Former child sex trafficking victim advances trauma-informed care for survivors

July 1, 2019


From outward appearances, Holly Austin Smith must have seemed like a typical 14-year-old girl in the summer of 1992. The youngest child from a small town, middle-class home in New Jersey, she was struggling with the transition from middle school to high school and having a hard time finding a group of friends with whom to hang out. But she was a good kid, certainly never in any trouble with the law.

Holly Austin Gibbs, center, is the 2019 recipient of CHA's Sister Concilia Moran Award for her work to advance trauma-informed care for survivors of human trafficking. Sr. Mary Haddad, RSM, left, president and chief executive officer of CHA, and Kevin Sexton, chair of the CHA Board of Trustees, present the award at the Catholic Health Assembly.
Photo by Jerry Naunheim Jr./© CHA

Inside, though, Holly was fighting much bigger foes — trauma associated with past sexual abuse by a relative, a strained relationship with her parents and more. So, when she met an attractive man at a local shopping mall and they began talking by phone, she was vulnerable to his flattery. Within weeks, he had convinced her to run away with him to start a glamorous new life in California.

What happened next was anything but glamorous. He bought her new clothes, took her to a motel and dyed her hair. Holly thought they were going to an Atlantic City, N.J., dance club until the moment he gave her a new name, a new birth date, and a new set of rules to live by — including how much money she needed to make per hour. Only then did she understand the situation she had been coerced into.

Thankfully, she was arrested just two nights after she was trafficked. "The officer was in a position to help me, but until he discovered I had been listed by my family as a missing person, he treated me as someone that no longer belonged in regular society," she says.

Now 41 and happily married, Holly Austin Gibbs has devoted herself to helping other human trafficking survivors, most recently as Dignity Health's Human Trafficking Response program director. For her leadership and breakthrough work improving the care of victims, she accepted CHA's 2019 Sister Concilia Moran Award at the Catholic Health Assembly in Dallas.

"Holly is a very compassionate and passionate person, the epitome of someone who had something tragic happen in life and then turned it around and made something good of it for the betterment of others," says Elizabeth I. Keith, executive vice president of mission integration at CommonSpirit Health, the entity formed when Dignity Health and Catholic Health Initiatives merged on Jan. 31.

Harrowing road
Gibbs' recovery was long and difficult. She says her experiences with law enforcement and health care were equally traumatizing, including an interrogation at the police station and a medical examination at a hospital emergency room. "I did not feel like a priority there; the agenda of the staff — the OB/GYN, the psychiatrist and the social services personnel — was to check all the boxes and release me to my parents, who were equally traumatized," she says.

Her unresolved emotional distress over the trauma led to a suicide attempt, followed by a stay in a mental health facility. Eventually, she returned to school, attended prom, graduated and enrolled in Richard Stockton College of New Jersey (now Stockton University). She excelled academically there, earning an undergraduate biology degree in 2000, and then worked in the environmental microbiology field for several years.

It wasn't until she was 31 and living in Virginia, though, that she actually realized what had happened to her. By happenstance, she turned on her TV and saw a documentary about sex trafficking in India.

"I never thought of myself as a victim of crime before; I just thought I had gotten into a bad situation through my own fault," she recalls. "I suffered from depression and low self-esteem for years."

Breaking trauma's bonds
Shortly thereafter, she contacted Courtney's House, a Washington, D.C., program for trafficking victims, and met another survivor there. It was a "life-changing" encounter, she says — the moment she really began to recover.

Soon she began consulting for organizations like AMBER Alert and traveling around the country to share her story. In 2014, she published a book, Walking Prey: How America's Youth Are Vulnerable to Sex Slavery. She switched careers in order to focus on the health care aspect of human trafficking, joining Dignity Health in 2015. She moved to Sacramento, Calif., to oversee a program that had been launched there just a year earlier.

Gibbs, center, was among those raising awareness of human trafficking in a Washington, D.C., march in 2012.

The Trafficking Victims Protection Act — the first comprehensive federal law to address trafficking through prevention, protection and prosecution — was passed in 2000. Many programs were already in place to raise awareness of the problem and educate everyone from law enforcement to hotel and transportation personnel and emergency room providers on how to identify possible victims. What Gibbs wanted to do was go beyond hospital screening tools to connect patients with appropriate resources.

"I want the health care industry to think differently about the needs of people who have suffered trauma. (Trauma victims) are typically not open to answering questions about abuse, violence and neglect. They feel stigmatized by past experiences with police and medical providers and may fear retaliation by their abusers," she says. "We need to prioritize safety, trust and open communication. And when they are ready to disclose their situation, we need to be able to refer them to local community resources to provide care on an ongoing basis."

Victim-centered care
At Dignity Health, Gibbs has led the development of several innovative health care models for victim-centered and trauma-informed approaches to caring for patients ensnared in labor or sex trafficking. Among them:

  • The Human Trafficking Response Program, which includes instruction for caregivers in how to approach and care for victims of human trafficking in the health care setting. The program, which Dignity Health shares as an open access document online, has been implemented at all of Dignity Health's hospitals across California, Arizona and Nevada.
  • The PEARR (Provide privacy, Educate, Ask, Respect and Respond) Tool, which was launched in 2018 in conjunction with HEAL (Health, Education, Advocacy, Linkage) Trafficking and Pacific Survivor Center to help social workers, nurses and other professionals provide assistance in a trauma-informed manner.
  • A series of web-based education sessions produced in conjunction with the American Hospital Association's Hospitals against Violence initiative in 2018.

Safe haven
Gibbs has worked closely with Dr. Ron Chambers, program director for Dignity Health's family medicine residency program, in the creation of Sacramento's Medical Safe Haven, which provides follow-up care for trafficking victims identified in the hospital as well as through law enforcement and community agencies.

"We provide medical care — including primary, prenatal, OB/GYN care and psychological services — for patients in order to stabilize them as well as follow up on an ongoing basis," says Chambers. "We also work with various agencies to secure safe housing and implement education plans. We aim to be a one-stop shop for all victims' needs so that we can reduce the high rate of recidivism that occurs with trauma bonding."

Chambers says he was inspired to found Medical Safe Haven after hearing Gibbs speak at a physician leadership conference in 2015, and has relied heavily on her expertise to develop care.

"Holly is an incredible teacher, role model and mentor to me," he says. "There are no textbooks or firm guidelines on how to handle these kinds of patient encounters, so I rely on her compassion and thoughtfulness in assessing each individual's situation and needs. She is the driving force behind everything we do."

That's a sentiment that is shared by Petra Linden, director of International Health and Human Trafficking for Dignity Health. "Her heart is in creating a movement to bring help to victims," she said.

Gibbs says, "As a Catholic health ministry, we are here to serve the most vulnerable populations. Trafficking survivors have suffered trauma and been abandoned by society. We need to continue to strive to improve services for them."


Copyright © 2019 by the Catholic Health Association of the United States

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