Author Type

Undergraduate Student

Publication Date

Winter 3-11-2026

Document Type

Instructional Material

Executive Summary

Trust Before Treatment: Educating Nurses on Trauma-Informed Care for Sex Trade Survivors

Survivors of the sex trade often seek healthcare during some of the most vulnerable times in their lives, yet many report experiences of judgment, dismissal, or re-traumatization within clinical settings. Trauma-informed care is an approach that recognizes the lasting impact trauma can have on a person’s physical and emotional well-being and calls healthcare professionals to adjust their practices to promote safety, trust, autonomy, and empowerment. Research shows that implementing trauma-informed care improves patient well-being, enhances staff collaboration, and reduces the risk of further harm (Huo et al., 2023). Our group collaborated with a nonprofit organization dedicated to building relationships with survivors and providing services that support healing and long-term stability. In partnership with the organization, our team developed a nursing-focused educational presentation designed to increase knowledge and confidence in trauma-informed care. By equipping nurses with practical, evidence-based strategies to recognize survivors and build trust, our presentation aims to reduce re-traumatization and foster healthcare environments where survivors feel safe seeking care.

Background

This project aims to increase knowledge on trauma-informed care in healthcare settings to improve the quality of care for survivors of the sex trade. The main population targeted is nurses who are involved in direct patient care and play a major role in advocacy. A study found that 89% of participating nurses and other healthcare workers had not received prior training on human-trafficking (Chambers, 2022). Since nurses are heavily involved in the care of these patients, they need to be able to not only recognize signs of trauma but also adjust their approaches to create a safe and trusting environment. By educating on trauma-informed care, the hope is to increase trust among survivors and increase their willingness to seek out medical care to reduce the risk of health-related issues.

Seattle is a major hot spot for trafficking, with the “most common areas being Aurora Avenue, Rainier Avenue, and Pacific Highway” (CEO of Organization, personal communication, 2026). It is estimated that about 2,000-3,000 individuals are currently being exploited in the Seattle and King County area, with over half of this number including people who are homeless or are in unstable housing (Real Escape from the Sex Trade, n.d.).

There are many barriers to receiving healthcare for survivors, as this environment can cause retraumatization due to a loss of autonomy, which may be similar to past traumatic experiences they have faced. Reliving these types of experiences may lead to withdrawal from seeking out healthcare (Huo et al., 2023). Not only can the healthcare environment cause stress, but many nurses are not competent in recognizing trauma. A lack of awareness may hinder an individual’s ability to be open about disclosing their abuse. Without proper recognition of trauma and survivors’ limited willingness to seek care due to this, they have less access to services and resources to escape the trade and receive adequate care that puts them at an increased risk for future health outcomes that may not be easily treated or reversible (Lorvinsky et al., 2023). Therefore, it’s important that nurses are skilled in providing trauma-informed care to remove these barriers to health to build a safe and trusting environment that will improve patient outcomes for survivors. 

Activities with Rationale

Our group and the organization recognized the need to improve the implementation of trauma-informed care used among nurses. Survivors of the sex trade frequently seek medical services but report feeling dismissed and misunderstood, often due to healthcare providers’ limited knowledge and empathy (Andersson & Ormon, 2024). As a result, these negative experiences can foster feelings of shame and fear, further discouraging survivors from seeking necessary healthcare. Additionally, health care workers risk retraumatizing survivors when they limit patients’ autonomy and sense of control (Huo et al., 2023).

Providing targeted education to health care professionals, such as nurses, can strengthen relationships between survivors and providers (Roberts et al., 2024). Nurses who serve as advocates help survivors navigate and overcome barriers within the health care system. By integrating trauma-informed care into their practice, nurses can foster a sense of safety, trust, empowerment, and support, allowing survivors to focus on healing and recovery. However, many health care settings fail to implement the highest quality of trauma-informed care into their practice, which can lead to mistrust and disengagement among survivors.

In collaboration with the organization, our group developed a PowerPoint video to educate nurses on what trauma-informed care is and how to implement it into their practice, and the impact it has on survivors. The 7-minute video included both a pre- and post-survey to assess whether nurses’ knowledge of trauma-informed care improved after viewing the educational content. Using evidence-based articles, our group created a comprehensive PowerPoint video to share with the organization, which will distribute the presentation to nursing staff. The goal of the presentation is to increase nurses’ understanding of how the care they provide affects survivors of the sex trade and to promote the implementation of trauma-informed care in clinical practice.

