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“A trauma-informed program for commercial, sexually exploited foster youth: A grant proposal”


Human trafficking involves the use of force, fraud, or coercion to exploit human beings for some type of labor or commercial sex purpose. According to the U.S. Department of State (2013), 600,000 to 800,000 individuals are trafficked nationally every year. Commercial sexual exploitation is the largest subset of human trafficking of adolescent women and children (U.S. Department of State, 2013). Nationally, it is estimated that there are millions of men, women and children who are victims of human trafficking on an annual basis (U.S. Department of Homeland Security, 2015).

Sex trafficking of children is a component of “modern day slavery” (L. A. Smith, Vardaman, & Snow, 2009, p. 4), consisting of the illegal trading of persons by forced sexual exploitation, also known as commercial sexual exploitation. The Trafficking and Violence Protection Act (TVPA; 2000) defines sex trafficking as “the recruitment, harboring transportation, provision, or obtaining of a person for commercial sex act” (p. 6). The National Center for Missing and Exploited Children (NCMEC) indicated that commercial sexual exploitation of children occur when individuals buy, trade, or sell sexual acts with a child (as cited in National Human Trafficking Resource Center [NHTRC], 2010), including activities such as prostitution, production of pornography, strip dancing, and sexual massage as well as survival sex (Institute of Medicine, Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors, 2003). The average age of entry into the commercial sex industry is as young as 13 years of age (Kotrla, 2010). However, according to Wolak, Mitchell, and Finkelhor (2003), children ages 6–12 were mostly victims used for pornography images and youth ages 13–15 were primarily solicited through the Internet by sexual predators (Wolak et al., 2003).

Statement of the Problem

Children in the United States are vulnerable to becoming victims of commercial sexual exploitation (Hughes, 2004) and still this social problem continues to be “ignored, abhorred, outlawed and yet accepted as another social ill” (Lloyd, 2011, p. 7). Despite the efforts of TVPA to increase penalties for trafficking and the development of programs to assist the needs of commercial, sexually exploited victims, the services are not equally distributed (Farrell & Fahy, 2009). While it continues to be difficult to know the prevalence of this problem and statistical data are little more than a guess due to the nature of sex trafficking, in the year 2010, it was estimated that there may have been 100,000 victims of sexual exploitation in the United States (Kotrla, 2010).

When data from the National Incident-Based Reporting System were analyzed, Finkelhor and Ormrod (2004) found that law enforcement was more likely to identify victims of commercial sexual exploitation of children as juvenile offenders and charge them with crimes, including prostitution and drug-related offenses.

The Federal Bureau of Investigation (FBI; n.d.) reported that in 2012, there were 609 arrests made for juvenile prostitution. Comparatively, there were 104,830 arrests made for juvenile drug use violations in the United States; and of those arrested 60%  were African American youth (FBI, 2013). These numbers indicate that there continues to be a lack of enforcement of laws that protect minors from sex trafficking.

According to the California Department of Justice (2013), there were 81,161 runaway children in the state and 18,342 in Los Angeles County. Lloyd (2011) reported that there were approximately 10% of adolescent females between the ages of 12 and 17 who were living in group homes and who could be potentially victimized by traffickers in Los Angeles. In 2005, research from the National Clearinghouse on Families and Youth estimated that 31% of the children who run away are solicited or coerced by a trafficker-pimp within the first 48 hours of being on the streets. Therefore, there is a high likelihood that runaways in Los Angeles County have already been or will be exposed to commercial sexual exploitation.

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Several studies have found that many adolescents who are victims of commercial sexual exploitation of children (CSEC) consume drugs and alcohol to cope with the trauma experience and are frequently diagnosed with posttraumatic stress disorder (PTSD) due to psychological manipulation, threats, and other abusive experiences (Brawn & Roe-Sepowitz, 2008; Wiechelt & Shdaimah, 2011). Among the adolescent victims of CSEC, many have exhibited self-injurious behaviors such as cutting, excessive piercings, and tattoos. Furthermore, victims of CSEC have also been shown to exhibit aggressive behavior and have feelings of anger, and a “negative appreciation of body size” (Iannaccone et al., p. 131). A number of female CSEC victims have been diagnosed with an eating disorder (Iannaccone et al., 2013).

CSEC and Substance Use

Brawn and Roe-Sepowitz (2008) found that among a sample of 128 adolescent females arrested for sex work, there was a relationship between CSEC and drug and alcohol use. Among the array of negative life consequences that may result from CSEC is a substance use disorder. Substance use, both licit and illicit, is common among CSEC victims as a strategy to cope with the recurring abuse (Brawn & Roe-Sepowitz, 2008). Victims of CSEC who have problems with substance use commonly engage in commercial sex work to obtain money to buy drugs or in direct exchange for drugs (Wiechelt & Shdaimah, 2011). Moreover, Wiechelt and Shdaimah (2011) found that the most common drugs used by the 17 CSEC victims interviewed were heroin, cocaine, marijuana, and alcohol.

