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Mercera G, Kooijmans R, Leijdesdorff S, Heynen E, van Amelsvoort T. Risk and Protective Factors for Sexual Exploitation in Male and Female Youth From a Cross-Cultural Perspective: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1966-1984. [PMID: 37818954 DOI: 10.1177/15248380231201815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Youth are at elevated risk of becoming victims of sexual exploitation, which has a detrimental impact on their physical and psychological well-being. Understanding factors associated with sexual exploitation is key for prevention efforts and adequate and timely treatment. This systematic review sheds more light on this by providing an overview of both risk and protective factors for sexual exploitation in male and female youth from a cross-cultural perspective. In all, 65 studies were selected meeting the inclusion criteria: qualitative or quantitative peer-reviewed studies in English, Dutch, or German with findings on risk and protective factors associated with sexual exploitation in youth aged up to 24 years. Results show that there are common risk factors in male and female youth worldwide (e.g., adverse childhood experiences, lack of a social network, substance use, and running away). Positive and supportive relationships are an important protective factor in mitigating the risk of sexual exploitation. Geographic differences were found. In non-Western continents, more environmental factors (e.g., economic vulnerabilities, residential instability) were cited. Research in countries outside the United States is limited and protective factors and males are underexamined. To fully understand vulnerabilities in youth, their interactions, and possible gender differences and to address the needs of diverse populations, more insight should be gained into the broader range of risk and protective factors worldwide. This systematic review has made a valuable contribution to this by providing practice, policy, and research guidance in the establishment of more targeted prevention efforts, adequate treatment, and areas to address in future research.
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Affiliation(s)
- Gabriëlle Mercera
- Koraal Center of Expertise, Sittard, The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Roel Kooijmans
- Koraal Center of Expertise, Sittard, The Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands
| | - Sophie Leijdesdorff
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Evelyn Heynen
- Department of Clinical Psychology, Open University, Heerlen, The Netherlands
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Pastor-Moreno G, Ruiz-Pérez I, Sordo L. [Barriers and proposals for a health care approach to trafficking for sexual exploitation]. GACETA SANITARIA 2023; 37:102333. [PMID: 37992461 DOI: 10.1016/j.gaceta.2023.102333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To examine the perception of the trafficking in women for sexual exploitation, identify the difficulties and collect the proposals of professionals in direct contact with the victims of trafficking in women for sexual exploitation in Andalusia (Spain). METHOD Qualitative study based on interviews with 10 key informants, selected from organizations providing support and care to victims of trafficking in women for sexual exploitation in 2021. Two researchers carried out a thematic categorical content analysis, integrative and relational analysis. Three themes with different sub-themes were analyzed. RESULTS Difficulties have been identified in relation to women (delay in recognizing themselves as victims, cultural differences, distrust of the system), traffickers (modification of strategies), health professionals (lack of sensitivity and lack of homogeneity in actions) and the health system (lack of cultural intermediation, administrative complexity). The key informants propose more training for professionals, the use of effective action protocols and better coordination between institutions. CONCLUSIONS The health sector faces a number of challenges in responding comprehensively and effectively to trafficking in women for sexual exploitation. Improvements are needed in raising awareness among health professionals, the development of standardized protocols, greater collaboration between sectors, the provision of specialized mental health services and effective cultural mediation.
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Affiliation(s)
- Guadalupe Pastor-Moreno
- Escuela Andaluza de Salud Pública, Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto de Investigación Biosanitaria de Granada, Granada, España.
| | - Isabel Ruiz-Pérez
- Escuela Andaluza de Salud Pública, Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto de Investigación Biosanitaria de Granada, Granada, España
| | - Luis Sordo
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Prior A, Shilo G, Peled E. Help-Seeking and Help-Related Experiences of Commercially Sexually Exploited Youth: A Qualitative Meta-Synthesis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1693-1711. [PMID: 35379052 DOI: 10.1177/15248380221074333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This interpretive qualitative meta-synthesis (QMS) aims to systematically review what we know about the help-seeking and help-related experiences of commercially sexually exploited youth (CSEY). A comprehensive search of the relevant databases was conducted to identify published qualitative peer-reviewed papers and research reports about the experiences and perceptions of CSEY. A corpus of 34 qualitative studies was compiled and synthesized, using the conceptual framework of help-seeking and QMS guidelines. The QMS reveals that although help-seeking of CSEY are rarely the focus of the inquiry, the reviewed studies include meaningful information about help-related experiences of CSEY. Thus, the synthesis of the available data yields novel insights about how CSEY perceive their involvement in CSE, define the problems they deal with, decide to seek help, choose the proper help, and engage in helping relations. Particularly, the QMS underscores that CSEY do not always perceive their involvement in CSE as problematic, nor do they identify themselves as victims of exploitation. The findings highlight the significance of developing social services that specialize in helping CSEY, the importance of actively identifying CSEY and reaching out to them, and the need to enable CSEY to be involved in decisions about the extent and type of support they are provided.
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Affiliation(s)
| | - Guy Shilo
- Tel-Aviv University, Tel Aviv, Israel
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Godoy SM, Perris GE, Thelwell M, Osuna-Garcia A, Barnert E, Bacharach A, Bath EP. A Systematic Review of Specialty Courts in the United States for Adolescents Impacted by Commercial Sexual Exploitation. TRAUMA, VIOLENCE & ABUSE 2023; 24:1344-1362. [PMID: 35001766 PMCID: PMC9262992 DOI: 10.1177/15248380211061403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Nationwide efforts to enhance services for adolescents experiencing commercial sexual exploitation (CSE) in the judicial system have led to the emergence of specialty courts, including human trafficking and girls' courts. Given that prior research has documented competing stances on the effectiveness of specialty courts for CSE-impacted populations, we conducted a systematic review of the literature to identify key characteristics of programming, profiles of adolescents served, and effectiveness of these courts. To identify relevant research and information, we systematically searched scholarly databases and information sources, conducted reference harvesting, and forwarded citation chaining. Articles presenting primary data with quantitative, qualitative, or mixed methodologies or programmatic descriptions of specialty courts serving adolescents at risk or with confirmed histories of CSE that were published after 2004 were included. We identified 39 articles on 21 specialty courts serving adolescents at risk or with confirmed histories of CSE, including seven specialty courts with evaluation or outcome data. Across specialty courts, adolescents benefited from an increase in linkage to specialized services, improved residential placement stability, and reduction in recidivism-measured by new criminal charges. Specialty court participation was also associated with improved educational outcomes and decreased instances of running away. A lack of empirical data, specifically of evaluation studies, emerged as a weakness in the literature. Still, findings support that specialty courts can be an integral judicial system response to CSE. Multidisciplinary collaboration can help target and respond to the multifaceted needs of adolescents, encourage healthy behaviors, and promote their overall wellness.
