurdles to access safe harbor or vacatur for criminal record, further inhibiting their journey towards recovery.

CBT programs are certainly promising for advancing the rehabilitation process for the survivors of human trafficking. Furthermore, criminal record relief is a lengthy process, and providing CBT therapy to survivors during the waiting period can help them during their waiting period. Finally, states should consider creating statutes recognizing “any non-violent crime committed by the victim while being trafficking is a result thereof” (Myatt, 2016, p. 594), thereby implementing additional protections for trafficked victims against being prosecuted. Addition of this provision in a victim-centered policy will facilitate trust in law enforcement officials and lessen the chances of misidentification of victims as offenders. The final model of the proposed policy is shown in Figure 3 and should include trauma-focused CBT, criminal relief, and a presumption of coercion for the victims of sex trafficking irrespective of their age. This multifaceted approach provides the best opportunity for both successful prosecution of traffickers and the healthy long-term recovery of victims.

Figure 3: Beneficial effects of victim-centered responses

Annotated Bibliography

Altun, S., Abas, M., Zimmerman, C., Howard, L. M., & Oram, S. (2017). Mental health and human trafficking: responding to survivors needs. BJPsych. International, 14(1), 21–23.
This special paper, written by highly respected professors and practitioners, briefly discusses the connection between human trafficking and mental health problems. Altun et al. provide explanation on the psychiatric mechanisms involved with trauma caused from human trafficking experience and possible therapeutic interventions for those victims. This article is a review of necessary needs of the survivors of human trafficking and even though it is brief, it mentions in-depth meaning of human trafficking, associated traumatic experiences, mental health caused by those experiences, indicators of trafficking in victims, ways to identify victims for mental health professionals, and finally current and future interventions.

Basson, D., Rosenblatt, E., & Haley, H. (2012). Research to action: sexually exploited minors (SEM) needs and strengths. Oakland: West Coast Children’s Clinic.
Researchers generated this extensive report at the West Coast Children’s Clinic. Basson et al. wrote this report as result of a collaborative research focusing on sexually exploited minors (SEM) their specific child and adolescent needs and strengths (CANS). The study represents results based on clinical profiles of 113 minors. The sample is presents 58% African American youth, 29% multiracial, and only 5% Caucasian, Asian, and other ethnicities. All participants had history of trauma or abuse from exploitation. The descriptive analysis shows the status of exploitation via youths exhibiting signs of youths’ knowledge about exploitation, Stockholm syndrome, and status of exploitation. The study used CANS to identify risk, needs, and strengths of every youth and accordingly provided Psychological and behavioral therapies. The results showed positive outcomes in that improvement behavior, school attendance and achievements; 50% of the youth were able to have a sound sleep after the therapy sessions. Authors provide avenues for training and support for service providers in the field of SEM-CANS along with prevention using early interventions. They also made policy recommendations for better identification and protection of youth at-risk.

Becker, S. P., Kerig, P. K., Lim, J.-Y., & Ezechukwu, R. N. (2012). Predictors of recidivism among delinquent youth: Interrelations among ethnicity, gender, age, mental health problems, and posttraumatic stress. Journal of Child & Adolescent Trauma, 5(2), 145–160.
This study investigates the interrelations between ethnicity, gender, age, mental health problems, and PTSD and the effect of those interrelations on delinquent youth and their potential to recidivate. The study found a positive relationship between PTSD and recidivism. They also found that even though girls are less likely to commit violent crimes, the effect was most noticeable in girls. Additionally, older adolescents with PTSD symptoms reported higher levels of criminogenic behavior than younger adolescents. This article was particularly useful for this brief as it explains the mechanism from trauma to criminal tendencies to recovery.

Castillo, R. (2016). Vacatur laws: Decriminalizing sex trafficking survivors. Journal of Gender, Social Policy & the Law. Retrieved from http://www.jgspl.org/vacatur-laws-decriminalizing-sex-trafficking-survivors/#_ftn21
This blog post explain what vacatur laws are and why are they needed for sex trafficking victims in a brief manner. Castillo explained vacatur related phenomenon in couple of sentences and in the end provided list of nine points explaining what is needed before we pass criminal record relief legislations.

