Spring 2024 | TRIO McNair Scholars Research Journal 30 The Foster Care System: A Segue to Sex Trafficking Blu Mackey is graduating with a Bachelor of Science degree in Psychology with minors in Business Administration and Product Design. Blu s̓ research project titled “The Foster Care System: A Segue to Sex Trafficking” was mentored by Dr. Jeff Todahl from the Department of Counseling Psychology and Human Services. Blu plans to attend University of the Arts London: London College of Fashion for a graduate degree in Fashion Psychology in Fall 2025. Dr. Jeff Todahl is an Associate Professor and the director for the Couples and Family Therapy Program (Counseling Psychology and Human Services Department) and co-Director and Director of Research of the Center for the Prevention of Abuse and Neglect. He has served as Director of the University s̓ Center for Family Therapy, as Director of the Couples and Family Therapy Graduate Program, and as CPHS Interim Department Head. Abstract Sex trafficking is a prevalent and persistent human rights, social justice, and economics issue. Fueled by a multi-million-dollar industry, this complex global epidemic is compounded by poorly resourced government and private sector response systems. The United States foster care system in particular serves youth at risk for sex trafficking and is well-positioned to provide trauma-informed services that support youth and act as a buffer for harm. However, given overall poor systems alignment and inadequate access to trauma-informed therapy and healthcare services, U.S. foster youth—who are disproportionately lower income and of historically excluded ethnicities—are particularly vulnerable to trafficking. As a result, advocacy groups have urged government officials to use their power for positive reform through the construction of systems and equitable foster care practices that account for race, ethnicity, and social class. This systematic literature review explores the evolution of sex trafficking in the United States between the years 2000 and 2023, examines systems response, and investigates a more effective approach to foster care and systematic reform in response to the prevalence of sex trafficking. Spring 2024 | TRIO McNair Scholars Research Journal 31 1. Introduction According to the U.S. Department of Justice, human trafficking is the “exploitation of a person for labor, services, or commercial sex” (U.S. Department of Justice). More specifically, sex trafficking is “the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act” (U.S. Department of Justice). Underage victims are particularly vulnerable to trafficking, but it is especially important to note there is no such thing as a child prostitute. Minors cannot give proper consent to sell their bodies to overage men due to developmental and authoritative differences. This reveals the importance of being sensitive to youthsʼ developmental age, individual backgrounds and circumstances, and vulnerabilities. Consequently, youth sex trafficking survivors are victims as opposed to delinquents. Although it seems as if sex trafficking is an issue that concerns populations regardless of socio-economic status, research has shown that foster care populations prove to be disproportionately at risk and victimized. Numerous studies report that 50-90% of child sex trafficking victims have been involved in the child welfare or foster care system where the instability present in their foster placements, and the child welfare system as a whole, affords opportunities for traffickers to prey on these vulnerable children (Thorn, 2022). According to The National Center for Missing and Exploited Children "1 in 6 of the 18,500 runaways reported to [the center] in 2016 were likely sex trafficking victims," and that “86% of these victims were under the protection of foster care or social services” (Selig, 2018, p.1). Additionally, the Los Angeles Probation Department found that 60% of youths who were arrested for sexual labor had been involved in foster care or had some involvement/past with the child welfare system, further exhibiting the overrepresentation of foster youth as victims and targets of the sex trafficking industry (Selig, 2018). These statistics demonstrate how traffickers target and prioritize group homes and foster care facilities in order to recruit new victims that no one will go looking for. This suggests the child welfare system is a “pipeline to child prostitution” and an opportune target for luring and victimizing youth (Selig, 2018, p.1). As a result, researchers are led to question government-led child welfare as a whole and investigate how and why foster children are so heavily prevalent in the sex trafficking industry. This raises important questions about issues related to government responsibility, policy and practice reform, and possible systemic solutions. Over the years, traffickers have become “skilled manipulators,” developing more creative tactics to lure naive children and young adults into their traps. For instance, traffickers will pose as “sugar daddies,” male models, modeling agencies, and businessmen in hopes of fooling potential victims on popular platforms like Snapchat and Instagram. As the scope of predatory online activity has grown exponentially, with online perpetrators employing encrypted technologies to conceal their identities and evade law Spring 2024 | TRIO McNair Scholars Research Journal 32 enforcement, it has become more important than ever to bring awareness to the potential predators lurking around the social media accounts of our younger generations and reinforce social media privacy and safety(Boys & Girls Club of America, 2019). An emphasis has been especially put on the protection of foster youth given their unique vulnerability and targeting in a multi-billion-dollar trafficking industry. Due to foster care youthsʼ vulnerable, and often dire circumstances, traffickers have learned to intentionally