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Affiliation(s)
- Sarah M. Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro Street, Room 400-I, Chapel Hill, NC United States, 27599
| | - Georgia E. Perris
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Mikiko Thelwell
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Antonia Osuna-Garcia
- Health and Life Sciences Library, UCLA Science Libraries, 12-077 Center for Health Sciences, Los Angeles, CA, United States, 90095
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children’s Hospital, Los Angeles, CA, UCLA Pediatrics, Box 951752, 12-467 MDCC, Los Angeles, CA, United States, 90095-1752
| | - Amy Bacharach
- Center for Families, Children, and the Courts, Judicial Council of California, 455 Golden Gate Avenue, San Francisco, CA 94102
| | - Eraka P. Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, United States, 90024
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Prior A, Eyal-Lubling R, Koren-Shimshoni D, Peled E, Shilo G. Forging help relationships with commercially sexually exploited youth: Perspectives of Israeli help providers. CHILD ABUSE & NEGLECT 2023; 143:106253. [PMID: 37267761 DOI: 10.1016/j.chiabu.2023.106253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/06/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Previous research points to the many challenges that help providers who support commercially sexually exploited youth encounter in their professional work-yet little is known about how they overcome these challenges, particularly with regard to youth of diverse social backgrounds. OBJECTIVE The present study applied the conceptual frameworks of help-seeking and intersectionality to explore the professional practices that help providers employ when forging a help relationship with commercially sexually exploited youth. PARTICIPANTS AND SETTING Israeli help providers who work with commercially sexually exploited youth at various social services. METHOD In-depth semi-structured interviews were conducted, and analyzed using constructivist grounded theory approach. FINDINGS We identified six major guiding principles that support the participants' processes of forging a help relationship with commercially sexually exploited youth: Do not assume that the youth view their involvement in commercial sexual exploitation as problematic; Continuously attempt to gain the youth's trust; Start from the point where the youth are; Be available at all times, and maintain a steady long-term relationship; Treat commercially sexually exploited youth as agentic individuals and encourage them to lead the process of establishing a help relationship; Similarity in social backgrounds of help providers and commercially sexually exploited youth promotes youth's engagement in the help relationship. CONCLUSIONS Assuming the co-existence of benefit and harm in commercial sexual exploitation is essential to forging a help relationship with the youth. Applying the intersectional lens to practice in this field can help preserve the delicate balance between victimhood and agency, thereby enhancing help processes.
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Affiliation(s)
- Ayelet Prior
- The Bob Shapell School of Social work, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 6997801, Israel.
| | - Roni Eyal-Lubling
- The Bob Shapell School of Social work, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 6997801, Israel.
| | - Danya Koren-Shimshoni
- The Bob Shapell School of Social work, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Einat Peled
- The Bob Shapell School of Social work, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 6997801, Israel.
| | - Guy Shilo
- The Bob Shapell School of Social work, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 6997801, Israel.
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Wallace C, Greenbaum J, Albright K. Global Perspectives on the Health and Social Impacts of Child Trafficking. Pediatrics 2022; 150:189511. [PMID: 36120743 DOI: 10.1542/peds.2021-055840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Survivors of child sex trafficking (CST) experience many health and social sequelae as a result of stigma, discrimination, and barriers to health care. Our objective was to obtain a cross-cultural understanding of these barriers and to explore the relationship between stigmatization and health outcomes through application of the Health Stigma and Discrimination Framework (HSDF). METHODS In-depth, semistructured interviews were conducted with 45 recognized CST expert service providers. Interview data were analyzed using established content analysis procedures and applied to the HSDF. RESULTS Barriers to medical and mental health services span each socioecological level of the HSDF, indicating the various contexts in which stigmatization leads to adverse health and social outcomes. Stigmatization of CST survivors is a complex process whereby various factors drive and facilitate the marking of CST survivors as stigmatized. Intersecting stigmas multiply the burden, and manifest in stigma experiences of self-stigmatization, shame, family and community discrimination, and stigma practices of provider discrimination. These lead to reduced access to care, lack of funding, resources, and trained providers, and ultimately result in health and social disparities such as social isolation, difficulty reintegrating, and a myriad of physical health and mental health problems. CONCLUSIONS The HSDF is a highly applicable framework within which to evaluate stigmatization of CST survivors. This study suggests the utility of stigma-based public health interventions for CST and provides a global understanding of the influence and dynamics of stigmatization unique to CST survivors.
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Affiliation(s)
- Carmelle Wallace
- Department of Pediatrics, Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine, and Children's Hospital Colorado, Denver, Colorado
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Karen Albright
- Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Denver, Colorado.,Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs, Washington, District of Columbia
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Murdock L, Hodge-Williams C, Hardin K, Rood CJ. Youth survivor perspectives on healthcare and sex trafficking. J Pediatr Nurs 2022; 66:95-103. [PMID: 35689954 DOI: 10.1016/j.pedn.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to assess the perspectives of youth survivors of sex trafficking on healthcare to improve care for this vulnerable and often unrecognized population. DESIGN AND METHODS Semi-structured focus groups were conducted with eight survivors in Southern California who interacted with the healthcare system while being sex trafficked. Interviews were audio- and/or video-recorded and transcribed verbatim. The analysis utilized a grounded theory approach, where researchers reviewed the data collected, then inductively generated codes and themes based on the findings from the interviews. RESULTS The focus group interviews revealed the following themes: unequal treatment, barriers to patient care, risk identifiers, support, and survivor recommendations. CONCLUSIONS Youth survivors seeking healthcare reported multiple barriers based on their interaction with healthcare providers, such as the lack of provider awareness, education, training, feelings of shame, judgment, fear, racial biases, and lack of empathy. Improving patient outcomes relies on understanding the complexities of human trafficking and implementing an approach to decrease barriers to care. PRACTICE IMPLICATIONS This study resulted in invaluable survivor recommendations with practical solutions on addressing human trafficking and exploitation in the healthcare system. The solutions proposed by participants included strengthening relationships and experiences with healthcare providers by increasing awareness, establishing rapport, creating a safe space, asking questions about their safety and situation, using a non-judgmental approach, and providing resources.
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Affiliation(s)
- Lisa Murdock
- Children's Hospital Orange County (CHOC), 1201 W. La Veta Ave., Orange, CA 92868-3874, United States of America.
| | - Candice Hodge-Williams
- Azusa Pacific University, 701 E. Foothill Blvd PO Box 7000, Azusa, CA 91702-7000, United States of America
| | - Kaitlin Hardin
- University of California, Irvine, 102 Aldrich Hall, Irvine, CA, 92697, United States of America
| | - Corey J Rood
- Children's Hospital Orange County (CHOC), 1201 W. La Veta Ave., Orange, CA 92868-3874, United States of America; University of California, Irvine, 102 Aldrich Hall, Irvine, CA, 92697, United States of America
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8
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Fraley HE, Subedi G. Confusing Terms: A Concept Analysis of Naming Youth Trafficking. JOURNAL OF FORENSIC NURSING 2022; 18:174-184. [PMID: 35293359 DOI: 10.1097/jfn.0000000000000382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human trafficking is a growing population health problem. More than half of all persons experiencing trafficking are youth, with many in the United States unrecognized despite experiencing exploitation. Available peer-reviewed articles report a myriad of descriptions of trafficking, yet the concept and operational definition of youth trafficking, specifically, is lacking and unclear. Youth trafficking is described differently across multidisciplinary researchers and clinicians working with trafficked youth. Furthermore, labor trafficking of youth is largely excluded from the conversation surrounding trafficking. This article presents a concept analysis of naming trafficking of persons under the age of 18 years to clarify the concept specific to youth experiencing all forms of trafficking and approaches professionals can take with this specific subpopulation of trafficked persons and survivors.
