Post-Trauma Growth Experiences Among Sex Trafficking Survivors in the United States: A Transcendental Phenomenological Exploration

Apr 1, 2026 | Volume 16 - Issue 1

Priscilla Rose Prasath, Devon E. Romero, Claudia G. Interiano-Shiverdecker, John J. S. Harrichand, Leslie Citlalli Garza Mendoza

This study explores the phenomenon of post-traumatic growth (PTG) among survivors of sex trafficking in the United States using a transcendental phenomenological approach. Through in-depth interviews with 10 survivors, the study illuminates the essence of PTG as experienced by participants, emphasizing personal and contextual factors that supported their change. Bracketing was used to reduce researcher bias, allowing the voices and meanings of participants to guide the analysis. Findings highlight two broad themes: internal agency driving change and external factors promoting change. The study offers implications for trauma-informed support and survivor-centered counseling interventions.

Keywords: post-traumatic growth, sex trafficking, internal agency, trauma-informed support, counseling interventions

     Post-traumatic growth (PTG) is the positive psychological change following the struggle with traumatic or highly challenging life circumstances (Tedeschi et al., 2018). Tedeschi and Calhoun (2004) argued that trauma is defined not by the event itself but by its effect on an individual’s core schemas or worldview, which may require reconstruction in order to integrate the traumatic experience. PTG’s framework allows us to understand the growth individuals may undergo after trauma (Tedeschi & Calhoun, 1995). This change results in new ways of thinking, feeling, and behaving that move beyond the trauma rather than returning to baseline functioning (Tedeschi & Calhoun, 1995). These long-term changes often emerge through deliberate reflection, not immediate reactions (Tedeschi et al., 2018). PTG is seen as an “ongoing process” rather than a “static outcome” (Tedeschi & Calhoun, 2004, p. 1).

Domains and Factors that Promote PTG
     Researchers have identified five domains of PTG: personal strength, close relationships, new possibilities, greater appreciation of life, and spiritual development (Tedeschi & Calhoun, 1995). These domains reflect positive changes following trauma. Personal strength includes enhanced self-reliance, increased fortitude, and a shift from seeing oneself as a “victim” to a “survivor” (Tedeschi et al., 2018, p. 27). Close relationships involve greater compassion, openness to help, and deeper connections (Tedeschi & Calhoun, 2004). New possibilities refer to recognizing new life opportunities, such as changes in interests or careers. Greater appreciation of life includes valuing things once taken for granted. Spiritual development entails changes in beliefs and reflections on life’s meaning (Tedeschi et al., 2018).

PTG may arise after major life crises, often following struggles to cope, though not always immediately (Tedeschi & Calhoun, 1995, 2004). It is important to note that PTG is not an automatic or inevitable outcome of trauma. Tedeschi and Calhoun (2004) emphasized that PTG involves an additional cognitive and emotional burden placed on survivors, who must grapple with the disruption of core schemas in order to reconstruct meaning. In other words, although trauma may create the potential for growth, survivors must actively engage in processes of reflection, sense-making, and struggle for PTG to occur (Tedeschi et al., 2018). Clarifying this distinction helps underscore that PTG requires effortful engagement beyond merely surviving or adapting. Although unplanned and unexpected, certain interventions can support PTG (Tedeschi et al., 2018). Contributing factors include cognitive processing, positive reappraisal, personality traits, trauma characteristics, individual differences, and social support (Henson et al., 2021). Coping strategies such as problem-solving, emotion regulation, forgiveness, religiosity, and spirituality have also been linked to PTG (Park, 2010; Schultz et al., 2020).

PTG in Individuals With Experiences of Sex Trafficking
     Sex trafficking is defined as “the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act” (Victims of Trafficking and Violence Protection Act of 2000, § 103). Survivors often experience trauma and symptoms of post-traumatic stress disorder. PTG may begin when individuals gain the strength to leave trafficking situations and reclaim control of their lives. Current peer-reviewed literature on PTG among sex trafficking survivors remains limited. Schultz et al. (2020) examined PTG and religious coping, finding that education and faith contributed to hope and resilience. However, their focus on scales and structured reflections did not capture the phenomenological essence of survivor-defined growth. Our study extends this work using a transcendental phenomenological approach, centering survivors’ voices and allowing meaning to emerge from their narratives of change, agency, and empowerment.

Highlighting survivor-defined PTG is important for the counseling profession because it provides a more authentic and nuanced understanding of how growth is experienced by individuals who have endured extreme trauma. Much of the existing counseling literature has conceptualized PTG through researcher-defined domains or standardized measures, which risks overlooking survivor-specific meanings and contexts (Zoellner & Maercker, 2006). By privileging survivor voices, counselors can gain insight into culturally and contextually grounded processes of growth, which informs more effective trauma-informed and strengths-based interventions (Hays & Singh, 2023). This perspective also contributes to the counseling profession’s ethical responsibility to amplify marginalized voices and to design interventions that align with survivors’ lived realities, rather than imposing externally constructed frameworks (Herman, 1997).

In extending this focus, we emphasize survivor-constructed understanding and the process of becoming, rather than solely coping or recovery, filling a gap in the literature. We also distinguish PTG from resilience, defined as the capacity to bounce back to pre-trauma functioning, and from healing, defined as the restoration of well-being, by focusing on psychological and existential growth beyond pre-trauma functioning (Tedeschi & Calhoun, 2004). Although resilience emphasizes adaptation and returning to prior levels of functioning after adversity, and healing involves the restoration of well-being, PTG reflects growth that surpasses baseline functioning (Zoellner & Maercker, 2006). In this study, instances in which growth was described as moving beyond survival or recovery into a redefined sense of identity and purpose were notated as PTG experiences. This framing underscores that PTG is not synonymous with resilience or healing but represents a qualitatively distinct process of change. This survivor-centered perspective contributes to the PTG and sex trafficking discourse, capturing survivor-defined growth that emerges not only from overcoming adversity but also from redefining oneself after exploitation.

