Module 5: Effective Service Delivery to CSEC Victims “The program is a space where I can be myself…Because it’s like, they don’t judge me on things that I do or things that I’ve been through in the past.” - CSEC survivor Effective Service Delivery to CSEC Victims Objectives… • Learn to integrate components of service provision and programming for CSEC victims into your agency’s services for youth. • Practice counseling techniques for working with commercially sexually exploited children and youth. • Discuss challenges inherent in providing services and programming to commercially sexually exploited children and youth. Tough Questions for Service Providers Tough Questions for Service Providers: 1. How do you engage with a child who doesn’t want to engage? 2. How do you get CSEC victims to understand exploitation when they don’t think they are being exploited? 3. How do you deal with a child who you have been working with long term, who is making positive progress in his/her life, who understands the dynamics of exploitation, who goes back to the life? 4. How do you work with a girl who has a “daddy” and says she is in love with him? 5. How do you engage with sexually exploited kids on the street? 6. How do you deal with a child who is actively recruiting other youth from your agency? 7. When recruiters and pimps know the location of your agency what should you do? Essentials of Service Delivery for Children and Youth Safe Space Cultural Competency Youth Development PHYSICAL SAFETY Safe Space Choose a safe location Install a security system Maintain a confidential address Recognize and respond to limitations of a confidential address: protocols around exploiters knowing location Set rules for appropriate conduct for youth Create a staff code of conduct/ethics and ensure training Create an inviting, youth friendly space Provide space for confidential interviews/counseling EMOTIONAL SAFETY Safe Space Appropriate music (do not play music that promotes sexual exploitation) Decorate the space with appropriate, informational, and/or inspiring images Use appropriate language (be especially sensitive to derogatory terms in reference to sexually exploited youth) Create policies that address recruitment in the agency Respect children’s need for privacy and confidentiality Set protocols for counseling that ensures privacy and confidentiality (i.e. Door open or closed) Conduct mental health assessments Encourage and practice self-soothing/self-care for staff and youth Promote an inclusive and non-judgmental community Provide ongoing professional development opportunities to ensure a trained and sensitive staff Cultural Competency Staff have a thorough understanding of impact, dynamics, and subcultures of CSEC Build on the cultural strengths of youth & incorporate these into programming Employ staff that speaks the language(s) of clients Print promotional materials in languages used in the community Make an effort to maintain a staff population that is representative of client population (consider gender, race/ethnicity, sexual orientation, etc.) Support survivor voices and/or work with survivors of CSEC Work with a CSEC victim as a whole person, not just a victim of abuse. Accommodate mental health services to ensure they are sensitive to cultural/community perception of metal health care Take into account community relationships with outside agencies when building relationships Celebrate and foster diversity in your agency (staff and youth populations) Youth Development Believe that all sexually exploited youth have the ability to be leaders Infuse programming with youth leadership opportunities Give youth ownership of aspects of program planning Provide age appropriate, engaging, and youth friendly activities Provide a continuum of services to meet immediate and long term needs Address all areas of adolescent development in programming: physical, cognitive, psychosocial Offer access to diverse learning experiences Create opportunities for youth to learn and master new skills Focus on providing opportunities for youth to build healthy self esteem Foster a sense of belonging and importance in the community Create opportunities for investment and empowerment within the community Incorporating CSEC Making CSEC a Priority at Your Agency 1. Decorate the space with posters or materials from CSEC awareness campaigns. 2. Make available youth friendly brochures on CSEC and local resources/service providers. 3. Offer staff training on CSEC and working with sexually exploited youth. 4. Include questions about CSEC on intake and processing forms. 5. Incorporate the issue of CSEC into broader social justice education programming. 6. Offer special workshops on CSEC. 7. Purchase educational materials from agencies serving CSEC victims. 8. Invite speakers from survivor led organizations to speak with your 9. Offer a weekly prevention youth group that is safe and non-judgmental. youth. 10. Design or modify intake, assessment, and referral forms to gather information specific to CSEC and risk factors. Reflection Questions... Homework! 1. Evaluate your agency/organization according to the 10 ways of Making CSEC a Priority at Your Agency. 1. How well does your agency prevent or address CSEC? 2. Is there anything about your agency that could contribute to or perpetuate CSEC? 3. Create a list of recommendations for your agency. Question: Have you ever initiated a conversation with a child about CSEC? What did you say? Addressing Concerns: Asking Youth About CSEC • “It seems like you’re a little scared of your boyfriend. Would you like to talk about that with me?” • “It’s tough to be out there on your own, how are you surviving on the streets?” • “Has anyone ever asked you to, or made you feel like you had to have sex in exchange for money, shelter, clothes, or food?” • “How does that make you feel?” Counseling Technique: Motivational Interviewing Activity: Personal Reflection Motivational Interviewing Is… a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. The examination and resolution of ambivalence is its central purpose, and the counselor is intentionally directive in pursuing this goal. Fundamentals of MI… 1. Motivation to change is elicited from the client, and not imposed from without. 