‭1‬ ‭SEXUALLY EXPLOITED YOUTH IN CARE:‬ ‭AN INTEGRATIVE LITERATURE REVIEW OF‬ T ‭ REATMENT MODELS AND POLICIES IN ALBERTA‬ ‭By‬ ‭McKenzie L. Thompson‬ ‬ H ‭ onours Thesis‬ ‭Submitted in partial fulfillment of the‬ ‭Requirements for the Bachelor of Arts in Criminal Justice (Honours)‬ S ‭ upervisor Dr. D. Scharie Tavcer‬ I‭ n the‬ ‭ epartment of Economics, Justice, and Policy Studies‬ D ‭Mount Royal University‬ ‭April 2024‬ ‭2‬ ‭Copyright 2024‬ ‭McKenzie Thompson‬ ‭ALL RIGHTS RESERVED‬ ‭This thesis was completed by Mckenzie L. Thompson. All rights reserved to the information‬ ‭provided within this document.‬ ‭MOUNT ROYAL UNIVERSITY‬ ‭CALGARY, ALBERTA, CANADA‬ ‭3‬ ‭DEDICATION & ACKNOWLEDGEMENTS‬ ‭To begin, I would like to acknowledge my Honours Supervisor, Dr. D. Scharie Tavcer.‬ ‭She has provided me with invaluable guidance, support, and mentorship throughout the last eight‬ ‭months. Thank you for sharing your knowledge, providing constructive feedback, helping me‬ ‭refine my ideas and improving the quality of my work. I am forever grateful and fortunate to‬ ‭have had the opportunity to work under your supervision.‬ ‭I would especially like to thank my mom, Lisa (Calvert) Thompson, as she always‬ ‭supported and believed in me. She consistently expressed interest by listening to my ideas,‬ ‭asking questions and providing me with endless words of encouragement. Thank you for always‬ ‭believing in me and being my biggest cheerleader and support person.‬ ‭I would also like to express my deepest gratitude to my grandparents, Cliff and Pauline‬ ‭Calvert, for their continued support throughout my degree. Thank you for your unwavering‬ ‭confidence in my abilities and for instilling the value of hard work and dedication in me.‬ ‭I would also like to thank my best friend, Emily, for the late-night hangouts whenever I‬ ‭was in desperate need of a break. I am truly grateful for your friendship and support.‬ ‭Lastly, I would like to dedicate this paper to three resilient and inspiring kids, C., L., and‬ ‭Z., whom I met in 2023 while working at a group home. You three are the inspiration behind this‬ ‭paper. Without you, my paper would not be what it is today. Each of you holds a special place in‬ ‭my heart, and I am honoured to be a part of your life. May your futures be filled with endless‬ ‭possibilities and happiness.‬ ‭4‬ ‭ABSTRACT‬ ‭This comprehensive integrative literature review examines sexually exploited youth in‬ ‭group care from a Canadian perspective. The focus was on treatment models and intervention‬ ‭programming available in Canada for sexually exploited youth, youth at risk of sexual‬ ‭exploitation in group care, sexual exploitation, and the risk factors associated with sexual‬ ‭exploitation. Youth are at an increased risk of sexual exploitation due to normative‬ ‭developmental changes and vulnerabilities and those who prey on those vulnerabilities.‬ ‭Moreover, youth in group care are a specifically vulnerable population because they are often‬ ‭unhoused, without persistent or positive caregivers, and under trauma and stress. Risk factors‬ ‭highlight that those most vulnerable are girls, Indigenous youth, runaway youth from care, and‬ ‭2SLGBTIQ+ youth. This literature review discovered that trauma informed care (TIC) is at the‬ ‭heart of most successful treatment models, and intervention and prevention programs, including‬ ‭trauma crisis intervention (TCI). The literature highlighted the lack of understanding about youth‬ ‭in group care and the need for ongoing research to inform policymakers. By synthesising‬ ‭existing literature, policies, and programs, this review aimed to promote the safety, well-being,‬ ‭and empowerment of youth within group care.‬ ‭5‬ ‭Table of Contents‬ ‭Methodology‬‭.................................................................................................................................‬‭10‬ ‭Limitations‬‭...............................................................................................................................‬‭12‬ ‭Definitions‬‭.....................................................................................................................................‬‭13‬ ‭Group‬‭Homes‬‭...........................................................................................................................‬‭13‬ ‭Group‬‭Home‬‭Staff‬‭....................................................................................................................‬‭13‬ ‭Child‬‭Sexual‬‭Exploitation‬‭........................................................................................................‬‭14‬ ‭Child‬‭Online‬‭Sexual‬‭Exploitation‬‭............................................................................................‬‭15‬ ‭Canadian‬‭Statistics‬‭......................................................................................................................‬‭17‬ ‭Alberta‬‭......................................................................................................................................‬‭19‬ ‭Theoretical‬‭Framework‬‭...............................................................................................................‬‭22‬ ‭Risk‬‭and‬‭Protective‬‭Factors‬‭........................................................................................................‬‭25‬ ‭Protective‬‭Factors‬‭.....................................................................................................................‬‭27‬ ‭Adverse‬‭Childhood‬‭Experiences‬‭..............................................................................................‬‭28‬ ‭History‬‭of‬‭Child‬‭Welfare‬‭in‬‭Canada‬‭...........................................................................................‬‭32‬ ‭History‬‭of‬‭Indigenous‬‭Child‬‭Welfare‬‭.......................................................................................‬‭34‬ ‭Canadian‬‭Legislation‬‭...................................................................................................................‬‭36‬ ‭Alberta‬‭Legislation‬‭...................................................................................................................‬‭38‬ ‭Interventions‬‭for‬‭Sexually‬‭Exploited‬‭Youth‬‭in‬‭Alberta‬‭............................................................‬‭40‬ ‭Trauma-Informed‬‭Care‬‭............................................................................................................‬‭40‬ ‭PSECA‬‭Interventions‬‭...............................................................................................................‬‭44‬ ‭Voluntary‬‭apprehensions‬‭....................................................................................................‬‭45‬ ‭Involuntary‬‭apprehensions‬‭.................................................................................................‬‭46‬ ‭Specialised‬‭Group‬‭Homes‬‭........................................................................................................‬‭46‬ ‭Safe‬‭Houses‬‭..............................................................................................................................‬‭48‬ ‭Programming‬‭............................................................................................................................‬‭50‬ ‭Conclusion‬‭....................................................................................................................................‬‭54‬ ‭Discussion‬‭.....................................................................................................................................‬‭55‬ ‭References‬‭.....................................................................................................................................‬‭58‬ ‭6‬ ‭Sexually Exploited Youth in Care:‬ ‭An Integrative Literature Review of Treatment Models & Policies in Alberta‬ ‭Young people are at an increased risk of sexual exploitation due to normative‬ ‭vulnerabilities, such as self-exploration, yearning for a romantic relationship, and their‬ ‭still-developing cognitive abilities (McDonald, 2023; National Academies of Science,‬ ‭Engineering, and Medicine, 2020). Therefore, this is a critical point in an individual’s life‬ ‭because they are experiencing normative developmental milestones such as forming peer‬ ‭relationships, exploring sexuality, and developing autonomy, all of which can be exploited by‬ ‭those preying on youth. Additionally, reaching developmental milestones becomes challenging if‬ ‭adversities or vulnerabilities such as running away, homelessness, mental health concerns, child‬ ‭welfare involvement, and poverty occur because of the effects of stress and trauma on the‬ ‭developing brain (Bick & Nelson, 2016).‬ ‭Throughout a youth’s development, they also experience behavioural changes, such as‬ ‭the presence or absence of emotional regulation strategies (NASEM, 2020) and impulse control,‬ ‭self-esteem, physical, identity, and mental changes (Allen & Waterman, 2019). Moreover, their‬ ‭brains continue to change and mature until their prefrontal cortex is fully developed at‬ ‭approximately age 25, which is responsible for impulse control and decision-making (Van‬ ‭Duijvenvoorde & Crone, 2013). Therefore, youth lack the ability to think critically (Allen &‬ ‭Waterman, 2019). This can lead them to trust those who may take advantage of them because of‬ ‭their desire for independence, curiosity about relationships, and likelihood to engage in‬ ‭risk-taking behaviour (Van Duijvenvoorde & Crone, 2013). These factors, coupled with being‬ ‭involved in the child welfare system and out-of-home care placements, put youth at an even‬ ‭greater risk of sexual exploitation because of their lack of support networks, absence of strong‬ ‭7‬ ‭community ties, limited access to mental health resources, and traumatic or adverse childhood‬ ‭experiences, (Carsley & Oei, 2020).‬ ‭Out-of-home care placements refer to a system in which youth are in the care of‬ ‭individuals or facilities outside their own homes due to various reasons, such as abuse, neglect,‬ ‭parental substance abuse, or other unsafe living conditions. Therefore, out-of-home care is often‬ ‭used as an umbrella term to encompass different types of care, such as foster care, group homes,‬ ‭residential treatment centres, extended family care, adoption and kinship placements‬ ‭(Saint-Girons et al., 2020). A study by Saint-Girons et al. (2020) examined the number of youth‬ ‭in out-of-home care across Canada and found that in 2019, the number of youth in out-of-home‬ ‭care was estimated to be 54,139. In Alberta, 7,872 youth were in out-of-home care in 2019,‬ ‭5,775 of whom were Indigenous (Saint-Girons et al., 2020). They also found that the number of‬ ‭children in out-of-home care has recently decreased (Saint-Girons et al., 2020).