Purpose of the Study and Research Question
     This study explores the lived experiences of PTG among survivors of sex trafficking in the United States using a transcendental phenomenological approach. By centering survivor voices, it seeks to understand how individuals make meaning of growth after exiting trafficking. This inquiry contributes to academic understanding and offers practical implications for trauma-informed, strengths-based interventions. The guiding research question was: How do survivors of sex trafficking in the United States describe their experiences of PTG?

Methods

Research Design
     This study employed transcendental phenomenology to explore how survivors of sex trafficking make sense of their PTG (Moustakas, 1994). Transcendental phenomenology focuses on describing the essence of a phenomenon as experienced by individuals, by setting aside or bracketing the researchers’ own assumptions and biases. Through systematic reduction and imaginative variation, we aimed to identify the core meanings of PTG within participants’ lived experiences. This approach was chosen to allow rich, first-person accounts of healing and growth to emerge, with the research team taking deliberate steps to bracket preconceptions.

Transcendental phenomenology was selected because it emphasizes the description of the universal essence of a phenomenon through the lived experiences of individuals while intentionally setting aside researcher assumptions (Moustakas, 1994). This design aligns with our purpose of privileging survivors’ voices and minimizing interpretive bias, which is particularly important in research involving historically marginalized populations (Hays & Singh, 2023). Compared to interpretive phenomenology, which centers the researcher’s interpretation, transcendental phenomenology places greater weight on participants’ meaning-making, making it well-suited for capturing survivor-defined PTG. This methodology also aligns with the counseling profession’s emphasis on client-centered and strengths-based approaches.

Researcher Positionality
     While transcendental phenomenology requires the bracketing of researcher assumptions, we also provide positionality statements to enhance transparency. We engaged in ongoing reflexivity, journaling, and bracketing discussions throughout data collection and analysis. These efforts helped us remain attuned to participants’ meanings and reduce potential bias. Hays and Singh (2023) considered subjectivity statements crucial to inform readers about the context and process of qualitative research. Priscilla Rose Prasath (cisgender female, Asian Indian), Devon E. Romero (cisgender female, biracial), Claudia G. Interiano-Shiverdecker (cisgender female, Latina), and John J. S. Harrichand (cisgender male, biracial/Asian) are current university counselor educators with numerous publications, presentations, and training given to counselors-in-training and professional counselors on sex trafficking. Prasath primarily studies positive psychological constructs such as PTG from a strengths-based perspective. Prasath, Romero, Interiano-Shiverdecker, and Harrichand all hold a license as a Licensed Professional Counselor (LPC); Harrichand also holds an LPC-S. They have a combined 20+ years of clinical experience working with diverse clientele and in a variety of settings.  Leslie Citlalli Garza Mendoza (cisgender female, Latina) is currently enrolled as a doctoral student at the same university as Prasath, Romero, and Interiano-Shiverdecker. Having conducted prior research on sex trafficking experiences, we approached this study with certain preconceptions. We anticipated that the findings would align with those of other trauma victims in the existing literature. However, our previous work led us to consider the possibility that PTG may manifest in more areas than the traditionally recognized five PTG domains.

Participants and Sampling
     Ten participants were selected using purposive sampling, having lived experience of post-trauma growth following sex trafficking, consistent with phenomenological methods (Moustakas, 1994). PTG was intentionally not an explicit inclusion criterion because one of the central aims of this study was to explore how survivors themselves describe growth following trauma without imposing a predetermined definition of PTG. By not requiring participants to self-identify with the concept of PTG, we were able to capture survivor-constructed understandings of growth, which is consistent with transcendental phenomenology’s emphasis on allowing meaning to emerge from participants’ voices (Moustakas, 1994). Survivors were invited to share their experiences of positive changes and post-trafficking healing, and PTG was identified through analysis when participants described growth beyond baseline functioning. This approach aligns with calls in the literature to privilege survivor perspectives and to avoid constraining data collection to researcher-driven constructs (Hays & Singh, 2023).

With regard to participants’ characteristics, ages ranged from 30 to 42 (M = 36.7, Mdn = 38.5, SD = 5.1). Most participants were White (n = 8), with one American Indian or Alaskan Native participant and one Black participant. Nine were U.S.-born; one was an immigrant residing in the United States for 4 years. Educational attainment ranged from secondary school to graduate school. Marital status included single (n = 3), married (n = 1), separated (n = 2), and divorced (n = 4). To provide additional context, participant demographic information is summarized in Table 1.

Table 1

Survivor Demographics

Note. GED = General Educational Development; age in years.

Data Collection Procedures
     After receiving IRB approval from the university, we sought participants through purposeful sampling. Interview questions were developed following Moustakas’ (1994) recommendations for phenomenological research, using open-ended, broad questions that allowed participants to reflect deeply on their lived experiences. To minimize bias, Prasath conducted bracketing activities before and throughout the data collection. Interviews were audio-recorded, transcribed, and reviewed for accuracy.

Inclusion and Recruitment
     Participants were required to be sex trafficking survivors over the age of 18. Recruitment began in early 2022. Initially, we reached out to professional networks and advocacy contacts known to members of the research team, including colleagues who had previously collaborated with survivor leaders or anti-trafficking initiatives. This initially yielded one volunteer, but after 2 months, additional participants could not be reached through these connections.

