Addressing the social and clinical service needs of minors who have been sexually exploited remains a challenge across the United States. While larger metropolitan centers have established shelters and service provision specific for trafficked persons, in smaller cities and more rural settings, survivors of trafficking (especially minors) are usually served by multiple, disparate social service and health providers working across different systems. Sexually exploited minors present an even greater challenge due to intersections with child welfare and juvenile justice systems, histories of abuse by family that limit placement options, and limited services that address the complex medical, mental health, and psychosocial needs of these youth. Major health organizations have recommended a coordinated care model that integrates the therapeutic and social service needs of trafficked persons including housing and education; implementation of such service provision requires intensive, multi-sectoral collaboration.


We present two case studies from an anti-trafficking coalition established in a smaller urban area.


Multi-sector collaboration requires the development of policies and protocols for addressing the diverse needs (acute and ongoing) of trafficked minors who are often “dual jurisdiction,” involved in both the juvenile justice and child welfare systems. Principles of care including autonomy, empowerment, protection, and safety may be at odds as systems may approach these youth differently. A clearly identified care coordinator can help navigate across these systems and facilitate communication among service providers while protecting client privacy, confidentiality, and autonomy. Assessing the quality of services provided and accountability among service providers remain significant challenges, especially in resource limited settings.

Key Take Away Points

  • A trauma-informed multi-sector collaboration may comprehensively and effectively meet the diverse needs of sex trafficked minors, who are often involved in both the juvenile justice and child welfare systems and served by multiple, disparate social service and health care providers.
  • A Coalition comprised of a wide range of professionals is critical to the care provided to these young people, with a clearly identified care coordinator to help navigate across these systems and facilitate communication among service providers while protecting client privacy, confidentiality, and autonomy.

Author Biography

Mary C. Burke, PhD: Dr. Mary C. Burke is a Professor of Psychology in the Department of Psychology and Counseling at Carlow University where she is the Program Director for the Doctoral Program in Counseling Psychology. Her scholarly interests include minority mental health in the context of oppressive systems, gender based violence, trauma and human trafficking. In 2004 Dr. Burke founded the Project to End Human Trafficking (www.endhumantrafficking.org), a United States based non-profit group that works regionally, nationally, and internationally to address this issue. Currently, Dr. Burke is involved in projects to prevent both gender based violence and human trafficking in Uganda. Heather L. McCauley, ScD: Dr. Heather L. McCauley is a social epidemiologist and Assistant Professor in the Department of Pediatrics at University of Pittsburgh School of Medicine and the Division of Adolescent and Young Adult Medicine at Children’s Hospital of Pittsburgh of UPMC. Her research focuses on the health impacts of intimate partner violence and sexual assault among adolescents and young adults with a particular focus on marginalized youth. Before joining University of Pittsburgh, Dr. McCauley was an Associate at Northeastern University’s Institute on Urban Health Research where she evaluated an HIV prevention program for women with co-occurring substance use and mental health disorders. Prior to IUHR, she was a Research Coordinator at Harvard School of Public Health where she managed studies in India, Thailand and Cambodia on the health impacts of sex trafficking. She earned a Doctor of Science in Social and Behavioral Sciences and a Master of Science in Global Health from Harvard University. She completed a postdoctoral fellowship in adolescent and young adult medicine at University of Pittsburgh School of Medicine. Anne Rackow, MS.Ed: Anne Rackow is a Research Associate at The National Center for Juvenile Justice (NCJJ), the research division of the National Council of Juvenile and Family Court Judges, and is the Director of Strategy and Operations at The Project to End Human Trafficking (PEHT). In addition, Anne co-facilitates the Western Pennsylvania Human Trafficking Coalition and serves on its steering committee. Anne has been with PEHT since 2009 and has held the previous positions of Special Projects Coordinator and Planning and Evaluation Manager. In her current role as Director of Strategies and Operations, she oversees the daily operations, strategic planning, fundraising, evaluations, and quality improvement processes at PEHT and regularly provides trainings and presentations related to human trafficking in the community. Anne has been with NCJJ since 2010 and has worked closely with juvenile justice practitioners in probation, community services, and residential settings providing training and technical assistance regarding continuous quality improvement principles and currently performs data collection and analysis for three national projects. She earned her Bachelor’s degree in Public Policy and Sociology with a concentration in Criminal Justice from Carlow University and her Master’s degree in Program Planning and Evaluation from Duquesne University. Bradley W Orsini: Supervisory Special Agent (SSA) Bradley W Orsini entered on duty as a Special Agent in September, 1988. Following completion of training in Quantico, Virginia, SA Orsini was transferred to the Newark Division of the FBI. SA Orsini spent over 16 years working violent crimes, gangs, drug organizations, public corruption and civil rights investigations. In 2004, SA Orsini was transferred to the Pittsburgh Division where he was assigned to the Public Corruption/Civil Rights Squad. In September, 2007, SA Orsini was promoted to Supervisory Special Agent (SSA). SSA Orsini currently supervises the Public Corruption and Civil Rights Squad for the Pittsburgh Division. SSA Orsini is also the Crisis Management Coordinator for the Pittsburgh Division. Prior to joining the FBI, SSA Orsini was on active duty as an officer in the Unites States Marine Corps. SSA Orsini earned a Bachelor of Science in Administration of Justice from the Pennsylvania State University. Bridget M. Simunovic, MSW, LSW: Victim Specialist (VS) Bridget M. Simunovic entered the Bureau in March 2008, assigned to the Pittsburgh Division. VS Simunovic is responsible for providing services to all victims of federal crimes in her territory which covers all of Western Pa. VS Simunovic has extensive experience in the field of victim services and trauma. Having worked in the field since 1999, she has worked as an advocate and therapist for victims of violent crime and spent a large part of her career providing those services to traumatized children. VS Simunovic earned her Bachelors and Masters degrees on Social Work from the University of Pittsburgh. Elizabeth Miller, MD, PhD: Elizabeth Miller, MD, PhD, is chief of Adolescent Medicine at Children’s Hospital of Pittsburgh of UPMC, and associate professor of Pediatrics at the University of Pittsburgh School of Medicine. Trained in medical anthropology as well as internal medicine and pediatrics, Dr. Miller’s research has included examination of sex trafficking among adolescents in Asia, teen dating abuse, and reproductive health, with a focus on underserved youth populations including pregnant and parenting teens; and foster, homeless, and gang-affiliated youth. She conducts research on brief clinical interventions to reduce partner violence and unintended pregnancy, funded by the National Institute of Child Health and Human Development and the National Institute of Justice. In addition, she is conducting a study of a sexual violence prevention program entitled “Coaching Boys into Men” which involves training coaches to talk to their young male athletes about stopping violence against women, funded by the Centers for Disease Control and Prevention. She is also involved in projects to reduce gender-based violence and improve adolescent and young adult women’s health in India and Japan.