Provider and Survivor Voices: Identifying Children and Youth Experiencing Sexual Exploitation without Relying on Self-Disclosure

Background: Protecting children and youth experiencing or at risk for commercial sexual exploitation is a major challenge facing the child welfare, juvenile justice, education, and health systems. To address this challenge, national, state and local agencies have called for screening and identification of youth experiencing commercial sexual exploitation (also called domestic minor sex trafficking), yet few validated screening tools exist, and those that do rely on self-disclosure by the victim. Though no data exist on rates of self-disclosure of this form of abuse, professionals have noted that lack of self-disclosure is a significant barrier to identification of victims, especially pre-adolescent children. The objective of this study was to identify the key indicators of exploitation that providers in a variety of settings may use to identify youth experiencing this form of abuse without relying on self-disclosure.

Methods: This qualitative study used grounded theory to develop a list of indicators in a manner that is heavily informed by the experiences of important stakeholders. The primary method of data collection was focus groups and interviews with over 100 providers and survivors of exploitation. Participants were located in different systems, including child welfare, juvenile justice, law enforcement, primary care, mental health, education, advocacy, and other human service settings across different geographic regions in California. Participants were asked to name and describe the indicators that they experience as most important for identification of exploitation among vulnerable youth. Constant comparative method was used to analyze transcripts from the focus groups and interviews. In addition, a literature review of the nascent research in this area and an environmental scan of existing screening tools identified a few indicators supported by research evidence.

Results: Analysis of the focus group and interview transcripts revealed 10 domains that providers and survivors relied on to identify youth experiencing exploitation, including youths’ instability in life functioning, relationships, finances and belongings, use of technology, physical health, risk behaviors, trauma exposure, trauma signs and symptoms, coercion and grooming, and direct indicators of exploitation activity. Specific indicators fell into one of these 10 domains, several of which are either not represented in the research literature or in many of the existing screening tools. Results also revealed important challenges and opportunities for identifying exploitation when the risk factors and indicators of this abuse overlap with indicators of other traumatic events, and when providers have strongly held prior beliefs about how exploited youth look or behave. Finally, participants discussed important aspects of interviewing procedures and agency protocols that encourage or inhibit information sharing by potential victims.

Implications:  Improved practice in this area can reduce prolonged exposure to trauma through improved identification of children experiencing exploitation, and can facilitate cross-system communication with regards to the number of children exhibiting the indicators of this form of abuse.