Consequently, we broadened recruitment to additional purposeful sampling strategies. Rather than working exclusively through organizations or mental health professionals, which may have limited access to survivors who publicly self-identify, we directly contacted individuals who had already chosen to share their survivorship openly via social media platforms such as TikTok, Instagram, and Twitter. This strategy aligned with our goal of centering survivor-defined PTG and ensured we recruited participants who were willing to narrate their experiences in their own terms. Through these efforts, nine more individuals volunteered within 2 months. Interested participants completed consent forms, a demographic form, and a one-time Zoom interview. To protect confidentiality, all references to organizations, programs, or initiatives were generalized, and identifying details were removed. Any names used in reporting were pseudonyms chosen by the research team to further protect anonymity. Participants received a $20 gift card for their involvement. Data collection concluded in May 2022.

Interview Protocol Development
     The interview questions were developed through an iterative process informed by both the research design and existing scholarship on PTG. We reviewed foundational literature on PTG domains (Tedeschi & Calhoun, 2004) as well as recent studies examining growth among trauma-affected populations (e.g., Schultz et al., 2020). This ensured our protocol included questions that tapped into constructs previously studied, such as changes in relationships, new possibilities, personal strength, and spirituality, while also leaving space for survivor-defined meanings to emerge. Additionally, members of the research team drew on our clinical expertise counseling individuals with trauma histories to ensure that the questions were phrased sensitively and reduced the risk of retraumatization. The resulting semi-structured protocol balanced theoretical grounding with clinical appropriateness, consistent with Smith et al.’s (2009) recommendations for qualitative interviewing.

Interview Content and Process
     Harrichand, a counselor educator with expertise in qualitative inquiry and a Certified Clinical Trauma Professional, conducted the interviews. The semi-structured format began with broad, non-threatening prompts (e.g., “Please tell me a little about yourself and your background”) before progressing to more specific questions about change, coping, and growth after trafficking. Questions included: “What do you think are the most common challenges that survivors experience after their sex trafficking experience?”; “Tell me about the person you are today—how does this person compare to who you were before?”; “What helped you overcome the impact of sex trafficking?”; “Were there services or resources that were helpful to you?”; “What is important for counselors to know when working with sex trafficking survivors?”; and “What is important about your experience that I haven’t asked you and you haven’t had the chance to tell me?” This progression followed Smith et al.’s (2009) emphasis on beginning with general questions before moving to potentially sensitive areas. Interviews were conducted with sensitivity and empathy, using counseling skills such as reflections, minimal encouragers, and attending behaviors to facilitate conversation. Interviews ranged from 41 to 145 minutes (M = 80.9), allowing for in-depth exploration of each participant’s lived experience.

Data Analysis
     Data analysis followed Moustakas’ (1994) transcendental phenomenological method. We began with epoché, or bracketing, to set aside preconceptions related to trauma and PTG. Prasath and Mendoza independently immersed themselves in the data by reading and re-reading interview transcripts. We conducted horizontalization by first treating all statements as equally valuable. From this pool, we then identified significant statements, defined as those that directly illuminated participants’ experiences of PTG, for further clustering into meaning units. Weekly meetings were held over a semester to review notes and merge coding. Mendoza conducted initial coding, followed by Prasath’s independent coding.

The coding process focused solely on identifying PTG, defined as growth beyond baseline functioning and recovery. Statements that reflected only symptom relief or a return to prior levels of functioning were not coded as PTG. In contrast, when participants described new perspectives, redefined identity, or discovery of new possibilities, these were categorized as PTG. Ambiguous expressions, such as “I am happy,” were coded as PTG only when participants explicitly tied such expressions to broader meaning-making or identity shifts. Coding judgments were discussed in team debriefings to ensure consistency and credibility.

Through imaginative variation, we then explored how context shaped meaning. Textural descriptions (what was experienced) and structural descriptions (how it was experienced) were synthesized into a composite narrative. For example, even when not directly prompted, participants’ accounts revealed structural descriptions of PTG as integral to their lived experiences.

Strategies of Trustworthiness
     To ensure rigor, we followed Moustakas’ (1994) guidelines and qualitative research best practices (Hays & Singh, 2023). Prasath and Mendoza maintained bracketing journals and engaged in regular reflexive dialogues to manage assumptions. Researcher triangulation was achieved through independent coding by team members from varied professional backgrounds, followed by collaborative debriefings to reach consensus. To strengthen credibility, we conducted peer debriefings and obtained an external audit by a qualitative research expert. Member checking was limited to transcript verification to remain consistent with phenomenological principles. An audit trail was maintained, and thick, descriptive narratives supported by direct quotations enhanced transferability and confirmability.

Results

We categorized the experiences of participants into two broad themes: Internal Agency Driving Change and External Factors Promoting Change (see Table 2).

Table 2

Themes and Subthemes

Internal Agency Driving Change

     Within the theme Internal Agency Driving Change, most participants identified the following five areas: Personal Strengths Resources, Finding Meaning in the Everyday, Creating Paths Forward, Spiritual Grounding and Rediscovery, and Past Survival Mechanisms Evolving Into Coping Strategies. To illustrate how they manifested in survivors of sex trafficking, we coupled each subtheme with representative quotes.

Personal Strengths Resources—“A Warrior and Survivor Mindset”
     All 10 participants shared the subtheme of Personal Strengths Resources, including confidence, forgiveness, self-awareness, and developing a warrior and survivor mindset. Many described reclaiming their confidence, learning self-forgiveness, enhancing their intuition for protection, and embracing a resilient mindset, with Monica summing up this subtheme by expressing, “I’m a survivor and a warrior first.” Niki shared the process of relearning that she “cannot control the actions of other[s] . . . but I can control what I can do to make myself safe to move on with my life . . . I can act—advocate for myself . . . giv[e] myself that space.” Six participants expressed confidence in their narratives—which was taken from them while being trafficked. Participants shared, “I like myself now,” “I’m happy,” and “I’m way more confident.”

