Book Review – Strong at the Broken Places – Building Resiliency in Survivors of Trauma by Linda T. Sanford (Neari Press, 2005)

I was really surprised to find this book.  Originally published in 1990, it was two years ahead of Judith Herman’s book, Trauma and Recovery, and well ahead of its time in discussing the long term impact of childhood trauma. 

This book is full of stories from survivors of trauma and how they were able to find their inner capacity to heal and overcome the preconceptions and stigma often associated with childhood survivors.  Linda Sanfield discusses and debunks the three most harmful theories associated with childhood survivors: 1) childhood survivors grow up to be offenders; 2) victims develop learned helplessness; and 3) victims identify with their aggressor in order to gain mastery of the trauma.  Her studies, statistical analysis, and interviews tell a much different story of hope and recovery, of inner resilience, and the ability to learn lessons from one’s childhood in order to be empowered in the present.

While some of the stories may trigger trauma responses in some readers, it is still a valuable book for survivors who are searching for stories about other people who have experienced childhood trauma.  The stories tell of the abuse but also of the recovery.  The writer also explains the trauma response in a way that trauma survivors will be able identify and understand.

The chapter “Human Doings: Survivors and Their Work” is specifically written for those of us who have chosen to work for and support victims of abuse after experiencing our own trauma.  Linda Sanfield discusses how we can become almost addicted to our work as a way of proving our value; and how we can also use our work as a healthy way to heal from and make meaning out of our own experiences.   

I highly recommend this book for both advocates and survivors.

Abraham Lincoln – A Case Study in Depression, Trauma and Resiliency

 I have recently been interested in reading about Abraham Lincoln and the depression that significantly affected his life to the point of being a defining characteristic of who he was. 

I started by reading (yes, I will admit this) Abraham Lincoln, Vampire Hunter by Seth Grahame-Smith.  I doubt it was Mr. Grahame-Smith’s intent, but in knowing that Lincoln suffered from depression I found the novel to be an allegorical representation of Lincoln’s struggle against the demons of depression (and slavery).  This fight strengthened him and led to the heroic acts that defined his presidency. 

The book, Lincoln’s Melancholy, How Depression Challenged a President and Fueled His Greatest by Joshua Wolf Shenk is definitely a more serious and enlightening depiction of the life of Abraham Lincoln.  I invite you to read the first chapter and listen to the podcast at http://www.npr.org/templates/story/story.php?storyId=4976127

Mr. Shenk does an excellent job in outlining the struggles that the president experienced in his life and is able to do research that delineates the genetic heritage of depression in the Lincoln family.  Although he makes a great amount of mention to the struggles in Lincoln’s earlier life, Mr. Shenk does not seem to make the connect between these early traumatic experiences and the depth of Lincoln’s depression.

According to historians (including Mr. Shenk and James Swanson in Manhunt: The 12 Day Search for Lincoln’s Killer) Lincoln experienced the following traumatic experiences in early life:

· the death of his mother when he was nine
· frequent moves due to poor business decisions on the part of Thomas Lincoln, his father
· the death of his older sister who had been his primary caretaker after the death of his mother until his father remarried.
· raised by a distant and abusive father who had witnessed his own father being killed in an Indian raid
· Living in neglect and poverty
· The death of two children before his assassination.
· Marriage to a woman with her own trauma and mental health issues.

If we used today’s ACE (Adverse Childhood Experiences) score see http://opendoorsnh.blogspot.com/2010/07/adverse-childhood-experiences.html , Lincoln would probably score 5 or above, well within the range that leads to risky and negative consequences in life.

Lincoln also experienced two strong characteristics of many trauma survivors. After the death of a woman with whom he may or may not have had a serious relationship in his twenties, Lincoln’s friends organized themselves into a suicide watch. Lincoln himself reported that he was fearful of carrying a knife for fear of following through on his desire to end his life.

In a letter to John T. Stuart, his first law partner, Lincoln wrote:

“I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I cannot tell; I awfully forebode I shall not. To remain as I am is impossible; I must die or be better, it appears to me.”

Secondly, Lincoln had what is known as a ‘foreshortened sense of future,’ which in hind sight was definitely prophetic. He often commented having a sense or dreams of his impending assassination. Given the politics of the time and his position, it is understandable that he may be fearful but this started much earlier than his rise to the national political stage.