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Barnert ES, Bath E, Heard-Garris N, Lee J, Guerrero A, Biely C, Jackson N, Chung PJ, Dudovitz R. Commercial Sexual Exploitation During Adolescence: A US-Based National Study of Adolescent to Adult Health. Public Health Rep 2022; 137:53S-62S. [PMID: 35775919 DOI: 10.1177/00333549211054082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES National data on the health of children and adolescents exposed to commercial sexual exploitation (CSE) are lacking, during both adolescence and adulthood. Using nationally representative data, we examined the health of male and female adolescents in grades 7-12 who experienced CSE exposure and subsequent adult health outcomes and access to health care. METHODS Our retrospective cohort study used data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) to characterize relationships between CSE exposure before or during adolescence and health during adolescence and adulthood. The analytic sample included 10 918 adult participants aged 24-34 in Wave IV. We performed bivariate analyses, stratified by sex, to quantify the relationship between CSE exposure before or during adolescence and adolescent and adult health outcomes. RESULTS Four percent of participants reported having a CSE exposure before or during adolescence (5% of males, 3% of females). Factors associated with CSE exposure among adolescents included race/ethnicity, parental education level, previous abuse, same-sex romantic attractions, history of ever having run away from home, and substance use. During adolescence, exposure to CSE was associated with worse overall health, depressive symptoms, and suicidal thoughts for both males and females. In adulthood, adolescent CSE exposure was associated with depression among males and functional limitations among females. A higher percentage of males with CSE exposure before or during adolescence, compared with their non-CSE-exposed peers, used the emergency department as their usual source of care during adulthood. CONCLUSIONS CSE exposure before or during adolescence was associated with poor adolescent and adult health outcomes and health care access. Observed differences between males and females warrant further exploration.
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Affiliation(s)
- Elizabeth S Barnert
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Nia Heard-Garris
- 2429 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Joyce Lee
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alma Guerrero
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher Biely
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nicholas Jackson
- 155697 Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Paul J Chung
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,6470 Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Los Angeles, CA, USA.,Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Rebecca Dudovitz
- 8783 Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
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Peterson LJ, Foell R, Lunos S, Heisterkamp B, Greenbaum VJ, Harper NS. Implementation of a screening tool for child sex trafficking among youth presenting to the emergency department - A quality improvement initiative. CHILD ABUSE & NEGLECT 2022; 125:105506. [PMID: 35091304 PMCID: PMC8862543 DOI: 10.1016/j.chiabu.2022.105506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Identification of sex-trafficked youth in the emergency department (ED) is difficult and routine screening is uncommon. OBJECTIVES Our Quality Improvement (QI) Project aimed to increase ED screening and identification of high-risk youth using the Short Screen for Child Sex Trafficking (SSCST). PARTICIPANTS Youth (11 through 17 years) seeking care at two metropolitan EDs with a high-risk chief complaint triggering a best practice alert (BPA). METHODS A BPA prompted administration of the SSCST and referral of screen 'positive' youth for comprehensive evaluation for child sex trafficking by the forensic nurse examiner (FNE). Targeted QI interventions defined three study periods (SP). Outcomes measures included screening 50% of high-risk youth with 50% of those youth referred for FNE evaluation. RESULTS Over three study periods, 5454/13,956 (39.1%) youth triggered a BPA for high-risk chief complaint; 4354 (78.6%) received the SSCST screen; 1336 (76.0%) of screen-positive youth were referred for FNE evaluation. Outcomes measures were exceeded during all three study periods. SSCST modifications to increase specificity led to a significant decrease in the percentage of positive screens (42.8% SP1 vs 29.4% SP3). Financial programmatic support and further staff training led to an increase in FNE evaluations (86.4 SP3 vs 5.7% of referred youth SP1). Identification of trafficked patients increased from 1.3% of screen-positive youth to 11.3% (SP1 vs SP3; p < 0.0001). CONCLUSIONS Routine screening for child sex trafficking can be implemented in the ED setting and increases the identification of at-risk youth.
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Affiliation(s)
- Loralie J Peterson
- Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, United States of America
| | - Rebecca Foell
- Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, United States of America
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, United States of America
| | | | - V Jordan Greenbaum
- International Centre for Missing and Exploited Children, United States of America
| | - Nancy S Harper
- Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, United States of America.
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11
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Chambers R, Greenbaum J, Cox J, Galvan T. Trauma Informed Care: Trafficking Out-Comes (TIC TOC Study). J Prim Care Community Health 2022; 13:21501319221093119. [PMID: 35438596 PMCID: PMC9021523 DOI: 10.1177/21501319221093119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Little is known about the impact of trauma-informed primary healthcare on recovery from human trafficking, or individual characteristics associated with successful participation in community services. OBJECTIVE To evaluate the efficacy of a trauma-informed family medicine clinic, the Medical Safe Haven ("MSH"), in facilitating success in a community-based anti-trafficking victim service program, Community Against Sexual Harm ("CASH"), and to identify participant characteristics associated with successful CASH completion. METHODS Retrospective analysis of data from 57 adult females participating in the CASH program, 37 of whom received care at MSH. We examined differences in descriptive statistics between those who completed the CASH program and those who did not; then conducted logistic and linear regressions testing the association between MSH care and CASH program outcomes. Survival analysis models examined the time to CASH program drop-out (program incompletion). RESULTS Odds of successful CASH completion increased by a factor of 5.37 for MSH patients compared to other participants. This association strengthened with increases in the duration of MSH care and degree of patient engagement. The positive association of MSH care on program completion was mediated by the length of program participation. The extended length of participation among MSH patients was even stronger when those patients were in a stable and independent housing situation. The risk of program incompletion was 68% lower for MSH patients compared to other participants. CONCLUSIONS Adults who experience human trafficking and receive healthcare at MSH are significantly more likely to successfully complete the CASH program than those who do not receive healthcare or who use alternative health systems. Study findings argue for the importance of consistent, trauma-informed longitudinal healthcare for trafficked persons.
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Affiliation(s)
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA, USA
| | - Jennifer Cox
- Commonspirit Health, Dignity Health, Sacramento, CA, USA
| | - Terri Galvan
- Community Against Sexual Harm, Sacramento, CA, USA
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12
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Human Trafficking in Rehabilitation: What Nurses Need to Know. Rehabil Nurs 2021; 47:24-30. [PMID: 34772899 DOI: 10.1097/rnj.0000000000000356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Violence and human trafficking are frequently paired and violate human rights. Human trafficking is a complex, global health issue. Trafficking survivors report seeking medical care for women's services, physical abuse, mental health, and gastrointestinal issues while being held in captivity. However, the majority of healthcare providers are unaware or unprepared to intervene, thus missing the chance to identify victims during these encounters. Rehabilitation nurses are no exception. Trafficking victims may come in contact with rehabilitation nurses because of injuries or chronic diseases caused by trafficking abuse. This article shares human trafficking red flags, victims' access to services, barriers to identification, and nursing interventions and implications.
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13
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Fraley HE, Aronowitz T. Obtaining Exposure and Depth of Field: School Nurses "Seeing" Youth Vulnerability to Trafficking. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:7547-7573. [PMID: 30879385 DOI: 10.1177/0886260519836779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Trafficking of youth is a growing phenomenon. How commercially exploited youth present in schools is multifaceted and poorly understood. Like other providers, school nurses are on the frontlines, yet can misunderstand youth who are commercially exploited. Using Grounded Theory, we employed theoretical sampling with school nurses and survivors of trafficking to generate a theory that explains (a) the factors that increase the risk of youth being trafficked and (b) how school nurses might identify youth at risk of being trafficked. The emerging theory developed from the data was Obtaining Exposure and Depth of Field: School Nurses "Seeing" Youth Vulnerability to Trafficking. Voices of school nurses and survivors illuminated the invisibility of youth in schools who are victims of trafficking and the magnified lens of exploiters who see their vulnerability. The lens of school nurses can be refocused to "see" youth who are victims of trafficking presenting at school.