‬ ‭According to estimates by Jones and colleagues, from 2003 to 2013, the number of youth‬ ‭in out-of-home care in Canada, excluding the territories, was estimated to be 62,063 to 64,755‬ ‭compared to 54,139 youth in 2019 (Saint-Girons et al., 2020). There are numerous reasons for‬ ‭this decrease in the number of youth in out-of-home care, but they can be broadly separated into‬ ‭changes in reporting methods and the actual number of children in out-of-home care‬ ‭(Saint-Girons et al., 2020). Changes in practice could include a greater emphasis on family‬ ‭preservation services to keep the child at home or reducing time in care through improved access‬ ‭to permanency options such as adoption or reunification (Saint-Girons et al., 2020). Therefore,‬ ‭changes in reporting methods and changes in practices help account for this decrease.‬ ‭Youth living in group homes, designed for young people who are unable to live with their‬ ‭families, are also at an increased risk of sexual exploitation because many come from homes‬ ‭8‬ ‭with dysfunction, abuse, and neglect (Carsley & Oei, 2020). A group home is a‬ ‭community-based facility primarily funded by the government. Group homes are intended to‬ ‭create an environment similar to that of a ‘normal’ home for youth who cannot live with their‬ ‭families or caregivers for various reasons such as neglect, abuse and other unsafe living‬ ‭conditions (Development Services Group, 2008). Youth in group homes have more freedom than‬ ‭those in locked or secure facilities as they often receive independent community time, internet‬ ‭access and a choice of activities, such as sports and planned group or individual excursions.‬ ‭Therefore, youth in group care are particularly vulnerable to sexual exploitation because of risk‬ ‭factors such as running away from care, interacting in the community, engaging in risky sexual‬ ‭behaviours, and lacking support networks, but also due to these increased freedoms (Carsley &‬ ‭Oei, 2020; Development Services Group, 2008).‬ ‭The risk of sexual exploitation is also amplified in youth who have adverse childhood‬ ‭experiences (McDonald, 2023). Adverse childhood experiences (ACEs) are stressful or traumatic‬ ‭events that occur in an individual’s first 18 years of life, such as emotional, physical or sexual‬ ‭abuse, neglect, mental health problems, and household dysfunction (Carsley & Oei, 2020). A‬ ‭study conducted by Turpel-Lafond (2016) reviewed 145 reports of sexualized violence against‬ ‭121 youth in the care of the Ministry of Children and Family Development (MCFD) and British‬ ‭Columbia’s 23 delegated Aboriginal Agencies (DAAs) between 2011 and 2014. The study found‬ ‭that sexually victimised youth in care were more likely to be absent from their placements,‬ ‭including leaving without permission or leaving with permission but not returning upon the‬ ‭agreed amount of time (Turpel-Lafond, 2016). These youth were more likely to be victims of‬ ‭sexual exploitation because they were left vulnerable, on the streets, without protection, and‬ ‭preyed upon (Carsley & Oei, 2020; Turpel-Lafond, 2016).‬ ‭9‬ ‭Youth in group care are a specifically vulnerable population as they are often unhoused,‬ ‭without persistent caregivers, and under trauma and stress. Therefore, it is crucial to identify‬ ‭whether the current prevention and intervention strategies work effectively to protect youth from‬ ‭sexual exploitation. The significance of this research lies not only in its potential to inform‬ ‭policymakers but also in its ability to foster a safe and supportive environment for sexually‬ ‭exploited youth in care. My project examined the literature to answer the following research‬ ‭questions:‬ ‭1.‬ ‭What are the risk and preventative factors associated with youth sexual exploitation?‬ ‭2.‬ ‭What intervention and prevention programs are available for sexually exploited youth in‬ ‭group care in Alberta?‬ ‭3.‬ ‭What are the themes and patterns of effective treatment models and interventions for‬ ‭sexually exploited youth in group homes?‬ ‭10‬ ‭Methodology‬ ‭The purpose of this paper was to provide an extensive understanding of sexually‬ ‭exploited youth in group homes in Alberta and explain how interventions and treatment models‬ ‭reduce the risk of future sexual exploitation. The treatment models being examined originate‬ ‭from both Canada and the United States and aim to answer the primary research question - What‬ ‭are the themes and patterns of effective treatment models available for sexually exploited youth‬ ‭in group homes?‬ ‭This paper is a combination of an integrative literature review about sexually exploited‬ ‭youth in group homes in Canada and Alberta and a look at what current intervention‬ ‭programming and treatment models are available in Alberta. The purpose is to provide a‬ ‭comprehensive understanding of youth in group homes and child exploitation and synthesise‬ ‭existing literature on intervention programming and treatment models aimed at addressing the‬ ‭needs of sexually exploited youth in group homes.‬ ‭This paper used a mixed methods approach, combining exploratory and descriptive‬ ‭research designs to answer the research questions. Descriptive research aims to describe what‬ ‭currently exists within the research problem and obtain information about the problem‬ ‭(University of Southern California, 2019). This design will answer the what, where, when and‬ ‭how questions, such as what treatments are available for sexually exploited youth and what is the‬ ‭effectiveness of these models. The descriptive design is limited because it cannot conclusively‬ ‭address answers to why. However, it is a valuable tool that is an initial step for producing new‬ ‭hypotheses (University of Southern California, 2019).‬ ‭Exploratory research gathers insights and investigates a problem by exploring the gaps in‬ ‭the literature (University of Southern California, 2019). Therefore, the exploratory design will‬ ‭11‬ ‭investigate the effects these programs and treatment models have on youth in group homes. This‬ ‭design benefits the paper by establishing an understanding of how to proceed in future research‬ ‭(University of Southern California, 2019).‬ ‭The integrative literature review data was collected from scholarly articles, intervention‬ ‭agency annual reports, police agency reports, official statistics, and Provincial and Federal‬ ‭statutes. The data sources and articles were gathered from scholarly article databases accessed‬ ‭via Google Scholar, MRU’s library, open-source repositories, and intervention websites. Using‬ ‭the keywords: “sexual exploitation,” “youth,” “group homes,” “child welfare system,”‬ ‭“intervention programming,” “treatment models,” and “Canada” allowed for more relevant‬ ‭literature to be retrieved surrounding the topic. The literature was analysed, and synthesised‬ ‭based on the findings, gaps, and themes to understand intervention strategies for sexually‬ ‭exploited youth in group homes in Canada.‬ ‭The applicability of sources was evaluated based on their relevance to the topic and‬ ‭subtopics; therefore, each source answers and addresses different questions. Eligible studies for‬ ‭this research included those: (a) were Canadian-based studies, (b) referred to sexual exploitation‬ ‭or abuse, and (c) specifically described a treatment model or intervention developed for youth‬ ‭who experienced sexual exploitation.‬ ‭For this project, youth is defined as anyone under 18. The terms youth and child will be used‬ ‭interchangeably as under the‬‭Protection of Sexually‬‭Exploited Children Act‬‭(PSECA), anyone‬ ‭under 18 is considered a child. PSECA deals directly with the protection of sexually exploited‬ ‭youth or youth at risk of sexual exploitation (Government of Alberta, 2010). The terms sexual‬ ‭exploitation and abuse will also be used interchangeably, as sexual abuse is a form of sexual‬ ‭exploitation.‬ ‭12‬ ‭Limitations‬ ‭Like all studies, some limitations occurred throughout this paper. This paper only‬ ‭contains secondary data, which can limit the research analysis (Prada-Ramallal et al., 2016).‬ ‭There was a lack of information about sexually exploited youth in group homes; therefore, much‬ ‭of the literature focuses on youth living at home. This paper is also limited in its scope and depth‬ ‭because of time constraints, as it was an undergraduate honours paper.‬ ‭13‬ ‭Definitions‬ ‭Group Homes‬ ‭Group homes, also known as residential group care or treatment centres, house youth sent‬ ‭by a government service who cannot live with their families or other caregivers (Pritchard,‬ ‭2018). These youth are unable to reside in their family homes and are placed in group homes for‬ ‭a variety of reasons, such as challenging behaviours, mental health concerns, unsafe home‬ ‭environments, family instability, and juvenile court involvement (Pritchard, 2018). Group home‬ ‭settings are intended to create a home-like atmosphere in the community where youth live 24‬ ‭hours a day, seven days a week (Baker & Calderon, 2004; Bigby et al., 2014; Pritchard, 2018).‬ ‭Youth in group homes have more freedom and responsibility and are provided with more‬ ‭privileges, fewer restrictions, community access, and the opportunity to attend neighbourhood‬ ‭schools (Baker & Calderon, 2004; Lee & Thompson, 2008).‬ ‭A cross-sectional analysis conducted by Pollock et al., (2024) gathered data from all‬ ‭Canadian provinces and territories from 2013/2014 to 2021/2022 to determine the number of‬ ‭youth in out-of-home care. This study found that an estimated 61,104 youth were in out-of-home‬ ‭care on March 31, 2022; therefore, the national rate of out-of-home care was 8.24 children per‬ ‭1000 population (Pollock et al., 2024). Moreover, rates were highest among males and youth‬ ‭aged one to three and 16 to 17 years (Pollock et al., 2024).