prey on them, further contributing to their overrepresentation in the sex trade industry and child prostitution rings. Historically, foster care and the needs of children were not seen as a “societal problem in the United States that needed an organized solution” (The Policy Circle, 2023). As issues in foster care, child abuse and neglect, and placements for homeless children began to gain recognition, state governments began compensating families that agreed to take in children which later led to the development of even greater subsidies for families that took in multiple children. It wasnʼt until the early 1900s when the federal government decided to make an official decree that “validated the authority of the state to step in and remove a child if they were a victim of abuse or neglect in the home” (The Policy Circle, 2023). This marked a turning point in state and federal government involvement in child welfare. On April 9, 1912, the Taft Administration created the federal government department devoted entirely to child welfare known as the Childrens̓ Bureau. With the establishment of this bureau, state-based social agencies began screening foster parents for suitable placements, keeping records, and providing services to families and children in need of familial support around the U.S. Although foster care seems to be a reasonable temporary solution for neglected or at-risk youth by moving them into a warm, healthy, safe, and stable environment, this “picture-perfect cloak disguises disastrous failures that leave children vulnerable and defenseless” (Chun, 2020) to the real dangers that lurk the streets around them. Those who remain in the system deal with a similar plethora of detrimental and negative living experiences. The United States faces a nationwide shortage of competent and eligible foster parents and placements. This national crisis in the search for suitable foster parents is compounded by inadequate training and support for foster parents, and disjointed systems that segue youth into unstable and often revolving-door placements, further contributing to their unorthodox and poor development as growing children. Consequently, fueled by a lack of proper training and experience with youth who have experienced multiple traumas, and the physical, financial, and emotional demands faced by foster parents who wish to provide support, approximately half of all foster parents decide to quit fostering youths after their first year (Chun, 2020). Additionally, many foster parents abuse and neglect their authority by using their government stipends solely for their own needs. Although foster care is meant to be a safe haven and catalyst for the healthy development of these adolescents, “earnings are prioritized over ensuring [a stable] permanent child placement, which hinders the potential for adoption” (Pesavento, 2021, p. 139). Not only are some foster parents financially https://www.casatravis.org/a_brief_history_of_foster_care_in_the_united_states https://www.acf.hhs.gov/cb/about https://www.acf.hhs.gov/cb/about Spring 2024 | TRIO McNair Scholars Research Journal 33 motivated, but they are unfit to parent a child with such a complex traumatic past and fail to love and care for these children properly. As the pool of capable and willing foster caregivers continues to diminish, countless children find themselves uprooted from their homes, left without a place to call their own and subsequently placed in juvenile detention facilities, shelters, and foster/group residences — all locations deemed by child welfare specialists as the “last resorts” for a child's growing environment (Chun, 2020). Not only are youth in these circumstances placed in isolated facilities, but they are also often repeatedly removed from their placements and moved from shelter to shelter. Chun (2020) refers to youth in these untenable situations as “homeless in foster care.” When youth age out of the foster care system they are often exposed to a variety of potential hazards and hardships such as a “lack of viable employment, incarceration, pregnancy, lower levels of education, and homelessness” (Selig, 2018). This increases their vulnerability to sex traffickers. In this context, many youth default to traffickers and “the streets” where they have freedom, some level of familiarity, a source of income, a place to stay, and perceived independence. In addition to receiving little support in the system while aging out, youth survivors also endure frequent occurrences of physical and sexual violence, cognitive impairment, sexually transmitted infections, and traumatic brain injuries, alongside a significant prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) (APA). Those who remain in the system deal with a plethora of similar detrimental and negative living experiences such as caregivers who lack experience and sensitivity to the youths̓ situation; an overall lack of basic house resources; support; and effective healing therapy to cushion their transitions. With the numerous impacts affecting young girls, many tend to struggle to thrive in the outside world and end up back in the places that either formed or reinforced their trauma from their past lives. When considering the colossal impacts of these realities, it reveals the importance of spreading awareness about this epidemic and calls for action to improve the conditions for the entire foster youth population to ensure their success and well-being later in life. This review will investigate the shortcomings of the foster care system, bring attention to systemic solutions, educate the public on the realities and dangers of the sex trafficking industry, and reinforce the responsibility of government authorities to honor their positions as legal guardians of children in state care. 2. Methodology This systematic literature review, using methods by Petticrew and Roberts (2006), drew on research and technical reports conducted between the