Four of the participants described their capacity to participate in forgiveness of self and others even after their experiences of sex trafficking. Annabel shared, “I guess my capacity to empathize with people who were like <laughing> doing awful stuff to me . . . I guess is endearing . . . an internal quality.” Monica noted that her healing journey involved forgiveness and “being compassionate again.” She explained, “The hardest action we have to take for ourselves and our mental state is forgiving those who trafficked us. . . . only then I feel like we can actually start forgiving ourselves and that’s been a really difficult piece.” She added, “I have forgiven myself.”

Like intuition, nine participants expressed increased self-awareness following their life of sex trafficking. Cassie reflected, “I’ve had to really kind of figure things out on my own.” She noted that self-awareness allows her to be present in the life she is living today. While Monica expressed that she is “finding her identity . . . doing everything for me authentically. . . . it’s releasing all that, it’s fully taking down that mask and being authentic . . . feeling emotion again.” Seven participants highlighted traits such as intelligence and resilience. Mia also emphasized the importance of stubbornness in her journey to healing, stating, “When I started the journey to healing, it was ‘I want healing at any cost.’” She further elaborated, “That’s why I was created so stubborn . . . digging my heels into the sand, being like, I’m not going to let them win. I’m not. And if it takes me 40 years, I’m not gonna let them.”

The final quality that was noted as a personal strength by all 10 participants was having both a warrior and survivor mindset. Crystal expressed this mindset by saying, “I refuse to let them [sex traffickers] win. . . . it took a lot of work to come back. . . . They tried to take my voice, but they didn’t. . . . I started voice therapy . . . and it’s already a little bit better.” Gretchen shared that feeling “powerful again . . . I am you know, like f*ck it. F*ck all of you, like, I’ll just do whatever . . . instead of feeling those true, awful, sad emotions . . . like, what happened to me wasn’t my choice.” Mia ascribed such a strength to her willingness to take risk, while Monica summarized it as, “I’m a warrior, I have superpowers, and I’m a superwoman.”

Finding Meaning in the Everyday—“I Have Joy”
     All 10 participants highlighted Finding Meaning in the Everyday despite their traumatic experiences from sex trafficking, with many expressing acceptance, gratitude, and self-empowerment as they reclaimed their lives and healed, exemplified through narratives of finding their voice, embracing happiness, reconciling with their bodies, drawing strength from their faith, and engaging in acts to make a new beginning. Annabel’s story captured this subtheme when she acknowledged the struggle of getting “comfortable exercising those new muscles” of learning to “value” oneself, to do “something healthy,” and doing things that make one “happy.”

Participants expressed a sense of acceptance and gratitude for where they are today. Niki expressed, “I’m <pause> having to accept that I am not the same person. . . . I’m just doing my best in that moment and being okay with that, instead of, like, trying to beat myself up.” Betty shared that her life could have been worse: “I’m pretty fortunate that I didn’t have any other long-term . . . like, I don’t have HIV, or Hep-C, or I didn’t have kids.” Monica noted that acceptance involved permitting herself to be happy: “I was truly in this push and pull of, like, is happiness real? . . . It’s okay to be happy. . . . It’s okay to feel fulfilled, it’s okay to feel abundance.” Cassie captured the magnitude of time it has taken her to heal and accept her body: “I have spent the last probably 15 years coming back into my body.”

Most participants reframed their perspective toward life and self-identity. Some of them, like Crystal, experienced this reframe because of their faith: “I have joy, which is like that inner contentment, that peace . . . that surpasses all understanding.” She went on to say, “The Crystal that I am now is who God intended me to be; the person that I was before is who my family made me think that I was.” Others, like Mia, reframed the way they viewed life after sex trafficking, emphasizing the potential for the experience to change and empower oneself.

Creating Paths Forward—“I Just Want to Get Out There and Do My Part”
     While five participants identified education as key to their story, all 10 participants shared about Creating Paths Forward after their life of sex trafficking. This involved pursuing a new career path, having an entrepreneurial mindset, desiring to educate and train other professionals, and having the drive to empower other survivors. All participants were pursuing a new career path focused on mental health, nursing, shelter coordination, or advocacy work. Participants discussed how education and work helped them find a new sense of purpose. Jennifer emphasized, “Education is key. That was probably one big part of my story.” Betty similarly noted that “finding something to give yourself purpose . . . finding purpose helps you overcome everything.” For Cassie, securing student loans was a step toward this new purpose. Crystal expressed a deep love for learning, while Betty pursued her goal of going to nursing school. Jes found that engaging in sales jobs when she left sex trafficking was “powerful for deep inner healing,” understanding how these avenues contributed to a sense of empowerment and recovery.

These professional roles highlighted how survivors’ traumas led them to engage in trauma-informed care, helping others navigate similar difficult experiences while healing from their past traumas. For example, Betty shared, “I am a nurse now. I’m a nurse educator,” and one of her main goals “is to integrate sex trafficking education for nursing staff.” Cassie commented on becoming a shelter coordinator for a “domestic violence and sexual prevention program,” and that she loves what she does: “I love helping other people—I don’t care how I’m helping them, what capacity, as long as I’m helping, I am happy.”