‬ ‭Group Home Staff‬ ‭Group home staff, also known as youth (care) workers or social educators, work in group‬ ‭homes or other residential facilities designed to provide care for youth using guiding frameworks‬ ‭(Anglin et al., 2023). Group home staff support these youth by helping with meal preparation,‬ ‭administering medication, ensuring the safety of all youth in the home, and implementing‬ ‭14‬ ‭interventions when necessary. Staff members have a responsibility to be educated and a high‬ ‭degree of compassion and patience to handle the individual’s behaviours (Pritchard, 2018).‬ ‭Therefore, all staff are provided with the necessary training to help a child through a crisis and‬ ‭teach more constructive ways to cope with stress or painful situations (Eenshuistra et al., 2019).‬ ‭Group homes also have different staff types, such as team lead or shift lead and critical workers.‬ ‭Child Sexual Exploitation‬ ‭Section 153(1) of the‬‭Criminal Code of Canada‬‭defines‬‭sexual exploitation as instances‬ ‭where an individual who is in a position of authority or trust over a young person is exploitative‬ ‭of the young person or is in a relationship of dependency with the young person under the age of‬ ‭eighteen years (‬‭Criminal Code,‬‭RSC, 1985, c C-46,‬‭s 153(1)). Individuals in a “position of‬ ‭authority or trust” to a young person can include online communities, romantic relationships,‬ ‭authority figures, and peer groups (Murillo, 2023). Additionally, engaging in the sexual‬ ‭exploitation of a young person encompasses multiple actions. Section 153(1)(a) to (b) outlines‬ ‭these actions. For instance, (a) touching, directly or indirectly, with a part of the body or with an‬ ‭object, any part of the body of a youth for sexual purposes; or (b) invites, counsels or incites a‬ ‭youth to touch the body of any person for sexual purposes (‬‭Criminal Code‬‭, 1985).‬ ‭There are various other offences under the umbrella of youth sexual exploitation,‬ ‭including human and sex trafficking. Under section 279.011, the‬‭Criminal Code‬‭defines‬ ‭trafficking of a person under the age of eighteen years‬‭as:‬ ‭279.011 (1) Every person who recruits, transports, transfers, receives, holds, conceals or‬ ‭harbours a person under the age of eighteen years or exercises control, direction or‬ ‭influence over the movements of a person under the age of eighteen years, for the‬ ‭15‬ ‭purpose of exploiting them or facilitating their exploitation is guilty of an indictable‬ ‭offence and liable (‬‭Criminal Code‬‭, RSC 1985, c. C-46,‬‭s. 279.011).‬ ‭Sex trafficking stands out as a prevalent form of youth sexual exploitation. It is one of the‬ ‭most common forms of trafficking, encompassing the sale of youth for sexual purposes within‬ ‭national boundaries (domestically) as well as beyond borders (internationally) (Baird et al.,‬ ‭2020). By age, all youth are vulnerable to involvement in sex trafficking. However, some youth‬ ‭populations are more vulnerable to recruitment than others, such as youth in the child welfare‬ ‭system (Baird et al., 2020).‬ ‭Additionally, the term child or youth prostitution is never used when discussing sexual‬ ‭exploitation because it is not a consensual experience (Government of British Columbia, 2024).‬ ‭The age of consent to sexual activity in Canada is 16. However, a 16 or 17-year-old cannot‬ ‭consent to sexual activity if (a) their sexual partner is in a position of trust or authority towards‬ ‭them, (b) is dependent on their sexual partner for care or support, and (c) the relationship is‬ ‭exploitative (Government of Canada, n.d.a.). To determine whether the relationship is‬ ‭exploitative, the following factors may be considered: the young person’s age, the age difference‬ ‭between the young person and their sexual partner, the development of the relationship and‬ ‭whether the partner may have controlled the young person (Government of Canada, n.d.a.).‬ ‭Child Online Sexual Exploitation‬ ‭Online sexual exploitation includes situations that encompass any form of sexual abuse,‬ ‭violence, and exploitation directed toward a young person through the use of the Internet and‬ ‭other technologies (Savage, 2024). Examples of this include child pornography, luring, invitation‬ ‭to sexual touching, and non-consensual distribution of intimate images (Savage, 2024; Sinclair et‬ ‭al., 2015). Rapid changes in technology, mainly beginning in the early to mid-2000s, have‬ ‭16‬ ‭enhanced the opportunities for online connections and the potential for online exposure to risks‬ ‭such as sexual exploitation (Dimitropoulos et al., 2022). The use of the Internet and‬ ‭Internet-related sexual exploitation drastically increased during the COVID-19 pandemic‬ ‭because large numbers of people relied on the Internet (Savage, 2024). For example, a Statistics‬ ‭Canada report by Savage (2024) found that between 2021 and 2022, there was an 18% increase‬ ‭in the rate of online sexual exploitation.‬ ‭17‬ ‭Canadian Statistics‬ ‭Sexual abuse is a prevalent form of sexual exploitation but is among the least likely to be‬ ‭reported to the police (Government of Canada, n.d.b.). Instances of sexual abuse may not be‬ ‭promptly reported following the occurrence of the offence because victims may not want to‬ ‭involve the police, it was deemed not necessary, it was considered a personal manner, or the‬ ‭incident was dealt with in a different way (Government of Canada, n.d.b.). Reasons for not‬ ‭wanting to involve the police often include the perception that police could or would not do‬ ‭anything to help them, the fear of revenge by the offender and wanting to avoid publicity‬ ‭regarding the incident (Government of Canada, n.d.b.).‬ ‭Results from the 2018 Survey of Safety in Public and Private Spaces (SSPPS) found that‬ ‭one in ten (7.8%) Canadians experienced at least one type of sexual abuse prior to age 15‬ ‭(Heidinger, 2022). Women (12%) were three times more likely than men (3.7%) to have‬ ‭experienced sexual abuse from an adult during their childhood, approximately three times more‬ ‭likely to have been coerced into unwanted sexual acts by an adult (5.3% compared to 1.9% for‬ ‭men) and nearly four times more likely to have been sexually touched by an adult (11% versus‬ ‭3.5% for men) (Heidinger, 2022). Additionally, most Canadians who experienced childhood‬ ‭sexual abuse reported that the most severe incident was perpetrated by either a friend, neighbour,‬ ‭or classmate or by a family member such as a grandparent, sibling, or relative (Heidinger, 2022).‬ ‭According to the SSPPS, a comparable percentage of individuals who suffered childhood sexual‬ ‭abuse identified the perpetrator of the most severe incident as either a friend, neighbour, or‬ ‭classmate (29%) or as another family member (30%) (Heidinger, 2022).‬ ‭Teen dating violence is a form of sexual abuse, including unwanted sexual touching experienced‬ ‭in dating or sexual relationships during their youth. These behaviours can manifest in‬ ‭18‬ ‭face-to-face interactions among dating partners or through electronic means online, commonly‬ ‭known as cyber dating abuse or technology-facilitated violence (Sutton & Burczycka, 2024).‬ ‭Like intimate partner violence (IPV) more broadly, teen dating violence might be a singular‬ ‭instance of abuse or consist of recurring forms of abuse over a period (Sutton & Burczycka,‬ ‭2024). Regarding long-term impacts, certain studies suggest that adolescents who undergo dating‬ ‭violence are at an increased risk of encountering violence in their adult relationships. They also‬ ‭exhibit higher rates of depression, suicide attempts, and mental health challenges, along with a‬ ‭propensity to abuse drugs and alcohol in later life (Sutton & Burczycka, 2024).‬ ‭According to the 2018 SSPPS, among teenagers aged 15 to 17 who have been in a‬ ‭relationship at some point since the age of 15, over four out of ten (45%) reported encountering‬ ‭abuse or violence from a dating partner in Canada (Sutton & Burczycka, 2024). This percentage‬ ‭was the same for both teenage girls (46%) and teenage boys (46%) within this age bracket‬ ‭(Sutton & Burczycka, 2024). Moreover, 4% of teenagers reported experiencing sexual violence‬ ‭from a dating partner after reaching the age of 15, with one in 14 (7%) girls aged 15 to 17‬ ‭included in this figure (Sutton & Burczycka, 2024). Within this age group, girls recounted‬ ‭instances of partners coercing them into unwanted sex acts (7%) or attempting to force them into‬ ‭sex (5%) (Sutton & Burczycka, 2024).‬ ‭Human trafficking is another prevalent form of exploitation (Heidinger, 2023). A‬ ‭secondary data analysis of sex trafficking cases from 2008 to 2016 in Ontario conducted by‬ ‭Baird et al., (2020) found higher rates of vulnerable young people under 25 in group homes‬ ‭experiencing sexualized violence such as sex trafficking and exploitation. Examples of‬ ‭vulnerable populations include homeless, runaway, and street-involved youth, youth in group‬ ‭homes, and gender minority youth (Kimber & Ferdossifard, 2021). The data analysis included‬ ‭19‬ ‭223 victims of sex trafficking, 52 of which were in the child welfare system and found that the‬ ‭majority (39.6%) of those involved in the child welfare system were living in group homes prior‬ ‭to being trafficked compared to only 12.2% of youth not involved in the child welfare system‬ ‭living in group homes prior to sex trafficking (Baird et al., 2020).‬ ‭Alberta‬ ‭A survey conducted in 2019 by the Association of Alberta Sexual Assault Services‬ ‭(AASAS) sought to produce an estimate of Albertan’s experiences of sexual abuse and identify‬ ‭the nature, extent and type of sexual abuse experienced (AASAS, 2020). 1,512 surveys were‬ ‭completed in Alberta by adults from June to September 2019 and found that one in three (34%)‬ ‭individuals under the age of 18 experienced sexual abuse (AASAS, 2020). Additionally, nearly‬ ‭one in two girls (44%) and one in four boys (24%) have experienced sexual abuse in Alberta‬ ‭(AASAS, 2020). The respondents were also asked what the most common type of support‬ ‭service available for survivors of youth sexual abuse should be and identified that access to‬ ‭counselling or mental health services (44%) was the most important (AASAS, 2020). 40% of‬ ‭respondents also stated that there are not enough support services or interventions available for‬ ‭victims of youth sexual abuse in Alberta (AASAS, 2020).