Exploring relationships as mediators of treatment outcomes among commercially sexually exploited youth

Author: Landers, Monica; Johnson, Melissa; Armstrong, Mary; McGrath, Kimberly & Dollard, Norín

Abstract: Research indicates that youth exposed to commercial sexual exploitation tend to have extensive histories of trauma, including physical abuse, sexual abuse, and neglect, which increases their vulnerability to exploitation. Trauma literature finds youth who present to treatment with greater behavioral health needs tend to have higher trauma scores than youth with fewer behavioral health needs (Copeland et al., 2007; Finkelhor et al., 2007).

There is, however, limited research on the role of youth strengths as a buffer against the outcomes associated with trauma. With this in mind, the purpose of this study was to examine the relationship between Adverse Childhood Experiences (ACE scores) and youth outcomes such as risk behaviors, behavioral needs, and impairment in functioning across major life domains. Secondly, we explored how this relationship might be better explained by examining youth strengths as mediators—specifically, peer relationships and the stability of significant relationships in the youth’s life. Participants and setting: Data on clients served in a treatment program specialized for commercially sexually exploited youth were used for this research.

Results indicated that youth with higher ACE scores had a greater number of risk behaviors, behavioral needs, and impairment in functioning across major life domains. Findings of the mediation analysis provide some support that peer relationships and relationship stability, at least in part, mediates the relationship between ACEs and youth outcomes. Post hoc analyses indicated youth strengths mediated 9–18% of the total effect of ACE scores on youth outcomes.

Conclusions: Developing peer relationships and sustaining significant relationships can mitigate some of the adverse effects of trauma experienced by exploited youth.

Keywords: adverse childhood experiences, commercially sexually exploited youth, trauma, strengths, emotional and behavioral health needs, relationships