Abraham Lincoln had tremendous resiliency. He was able to take each negative experience and eventually turn it to his advantage. Even his backwoods poverty served him well in connecting to the constituency that eventually elected him to office. Lincoln also was able to attract people into his life that enhanced his abilities and balanced his deficits.

In understanding Lincoln’s history and theories of attachment, it can be seen that four people nurtured Lincoln’s innate resilient nature: his mother, Nancy; his sister, Sarah; his stepmother, Sarah Bush Johnston; and his friend, Joshua Speed. I encourage you to read more about these relationships, but I wish to particularly note that it was his stepmother who encouraged his love of learning even in opposition to a father who believed that reading anything other than the Bible was frivolous and lazy. It is my opinion that this relationship was the most stabilizing influence of his life and greatly offset the mercurial relationship he had with his abusive and distant father.

It is very apparent that Lincoln was a great politician with high ideals. His desire to be of service and to make meaning of his life was a component of his strength and resiliency. Abraham Lincoln was a man of conscience who was determined to leave this world better for his being in it and he succeeded, not in spite of his depression, but because he was able to use his struggles to his advantage. Unfortunately, a person with the same history of mental illness would probably be unable to rise to the status that Abraham Lincoln did due to stigma. However, I think that those of us who struggle with depression and the effects of childhood and adult trauma can find Lincoln’s story enlightening and inspiring.

Trauma and Relationship

Often, when I am consulting with advocates about working with a domestic violence or sexual assault survivor who has complex needs, an advocate will state that he/she is not trained or equipped to work with a survivor who has mental health issues. An advocate may feel that only a person who is trained in one of the alphabet interventions (EMDR, DBT, CBT, TF-CBT, etc.) has the skills necessary to provide what the survivor needs. Fortunately, the field of counseling/psychology is learning what grass roots advocates have known for years. It is the quality of the relationship between the survivor and the counselor/advocate that determines the person’s satisfaction with the intervention or contact.

Back in the 1950s and 60s Carl Rogers developed humanistic psychology and was considered to be at the forefront of understanding the need to develop therapeutic relationships. Here are the tenants of humanistic or client centered therapy as outlined in Rogers’ books Client Centered Therapy and On Becoming a Person:

The therapeutic relationship consists of a non-judgmental attitude, mutual respect, empathy, and unconditional positive regard.
The client has the answers.
The therapist’s job is to lead the client toward this self-knowledge.
The therapist’s opinion is unimportant.

Do these sound familiar? They should. They are the basics of empowerment based advocacy.

Carl Rogers’ work was well-respected until the mid 1990s when managed care companies began to require the use of evidence based interventions with measurable outcomes that could be a part of brief therapy (usually 6-8 sessions). Since it is difficult to measure attitudes and the value of a therapeutic relationship that develop over time, Rogers’ theories were set aside. Unfortunately, these new evidence based interventions did not necessarily meet the needs of clients and many dropped out of treatment.

Barry Duncan and Scott Miller, co-founders of the Institute for the Study of Therapeutic Change have authored and edited numerous professional articles and books. They have done research over 40 years to determine what really matters in the day to day work of a therapist and found the following:

The client's view of the relationship [with the therapist] is the 'trump card' in therapy outcome... Clients who rate the relationship highly are very likely to be successful in achieving their goals. Despite how chronic, intractable or 'impossible' a case may appear, if the client's view of the relationship is favorable, change is more likely to occur." From The Heart and Soul of Change: What Works in Therapy by Mark Hubble, Barry Duncan and Scott Miller.

In Judith Herman, M.D.’s book Trauma and Recovery, she outlines three stages of recovery from trauma – safety, remembrance and mourning, and reconnection. Advocates provide the safe place for all three stages. Advocates provide the means for a victim to obtain safety if she chooses and creates the safe relationship within the survivor can tell her story and reconnect and develop a trusting relationship. This does not need to be done through the use of evidence based interventions. It just takes being willing to connect and maintain a safe and trusting relationship.

