Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK.
Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK.
Lancet Psychiatry. 2023 Jul;10(7):557-574. doi: 10.1016/S2215-0366(23)00105-0.
More than 50 million people globally are subjected to modern slavery and human trafficking. Adverse mental health consequences of extreme exploitation are prevalent and often severe. We conducted a systematic and realist review on evaluations of psychosocial interventions for survivors of human trafficking. The review aimed to identify the influence of these interventions on the mental health and wellbeing of trafficked people and examine how they worked for which survivors in which contexts. We searched eight databases (MEDLINE, MEDLINE In-Process, Embase, PsycINFO, Global Health, CINAHL Plus, Web of Science, and Cochrane) for published evaluations of psychosocial interventions for survivors of human-trafficking. We followed a realist approach to analyse the data and report on the limitations of the studies identified. We identified four mechanisms of change as being triggered by the various intervention activities: (1) awareness and understanding; (2) trust, safety, and security; (3) agency, autonomy, empowerment, and social connections; and (4) self-reflection, self-expression, and self-care. Improving mental health after traumatic events is an ongoing, nonlinear process. Intervention effectiveness and transferability would benefit from more transparent programme theories and well articulated assumptions that identify the pathways to change.
全球有超过 5000 万人遭受现代奴役和人口贩卖之苦。极端剥削对心理健康造成的不良后果普遍存在，且往往非常严重。我们对人口贩卖幸存者的心理社会干预措施进行了系统的、现实主义的评价。该评价旨在确定这些干预措施对被贩卖者心理健康和福祉的影响，并研究它们在何种情况下对哪些幸存者有效。我们在 8 个数据库（MEDLINE、MEDLINE In-Process、Embase、PsycINFO、全球健康、CINAHL Plus、Web of Science 和 Cochrane）中搜索了有关人口贩卖幸存者心理社会干预措施的已发表评价。我们采用现实主义方法来分析数据，并报告所确定研究的局限性。我们确定了四种变化机制，这些机制是由各种干预活动触发的：（1）意识和理解；（2）信任、安全和保障；（3）代理、自主、赋权和社会联系；以及（4）自我反思、自我表达和自我护理。创伤后改善心理健康是一个持续的、非线性的过程。干预措施的有效性和可转移性将受益于更透明的项目理论和明确阐述的假设，这些假设确定了实现变革的途径。