Council of State Governments (CSG). (2020). In Brief: Using a cognitive-Behavioral Approach in Programs to Reduce Recidivism. Retrieved from https://csgjusticecenter.org/in-brief-using-a-cognitive-behavioral-approach-in-programs-to-reduce-recidivism/
CSG staff wrote this brief online article to explain the connection between recidivism and mental health problems and how CBT can help in change offending behavior. The charts provided in the article is used in this policy brief to better understand how CBT works.

Emerson, J. & Aminzadeh, A. (2016). Left behind: How the absence of federal vacatur law disadvantages survivors of human trafficking. University of Maryland Law Journal of Race, Religion, Gender and Class, 16(2), 239-258.
The authors used interviews with trafficked victims to portrait the disadvantages of absence of criminal record vacatur laws for victims of human trafficking. This article is more like a critique of current legislations and policies in place to help the victims, Emerson and Aminzadeh predict that without a full vacatur of criminal record in federal, victims cannot move forward as they unable to get stable jobs and housing which in return makes them vulnerable to trafficking again.

Feucht, T., & Holt, T. (2016). Does cognitive behavioral therapy work in criminal justice? A new analysis from crimesolutions.gov. NIJ Journal, (277).
This is one of the most important articles for this brief as it is a meta-analysis conducted on 50 programs and 8 practices listed on CrimeSolutions.gov (An online NIJ entity). Feucht and Holt found CBT works best for victims and in cases of victimization. Overall, CBT programs and practices worked in more than 50% of the cases, however, how much it works differs in different kinds of justice issues.

Hemmings, S., Jakobowitz, S., Abas, M., Bick, D., Howard, L. M., Stanley, N., Zimmerman, C., & Oram, S. (2016). Responding to the health needs of survivors of human trafficking: a systematic review. BMC health services research, 16(1), 320.
This systematic review explored the health risks and needs of human trafficking survivors by reviewing and conducting a qualitative analysis on peer reviewed and gray literature on human trafficking issues. They reviewed total of 44 documents and found that misidentification, insufficient care, and absence of referrals is frequently observed in cases of trafficked victims. Key themes that represented health needs of the victims were trauma informed care, risk and needs assessment, and cultural sensitivity. The authors recommended taking a multi-agency and multipronged approach in defining and adhering to needs of sexually trafficking victims.

Hopper, E. K. (2017). Poly-victimization and developmental trauma adaptations in sex trafficked youth. Journal of Child & Adolescent Trauma, 10(2), 161-173.
Like Hemmings et al. (2016), Hopper investigated poly-victimization (also called re-victimization) and trauma adaptations in sex trafficked youth and found similar results in terms of inadequate trauma informed services. The study included detailed interviews with the 32 participants to conduct a qualitative analysis using thematic analysis. The results showed most of these victims to be symptomatic of PTSD and depression. The author also found commonalities in strategies between different traffickers which can be extremely helpful in understanding the psychological mechanisms of traffickers and better policymaking. Additionally, Hopper made recommendations including parental support, trauma informed consistent care for victims, safety planning, and diversified services in terms of culture and languages.

Hossain, M., Zimmerman, C., Abas, M., Light, M., & Watts, C. (2010). The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women. American Journal of Public Health, 100(12), 2442–2449.
Using subscales of Harvard Trauma questionnaire and brief symptom inventory, this article investigates the relationship between trauma and mental health problems by interviewing 204 trafficked minors and 7 post rescue service centers for previously trafficked women. The authors reported that victims with physical and sexual abuse were more prone to experiencing symptoms of PTSD, depression, and anxiety. The research in this area has grown tremendously since 2010 so this article was only used to understand the relationship between trauma and healthcare 10-12 years ago and how the therapeutic services have changed since.

Levine, J. A. (2017). Mental health issues in survivors of sex trafficking. Cogent Medicine, 4(1).
This article presents a significant amount of reviewed research to explain psychological mechanisms associated with trafficking. The visual representations like cycles and charts to explain the relationship between chronic stress and how it induces structural changes in the human brain was fascinating. Levine combined sociological perspectives, psychological, and biological mechanism in this article to suggest mental health treatments for survivors of sex trafficking.