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Lanctot N, Turcotte M, Pascuzzo K, Collin-Vezina D, Laurier C. Commercial Sexual Exploitation, Stigma, and Trauma: A Detrimental Trio for an Altered Sense of Self. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:703-721. [PMID: 34470596 DOI: 10.1080/10538712.2021.1970679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/29/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to assess whether, and to what extent, the commercial sexual exploitation of female adolescents placed in residential care predicted different manifestations of an altered sense of self in emerging adulthood while considering the possible confounding effects of child maltreatment and perceived stigmatization. Data were gathered in a broader longitudinal study conducted among a sample of 124 female adolescents placed in residential youth care centers. Commercial sexual exploitation was self-reported during adolescence. Altered sense of self was self-reported in emerging adulthood with the following dependent variables: sense of failure, sense of defensiveness and shame, lack of self-awareness, and other-directedness. Findings suggest that, even after accounting for the significant effects of confounding variables, commercial sexual exploitation increases specific vulnerabilities pertaining to identity development. This creates unique intervention needs among young women. Our study adds to the literature by highlighting the unique influence of commercial sexual exploitation experiences among vulnerable female adolescents on their sense of self in young adulthood. Our results point to the relevance of considering the intersection of trauma and stigmatization when working with and providing services to adolescent females with a history of commercial sexual exploitation.
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Affiliation(s)
- Nadine Lanctot
- Université De Sherbrooke - Campus De Longueuil, Psychoeducation, Longueuil, Quebec, Canada
| | - Mathilde Turcotte
- Centre Intégré Universitaire De Santé Et De Services Sociaux Du Centre-Sud-de-l'Île-de Montréal, Montreal, Canada
| | - Katherine Pascuzzo
- Université De Sherbrooke - Campus De Longueuil, Psychoeducation, Longueuil, Quebec, Canada
| | | | - Catherine Laurier
- Université De Sherbrooke - Campus De Longueuil, Psychoeducation, Longueuil, Quebec, Canada
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15
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Gezinski LB. (De)criminalization of Survivors of Domestic Minor Sex Trafficking: A Social Work Call to Action. SOCIAL WORK 2021; 66:236-244. [PMID: 34148091 DOI: 10.1093/sw/swab015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/04/2019] [Accepted: 01/13/2020] [Indexed: 06/12/2023]
Abstract
Survivors of domestic minor sex trafficking (DMST) are failing to be identified and are frequently criminalized. Examining the linkages between DMST and the juvenile legal system is important, as many trafficked youths are only identified after entry into the child welfare or juvenile court system as a result of being arrested or detained on related delinquency charges. Due to legacies of structural violence, marginalized youths are reluctant to approach police officers for help. Therefore, social workers have an opportunity to identify, intervene, and advocate for trafficked youths. In this article, the author provides an overview of existing research related to the demographic profile of DMST, homelessness and survival sex, recruitment and entry, barriers to effective community response, and prevention and intervention strategies. This article represents a call to broaden our view of young people in the sex trade and supports the decriminalization of trafficked youths. Interventions and policies must be designed to fit their complex needs and experiences, resulting in empowerment, opportunity, and new beginnings.
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Affiliation(s)
- Lindsay B Gezinski
- independent researcher and adjunct professor, Spaarndammerstraat 149F, 1013TG, Amsterdam, Netherlands
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16
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Abstract
Human trafficking and child sex trafficking and sexual exploitation in particular are global public health issues with widespread, lasting impacts on children, families, and communities. Traditionally, human trafficking has been treated as a law enforcement problem with an emphasis on the arrest and prosecution of traffickers. However, use of a public health approach focuses efforts on those impacted by exploitation: trafficked persons, their families, and the population at large. It promotes strategies to build a solid scientific evidence base that allows development, implementation, and evaluation of prevention and intervention efforts, informs policy and program development, and guides international efforts at eradication. This article uses the public health approach to address human trafficking, with a focus on child sex trafficking and exploitation. Recommendations are made for public health professionals to contribute to antitrafficking efforts globally.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia 22314, USA; .,Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, Georgia 30342, USA
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17
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Cook MC, Talbert RD, Thomas B. A longitudinal study of justice characteristics among girls participating in a sex trafficking court program. HEALTH & JUSTICE 2021; 9:1. [PMID: 33404788 PMCID: PMC7789193 DOI: 10.1186/s40352-020-00127-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/16/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Sex trafficking is a public health and social justice issue that has traditionally been addressed with criminal justice solutions. Because many sex trafficking survivors are incarcerated for crimes related to their exploitation, specialty, human trafficking courts were developed to offer resources and assistance to labor and sex trafficking survivors. This study assessed justice-involved youth participating in a specialty, anti-trafficking court program. The purpose of this study was to investigate justice-related outcomes of participants in a specialty court program. We examined: (1) the relationship between age at first citation and justice characteristics (number of bench warrants, number of citations, number placements, and number of times ran away); and (2) the number of months between first citation and enrollment into the program with the aforementioned justice characteristics. We used negative binomial models to estimate the relationships between age at first citation, number of months between first citation and program enrollment, with the four justice characteristics (n = 181). RESULTS Adjusted models showed that younger age at first citation was associated with significantly more bench warrants and citations while in the program. Likewise, fewer months between first citation and program entry was related to more bench warrants and citations. CONCLUSIONS There is a need to evaluate the appropriateness of specialty, trafficking court programs in reducing continued justice involvement and these programs ability to meet the evolving needs of sex trafficking survivors over time. We recommend universal screening for trafficking indicators for all systems-involved youth and relocating trafficking specialty courts out of juvenile courts to dependency courts.
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Affiliation(s)
- Mekeila C Cook
- Division of Public Health Practice, Meharry Medical College, 1005 Dr. DB Todd Blvd., Nashville, TN, 37209, USA.
| | - Ryan D Talbert
- Department of Sociology, University of Connecticut , Storrs, CT, USA
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18
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Recognizing Victims of a Hidden Crime: Human Trafficking Victims in Your Pediatric Trauma Bay. J Trauma Nurs 2020; 27:37-41. [PMID: 31895318 DOI: 10.1097/jtn.0000000000000480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human trafficking is the second largest criminal industry in the United States and almost half of the victims are children. This crime against children is referred to as domestic minor human sex trafficking (DMHST). The majority DMHST victims access health care, often at an emergency department, at some point during their captivity. Trafficking of minors has been cited as the most underreported form of child abuse making education on this topic essential for all health care providers to help meet the needs of this population. A case study provides an illustration of a pediatric trauma patient who was a victim of DMHST and presented to an emergency department for care. As nurses who care for pediatric trauma patients in all settings strive to learn more about child abuse, topics in DMHST should also be included in these educational activities.
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19
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Haney K, LeBeau K, Bodner S, Czizik A, Young ME, Hart M. Sex Trafficking in the United States: A Scoping Review. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:714-748. [PMID: 32678726 DOI: 10.1080/26408066.2020.1765934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Human trafficking is a public health social work issue. This review aimed to present the current state (nature and extent) of sex trafficking research, categorize best practices, and identify recommendations for professionals. METHODS Comprehensive literature searches of online databases were conducted to identify eligible articles from January 2000 to March 2019. RESULTS The search yielded 467 studies, 87 met the predetermined criteria for inclusion. Seven themes identified: awareness, identification, at-risk populations, health issues, implementation of trafficking legislation, service and program implementation, and exploiters. DISCUSSION AND IMPLICATIONS FOR PRACTICE Findings indicate the need for additional research to determine the most effective practices to increase awareness and identification, widespread TVPA implementation, reduce risk factors and resulting health disparities, offer services to survivors and prevention of potential victims. CONCLUSION There should be significant efforts to enhance all sex trafficking research in the United States to implement effective, sustainable and evidence-based interdisciplinary interventions.
