BILLINGS, Mont.-Rick and Pat Freeland have cared for hundreds of troubled girls and women at their log cabin refuge deep in the Rocky Mountains, but there's one rule; they will only take two victims of sex trafficking at a time.

Survivors of sex trafficking can be among the most difficult crime victims to assist, often resisting help, refusing to see themselves as victims and returning to their traffickers, experts say.

Added to that, they can be smart, manipulative and deceptive, using the same behaviors they learned to survive on anyone who tries to help them.

"When it comes to trafficked girls, we will not take any more than two at a time," Rick Freeland told the Thomson Reuters Foundation.

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The Freelands' sprawling home could hold more but "as damaged as they are, it just doesn't work," he said.

Trafficking victims' needs vary hugely, depending on the kind of damage done to them and how early on in their lives, he said.

The average age of girls drawn into the U.S. commercial sex industry is 12 years, according to the Department of Justice.

"They need so much one-on-one individual attention. It's just almost impossible to give them that and have them not be jealous of each other," Freeland said last week.

The couple receive women and girls who have been referred from an array of organizations and agencies.

"Teaching them their self-worth, that's our goal," said Pat Freeland. "To show them that they have worth more than their bodies can give them."

They arrange for victims to get medical care, education, counseling and other help. Some survivors have stayed at the refuge more than two years, Pat Freeland said.

In the United States, the National Human Trafficking Resource Center received reports of more than 4,000 cases of sex trafficking last year and says it knows of nearly 15,000 sex trafficking cases since 2007.

The NHTRC defines sex trafficking as the use of violence, threats, lies, debt bondage and other coercion to compel adults and children to engage in commercial sex acts.

Some 4.5 million people around the world are trapped in forced sexual exploitation, the International Labour Organization estimates.

Sex trafficking may include prostitution, pornography, exotic dancing, stripping and live sex shows.

Runaways, children in foster care or from backgrounds of broken homes, violence, absent parents and drug abuse are especially vulnerable to being trafficked, experts say.

Victims resist help

Victims are resistant to accepting help because traffickers give them money, attention, shelter, drugs and relevance, said Sgt. Grant Snyder, a trafficking investigator and expert with the Minneapolis Police Department.

"That's why you can take a kid that's been choked into unconsciousness, hooked on methamphetamines, beaten up, raped, put in a motel room and forced to have sex with a bunch of guys she doesn't know and ... three days later she will run away back to her trafficker," he said at a recent seminar on sex trafficking in the state of Montana.

Many are very unhappy to be considered victims, said Agent Gary Seder of the Montana Division of Criminal Investigation, who works undercover on trafficking cases in the city of Billings.

"One of the standard answers we get is ... 'I'm free to go at any time I want to,'" he said.

Getting them to leave 'the life' for a shelter or rehabilitation is a delicate dance, involving such tactics as letting them choose something as simple as what to eat for dinner, Seder said.

They start realizing they were not free to make their own choices when they were being trafficked, he said.

"They start putting two and two together," he said.

Victims of sex trafficking commonly experience post-traumatic stress disorder, acute anxiety and depression and feel humiliation, distrust and self-hatred, according to the National Institutes of Health.

Untangling trafficker's tentacles

Pat Freeland described the trafficking victims she has met as chameleons, skilled at acting and saying what is needed to survive.

"They will become what they have to become," she said.

Their chameleon-like behavior makes it hard to know if victims at the refuge are ready for a fresh start or will return to the life they knew before, she said.

Victims typically need medical care, housing, counseling, drug treatment, education, job training and work, experts say.

Seder said untangling the psychological tentacles of their traffickers is painstaking work.

"Girls really do believe they are loved by these guys .... but the reality is, no legitimate relationship is going to want you out doing this sort of thing with other guys for money and stuff," he said.

"They're definitely brainwashed with these guys. There's no doubt."