‬ ‭In March 2020, 10,580 youth received intervention services in Alberta (Government of‬ ‭Alberta, 2021). Of those 10,580 youth, 8,260 were in out-of-home care placements while‬ ‭receiving services, including group homes (Government of Alberta, 2021). Additionally, of those‬ ‭8,260 youth in out-of-home care, only 625 youth were in community group homes (Government‬ ‭of Alberta, 2021). Comparatively, in March 2023, there were 9,363 youth receiving intervention‬ ‭services in Alberta (Government of Alberta, 2023). Of those 9,363 youth, 7,851 were in‬ ‭out-of-home care placements while receiving services (Government of Alberta, 2023). Moreover,‬ ‭20‬ ‭of those 7,851 youth in out-of-home care, 668 were in community group homes (Government of‬ ‭Alberta, 2023).‬ ‭For a more in-depth look, Table 1 below presents the number of youth receiving‬ ‭intervention services in group homes, other out-of-home care placements and at home (not in‬ ‭care) in Alberta from 2018 to 2023.‬ ‭Table 1‬ ‭Number of youth receiving intervention services in Alberta from 2018 to 2023‬ ‭Note.‬‭Government of Alberta (n.d.)‬ ‭Based on Table 1, the total number of youth receiving youth intervention services‬ ‭decreased by 10.5% from 2018 (March) to 2023 (March). The number of youth receiving‬ ‭intervention services at home (not in care) also decreased (52%) from 2018 (March) to 2023‬ ‭(March). In comparison, the number of youth receiving intervention services in community‬ ‭21‬ ‭group homes dramatically increased by 44% from 2018 (March) to 2023 (March). The number‬ ‭of youth receiving intervention services in other out-of-home care placements also increased‬ ‭(5%) from 2018 (March) to 2023 (March). In addition, the total number of Indigenous youth‬ ‭receiving intervention services increased by 29% from 2018 (March) to 2023 (March)‬ ‭(Government of Alberta, n.d.).‬ ‭22‬ ‭Theoretical Framework‬ ‭The theory of planned behaviour (TPB), developed by Ajzen in 1985, states that‬ ‭behavioural decisions result from a reasoned process in which control influences behaviour‬ ‭(Sommer, 2011). TPB is an extension of the theory of reasoned action (Ajzen, 1991; Sommer,‬ ‭2011) and shares the same central feature: an individual’s intention to perform a particular‬ ‭behaviour is driven by motivation (Ajzen, 1985). Ajzen (1985) found that the stronger the‬ ‭motivation to engage in a behaviour, the more likely they will partake. At its core, the theory‬ ‭proposes that behaviour is influenced by prominent information or beliefs pertinent to it. TPB‬ ‭suggests that three key factors, attitude, subjective norms, and perceived behavioural control,‬ ‭predict motivation (Mlyakado & Li, 2022). These three variables predict intentions to act, and‬ ‭those intentions predict behaviour.‬ ‭Attitude refers to an individual’s perception of a particular behaviour and decreases or‬ ‭increases the likelihood of a young person engaging in the behaviour; subjective norms are‬ ‭perceived social pressures that influence behaviour, and; perceived behavioural control relates to‬ ‭an individual’s perception of their ability to perform the behaviour (Ajzen, 1991). It is essential‬ ‭to understand these key factors to help predict behaviour and improve efforts to change‬ ‭behaviour through interventions (Ajzen, 1985). Moreover, as a broad principle, when attitudes‬ ‭and subjective norms toward a behaviour are more favourable and perceived behavioural control‬ ‭is higher, an individual’s intention to engage in the behaviour is stronger (McArthur et al., 2023).‬ ‭According to Ajzen’s formulation of TPB, attitude toward a behaviour includes beliefs‬ ‭regarding its effectiveness (instrumental beliefs) as well as beliefs concerning the experiential‬ ‭aspect of the behaviour (affective beliefs) (McArthur et al., 2023). Affective beliefs pertain to a‬ ‭person’s perception of the pleasantness of engaging in a behaviour, while instrumental beliefs‬ ‭23‬ ‭relate to beliefs about the effectiveness of specific behaviours (McArthur et al., 2023). The‬ ‭significance of attitude, subjective norm, and perceived behavioural control in predicting‬ ‭intention is anticipated to differ depending on the behaviour and context. Consequently, it might‬ ‭be observed that only attitudes significantly influence intentions. In contrast, in others, attitudes‬ ‭and perceived behavioural control adequately explain intentions, and in other cases, all three‬ ‭predictors may independently contribute to intentions (McArthur et al., 2023).‬ ‭TPB has been adopted to understand human behaviours, such as help-seeking intentions‬ ‭for sexual exploitation among youth (Mlyakado & Li, 2021; Mlyakado et al., 2023). For‬ ‭example, positive attitudes, such as believing that seeking help is effective and beneficial, may‬ ‭increase the likelihood of help-seeking behaviour. These attitudes can be influenced by trust in‬ ‭support systems or service providers, perceptions of personal safety, social stigma, and social‬ ‭support (Mlyakado & Li, 2021). Therefore, if a youth is in an unsupportive environment, it may‬ ‭deter them from seeking help and reporting any incidences of sexual exploitation.‬ ‭Mlyakado and Li (2021) conducted a cross-sectional survey containing 60 items to‬ ‭collect data from a stratified random sample of 1,116 secondary school youth aged 13-17 in‬ ‭Tanzania to explain the factors that determine the help-seeking intentions of youth subject to‬ ‭sexual exploitation by drawing on the TPB. The participants were selected from two areas in‬ ‭Tanzania’s eastern and northwestern regions, and the data were analysed utilising hierarchical‬ ‭multiple regression (Mlyakado & Li, 2021). The survey revealed that 19.3% of the teenage‬ ‭respondents showed minimal inclination to seek help regarding sexual exploitation, while 42.4%‬ ‭exhibited moderate intentions, and 38.4% demonstrated high intentions (Mlyakado & Li, 2021).‬ ‭Consequently, the data showed that more than 60% of the participants had either low or moderate‬ ‭levels of intention to seek help regarding sexual exploitation (Mlyakado & Li, 2021). Mlyakado‬ ‭24‬ ‭and Li (2021) found that the reasons for low to moderate levels of the help-seeking intentions of‬ ‭youth subject to sexual exploitation include the lack of perceived social support and negative‬ ‭attitudes toward seeking help.‬ ‭A similar study was conducted by Mlyakado et al., (2023) to understand youths’‬ ‭help-seeking intention for online sexual exploitation (OSE) using the TPB in Tanzania.‬ ‭Mlyakado et al., (2023) gathered data through a cross-sectional survey design, sampling 1,014‬ ‭secondary school adolescents using a stratified random method from two regions in Tanzania,‬ ‭specifically Dar es Salaam and Ruvuma. The findings from this study suggest that as adolescents‬ ‭grow older, their willingness to seek assistance for OSE also rises because young adults and‬ ‭adults have more autonomy and decision-making power compared to youth and have access to‬ ‭more support networks. Furthermore, the data also indicates that the TPB is applicable in‬ ‭comprehending adolescents’ intentions to seek help for OSE. Specifically, the variables studied‬ ‭accounted for approximately 10.8%, 9.2%, and 11.2% of the variability in their intentions to seek‬ ‭help from any source, formal channels, and family, respectively (Mlyakado et al., 2023). These‬ ‭results affirm the TPB’s ability to identify factors influencing individuals’ intentions to seek help‬ ‭regarding sexual exploitation.‬ ‭The TPB also helps explain why youth engage in risky behaviour such as running away,‬ ‭connecting with strangers online, and unsafe sexual practices (Ajzen, 1991). This theory suggests‬ ‭that behaviour is determined by behavioural intention, which measures a person’s motivation to‬ ‭engage in such behaviours and is determined by either attitudes, subjective norms, or perceived‬ ‭behavioural control (Mckellar & Sillence, 2020). Attitudes are beliefs about the perceived costs‬ ‭or rewards of behaviour in a positive or negative evaluation; subjective norms are beliefs about‬ ‭the pressure they feel from their friend group or other social groups; and perceived behavioural‬ ‭25‬ ‭control is a summary of beliefs about the simplicity or difficulty of performing a behaviour‬ ‭(Ajzen, 1991; Mckellar & Sillence, 2020; Mlyakado & Li, 2022).‬ ‭Risk and Protective Factors‬ ‭Risk factors for youth sexual exploitation are variables that predict a high probability of‬ ‭sexual exploitation (Farrington et al., 2012). The threat of sexual exploitation in youth who have‬ ‭multiple risk factors is amplified due to a combination of vulnerabilities such as a history of‬ ‭abuse and neglect (McDonald, 2023); therefore, youth in group care are more likely to‬ ‭experience sexual exploitation because they often encompass numerous risk factors such as‬ ‭frequently running away from care, lack of supportive family relationships, and substance‬ ‭misuse. In fact, a study conducted by Fedina et al., (2019) with 328 participants engaged in the‬ ‭commercial sex industry examined runaway histories and found that runaway youth have‬ ‭experienced disproportionately high rates of youth sexual exploitation. Therefore, as per the‬ ‭definition of risk factors, the variable running away predicts a high probability of sexual‬ ‭exploitation.‬ ‭Risk factors often include societal, family, and individual factors that are linked to a‬ ‭youth’s likelihood of experiencing sexual exploitation (Development Services Group, 2015).‬ ‭Family risk factors refer to relationship and family-structure-based factors and can include poor‬ ‭parenting and attachment styles, a family history of addiction, and lack of parental involvement‬ ‭(Hay, 2004). Involvement in the child welfare system is also an example of a family risk factor.‬ ‭For instance, six studies conducted in the United States and Canada, researched by Mercera et‬ ‭al., (2023), found that involvement in the Canadian child welfare system was another risk factor‬ ‭for sexual exploitation. Two of the six studies found that homeless or runaway youth often report‬ ‭26‬ ‭past or current involvement in the child welfare system (Greeson et al., 2019; Wright et al.,‬ ‭2021).