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COUN 6785: Social Change in Action:

Prevention, Consultation, and Advocacy

Social Change Portfolio

J. Cosme

Contents

Below are the titles for each section of the Social Change Portfolio. To navigate directly to a particular section, hold down <ctrl> and click on the desired section below.

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Introduction

Scope and Consequences

Social-ecological Model

Theories of Prevention

Diversity and Ethical Considerations

Advocacy

INTRODUCTION

Social Change in Action: Prevention, Consultation, and Advocacy

Sex trafficking is the exploitation of any person by means of sexual exchange by way of transporting them from one place to another against their will. The victim is coerced and recruited by a trafficker in a variety of ways, provided for in some small way, transported to a different location, harbored against their will and then made to give sexual favors to the trafficker’s clients. For the victims who are not rescued or who do not escape, they are trapped in sexual slavery. They are provided food, clothing and many times travel by force of their traffickers, even abroad, to fulfill the requests of the clients they serve. Victims are targeted when in distress, having low self-esteem, being a run-away or just being naive to manipulation. Both boys and girls are victims of this global health crises with girls entering the trade, generally, at 12-years-old and boys as young as 11-years-old, generally (U.S. Department of Justice, National Center for Missing and Exploited Children, United Nations Office on Drugs and Crime, n.d.). My goal for this target population is to regain self-efficacy and rebuild their lives to become positive contributors of social change in their communities to help prevent the spread of this plague.

PART 1: SCOPE AND CONSEQUENCES

I will be focusing on the target health problem of sex trafficking in Phoenix, AZ. Sex trafficking is most prevalent in the United States (Fortune, 2020), contributing to a billion dollar industry (Niethammer, C., 2020) and is the second largest industry in the world. Arizona is a hotspot for traffickers because of an ideal climate, many major sporting attractions that make maneuvering with victims seemingly undetectable and connection to five different U.S. borders not including Mexico, leaving traffickers and their victims various points of entry and escape.

The Polaris Project (2020), a non-profit that operates the National Human Trafficking Hotline, details there are three top trafficking tiers which are sex trafficking, labor trafficking and sex and labor trafficking. Labour trafficking, as you can imagine, is when a trafficker lures an unassuming victim to prospects of a better life through employment, details of which are never true, only to hold onto the victims credentials so they cannot escape once arrived. Victims are enslaved, forced to work under illegal conditions, under paid or not paid at all, beaten, raped and many times killed for fear from the trafficker of revealing the operation. Of these three tiers, there has been a 25% increase in cases from 2017 to 2018. There have been 23,078 survivors identified, 10,949 human trafficking cases, 5,859 potential traffickers and 1,905 suspicious businesses. A screening tool called QYIT (Quick Youth Indicators for Trafficking) was validated (Children and Youth Services Review, 2019) and found that homeless youth were the most susceptible to become trafficked. For an estimated year and a half, 307 participants were assessed with results being 66.7% (20) had been sex trafficked, 46.7% had been labor trafficked and 16.7% had experienced both forms of trafficking (Children and Youth Services Review, 2019). Completely thorough estimates of trafficking victims cannot be known because of the unscrupulous nature of the crime (Farrell, McDevitt, & Fahy, 2010; Farrell & Pfeffer, 2014; Farrell & Reichert, 2017; US Department of State, 2002, US Department of State, 2006).

All forms of trafficking are heinous, however, child sex trafficking is especially horrific for obvious reasons and therefore has been my focus. There are endless mental and physical consequences in all of these circumstances (Greenbaum, J., & Bodrick, N., 2017) and they must be vindicated by reform. In Arizona specifically, the local government agencies and non-profit organizations have taken a stand to become a model for the rest of the country to stand, fight and disband all forms of trafficking. These offices make a loud voice to be heard throughout the state that trafficking will not be tolerated here and for that I am grateful. There is a task force comprised of police, social workers, public agencies and other resources that make up a coalition against trafficking in Arizona as a preventative measure, they can be found here: https://www.phoenix.gov/district2site/Documents/City%20of%20Phoenix%20COMPASS%20Plan.pdf. Overall, human slavery never ended, it just sounds different. Whether labour or sex or both, people are not free and are living their days in misery and grief. Preventative measures will only help those in need if it is a collective effort. Education on what the signs are, what numbers to call, how to help and how to stay vigilant is a great start of fighting this global problem.

