Recommendations

Recommendations to Improve Identification

There is a significant need for medical professionals to receive training on CSE that is trauma informed and grounded in the experiences of survivors.

  • Healthcare Education: Healthcare professionals must better understand how CSE impacts health and the common health concerns facing survivors.
  • Building Trust: Providers must understand why survivors do not easily disclose exploitation and work to build trust to ensure healthcare needs are met.
  • Presenting Conditions: Understanding that people experiencing CSE may initially present with other identities, such as homelessness or substance use disorder, may help practitioners better identify CSE victimization.
  • Screening Systems: Screening tools are increasing, but providers need to consider the implications of identification and ensure systems are prepared to support young people once identified.
  • Resource Networks: Health providers should have resource lists for individuals suspected to be victims of CSE, particularly referrals to services specialized in exploitation and trauma-informed care.
  • Focus Areas: Identification of CSE may be particularly important for clinics, reproductive health services, and emergency rooms, which are primary locations of care during exploitation identified by survivors.

Recommendations to Better Meet Healthcare Needs

The relationships that CSE survivors have with healthcare before, during, and after exploitation are critical to promoting or inhibiting their trust in healthcare professionals and willingness to disclose information about exploitation that might be critical to their care.

  • Safe Environments: Healthcare providers should create environments where survivors feel safe by building trust and ensuring privacy and confidentiality.
  • Trauma-Informed Care: Focus on providing trauma-informed care that recognizes the impact of exploitation on physical and mental health.
  • Continuity of Care: Develop continuity of care systems to support survivors throughout their healthcare journey, from identification to long-term recovery.
  • Multi-Disciplinary Approaches: Create multi-disciplinary approaches that connect healthcare with mental health services, substance use treatment, and social services.
  • Communication Strategies: Ensure providers use communication approaches that are trauma-informed, non-judgmental, and culturally sensitive.
  • Strength-Based Approaches: Develop healthcare approaches that recognize the unique strengths and resilience of survivors and build upon these in treatment plans.

Recommendations for Research

While this study provides important insights into the healthcare experiences of CSE survivors, additional research is needed to further build knowledge and guide evidence-based interventions.

  • Screening Tool Evaluation: Evaluate the effectiveness of screening tools for CSE in healthcare settings, particularly for diverse populations.
  • Provider Training Impact: Study the impact of trauma-informed training for healthcare providers on identification rates and quality of care for CSE survivors.
  • Diverse Population Needs: Investigate specific healthcare needs for different survivor populations, including males, LGBTQ+ youth, and various racial/ethnic groups.
  • Mental Health Interventions: Research effective mental health interventions specifically tailored for CSE survivors with complex trauma.
  • Collaborative Models: Explore collaborative care models that connect healthcare, social services, and community-based organizations for CSE survivors.
  • Long-term Outcomes: Study long-term health outcomes for CSE survivors and the impact of early intervention on overall health trajectories.

Pediatrics and Preventive Care – Establishing a Foundation of Trust

Key Takeaways:

  • Young people at risk of exploitation need a strong foundation of trusting relationships with healthcare providers before, during, and after exploitation.
  • Without this foundation, it's harder for exploited youth to seek needed medical care or disclose information that could increase safety and support.
  • Current training for healthcare workers focuses on identification tools rather than building trust.
  • Young people experiencing exploitation are unlikely to trust healthcare professionals without prior positive experiences.

Recommendations:

  • Foster and reward pediatric practices that develop foundationally healthy relationships with healthcare providers:
    • Providers model communication that is trusting
    • Providers model relationships that are non-transactional
    • Promote individual agency and the importance of self-advocacy around health
    • Provide young people with developmentally and legally appropriate opportunities to be "in control" of their health
    • Healthcare should be seen as a site of agency and control rather than helplessness and stigma
  • Ensure pediatric practices include training of CSE and are survivor informed
Read Research Brief Here

Serving Survivors of Commercial Sexual Exploitation

Key Takeaways:

  • Service providers work to meet survivor needs across multiple domains: safety, housing, education, employment, and relationships.
  • These factors are key social determinants of health that impact survivors' overall wellbeing.
  • Service organizations typically have less focus on connecting survivors to specifically trained healthcare professionals.
  • There's a gap in connecting survivors with healthcare providers equipped to provide specialized care.

Recommendations:

  • Agencies and organizations should integrate healthcare navigation into their practices:
    • Patient Navigators can support patients instrumentally and emotionally through complex healthcare needs
    • Navigation services help reduce health disparities often faced by those with public health insurance or without quality insurance
    • For CSE survivors, navigation strategies would strengthen connections to experienced providers
    • Navigators provide emotional support and help reduce health disparities experienced by CSE survivors
    • Navigators can support clients in getting specialized care referrals and advocating for tailored services
  • Explore engaging trained survivor mentors as Patient Navigators:
    • Survivor peers/mentors play a critical role in helping young people transition away from exploitation
    • Trained survivor mentors could serve as a critical source of information and support
Read Research Brief Here

Clinics and Emergency Services

Key Takeaways:

  • Survivors of commercial exploitation face significant physical and psychological health challenges.
  • These health issues are often related to and exacerbated by their exploitation experiences.
  • During exploitation, survivors most commonly seek healthcare from local clinics.
  • Reproductive health clinics and emergency rooms are the primary locations where survivors seek care.

Recommendations:

  • Development of training focused on clinic and emergency room practitioner understanding of CSE risk factors and associated care responses.
  • Prioritization of meeting immediate medical needs (e.g., reproductive health or emergency health) informed by understanding CSE survivorship's realities.
  • Recognition of comorbid concerns such as substance abuse that both exacerbate health problems and increase risk and also are difficult to manage and interrupt.
  • Ensuring clinical and emergency staff at all levels provide care that does not stigmatize CSE survivors and creates space for agency and control that is not transactional.
  • Develop innovative health care system navigation models, engaging patient navigators to support CSE survivors in engagement and continuity of care.
Read Research Brief Here