years 2000-2023 with a specific focus on young girls within the commercially sexually exploited (CSE) foster youth population. The research used the following search engines: Google Scholar, APA format manual, Zotero, and University of Oregon Libraries. In order to mold this research, searches were based on the keywords "foster youth," "sex trafficking," "policy reform," and "Sexual Trauma-focused Therapy.” After an initial review, these keywords were Spring 2024 | TRIO McNair Scholars Research Journal 34 adapted to focus on data-based publications that used qualitative methods and technical reports that specifically addressed the research questions. In addition to the 23-year timeframe, articles and technical reports were selected from either peer-reviewed publications or technical reports produced by a) widely accepted discipline leaders, b) organizations that dedicate their time to fighting the sex trafficking industry, and c) government-published resources. This review s̓ overall purpose is to identify the necessary steps to transform sex trafficking response systems, including child welfare and foster care policies and practices. The review addresses the following primary research questions: 1. What current child welfare system practices are negatively impacting child development and contributing to the risk of sex trafficking for foster care youth? 2. What child welfare system reforms and strategies may best reduce sex trafficking risk and improve outcomes for foster care youth? 3. What are the most effective policies and practices within the child welfare system that will ensure the success and healthy development of these youths in the future? Of the 300 English language manuscripts that met general inclusion criteria, approximately 50% met full search criteria parameters. Among those manuscripts, about 100 directly addressed the 3 primary research questions. Of those, 30 sources fully aligned with search parameters and research questions, and 25 of those 30 were accessible through databases and institution-affiliated libraries. After reading and reviewing each source, it is apparent how each author highlights the intersectionality of sex trafficking and foster care with an emphasis on provider skill and experience level, policy reform, and shortcomings within the child welfare system as a whole. Policy and systemic reform were the most emergent solutions throughout these articles, emphasizing the improvement of in-house frameworks and policies. For instance, a vast majority of included sources focus on learning to understand the needs of sex trafficking victims first, and then addressing what resources and services will be necessary for a healthy and stable transition and experience in the child welfare system. According to researchers Heather Clawson and Nicole Dutch, once the immediate emergency needs are met for victims, such as health screenings and addressing miscellaneous medical injuries from traffickers, the next best steps for healthy development long term are: “service needs, including a) child care (for both adults and minors with children), b) education (GED assistance, enrollment in school, technical training/certification), c) life skills training (including assisting some international victims with the operation of basic household appliances, using public transportation, using a telephone, mailing a letter, etc.), and d) job training, finding employment, financial management, and where appropriate, family reunification or repatriation” (U.S. Department of Health and Spring 2024 | TRIO McNair Scholars Research Journal 35 Human Services). These kinds of services and growth opportunities are vital to the success and well-being of victims who have dealt with such complex trauma and further exhibit the importance of a structured and reliable support system to guide them through the trials and tribulations of adult life after aging out of the system or running away from home. This systematic literature review will identify the various necessary practices and strategies that will successfully confront the sex trafficking epidemic, reduce the risk of sex trafficking among foster youth, improve outcomes for foster care youth, and ensure the success and healthy development of these youths in the future. Not only will this review address the needs of commercially sexually exploited foster youth, but it will also hold the government and child welfare system accountable for contributing to the overrepresentation of the foster youth population in sex trafficking and officially abolish this “pipeline to [child] prostitution” for good (Selig, 2018). 3. Systematic Literature Review This literature review identifies 4 primary themes 1) staff and foster care resources, training, and suitability, 2) policy reform, 3) trauma-informed systems, and 4) trauma- specific health care. Following the systematic literature review, core concepts and insights from these scholarly resources were summarized according to the themes previously mentioned. 3.2. Staff and Foster Care Resources, Training, and Suitability Although the child welfare system attempts to maintain a framework that promotes safety, permanency, and well-being, many children in foster care find themselves in unsafe environments, unstable living placements, and with little of the support or resources necessary for their health and development (Smith, 2020). When taking a closer look into the structure and practices of the child welfare system, there are a series of shortcomings that negatively impact the development of foster youth and further contribute to their trauma and risk of being trafficked. Vulnerable youth are placed into shelters and group homes that often lack basic necessities, adequate living space, or in- house chaperones who are adequately trained or equipped to meet the needs of the children they care for. Given the diverse trauma and abuse experienced by these youths, caretakers must be