PART 2: SOCIAL-ECOLOGICAL MODEL

For women and children, risk factors are early teen pregnancy that leads to fistulas for girls. This medical condition plagues a young women, many times for the rest of her life and leaves her with a stigma of being tainted and unclean forever damaged goods. For women, they are left with unwanted pregnancies, forced abortions or death in child birth because of so much trauma and stress. These all would be biophysical risk factors (American Mental Wellness Association, 2020).

There is also the burden of addiction to hard drugs. These women and children are drugged by their captors in order to cooperate and ‘perform’ so many times they become addictive to the substances and then start ‘needing’ them to survive. If they are allowed to survive and be set free, they are many times junkies and addicts, destitute and lost. They no longer fit in with peers their same age and are among a community that shuns them. Only the fortunate ones will be supported in a community that is knowledgeable and understanding, having the resources and education that fits them with compassion and empathy to help those until they can help themselves.

The goal is to educate these women and young girls to understand that what they went through is an abnormality, a treacherous mishap and not all men behave this way. These would be social risk factors (American Mental Wellness Association, 2020). The goal here is to have them avoid thinking that the kind of men that abused them are the very men they should pick as mates. The goal is to help them see the positive aspects a male partner can bring, such as peacemaker, provider, protector and friend. With a supportive family structure, these women and children will hopefully have the tools to restructure their lives with positivity and balance. It is also important to assess what kind of family structure these clients are coming from and dealing with. In no way should a client be replaced into a family structure that is in any way a threat to their psychological or physical wellbeing. This would be considered a biophysical risk factor (American Mental Wellness Association, 2020).

A great way to reacclimatize themselves into society is through education. Going back to school is a great way to distract with positive influences, become involved in extracurricular activities that stimulate them mentally and physically and also to make friendships they can trust. Depending on their cultural background, all or some of these different aspects of readjusting may take a different path or need to be approached more creatively. However, depending on their unique circumstances, family support and determination, there are many avenues of reform to choose from.

PART 3: THEORIES OF PREVENTION

Human sex trafficking is literally a cancer embedded in our global society. One attempt that might prove successful is to combat it with structured theory(s) to help the individual strategically outline a method of success. This theory can also translate to effected communities at large. Greater numbers of trafficked survivors come from communities rooted in cultural norms that promote, advance and make trafficking an all too easy and common occurrence. Implementation of specific theories to plan, develop and sustain community programs have proven effective (National Cancer Institute, 2005).

A theory that would provide introspection and prevention would be the theory of planned behavior, which focuses on “behavioral intention, attitude, subjective norm and perceived behavioral control” (National Cancer Institute, P. 16, 2005). This would be especially useful to implement into the education system with the hopes of eliminating runaway youth. Giving these young adults insight into how their decisions most likely will play out in the real world quite possibly may deter many from making hasty decisions that could affect their lives forever. Runaway and homeless youth, youth that drop out of high school or receive their GED are more likely to become sex trafficked (Greeson, Treglia & Wasch, 2019). It is common that youth cannot foresee how their immediate behaviors have long lasting affects not only for them but for their communities at large. It would be helpful and preventative in some respects to give them the big picture and their part in it. Playing out scenarios with questions to be answered by them, followed up with researched responses and statistics of outcomes would be sobering in the very least. Suggested questions and conversation starters could be as follows: If you ran away, where would you go? How would you support yourself until you graduate? Provide a detailed account of how to get and sustain housing, food, supplies and transportation.

