Screening Tool Helps Identify Sexually Exploited Minors

By the time youth are referred to WestCoast Children’s Clinic for mental health services to help them heal from commercial sexual exploitation, it has likely been going on for years. Despite their having interacted with child welfare, juvenile justice, school, or health care systems, for many of these youth, the fact that they are being trafficked, or sold for sex, has gone unnoticed by professionals in a position to help them.

In their 2012 study, Research to Action: Sexually Exploited Minors (SEM) Needs and Strengths, WestCoast, a mental health services provider based in Oakland, Calif., found that this gap in time from the start of exploitation to intervention was alarmingly common among sexually exploited minors served by programs like WestCoast’s.

The study, which included WestCoast and eight other providers in the Bay Area, found that nearly three-quarters of all youth in the study had been exploited for two or more years by the time they were referred for services to address it, often despite their having been served during that time by child welfare, juvenile justice, school, or health care systems.

According to Autumn Burris, founding director of Survivors for Solutions, the reason professionals interacting with exploited youth often miss the signs “is because the child doesn’t realize she’s being exploited. When we’re out there involved in systems of prostitution, we’re thinking how do I survive this mentally? The way we survive mentally is we act like it’s a choice.”

Fewer than half of the youth in WestCoast’s study recognized that their exploiter was not acting in their best interest. Studies estimate that anywhere from fifty to eighty percent of victims of commercial sexual exploitation have been in the child welfare system, making them particularly vulnerable to exploiters, many of whom target group homes.

“It became clear to us,” said Hannah Haley, policy and communications associate at WestCoast, “that there was a need for something to help professionals in whatever field they’re in to identify youth earlier who are being exploited.”

WestCoast conducted an extensive search for existing screening tools, and found that the available tools were either not appropriate for youth, not conducive to quick identification, or not research-backed and validated. And so, building upon the work of their C-Change: Transforming the Lives of Sexually Exploited Minors program, WestCoast set out to create their own.

The Commercial Sexual Exploitation-Identification Tool (CSE-IT,) now being piloted throughout California in a range of sites including child welfare, probation, dependency legal services, schools, and health clinics, provides a way for professionals interacting with vulnerable youth to document concerns about possible exploitation. The tool helps professionals organize information they gather during their own intake process. It does not require a separate conversation, and in fact, the questions are not meant to be asked directly of the youth.

The screening tool is a set of ten key indicators that research has shown to be correlated with exploitation or that survivors and providers working with them noted were significant. The ten indicators include “Instability in Life Functioning,” “Finances and Belonging,” and “Trauma Exposure.”

Each indicator has a set of supporting questions to help users of the tool assess a youth’s involvement in exploitation. For example, under “Instability in Life Functioning,” the questions include: “Does the youth experience unstable housing, including multiple foster care placements?” Under “Trauma Exposure,” the questions address exposure to traumatic experiences such as sexual, physical, or emotional abuse.

To determine what sort of indicators to include on the tool, WestCoast held focus groups with survivors of sexual exploitation, asking what would have helped a teacher, doctor, child welfare worker, or other professional recognize that they were being exploited.

Burris, who helped recruit participants for the focus groups, noted the importance of having survivor input: “As good-hearted and helpful and expert as the average individual may be, survivor leaders are subject matter experts so we’re going to know what those questions need to look like.”

WestCoast trains sites before they begin using the tool, which is based on a ‘concern scale,’ ranging from ‘no concern’ to ‘possible concern,’ to ‘clear concern.’ The ‘concern score’ helps guide the intervention, which will vary depending on where the tool is used.

A qualifying concern score triggers whatever local systems are in place for serving exploited minors. The level of coordination among agencies interacting with commercially sexually exploited minors is rapidly changing throughout California as a result of Senate Bill 855, which became law in June 2014.

Amending California’s Welfare and Institutions Code (WIC) section 300, SB 855 clarifies that commercially sexually exploited children whose parents or guardians are unable to protect them may be served by the dependency system rather than the juvenile justice system. The law also provides funding for counties to develop interagency protocols to establish agreed-upon means of collaboration among the local child welfare, juvenile justice, health, and school systems.

Initially, WestCoast had funding to pilot the CSE-IT in just five counties but with the passage of SB 855, the demand for the tool has jumped, and they are now piloting it at 35 sites in 20 counties.

“We knew there was a need for a screening tool,” said Haley. “We didn’t know there would be so much demand for it.”

WestCoast is collecting data (de-identified so as to protect the privacy of the children screened) from pilot sites over the course of the year to help validate the tool, which will be revised after the pilot phase.

Initial funding for the development of WestCoast’s CSE-IT came from Zellerbach Family Foundation, Walter S. Johnson Foundation, JaMel Perkins and the Quint Family Trust. Counties that have received training funds through SB 855 are using those funds to pay for the training to become a pilot site.

Melinda Clemmons is a reporter and marketing manager for The Chronicle of Social Change.

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Sara Tiano, Staff Writer, The Chronicle of Social Change
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