What about someone with severe mental illness? In the community mental health system, the person who has the most contact with a person with a severe and persistent mental illness (the persons whom most advocates seem to feel unprepared to work with) is the client’s mental health case manager. In my experience as a case manager supervisor I found it was not what interventions that were used in working with a client, it was the relationship of trust and respect, non-judgment, and positive regard that predicted success for the person with the mental illness. Case managers are not necessarily trained therapists. Most have the same education and training as domestic violence advocates. They meet with persons with paranoid schizophrenia and psychosis in the clients’ homes and assist them in managing their daily lives. They may have some basic knowledge of an evidence based practice such as DBT (dialectical behavior therapy), but it is the quality of the relationship that is the basis for success as defined by the client.

Abused teens show mental scars

This article by Michelle Hackman, staff reporter for the Yale Daily News (Tuesday, January 10, 2012)
 was forwarded by Susan Blumenfeld of the National Center of Domestic Violence, Trauma and Mental Health.


Adolescents who experienced abuse or neglect as children have fewer brain cells than teens who did not undergo childhood maltreatment, a new Yale study finds.

A study conducted by scientists from the Yale School of Medicine, published in the Dec. 5 edition of Archives of Pediatric Adolescent Medicine, found that adolescents who were exposed to maltreatment as children showed a reduction in gray matter in areas of the brain that control emotions and impulses, though they had not been diagnosed with a psychiatric disorder. It found that the specific brain areas affected may differ according to whether adolescents reported experiencing abuse or neglect, whether the maltreatment was physical or emotional and whether they were male or female. Experts cautioned that the results of the study were only an association, and longer-term studies were needed.

“Though these kids do not have a diagnosable psychiatric disorder, they are still showing physical signs of maltreatment,” said Hilary Blumberg, associate professor of psychiatry in the Child Study Center and the senior author of the study. “The results could explain possible difficulties in school or future depression or behavioral issues.”

Forty-two adolescents filled out questionnaires that measured their perceived exposure to physical and emotional abuse, as well as physical and emotional neglect as children. Structural MRI scans found reductions in the prefrontal cortex, important in emotional and behavioral regulation, across all cases of maltreatment. Other areas affected depended on the type of maltreatment reported.

Those who reported physical or emotional neglect, for example, showed reductions in the cerebellum, which controls motor functions and regulates pleasure and fear. Those who had been exposed to physical abuse in particular showed reductions in the insula, an area that controls self-awareness ¬¬— which may explain why so many people who have been abused as children report out-of-body experiences, Blumberg said.

The study also found gender differences in the grey matter losses. In girls, the reduction was concentrated in areas important in regulating emotion, while in boys, the reduction was seen in areas important in impulse control. Because depression is associated with an inability to regulate emotions, this finding highlights the fact that the rate of depression is much higher in women than men, according to Jennifer Pfeifer, an assistant professor of psychology at the University of Oregon, who wrote an editorial on ScienceDaily.com, a major science news website, critiquing the study.

Blumberg said that despite the physical symptoms of childhood maltreatment, some adolescents in the study remained more resilient than others. Pfeifer and her colleague Philip Fisher, also of the University of Oregon, speculated two possible reasons for this apparent resilience in their editorial. The structural decreases may have left adolescents vulnerable to future psychological problems — which just haven’t occurred yet, or the adolescents tested have found alternative mechanisms to adapt to their difficult surroundings.

Because it only shows correlation, the study cannot prove that childhood maltreatment precipitated any structural changes in the brain, said Everett Waters, professor of psychology at the State University of New York at Stony Brook.

“It is also possible that brain problems led to the kids being abused,” Waters said, “or more likely, that some third factor led to both the brain problems and the abuse.”

Waters and Pfeifer both emphasized the importance of conducting a longitudinal study that would track children from infancy, in order to better understand the development of structural differences in the brain. Linda Mayes, a co-author of the study, said she will continue to track this group of adolescents and monitor them to see if they develop psychiatric disorders.

The research was funded by the National Institutes of Health.

Book Review: Enhancing Resilience in Survivors of Family Violence

 Anderson, Kim M. Enhancing Resilience in Survivors of Family Violence. New York: Springer, 2010.


Kim Anderson Ph.D., LCSW of the School of Social Work at the University of Missouri has written a book that provides advocates and mental health professionals a common language in meeting the needs of survivors of family violence. She states that“resilience research, posttraumatic growth literature, and strengths-based social work practice contribute to a helping framework that optimizes human potential while counterbalancing a more traditional vulnerability/deficit model in mental health practice” (pg. 17).