‬ ‭A systematic review of risk and protective factors for sexual exploitation in youth from a‬ ‭cross-cultural perspective was conducted by Mercera et al., (2023) using a total of 65 studies and‬ ‭found that risk factors such as neglect (‬‭n=‬‭23), sexual‬‭abuse (‬‭n=‬‭21), compromised family‬ ‭functioning (‬‭n=‬‭17), economic vulnerabilities (‬‭n=‬‭17),‬‭and risky sexual behaviour (‬‭n=‬‭14) can‬ ‭underlie a youth’s vulnerability and can create pathways to sexual exploitation. The most cited‬ ‭risk factor for sexual exploitation in both male and female youth within the review by Mercera et‬ ‭al., (2023) was a history of physical/emotional abuse or neglect (‬‭n=‬‭23). Youth in group care‬ ‭often encounter these risk factors before, during or after group care, making them more‬ ‭vulnerable. This makes them more vulnerable to sexual exploitation because they lack support‬ ‭systems, services, and basic needs and run the risk of mental health issues and desperation to‬ ‭survive.‬ ‭Individual or personal risk factors are specific to the individual. They can include mental‬ ‭health disorders, addictions, behaviours, deviance, homelessness as a result of running away, and‬ ‭learning disabilities (Hay, 2004), as well as cultural, racial, or socioeconomic factors. Risky‬ ‭sexual behaviour is an example of an individual risk factor for sexual exploitation because being‬ ‭willing to engage in risky sexual behaviour, such as without STI protection, birth control, or‬ ‭without discerning partner selection, can be taken advantage of by predators looking to exploit‬ ‭youth. A systematic review and meta-analysis of 37 studies conducted with 67,453 participants‬ ‭aged 8 to 17 by Laird et al., (2020) found 52 factors associated with youth sexual exploitation,‬ ‭such as sexual abuse (‬‭n=‬‭19), running away (‬‭n=‬‭15),‬‭physical abuse (‬‭n=‬‭14), risky sexual‬ ‭behaviours (‬‭n=‬‭14), emotional dysregulation (‬‭n=‬‭10),‬‭and child protection involvement (‬‭n=‬‭8).‬ ‭27‬ ‭Laird et al., (2020) discovered that the most substantial risk factor overall for youth sexual‬ ‭exploitation is sexual abuse, and the most substantial externalizing factor is risky sexual‬ ‭behaviours, including sex with an adult (over 18), condomless sex, or meeting online strangers in‬ ‭person for sex.‬ ‭Protective Factors‬ ‭​Several protective factors also exist to protect youth from sexual exploitation. Protective‬ ‭factors are attributes linked to a decreased probability of adverse childhood experiences and‬ ‭serve to mitigate the impact of risk factors. Examples of protective factors include communities‬ ‭where individuals have access to economic help, safe and stable housing, extracurricular‬ ‭activities, and mental health services; youth who have positive friendships, do well in school,‬ ‭and have caring adults outside the family who serve as role models, and families who create safe‬ ‭and supportive environments (SAMHSA, 2014). Moreover, protective factors are important‬ ‭mechanisms that modify occurrences of adverse sexual behaviour outcomes such as sexual abuse‬ ‭and exploitation (Carsley & Oei, 2020; Heerde & Hemphill, 2016) and promote resilience‬ ‭(Buchanan, 2014).‬ ‭A systematic review of protective factors for sexual exploitation in youth was conducted‬ ‭by Mercera et al., (2023) using a total of 65 studies and found that positive experiences (‬‭n=‬‭9),‬ ‭such as positive and supportive relationships, act as protective factors from sexual exploitation.‬ ‭These relationships can exist with friends, family, group home staff, or others and are crucial for‬ ‭the positive development of youth (Mercera et al., 2023). Drawing on a Canadian study, Mercera‬ ‭et al., (2023) found that among substance-using high school students, involvement in clubs (e.g.,‬ ‭sports) also decreased chances for sexual exploitation and acted as a protective factor.‬ ‭28‬ ‭A similar systematic review was conducted by Heerde and Hemphill (2016) to investigate‬ ‭the role of protective factors in modifying the occurrence of sexual exploitation and also found‬ ‭that supportive and positive relationships were critical protective factors. These essential factors‬ ‭provide a sense of belonging, security, guidance, and a framework for healthy relationships.‬ ‭Unfortunately, youth in group care harbour a combination of risk factors but few protective‬ ‭factors (Wright et al., 2021). Therefore, it is crucial for treatment models and intervention‬ ‭programming in group homes to promote these protective factors.‬ ‭Adverse Childhood Experiences‬ ‭CDC-Kaiser first explored Adverse Childhood Experiences (ACEs) concerning health‬ ‭outcomes in 1998, which quickly led to an interest in the impact of ACEs on behaviour (Boulier‬ ‭& Blair, 2018). The original CDC-Kaiser study was conducted with 17,000 patients from‬ ‭Southern California who had attended the Health Maintenance Organisation for a standardised‬ ‭medical evaluation between 1995 and 1997 (Boulier & Blair, 2018). The study was conducted‬ ‭via two waves of surveys, which asked patients about their childhood experiences, including any‬ ‭experiences of abuse, household dysfunction, or neglect (neglect was added in the second wave)‬ ‭using the ten specific ACE exposures (Boulier & Blair, 2018; Watson, 2019). Therefore,‬ ‭screening for ACEs involves asking children or adults to complete a 10-item questionnaire‬ ‭(Watson, 2019).‬ ‭The study found that 12.5% of adult respondents experienced four or more ACEs in their‬ ‭childhood (first 18 years), and 64% experienced at least one ACE (Boulier & Blair, 2018). A‬ ‭more recent cross-sectional analysis of the Canadian Longitudinal Study on Aging by Joshi et al.‬ ‭(2021) found that 61.6% of the 44,817 Canadian participants aged 45-85 reported experiencing‬ ‭at least one ACE before age 16. The ACE scores of these 44,817 participants were examined to‬ ‭29‬ ‭assess the prevalence of ACEs and their potential impacts on health and well-being in later life‬ ‭(Joshi et al., 2021). Having a high score amounts to problems in adulthood, such as mental health‬ ‭conditions (Heidinger, 2022), cardiovascular disease and other health issues, substance misuse,‬ ‭and high rates of suicide as a result of toxic stress responses (Carsley & Oei, 2020). Having a‬ ‭high ACE score also contributes to the cycle of abuse across generations, wherein individuals‬ ‭who have experienced abuse as children are more prone to becoming abusers themselves or‬ ‭being subjected to abuse in adulthood (Heidinger, 2022).‬ ‭ACEs refer to potentially stressful or traumatic experiences that occur during the first 18‬ ‭years of life, such as sexual or emotional abuse, neglect, and types of household dysfunction‬ ‭such as divorce and witnessing violence in the home (Centers for Disease Control and‬ ‭Prevention, 2019). The original CDC-Kaiser study identified ten categories of ACEs, including‬ ‭physical, emotional and sexual abuse; physical and emotional neglect; mental illness;‬ ‭incarcerated relative; mother treated violently; substance use; and divorce (Boulier & Blair,‬ ‭2018). To determine an individual’s ACE score, they are asked to report whether they‬ ‭experienced any of these ACEs, and the total number is calculated (CDC, 2019). Several‬ ‭surveillance systems also collect information about ACE exposures and consequences, including‬ ‭the Behavioural Risk Factor Surveillance System (BRFSS) (CDC, 2019).‬ ‭Following the original study, various studies divided ACEs into three broad categories:‬ ‭abuse, neglect, and household dysfunction. This breaks up the ten ACEs identified by Kaiser into‬ ‭three distinct categories: abuse, neglect, and household dysfunction. Examples of abuse include‬ ‭physical (e.g., beating, burning, and kicking), emotional (e.g., verbal, mental, and psychological‬ ‭abuse), and sexual abuse (e.g., fondling, sexual exploitation, and violations of bodily privacy).‬ ‭Neglect includes both physical (e.g., failure to provide food, clothing, safety, and supervision in‬ ‭30‬ ‭the home) and emotional neglect (e.g., failure to provide support, love, and affection). Lastly,‬ ‭household dysfunction includes mental illness, incarcerated relatives, mothers treated violently,‬ ‭substance abuse, and divorce.‬ ‭Another review by Murillo (2023) examined a sample of 95 youth from 11 secure‬ ‭facilities drawn from the Leveraging Safe Adults (LeSA) study in Texas and Illinois, which‬ ‭concentrates on deterring opioid use among youth involved in the justice system, to determine‬ ‭how many youth experience sexual exploitation. The findings revealed that, particularly for‬ ‭young females (15 to 18), both neglect and physical abuse ACEs put females at a greater risk for‬ ‭sexual exploitation (Murillo, 2023). For example, physical abuse, such as sexual abuse, is‬ ‭considered the “gateway” trauma to exploitation because of its lasting psychological impact‬ ‭(Cole et al., 2014; Murillo, 2023). Moreover, of the young females in the review by Murillo‬ ‭(2023) who have been exploited, 90% of them first experienced sexual abuse at home, many of‬ ‭whom are in foster care. “Of the victims who have been exploited, 60-85% were also victims of‬ ‭child sexual abuse, rape, or incest” (Murillo, 2023, p. 4).‬ ‭These ACEs are indicators of sexual exploitation because what youth are lacking at‬ ‭home, such as love, attention, validation, acceptance, guidance, and affection, they will often‬ ‭look for elsewhere (Murillo, 2023). Therefore, the lack or absence of these factors can lead youth‬ ‭to seek fulfilment and connections elsewhere, such as online communities, romantic‬ ‭relationships, authority figures, and peer groups (Murillo, 2023). Unfortunately, knowingly or‬ ‭unknowingly, these connections can also be formed with pimps or exploiters (Casassa et al.,‬ ‭2021). Pimps or exploiters are people or groups that procure youth for sex acts (Casassa et al.,‬ ‭2021). Pimps or exploiters may initially offer these youth affection, but once a bond is‬ ‭established, it slowly diminishes. This bond is often called a trauma bond. A trauma bond is an‬ ‭31‬ ‭emotional tie between a victim and an exploiter, where the exploiter instills fear as well as‬ ‭gratitude (Casassa et al., 2021; Reid et al., 2013; Sanchez et al., 2019). This bond is necessary for‬ ‭an exploiter because it ensures that the victim will come back and not defy their needs (Casassa‬ ‭et al., 2021).