Participants shared how they developed an entrepreneurial mindset, starting nonprofits or other organizations to bridge gaps in services, such as emergency response and long-term support programs. Crystal expressed the desire to open a nonprofit organization to help women escape sex trafficking: “I’m trying to bridge that gap. . . . I’m not gonna wait and say, ‘Oh you have to call me back so we can do an intake process to see if you’re good fit or not [to get help].’” Similarly, Monica’s platform is focused on “bring[ing] awareness that survivors are not a threat or they’re not a victim . . . they need to be treated with such respect as an identity, like a superpower.”

Participants also expressed the desire to educate and train other professionals, helping others and making systemic changes, particularly in health care, law enforcement, and legal systems. For example, Mia has visited “14 countries on four continents doing missions work and working with non-government organizations doing humanitarian work” in which she focuses on helping lawmakers or government agencies specifically around child trafficking. She is using her story of sex trafficking “to help police departments and DAs and lawmakers . . . see [sex trafficking]. . . . I want to be able to equip, you know, whether it be therapists or cops, or law enforcement, or you know, the legal system.

A final dimension of this subtheme highlighted by all 10 participants was the desire to empower other survivors, shifting the narrative from victimhood to empowerment. Their stories also revealed the challenges faced in overcoming criminal records, trauma, and societal stigma, inspiring them to advocate for more respect and understanding of survivors’ journeys. Crystal shared, “I’m trying to save people’s lives. People saved my life . . . I intend to use [it] to help other women . . . I just want to get out there and do my part.” Jennifer described working as the shelter coordinator and also serving as “a part-time deputy” to help other survivors. And Monica is using her education as a life coach to help survivors with their “trauma response and transformation. . . . I really work hard on helping survivors heal . . . [to] stop placing themselves as victims and start thriving as survivors and leaders.” Collectively, these narratives underline the resilience of survivors and their dedication to using their experiences to educate, advocate, and support others within and beyond their communities.

Spiritual Grounding and Rediscovery—“Untangling the Mess”
     Seven participants reported relying on religion to cope with the aftermath of their sex trafficking experiences and to search for deeper meaning. Crystal stated, “That’s been the best thing out of all this, like kind of makes it all worth it, because the relationship I have with God now, yeah. It was worth going through everything I went through.” The discovery of purpose and strength through religion and spiritual practices was commonly reported among participants. Crystal emphasized the importance of her faith, stating, “Obedience to God is the only thing that kept me here.” Jes added, “I just started searching for answers,” reflecting a journey of meaning-making that helped anchor her during her healing.

They found comfort in their faith as they navigated the healing process, valuing the relationship and sense of meaning that emerged from their sex trafficking experiences. Six participants reported continuing to practice religion and finding a silver lining in their experiences. Gretchen reported, “Hopefully, God willing, I will be able to move away from here someday, but I think, you know, I have, like, really big faith and, like, God put me here for a reason.” For others, spirituality became a path for self-discovery and identity formation. Mia described being on a journey to understand who she truly was, while Monica highlighted the role of spiritual beliefs in helping her recognize and embrace her identity as a survivor. Of them, three participants described reframing their view of religion, recognizing that individuals have some control over their divine life, destiny, and purpose. For example, Mia and Monica spoke about their journeys of self-discovery and finding their identity through spiritual exploration. In contrast, two participants expressed redefining their spiritual identity as neither religious nor spiritual. Betty shared her journey: “I absolutely decided like I’m not Christian. For a long time, I considered myself an atheist, I don’t believe in anything, but over time I have really connected with my spiritual self . . . I would consider myself a Pagan now.”

Past Survival Mechanisms Evolving Into Coping Strategies
     All 10 participants identified past survival mechanisms that once shielded them from immediate psychological harm but have since evolved into coping strategies, facilitating PTG. These mechanisms, such as acceptance, handling crisis situations, substance coping, and avoidance coping, highlight the participants’ resilience and ability to navigate challenging environments while seeking healing
and growth.

Acceptance coping emerged as a pivotal process for participants, marked by an eventual awareness of their trauma and a willingness to confront it. Many described the delayed realization of their experiences, often occurring long after the traumatic events. Jennifer shared how she initially failed to recognize her reality, noting that when she was in the midst of it, she “didn’t even realize that’s what it was.” Similarly, Annabel reflected on how she spent years believing her experiences were normal or expected, only to later understand the severity of her situation. She recalled a conversation with a friend who said, “I can’t believe I know a victim of trafficking,” to which Annabel responded, laughing, “Who?” Her friend’s reply, “You,” was a startling revelation. As participants moved toward acceptance, many began dismantling survival personas they had developed to protect themselves. Monica explained how she had “played roles and characters” during her trauma, but healing required her to “take down that mask” and embrace her authentic self. For her, the journey to authenticity involved intense healing and self-discovery, which she described as both liberating and transformative.

Participants also demonstrated exceptional crisis management skills, or a sense of keen intuition, often rooted in their need to survive. Jes shared needing to “read body language and understand how to perceive people,” a skill that became second nature over time. Mia further commented that “trafficking survivors have been taught to read their audience. . . . they’re gonna be able to see it on your face because that’s what they’ve been trained to do. . . . I still to this day can read people really well.” Dissociation also played a significant role, allowing participants to detach from their immediate realities. Cassie explained how she “detached from [herself]” as a survival mechanism, while Betty noted that dissociation led to “huge blocks of memories that are gone,” which helped protect her from the overwhelming trauma. For Annabel, dissociation was both a liability and a tool that allowed her to function. She reflected on how it helped her succeed in academic and workplace settings, as it gave the impression that she was “much more functional.” While acknowledging its downsides, she described her dissociation as more “managed” now, highlighting its adaptive value.

