Adapting a family intervention to reduce risk factors for sexual exploitation

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 evidencebased 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.

Safeguarding Young People Beyond the Family Home

“…Consider Lenny who said, 'Because, at first before the social worker stuff, I didn't really care too much about what other people thought.' (Bulanda and McCrea, 2013: 111) Person-centred qualities were mentioned time and again across the studies we reviewed, for example, being friendly, relatable, empathic, relaxed and non-judgemental, and showing unconditional positive regard (Sturrock, 2012;Countryman-Roswurm and Bolin, 2014;Bounds et al, 2020). A 21-yearold young woman involved with the Safe Choices Leaving Care and Custody Project Programme on Sexual Exploitation described the impact of her worker's approach: I don't know why, but I feel comfortable.…”

“…This is important as improved parent-child relationships have been found to be protective against future exploitation (Thomas and D'Arcy, 2017;Pike et al, 2019). A US-based family intervention to reduce risk factors for sexual exploitation included mediation between family members to address this directly (Bounds et al, 2020).…”

“…However, the factors that characterise 'trusted' community relationships are somewhat different to those identified for relationships between young people and professionals. Relationships developed in young people's own social contexts are more often experienced as enduring, authentic or reliable: where adults involved are from young people's local communities, they are considered more capable of understanding the realities of young people's lives; as they are involved without being paid, young people may feel that they have their best interests at heart; and, finally, as their involvement is not because of EFRH, young people may be less concerned that they will disappear if and when the EFRH ends (Bulanda and McCrea, 2013;Miller et al, 2013;Bounds et al, 2020;National Youth Agency, 2020;Wroe and Lloyd, 2020). Some studies reviewed suggested that professionals might also benefit from building relationships with community organisations and residents in areas with a prevalence of EFRH to better understand the specific nature of risks in that area and extend their capacity to reach affected young people (D'Arcy and Thomas, 2016).…”

Considerations for working with youth with socially complex needs

“…In human immunodeficiency virus research, the age of informed consent for research with adolescents is guided by reproductive health consent laws of the local jurisdiction which allow adolescents under the age of 18 (as young as 12 in some states) to consent to sexually transmitted infection testing and treatment without parental permission (Mustanski, 2015; Nelson, Lewis, Struble, & Wood, 2010). In our research with homeless youth, we allowed adolescents ages 16 and older to provide informed consent given their ability to consent for housing services at age 16 (Bounds, Otwell, Melendez, Karnik, & Julion, 2020). Given the variability of literacy levels, we asked youth to restate in their own words what their involvement in the study will entail and embedded validity questions throughout the questionnaires in which we instruct the youth to give a specific answer to a question (e.g., select the response “yes” to this question) to ensure comprehension.…”

Harnessing Phones to Target Pediatric Populations with Socially Complex Needs: Systematic Review

“…Pediatric populations with socially complex needs are likely to have their behavioral health negatively impacted—from having a lower health status than peers to being less likely to receive appropriate physical and mental health diagnoses [ 1 ]. The term “socially complex needs” is used to describe pediatric populations that face overlapping adversities [ 2 ]. Such youth may endure adverse childhood experiences, physical symptoms (eg, pain), or be from traditionally underserved populations (eg, low socioeconomic status [SES], belonging to a minority racial/ethnic or gender/sexual minority group, or living in isolation from accessible services [ 3 ]).…”