share and prioritise many of the same principles. Considering these approaches, and drawing from the initial review of literature and messages from the field research, nine cross-cutting elements or principles of professional practice have been identified as particularly pertinent when supporting children in their recovery and reintegration. In this chapter, trauma-informed and rights-based approaches are briefly outlined and the nine cross-cutting principles are introduced.
Key Approaches
Trauma-Informed Approaches
In recent years, those working with survivors of CSE have begun to discuss the importance of ‘trauma- informed’ care and practice.71 For example, in one systematic review exploring aftercare services, the
authors note general agreement in the literature for supporting a trauma-informed approach to caring for child victims of trafficking for the purposes of sexual exploitation.72
69 Radford, L., Allnock, D. and Hynes, P. (2015), “Preventing and responding to child sexual abuse and exploitation:
Evidence review,” accessed 3 February 2017, https://core.ac.uk/download/pdf/42138011.pdf.
70 Muraya, D. and Fry, D. (2015), “Aftercare services for child victims of sex trafficking: A systematic review of policy and practice,” Trauma, Violence and Abuse, Vol. 17(2), 204-220; Macy, R. and Johns, N. (2010), “Aftercare services for international sex trafficking survivors: Informing U.S. service and program development in an emerging practice area,”
Trauma, Violence and Abuse, Vol. 12 (2), 87-98.
71 Sapiro, B., Johnson, L., Postmus, J and Simmel, C. (2016), “Supporting youth involved in domestic minor sex trafficking: Divergent perspectives on youth agency,” Child Abuse & Neglect, 58, 99–110.
72 Muraya, D. and Fry, D. (2015), “Aftercare services for child victims of sex trafficking: A systematic review of policy and practice,” Trauma, Violence and Abuse, Vol. 17(2), 204-220.
Trauma-informed care starts from an understanding of what it means to be a victim of trauma. It also requires an understanding of how standard care responses can be re-traumatising. It acknowledges that the responses of the child (for example disengagement, running away or anger) are associated to the trauma a child may have experienced and should be viewed as coping strategies rather than problematic attitudes and behaviours.73
The literature around trauma-informed responses recognises that even if children are able to access specialist psychological care, other adults in non-clinical settings who surround the child, caregivers, police, social workers, teachers, case managers and family, are the ones who provide the majority of care and support.74 Therefore, it is these individuals who need to have an understanding of the impact
of trauma and how to respond.
‘Trauma-informed’ responses do not require individuals to have specialist qualifications or for children to have access to highly specialised therapeutic interventions. For those working in low resource settings, where such specialist care is often unavailable, training on ‘trauma-informed care’ may be particularly helpful. Supporting those working with children harmed by CSE so that they understand the impact of trauma and can develop skills in responding appropriately, may be a more realistic and sustainable approach to improving overall levels of care. That said, such approaches do not negate the need for specialist mental health care and interventions for children where this is deemed necessary. Trauma-informed responses are based on a set of principles that aim to:
y
y Understand and recognise ‘symptoms’ of trauma, y
y Build supportive, trusting and consistent relationships, y
y Address safety, y
y Minimise re-victimisation, y
y Adopt a strength-based framework - putting an emphasis on competencies and resilience, y
y Empower survivors and create opportunities to build choice and control, and y
y Provide clear information.
Rights-Based Approaches
A trauma-informed response aligns to a rights-based approach to care. The authors of one systematic review exploring aftercare services for child victims of trafficking note that the literature clearly points to the need for a human rights centred approach to service provision.75 Rights-based approaches are
distinguishable from more traditional welfare based approaches by focusing on supporting individuals to claim their rights and hold duty bearers to account.
73 Butler, L., Critelli, F., and Rinfrette, E. S. (2011), “Trauma-informed care and mental health,” Directions in Psychiatry, 31(3), 197–212.
74 Bath, H. (2015), “The three pillars of traumawise Care: Healing in the other 23 hours,” Reclaiming Children & Youth, Volume 23, number 4, 5-11.
75 Muraya, D. and Fry, D. (2015), “Aftercare services for child victims of sex trafficking: A systematic review of policy and practice,” Trauma, Violence and Abuse, Vol. 17(2), 204-220.
When it comes to working with children, this means adopting a child-rights approach and drawing on the principles and provisions outlined in the UN Convention on the Rights of the Child. The interagency group’s guidelines on children’s reintegration also highlight the need for a rights-based approach.76 The
guidelines draw attention to the indivisible and interdependent nature of children’s rights. However, they also recognise that due to the lack of resources available, agencies may need to make difficult choices about which rights to prioritise in the short term.77
For example, children have a right to an education, however, they also have a right to an adequate standard of living (having enough food, water, clothing and shelter). In some circumstances, where resources are limited, service providers may prioritise ensuring that a child has enough food to eat as opposed to spending money on a school uniform and schools supplies.
In the literature there is agreement that ensuring any action taken is in the best interests of the child. This is one of the four guiding principles of the UN Convention on the Rights of the Child and should be the primary consideration. In addition, a number of other ‘rights’ have been highlighted as particularly pertinent in recovery and reintegration. These include ensuring that children:
y
y Receive care without discrimination, y
y Are involved in decision-making about their care, y
y Are made aware of their rights, y
y Have access to accessible information, and y
y Have a right to confidentiality.