‬ ‭Adverse childhood experiences, especially sexual abuse, are unfortunately common for‬ ‭youth who are in group care and amount to short to long-term adverse consequences to their‬ ‭mental and physical health as well as interactions with the criminal justice system (Boulier &‬ ‭Blair, 2018; Murillo, 2023). Youth in group care who have been exposed to ACEs such as sexual‬ ‭abuse and exploitation have unique needs, including therapy, crisis interventions, and‬ ‭trauma-informed care (Murillo, 2023). Through the use of trauma-informed care, group home‬ ‭staff foster a safe and supportive environment for the youth to heal, develop coping skills, and‬ ‭build trust.‬ ‭32‬ ‭History of Child Welfare in Canada‬ ‭The child welfare system (CWS) in Canada is vital for promoting the safety and‬ ‭well-being of youth. The CWS prioritises family preservation and reunification for youth in‬ ‭out-of-home care, including those in group home placements. This system is designed to‬ ‭intervene and provide support in situations where children may be at risk of abuse, neglect,‬ ‭exploitation, or other forms of harm. In Canada, the 13 provinces and territories and Indigenous‬ ‭child welfare organisations are responsible for protecting and supporting youth at risk of abuse‬ ‭and neglect (Trocmé et al., 2018). For example, The‬‭Child Youth and Family Enhancement Act‬ ‭(CYFEA) and the‬‭Protection of Sexually Exploited Children Act‬‭(PSECA) protect youth in‬ ‭Alberta.‬ ‭In response to the growing movement of “child-saving” societies, Canada’s CWS‬ ‭emerged near the end of the nineteenth Century by reorganising church-run orphanages (Trocmé‬ ‭et al., 2018). A “child-saving” society refers to a societal approach that prioritises the protection‬ ‭of youth by intervening to protect and potentially save youth at risk of abuse and other harms‬ ‭that threaten successful development (Katz, 1986; Trocmé et al., 2011; Trocmé et al., 2018). To‬ ‭aid in the protection of women, youth and animals in 1887, The Toronto Humane Society was‬ ‭founded, renamed the Children’s Aid Society in 1891, and was the first such child protection‬ ‭organisation in Canada (Trocmé et al., 2018). The Children’s Aid Society advocated for foster‬ ‭care and adoption, granted guardianship authority to children’s aid societies, and created the‬ ‭position of superintendent of neglected children (Trocmé et al., 2018). Similar organisations and‬ ‭agencies were developed across Canada in the following years. These organisations pursued‬ ‭legal mandates at the provincial level granting them the authority to take action by removing‬ ‭youth who were experiencing or at risk of abuse or neglect (Trocmé et al., 2018).‬ ‭33‬ ‭In the 1970s and 1980s, jurisdictions across Canada sought to modernise child welfare‬ ‭statutes by incorporating more specific procedures to protect parent and child rights and provide‬ ‭in-home support services as an alternative to placement whenever possible (Trocmé et al., 2018).‬ ‭The goal of the modernisation was to promote family reunification by rebuilding and‬ ‭straightening community and family ties. Beginning in the late 1990s, several jurisdictions‬ ‭broadened their child welfare statutes to encompass acts of emotional maltreatment by caregivers‬ ‭explicitly. Certain jurisdictions also included exposure to intimate partner violence (IPV) as a‬ ‭basis for child protection intervention (Trocmé et al., 2011; Trocmé et al., 2018). Several‬ ‭jurisdictions also adopted risk assessment tools, service eligibility, and triage guidelines (Trocmé‬ ‭et al., 2018). The legislation in each province now defines circumstances necessitating state‬ ‭intervention to safeguard children. These include cases where children have been orphaned,‬ ‭abandoned, subjected to physical, sexual, or emotional abuse, or are not receiving adequate care‬ ‭from their guardians (Trocmé et al., 2011). Additionally, intervention may be mandated for‬ ‭children whose behaviour poses a risk to themselves or others.‬ ‭In the present era, the Canadian CWS has continued to advocate for less intrusive family‬ ‭and community-centred approaches, such as interventions at home. Despite these adjustments,‬ ‭the child welfare mandates have led to a continuous rise in the number of youth placed in‬ ‭out-of-home care, along with higher rates of overrepresentation for Indigenous children (Trocmé‬ ‭et al., 2018). A more detailed analysis of these increases reveals that they are not primarily‬ ‭driven by immediate safety concerns for children but rather by concerns regarding the overall‬ ‭well-being of children living in challenging circumstances (Trocmé et al., 2018). Although the‬ ‭number of investigations involving severe abuse remains unchanged, there has been a significant‬ ‭34‬ ‭surge in the number of children referred due to risks of abuse and neglect, emotional‬ ‭maltreatment, or exposure to violence (Trocmé et al., 2018).‬ ‭History of Indigenous Child Welfare‬ ‭The development of the Indigenous child welfare system has followed a significantly‬ ‭different trajectory, shaped by colonialism (Trocmé et al., 2018). The colonialist history of child‬ ‭welfare for Indigenous peoples in Canada traces back to the 1800s when the residential school‬ ‭system was established. This system, along with other colonial policies, aimed to erase‬ ‭Indigenous culture, including language, traditions, and beliefs, through assimilation into‬ ‭Canadian culture (Trocmé et al., 2018). Although the last residential school was closed in the late‬ ‭1990s, these racist colonial policies continue to impact the CWS across Canada (Trocmé et al.,‬ ‭2018). For instance, approximately 30 years before the last residential school was closed, a new‬ ‭form of child apprehension began to emerge in the CWS. A period commonly referred to as the‬ ‭‘sixties scoop’ began with the 1951 amendment to the Indian Act to include language under‬ ‭Section 88, which stated “all laws of general application from time to time in force in any‬ ‭province are applicable to and in respect of Indians in the province” (‬‭Indian Act,‬‭1985, s. 88).‬ ‭This cleared the way for provincial and territorial laws to be applied to Indigenous people,‬ ‭including the CWS expanding onto reservations (Trocmé et al., 2018).‬ ‭During the ‘sixties scoop,’ youth were removed from their families and communities and‬ ‭often never returned home but were instead adopted or placed in out-of-home care (Trocmé et‬ ‭al., 2018). Youth who were adopted or placed in foster care mainly lived in white households and‬ ‭other provinces away from home (Trocmé et al., 2018). By the 1970s, foster care and adoption‬ ‭had taken over from residential schools as the primary system for protecting Indigenous children‬ ‭and providing out-of-home care (Trocmé et al., 2011; Trocmé et al., 2018). In the present era,‬ ‭35‬ ‭Indigenous youth remain overrepresented in the CWS; therefore, the push for increased family‬ ‭and community-centred options has gathered significant momentum, especially given mounting‬ ‭evidence showing a significant overrepresentation of Indigenous youth in Canada (Trocmé et al.,‬ ‭2018). In certain provinces, this overrepresentation is so pronounced that Indigenous children‬ ‭account for more than 75% of all children placed in out-of-home care (Trocmé et al., 2018).‬ ‭Significant transformations have taken place in Canada’s child welfare and Indigenous‬ ‭child welfare sectors over the last three decades, including a heightened awareness of the‬ ‭complexities surrounding physical, emotional, and sexual abuse, as well as neglect of children.‬ ‭These developments have not only influenced the type and emphasis of services offered to‬ ‭children and families but have also resulted in legislative changes mandating professionals and‬ ‭the public to report any suspected instances of child abuse (Trocmé et al., 2018).‬ ‭36‬ ‭Canadian Legislation‬ ‭In 1992, a working group of Federal, Provincial, and Territorial Deputy Ministers was‬ ‭established to propose solutions regarding youth sexual exploitation. Their efforts resulted in‬ ‭amendments to the existing legislation through Bill C-27, which introduced harsher penalties for‬ ‭individuals involved in profiting from the prostitution of a child and employing violence to‬ ‭facilitate prostitution-related activities (Bill C-27,‬‭An Act to amend the Criminal Code (child‬ ‭prostitution, child sex tourism, criminal harassment and female genital mutilation),‬‭2nd Sess,‬ ‭35th Parl, 1997). More recent legislative amendments to the protection of sexually exploited‬ ‭youth include Bill C-22, Bill C-22, and Bill C-63.‬ ‭Bill C-22.‬‭This bill, named‬‭An Act to amend the Criminal Code (age of protection)‬‭, was‬ ‭passed by the House of Commons on May 4, 2007, to increase the age of consent from 14 years‬ ‭of age to 16 years of age for non-sexually exploitative activity (MacKay, 2007). Exceptions‬ ‭under Bill C-22 encompass scenarios where an individual, within a five-year age gap, engages in‬ ‭sexual activity with a 14-15-year-old, individuals married to a youth, or individuals expecting a‬ ‭child with a youth prior to the Act’s enactment (MacKay, 2007). Furthermore, sexual activity is‬ ‭not considered exploitative if it involves 12-13-year-olds engaging with someone no more than‬ ‭two years older (MacKay, 2007). However, Bill C-22 lacks emphasis on strategies to prevent,‬ ‭educate, and mitigate harm for children and youth impacted by sexual exploitation.‬ ‭Bill C-26.‬‭This bill, named‬‭An Act to amend the Criminal‬‭Code, the Canada Evidence Act‬ ‭and the Sex Offender Information Registration Act, to enact the High-Risk Child Sex Offender‬ ‭Database Act and to make consequential amendments to other Acts (Tougher Penalties for Child‬ ‭Predators Act)‬‭, was introduced on February 26, 2014,‬‭in the House of Commons (MacKay,‬ ‭2014). The amendment aims to modify the provisions of the Criminal Code related to sexual‬ ‭37‬ ‭offences against children and youth, specifically by raising the mandatory minimum and‬ ‭maximum penalties for these offences. Clauses 7 and 9 to 14 of Bill C-26 amend the‬‭Criminal‬ ‭Code‬‭to increase the mandatory minimum penalty for‬‭several Code offences, most of them‬ ‭sexual offences involving youth (MacKay, 2014). For instance, Bill C-26 increased the‬ ‭mandatory minimums on summary convictions for the possession of child pornography,‬ ‭accessing child pornography, luring a child, sexual assault (complainant under 16 years of age),‬ ‭and agreement or arrangement to commit a sexual offence against a child from 90 days to six‬ ‭months (MacKay, 2014).