Outcomes 

Our goal was to increase nurses’ knowledge and confidence in providing trauma-informed care to survivors of the sex trade. Our group developed a prerecorded, evidence-based educational presentation with pre- and post-survey tools to assess learning. Although our group was unable to directly measure survey results or long-term practice changes, our group expects the training will improve nurses’ awareness, willingness to implement trauma-informed strategies, and ability to provide holistic, patient-centered care. Our group successfully completed and delivered the educational materials to the organization and hope that continued distribution will support sustained impact in clinical settings.

Conclusion 

This project highlighted the critical role nurses play in creating safe, supportive healthcare environments for survivors of the sex trade. In partnership with the organization, our group developed an evidence-based, trauma-informed educational presentation designed to increase nurses’ knowledge, confidence, and ability to reduce re-traumatization in clinical settings. Our team successfully met our primary goal of creating and delivering the educational materials to the agency for ongoing distribution.

Although our group was unable to directly measure long-term impact or engage personally with survivors to evaluate behavioral change in practice, this project establishes a foundation for continued education and awareness. Future opportunities include integrating this training into mandatory hospital education modules and expanding evaluation methods to assess sustained practice change. By strengthening trauma-informed approaches in healthcare, our team hopes to contribute to environments where survivors feel respected, empowered, and safe seeking care.

References

Andersson, M., & Örmon, K. (2024). Healthcare providers’ experience of identifying and caring for women subjected to sex trafficking: a qualitative study. 2BMC Women’s Health, 24(1), 1–11. https://doi.org/10.1186/s12905-024-02992-6

Chambers, R., Greenbaum, J., Galvan, T., & Cox, J. (2022). Trauma informed care: Trafficking out-comes (TIC TOC study). Journal of Primary Care & Community Health, 13:e21501319221093119. https://doi.org/10.1177/21501319221093119

Decker, M. R., Tomko, C., Wingo, E., Sawyer, A., Peitzmeier, S., Glass, N., & Sherman, S. G. (2017). A brief, trauma-informed intervention increases safety behavior and reduces HIV risk for drug-involved women who trade sex. BMC Public Health, 18(75). https://doi.org/10.1186/s12889-017-4624-x

Evans, H. (2021). Understanding complex trauma and post-traumatic growth in survivors of sex trafficking: Foregrounding women's voices for effective care and prevention. Taylor & Francis Group. https://doi.org/10.4324/9781003108078

Huo, Y., Couzner, L., Windsor, T., Laver, K., Dissanayaka, N. N., & Cations, M. (2023). Barriers and enablers for the implementation of trauma-informed care in healthcare settings: A systematic review. Implementation Science Communications, 4(49), 1-18. https://doi.org/10.1186/s43058-023-00428-0

Liu, V. C., Nelson, L. E., & Shorey, S. (2024). Experiences of Women Receiving Trauma-Informed Care: A Qualitative Systematic Review. Trauma, Violence & Abuse, 25(4), 3054–3065. https://doi.org/10.1177/15248380241234346

Lorvinsky, J., Pringle, J., Filion, F., & Gagnon, A. J. (2023). Sex trafficking survivors’ experiences with the healthcare system during exploitation: A qualitative study. PLOS One, 18(8), e0290067. https://doi.org/10.1371/journal.pone.0290067

Pederson, A. C., & Gerassi, L. B. (2022). Healthcare providers’ perspectives on the relevance and utility of recommended sex trafficking indicators: A qualitative study. Journal of Advanced Nursing, 78(2), 458-470. https://doi.org/10.1111/jan.15019

Real Escape from the Sex Trade. (n.d.). About Us. https://iwantrest.org/

Richie-Zavaleta, A. C., Villanueva, A., Martinez-Donate, A., Turchi, R. M., Ataiants, J., & Rhodes, S. M. (2019). Sex trafficking victims at their junction with the healthcare setting—a mixed-methods inquiry. Journal of Human Trafficking, 6(1), 1–29. https://doi.org/10.1080/23322705.2018.1501257

Roberts, V. N., Hutchinson, A. M., & Fiolet, R. L. (2025). The impact of trauma‐informed care on patient engagement, experience and barriers to care: A qualitative study: Empirical research qualitative. Nursing Open, 12(9), 1–12. https://doi.org/10.1002/nop2.70331

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