Social Service Providers' Perceived Sex Trafficking Indicators and Use of Risk Assessment Questions: Findings from a Survey of Social Service Providers

Background and Purpose: Service providers (i.e. child welfare, youth justice, organizations that address homeless youth, intimate partner/sexual violence) encounter youth at risk of sex trafficking. The extent to which providers are aware of sex trafficking indicators and ask risk assessment questions is understudied. This study sought to determine whether and how providers (1) observe sex trafficking indicators/red flags among youth and follow-up, and (2) ask youth sex trafficking risk assessment questions.

Methods: A cross-sectional, web-based survey was disseminated to service providers, who represented child welfare, youth justice, and social services (e.g. runaway youth, sexual violence), in a 17-county region of a Midwestern state. Participants (n=267) were asked to indicate whether they provided direct services to minors (ages 12-17, n=245), adults (ages 18-29, n=148), and/or families/foster families of minors (ages 12-17, n=163), resulting in three respective client groups.

Aim 1: Participants were asked how often they identified 45-46 (depending on their respective client group) possible sex trafficking indicators on a Likert scale (1=no clients, 5=all clients) across 5 domains (e.g. behavioral health, physical health, client presentation, system involvement, social support/abuse). We used means to rank responses from most to least common. Providers were asked what, if any, actions they took after observing sex trafficking indicators (e.g. made a mental note, asked any sex trafficking question) on a Likert scale (1=never, 4=always).

Aim 2: Participants were asked to determine the extent to which they asked their respective client groups (e.g. minors, adults, families) 11 possible sex trafficking risk assessment questions on a Likert scale (1=no clients, 5=all clients), including recommended and commonly asked screening questions and fill-in-the blank options.

For both aims, we compared differences among those who received sex trafficking specific trainings (compared to those who did not) and job sectors (e.g. child welfare/youth justice, behavioral health) across provider groups.

Results:

Aim 1: The most commonly identified indicators across provider groups included behavioral health indicators (e.g. depressive symptoms, shame and guilt), history of child protective services, and weak ties/lack of social support. Least commonly identified indicators showed more variation between groups but generally included signs of torture, false IDs, and hotel involvement. Provider means suggested that they occasionally asked a sex trafficking risk assessment question (M=1.9-2.1) and often documented red flags (M=2.8-3.2). Providers who reported receiving sex trafficking specific trainings had slightly higher means for asking assessment questions (M=2.0-2.3) than those who did not (M=1.8-1.9).

Aim 2: Providers reported generally asking no, few, or some clients sex trafficking assessment questions (M=1.4-2.5), across all questions and all three client groups. Providers asked fewer recommended screening questions about online forms of sex trading (M=1.4-1.9) than in-person forms (M=1.5-2.5). Providers who received sex trafficking trainings had slightly higher means across categories than those without training.

Conclusion and Implications: Providers who work in these systems may not be consistently assessing for sex trafficking, despite consistently identifying sex trafficking indicators. Sex trafficking specific trainings may make some differences in providers’ actions, though more work is needed to understand their impact. Implications will be discussed.