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Affiliation(s)
- Kanathy Haney
- Health Sciences, Palm Beach State College , Lake Worth, Florida, USA
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Kelsea LeBeau
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Samantha Bodner
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Annika Czizik
- Department of Medical Geography in Public Health, University of Florida , Gainesville, Florida, USA
| | - Mary Ellen Young
- Department of Occupational Therapy, University of Florida , Gainesville, Florida, USA
| | - Mark Hart
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
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20
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Yaklin S, Rolin D. Recognizing the Risk Factors, Signs, and Symptoms of Domestic Minor Sex Trafficking in Mental Health Clinical Practice. J Psychosoc Nurs Ment Health Serv 2020; 58:21-28. [PMID: 33119118 DOI: 10.3928/02793695-20201013-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/23/2020] [Indexed: 11/20/2022]
Abstract
The purpose of the current article is to educate psychiatric providers on domestic minor sex trafficking (DMST). Psychiatric providers (e.g., psychiatric-mental health nurse practitioners, psychiatrists, physician assistants, therapists, case managers) interact with victims of sex trafficking but may fail to recognize the signs of victimization and the risk factors associated with becoming a victim of DMST. This educational article offers an overview of the definitions of sex trafficking, and the risk factors, prevalence, and health consequences of DMST. It also summarizes what is known about how those at-risk for DMST and DMST victims interact with the mental health care system. Mental health professionals provide a crucial point of contact with these populations and must strive to prevent, identify, and respond to DMST and at-risk youths. [Journal of Psychosocial Nursing and Mental Health Services, 58(11), 21-28.].
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21
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Abrams LS, Godoy SM, Bath EP, Barnert ES. Collaborative Responses to Commercial Sexual Exploitation as a Model of Smart Decarceration. SOCIAL WORK 2020; 65:387-396. [PMID: 33275664 DOI: 10.1093/sw/swaa040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 04/27/2020] [Accepted: 05/14/2020] [Indexed: 06/12/2023]
Abstract
Historically, youths who are affected by commercial sexual exploitation (CSE) in the United States have been implicated as perpetrators of crime and overrepresented in the juvenile justice system. As an intriguing example of the "smart decarceration" social work grand challenge, policy and practice initiatives have converged to decriminalize cisgender girls and young women experiencing CSE by reframing them as victims of exploitation rather than as criminals. To date, these efforts have largely focused on gender-specific programming for cisgender girls and young women. In this article, the authors describe how federal, state, and local policy and practice innovations have supported reframing CSE as a form of child maltreatment and rerouted girls and young women from the juvenile justice system to specialized services. Using Los Angeles County as a case example, the authors detail how innovative prevention, intervention, and aftercare programs can serve as models of smart decarceration for CSE-affected cisgender girls and young women with the potential to address the needs of youths with diverse gender and sexual identities.
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Affiliation(s)
- Laura S Abrams
- Department of Social Welfare, University of California, Los Angeles (UCLA), 3250 Public Affairs Building, Box 951656, Los Angeles, CA 90095-1656
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22
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Preis H, Peled E, Shilo G. Health behaviour change among commercially sexually exploited Israeli youth and young adults in a multi-module program. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1448-1458. [PMID: 32097535 DOI: 10.1111/hsc.12966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
Commercially sexually exploited youth and young adults (hereafter CSEY) are at high risk for various health adversities, but little is known about interventions that can improve their health outcomes. This study reports changes in health behaviours-positive health behaviours, drug use and risky sexual behaviour-in the first stages of treatment of 122 participants in a comprehensive multi-module program for CSEY in Israel. Data included sociodemographic and background information upon program entry, monthly reports on the treatment the participants received and their status. Data were collected monthly through online questionnaires completed by case managers for each of the CSEY in their care. A three-part analytic strategy assessed changes in repeated measures over time and their contributors. Latent class analysis helped identify differential trajectories of change over time among different participant groups. Findings showed overall significant decrease in risky sexual behaviours and improvement in positive health behaviours among certain CSEY groups. Participants with higher levels of health-risk situations and behaviour at program entry (e.g. more victimisation, less residential safety) were more likely to show improvement in health behaviours during intervention, but less likely to change their moderately risky sexual behaviours. Program participants with high levels of drug use did not show improvement in drug use patterns over time. This study demonstrates that a comprehensive multi-module intervention for CSEY can significantly improve health behaviour outcomes among serviced CSEY, and highlights the value of person-oriented care, and of research that can detect vulnerable subpopulations within CSEY who require uniquely tailored interventions. Personalising treatment to specific differential needs of CSEY, coupled with early detection and intervention, can improve program outcomes. Further research is needed to understand contributors to change and changes in subsequent health outcomes.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Einat Peled
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Guy Shilo
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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23
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Robitz R, Ulloa EC, Salazar M, Ulibarri MD. Mental Health Service Needs of Commercially Sexually Exploited Youth: Voices of Survivors and Stakeholders. VIOLENCE AND VICTIMS 2020; 35:354-362. [PMID: 32606217 DOI: 10.1891/vv-d-18-00213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Youth who experience commercial sexual exploitation (CSE) have complex mental health needs. This study describes what CSE survivors and stakeholders who work with them desire in mental health services. We conducted semi-structured interviews with 10 CSE survivors 16-20 years old, and 15 community experts on CSE (n = 25). Thematic analyses indicated CSE survivors value mental health services including individual therapy and coping skills, and they wanted providers who are nonjudgmental, and exhibit some level of understanding of CSE. Community stakeholders described skills important for CSE survivors to gain from mental health services including recognition of patterns of victimization, self-worth, and emotion regulation. Both stakeholders and CSE youth desired services that give survivors some control over their treatment and recovery utilizing a trauma-informed approach.
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Affiliation(s)
- Rachel Robitz
- Department of Psychiatry, University of California, San Diego, California; Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, California
| | - Emilio C Ulloa
- College of Sciences, San Diego State University, San Diego, California
| | - Marissa Salazar
- Assistant Professor, Grossmont-Cuyamaca Community College District, San Diego, California
| | - Monica D Ulibarri
- Department of Psychiatry, University of California, San Diego, California; School of Professional Psychology, Alliant International University, San Diego, California
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24
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Kahan D, Lamanna D, Rajakulendran T, Noble A, Stergiopoulos V. Implementing a trauma-informed intervention for homeless female survivors of gender-based violence: Lessons learned in a large Canadian urban centre. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:823-832. [PMID: 31814189 DOI: 10.1111/hsc.12913] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 06/10/2023]
Abstract
Gender-based violence is associated with an elevated risk of physical and psychological harm for girls and women. This study examines service user and provider experiences of a trauma-informed, peer-facilitated group psychosocial intervention (Peer Education and Connection through Empowerment [PEACE]) targeting female-identified youth experiencing homelessness and gender-based violence. Participants were recruited among service users and providers of the intervention, delivered in Toronto, Canada. We conducted 19 semi-structured interviews between May and October 2017, engaging 12 service users and 7 additional stakeholders (including social service providers, peers and program administrators). We elicited participant perspectives on the acceptability of the intervention and key enablers of successful implementation and engagement of the target population. Qualitative transcripts were analysed using thematic analysis. Service users, including survivors of sexual exploitation, forced marriage and honour crimes, described satisfaction with and acceptability of the intervention. A number of factors were perceived by service users and providers as contributing to the intervention's successful implementation, including a focus on service user needs, program quality, flexibility and accessibility and strong inter-and intra-agency networks. Introducing peers as mentors led to challenges that could be mitigated through peer mentor education and training to maintain healthy boundaries and enhance peer mentor retention. The need for clear guidelines on the management of trauma disclosures in community settings and a systems-wide approach to service provider and administrator training in the effective integration of peer support services also emerged as important areas for future development. A group-based, trauma-informed and peer-supported psychosocial intervention was acceptable to service users and providers and successfully engaged female-identified survivors of gender-based violence who were also experiencing homelessness. Findings add to the scant knowledge base on interventions to support this population and identify important areas for future research.