Advocates have been doing strength-based work under the empowerment model for years and this has often led to a mistrust of the mental health community in which a victim is often pathologized rather than commended for having the skills she needed to survive the abuse. “A pathology model of trauma leads practitioners, who lack the ability to understand the full meaning of victimization and its consequences, to interpret the pain and hurt expressed by survivors as evidence of psychopathology. To label as pathology rather than acts of resistance and signs of creative survival obscures and denigrates courageous efforts in the face of immense adversity. Therefore, mental health assessment tools that highlight survivors’ capacity for agency, resistance and resilience are necessary (Gilfus, 1999)” (pg. 82).

This book is not just for mental health professionals. It is an excellent guide for advocates in assisting trauma survivors in recognizing how their actions (or even inactions) were a sign of strength and resilience in the face of extreme adversity. Through the use of case studies and transcripts of sessions with survivors, Dr. Anderson provides examples of how survivors can be guided to recognize their own strengths. She also includes a number of assessment tools that could be used and discussed in the context of support groups.

Dr. Anderson also recommends ways in which to lead the survivor in creating a self narrative of “strength, purpose, and possibility” using Photo Story 3 (a free download from Microsoft) to create a self narrated story board. See http://www.silencespeaks.org/ (The DVD from this website will soon be in the NHCADSC library.

Exploration of a person’s spiritual connections also is discussed as a means for a person to find meaning in their suffering which not only leads to an experience of psychological relief but also a greater life purpose. Many survivors who are trying to understand their experiences blame themselves for their actions or inability to leave or change their circumstances. Self forgiveness and compassion towards self helps the survivor move forward and begin to “embrace the ‘broken places.’” Dr. Anderson also discusses the some faiths’ desire for the survivor to forgive the abuser. “In the author’s experience, forgiveness of one’s perpetrator does not necessarily provide wholeness and resolution in the same vain as self-forgiving. It is helpful to shift self-blame to its appropriate owner, the abuser, and hold him accountable particularly as family and legal systems often fail to do so” (pg. 123).

I also found the chapters “Recommendations from Survivors to Other Survivors” and “Recommendations of Survivors of Violence to Helping Professionals to be enlightening and validating of the work that domestic violence and sexual assault advocates do. There is also a chapter on vicarious trauma and compassion fatigue to assist the worker in managing their own reactions to the stories that they hear everyday.

I highly recommend this book to anyone working with survivors of violence.

Compassion Fatigue and Our Role as Advocates

As advocates we spend a lot of time discussing vicarious trauma. It is easy to see how hearing other people’s stories of abuse and trauma can negatively effect our beliefs and relationships. However, we often forget that we also are very susceptible to compassion fatigue. Compassion fatigue and vicarious trauma can overlap and often look quite alike. It is almost as if one is the flu and the other is a bad cold. A little hard to tell what is happening at the time, but both seriously affect our ability to be objective and compassion when working with victims of domestic violence and sexual assault.

The website http://www.compassionfatigue.org/ states the following about caregivers who are experiencing compassion fatigue:

“Studies confirm that caregivers play host to a high level of compassion fatigue. Day in, day out, workers struggle to function in care giving environments that constantly present heart wrenching, emotional challenges. Affecting positive change in society, a mission so vital to those passionate about caring for others, is perceived as elusive, if not impossible. This painful reality, coupled with first-hand knowledge of society's flagrant disregard for the safety and well being of the feeble and frail, takes its toll on everyone from full time employees to part time volunteers. Eventually, negative attitudes prevail.”

One side affect of compassion fatigue that often occurs is decreased lack of empathy towards those whom we are working to support. Often I will begin to hear comments about victim/survivors such as “this person doesn’t seem to be trying hard enough,” “she is using too many of our resources,” “she ‘should’ be ____________ (whatever it is the advocate feels that she should be doing, rather than what the victim/survivor feels empowered to do).”

In the article Changing the Script: Thinking about our relationships with shelter residents by Margaret Hobart at the Washington State Coalition Against Domestic Violence http://www.wscadv.org/resourcesAlpha.cfm?aId=D00E1151-C298-58F6-025BBD925C7F8AF8, Ms. Hobart ask us to take a look at the type of relationships we may develop with shelter guests (and other victim/survivors). When we fall into one of the less productive relationships such as parent/child, teacher/student, drill sergeant/recruit, employer/employee, or rescuer/victim it is often because we have become overwhelmed by the needs of the survivor or we have created our own agenda of what we feel should be her focus. We forget about recognizing strengths and helping the person find their inner power and we become directive rather than collaborative in helping the woman move forward. Or, we may able to put our own agenda aside and be collaborative but we still end up being resentful and disappointed because she did not follow through on suggestions we made.

