U.S. Department of Health and Human Services, 

Office of the Assistant Secretary for Planning and Evaluation 

FINDING A PATH TO RECOVERY: 

RESIDENTIAL FACILITIES FOR MINOR VICTIMS OF 

DOMESTIC SEX TRAFFICKING 

Heather J. Clawson, Ph.D. and Lisa Goldblatt Grace, LICSW 

I. STUDY OVERVIEW 

This is the first in a series of Issue Briefs produced 

under a contract with the Department of Health and 

Human Services (HHS), Office of the Assistant 

Secretary for Planning and Evaluation (ASPE), to 

conduct a study of HHS programs serving human 

trafficking victims. Funded in fall 2006, the purpose 

of this 12-month exploratory project is to develop 

information on how HHS programs are currently 

addressing the needs of victims of human trafficking, 

including domestic victims, with a priority focus on 

domestic youth. This project also consists of 

reviewing relevant literature, and identifying barriers 

and promising practices for addressing the needs of 

victims of human trafficking, with a goal of 

informing current and future program design and 

improving services to this extremely vulnerable 

population. 

This issue brief focuses on minors who are 

victimized by sex traffickers across the United States 

and is intended to provide practical information about 

the characteristics and needs of these minors, and 

describe the type of residential programs and 

facilities currently providing services for this 

population. The promising practices discussed here 

were identified by directors and staff of residential 

facilities housing and serving minor victims of 

domestic trafficking, juvenile corrections facilities, 

programs for runaway and homeless youth, child 

protective services personnel, and law enforcement. 

While many of the service providers and law 

enforcement officials we met with recognized that 

males and transgender youth are also victims of 

domestic sex trafficking, current emphasis and 

service delivery is focused on females. It was also the 

case that very few programs are identifying cases of 

domestic minor labor trafficking. Therefore, the 

information in this issue brief is limited to minor 

female victims of domestic sex trafficking. 

II. INTRODUCTION TO THE PROBLEM 

What are the impacts of domestic sex 

trafficking on minors? 

While there is no consensus on the number of minor 

domestic sex trafficking victims in the United States, 

there is clear consensus that the impact of this crime 

on the victims is devastating. Girls who have been 

domestically trafficked experience physical, 

emotional, psychological, and spiritual repercussions 

from the trauma of sexual exploitation. Providers 

reported that victims often present with the following 

health-related issues: 

 Physical health problems associated with 

beatings and rapes, including broken bones and 

the need for wound care; 

 Reproductive health problems, including 

exposure to HIV and other STDs, pregnancies, 

and fertility issues; 

 Malnutrition; 

 Mental health problems, including PTSD and 

somatic complaints (headaches, chronic pain) 

resulting from the trauma, and others listed 

below; and 

 Alcohol and other drug use, as well as addiction. 

As described by several of the service providers 

during the course of the study, mental health 

symptoms resulting from repeated abuse include: 

 Extreme anxiety and fear; 

 Changed relationships with others (including the 

inability to trust); 

 Self-destructive behaviors (including suicide 

attempts); 

 Changed feelings or beliefs about oneself 

(including profound shame and guilt); 
 Changed perception of the perpetrator (including 

establishing a traumatic bond); and 

 Despair and hopelessness. 

The themes of trauma, abandonment, and disruption 

are central to the narratives of minor victims of 

domestic sex trafficking. It was recognized that while 

these minors are victims of sexual abuse, 

domestically trafficked girls have experienced a 

different level of abuse and trauma. As described by 

one provider, “Their level of trauma is much greater 

and their level of damage, severe.” These girls are in 

need of a new identity separate from “The Life.” 

They also need to develop healthy attachments with 

peers, adults, and family members (whenever 

possible). Perhaps most important, these girls need to 

feel safe, both physically and emotionally. 

2 

“Shelter providers are 

not trained to serve 

this population. 

Shelters are equipped

for runaways; not

trafficking victims.”

– Law enforcement

What are current challenges and 

limitations to serving this population? 

Law enforcement and health and social services 

providers working with this population 

acknowledged several challenges and limitations to 

effectively meeting the needs of these girls. 

Overarching challenges include: 

 Difficulty identifying victims. The hidden 

nature of the crime and the use of the Internet by 

traffickers make identifying victims challenging. 