Substance use was identified as another critical survival mechanism, providing temporary relief from the pain and chaos participants endured. For Annabel, drug use was a means of survival, as she admitted that “a good stint of drug use” likely saved her life. She described how substances helped her tolerate what she was experiencing, echoing sentiments shared by Betty and Cassie, who also turned to drugs as a way of coping with their trauma. Although harmful in the long term, substance use offered an escape during moments of extreme distress. As participants transitioned into recovery, some replaced illicit substances with prescribed medications to manage ongoing challenges. Gretchen, for example, explained how she now uses medication to address high blood pressure and anxiety, demonstrating a shift toward healthier coping strategies.

Finally, avoidance strategies, including running away and emotional distancing, were essential survival tools for many participants. Crystal shared how physical avoidance, or running, was a literal means of staying alive for her. Emotional avoidance also played a role, with Betty describing herself as “very distrustful” of others as a way to protect herself. Although these strategies sometimes prevented participants from fully engaging with their trauma, they were vital in enabling them to navigate and survive their immediate environments.

Together, these diverse coping mechanisms, whether acceptance, dissociation, substance use, spirituality, or avoidance, illustrate the complex, adaptive ways in which survivors of trafficking have navigated their pasts. Over time, these mechanisms have evolved, allowing participants to pursue growth and healing while continuing to adapt to the challenges of their unique journeys.

External Factors Promoting Change
     All participants highlighted various external contextual factors that supported their growth and healing, ranging from supportive resources and services to meaningful social support systems, including the role of counselors. We organized these insights into three subthemes: Close Relationships,  Supportive Resources and Services, and Counseling Experiences and Alternative Paths to Healing.

Close Relationships—“I Needed Somewhere to Go”
     This subtheme was endorsed by all 10 participants, reflecting the significant challenges and complexities survivors of sex trafficking face in their relationships, trust, and healing. Participant narratives revealed the profound challenges of forming and maintaining close relationships, alongside the critical role of family, community, and pivotal interventions in their healing. Although many survivors continue to grapple with distrust and self-protection, the presence of supportive networks and key turning points fosters resilience and PTG, enabling them to navigate their journeys toward recovery.

Firstly, all participants described how trust and vulnerability became extremely difficult after their trafficking experiences. Monica, for example, explained how it takes time to feel safe opening up to loved ones, contrasting it with the transactional nature of sex trafficking. Despite being 7 years removed from her trafficking experience, Monica noted she is “still working on trust issues,” particularly in the context of her small, close-knit community. Additionally, Betty and Annabel highlighted how survival mechanisms during trafficking carried over into their post-trafficking lives. Betty described herself as “distrustful” and admitted to avoiding romantic relationships entirely, saying, “I don’t really bond with men. . . . Like, I could see myself being single forever.” Though initially difficult, she shared that she has come to terms with this choice, adding, “I am finally at a point now where I am okay with being alone.” Annabel, on the other hand, described how she learned to maintain superficial relationships as a way to stay safe, stating that she became “really good at superficial relationships” and intentionally shares “just enough personal details so that people think they have some understanding of me.”

The lasting effects of trauma created further barriers to forming close relationships. Crystal spoke about the overwhelming impact of triggers, explaining that “the nightmares, the flashbacks . . . smells, areas” make it difficult to rebuild trust. She poignantly concluded, “You can’t teach somebody how to trust again. You just can’t.” Secondly, despite these challenges, five participants described how community support played a crucial role in their healing process. Niki emphasized the normalizing and validating effect of being in a survivor community, noting that connecting with others who had similar experiences made her feel less isolated and helped her develop compassion for herself and others. She reflected, “It’s given me a new level of grace for . . . people’s brokenness.” Mia encapsulated the importance of collective care in her statement that “it takes a village to have a human trafficking survivor recover and live a meaningful life.” Thirdly, support from family members emerged as a critical factor for most participants. Monica expressed deep gratitude toward her daughter, who encouraged her to seek help and begin her recovery journey. Similarly, Betty described the unwavering support of her parents, who were aware of what she had endured but never judged or mistreated her. Betty also described how her family helped her escape, recalling, “They packed up my apartment and moved me to an undisclosed location. And that’s kind of how I actually found my freedom.” Jennifer noted that her mother played an essential role in her recovery, sharing that “she was always there for everything, if I needed to talk, if I needed somewhere to go.” Gretchen echoed this sentiment, reflecting on how her family stepped in to help her, saying, “Luckily, I had family that would help me.” Other participants recalled individuals who helped them envision a different future. Betty shared how a preceptor during her training encouraged her to pursue nursing, saying, “She’s like, ‘You shouldn’t be a medical assistant; you need to be a nurse and go back to school.’”

Next, several participants highlighted how their upbringing and privilege laid a foundation for resilience. Betty reflected on her stable background, saying, “I had a great family . . . a wonderful upbringing. I was a middle-class White female from a very conservative military family.” Gretchen similarly described her childhood as “pretty normal,” emphasizing the stability of having “both my parents together” and a mother who had a successful career. Finally, Jes added that she consciously uses her privilege to make a difference, stating, “I use my privilege to kick open the door.”

Supportive Resources and Services
     All 10 participants described the availability and access to various services as crucial factors in promoting their PTG experience. Frequently mentioned were access to education, housing, mental health services, substance abuse recovery centers, and advocacy agencies. For example, Crystal emphasized the importance of “resources for education and housing,” while Cassie underscored the value of “having survivor leaders in those types of programs” to foster a deeper sense of understanding and connection. Similarly, Annabel highlighted the importance of mental health deputies who are “trained to respond to her unique needs,” explaining how they could “use the powers of law enforcement to quickly get to me, before I get too far.”