Madigan, L., & Gamble, N. (1991). The second rape: Society’s continued betrayal of the victim. New York, NY: Lexington Books.
An analogy “good or bad rape victim” from this book was used to explain law enforcement officers’ reaction towards prostitution and sexually exploited victims. Most of the victims’ first encounter with law enforcement is not as a victim but as an offender and these arrests add more traumatic experiences in the victim’s life. The root cause of these arrests is misidentification of victims by the law enforcement officials and biased understanding of indicators of sexually exploited victims. This book unfolds how society nurtured feelings of violations and trauma in women who reported to be have been raped in the 1980-90s.

Marsh, E., Anthony, B., Emerson, J., & Mogulescu, K. (2020). State report cards: Grading criminal record relief laws for survivors of human trafficking. Retrieved from https://polarisproject.org/wp-content/uploads/2019/03/Grading-Criminal-Record-Relief-Laws-for-Survivors-of-Human-Trafficking.pdf
The Polaris Project researchers published this grade-report on whether states are forming legislations to help victims of human trafficking lead a normal life and one of the steps in achieving that is criminal record relief. After carefully assessing each legislation passed by each state, they described 11 categories which are to be kept in mind while devising legislations for different states. Additionally, recommendations were made related to federal funding for trafficking advocacy projects, data collection processes, provisions for returning fines/fees related to victim’s criminal conviction, trauma informed approaches, and need for outreach and awareness programs

Myatt, M. (2019). The victim-perpetrator dilemma: The role of state safe harbor laws in creating presumption of coercion for human trafficking victims. William & Mary Journal of Race, Gender, and Social Justice, 25(3), 555-606.
Unlike most articles in this bibliography, the author suggests that instead of focusing on inadequate vacatur laws and safe harbor laws, the emphasis should be on creating presumption of coercion in trafficking cases. Most of the trafficking cases go through various procedural hurdles due to their inability to prove that trafficker used coercive techniques. This also partially the reason for limited prosecutions against traffickers in the United States.

Office on Trafficking in Persons (OTIP). (2017). Fact Sheet: Human Trafficking. Retrieved from https://www.acf.hhs.gov/otip/resource/fshumantrafficking
OTIP regulates this webpage is frequently updates its contents in case of any changes made in the legal definition of human trafficking and related legislations and laws.

Phillips, S., Coates, C., Ortiz, C., Rast, L., Sheltry, J., & Thomas, K. (2014). Clearing the slate: Seeking effective remedies for criminalized trafficking victims. New York, NY: International Women’s Human Rights Clinic. Retrieved from https://mvlslaw.org/wp-content/uploads/2017/06/Effective-Remedies-for-Criminalized-Trafficking-Victims-CUNY-2014.pdf.
International women’s rights clinic generated this document to report the effective remedies for trafficked and later criminalized victims in the New York state. The report uses literature on current vacatur laws and international human rights framework to provide recommendations for federal and state level legislations, law enforcement, human trafficking attorneys and advocates, and service providers. This article was used to comprehend best practices—if any—in terms of legislations for vacatur laws.

Reid, J. A., & Piquero, A. R. (2014). On the relationships between commercial sexual exploitation/prostitution, substance dependency, and delinquency in youthful offenders. Child Maltreatment, 19(4), 247–260
This article explores commercial sexual exploitation and delinquency in youth. The study used longitudinal analysis drawing upon a sample of 114 youth in prostitution participating in the program “Pathways to Desistance.” The results show there was positive correlation between drug involvement and prostitution, however, these adolescents were seen to be involved drug abuse related crimes which subsequently lead to prostitution a year later.

Salami, T., Gordon, M., Coverdale, J., & Nguyen, P. T. (2018). What therapies are favored in the treatment of the psychological sequelae of trauma in human trafficking victims? Journal of Psychiatric Practice, 24(2), 87–96.
In this study, authors assessed different therapeutic treatments and their effect on human trafficking victims. The results suggest that cognitive behavioral therapies should be preferred over other therapies to address the needs of human trafficking victims.