Additionally, the lack of standard protocols for 

identifying potential victims coming in contact 

with law enforcement, child protective case 

workers, street outreach workers, drop-in centers, 

school counselors, and emergency shelters was 

problematic. Perhaps the greatest challenge was 

the lack of recognition of these minors as 

victims. It was reported that many law 

enforcement, child protective services workers, 

and shelter providers believed that these girls had 

“chosen” to become involved in prostitution and 

therefore should be held accountable for their 

“criminal” actions. The stigma associated with 

prostitution was evident across many of the 

respondents in this study, including the minors 

themselves. It was reported that the girls did not 

view themselves as victims and, in many cases, 

stated that they did not want help. Viewing these 

minors as victims of domestic sex trafficking 

instead of “criminals” or “prostitutes” represents 

a huge paradigm shift that has occurred in statute, 

but not in practice. 

 Lack of understanding of domestic human 

trafficking. A significant challenge reported by

all was the lack of knowledge and understanding 

that human trafficking can occur domestically. 

Specifically, many providers described human 

trafficking as a crime that happened to 

immigrants. The relationship between the 

prostitution of minors and human trafficking was 

not well understood by most providers. Not only

did this impact the ability to identify victims, but 

it impacted the ability of staff to provide 

appropriate services to meet the needs of these 

girls. 

 Inadequate 

services. Across 

the board, it was 

clear that the 

services provided 

to this population 

were inadequate. 

In some runaway

and homeless 

youth shelter programs, the time restrictions on 

the length of stay imposed by funding sources 

made it impossible to build trust with the girls, let 

alone begin any meaningful treatment. 

Additionally, the diversity of the minors in 

shelter programs and group homes made it 

difficult to tailor 

services for a specific 

population. Within 

juvenile detention 

facilities, treatment 

plans were often 

aligned with the 

criminal charges—

often crimes 

unrelated to prostitution (e.g., curfew violations, 

truancy, shoplifting, runaway)—and, therefore, 

they were ineffective in addressing the real issues 

facing these girls. For minors placed in foster 

care or group homes, once again, the sexual 

exploitation was often not recognized and, 

therefore, the trauma and related problems were 

not treated. 

“The short-term 

nature of the stay is a 

real challenge for 

raising issues like 

prostitution. We 

provide a lot of bandaids.” 

– Service provider

 Safety concerns. The issue of safety for staff, 

other residents, and the girls themselves was 

expressed across sites. In the case of runaway

and homeless shelters and drop-in centers, the 

location was often known to the trafficker. In 

fact, several sites reported cases of traffickers 
recruiting girls outside the facilities or, in some 

cases, girls being sent into the shelters to recruit 

other girls. Not all programs were equipped to 

handle these situations. 

Another challenge was the flight risk that these girls 

posed for law enforcement and the programs working 

with them. Law enforcement and providers described 

how a girl usually believed she was in love with her 

trafficker and felt compelled to return to him, out of 

this love or out of fear of retribution if she didn’t 

return. This is a facet of the powerful trauma bond 

created with her abuser, which is one form of the 

Stockholm Syndrome—an extreme form of PTSD 

otherwise most frequently seen in torture victims. 

Additionally, providers reported that these girls often 

feel like there is nothing they are good at outside of 

“The Life”; which is the term girls often use to 

describe their experiences with prostitution. This 

belief that their value lies in being an object of sexual 

abuse—a belief often first developed as a child 

sexual abuse victim—often compels a victim to 

return to her perpetrator and “The Life.” One 

residential provider spoke of the immediate 

gratification or lure associated with street life in 

general, and “prostitution” in particular; something 

difficult for any program to compete with. 

Furthermore, for the majority of girls, their current 

situation includes a sense of belonging that feels 

better than where they were before they were 

recruited and includes various “perks” such as trips to 

different states, nice clothing and jewelry, etc. 

3 

III. RESPONDING TO THE CHALLENGES 

OF SERVING THIS POPULATION: 

PROMISING PRACTICES FROM 

THE FIELD 

Residential Facilities 

The majority of domestically trafficked girls who 

were not living in their homes during the exploitation 

were being placed in a variety of settings, including 

residential treatment centers, child protective 

services-funded group homes and foster care 

placements, and juvenile corrections facilities. 

Additionally, many of these girls were flowing in and 

out of shelters for runaway and homeless youth and 

frequenting drop-in centers, often without detection 

as a victim of domestic sex trafficking by the staff. At 

the time of the study, we identified only four 

residential facilities specific to this population in 

existence across the country. These include Girls 

Educational and Mentoring Services (GEMS) 

Transition to Independent Living (TIL) program, 

Standing Against Global Exploitation (SAGE) Safe 

House, Children of the Night, and Angela’s House 

(see the table at the end of this issue brief for more 

details). Despite the limited number of these 

programs, across 

sites, street 

outreach workers, 

shelter providers, 

residential facility 

staff, law 

enforcement, and 

child protective 

services workers 

spoke of the 

importance and 

priority need for 

more residential 

programs uniquely 

tailored to this 

population. 