Participants also shared names of specific organizations and programs that played influential roles in their recovery journeys. Some of them were nonprofit organizations, or a community-based advocacy initiative, or a faith-based program. Additionally, many found the scholarship support that some of the school programs offered to be incredibly helpful. Many also emphasized the role of programs that offered vocational training and legal assistance to be extremely instrumental in regaining stability.

Participants experienced interventions or moments that prompted lasting change. Health care providers, educators, family members, and peers often served as catalysts for PTG. Betty credited her primary care doctor for recommending her first counselor after learning about her trauma during a routine clinical exam. She explained, “I wouldn’t have seen that first counselor at Kaiser if it wasn’t recommended by my primary care doctor.” For Mia, safe spaces at school—like time spent with the librarian—provided much-needed respite: “I could escape for half an hour, 45 minutes.” These supports were often intertwined with personal growth and self-discovery. Jes highlighted how sales training helped her “establish better boundaries and figure out who I was and how I wanted to help people,” while Gretchen shared how bodybuilding boosted her confidence and strengthened her faith.
Niki credited exercise for rebuilding trust in herself and staying physically present: “It was really helpful for me because I was checking out all the time.”

Spirituality and faith were also recurring themes. Many participants found strength through religious programs, community resources, or personal faith. Gretchen described how faith and bodybuilding were interwoven in her journey to healing. Finally, advocacy agencies and survivor-led programs emerged as critical enablers of recovery. Cassie stressed the importance of survivor leaders, noting, “It takes someone who is a survivor who is really going to be able to understand how to respond.” Similarly, Gretchen noted the value of advocacy agencies and peer support groups, while Annabel highlighted the role of trauma-informed law enforcement and ritual abuse trafficking supports.

Counseling Experiences and Alternative Paths to Healing
     All participants described varied experiences with mental health services, which were pivotal in their journeys toward PTG. Key themes included the importance of counseling, support groups, and alternative healing methods. Critical factors were counselor characteristics, multidisciplinary support, and access to alternative therapies.

For many, counseling played a central role in healing. Cassie shared attending therapy “off and on, pretty much [her] whole life,” while Gretchen found it consistently helpful. Monica said, “Because of therapy, I got in touch with my first nonprofit,” which led to public speaking and professional growth. Therapy addressed trauma and empowered participants to explore their potential. Mia found strength in her therapist’s gentle honesty, and Monica credited therapy with healing from sex addiction. Jes emphasized that having the “right therapist” was essential.

Participants identified key counselor traits in four areas: knowledge, skills, disposition, and practices. Annabel emphasized the importance of understanding trafficking-specific dynamics. Creativity was a valued skill. Jes appreciated a “tender heart” balanced with desensitization, while Mia praised “gentle reality checks with massive doses of compassion.” Patience and honesty were highlighted repeatedly as essential for building trust. Monica and Annabel emphasized the importance of safety and collaboration, while Annabel also recommended involving survivor mentors.

Participants also turned to alternative healing approaches. Betty credited her dog for saving her life and praised animal therapy. Niki found yoga and dance helped release trauma: “Trauma can get locked in your body . . . doing certain movements helps.” Somatic therapies such as massage, float therapy, and trauma touch therapy were described as deeply calming. Mia appreciated trauma touch therapy because “you don’t have to say a word . . . it simply lets your body release the trauma.” Reiki, bodybuilding, retreats, and art therapy also provided outlets for recovery. One participant described reiki as emotionally freeing, while another found smashing objects helped release rage.

Support groups were vital, especially when individual counseling wasn’t accessible. One participant noted that support from peers “made a big difference,” while another participant saw survivor groups as protective against re-trafficking. Another participant stated that she gained confidence speaking in group settings, while one other participant stressed the importance of a coordinated trauma response and informed professionals who could meet survivors where they were in their healing.

Discussion

This study examined the lived experiences of PTG among sex trafficking survivors using a transcendental phenomenological approach. By bracketing assumptions and centering participant voices, we identified themes reflecting both internal agency and external influences. Rather than imposing a framework, we allowed themes to emerge from survivor narratives and later contextualized them through PTG scholarship. Findings highlight the complex nature of growth and the dynamic interplay between survival mechanisms, personal development, and supportive environments.

Internal Agency Driving Change
     Participants’ narratives revealed that PTG was not linear but a dynamic process rooted in reclaiming power, identity, and meaning. Survivors drew on personal strengths such as resilience, confidence, forgiveness, and self-awareness. Developing a “warrior” and “survivor” mindset marked a shift from victimhood to agency as participants redefined their self-concept and resisted being reduced to their past. These accounts align with the PTG domain of personal strength (Tedeschi & Calhoun, 2004), though the framing came from survivors’ voices. Resilience was seen as both empowering and protective, reflecting a nuanced understanding of strength (Luthans et al., 2006). Survivors acknowledged vulnerability not as weakness but as a space for growth. Healing required confronting fear and suffering while reclaiming agency—consistent with trauma-informed resilience, which emphasizes growth through engagement with pain (Courtois & Ford, 2013).

Survivors also cultivated joy, gratitude, and acceptance through reflection and reframing. This shift supported a more empowered relationship with self and others. These experiences mirror findings on the role of gratitude in fostering growth (Fredrickson et al., 2003; Park & Ai, 2006). Redefining purpose through advocacy and education emerged as another form of internal agency. Survivors pursued careers and roles that allowed them to “do their part,” transforming past suffering into purposeful action. Advocacy became a way to reclaim power, support others, and create change. These findings align with research linking prosocial behavior to PTG (Linley & Joseph, 2004) and reflect both personal and relational redefinition (Park & Ai, 2006; Tedeschi et al., 2018). Spiritual grounding also contributed to identity reconstruction, with survivors finding meaning through faith or redefining their beliefs. This spiritual growth reflected personal framing and aligned with broader PTG literature (Park & Ai, 2006).