Self care, of course, needs to be a priority and there are many resources that talk about compassion fatigue and vicarious trauma and self care. I would also like to suggest that when you are feeling the effects of compassion fatigue i.e excessive blaming, bottled up emotions, isolation, complaining, compulsive behaviors and poor self care, that you take time for self reflection using Margaret Hobart’s article and determining if your expectations of victim/survivors are based on the role you are playing in their life or on a collaborative/team approach to support and advocacy. Being aware of our own perceptions and triggers is also very important in managing compassion fatigue. Are you having difficulty working with survivors who have mental health or substance abuse issues because of feeling overwhelmed or unequipped? Has your agency lost personnel and you are feeling overwhelmed by your workload and it is impacting your attitude toward victims and co-workers? Or are you spending so much time in a care-taking role that it may be time to look at your professional boundaries and the impact it has on you and your relationship with victim/survivors?

Being aware of how compassion fatigue affects us and the people for whom we advocate is vital to our continuing to be effective in our jobs and the community.

Human Trafficking in New Hampshire - Guest Post by Jennifer Durant

    Jennifer Durant is the public policy specialist at the New Hampshire Coalition Against Domestic and Sexual Violence.  She has been responsible for bringing awareness of the issue of human trafficking to New Hampshire and working very hard for the passage of NH's human trafficking law (see below).  The following was written for Human Trafficking Awareness Day in 2011.

January is nationally recognized as human trafficking awareness month. Human trafficking is modern day slavery that involves the sexual and labor exploitation of millions of men, women, and children worldwide. Human trafficking has no borders. Victims can be abused within their own communities or moved throughout the world to avoid detection, forced to live a life of servitude.

It is estimated that about 800,000 to 900,000 individuals are trafficked across international borders worldwide. In the United States alone between 18,000 to 20,000 victims are trafficked into or within this country every year. Sadly, approximately 80% of these victims are children.

New Hampshire is certainly not immune to human trafficking. While human trafficking is very difficult to quantify or count, there is evidence that New Hampshire has experienced both labor and sex trafficking. In fact, ALL 50 states have reported seeing some form of human trafficking. New Hampshire was the location of the second labor trafficking case in the nation brought under federal law in 2003. Timothy Bradley and Kathleen O’Dell both of Litchfield, New Hampshire were convicted of human trafficking for withholding promised wages and refusing to release passport and legal travel documents of four Jamaican men.

There has also been evidence of sex trafficking in New Hampshire. Over the past few years NH’s domestic and sexual crisis centers have worked with several victims of sexual exploitation, who have been forced into street prostitution or forced to work in brothels.

Almost all of New Hampshire’s border states have experienced human trafficking, indicating that this crime clearly exists in the Northeastern region of this country. In Vermont police invaded a brothel where Asian women were forced to work as sex slaves. Experts say the Vermont case fits the pattern of a problem that is reaching into the smallest corners of the country.

In Kittery, Maine, Russell Pallas, a former lawyer and one-time chairman of the Kittery Town Council, was convicted in 2005 of operating a brothel that was disguised as a health club where women and children, as young as 13 years old, were forced to work as prostitutes.

In East Boston, Brighton, and Allston, Massachusetts police made nearly 100 arrests in 2006, posing as johns and then arresting suspects allegedly operating brothels in apartments and houses tucked away on quiet residential streets.

If this problem is prevalent in our border states, then New Hampshire is certainly vulnerable to such activities. These highly publicized cases serve as examples of trafficking taking place in our area but it is important to remember that many cases of trafficking go unnoticed. Most are invisible victims because of their uncertain position of either being undocumented immigrants or seen as social degenerates who voluntarily enter the sex industry.

What can you do?

*Become familiar with our laws…

-In August 2009, Governor Lynch signed HB 474 into law, the first comprehensive human trafficking law in New Hampshire. Human trafficking is now defined in NH’s Criminal Code, making it a class A felony with enhanced penalties for trafficking someone under the age of 18.