The following are 

promising 

components or elements for a residential facility as 

identified across sites by shelter providers, law 

enforcement, case workers, and the directors and staff 

of the four residential facilities serving minor victims 

of domestic sex trafficking. While there is no 

research yet validating these shared observations, we 

believe nonetheless that this information can help 

provide a guide or road map in the development of 

new residential facilities or, in some cases, to help 

others tailor their existing programs to better meet the 

needs of this population, even if only temporarily 

until more appropriate placement can occur.

“We need an integrated 

program that doesn’t

institutionalize.” 

– Service provider

“We lack a good quality 

facility for U.S. kids.”

– Law enforcement

“The girls really have no

place to go.”

– Service provider

“There needs to be a whole 

new model; using the old

model is setting these kids up 

for failure.” 

– Law enforcement 

Population Served. While there was variation in the 

populations served by existing residential programs, 

providers and law enforcement agreed that residential 

facilities should be designed to serve homogeneous 

populations. While the current focus across sites is on 

female minor victims of domestic trafficking, there 

was acknowledgment that the need for similar 

facilities for males and transgender youth exists. 

Several of the runaway and homeless youth shelters 

noted challenges trying to house this population 

among mixed age and mixed gender populations. In 

terms of size, the current programs range from 6 beds 

to 24 beds. Most providers advocate for smaller 

programs of congregate care settings regardless of the 

population. It was reported that minor victims of 
4 

domestic sex trafficking have difficulty navigating 

relationships and, therefore, need—and are more 

likely to benefit from—a smaller, more intimate 

setting. This extends to believing that no more than 

two girls should share a room; a model similar to 

domestic violence shelters. Advocates for larger 

programs believe in the ability to serve a greater 

number of young people more economically. As 

described by Children of the Night, “The cost of staff 

for 10 kids is half the cost of staffing for 11, so if you 

have 11, you might as well have 20.” It was 

expressed, however, that a larger program must have 

appropriate space to allow for smaller subgroups to 

interact. The age of the residents at current facilities 

for this population ranged from as young as 11 to as 

old as 21. It was suggested that facilities consider 

grouping residents by similar age and/or stage of 

recovery. This could be done through different units 

within a single residence or through different 

facilities. Finally, there were some exclusion criteria 

or conditions under which the existing residential 

facilities and alternative placements, including 

runaway and homeless youth shelters and domestic 

violence shelters, would not serve minors. While 

these varied by program, the criteria often included 

the presence of a severe mental disorder (psychotic, 

suicidal), active and severe substance abuse and 

addiction, and severe violent behavior (homicidal, 

threat to others). These girls were determined to need 

the intensive treatment often available through 

hospitalization, staff-secured residential treatment 

facilities for minors with emotional and/or behavioral 

disorders, or inpatient substance abuse treatment 

facilities. However, providers remarked on the 

paucity of beds available for a minor with either no 

insurance or Medicaid and the lack of in-depth 

understanding of the experiences of victims of 

domestic sex trafficking among staff at these other 

facilities. 

Length of Stay. Providers and law enforcement 

working with this population advocated for a 

minimum length of stay at an appropriate facility of 

at least 18 months. This was also echoed by 

survivors. While one of the existing programs 

reported a shorter length of stay (3 to 6 months), they 

operated under a flexible policy that allowed for 

longer stays if needed. The 18-month length of stay 

was recognized as sufficient time to build trust with 

the girls, provide the necessary therapy to address 

their trauma, and to begin “working their treatment 

plan” and rebuilding their lives. Providers also 

advocated for continued connection to the program 

following exit and long-term aftercare services. 

Voluntary Stay. Most providers felt strongly that 

recovery from the trauma and victimization cannot 

happen until a victim is ready and willing to work on 

her recovery. These providers advocated for a 

voluntary residential program in which participants 

could opt in once they were invested in exiting “The 

Life.” Survivors interviewed universally advocated 

for voluntary placement, “The girls need to make the 

choice themselves.” Furthermore, providers 

acknowledged that being ready to use the services 

and support in a residence takes time. For example, 

providers at SAGE report, “Bringing girls into the 

group home slowly has shown benefits in terms of 

buy-in.” For Children of the Night, their success rate 

is reportedly higher among residents who voluntarily 

enroll in their program compared to court-mandated 

placements. Whether advocating for a voluntary or 

mandatory program, everyone recognized that this 

population is prone to run away or relapse, similar to 

the phenomenon in substance abuse treatment 

programs. Unlike some residential treatment 

programs and group homes funded through the child 

protection system within the United States and 

several of the runaway and homeless youth shelters, 

all of the dedicated programs for minor victims of 

domestic sex trafficking (and other forms of 

commercial sexual exploitation) had a policy to allow 

girls to return after they run away from the facility. 