A novel insight was the recontextualization of survival mechanisms such as dissociation, substance use, and hypervigilance, which were described as adaptive tools that later evolved into coping strategies. Survivors did not view these as inherently maladaptive but as necessary for survival. Over time, they became integrated into intentional healing. This perspective affirms trauma-informed models that recognize these behaviors as adaptive (van der Kolk, 2014). For example, hypervigilance was reframed as intuition, and dissociation transitioned into mindful awareness, demonstrating survivors’ capacity to extract meaning from adversity (Luthans et al., 2006).

External Factors Promoting Change
     External support systems played a vital role in participants’ growth. Survivors emphasized the value of close relationships with family, mentors, or peers, while also naming the difficulty of rebuilding trust. Survivor-led networks helped them connect without fear of judgment, underscoring the importance of relational safety in trauma recovery. Though many initially struggled with vulnerability, forming safe connections brought healing benefits, even amid ongoing trust issues. This finding aligns with attachment-based trauma recovery models, which highlight the reparative potential of secure relationships (Courtois & Ford, 2013; Herman, 1997).

Access to counseling and trauma-informed relationships was also pivotal in supporting participants’ growth. Participants valued counselors who showed patience, honesty, warmth, and structure. These were reported as some qualities that foster trust and reflection. These traits reflect trauma-informed principles (Hays & Singh, 2023; Herman, 1997). Support groups further offered validation and community, reinforcing survivor networks as protective against re-trafficking. Survivors also engaged in non-traditional healing approaches, including movement-based therapy, spiritual practices, creative arts, retreats, and animal-assisted interventions. These practices enabled emotional release, reconnection with the body, and creativity, affirming the need for individualized, culturally relevant care.

Implications for Practice
     This study underscores the complexity of PTG among sex trafficking survivors, demonstrating that growth involves both internal processes and external sources of support. By centering participants’ voices, we uncovered themes that reflect established PTG domains (Tedeschi & Calhoun, 2004) while expanding the framework to include survival mechanisms as foundations for growth.

The findings offer insights for enhancing trauma-informed care and guiding counselors, researchers, and policymakers. Key implications include integrating strengths-based, individualized interventions that emphasize support networks, empowerment, and community engagement. Counselors should view survival mechanisms like dissociation or substance use as adaptive responses and help survivors reconceptualize them into healing tools. Creativity, patience, and honesty were identified as essential counseling traits. Therapies such as somatic work, art, and movement-based interventions should be considered. Involving survivors in treatment planning helps tailor care to their unique goals.

Support groups and survivor-led programs are vital for fostering PTG and preventing re-trafficking. Counselors should collaborate with nonprofits and survivor communities to build peer support models that offer connection and validation. A multidisciplinary approach is essential, requiring collaboration among mental health professionals, social workers, medical providers, and legal advocates. Training in trauma-specific competencies such as recognizing trafficking indicators and addressing ritualistic abuse is critical. Survivors also emphasized rediscovering identity and agency. Counselors can support this by creating leadership opportunities including mentoring, advocacy, writing, or speaking. Incorporating survivor voices into policies and services can strengthen the effectiveness of survivor-centered care.

Finally, consistent with the counseling profession’s emphasis on strengths-based approaches, our findings underscore the importance of recognizing and building upon survivors’ existing resources, including resilience, agency, and the warrior mindset described in their narratives. Counselors can integrate trauma-informed best practices with these strengths to promote empowerment, identity reconstruction, and long-term well-being (Courtois & Ford, 2013; Hays & Singh, 2023).

Limitations and Recommendations for Future Research
     Although this study offers valuable insights into PTG among sex trafficking survivors, several limitations should be noted. Participants were recruited primarily through advocacy networks and social media, which likely attracted individuals already engaged in healing or public advocacy. This self-selection may reflect those already experiencing PTG and may have excluded individuals in earlier or more complex stages of recovery. Future research should include more diverse survivor experiences, especially those in the immediate aftermath of trauma, to capture a broader range of recovery trajectories.

The study’s limited cultural and racial diversity also affects generalizability, underscoring the need to explore how cultural factors influence PTG and intervention effectiveness. The cross-sectional design offered only a snapshot of PTG. Longitudinal research could better illuminate how survival mechanisms like dissociation evolve into adaptive strategies. Further research is needed to examine the role of alternative practices such as somatic approaches, yoga, or animal-assisted activities, which some survivors found meaningful, though their effectiveness in addressing mental health concerns remains under investigation. Finally, engaging survivors as co-researchers can ensure their lived experiences meaningfully shape future research and advocacy.

Given these limitations in generalizability, future research should also focus on refining theory related to survivor-defined PTG. Clearer theoretical frameworks are needed to distinguish PTG from related constructs such as resilience and healing, and to guide counseling interventions that are both evidence-based and survivor-centered.

Conclusion
     This study examined survivor-defined PTG among sex trafficking survivors, highlighting resilience, identity shifts, and renewed purpose. Survivors described PTG as more than recovery, involving meaning-making, agency, and hope. These findings support strengths-based, trauma-informed counseling that amplifies survivor voices and fosters growth beyond symptom relief. Training programs should prepare counselors to recognize and support PTG, while future research can expand survivor-centered definitions across diverse contexts and evaluate interventions that intentionally promote growth.

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript. 

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