CSE-IT Research

Read our research about the CSE-IT and universal screening.

  1. Technical Report: Validation of the CSE-IT
  2. Brief: Universal Screening Makes Exploitation Visible
  3. Brief: Commercial Sexual Exploitation of Children in Alameda County: Estimating the Scope of the Problem
  4. Exploitation & Gender: Increasing the Visibility of Cismale, Transgender, and Gender Nonconforming Youth
  5. Research to Action: Sexually Exploited Minors (SEM) Needs & Strengths
  6. Psychotherapy for Commercially Sexually Exploited Children: A Guide for Community-Based Behavioral Health Practitioners and Agencies

1. Validation of the CSE-IT – Technical Report

Child sex trafficking is hard to see. As a result, most youth are exploited for more than two years before anyone notices. To address this, we developed The Commercial Sexual Exploitation – Identification Tool.

Our report, Validation of the CSE-IT, based on data from 5,537 youth screened in the pilot, presents new evidence on the effectiveness of universal screening to identify signs of exploitation. Our pilot included youth served by child welfare, juvenile justice, and related systems. We found that 1 in 10 children showed clear signs of exploitation.

The report also describes which youth in the study have the highest rates of trafficking indicators:

1 in 3 African-American girls
1 in 4 transgender youth
1 in 5 girls overall
1 in 5 homeless boys

Based on lessons learned from piloting the tool in 56 agencies around California, we also developed a CSE-IT Implementation Guide. This guide will help agencies establish universal screening protocols to improve early identification.

2. Universal Screening Makes Exploitation Visible

Our experience using the Commercial Sexual Exploitation – Identification Tool (CSE-IT) shows that universal screening is critical to both prevention and early intervention. 

Early identification and intervention prevent prolonged abuse

Most children experiencing exploitation go two or more years before anyone notices the signs. After implementing a universal screening protocol, child welfare staff in one large urban county identified ten times as many trafficked youth.

“Screening universally was a game changer for us. It allowed us to do more than just verify our gut instinct about cases. We started to see how all the complicating factors point to exploitation. We’re better able to recognize the abuse.” 
– Child Welfare Manager, large California County 

Universal screening can be implemented in any setting

Screening universally with a validated tool like the CSE-IT only takes 3-5 minutes to complete. WestCoast has trained providers in 20 states to use the CSE-IT in settings such as child welfare, juvenile justice, schools, foster family agencies, child advocacy centers, healthcare settings, and homeless shelters. These agencies range in size and staff capacity, demonstrating that universal screening is feasible in all systems and settings. 

As of this publication, providers have screened nearly 134,000 youth using the CSE-IT, and identified 15,197 youth, or 11%, as having a clear concern for exploitation. If you are interested in learning more about the CSE-IT, please contact us at screening@westcoastcc.org.

3. Commercial Sexual Exploitation of Children in Alameda County: Estimating the Scope of the Problem

This brief describes the prevalence of child sex trafficking in Alameda County using data from the Commercial Sexual Exploitation Identification Tool (CSE-IT) collected between 2016 and 2021. In order to effectively serve victims of trafficking, we need to understand the scope of the problem. Here’s what we found: 

1 in 7 system-involved youth had clear signs of trafficking     

Of 2,204 children under the age of 18 who were screened, 348 youth (15.8%) had clear signs of trafficking and an additional 565 children (25.6%) had possible signs of being exploited. 

Gaps in screening result in ongoing exploitation

Universal screening using a validated tool like the CSE-IT is the most accurate way to understand how many youth have signs of sex trafficking. However, only four agencies in Alameda County conduct universal screening, resulting in an undercount of youth experiencing exploitation. 

Screening is only the first step 

Screening for signs of trafficking should be part of a universal screening and response protocol that guides next steps, such as getting youth the help they need, safety planning, and mandated reporting. 

4. Exploitation & Gender: Increasing the Visibility of Cismale, Transgender, and Gender Nonconforming Youth

There is a common misconception that sex trafficking and exploitation only impacts cisgender girls. However, cismale, transgender, and gender nonconforming youth also experience exploitation, yet remain unseen by providers.

Through focus groups with survivors and providers, we found that though indicators of trafficking are universal across gender identities, they are often overlooked or discounted for cismale, transgender, and gender nonconforming youth.

Based on our findings, we recommend the following: 

  • Incorporate gender inclusivity in trainings to combat myths about exploitation and gender.
  • Highlight the exploitative nature of survival sex, which may be more common among cismale, transgender, and gender nonconforming youth.
  • Implement universal screening to support identification of all vulnerable youth.

Our research also underscores the need to create welcoming, non judgemental, culturally relevant systems of care. Youth of all gender identities need safe environments where providers take their experiences seriously and can identify the signs of sexual exploitation.

We are grateful to our focus group participants and interviewees for sharing their time, expertise, and insight with us. 

Acknowledgements:

This report was possible through the expertise provided by more than 30 focus group participants and interviewees. We would like to thank them for being generous with their time and for their willingness to share their thoughts, insights, and experiences. We are also grateful to all of the individuals who generously provided input and reviewed this report.

Sincere thanks to our consultants who provided candid feedback and helped steer this report in the right direction:

Thank you to the staff at WestCoast Children’s Clinic who provided significant support to carry out this project: Morgan Bernados, Leilani Diaz, Hannah Haley, Eden Moore, and Nick Nguyen.

5. Research to Action: Sexually Exploited Minors (SEM) Needs & Strengths

The disturbing underground industry that thrives on selling children for sex is an alarming and complex problem that has no simple solution. But we’re dedicated to doing what it takes to end child sexual exploitation.

Our Research-to-Action project brings us one step closer to understanding the characteristics of sexually exploited youth and the effects of exploitation on their mental health. This groundbreaking collaborative research project brought together 10 agencies in Alameda and Contra Costa counties who serve these youth in a variety of settings.

This paper presents the findings from our two-year project and includes recommendations for prevention and treatment, and presents a policy agenda for ending the practice of trafficking children in the Bay Area and nationally.

6. Psychotherapy for Commercially Sexually Exploited Children: A Guide for Community-Based Behavioral Health Practitioners and Agencies

After a decade of providing community-based mental health services to youth who are commercially sexually exploited, WestCoast Children’s Clinic, in collaboration with the Center for Trauma Recovery and Juvenile Justice and the National Center for Youth Law, has developed a new framework for treatment: Psychotherapy for Commercially Sexually Exploited Children: A Guide for Community-Based Behavioral Health Practitioners and Agencies.

The guide describes the core components of treatment, the impact of ongoing trauma, and the importance of understanding exploitation in the context of social injustice and systemic oppression.

As awareness of child sex trafficking grows and systematic screening for signs of exploitation improves, the need for information about how to serve youth who are sexually exploited is all the more urgent. Alameda County District Attorney Nancy O’Malley heard this echoed throughout California:

“The Human Exploitation and Trafficking (H.E.A.T.) Institute held seven summits across California in 2015 – 2016. In every community we visited, professionals called for more guidance on effective mental health treatment for trafficked youth. This framework advances our ability to help children who are sexually exploited and those professionals who provide psychological counseling and support.”