Treatment of a Commercially Sexually Abused Girl Using Trauma-Focused Cognitive Behavioral Therapy and Legal Interventions

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.

Effectiveness of TF‐CBT with sex trafficking victims in a secure post‐adjudication facility

“…For example, our participants did not all buy into traditional deep breathing techniques; thus, it was important to incorporate methods that were more helpful, such as square breathing and grounding techniques. Victims of sex trafficking are very dysregulated emotionally (Cohen et al., 2017; Kenny et al., 2019). Staying in a state of emotion dysregulation will often lead to more externalizing behaviors: being argumentative, fighting with peers and power struggles with staff along with suppression or avoidance to working on their trauma (Kenny et al., 2019).…”

“…Victims of sex trafficking are very dysregulated emotionally (Cohen et al., 2017; Kenny et al., 2019). Staying in a state of emotion dysregulation will often lead to more externalizing behaviors: being argumentative, fighting with peers and power struggles with staff along with suppression or avoidance to working on their trauma (Kenny et al., 2019). Understanding what will help DMST victims take interest and use emotion regulation and relaxation skills within their environment is a significant focus of TF‐CBT in preparation for working through cognitive distortions and memories of their trauma (Cohen et al., 2017; Kenny et al., 2019).…”

“…Johnson (2012) reported positive results from an adapted form of TF-CBT with young girls in Cambodia who were rescued from sex trafficking. Kenny et al (2019) presented a case study with one DMST victim in the United States who completed TF-CBT over the course of 1 year, and demonstrated decreased anxiety and PTSD symptoms, increased self-concept, cessation of all substance use, and discontinued involvement in sexual exploitation.…”

“…Kenny et al. (2019) presented a case study with one DMST victim in the United States who completed TF‐CBT over the course of 1 year, and demonstrated decreased anxiety and PTSD symptoms, increased self‐concept, cessation of all substance use, and discontinued involvement in sexual exploitation.…”

Improving the value of school professionals as partners in efforts to enhance recognition of and responses to youth sex trafficking

“…These skills likely far exceed those of other professionals, such as law enforcement, who may have more limited training and exposure engaging youth in conversations beyond interrogations and witness questioning. On the other hand, however, it is not clear that school professionals have received training in or are knowledgeable about effective rapport building or interview strategies known to elicit disclosures of abuse or other forms of victimization (Hershkowitz & Lamb, 2020;Karni-Visel et al, 2019, 2021Saywitz et al, 2019), or about open-ended prompting, which has been widely shown to elicit complete disclosures of abuse from victims and witnesses spanning childhood through early adulthood (Ahern et al, 2017(Ahern et al, , 2019Cleary, 2017;Kenny et al, 2019;Simpson et al, 2023). Adolescents, like children and adults can be led to error when asked closed-ended and possibly leading questions (Leach et al, 2017), including from well-intentioned and supportive 1 It should be noted that sexual exploitation of minors and sex trafficking of minor overlap some but are not synonymous (Institute of Medicine & National Research Council, 2013).…”