One survivor stated, “[Programs] need to be able to 

hold a space open for someone to come back.”

Programs also reported having specific protocols in 

place to work with running as part of each girl’s 

treatment plan and provided intensive one-on-one 

case management during heightened risk periods for 

running (e.g., initial intake, specific points in therapy, 

etc.). 

Program Location. There is a great deal of debate 

among providers as to the appropriate setting for a 

stand-alone residential program for domestically sextrafficked girls. Currently, three out of four of the 

residential programs are sited within urban areas, 

although all of these programs are away from “the 

track” or known areas of street prostitution. Angela’s 

House is located two hours from any urban areas in a 

rural community. All of the current programs, 

however, have geographic connections to urban areas 

from where most of the girls are referred. Those 

providers that advocate for a program within city 

limits believe that locating a program within the city 
allows girls to retain any healthy emotional supports 

already in place, including any family members, 

therapists, outreach workers, and school personnel. 

The girl may also be in a position to better access 

supports that an urban area can provide, such as a 

diversity of medical providers, therapists, educational 

opportunities, recreational opportunities, and job 

training and employment opportunities. In addition, 

these providers believe that her real recovery can 

only occur within the context of her triggers; a victim 

must learn how to navigate the environment to which 

she will undoubtedly return. 

Providers who 

advocate for 

programs sited 

outside of an 

urban 

environment 

believe that 

anyone with 

PTSD is better 

able to begin recovery away from the daily triggers. 

For combat veterans, this would be outside of the 

area of war; for girls who have been the victims of 

domestic sex trafficking, this would be away from the 

areas of their exploitation. Furthermore, these 

providers believe that the distance will provide an 

added measure of security from traffickers and other 

predators, and decrease the likelihood that a girl on 

the run from a program will easily find her way back 

to the area in which she was trafficked for sex. 

5 

In some cases, the decision as to where to locate a 

residential facility may be driven by availability and 

cost. Some of these providers found that they were 

constrained by which neighborhoods would allow 

their program to be located there and the costs 

associated with housing in each neighborhood. 

Security of Facility. There was universal agreement 

that any residential facility needed to be secure in 

order to establish physical and emotional safety for 

these girls, which is an essential ingredient for their 

recovery. Ensuring the safety of the facility and staff 

themselves was also a priority. Examples of security 

measures to put in place at a residential facility were 

identified from the existing residential facilities, 

domestic violence shelters, and many of the runaway 

and homeless youth shelters. These measures 

included: undisclosed location, security cameras and 

alarm systems, 24-hour staffing and presence of 

security guards, unannounced room searches and 

drug screens, limited phone use, supervised or no 

access to the Internet, locked doors at all times with 

staff and residents buzzed in and out of the facility, 

pre-approved/screened contact lists, etc. For some 

runaway and homeless youth shelter programs 

currently housing this population, the staff noted that 

close relationships with local law enforcement and 

ongoing safety training for staff and residents were 

key elements to ensuring a safe environment. Not 

only are these security measures important for 

programming, they are also important items to 

consider when developing a program budget. 

Additionally, the development of safety plans for 

each resident, similar to practices employed by

domestic violence shelters, was practiced and 

recommended across the residential programs. Girls 

are taught to find safety zones for themselves (e.g., 

within a local convenience store or a fire station) that 

they can use to flee their trafficker or simply avoid an

old acquaintance. These safety plans are put in place 

to address both the possibility of running and to 

navigate day-to-day life after exit. 

“It was nice to be away from

urban noise ... the country is 

really therapeutic. ... [It was]

nice to be home at night and not

worry that I will bump into the 

pimp. ... You stay in the mindset

of hustling in the city.” 

– Survivor

Program Staffing. 

Across sites, 

providers commented 

that programs for 

domestically sextrafficked girls must 

be run by individuals 

who “live and 

breathe trafficking” 

in contrast to 

administrators

lacking that expertise 

and specialization. 