Unfortunately for those youth who must leave their homes for their own health and safety and are placed into a shelter or foster care agency, they too are at great risk for commercial sex trafficking. 98% of children who had been sex trafficked had a background of foster care and were trafficked and abused while being in the care of the state (University of Nebraska at Lincoln, 2013). The majority are female, Latino, high school drop outs or have acquired their GED (Greeson et al., 2019) and a longer sex history, involvement with authorities and a history of violence (Varma, Gillespie, McCracken, Greenbaum, 2015).

Many high school graduates do not know how to balance a checkbook, apply for an apartment, write a letter or access resources available to them in their community to help sustain themselves if an emergency arose. It is important not just to point out these areas of lack, but to give them the knowledge and present them with introspection as to sort out a better plan if leaving their current situation is a must. Providing them with all of the statistics and areas of concern that face them if they were to venture out into the world predestined, would at least pre-warn them of dangers that face them.

Research shows that through stages of the precaution adoption process model, with its 7 stages, it advances an individual from being unaware of an issue with decisions and outcomes reflecting that, to maintenance of the circumstance having been fully aware of the outlying influences (National Cancer Institute, 2005). According to the U.S. Department of Health and Human Services (2018) evidence-based research has found significant results with runaway and trafficked children while implementing the following:

• Advocates and health personal will identify and unify with medical providers and their resources in the community to form alliances to help survivors of trafficking.

• Advocates and medical personnel will seek to minimize barriers for survivors to get necessary healthcare

• Success is measured by efforts to reduce isolation and to improve options for safety, health and healing

• Healthcare personnel should screen potential victims privately and be fully receptive and attentive while doing so

• Go beyond yes or no questions

• Assume possible victims are not comfortable with disclosure, therefore, take more time with them explaining the confidentiality process

• Inform potential victim of their right to speak alone with the Dr.

• Make it effortless for potential victim to speak alone with doctor by having signs throughout clinic/care facility of one patient at a time

• Look for red flags and know what to say and do for potential victim

• Confidentiality is a necessary must to understand and implement throughout the medical relationship; Dr. should give contact information with minimal information on it but the receiver knows it is a helpline

• Universal Education for all resources involved to be on the same page and readily available to understand various situations of healing; willing to help

• Empowerment / altruism; others find strength in helping others

• Promote harm reduction for those in abuse

• Warm referral; having connection to local advocacy program (let them use Dr. phone to call if safer)

• Identify strengths of potential victim; how they survived, took care of, helped friends survive (empower)

• Know latest terms of youth; street language communicated amongst themselves as code

• Healthcare professional needs to be comfortable talking about sex with youth

• Consider that boys can be victims too; mindful of language - do not assume boys cannot be victims, therefore treat necessary assessment questions with dismissive attitude (boy will instantly know this is not a safe/knowledgeable person to talk to/confide in.

PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS

The population I chose to work with is children survivors of sex trafficking and the subgroup would be those children whose cultures sustain/enforce it. Children under this subgroup are exposed and victimized by this crime at an increasing rate (Mourtada, Schlecht and DeJong, 2017). The reason human sex trafficking is so globally prevalent is because child marriage is the loop hole to keep this syndicated crime organization constantly fueled. Cultural norms from around the globe allow, more girls than boys, to become the spouse to an adult. There are countries on every continent that houses the practice of child marriage as legal and, sometimes, common. Kenya, Sri Lanka, Nepal and India are the top contenders for the most child marriages globally, leaving Africa and Asia to be the biggest proponents of child marriage (UNICEF, 2014).

Most of the reasoning behind these practices are tradition and religion but poverty and ignorance also play their part (Millett-Barrett, 2019). By ignorance, I mean a poverty stricken household in Africa might send their adolescent child off to live with a distant uncle for a better way of life. That uncle might have alternative notions toward the girl or might get propositioned later by someone else for a price that can not be refused. There is no communication between the uncle and the child’s parents because her parents fo not have a phone/electricity. The parents may not find out the child has been sold off for months or even years. In the Middle East, various emirate states might have child marriage banned under their civil codes. However, all emirate states are all under Shari Law which is also enforced by federal law since 2005, which allow child marriage. In all emirate states, Muslims and non-Muslims are held by these laws. The Quran, the Bible of the Middle East, indicates that Muhammed married his bride at the tender age of nine-years-old. For them adolescents for boys are twelve-years-old and for girls it is nine-years-old. These are the ages considered old enough to be wed because if it was suitable for the prophet, who can argue differently?