Scott-Clayton, J. (2017). Thinking “beyond the box:” The use of criminal records in college admissions. Washington, DC: Brookings Institution.
This report by the Brookings institution emphasize on the depth of criminal record relief and how it keeps the ex-offenders from living a normal life. The author mentioned of stories of ex-offenders who wanted to go to college and get proper education to lead a better life but were rejected due to prior criminal record. Implications of policies related to criminal history are discussed.

Turanovic, J. J., & Pratt, T. C. (2013). The consequences of maladaptive coping: Integrating general strain and self-control theories to specify a causal pathway between victimization and offending. Journal of Quantitative Criminology, 29, 321–345.
This article discusses the relationship between substance abuse (maladaptive coping) and victimization on general strain theory and social control theory and whether that constitutes violent offending. Authors used quantitative methods (negative binomial regression models) to investigate the interactive effects. The results showed positive relationship between victimization and substance abuse. Victims with low self-control tend to cope with trauma using drugs, however, the study also presented that low self-control and substance abuse can lead the pathway from victimization to offending.

U.S. Department of State. (2018). Trafficking in Persons Report. Washington, DC: Author.
U.S. Department of State issues an annual extensive report on human trafficking around the world. The report is created by grading different countries according to the 4-tier system. Tier 1 countries are the ones complying with all recommendations and policies to decrease extent of trafficking; tier 2 countries are somewhat complying, with international laws and acting upon recommendations; tier-2 watch-list are the countries who were doing better but they decrease their efforts to combat human trafficking; and finally tier 4 countries are the ones that are not complying with any recommendations or putting any efforts to combat human trafficking. This report is useful in understanding how different countries are dealing with the same problem in different ways.

Van Vugt, E., Lanctot, N., & Lemieux, A. (2016). Can institutionalized adolescent females with a substantiated history of sexual abuse benefit from cognitive behavioral treatment targeting disruptive and delinquent behaviors? Criminal Justice and Behavior, 43(7), 937-950.
This article focuses on the effects of CBT programs on institutionalized women with history of sexual abuse, anger, and drive to recidivate. An evaluative study was conducted utilizing a sample of 104 women in treatment group and 78 in the control group. The results showed that women with conduct and anger problems benefited and showed a decrease expressing anger and the declining effect for anger and behavioral issues was even greater in women who were administered CBT for a longer period.

Vitopoulos, N. A., Peterson-Badali, M., Brown, S., & Skilling, T. A. (2019). The relationship between trauma, recidivism risk, and reoffending in male and female juvenile offenders. Journal of Child & Adolescent Trauma, 12(3), 351-364.
This study investigated the connection between PTSD, maltreatment history, and childhood adversity regarding risk-need-responsivity risk factors and recidivism. The sample consisted of
15-19 years old 50 male and 50 female juvenile offenders. The results found maltreatment had the strongest relationship with recidivism and criminogenic needs; female offenders were more likely to have experienced maltreatment. This article is of particular importance since it generates avenues for rehabilitative care for juvenile offenders with childhood maltreatment.

Williamson, E., Dutch, N. M., & Clawson, H. J. (2010). Evidence-based mental health treatment for victims of human trafficking. Retrieved from https://aspe.hhs.gov/report/evidence-based-mental-health-treatment-victims-human-trafficking
This online article from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) explains the evidence-based treatments for the victims of human trafficking at length. This is a review and assessment of mental health needs and potential treatments for human trafficking victims instead of findings-oriented article.

Zabyelina, Y. (2020). The Application of the non-punishment principle to victims of human trafficking in the United States. In J. Winterdyk & J. Jones (Eds.), The Palgrave International Handbook of Human Trafficking (pp. 1165–1181). Springer International Publishing.
This chapter indicates the pros of the non-punishment principle in case of human trafficking victims in the United States. The author primarily focused on the inconsistency between U.S. laws related to criminal record relief in that safe harbor laws, affirmative defense, and vacatur laws.

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