Because domestically

sex-trafficked girls 

have been exploited 

primarily by males, 

programs believe it is 

important to begin 

their recovery in an 

all-female 

environment and therefore advocate for hiring only 

female staff. One survivor commented on the need to 

create a “community of women.” However, some

providers do advocate for the appropriate use of male 

staff to demonstrate the possibility of a relationship 

with a male that is nonexploitative. As described by 

providers, it is of primary importance that staff truly

“These girls require staff to 

‘be real,’ use lots of humor, 

have street credibility, and be

able to compassionately 

confront their behaviors 

without judgment.” 

– Case manager

“Staff must be culturally 

competent—knowledgeable 

about the culture of the 

street.” 

– Service provider

“[Girls] need a person who 

truly understands where 

[they’ve] been—either by 

being a survivor themselves

or immersing oneself in the 

culture, language, 

experience.” 

– Service provider
understand minor victims of domestic sex trafficking 

and the impact of their life experience. All providers 

agreed that staff need to be able to be consistent, 

nonjudgmental, and treat victims with the utmost 

respect. 

6 

This need to hire staff with an authentic 

understanding of “The Life” and a natural ability to 

connect with domestically sex-trafficked girls has led 

to some providers advocating for the hiring of 

survivors. Both SAGE and GEMS prioritize hiring 

women who were sexually exploited, including minor 

victims of domestic sex trafficking and have 

successfully exited “The Life.” SAGE explains the 

rationale for using a “peer support model” as follows: 

—“Clinicians spend 75% of their time establishing 

trust, while peers can start from a place of trust.” 

One provider remarked that someone who has exited 

“can convey hope in a way those of us who haven’t 

been there cannot,” while another commented that 

survivors show that “people can survive and pull 

themselves out.” Among the benefits of survivor 

mentoring is that hearing the life story of someone 

who has been trafficked for sex often paves the way 

for girls to open up. 

Regardless of whether a program employs survivors 

or not, it is important for all staff to be well trained in 

understanding sexual exploitation, the realities of 

prostitution and sex trafficking, the methods of 

recruitment, the physical/psychological/spiritual 

impact of the trauma, potential methods for exit, an 

overview of youth development programming, and 

appropriate boundaries and healthy working 

relationships. 

Services Provided. While not all programs were able 

to offer all services onsite, there was agreement 

regarding the range of services that needed to be 

available to residents. These include: 

 Basic needs. Each of the programs currently 

housing domestically sex-trafficked girls meet 

the basic needs of all residents, similar to 

runaway and homeless youth programs. That is, 

each program provides clothes that fit 

appropriately (including undergarments); food; 

shelter, including showers; and a safe place to 

sleep. 

 Intensive case management. One of the most 

central services offered by the existing residential 

facilities is intensive case management. Girls are 

paired with staff with an emphasis on their 

relational development—their connection to the 

staff person builds simultaneously while the 

services are provided. As described by one 

provider, this requires “lots of time 

commitment—she 

needs 24-hour 

access to her 

advocate/case 

manager.” Girls 

are referred to and 

supported through 

the complexity of 

their life situations 

by case managers 

(i.e., legal services, 

medical services, 

etc.). The case 

managers work in 

collaboration with 

girls to develop 

Individual Service Plans. The overall goal of 

treatment was described by providers in a variety 

of ways, but all related to the general mental and 

physical health-related goals of building selfworth, self-respect, and self-efficacy. As 

described by GEMS, this treatment must be 

delivered within the context of “understanding 

the developmental hindrances of having been 

under the control of someone [her trafficker] for 

so long.” 

“The objective [of the 

program] is to teach the 

girl how to value 

herself.” 

– Case manager

“To get these girls to like 

who they are, girls need

to know it is OK to take 

care of yourself.” 

– Provider

“You are getting these 

kids back in their 

bodies.”

– Case manager

 Mental health counseling/treatment. Across 

sites, providers and law enforcement agreed on 

the need for trauma-informed ongoing mental 

health services, with a variety of specific 

treatments receiving particular emphasis (i.e., 

cognitive behavioral therapy (CBT), dialectical 

behavioral therapy (DBT), eye movement 

desensitization and reprocessing (EMDR)). In 

addition, programs sought to tailor their program

to ensure trauma-informed care. One example is 

that SAGE provides each resident with a portable 

CD player and headphones as a means of offering 

one particular coping and self-soothing tool. In

addition, across sites, providers mentioned the 

need for trained staff to provide crisis 

management around the clock. As one outreach 

program described it, vulnerable youth, in

general, and sex-trafficked minors, in particular, 

“need someone there all the time to help them 

stop and process the crisis.” 

