From the Institute of Medicine/
National Research Council Report

Confronting
Commercial
Sexual
Exploitation

and

Sex Trafficking
of Minors

in the United States

A Guide for Providers of
Victim and Support Services

    INSTITUTE OF MEDICINE AND
NATIONAL RESEARCH COUNCIL
                         OF THE NATIONAL ACADEMIES



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From the Institute of Medicine/ National Research Council Report Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States A Guide for Providers of Victim and Support Services

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In 2013, the Institute of Medicine (IOM) and the National Research Council (NRC) published a report about commercial sexual exploitation and sex trafficking of minors in the United States. The report, Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States, was funded by the U.S. Department of Justice Office of Juvenile Justice and Delinquency Prevention. It provides a comprehensive view of this issue and offers a detailed explanation of its findings and recommendations. The content of this guide was derived entirely from the original report as an abridged ver- sion for providers of victim and support services. This guide, which was also funded by the U.S. Department of Justice Office of Juvenile Justice and Delinquency Prevention, was edited by Rona Briere and Patti Simon. Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States was authored by the IOM/NRC Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States: ELLEN WRIGHT CLAYTON (Co-Chair), Craig-Weaver Professor of Pediatrics, Professor of Law, and Co-Founder, Center for Biomedical Ethics and Society, Vanderbilt University RICHARD D. KRUGMAN (Co-Chair), Vice Chancellor for Health Affairs, University of Colorado School of Medicine TONYA CHAFFEE, Medical Director of Child and Adolescent Support, Advocacy and Resource Center, University of California, San Francisco ANGELA DIAZ, Jean C. and James W. Crystal Professor of Pediatrics and Preventive Medicine, Mount Sinai School of Medicine ABIGAIL ENGLISH, Director, Center for Adolescent Health & the Law BARBARA GUTHRIE, Associate Dean for Academic Affairs and Professor, Yale University School of Nursing SHARON LAMBERT, Associate Professor of Clinical/Community Psychology, The George Washington University MARK LATONERO, Research Director, Annenberg Center on Communication Leadership & Policy, University of Southern California NATALIE McCLAIN, Assistant Professor, Boston College William F. Connell School of Nursing CALLIE MARIE RENNISON, Associate Professor, School of Public Affairs, University of Colorado Denver JOHN A. RICH, Professor and Chair of Health Management and Policy, Drexel University School of Public Health JONATHAN TODRES, Professor of Law, Georgia State University College of Law PATTI TOTH, Program Manager, Washington State Criminal Justice Training Commission International Standard Book Number-13: 978-0-309-30489-4 International Standard Book Number-10: 0-309-30489-X Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http:// www.nap.edu.

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Contents 1 Introduction 1 Purpose of This Guide, 1 Intended Audience, 2 How This Guide Is Organized, 2 2 The Problem 5 The Definition Issue, 5 Guiding Principles, 7 Extent of the Problem, 8 Risk Factors, 9 Consequences, 11 3 How Victim and Support Services Can Help 13 Child Welfare, 14 Creating an “Allegation of Harm,” 15 Requiring Reporting to Child Protective Services, 15 Raising Awareness and Building Capacity in Child Welfare, 16 Developing State Guidelines and Tools for Child Welfare Professionals, 16 Federal and State Governments, 17 Making Federal Benefits and Services Available to Victims of Trafficking, 17 Funding Service Organizations, 18 Providing Employment and Job Training to Trafficking Victims, 19 iii

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iv Contents Using a Statewide Coordinated Care Approach to the Provision of Victim and Support Services, 19 Nongovernmental Organizations, 19 Curriculum Development and Education, 20 Training for Victim and Support Service Professionals, 20 Direct Care and Services, 21 Outreach and Public Awareness Initiatives, 23 Prevention Efforts, 24 Hotlines, 25 Direct Support to State and Local Organizations, 25 Multisector and Interagency Efforts, 26 Models from Other Domains, 27 Multisector and Interagency Initiatives Addressing Commercial Sexual Exploitation and Sex Trafficking of Minors, 28 4 Approaches and Challenges to Service Provision 33 Approaches to the Provision of Services, 33 Trauma-Informed Care, 33 Case Management, 35 Survivor-Led and Survivor-Informed Models, 36 Challenges to Service Provision, 36 Lack of Adequate Shelter and Housing, 37 Few Victim and Support Services for Boys, 37 Lack of Awareness Among Service Providers, 37 Lack of Information Sharing and Communication, 37 Impact on Service Providers of Working with Victims and Survivors, 38 Lack of Consensus on Services and Service Delivery, 38 5 Recommended Strategies 39 Increase Awareness and Understanding, 39 Training, 39 Public Awareness Campaigns, 40 Strategies for Awareness Among Children and Adolescents, 40 Strengthen the Law’s Response, 40 Strengthen Research on Prevention and Intervention, 41 Support Collaboration, 42 Support Information Sharing, 42 Final Thoughts, 43 References 45