trauma-informed, patient, and empathetic to provide the necessary quality care for their complex transitions at such a young age. Additionally, caretakers should also be able to form meaningful connections with youth to enforce feelings of trust and security for foster children. Along with inexperienced staff, foster care providers and shelter care systems will also lack the on-call psychological services necessary for youth navigating body dysregulation due to trauma and turbulent histories. When youth are struggling with trauma and are Spring 2024 | TRIO McNair Scholars Research Journal 36 unable to find a safe outlet to go to, they tend to resort to old patterns and contacts that reinforce their trauma or bad habits. Additionally, when foster homes lack the institutional support they need to support youth, the emotionally fragile children in their care are more prone to “turn to the underground sex industry, where pimps promise them the security and affection they crave” (Walters, 2017). Activists, therefore, generally call for building a child welfare and foster care system that bolsters protective factors and shields youth from well-known strategies employed by traffickers. This entails establishing a form of 24/7 trauma therapy and counseling within the home to ensure youth are supported when needed in order to buffer against would-be traffickers. 3.3. Policy Reform In addition to finding solutions to systemic issues within child welfare agencies and group homes, it is important to call upon government authorities to use their authority to combat the sex trade industry in its totality. Because of the new and sophisticated methods of manipulation and coercion used by traffickers to prey on vulnerable foster youth populations, there is an increased responsibility for government authorities and organizations to diminish the supply chain of underage youths. Although government officials have published statements regarding the sex trafficking epidemic among youth in the U.S., such as the Trafficking Victims Protection Act (TVPA) of 2000, updated, vigorous, protections are needed. Reforms designed to change the legal and social landscape for foster youth health and wellbeing are especially necessary. The mission statement from Joe Bidens̓ National Action Plan to Combat Human Trafficking outlines a list of 17 priority action goals “organized under six principles related to applying an equitable victim-centered and trauma-informed approach to engaging with victims; safeguarding victims from inappropriate penalization; expanding and improving victim assistance associated with federal law enforcement; seeking financial remedies for victims” (The United States Government, 2021). This legislation is designed to reduce risk factors, prevent harm, connect victims to social services, and lower revictimization. Additionally, the U.S. Department of Health and Human Services released a manual, Human Trafficking and Child Welfare: A Guide for Child Welfare Agencies, which offers “a comprehensive, multidisciplinary approach that is coordinated at the local, State, national, and international levels” (Child Welfare Information Gateway, 2023). These systematic recommendations identify the child welfare system as a key partner in any effort to curtail the victimization of children in, or formerly in, foster care including those who run away from foster placements (U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families Childrens̓ Bureau). 3.4. Trauma-Informed Systems With the diverse trauma and abuse experienced by trafficked youth caregivers must be trauma-informed, patient, and to provide quality care for youths̓ complex needs during Spring 2024 | TRIO McNair Scholars Research Journal 37 their transitions. These traits will help the caregiver to form meaningful connections with youth to foster feelings of trust and security with those in the home. Given that foster children are at a higher risk of exposure to sex trafficking, it is increasingly essential to form systems and protocols that provide resources to meet the needs of abused and neglected children. This is why it is especially important for child welfare systems to develop and maintain a cadre of professionals who have the skills and knowledge to identify and respond to child trauma. An adequately trauma-informed child and family service system is one in which all parties recognize and respond to the impact of traumatic stress on those involved (Bartlett-Rushovich, 2018. This includes children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with those who are involved with the child, using the best available science to maximize physical and psychological safety, facilitate the recovery of the child and family, and support their ability to thrive. Following the review, it was concluded that “Trauma-systems Therapy-Foster Care (TST- FC) is a systemwide model of trauma-informed care focused on meeting the emotional needs of children in foster care who have experienced traumatic events” and is the best possible solution to the current stability issue within foster youth placements (Bartlett- Rushovich, 2018). By providing an abundance of services and resources to these youths, along with employing trauma-informed individuals who will both be sensitive to their individual experiences and promote the healthy development of these youths, this model can ensure their success and well-being later on. 3.5. Trauma-Specific Health Care One innovative solution to this mental health crisis would be to broadly implement the Trauma Systems Therapy Model (TSTM) developed by Dr. Glen Saxe. TSTM uses “a research-based integrative treatment approach that attends to both the child's individual emotional needs and his or her social environment, including parents and other caregivers, social service workers, and clinicians” (Bartlett-Rushovich, 2018). This model is rooted in Urie Bronfenbrenner's ecological systems theory (Bronfenbrenner, 