 Medical screening/routine care. Given the 

physical health needs of this population, all 
programs provided medical screening for STDs, 

pregnancy, and other health-related problems, 

often through local medical providers sensitive to 

this issue or onsite nurse practitioners. 

Depending on the source of referral to the 

program, many of the girls receive medical 

screening (and emergency treatment, if required) 

prior to entering the facility (e.g., detention 

facility, child protective services). For more 

critical or emergency needs while staying at the

facility, programs access local urgent or 

emergency care facilities. Mobile health clinics 

and local teen clinics were also utilized by 

several of the runaway and homeless youth 

shelters housing this population.

7 

ers 

sic 

art and poetry, and sports and 

recreation.

 Life skills and job training programs. Across 

sites, providers agreed that programs serving 

domestically sex-trafficked girls should integrate 

some type of life skills, job training, and career 

development process as part of a girl’s treatment 

plan. This may include check writing, bank 

account management, learning to pay phone bills, 

and other types of financial literacy. As described 

by SAGE, a primary goal when working with 

these girls is to “deconstruct their relationship 

with money.” Within the GEMS program, girls 

can become involved in a pre-employment and 

employment program. Girls can apply for hourly 

work in the office or as part of outreach, building 

skills they can take with them. Furthermore, girls 

are offered a stipend in the form of a $5 coupon 

for attending workshops, classes, or helping out 

in general. They are then able to cash these 

coupons with staff once every other week. GEMS 

seeks to communicate to girls “you can do things 

that aren’t harmful to yourself and still get 

compensated and keep the money.” 

 

 Youth development programming. Many 

programs, both those serving minor victims of 

domestic sex trafficking and other forms of 

commercial sexual exploitation and those serving 

vulnerable youth in general (runaway and 

homeless populations), discussed the importance 

of creative youth development-oriented 

programming that builds on the strengths of each 

young person—programming that helps her “find 

her gifts.” As described by one resident, a 

program needs to provide multiple types of 

educational opportunities for victims to “keep her 

engaged and busy.” Another provider described 

that “it can’t be boring—it has to be a meaningful 

alternative [to ‘The Life’].” As reported, the most 

important piece of this creative programming was

to involve the young people in its development—

the “key is that kids are included in determining

what they want to do.” Several of the runaway 

and homeless youth programs and drop-in cent

provided engaging programming informed by 

youth and often led by youth, including mu

production, 

Examples of Innovative Youth Programming 

The “Hopes & Ropes Program” at Angela’s House is a 

risk-taking program in which residents experience the

challenge of a ropes course in the context of their 

personal recovery. Furthermore, volunteers come on 

site to offer a variety of group programming, including

book groups and a self-confidence building program

called Cirque Du Monde. 

The On Track Program at the drop-in center Youth on

Fire (developed by the Children’s Trauma Recovery

Foundation) encourages youth to write and record

music that tells their own narrative. 

At GEMS, girls are offered a variety of educational 

and recreational opportunities, including Yoga and

poetry writing. In addition, girls can choose to be

involved in a youth leadership group in which they 

develop programming for GEMS, speak out about

exploitation (their own and in general) to legislators 

and providers, and conduct public awareness and 

advocacy campaigns. 

At Children of the Night, residents are able to express

their programmatic ideas, concrete needs (i.e., special 

snacks), and program concerns (i.e., staff who are 

being disrespectful) through a weekly Resident’s 

Council run by the Executive Director.

 Education. The educational programming

offered by the existing residential facilities 

varied. Some programs opt for referring girls to 

mainstream schools, GED programs, or 

vocational schools. Other programs offer 

educational programming through a collaborative 

arrangement with a local day-treatment provider. 

These models were also similar for the runaway

and homeless youth shelter programs. All of the 

programs agree that it can be difficult to serve all 

of the girls in the same educational program, 

given the differences in their cognitive abilities, 

past school experiences, and interests. Children 
8 

of the Night offers one example of a successful 

onsite educational program for residents. 

Children of the Night has developed their own 

school, under a different name to avoid the 

stigma associated with trafficking for sex or 

sexual exploitation through prostitution. Each 

child is tested in English, math, and social studies 

so that they can work according to their ability. 