‬ ‭Bill C-63.‬‭This bill, named the‬‭Online Harms Act‬‭, was introduced on February 26, 2024,‬ ‭in the House of Commons to prevent exposure to harmful online content, including youth sexual‬ ‭exploitation (Canadian Heritage, 2024). This bill would accomplish this by mandating online‬ ‭platforms to adopt measures that reduce the risk of harm, providing accessible ways to flag‬ ‭harmful content and block users, creating stronger laws to help protect all people in Canada from‬ ‭hatred and establishing a new Digital Safety Commission to oversee and enforce the‬‭Online‬ ‭Harms Act’s‬‭regulatory framework (Canadian Heritage,‬‭2024). This bill would also require‬ ‭online platforms and services to remove content (1) that sexually victimises or re-victimises a‬ ‭child and (2) intimate content posted without consent (Canadian Heritage, 2024).‬ ‭Additionally, the‬‭Online Harms Act’s‬‭framework focuses‬‭on seven types of‬ ‭extraordinarily harmful and damaging online content:‬ ‭Content that sexually victimises a child or re-victimises a survivor; intimate content‬ ‭communicated without consent; violent extremist and terrorist content; content that‬ ‭incites violence; content that foments hatred; content used to bully a child; and content‬ ‭that induces a child to harm themselves. (Canadian Heritage, 2024, para. 4).‬ ‭38‬ ‭For the purpose of this paper, content that sexually victimises or re-victimises a child and‬ ‭intimate content communicated without consent is of great importance because there is currently‬ ‭a lack of legislation that protects youth from online sexual exploitation (Dimitropoulos et al.,‬ ‭2022).‬ ‭Alberta Legislation‬ ‭Two vital pieces of legislation in Alberta are in charge of protecting youth: The‬‭Child‬ ‭Youth and Family Enhancement Act‬‭(CYFEA) and the‬‭Protection‬‭of Sexually Exploited Children‬ ‭Act‬‭(PSECA). CYFEA, under the Alberta Ministry of‬‭Children’s Services, is responsible for‬ ‭protecting youth and is the legal authority for child intervention services (Government of‬ ‭Alberta, 2010). First, the CYFEA provides guidelines for caseworkers working with families and‬ ‭outlines the situations in which interventions by Alberta Children and Youth Services may be‬ ‭necessary (Government of Alberta, 2010). In other words, this means that the CYFEA provides‬ ‭instructions and recommendations for caseworkers and specifies the circumstances in which‬ ‭Alberta Children and Youth Services may need to intervene, such as parental neglect and abuse‬ ‭in the household. The CYFEA also emphasises the use of support services for families to prevent‬ ‭the removal of a child unless alternative measures prove inadequate in ensuring the child’s safety‬ ‭(Government of Alberta, 2010).‬ ‭The second piece of legislation, PSECA, deals directly with the protection of sexually‬ ‭exploited youth or youth at risk of sexual exploitation (Government of Alberta, 2010). PESCA‬ ‭was initially named the‬‭Protection of Children Involved‬‭in Prostitution Act‬‭(PChIP) when first‬ ‭enacted in 1999 but was later amended in 2007 to be PSECA (Government of Alberta, 2010).‬ ‭PChIP, the first of its kind in Canada, was intended to protect sexually exploited youth but was‬ ‭amended in 2001 because the term child or youth prostitution is no longer used to discuss youth‬ ‭39‬ ‭sexual exploitation because it is not a consensual experience. PChIP was also amended to‬ ‭strengthen youth protection and preserve their legal rights (Government of Alberta, 2010).‬ ‭PSECA is based around the guiding principles that sexually exploited youth are victims‬ ‭of sexual abuse, that they have the right to safety and security, that they require protection and‬ ‭support, that youth and their families require access to support services, and that perpetrators‬ ‭must be held legally accountable (Government of Alberta, 2010). Additionally, PSECA provides‬ ‭protection and specialised services to sexually exploited youth to reduce the and prevention‬ ‭programs to reduce the risk of youth sexual exploitation (Government of Alberta, 2014). From‬ ‭2019 to 2020, 127 youth were served through the‬‭Protection of Sexually Exploited Children Act‬ ‭(PSECA) (Government of Alberta, n.d.). Comparatively, from 2022 to 2023, 103 youth were‬ ‭served through PSECA (Government of Alberta, 2023). There has been a 19% decrease in youth‬ ‭served through PSECA from 2019-2020 to 2022-2023.‬ ‭40‬ ‭Interventions for Sexually Exploited Youth in Alberta‬ ‭To help prevent at-risk youth from types of victimisation such as sexual exploitation and‬ ‭support those who have already been sexually exploited, understanding intervention‬ ‭programming is crucial. Treatment programs work to prevent and help youth recover from sexual‬ ‭exploitation through the use of group homes, safe houses for street or runaway youth,‬ ‭educational training, life skills training, and crisis intervention services such as therapeutic crisis‬ ‭intervention.‬ ‭Trauma-Informed Care‬ ‭Harris and Fallot (2001), the early promoters and inventors of trauma-informed care‬ ‭(TIC) approaches in the field of human services, such as residential treatment centres and group‬ ‭homes, outlined five principles that TIC in human services should be built around: safety,‬ ‭trustworthiness, choice, collaboration, and empowerment. These principles emphasise creating‬ ‭an environment that is sensitive to the needs of individuals who have experienced trauma. Safety‬ ‭includes both the emotional and physical safety of everyone by creating a respectful environment‬ ‭to reduce the likelihood of re-traumatisation; trustworthiness means providing clear and‬ ‭transparent information; choice means to provide autonomy and encourage the expression of‬ ‭choices, allowing individuals to have a voice in decisions that affect them; collaboration means‬ ‭that both staff and clients should collaborate to reduce power differentials; and empowerment is‬ ‭concerned about bringing people’s self-esteem up through skill development (Harris & Fallot,‬ ‭2001).‬ ‭Trauma-informed care (TIC) is a methodology of treatment and service to clients,‬ ‭typically in health care or crisis intervention work (Harris & Fallot, 2001). This approach‬ ‭recognizes and responds to the impact of trauma on a young person’s behaviour, emotions, and‬ ‭41‬ ‭well-being. For example, TIC can be applied to mental health services, school settings and‬ ‭residential care facilities such as group homes to enhance trauma-sensitive environments. TIC is‬ ‭essential for group home settings to create a positive and trauma-aware environment that helps‬ ‭youth heal and grow.‬ ‭Using TIC approaches with children impacted by trauma is valuable because this type of‬ ‭intervention focuses on skill acquisition and supportive relationship management and recognizes‬ ‭the traumatic roots of challenging behaviours (Brend et al., 2020). In addition, Brend and Sprang‬ ‭(2020) described how this framework influences the environment:‬ ‭This framework is used to create an organisational culture that recognizes the ubiquity of‬ ‭trauma in the development of altered neurodevelopment and compromised immune‬ ‭responses, traumatic stress symptoms, maladaptive behaviours, and impaired functioning‬ ‭in those with toxic levels of exposure. (p. 159)‬ ‭This quote refers to how sensitivity and awareness of the needs of youth affected by‬ ‭trauma influence the environment. Therefore, the more trauma-informed a staff member is, the‬ ‭more supportive the environment will be for youth to grow and heal.‬ ‭Using TIC approaches in group care will more vigorously address the effects of trauma‬ ‭without additional re-traumatisation. For instance, Program Penguin (Programme Pingouin),‬ ‭created by Boscoville, uses a TIC approach to respond to the needs of youth aged six to twelve in‬ ‭residential treatment centres or group homes in Québec and is aimed at helping staff develop‬ ‭trauma-informed attitudes and implement the five principles (Brend et al., 2020). Program‬ ‭Penguin aims to improve the services available for youth by developing the skills of group home‬ ‭staff and other workers to address the needs of youth better (Boscoville, 2023). The program’s‬ ‭42‬ ‭approach to helping youth who have been affected by trauma is to understand that the young‬ ‭person’s behaviours are primarily based on the trauma they have experienced (Boscoville, 2023).‬ ‭Since Harris and Fallot first prompted the idea of TIC approaches in human services, new‬ ‭principles are often intertwined with the existing five principles in literature. For example, the‬ ‭Substance Abuse and Mental Health Services Administration (SAMHSA) (2014) incorporated a‬ ‭sixth principle, cultural, historical and gender issues. The sixth principle is to recognize and‬ ‭address any cultural, historical, and gender issues sensitively (SAMHSA, 2014). In other words,‬ ‭this principle emphasises the importance of group home staff or other adults recognizing cultural,‬ ‭historical and gender-related factors to respond to and address trauma by creating a safe and‬ ‭inclusive environment for youth to heal.‬ ‭Established in 1992, SAMHSA (2014) addressed the need to recognize trauma as a‬ ‭crucial component of effective behavioural health service delivery and strongly emphasised early‬ ‭intervention strategies. SAMHSA put forth a framework for behavioural health sectors that can‬ ‭be adapted to other sectors such as child welfare, education, criminal and juvenile justice,‬ ‭primary health care, the military and other settings that have the potential to ease or exacerbate‬ ‭an individual’s capacity to cope with traumatic experiences (SAMHSA, 2014). SAMHSA aims‬ ‭to provide a viable framework that can be used to support people receiving services. From‬ ‭SAMHSA’s perspective, it is critical to promote the linkage to recovery and resilience for those‬ ‭individuals and families impacted by trauma (SAMHSA, 2014).‬ ‭TIC is increasingly becoming one of the standard practices in youth group care across‬ ‭Canada and the USA (Schwickrath, 2021). For instance, systems such as youth group care‬ ‭facilities often adopt TIC via multiple intersecting pathways, including staff training models,‬ ‭policies, procedures, protocols, trauma-informed interventions, and leadership development‬ ‭43‬ ‭(Baker et al., 2018). One way to perform trauma-informed care is through Therapeutic Crisis‬ ‭Intervention (TCI). Group home staff in Canada and the USA are primarily trained using TCI‬ ‭(Nunno et al., 2003).