Impact in Qualitative Research: Sharli Paphitis and Sohail Jannesari on prioritising the voices of human trafficking survivors to develop a holistic approach to recovery
Dr Sharli Paphitis is a Senior Research Fellow in Qualitative Research at the Institute of Psychiatry, Psychology and Neuroscience at King's College London. Her interdisciplinary research focuses on epistemic justice, mental health, and community-based participatory methods. Dr Sohail Jannesari is a Research Fellow at King’s College London and a Senior Teaching Fellow at Imperial College London. His research focuses on migration and mental health, outcomes for survivors of human trafficking, creative, participatory and decolonial methods, equitable knowledge production, and research ethics. In this blog, they discuss the importance of prioritising the voices of human trafficking survivors to develop a holistic approach to recovery.
Survivors of human trafficking face significant challenges in rebuilding their lives. Despite various interventions aimed at supporting them, there has been a lack of consensus on what constitutes meaningful recovery and well-being, or how this should be measured. The Modern Slavery Core Outcome Set (MSCOS), developed through survivor-centred research, is a ground-breaking framework designed to help standardise and improve the effectiveness of interventions for survivors. By identifying seven core outcomes essential for recovery, the MSCOS provides a much-needed structure for policymakers, service providers, and researchers to design and evaluate interventions and support services.
The Power of Survivor-Centred Research
The MSCOS was developed through a rigorous, participatory approach involving survivors at every stage. The research team conducted systematic literature reviews, 46 survivor interviews, three stakeholder workshops, and a survivor-centred Delphi consensus process to determine the most critical outcomes for recovery.
A key impact of this approach is that the MSCOS reflects holistic and multidimensional needs, rather than imposing external, potentially disconnected measures of success. By integrating lived experience into research, we move beyond the traditional top-down models of support and towards survivor-informed policy and practice.
Survivors’ voices were prioritised in our research, with their responses carrying more weight than those of other participants. We also employed survivor leaders as researchers and worked with an active survivor research advisory board. This survivor-centred methodology not only ensured the findings were relevant but meant that our research process itself positively impacted survivors in terms of skills-building, confidence and agency.
To improve, we should have involved survivors in the shaping of the research proposal and included survivors as CO-I’s in the initial application.
Seven Core Outcomes for Survivor Recovery
The MSCOS identifies seven essential outcomes that should be the minimum standard for measuring interventions aimed at survivor recovery:
- Secure and suitable housing – Survivors need stable, safe housing to rebuild their lives.
- Safety from traffickers or other abusers – Ensuring survivors are protected from re-exploitation is paramount.
- Long-term, consistent support – Recovery is not linear; survivors require ongoing, dependable assistance.
- Compassionate, trauma-informed services – Service providers must understand and integrate trauma-informed approaches.
- Finding purpose and self-actualisation – Employment, education, and meaningful activities play a key role in recovery.
- Access to medical treatment – Both physical and mental health support are essential.
- Access to education – Education equips survivors with tools for independence and empowerment.
For researchers, the MSCOS provides a consistent framework for evaluating survivor recovery, improving the comparability of studies and enhancing the evidence base. This is particularly important for securing funding, as policymakers and service providers increasingly look for standardised metrics to justify investment in interventions. By co-developing the outcomes with survivors, we have ensured that they, and the work the uses them, reflect real needs rather than assumed outcomes that may not align with lived experiences.
Impact on Policy and Practice
One of the most significant contributions of the MSCOS is its potential to reshape policy and service provision for survivors. Currently, interventions vary widely, with no unified approach to measuring success. This fragmentation makes it difficult to assess which interventions work best. By adopting the MSCOS, policymakers and service providers can align their efforts, ensuring that all initiatives contribute towards the same core outcomes. We worked with survivors to present the MSCOS to Home Office policymakers and asked them to integrate the outcomes into the contracts they gave out for anti-trafficking services.
The interconnected nature of survivor recovery is highlighted in the MSCOS. Many existing interventions focus on single aspects, such as legal support or housing, without considering how these areas overlap. For example, access to medical care is crucial for mental health recovery, which in turn affects a survivor’s ability to engage in education or employment. The MSCOS promotes a holistic approach, recognising that all seven outcomes are relevant throughout a survivor’s life. One of the MSCOS survivor experts, Kieth Lewis, explains how the MSCOS elements function holistically as follows:
The MSCOS is like the tower in a Jenga game: If you remove one outcome - one ‘block’, - the tower becomes unstable; remove another block and the tower can crash down; the survivor is failed, they can’t recover, and the chances are they will suffer more exploitation and human trafficking.
A crucial lesson from this research has been the impact of including survivors throughout the process. The participatory approach we took to conducting the research, generally made a positive difference to the survivor leaders we worked with. For instance, in terms of confidence and skill-building among peer-researchers and advisory board members. It demonstrated that involving those with lived experience enhances both the research itself and the well-being of those involved. The emotional toll of contributing to this kind of work should not be underestimated, however, and future projects should prioritise long-term well-being, flexible participation options, and additional mental health support for survivor-researchers. Our project could have factored and budgeted in to support survivors with unpredictable life events, such as being refused government support.
The MSCOS is already making an impact beyond the research and participants. A Community of Practice has been established to embed these outcomes in real-world practice, providing training, peer support, and knowledge-sharing opportunities for organisations adopting the framework. The Community of Practice is an open, collaborative space for researchers, service providers, policymakers, and survivors to discuss challenges and innovations in implementing the MSCOS. Through webinars, workshops, and ongoing engagement, the community ensures that best practices are continuously refined and shared. There are now plans to spin-off the Community of Practice into an independent charity to make its work more sustainable.
A Path Towards Meaningful Change
Our research represents a major step forward in ensuring that survivor recovery is measured and supported in ways that truly reflect their needs. The impact of qualitative research in this space is undeniable. It has amplified survivor voices, shaped meaningful policy recommendations, and laid the groundwork for a more consistent, trauma-informed approach to survivor recovery.