In America, there are several states that allow minors to marry with their parental/guardian consent. For those living in the US but come from cultures outside of the US with the normal custom of child marriage at ages 14-years-old and below, the child needs not to consent, only parental signatory in front of a judge and a clerk to take the check. This is permitted because the US government, as it stands today, feels they need not interfere in the traditions and customs of those born outside their borders, even though those same customs are illegal on paper for US-born citizens. For example, if a Saudi man living in the US wanted a child bride, all he would have to do is go to Saudi Arabia or whichever country of his choosing that permits such a practice, obtain legal documents of marriage and to travel abroad, come to America with his documentation and have his child bride living with him here and no authority could arrest him. The girl would be helpless in a tangled system.

In Arizona, where I live, prior to 2006, there was no legal minimum requirement to marrying children. A bill was presented to ban child marriage for those under 18-years-old, but some republican lawmakers thought that would be too restrictive (azcentral, 2020). Today, the minimum age of consent in Arizona is 16-years-old only with parental consent. There are still many concerns with marrying at such a young age. Of course, not all children are the same, leaving those without the body structure to bare children at extreme physical disadvantage when carrying a child and giving birth. Fistulas are common among bodies not mature enough to handle childbirth. Mentally, children of all ages struggle with the challenges of marriage and the responsibilities therein. Scientifically, the cerebral cortex is not developed within a human being until they are twenty-five-years-old that impacts their decision making capabilities. This is why car insurance is always higher for those who are under this age. I find it ironic how one can be unfit to vote until they are eighteen-years-old on matters that affect their lives and their communities for only four years, but can be given the platitude of making a decision that will last them, potentially, their whole life.

The mechanisms that might have some significance in this community would be awareness of current literature that supports the physical, mental and emotional long-lasting adversities and negative affect that will last a lifetime (Hage, S., & Romano, J.L., 2013). Community support is another huge strategy in gaining recognition from parents and children alike. Many collectivist cultures rely strongly on cultural norms and need a sense of belonging to their community. When something is introduced that goes against the norm of the community, it is readily rejected as the people do not want to feel like or be treated like an outcast. Outside of counseling, community outreach to spread awareness to the matter, to get the community talking about the varying dangers that surround child marriage with proof and examples, experiences and lives lost can make a difference (Vera, E. M., & Kenny, M. E., 2013).

Regarding ethical guidelines regarding this topic, I always pondered what to do in conflict between ethical demands and legal parameters. According to the American Counseling Association (2014) a counselor’s duty is to prevent harm to the client, while acting in correlation to current laws (I.1.c). However, if those laws are in direct conflict with the child’s welfare but the children/parents themselves cannot see the conflict because of cultural norms, this is where I would have to seek guidance from peers/supervisors.

Regarding confidentiality, of course I would explain to the client my obligation to keep all exchanges, verbal or written, electronic or otherwise strictly prohibited from anyone outside of maybe insurance personnel. However, with the exception of harm, whether to self or another, I would remain a closed diary. In these situations, confidentiality would be stressed because the very nature of the business would be under duress; client confiding in me abuse. Parents/spouse may be causing said abuse. Above all else, the client’s welfare must come first and foremost while acting within legal parameters. I still may need supervision, because as I said, the nature of these conversations is difficult at best.

PART 5: ADVOCACY

Advocacy across all spectrums is of dire need for the population of survivors of sex trafficking and prevention. This is a domain that does not have to exist. Countless efforts are already in place for the prevention and advocacy of this marginalized group, but still, more has to be done to eradicate it completely. On the individual and client level, this group needs to be understood on a micro and macro level. Most of these survivors are young girls, limited education, and no resources of their own. They have been duped into a system of unforgiveness and hardship so by the time they come to counseling, they should not be expected to detail every event for the counselor to understand their story. Every story will be different but the broad outline is the same. An undeserved youth was mistreated in the worst way and now have to pick up the pieces to their lives. Becoming knowledgeable on who is targeted, where they are picked up and by whom, where they go and what becomes of them are all questions to be sought after before the client comes in. Variations will exist of course, but the underlying story will be the same - they were targeted for profit.

