Friday, June 3, 2016

Child Victims of Human Trafficking: Outcomes & Service Adaptation within the URM Program

Catholic Relief Services
In the United States, the Trafficking Victims Protection Act (TVPA) defines the crime of trafficking of persons and outlines the services and benefits available to victims. Foreign-born victims of human trafficking are eligible for many of the same protections, services, and benefits as refugees,[i] and so foreign-born child victims without the care of a parent or legal guardian are eligible to enter the Unaccompanied Refugee Minor (URM) program, a specialized system of community-based and licensed foster-care programs developed and funded specifically for certain foreign-born children.[ii]

As expected, child[iii] victims of trafficking have a range of complex needs and vulnerabilities, especially as they begin to rebuild their lives. The URM programs are able to address these needs, because they operate under the principles of safety, permanency, and child well-being, coupled with the principles of integration and cultural competency. The URM network employs a strengths-based and trauma-informed approach to meet the unique needs of those children and youth in their care. For almost 35 years, USCCB/MRS has coordinated a network of URM programs, and from 2002 to 2013, cared for 110 child victims of trafficking. 

Last year, a small study was conducted on the URM network, to look specifically at the outcomes of the child trafficking victims served. This study examined 3 sets of data:
  • Individual service provision and outcomes of child victims of trafficking placed in the URM program
  • Program policies and practices from the 12 URM programs in the USCCB/MRS network
  • Foster parent and key program staff experiences caring for child victims of trafficking placed in their homes/URM programs
Among the key findings, we found that child victims of trafficking:
  • Have greater safety considerations, which must be addressed, particularly if there was a prior relationship between the victim and trafficker;
  • Have more complex and significant trauma histories and benefit from creative, non-traditional therapies;
  • Have greater difficulty forming connections with adults, but many do eventually connect with a caring adult;
  • Benefit from placement stability, even in AWOL cases;
  • Can thrive in family-based foster care and small group homes; there are particular traits that effective foster families share, and they benefit from specialized training.

BRYCS Photo, Katrina Hobbs
Overview of the Children and Youth Served
The sample included victims of labor trafficking, sex trafficking, and victims of both types. The children ranged from 13-17 years of age at the time of their identification and initial placement. The children were exploited in a wide variety of industries and settings, including domestic servitude, retail personal care services (hair braiding), construction and manual labor, restaurant work, and agricultural processing. Sex trafficking victims were exploited in cantina- or nightclub-based prostitution, street prostitution, brothels, and Internet-based prostitution. Some children were relatively isolated in people’s homes while others were in contact with the general public in retail settings. In later years of the study period, children compelled to smuggle drugs by international gangs and cartels were recognized as being victims of human trafficking and received the designation.

Overall, almost half of the children were exploited by someone with whom they or their family had a prior relationship, with authors noting a prior relationship between the child and trafficker in 46% of the cases, often times family members, family friends or intimate partners. These relationships have implications for the children’s short-term and long-term needs and their future stability and well-being. They limit their family reunification options and affect their ability to form meaningful relationships with others.

As a result of their trauma, program staffers thought that the victims of trafficking had a higher level of therapeutic need than the other populations served in the URM programs. They noted that, among this population, children were “needier,” had “significant trust issues,” had problems with “boundaries,” and needed “a sense of stability.” Staff members also shared that the mental health needs among this population sometimes take longer to resolve due to trust issues, the child’s utilization of “survivor skills,” and children going into “survivor mode” after their placement within the URM program.

The URM program staff were asked what types of interventions they thought were the most helpful in meeting the therapeutic and behavioral needs of the child victims of trafficking, and 3 themes emerged.
  • Staffers at several programs believed that recreational activities, including those that had a cultural component and/or were structured, were of most assistance. They pointed to soccer, music, and other types of recreational activities as good examples.
  • Staffers at several programs stressed the benefits of what are not typical interventions: the importance of facilitating connections with people who the child felt understood them and to whom the child felt attached. A “sense of belonging” and “family” were articulated as important in meeting the child’s therapeutic needs. One respondent stressed the importance of children “knowing they are cared for no matter what” and “placement with the right family.”
  • Staffers also identified helpful therapeutic practices other than traditional forms of individual counseling, specifically, assistance with biofeedback and breathing exercises, journaling, and sandplay.
Keeping child trafficking victims safe in community-based care
When the perpetrators of child trafficking victims are at large, URM programs incorporated measures to
keep children safe within their community-based settings in family foster care or group home care:
  • Increased attention to external contacts and monitored external communications. For example, some programs have mail sent through the URM program office rather than directly to the foster home, restrict access to social media, and/or educate children about the use of social media. In foster family homes and group homes, some programs implement restrictions on phone calls, for example, preparing “safe-to-call lists,” screening incoming calls, and blocking certain numbers. 
  • Formal safety planning with child and foster family; with schools or others in the community; and with law enforcement. One program reported that the most important element in formal safety planning was for the child to understand his or her own safety concerns.
  • Individual risk assessments, bio-psychosocial assessments, and lethality assessments.[iv]
  • Half of the programs reported that children in their care had wanted to maintain contact with the traffickers, complicating the efforts to keep their clients safe. This situation is especially common among girls who may view the traffickers as their boyfriends and who have formed emotional attachments to them. Two programs had experience with assisting girls who had given birth to the children of their traffickers.