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Affiliation(s)
| | - Denise Lamanna
- Centre for Addition and Mental Health, Toronto, ON, Canada
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25
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Barnert ES, Godoy SM, Hammond I, Kelly MA, Thompson LR, Mondal S, Bath EP. Pregnancy Outcomes Among Girls Impacted by Commercial Sexual Exploitation. Acad Pediatr 2020; 20:455-459. [PMID: 31841662 PMCID: PMC7200271 DOI: 10.1016/j.acap.2019.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We measured pregnancy rates and pregnancy outcomes among girls with histories of commercial sexual exploitation (CSE), and then quantified the associations between the outcome of pregnancy with: a) girls' exposure to childhood adversity, and b) their behavioral health. This is the largest study of pregnancy outcomes and associated factors among girls impacted by CSE in the United States. METHODS We reviewed court files of participants in a juvenile specialty court for youth impacted by CSE, between 2012 and 2016. We collected data on pregnancy, health, and social factors. Data were updated through 2018 and descriptive statistics were calculated. Two-sample tests for equality of proportions explored associations between pregnancy with adverse childhood experiences and the girls' behavioral health profiles. RESULTS Among the 360 biological females, 31% had ever been pregnant. Of the girls ever pregnant, 18% had multiple pregnancies. Outcomes for the 130 reported pregnancies were: 76% live births; 13% therapeutic abortions; 5% miscarriages or stillbirths; and 6% of pregnancies were ongoing at case closure. Parental incarceration and histories of maternal substance abuse were both associated with pregnancy. CONCLUSIONS High pregnancy rates among girls with histories of CSE suggest the importance of applying a reproductive justice approach to deliver reproductive education, family planning services, prenatal care, and parenting support to girls impacted by CSE.
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Affiliation(s)
- Elizabeth S Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Mattel Children's Hospital, Los Angeles, Calif (ES Barnert).
| | - Sarah M Godoy
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, Calif (SM Godoy)
| | - Ivy Hammond
- UC Berkeley, School of Social Welfare, Berkeley, Calif (I Hammond)
| | - Mikaela A Kelly
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, Calif (MA Kelly)
| | - Lindsey R Thompson
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children's Hospital, Los Angeles, Calif (LR Thompson)
| | - Sangeeta Mondal
- Stanford University, Stanford School of Medicine, Stanford, Calif (S Mondal)
| | - Eraka P Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, UCLA Semel Neuropsychiatric Institute, Los Angeles, Calif (EP Bath)
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26
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Bounds DT, Otwell CH, Melendez A, Karnik NS, Julion WA. Adapting a family intervention to reduce risk factors for sexual exploitation. Child Adolesc Psychiatry Ment Health 2020; 14:8. [PMID: 32099581 PMCID: PMC7029494 DOI: 10.1186/s13034-020-00314-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexually exploited youth are disconnected from societal tethers and need support systems, which makes them some of the most vulnerable of youth. This heightened level of vulnerability increases their risk for violence, abuse, ongoing sexual exploitation and all its sequelae. The purpose of this study was to examine an evidence-based intervention called STRIVE (support to reunite, involve and value each other) that has been a successful family re-engagement strategy with newly homeless youth. We sought to explore its contextual relevance for youth with risk factors for sexual exploitation and identify necessary adaptations to reduce risk factors for sexual exploitation. We deliberately took an intersectional approach in conducting this study. METHODS Six community-based focus groups were conducted with youth at risk for sexual exploitation and their service providers. Each group was recorded, transcribed, coded, and thematically analyzed. RESULTS Results from 29 youth and 11 providers indicate that there are unique considerations that must be taken into account while working with youth at risk for sexual exploitation to ensure effective service delivery and/or ethical research. Emergent themes included: setting the stage by building rapport and acknowledging experiences of structural violence, protect and hold which balances youth's need for advocacy/support with their caregivers' need for validation/understanding, and walking the safety tightrope by assessing risks and safety planning. DISCUSSION Focus groups are an effective methodology when working with traditionally disempowered populations particularly in gaining a range of perspectives to meet unique needs/preferences. Youth at risk for commercial sexual exploitation needs require strengths-based, individualized, multi-systemic approaches.
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Affiliation(s)
- Dawn T. Bounds
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, College of Nursing, Community, Systems, & Mental Health Nursing, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Caitlin H. Otwell
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Adrian Melendez
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Niranjan S. Karnik
- grid.262743.60000000107058297Department of Psychiatry & Behavioral Sciences, Rush Medical College, Rush University, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Wrenetha A. Julion
- grid.240684.c0000 0001 0705 3621College of Nursing, Department of Women, Children and Family Nursing, Rush University Medical Center, 600 S. Paulina St. Suite 1080, Chicago, IL 60612 USA
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27
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Albright K, Greenbaum J, Edwards SA, Tsai C. Systematic review of facilitators of, barriers to, and recommendations for healthcare services for child survivors of human trafficking globally. CHILD ABUSE & NEGLECT 2020; 100:104289. [PMID: 31787336 DOI: 10.1016/j.chiabu.2019.104289] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/12/2019] [Accepted: 11/16/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Child trafficking is associated with multiple physical and mental health problems, yet relatively little is known about the factors that facilitate or hamper delivery of high-quality health care services to trafficked children. OBJECTIVE To summarize information about identified facilitators of, barriers to, and recommendations for medical and mental health service provision to trafficked children. PARTICIPANTS AND SETTING A systematic review was conducted of the English-language, peer-reviewed literature on medical and mental healthcare of trafficked children published since 2010. METHODS Inclusion criteria were: (1) the study population or focus included, wholly or in part, individuals under the age of 18 years; (2) the study focus was clearly defined as human trafficking or commercial sexual exploitation; (3) a main focus included health services or barriers to care, and (4) the article contained original data. RESULTS Of the 29 articles meeting inclusion criteria, 19 included facilitators of health service provision to trafficked populations, 22 included barriers to that provision, and 25 included explicit recommendations for service improvement. 45 distinct facilitators were identified a total of 140 times, 118 distinct barriers were identified a total of 174 times, and 52 distinct recommendations were identified a total of 100 times. The majority of facilitators, barriers, and recommendations fell under the locus of the healthcare provider and healthcare organization. CONCLUSIONS Existing research reveals abundant areas of opportunity for healthcare professionals and healthcare administrators to improve access to, and quality of, medical and mental health care for trafficked children.
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Affiliation(s)
- Karen Albright
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA, USA; Institute on Healthcare and Human Trafficking, SVB Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | | | - Carmelle Tsai
- Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
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28
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Barnert E, Kelly M, Godoy S, Abrams LS, Bath E. Behavioral health treatment "Buy-in" among adolescent females with histories of commercial sexual exploitation. CHILD ABUSE & NEGLECT 2020; 100:104042. [PMID: 31227269 PMCID: PMC6920601 DOI: 10.1016/j.chiabu.2019.104042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/07/2019] [Accepted: 06/06/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND Adolescent females with histories of commercial sexual exploitation (CSE) have high mental health and substance use treatment needs, yet little is known about their perspectives regarding behavioral health and behavioral health treatment. OBJECTIVE We sought to understand the attitudes of adolescent females with histories of CSE regarding behavioral health to identify factors influencing "buy-in" to behavioral healthcare. PARTICIPANTS AND SETTING Participants included 21 adolescent females, affiliated with our partner organizations (two group homes, a service agency, and a juvenile specialty court), who reported having exchanged sex for something of value. METHODS In-depth qualitative interviews explored participants' perspectives towards behavioral health. We conducted thematic analysis to identify themes concerning behavioral health. RESULTS Participants provided insightful definitions of "mental health" that included positive and negative aspects of emotional and cognitive states (e.g. "being happy with yourself" and "not thinking suicidal"), indicating intensified mental health challenges and resilience. Substance use was viewed as a coping mechanism for childhood trauma and their exploitation. Trusted relationships with providers and navigable health systems that encourage autonomy were key to promoting "buy-in" and thus engagement in behavioral health treatment. A conceptual model emerged illustrating factors leading to treatment engagement. CONCLUSION Adolescent females with histories of CSE constitute a vulnerable population with high levels of trauma as well as unmet mental health and addiction treatment needs. The delivery of trauma-focused, behavioral healthcare centered on patient-provider trust and shared-decision making that encourages client autonomy should be prioritized.