Eating Disorders

One of the physical consequences of CSEC is that many victims are malnourished. Malnutrition is a medical health issue among CSEC victims that can result from anorexia, bulimia, and other eating disorders. There are high rates of eating disorders among adolescent females who are victims of CSEC (Iannaccone et al., 2013). According to Iannaccone et al. (2013), body dissatisfaction may be associated with insecure attachment, low self- esteem, and negative affect that subsequently result in a high prevalence of eating disorders among the CSEC victims.

Nonsuicidal Self-Injury

Iannaccone et al. (2013) found that of the 65 female clients they treated for eating disorders, approximately 50% reported some self-injurious behavior such as cutting, piercings, and/or drug use. The researchers posited that adolescent victims of CSEC often experience deep feelings of dissatisfaction toward their own bodies, subsequently resulting in attempts to modify their bodies with tattoos and piercings and engaging in self-injurious behaviors.


Experiencing traumatic events during adolescent development may lead to serious psychological impairment such as PTSD (Layne et al., 2014). PTSD is caused by experiencing traumatic events. CSEC victims are often diagnosed with PTSD because they experience feelings of “hopelessness, horror, or intense fear, suicidal behavior and emotional problems” after traumatic events (Twill, Green, & Traylor, 2010, p. 3).

Definitions of Terms

For the purpose of this thesis, the following terms are defined:


The sexual abuse of a minor for economic gain. This can include but is not limited to physical abuse, prostitution, pornography, and/or smuggling (Thomson, Hirshberg, Corbett, Valila, & Howley, 2011).

Sex Trafficking

A form of human slavery in which commercial sex act is induced by force, fraud, or coercion (TVPA, 2000).

Survival Sex

The “exchange of sex for food, shelter, drugs, and other needs and wants” (Walls & Bell, 2011, p. 424).

Traffickers and/or Pimps

Individuals who recruit, entice, or obtain a person to engage in commercial sex act or to benefit from such activities (Wilson & Butler, 2014).

Trauma-Informed Treatment

A treatment framework that is shaped by the acknowledgment and understanding of the impact of trauma on an individual’s mental, physical, and psychological state of well-being (Substance Abuse and Mental Health Services Administration [SAMHSA], 2015).

Purpose of the Project

The purpose of this project was to design a program, identify a potential funding source, and write a grant application to fund a comprehensive, trauma-informed program that addresses substance use, nonsuicidal self-injury, and eating disorders among adolescent females ages 12 to 17 who are victims of commercial sexual exploitation. This proposed program will be executed in partnership with the Restoration Diversion Services (RDS) Drop-In Center located in the city of Compton, California.

Social Work Relevance

This project is important to social workers because the social work mission is to promote social welfare (McMahon-Howard & Reimers, 2013). That includes providing advocacy and effective services to the victims of commercial sexual exploitation. Given that the majority of exploited youth come from impoverished families and neighborhoods and often from abusive or neglectful homes (Annitto, 2013), social workers can play a vital role in ensuring child safety and stability for the victims of CSEC. The victims, who are usually runaways, have been exposed to emotional, physical, and sexual abuse and are at risk of suffering severe emotional, psychological, and health problems (Albanese, 2007). Because CSEC is a form of child abuse, it is a child welfare concern (California Child Welfare Council, 2013). As a result, child welfare workers investigate CSEC cases and will make efforts either to keep children within their homes or to provide appropriate out-of-home placements (McMahon-Howard & Reimers, 2013). One reason that CSEC is a challenge for social workers is that often professionals lack awareness of the signs of sexual exploitation as a result of ineffective assessments of the actual risks (California Child Welfare Council, 2013). The social worker’s role becomes crucial in advocating and enhancing the chances for these youth to have a better life. In working with CSEC victims, one of the greatest achievements to which child welfare agencies can aspire is to change the perceptions of these children, not only perceptions of others but also their own, from “offenders” to “victims” (Clawson & Goldblatt Grace, 2007). 

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Multicultural Relevance

It is notable that victims of commercial sexual exploitation include male, female, and gay, lesbian, bisexual, and transgendered or questioning youth (LGBTQ; Quintana, Rosenthal, & Krehely, 2010). In fact, LGBTQ youth face significant challenges while in foster care, including higher rates of sexual abuse and elevated self-blame and stigmatization; many were also rejected by their families (R. C. Mitchell, Panzarello, Grynkiewicz, & Galupo, 2015). Also, LGBTQ who are homeless have increased rates of high-risk survival strategies, including survival sex, and are at greater risk of being sexually victimized. Runaways and homeless youth are the most frequent victims of sex trafficking. Chronic runaways are known to come from abusive and neglectful homes, and 58% experienced sexual victimization (Greenbaum et al., 2013). Kruger et al. (2013), in their qualitative research on children at risk for commercial sexual exploitation, interviewed 36 low-income African American girls and found that “children who live in communities that place them at risk for sexual exploitation face the dual problems of chronic exposure to physical violence in relationships and routine exposure to sexualization and prostitution” (p. 374). Research has suggested that African American youth have a disproportionately high risk of being sexually exploited (Reid & Piquero, 2014). The research discussed thus far also revealed that CSEC program participants were primarily African American females (Brawn & Roe-Sepowitz, 2008; Gibbs, Walters, Lutnick, Miller, & Kluckman, 2015; Iannaccone et al., 2013).

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