Child Well-being
BRYCS Photo, Courtesy CSS Anchorage
Whether or not children in the sample group formed meaningful connections with adults was used as a proxy for well-being. Through case files and interviews, the authors were able to identify the adult who formed a meaningful relationship with the child, that is, case manager, foster parent, family friend, or adult community member. 40% of children had no documented connection to an adult. While it is likely that some of these children did have meaningful relationships, documentation was missing from the case files. Anecdotally, children without connections experienced difficulty adjusting to routines and the restrictions of living in a family, difficulty in school, and difficulties forming relationships with peers. Some struggled with assimilating or acculturating, and some also suffered from serious mental health conditions, including bipolar disorder, major depression, and eating disorders. In several cases, even for those children with meaningful connections to adults, these relationships did not form until the children had been in their programs for months or even years.

Other proxies for well-being were absence without leave (AWOL) incidents or instances when caregivers did not know where the child was. Within the sample, very few children went AWOL from their placements. Of the 5 children who went AWOL from the program and did not return, 2 children contacted the program staff to report that they were living with family members. Other AWOL incidents were reported, with some children being away from their placements several times during the study period. Anecdotally, children appeared to leave without notifying their caregiver to meet up with friends and romantic interests—including traffickers—to engage in prohibited activities such as drinking and/or drug use. These incidents appeared to be infrequent, and a relatively small number of children engaged in these activities. The program responses generally resulted in additional safety planning, development of safety contracts, and losses of privileges. Placement changes were not among the consequences—because maintaining relationships and stability were recognized as significant contributing factors to the youth’s overall well-being.

Foster Family Selection and Placement
Much of what was reported by program staff was relevant to all their populations in care; they need foster parents who are nurturing and understanding, neutral and open minded, and self-actualized. One program representative mentioned that they look for foster parents who understand that foster care is “not about them, but about the [children].” Program staff look for foster parents who are motivated to assist the child rather than feel good about themselves as caretakers.

Some programs appeared to have learned through their experiences what types of families were more suited to caring for the child trafficking victims, and they actively recruited for parents who lived in certain situations or had certain attributes listed below.
  • "Flexibility”demonstrated, for example, by parents who could adapt rules and boundaries to fit an individual child’s needs
  • Organized and predictable helped the child trafficking victim feel safe in his or her new environment.
  • Open to continual learning and have a “teachable spirit,” while also being experienced in parenting
  • “Savvy and smart” enough to recognize cues and know when children were possibly engaging in inappropriate behaviors
  • Knowledgeable about social media and the new ways that children may engage with their peers

Foster parent training and retention 
Foster family retention is key to the stabilization of placements for any child in foster care and can be
BRYCS Photo, Katrina Hobbs
particularly important for child victims of trafficking who often have had little stability in their lives. URM program staff members shared their strategies for successful foster family retention among all URM populations, including child victims of trafficking. These strategies included providing ongoing training, being available and responsive to the families’ needs, providing respite care (temporary foster care placements), providing joint counseling for the foster parents and the foster child, offering foster parent support groups, including foster parents in case planning with the child (family decision-making processes), providing more financial assistance for higher needs children, offering organized social and recreational opportunities for foster parents to spend time with their foster children, sponsoring foster family appreciation events and holiday celebrations, and giving gifts. One program staffer noted that smaller programs with lower ratios of parents to staff helped foster parents feel appreciated, supported, and included in the program’s work.

It is apparent from this study that there are numerous considerations in serving this population. Exploring connections with a child’s biological family, including the potential for reunification; meeting the therapeutic and behavioral needs through recreational activities and other nonconventional methods; and helping children feel safe in addition to keeping them safe were some of the more notable service considerations the URM program staff discussed with the authors. However, it is also clear that foreign-born child victims of human trafficking, and by extension U.S. born victims can be served well in community-based care settings. To respond to this population’s unique and intense needs, the URM programs often adapted their services to ensure that they provided positive long-term outcomes for the children. Adapted services include placing child victims of trafficking with foster parents who are structured, flexible and savvy; increasing supervisor involvement with trafficking cases; and setting clear expectations with trafficked children upon initial placement in a foster home.

Click here, for the full report.

This month's guest blogger: Hilary Chester, Associate Director, Anti-Trafficking Program, U.S. Conference of Catholic Bishops/Migration and Refugee Services (USCCB/MRS)




[i] Office of Refugee Resettlement, State Letter #01-13: The Trafficking Victims Protection Act of 2000, 2001.
[ii] Child populations eligible for the URM program include refugees, asylees, certain children with special immigrant juvenile status, victims of human trafficking, and Cuban/Haitian entrants.
[iii] For the purposes of this paper, the term “child” refers to individuals under the age of 18.
[iv] Lethality assessments allow mental health professionals to assess the severity of suicide or homicide ideation.