Children of the Night is a recipient of the Kumon 

Math & Reading program where the youth do 

math problems and reading skills development 

each night for small monetary rewards. They 

have had good success with this program, 

improving math abilities, as well as literacy. The 

school utilizes an intensive independent-living 

curriculum and a copyrighted keyboarding 

program that quickly teaches students to touch 

type. They offer a lot of one-on-one tutoring and 

educational support. They have recently 

developed a relationship with the Los Angeles 

Unified School District whereby a motivated 

youth who completes the Children of the Night 

education program, passes the GED, and 

completes 10 hours of education on site at the 

local high school can receive a Los Angeles 

Unified School District High School Diploma. 

 Family involvement/reunification. Many of the 

providers acknowledged the importance of 

involving biological family members or other 

appropriate support people in the lives of girls 

when a healthy relationship is possible. One child 

protective services official commented that many 

providers assume that there is no family of origin 

to whom the girl can return. While the outcome 

may never be returning home, it was expressed 

that through counseling and education, there may 

be an opportunity to maintain some type of 

family relationship. It was clear, however, that 

because of the extensive abuse histories of most 

domestically sex-trafficked girls, programs need 

to provide structured, safe environments in which 

families can reconnect. Angela’s House has 

visiting time for one hour, one day per week with 

“authorized” family members in a local church. 

The visits are supervised by Angela’s House 

staff. Family therapy is offered at another time 

during the week in a more central location. 

Children of the Night is able to facilitate 

reunification when appropriate. Staff supervise 

telephone visits with parents that have not been 

accused of sexual or physical abuse. If the parent 

attends five counseling sessions on their own 

(Children of the Night will help them find a 

clinic that charges on a sliding scale) and there is 

a family reunification program on file with child 

protective services, Children of the Night will fly 

the parent to Van Nuys, pay for their hotel, and 

supervise the first day of a reunion, allowing the 

child to stay in the hotel with the parent. In some 

cases, when a child incorrectly believes that 

reunification is possible, Children of the Night 

will facilitate this process so that the child may 

have a more realistic view of viable placement 

options following residential treatment. 

Other Factors Needed for Success 

While providers and law enforcement stressed the 

need for residential facilities for this population as a 

priority, they also recognized that a residential 

facility alone would not be enough to effectively 

serve these girls. There was universal agreement that 

the residential facility needed to be situated along a 

continuum of care that began with prevention 

education and outreach to at-risk populations, 

teachers and school counselors, health and human 

services professionals, juvenile justice and child 

welfare systems personnel, parents, and communities 

at large. The residential facilities also need to be 

connected to existing community-based programs, 

including youth drop-in centers and emergency 

shelters, given their contact with this population and 

the importance of these programs as an identification 

and referral source for the facilities. Finally, 

providers and law enforcement alike noted the need 

for long-term aftercare services, including support 

groups, mentoring, individual counseling, and 

education. It was believed that once we had in place 

well-designed and well-funded residential facilities to 

house these girls, we could begin to work on the 

other aspects of the continuum. 

It was acknowledged, however, that one program 

alone was unlikely to be able to provide the entire 

continuum of services needed. Collaboration, 

specifically among law enforcement, juvenile courts 

and probation, schools, child protective services, and 

direct service providers (including runaway and 

homeless youth shelters), was echoed as an essential 

ingredient for successfully meeting the needs of these 

girls. In fact, providers and law enforcement alike in 

Atlanta, Boston, New York, San Diego, San 

Francisco, and Washington, DC, attributed their 
current successes to 

collaboration, open 

communication, a 

common language 

and shared definition 

of domestic sex 

trafficking and minor 

victims, information 

sharing, trust, and 

ultimately a genuine 

desire to help this 

most vulnerable 

population. 

Finally, funding to 

support new programs 

or enhancements to existing programs along the 

continuum was viewed by the field as critical for this 

movement. In fact, one of the residential programs 

had to close its doors until new funding became 

available. Not only were resources scarce, but 

limitations on funding with respect to who could be 

served (e.g., age, city/county of residency) and how 

long services could be provided (e.g., 14 days, 

30 days, 90 days) created significant obstacles that 

limited access to much needed services for this 

population. 