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Affiliation(s)
- Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children's Hospital, UCLA Pediatrics, 2-467 MDCC, Los Angeles, CA, 90095-1752, United States.
| | - Mikaela Kelly
- Department of Psychiatry, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, 90024, United States
| | - Sarah Godoy
- Department of Psychiatry, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, 90024, United States
| | - Laura S Abrams
- Department of Social Welfare, UCLA Luskin School of Public Affairs, 5323 Public Affairs Building Los Angeles, CA, 90095-1656, United States
| | - Eraka Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, 90024, United States
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Bani-Fatemi A, Malta M, Noble A, Wang W, Rajakulendran T, Kahan D, Stergiopoulos V. Supporting Female Survivors of Gender-Based Violence Experiencing Homelessness: Outcomes of a Health Promotion Psychoeducation Group Intervention. Front Psychiatry 2020; 11:601540. [PMID: 33362610 PMCID: PMC7755885 DOI: 10.3389/fpsyt.2020.601540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/17/2020] [Indexed: 11/21/2022] Open
Abstract
Homelessness is an important risk factor for gender-based violence (GBV), particularly among youth, and disproportionally affects women and girls. Survivors of GBV experience enduring and severe physical, psychological, and sexual health problems. Although key elements in service delivery for survivors of GBV have been identified, little is known about outcomes of community-based programs aiming to assist homeless and unstably housed youth experiencing GBV. This longitudinal study aimed to quantitatively evaluate changes in mental health and well-being outcomes in female identified youth experiencing GBV and homelessness, 12 months after enrolment in a community-based, trauma-informed, brief group psychoeducation intervention. Standardized survey measures were administered at baseline, 6 and 12 months for 70 participants, recruited between February 2017 and April 2019, assessing quality of life, psychological distress, traumatic symptoms, substance use, resilience, victimization, and sense of mastery. Linear mixed models were used to examine longitudinal changes in quality of life as well as secondary outcomes among study participants. After 12 months, quality of life increased significantly among participants (p = 0.009), and the 12-month victimization score was significantly decreased relative to baseline (p = 0.05). Changes in other outcomes were not statistically significant. Findings suggest that community-based brief group psychoeducation interventions may be a promising approach to improving outcomes for this disadvantaged population.
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Affiliation(s)
| | - Monica Malta
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Deborah Kahan
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Lavoie J, Dickerson KL, Redlich AD, Quas JA. Overcoming Disclosure Reluctance in Youth Victims of Sex Trafficking: New Directions for Research, Policy, and Practice. PSYCHOLOGY, PUBLIC POLICY, AND LAW : AN OFFICIAL LAW REVIEW OF THE UNIVERSITY OF ARIZONA COLLEGE OF LAW AND THE UNIVERSITY OF MIAMI SCHOOL OF LAW 2019; 25:225-238. [PMID: 32103880 PMCID: PMC7043240 DOI: 10.1037/law0000205] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An alarming number of youth worldwide are victims of commercial sexual exploitation, particularly sex trafficking. Normative developmental processes and motivations across the adolescent period-the age when youth are at greatest risk for trafficking-combined with their history, make them highly likely to be reluctant to disclose their exploitation to police, who often encounter victims because they are suspected of delinquency and crime and who interrogate the victims as suspects. Little scientific and policy attention has been devoted to understanding how to question these victims in a way that reduces their disclosure reluctance and increases their provision of legally relevant information. In the current review, we describe research concerning trafficking victims' histories and exploitative experiences, juvenile suspects' and victims' encounters with the legal system, and best-practice forensic interviewing approaches to elicit disclosures from child victims. We highlight the implications of these areas for understanding the dynamics between how police encounter and interact with adolescent trafficking victims and whether and how the victims disclose trafficking details during these interactions. We close with an agenda for research to test interviewing methods for suspected victims of sex trafficking and with policy and practice recommendations for interviewers.
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Affiliation(s)
| | - Kelli L Dickerson
- Department of Psychological Science, University of California, Irvine
| | | | - Jodi A Quas
- Department of Psychological Science, University of California, Irvine
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31
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Kenny MC, Helpingstine C, Long H, Perez L, Harrington MC. Increasing Child Serving Professionals' Awareness and Understanding of the Commercial Sexual Exploitation of Children. JOURNAL OF CHILD SEXUAL ABUSE 2019; 28:417-434. [PMID: 30762481 DOI: 10.1080/10538712.2018.1563264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/07/2018] [Accepted: 12/09/2018] [Indexed: 06/09/2023]
Abstract
Child serving professionals need increased understanding of the identification and therapeutic needs of child victims of commercial sexual exploitation. This study evaluated the effectiveness of a training program aimed to increase awareness of commercial sexual exploitation of children (CSEC) among professionals likely to encounter victims in their work. Professionals' (N = 227) knowledge level was examined prior to the training, immediately thereafter, and in a 6-12 month follow-up. Despite professional position or years of experience, participants had similar levels of CSEC knowledge before the training and all showed a significant improvement in their knowledge after the training. However, follow-up testing on a smaller subsample demonstrated that knowledge gains were not maintained. The analysis of the participants' responses to how their behavior would change subsequent to the training revealed important themes including: (1) greater ability to identify/assess or recognize CSEC victims, (2) greater understanding and knowledge of CSEC, (3) increased ability to communicate, interact, and engage with CSEC victims, and (4) heightened desire to educate others and raise awareness about CSEC. Results also indicated that participants were very satisfied with the training and found it highly relevant to their work.
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Affiliation(s)
| | | | - Haiying Long
- a Florida International University , Miami , FL , USA
| | - Lorena Perez
- a Florida International University , Miami , FL , USA
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Barnert E, Kelly M, Godoy S, Abrams LS, Rasch M, Bath E. Understanding Commercially Sexually Exploited Young Women's Access to, Utilization of, and Engagement in Health Care: "Work Around What I Need". Womens Health Issues 2019; 29:315-324. [PMID: 30962075 DOI: 10.1016/j.whi.2019.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 02/09/2019] [Accepted: 02/19/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE We sought to understand the perspectives of commercially sexually exploited (CSE) young women regarding their health care needs, access, and use patterns. METHODS Twenty-one CSE young women participated in this mixed methods study. Data collection included brief surveys measuring health care use, followed by in-depth, semistructured interviews to gain insight into CSE young women's health care needs, barriers and facilitators to health care, use patterns, and recommendations for improving care. Data analysis techniques included descriptive statistics for the quantitative survey data and thematic analysis for the qualitative interviews. RESULTS Survey data demonstrated relatively high health care use across health care types, especially for reproductive and mental health treatment services. Barriers to care included being "on the run," fear of bad diagnoses, and trafficker control. The fierce autonomy conceptual model emerged from the analyses to describe participants' strong desire for self-determination in their health care decision making, including when to access care. Recommendations for improving care for CSE young women include preserving autonomy in health care decisions while meeting their basic needs, such as safety and shelter. CONCLUSIONS Overall, the CSE young women expressed high health care needs. Despite experiencing significant barriers to accessing care, study participants frequently sought care in a variety of settings. Furthermore, they shared insights about how to improve engagement in health care among CSE young women. Improving CSE young women's engagement in care requires health professionals and health systems that foster a sense of safety, trust, and autonomy over health care decisions-a need intertwined with CSE young women's experiences of abuse, survival, and sexual exploitation.