*Talk about human trafficking in your community and ask others to educate themselves

-Invite a speaker from a local organization to talk to your group

-Read a book, hold a documentary screening, or write a blog

-Continue to educate yourself and others on the growing crime of human trafficking

Ratified in 1865, the 13th Amendment abolished slavery and outlawed involuntary servitude. And here we are today nearly 150 years later and there is a need for me to be writing this in 2010, for National Human Trafficking Awareness Day. While the term human trafficking is fairly new, the act itself is clearly not. Until we effectively identify victims and provide them with the services they need; until we hold traffickers accountable in a meaningful way for their unspeakable crimes; and until we adequately prevent human trafficking from happening in the first place, the fight will continue – throughout the world, throughout the nation, and throughout the state of New Hampshire.



New Hampshire’s Human Trafficking Efforts

During the 2007-2008 Legislative Session, NHCADSV’s Public Policy Department helped drafted legislation that formed the Interagency Commission to Study the Trafficking of Persons Across Boarders for Sexual and Labor Exploitation to research the issue of human trafficking in the state. Public Policy Specialist, Jennifer Durant, organized the Commission, served as the group’s clerk, and authored a 50-page report setting forth recommendations for the legislature during the 2009-2010 Session. Jennifer has worked in collaboration with several state and social service agencies, law enforcement, and community members to garner support for this legislative effort.

As the result of her work on the Statewide Interagency Commission (SB 194, Chapter 122:1, Laws of 2007), Jennifer then became the primary author of an 8-page bill and lobbied for the passage of the first-ever attempt to criminalize human trafficking in New Hampshire. Signed by Governor Lynch in August 2009 and just in effect since January 1, 2010, it is now a class A felony to traffic a human being for labor and sexual exploitation. The law also allows the state to convict a trafficker with enhanced penalties if they exploit someone under the age of 18.
After two years of legislative successes on human trafficking NHCADSV continued to work with the state’s top leaders to train first-responders and create a statewide protocol to address human trafficking in New Hampshire. Jennifer became the State Coordinator for the newly formed New Hampshire Coalition Against Trafficking (NHCAT), a statewide Coalition that is part of a 2-year project operating with 4 other New England states. This Coalition was made up of key members and organizations in the work against human trafficking. Through NHCAT Jennifer worked to (1) increase awareness of the issue of human trafficking, (2) train providers to work with trafficking victims, (3) identify victims of human trafficking within the New England region, and (4) link trafficking survivors to needed services.

From 2009 to 2010 Jennifer organized and implemented one of the largest trainings on human trafficking for NH’s law enforcement, held on January 20, 2010. The January 20th NH statewide law enforcement training on human trafficking was a successful event in which attendance ranged from NH Prosecutors to State, County, Local, and Federal Law Enforcement officials. A total of 95 Law Enforcement officials attended the training. A little over 70% of attendees came from local police departments (65 officers).

The 8-hour training curriculum included detecting and investigating cases that involve human trafficking. The training was designed to help police officers understand, identify, and investigate human trafficking cases in New Hampshire

Informational pocket cards were created for the January 20th law enforcement training that were designed to be useful in other disciplines. The cards contain information on red flag indicators, as well as who to contact locally if it is believed that someone is being trafficked in the state.

Just to name a few, NHCADSV has worked closely with and has received support from the NH State Liquor Commission, NH State Police, NH Chief’s Association, Manchester PD, Nashua PD, NH Police Standards & Training, NH Sheriffs Association, NH Attorney General’s Office, U.S. Attorney General’s Office, Immigration and Customs Enforcement (ICE), and Department of Children, Youth and Families (DCYF).

After 2 years of work, the NH Coalition Against Trafficking (NHCAT) officially cae to a close in Spring 2011. .

Thanks to the work of NHCAT, a little over 4,300 materials on human trafficking were distributed throughout the state, either at trainings, awareness events, or fundraisers.

Thanks to the work of NHCAT, a little over 400 individuals were trained on human trafficking issues throughout the state of New Hampshire. These trainings covered a wide-range of disciplines including law enforcement, victim advocates, medical professionals, or professionals working in the child protection field.

NHCADSV continues to raise awareness on human trafficking throughout the state. On August 15, 2011 NHCADSV collaborated with a non-profit called Sex + Money - A National Search For Human Worth. The NH screening of this important film on child sex slavery here in the United States brought out 170 NH residents to the event.