New developments on the Commercial Sexual Exploitation of Children (CSEC)

(CSEC youth served each quarter in 2022)

Child abuse can take on many forms, including the Commercial Sexual Exploitation of Children (CSEC).

CSEC is characterized as any sexual activity involving a child in exchange for anything, or the promise of anything, of value. It includes everything from child trafficking to sharing images of child pornography, and the children exploited are often those with a history of running away, abuse, or neglect.

CSEC cases have doubled in recent years, with experts citing increased time spent online as a major factor.

Problematic sexual behaviors (PSB) in youth are defined as children or adolescents that are initiating behaviors that typically involve sexual body parts that are:

  • Developmentally inappropriate,
  • Potentially harmful to themselves or others, and/or
  • Illegal

Sexual exploration and play are a natural part of childhood sexual development. However, some sexual behaviors indicate more than harmless curiosity and pose a risk to the safety or well-being of children.

Annually, Massachusetts has on average 1,800 PSB cases. More than a third of sexual offenses against child victims are committed by other youth and often occur with children or adolescents they already know.

Here’s how we’re helping with each:

How MACA is Addressing CSEC

As cases increase, we’re working harder than ever to meet the demand for services by expanding our CSEC Service Enhancement Project. Thanks to funding from a multi-year Victims of Crime Act (VOCA) award, we secured enough money for 12 CSEC Coordinators/Case Managers statewide.

Now, every county throughout the Commonwealth has a designated CSEC Coordinator assigned to facilitate the CSEC Multidisciplinary Team (MDT) response for youth identified as at-risk or have been exploited. Working together, we’re supporting children’s safety, helping them heal, and investigating their alleged exploitations.

The CSEC Service Enhancement Project strives to continue improving coordination, information, and referrals to services like victim advocacy, peer mentor projects, emotional support, and safety services.

(Ages of CSEC youth and young adults served in FY ‘22)

In FY ‘22, 871 unique victims of CSEC received 29,730 services.

  • 22% of the child helped were age 12 or younger
  • 49.4% experienced multiple years of victimization

We also provided 131 outreach activities to increase community awareness of CSEC, and are convening with the MA Child Trafficking Leadership Advisory Board to continue developing innovative solutions to this escalating form of abuse.

How MACA is Helping Youth With PSB

First and foremost, youth who have PSBs are children and adolescents. Their path to problematic behavior was formed by life circumstances and individual factors contributing to challenges following rules about sexual behavior, respect, and safety. It’s imperative for families and communities to step in and mitigate through proper identification, treatment, and intervention.3

Here’s the good news: Ninety-eight percent of children and adolescents with PSBs who receive early and effective interventions don’t re-offend and instead grow into healthy adults. 4 5

In July 2020, we launched our pilot program leading statewide awareness and interventions for children showing PSBs. We also started a clinical learning collaborative and trained 38 clinicians in problematic sexual behavior cognitive behavioral therapy (PSB-CBT) at six CACs and their mental health partnering organizations.

CBT is rooted in the idea that how you think, feel, and act is interconnected and that you can manage your problems by changing how you think and behave.6 PSB-CBT is evidence-based and highly effective for children and adolescents ages 7-14 with PSBs and their caregivers. It can eliminate PSBs, encourage prosocial behavior, and enhance parenting skills.

In April 2021, the learning collaborative included an additional three CACs and their partner mental health partners.

Then, in 2022, we educated more than 2,500 mental health professionals, counselors, psychiatrists, psychologists, social workers, and community members on PSB and the services available. This includes conferences, in-person and virtual trainings, on-site technical assistance, and one-to-one support.

We’re also improving access to children with PSBs by further developing the Out of County Referral and promotion of Telemental Health (TMH). This encourages a cross-state referral process for when a CAC is unable to take on a case. Currently, four CACs use telehealth when feasible.

TMH was used by 71% of CACs nationally due to its flexibility and accessibility.7 It allows CACs to utilize TMH as a method for counseling when scheduling, childcare issues, and transportation barriers prevented them from attending in the past. The issues in rural areas of the state have been largely overcome during the pandemic with funding to improve internet, broadband, and hotspot access. While there will always be some barriers to 100% access, TMH has expanded services in the last three years.

We are continuing to expand on our work with the latest trainings and addressing multiple topics surrounding PSB, including dispelling common myths, improving assessments, and implementing trauma-focused CBT with trauma-related PSB.

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