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Affiliation(s)
- Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children's Hospital, Los Angeles, California
| | - Mikaela Kelly
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, California.
| | - Sarah Godoy
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Laura S Abrams
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, California
| | - Madeline Rasch
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, California
| | - Eraka Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, California
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Kenny MC, Helpingstine CE, Weber M. Treatment of a Commercially Sexually Abused Girl Using Trauma-Focused Cognitive Behavioral Therapy and Legal Interventions. Clin Case Stud 2018. [DOI: 10.1177/1534650118800809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This case study describes the use of trauma-focused cognitive behavioral therapy (TF-CBT) and legal interventions for a 16-year-old girl who was the victim of commercial sexual exploitation (CSE) and suffered from substance abuse, anxiety, and body image issues. Over the course of 1 year, the client was able to discontinue involvement in sexual exploitation, cease substance use, decrease her anxiety level, improve her self-concept, and reduce posttrauma symptoms. The case calls attention to the need for extended rapport building, flexibility in treatment, and tailoring manualized treatments. It highlights the path to CSE for one teenager as well as the resultant emotional and behavioral consequences. Given the extensive nature of her past traumas, case management was continued following the clients’ discharge from treatment to support her adjustment. These follow-up sessions were conducted about once a month and assisted with maintenance of treatment goals.
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Abstract
This article demonstrates how structural social work theory and critical consciousness development can be used to help facilitate a transition from a deficit model approach to an inequities perspective in a child welfare system that was working to improve the identification of and services for domestic minor sex trafficked youth (DMST). The response of Connecticut’s child welfare system to the issue of DMST is provided as an example of how a child welfare systems could apply an inequities perspective to a population involved in and at risk for exploitation. Structural social work theory helps illustrate how neo-liberalist social structures in the United States perpetuate and maintain social inequity based on race, gender, age, sexual orientation, and socio-economic status for youth at risk for DMST. Through critical consciousness development, youth can be recognized as victims of intersecting forms of oppression, rather than criminals. These theories can be combined to increase individual awareness of the risks and oppression of youth across the population, and to identify how child welfare services can be leveraged to decrease inequities and improve child well-being.
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Coverdale J, Balon R, Beresin EV, Brenner AM, Guerrero APS, Louie AK, Roberts LW. Family Planning and the Scope of the "Reproductive Psychiatry" Curriculum. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:183-188. [PMID: 29368142 DOI: 10.1007/s40596-018-0884-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 01/11/2018] [Indexed: 06/07/2023]
Affiliation(s)
| | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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36
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Robitz R, Gajaria A, Stoklosa H, Jones E, Baldwin SB. A Young Transgender Woman with Fatigue, Malnutrition, and a Previous Suicide Attempt. Psychiatr Ann 2018. [DOI: 10.3928/00485713-20180211-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ijadi-Maghsoodi R, Bath E, Cook M, Textor L, Barnert E. Commercially sexually exploited youths' health care experiences, barriers, and recommendations: A qualitative analysis. CHILD ABUSE & NEGLECT 2018; 76:334-341. [PMID: 29195171 PMCID: PMC5949300 DOI: 10.1016/j.chiabu.2017.11.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/01/2017] [Accepted: 11/02/2017] [Indexed: 05/25/2023]
Abstract
The current study sought to understand commercially sexually exploited (CSE) youths' health care experiences, barriers to care, and recommendations for improving health care services. We conducted focus groups (N=5) with 18 CSE youth from February 2015 through May 2016 at two group homes serving CSE youth in Southern California. We performed thematic content analysis to identify emergent themes about CSE youths' perspectives on health care. Youth described facilitators to care, including availability of services such as screening for sexually transmitted infections, knowledge about sexual health, and a strong motivation to stay healthy. Barriers included feeling judged, concerns about confidentiality, fear, perceived low quality of services, and self-reliance. Overall, youth emphasized self-reliance and "street smarts" for survival and de-emphasized "victimhood," which shaped their interactions with health care, and recommended that health providers develop increased understanding of CSE youth. Our findings suggest that providers and community agencies can play an essential role in raising awareness of the needs of CSE youth and meet their health needs through creating a non-judgmental environment in health care settings that validates the experiences of these youth.
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Affiliation(s)
- Roya Ijadi-Maghsoodi
- VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Bldg. 206, Los Angeles, CA, 90073, United States; UCLA Nathanson Family Resilience Center, 760 Westwood Plaza, Rm A8-224, Los Angeles, CA, 90095, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90095, United States.
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90095, United States
| | - Mekeila Cook
- Division of Public Health Practice, Meharry Medical College, 1005 Dr. D.B. Todd Blvd, Nashville, TN, 37208, United States
| | - Lauren Textor
- Department of Anthropology, University of California, Los Angeles, 375 Portola Plaza, Los Angeles, CA, 90095, United States
| | - Elizabeth Barnert
- Department of Pediatrics, University of California, Los Angeles, 10833 Le Conte, MDCC 12-467, Los Angeles, CA, 90095, United States
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Abstract
Commercial sexual exploitation of children and child sex trafficking is a major public health issue globally. Domestic minor sex trafficking has become increasingly recognized within the United States. Sexually exploited minors are commonly identified as having psychosocial risk factors, including histories of abuse or neglect, running away, substance use or abuse, and involvement with child protective services. Youth also suffer a variety of physical and mental health consequences, including posttraumatic stress disorder, depression, anxiety, and suicidality. Child psychiatrists and other medical providers have the opportunity to identify, interact, and intervene on behalf of involved and at-risk youth.
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Affiliation(s)
- Amy Goldberg
- Department of Pediatrics, The Warren Alpert Medical School of Providence, RI 02906, USA.
| | - Jessica Moore
- Hasbro Children's Hospital, Providence, RI 02906, USA
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39
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Fraley HE, Aronowitz T. The Peace and Power Conceptual Model: An Assessment Guide for School Nurses Regarding Commercial Sexual Exploitation of Children. Nurs Sci Q 2017; 30:317-323. [PMID: 28934053 DOI: 10.1177/0894318417724456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Human trafficking is a global problem; more than half of all victims are children. In the United States (US), at-risk youth continue to attend school. School nurses are on the frontlines, presenting a window of opportunity to identify and prevent exploitation. Available papers targeting school nurses report that school nurses may lack awareness of commercial sexual exploitation and may have attitudes and misperceptions about behaviors of school children at risk. This is a theoretical paper applying the Peace and Power Conceptual Model to understand the role of school nurses in commercial sexual exploitation of children.
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Affiliation(s)
- Hannah E. Fraley
- Assistant Professor, Solomont School of Nursing, University of Massachusetts Lowell, MA, USA
| | - Teri Aronowitz
- Associate Professor, Department of Nursing, University of Massachusetts Boston, MA, USA
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40
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Affiliation(s)
- James A. Levine
- Health Solutions, Mayo Clinic Arizona and Arizona State University, Suite 200 CRB, 13400 East Shea Blvd, Scottsdale, AZ 85259, USA
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