9 

IV. SUMMARY 

Minor victims of domestic sex trafficking are 

frequently in need of services, including out-of-home 

placement. Providers and law enforcement across 

multiple cities are advocating for more options for 

residential facilities in which these girls can receive 

support, comprehensive services, and a start on the 

path to recovery. But there is a great need across all 

sectors of society to recognize that minors exploited 

as “prostitutes” by a “pimp” meet the statutory 

definition of a “minor victim of sex trafficking” and 

therefore deserve the humanitarian protections called 

for under Federal statutes. This change in paradigm is 

made more difficult, however, by the historical 

treatment of prostitution and prostitutes as a criminal 

matter, and the denial of minor victims themselves 

that they are “victims” of sex trafficking and sexual 

exploitation. Providers and law enforcement agree 

that there is not a “one size fits all” model to serving 

domestically sex-trafficked girls. Different levels of 

care and different types of care are needed to ensure 

long-term stability and exit. However, as presented 

here, those few programs that are currently providing 

tailored services for this population identify certain 

common components or elements that show promise 

of being effective. At a minimum, it is suggested that 

these programs need to be safe, trauma informed, 

population specific, and adequately funded. 

Furthermore, programs currently housing 

domestically sex-trafficked girls, such as runaway 

and homeless youth shelters, detention facilities, and 

group homes, need additional training and access to 

appropriate resources to better serve this population. 

It was stressed that the future safety and stability of 

this vulnerable population of girls rests on our ability 

to provide a “home” in which they can recover from 

the trauma of their trafficking situation and be given 

a chance at a new life free from exploitation. 

Both Boston and Atlanta have 

created databases for use by

multiple agencies (law 

enforcement, child protective

services, juvenile courts and

probation, schools, and other 

providers) to identify and flag 

minors at risk for or already

victims of sexual exploitation,

including sex trafficking, and to

track services and activities for 

each minor across agencies. 

These systems are designed to 

promote information sharing, 

timely response and increased 

protection of minors, and

coordination of services. 

The issue briefs in this series and the final study 

report can be downloaded from the following Web 

sites: 

http://aspe.hhs.gov/hsp/07/HumanTrafficking/

http://www.icfi.com/markets/social-programs/
10 

RESIDENTIAL FACILITIES FOR MINOR VICTIMS OF DOMESTIC SEX TRAFFICKING 

Program: Girls Educational and 

Mentoring Services (GEMS) Transition 

to Independent Living (TIL) 

Description: Founded in 1999 by Rachel Lloyd, a 

survivor of commercial sexual exploitation, GEMS 

seeks to prevent sexual exploitation among adolescent 

girls, assist girls in exiting prostitution, and support girls 

as they rebuild and stabilize their lives. 

Location: New York City 

Population Served: Girls ages 16–21 

Length of Stay: Up to 18 months 

Number of Beds: 9 

Services Provided: Basic needs, case management, 

counseling, medical screening, education, life skills and 

job training 

Operating Costs: $500,000 annually or approximately 

$55,000/resident 

Contact: Rachel Lloyd, Rachel@gemsgirls.org

Program: Standing Against Global 

Exploitation (SAGE) Safe House 

Description: Founded in 1992 by Norma Hotaling, a 

survivor of commercial sexual exploitation, SAGE 

provides trauma and addiction recovery services to 

young women who have been sexually exploited. 

Location: San Francisco 

Population Served: Girls ages 12–17 

Length of Stay: Up to their 18th birthday 

Number of Beds: 6 

Services Provided: Basic needs, case management, 

counseling, medical screening, education, life skills and 

job training 

Operating Costs: Approximately $64,000 annually per 

resident 

Contact: Norma Hotaling, NormaH@sagesf.org

Program: Children of the Night

Description: Founded in 1979 by Lois Lee, Children of 

the Night operates a residential facility serving boys, 

girls, and transgender individuals who have been 

exploited through prostitution. 

Location: Van Nuys, California 

Population Served: Boys, girls, transgender girls, and 

gay-identified boys ages 11–17 

Length of Stay: Up to their 18th birthday; alumni 

organization serves youth over the age of 18 

Number of Beds: 24 

Services Provided: Basic needs, case management, 

counseling, medical screening, onsite education, life 

skills and job training, family reunification 

Operating Costs: Approximately $2 million annually 

(includes outreach services) 

Contact: Lois Lee, LLee@childrenofthenight.org

Program: Angela’s House 

Description: Established in 2001, Angela’s House is a 

collaborative effort between the Juvenile Justice Fund 

and Inner Harbour, a psychiatric residential treatment 

facility for minors 

Location: Rural community outside Atlanta 

Population Served: Girls ages 12–17 

Length of Stay: 3–6 months (exceptions for longer 

stays allowed) 

Number of Beds: 6 

Services Provided: Basic needs, case management, 

counseling, chemical dependency treatment, medical 

screening, onsite education, life skills and job training, 

family reunification 

Operating Costs: Not available 

Contact: Kaffie McCullough, 

Kaffie.McCullough@fultoncountyga.gov