1979; Bronfenbrenner & Morris, 2006), which acknowledges the interplay between individual development and the social ecology of children ages 6-18. Implementing this model in child welfare agencies will help “emphasize breaking down barriers between services, [and help to understand] the child's trauma symptoms in his or her developmental context,” while also allowing for youths to be cared for from a trauma-informed approach. Furthermore, in a study on the effectiveness of this clinical model, researchers found that “child welfare staff reported that TST-FC was an effective training, increasing their knowledge about child trauma, offering useful strategies for working with children who have experienced trauma and providing a common language for talking about trauma that was beneficial to their work with one another” (Bartlett-Rushovich, 2018). Spring 2024 | TRIO McNair Scholars Research Journal 38 Not only does this model offer a sensitive approach to the complex trauma of each individual youth, but it leads to a reformed and trauma-specific child welfare outcome for children, including increased placement stability and foster home retention. This both supplements and improves youthsʼ living experience and surrounds them with trauma-informed caregivers they can trust, and who will understand them with a more expansive level of knowledge on victims of sex trafficking. 4. Conclusion In the words of Withelma Ortiz Walker Pettigrew, a youth survivor, “youth within the system are more vulnerable to becoming sexually exploited because youth accept and normalize the experience of being used as an object of financial gain by people who are supposed to care for us…” (Saar, 2014). After looking at the various factors that contribute to both negative living conditions and increased risk of sex trafficking for foster care youth, it is critical to bring awareness to the discrepancies and maltreatment experienced by these developing adolescents. Additionally, it is important to hold those who have the agency and authority to create lasting change and reform in the child welfare system accountable. By implementing strategies to improve the living environments and placements of foster youth, and by employing empathetic, patient, and trauma-informed specialists, foster care systems can then be better positioned to prevent future re-victimization. The reforms and legislation outlined in this review offer promise for creating valuable support and necessary resources for those in the foster care journey through their emerging adulthood. These efforts can collectively enhance the safety, well-being, and prospects of vulnerable youth, ensuring a brighter future beyond the foster care system. As the prevalence of sex trafficking continues to skyrocket, further contributing to the global sex trade epidemic, it is vital to tackle this massive adversary at the core of the issue, sustain trauma awareness, and build knowledge, and skills in the organizational cultures, practices, and policies of the child welfare system. This can disrupt the much too familiar pipeline from foster care to the sex trade industry, facilitate recovery, and build pathways toward thriving childhoods. 5. A Personal Reflection Over the summer, I volunteered as an intern for a non-profit organization called Give- Mentor-Love and spent time mentoring both at-risk youths and young women involved in the sex trade industry or the foster care system. As a result of my time, I learned that these young men and women were experiencing extreme symptoms of trauma such as high anxiety, stress, depression, flashbacks, nightmares, and irrational acts of aggression. Additionally, these youth were not given the proper treatment during their healing process, and many of the young women I mentored were suffering from homelessness and were sexually exploited by pimps and Jons that abused their innocence and youth. My observations led me to have an increased interest in the topic of sexual trauma and its effects on such a young population. With my research, I can Spring 2024 | TRIO McNair Scholars Research Journal 39 learn more about this community and find ways to bring awareness to this community. As well as advocate for justice within the trauma therapy practice to improve the treatment methods for youths suffering from traumatic pasts. Furthermore, I want to hold those people accountable who have subconsciously and directly added to its prevalence with their lack of empathy and resources and their negligence of the real issues. Acknowledgments I would like to give a special thank you to my faculty mentor Dr. Jeff Todahl for his unconditional, professional guidance and support throughout this intensive research process of completing this manuscript. I would also like to thank our McNair Scholars Program Director and Coordinator Dr. Christabelle Dragoo and Denise Elder for their unrelenting support and resources used to facilitate this research process and make sure I succeeded in the world of academia and in my journey to grad school. Lastly, I would like to thank my fellow McNair scholars for the constant peer support and advice that aided in fueling my academic confidence both in my work and in myself. In sum, I would like to address my heartfelt appreciation and gratitude to all faculty members, McNair staff, TRIO faculty, and McNair Scholars that helped me curate a wonderful final piece for my research. References Bartlett, & Rushovich, B. (2018). Implementation of Trauma Systems Therapy-Foster Care in Child Welfare. Children and Youth Services Review, 91, 30–38. https://doi.org/10.1016/j.childyouth.2018.05.021 Biden, J. (2021, December 3). The National Action Plan to Combat Human Trafficking - The White House. https://www.whitehouse.gov/wp- content/uploads/2021/12/National-Action-Plan-to-Combat-Human- Trafficking.pdf Preventing Child Sex Trafficking. Boys & Girls Clubs of America. 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