These children and young adults need special attention. According to Chisolm-Straker, Macias-Konstantopoulos, Landerholm, Marjavi & Douglas (2018) the attitudes and belief systems of each client may be different considering culture, values, community status and experiences. Considering from whence they came, the counselor should be knowledgeable of the experiences of underprivileged youth and the biases they face for having a very unique history. According to MJSCC (2015) It is important to note to the client their strengths and value and work with them from their strongest point - wether that be an optimistic mindset to how they managed to get out of that world or possibly helped their friends out. That takes courage and determination - all highlights.

At the community level, school in particular, one barrier for this marginalized group is that not enough faculty and friends know the signs of one who could be trafficked. Yes, there are trafficked girls still going to school every day and they are distinct from their peers. Not realizing a problem exists is a bigger problem than the problem itself. There needs to be after school programs easily accessible for these youths if they can’t or don’t want to go home to escape to, people who understand that work there are assets. At the public policy level there needs to be legislature that mandates minimum age requirements for marriage and dating which is enforced and enforceable by local authorities including school officials. Much of the experiences these trafficked girls go through have been launched by a sexual history that started in high school or even middle school. These experiences give them false courage to explore the dangers of the unknown beyond their school fence. There needs to be more monitoring of online chats also because much of the conversation is initiated through fictional online personas.

The community involvement needs to be more involved by knowing who their children are. From councilman to neighborhood watch, people should know who their neighbors are, who lives on their block, in their neighborhoods and when they see a young girl with a much older man, it should be understood why intervening to strike up a conversation could mean the difference between this girl being trafficked or going home that day. Currently, the consensus is mind your own business or that’s not my problem. It’s everyone’s problem when the child comes up missing or dead and then the community is left with a grieving family, loss of work, dependency on the government, tax dollars going toward death arrangements etcetera.

In Arizona where I live, they are so strict on trafficking of any kind and that’s progress, but much still has to be done. Injustices towards these young people are happening at the local, state and federal level by the very people creating, enforcing and sustaining the laws that are supposed to be protecting them. Public policy is so important to pay attention to because through loop holes is how these young people get abused and keep getting abused with little power from anyone to stop the perpetrators. Voting appropriately by citizens is vital at the local and federal level to make sure candidates have these issues on their radar and have action plans to fight back against this infestation.

Counselors also need to be knowledgeable of multicultural backgrounds of clients and know how to address them, what their cultures deem acceptable, what the goals are, the type of lifestyle they came from and are expected to go back to. Questions like is it appropriate for a young, single woman to be alone with a male counselor? Is it culturally respectful to look this client in the eye or expect that in return? There are nuances to any relationship but cultural variations along with an already sensitive topic needing discussion can brew mismanagement and discomfort.

According to MJSCC (2015) counselors should do all they can to make known the different aspects of culture, expectation, stigma, community stance and parental consent as much as possible before even seeing the client. Even if the counselor is wrong on some aspects, a thorough investigation of the client’s culture can go a long way in a session and prove to the client that they care, are well versed within their traditions and customs and make the client feel more prone to trust and open up with someone who obviously took the initiative to know as much as possible about them.