2. It is the client's task, not the counselor's, to articulate and resolve his or her ambivalence. 3. Direct persuasion is not an effective method for resolving ambivalence. 4. The counseling style is generally a quiet and eliciting one. 5. The counselor is directive in helping the client to examine and resolve ambivalence. 6. Readiness to change is not a client trait, but a fluctuating product of interpersonal interaction. 7. The therapeutic relationship is more like a partnership or companionship than expert/recipient roles. Therapist Behaviors… Seeking to understand the person's frame of reference, particularly via reflective listening Expressing acceptance and affirmation Eliciting and selectively reinforcing the client's own self motivational statements expressions of problem recognition, concern, desire and intention to change, and ability to change Monitoring the client's degree of readiness to change, and ensuring that resistance is not generated by jumping ahead of the client Affirming the client's freedom of choice and self-direction Stages of Change Model Take a look at Handout 5.5 Stages of Change in CSEC Counseling… How familiar are these behaviors to you? Motivational Interviewing Techniques Open-Ended Questions Cannot be answered with a "yes" or "no" Begin treatment sessions with open-ended questions "What brings you here today?" "Tell me about what's been happening since we last met?" "So what makes you feel that it might be time for a change?" Motivational Interviewing Techniques Affirmations Build rapport and confidence Must be congruent and genuine Recognition of strengths Communicate that change is possible and that they are capable of implementing that change Can be rare and valuable for individuals focused on failure Motivational Interviewing Techniques Reflective Listening The key to this work: listen carefully to your clients Listen for what has worked and what hasn't When in doubt about what to do, listen Focus on their change talk and provide less attention to nonchange talk "You are not quite sure you are ready to make a change, but you are concerned that…” Can be surface level reflection (repeating back what an individual says) or in reference to deeper, perhaps unstated feelings Keeps momentum moving forward Motivational Interviewing Techniques Summarize A specialized form of reflective listening Reflect back to the individual what he or she has been telling you A way to communicate your interest in a client Call attention to important elements of the discussion or shift attention or direction Summarize frequently as too much information can be unwieldy Highlight ambivalence Announce that you are about to summarize, list selected elements, give an invitation to correct anything, and conclude with an open-ended question Interaction Technique: OARS Open-ended Questions A question that cannot be answered with yes or no, that opens up a larger conversation. Affirmations Recognition of the client’s strengths. Reflective Listening Listen to the client and focus on change talk. Reflect back to them what they have told you, making connections between themes. Summary Announce that you are going to summarize, list selected elements of what the client has told you, and ask them to make meaning of these things. Motivational Interviewing: Role Play • Each group will do 3 role plays. • Each role play will be 3 minutes long. • Act out stage of change: pre-contemplation, contemplation, and relapse. • Use all counseling tips, tools, and sample questions to help you. • Observers fill out form. Guidelines • Do your best to empathize with your character. • Do not rely on stereotypes for your acting. • Incorporate aspects of yourself, your thoughts and feelings. • Be patient with yourself, this is just practice. • Observers observe only. Debriefing Questions: 1. How did that feel? 2. How did it feel to be the counselor? 3. How did it feel to be the child? 4. What did you notice as the observer? 5. On a scale of 1-5 how prepared do you feel to talk about CSEC with children/youth at your agency? More on Counseling… • Handout 5.8 Service Provision Tips 101 • Module 8: Medical and Mental Healthcare of CSEC Victims • Handout 8.4 Behaviors and Symptoms Associated with CSEC Trauma Bringing Back the Tough Questions… Tough Questions for Service Providers: 1. How do you engage with a child who doesn’t want to engage? 2. How do you get CSEC victims to understand exploitation when they don’t think they are being exploited? 3. How do you deal with a child who you have been working with long term, who is making positive progress in his/her life, who understands the dynamics of exploitation, who goes back to the life? 4. How do you work with a girl who has a “daddy” and says she is in love with him? 5. How do you engage with sexually exploited kids on the street? 6. How do you deal with a child who is actively recruiting other youth from your agency? 7. When recruiters and pimps know the location of your agency what should you do? Debriefing Questions: Did you find any of the service provider responses on Handout 5.9 valuable? At this point in the training, do you have any tough questions of your own you would like to put out to the group?