There are resources available at the local, state and national levels for trafficking survivors such as:

Office of the Arizona Attorney General

2005 N Central Ave

Phoenix, AZ 85004

602-542-2123

TRUST

Training and Resources United to Stop Trafficking

1-844-TRUSTAZ (1-844-878-7829)

[email protected]

Department of Justice * Office of Justice Programs

OVC

Office for Victims of Crime

810 Seventh Street NW., Second Floor

Washington, DC  20531

Phone: 202–307–5983

References

2018 U.S. National Human Trafficking Hotline Statistics. (2020, February 13). Retrieved from

https://polarisproject.org/2018-us-national-human-trafficking-hotline-statistics/

American Counseling Association (2014). 2014 ACA Code of Ethics. Retrieved from https://

www.counseling.org/Resources/aca-code-of-ethics.pdf

American Mental Wellness Association: Risk and Protective Factors. Retrieved from: https://

www.americanmentalwellness.org/prevention/risk-and-protective-factors/

Contact Us. (n.d.). Retrieved from https://ovc.ojp.gov/contact

Chisolm-Straker, M., MD, MPH, Macias-Konstantopoulos, W., MD, MPH, Landerholm, M.,

MSW, Marjavi, A., & Douglas, V. (2018, December 3). Health & Human Trafficking Sym-

posium | November 2018 | Part 4: Identifying Trafficking Survivors. Retrieved from https://

www.youtube.com/watch?v=HHB8FZp1J0c

Gardiner, D. (2018, April 12). Arizona Gov. Ducey signs laws on child marriage, state dinosaur,

egg expiration dates. Retrieved from https://www.azcentral.com/story/news/politics/

arizona/2018/04/12/arizona-gov-ducey-signs-laws-child-marriage-state-dinosaur-

sonorasaurus-egg-expiration-dates/509474002/

Greenbaum, J., & Bodrick, N. (2017). Global Human Trafficking and Child

Victimization. Pediatrics, 140(6). doi: 10.1542/peds.2017-3138

Greeson, J., Treglia, D., Wolfe, D. S., & Wasch, S. (2019). Prevalence and Correlates of Sex

Trafficking among Homeless and Runaway Youths Presenting for Shelter Services, 91-100.

http://dx.doi.org.ezp.waldenulibrary.org/10.1093/swr/svz001

Hage, S., & Romano, J. L. (2013). Best practices in prevention. In R. K. Conyne & A.

M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 32-46). Thousand Oaks, CA: SAGE.

Hotline Statistics. (n.d.). Retrieved from https://humantraffickinghotline.org/states

https://fortune.com/2019/04/14/human-sex-trafficking-us-slavery/

https://www.phoenix.gov/district2site/Documents/

City%20of%20Phoenix%20COMPASS%20Plan.pdf

Lillie, M. R. (2013, October 10). An Unholy Alliance: The Connection Between Foster Care and

Human Trafficking [Pdf]. Lincoln: OLP Foundation.

Millett-Barrett, Jennifer (2019) "Bound by Silence: Psychological Effects of the Traditional

Oath Ceremony Used in the Sex Trafficking of Nigerian Women and Girls," Dignity: A Journal on Sexual Exploitation and Violence: Vol. 4: Iss. 3, Article 3. DOI: 10.23860/

dignity. 2019.04.03.03

Mourtada, R., Schlecht, J., & DeJong, J. (2017, November 14). A qualitative study exploring

child marriage practices among Syrian conflict-affected populations in Lebanon. Retrieved

from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688503/

Multicultural and Social Justice Counseling Competencies. (2015). Retrieved October 27, 2015,

from http://www.counseling.org/docs/default-source/competencies/multicultural-and-social-

justice-counseling-competencies.pdf?sfvrsn=20

Niethammer, C. (2020, February 4). Cracking The $150 Billion Business Of Human Trafficking.

Retrieved from https://www.forbes.com/sites/carmenniethammer/2020/02/02/cracking-

the-150-billion-business-of-human-trafficking/#24e67df14142

Varma, S., Gillespie, S., McCracken, C., & Greenbaum, V. J. (2015). Characteristics of child

commercial sexual exploitation and sex trafficking victims presenting for medical care in

the United States. Child Abuse & Neglect, 44, 98–105. https://doi-org.ezp.waldenuli

brary.org/10.1016/j.chiabu.2015.04.004

Vera, E. M., & Kenny, M. E. (2013). Social justice and culturally relevant prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 1-59). Thousand Oaks, CA: SAGE.

United Nations Children’s Fund, Ending Child Marriage: Progress and prospects, UNICEF, New York, 2014.