‬ ‭The development of TCI began in 1979 at Cornell University by staff at the Family Life‬ ‭Development Center (FLDC) to assess the nature and extent of child abuse and neglect when it‬ ‭occurs in group care and identify those factors associated with its incidence (Cornell University,‬ ‭2022). The FLDC discovered that inappropriate use of discipline, isolation and restraint, poor‬ ‭management policies, and abuse were all factors. Therefore, unlike other techniques, the‬ ‭objective of TCI is to de-escalate potential crises by acknowledging triggers, preventing crises‬ ‭before they occur, mitigating potential and actual injuries to staff and youth, and providing care,‬ ‭support and control (Bitton & Rajpurkar, 2015; Cornell University, 2022). For example, over 12‬ ‭months, a residential treatment centre in New York, using TCI techniques, observed a decrease in‬ ‭running away, physical aggression and injuries (Farragher, 2002). There was also an 80%‬ ‭decrease in the average number of restraints completed by staff per month, from an average of 45‬ ‭to 8.6 restraints (Farragher, 2002).‬ ‭TIC assumes that the successful resolution of a youth’s crisis depends on the adults,‬ ‭including the staff’s ability to respond in the most sensitive, caring, and appropriate manner‬ ‭(Nunno et al., 2003). The TCI certification process for group home staff involves (Cornell‬ ‭University, 2022):‬ ‭●‬ ‭a five-day training process‬ ‭●‬ ‭active participation, such as role-playing a potential crisis‬ ‭●‬ ‭a passing score on a written test (>80%)‬ ‭●‬ ‭complete attendance‬ ‭44‬ ‭Participants of the TCI program receive a training manual, PowerPoint presentations, live‬ ‭examples from trainers, and a workbook to train them effectively (Cornell University, 2022). The‬ ‭teachers and trainers for this program are staff within an organisation that utilises TCI‬ ‭approaches and delivers training to all levels of group home staff by observing, assessing,‬ ‭delivering hands-on training, and providing feedback (Cornell University, 2022).‬ ‭PSECA Interventions‬ ‭Under the PSECA legislation, there are two types of apprehensions: voluntary and‬ ‭involuntary. Apprehension is different from arrest because apprehension refers specifically to the‬ ‭Act of taking a person into custody under the provisions of PSECA, which protects youth from‬ ‭sexual exploitation. This apprehension can occur based on suspicion, complaint, or other legal‬ ‭grounds related to offences covered under PCESA, such as sexual abuse, exploitation, or‬ ‭harassment of children (Government of Alberta, 2014). On the other hand, arrest refers to taking‬ ‭a person into custody by law enforcement authorities for alleged involvement in a crime.‬ ‭Therefore, apprehension is concerned with protecting youth, not punishing them.‬ ‭There are also two types of facilities: open and secure. Open facilities are non-secure‬ ‭environments where youth have a certain degree of freedom, including community group homes,‬ ‭foster homes, or staffed independent living services. Open facilities provide a supportive‬ ‭environment and help maintain young people’s connections with their communities and families.‬ ‭Secure facilities are heavily monitored environments with strict security measures, such as‬ ‭secure treatment centres. Secure placements are intended for youth who pose a risk to themselves‬ ‭or others, require intensive supervision, or need a controlled environment to address specific‬ ‭behavioural or safety concerns. The key difference between open and secure placements lies in‬ ‭the level of security and control. Open placements offer a more flexible and supportive setting,‬ ‭45‬ ‭while secure placements prioritise safety, supervision, and containment for youth with higher risk‬ ‭levels or specific treatment needs.‬ ‭Voluntary apprehensions‬ ‭Under the PSECA legislation, there are two distinct types of interventions. The first is a‬ ‭voluntary intervention, where the youth voluntarily agrees to be enrolled in community-based‬ ‭programs, including group homes and safe houses (Government of Alberta, 2014).‬ ‭These community-based programs are designed to assist youth to successfully exit from sexual‬ ‭exploitation (Government of Alberta, 2014) and reintegrate into their communities and families.‬ ‭Youth aged 16-18 can voluntarily access these programs with or without their guardian’s‬ ‭permission; additionally, if the victim is over 18 but was victimised while they were under 18,‬ ‭then they can still voluntarily access these services (Government of Alberta, 2014). In‬ ‭comparison, youth under 16 can only voluntarily access interventions under PSECA with their‬ ‭guardian’s permission. Moreover, upon apprehension, the child’s legal guardian must be‬ ‭informed. Children & Family Services acts as their guardian in certain instances due to previous‬ ‭engagement in services like foster care or family intervention (Government of Alberta, 2010).‬ ‭Youth interested in voluntarily accessing PSECA interventions are required to complete a‬ ‭voluntary service agreement. This agreement includes a description of the programs or services‬ ‭to be made available by attaching the Voluntary Service Plan or Transition to Independence Plan,‬ ‭the contributions to be made by the guardian, the duration of the agreement, and how the‬ ‭agreement may be amended or terminated (Government of Alberta, 2014). The Voluntary‬ ‭Service Plan is designed for children below 16 years old, while the Transition to Independence‬ ‭Plan is for youth aged 16 and above. These plans must detail the intended service providers,‬ ‭programs, and services, along with overall outcomes, goals, and progress indicators‬ ‭46‬ ‭(Government of Alberta, 2014). In cases where a child already has a Transition to Independence‬ ‭Plan due to previous intervention services, the plan should be reviewed and amended to‬ ‭incorporate services and objectives related to PSECA, aiming to help the child disengage from‬ ‭sexual exploitation.‬ ‭Involuntary apprehensions‬ ‭The second form of intervention within PSECA involves an emergency court-authorised‬ ‭apprehension. In this scenario, law enforcement or Children & Family Services must petition the‬ ‭court to seek legal authorization to take custody of the child where the child or youth is unwilling‬ ‭to cooperate voluntarily (Government of Alberta, 2010). This court order authorises the police‬ ‭officer or director to apprehend the child and bring them to a secure facility group home or safe‬ ‭house with intervention services (Government of Alberta, 2014). Upon admission to the group‬ ‭home or safe house, the child may be kept under confinement for up to five days initially,‬ ‭primarily for assessment and, if necessary, detoxification. Subsequently, the director can request‬ ‭up to two additional terms of confinement, each lasting up to 21 days (Government of Alberta,‬ ‭2010).‬ ‭Specialised Group Homes‬ ‭Group homes for sexually exploited youth are specialised homes for youth at risk of‬ ‭sexual exploitation or currently involved in sexual exploitation and are designed to provide a safe‬ ‭and supportive environment allowing for personal growth (Trellis Society, n.d.a.). These homes‬ ‭offer various services, including educational and social-emotional learning (Hull Services, n.d.;‬ ‭Trellis Society, n.d.a.), TIC, cultural opportunities, community integration, and life skill‬ ‭development (Bell, 2011). Listed below are a few group homes in Alberta, but various others‬ ‭exist, including Heritage Family Services, located in Red Deer, Lacombe, and Rocky Mountain‬ ‭47‬ ‭House; Ben Calf Robe Society, Family Connections Inc. and Big Heart Homes Inc., located in‬ ‭Edmonton, and Mountain Plains Community Services Society of The North (MPCSSN), located‬ ‭in Grande Prairie.‬ ‭Eleanor’s House.‬‭A program provided by the Trellis‬‭Society, Eleanor’s House, located in‬ ‭Calgary, is a voluntary short to long-term transitional group home for youth aged 13 to 17 at risk‬ ‭of sexual exploitation or experiencing sexual exploitation (Trellis Society, n.d.a.). Youth are‬ ‭referred to the program through Calgary Region Child and Family Services under PSECA‬ ‭(Trellis Society, n.d.a.). Additionally, Trellis Society’s website offers a child sexual exploitation‬ ‭screening tool for parents or other individuals who are concerned that their child may be a victim‬ ‭of sexual exploitation (Trellis Society, n.d.a.).‬ ‭Be Brave Ranch.‬‭A program provided by Little Warriors,‬‭Be Brave Ranch, located‬ ‭outside of Edmonton, is a specialised, trauma-informed, intensive based treatment program‬ ‭focused on helping youth who have been sexually abused (Little Warriors, 2019). Be Brave‬ ‭Ranch aims to provide a safe and supportive environment where youth can heal, develop coping‬ ‭skills, and rebuild their self-worth and resilience. The program begins with a 26-day stay at Be‬ ‭Brave Ranch for youth aged 8-12 and a 12-day stay for females aged 13-17 (Little Warriors,‬ ‭2019). After the 26 or 12-day stay, throughout the year, youth will return to the ranch three times‬ ‭for 12 days to continue their face-to-face therapy and reconnect with their peers (Little Warriors,‬ ‭2019). In between stays, youth will have access to the clinical team at the ranch via outpatient‬ ‭methods and community support (Little Warriors, 2019).‬ ‭Hull Services.‬‭An agency that works with youth who‬‭have experienced chaotic lives,‬ ‭Hull Services, located in Calgary, offers youth and their families an opportunity to seek‬ ‭behavioural and mental health services (Hull Services, n.d.). Hull Services offers various‬ ‭48‬ ‭services such as group homes, including Raddisson and Cedarbrae Teaching Home, independent‬ ‭living services, campus-based residential care, and five immediate intervention programs.‬ ‭Reflections is one of the five immediate intervention programs provided by Hull Services and‬ ‭offers support to sexually exploited youth or youth at risk of sexual exploitation via a confined,‬ ‭court-ordered, and monitored service (Hull Services, n.d.).‬ ‭Woods Homes.‬‭This mental health agency provides treatment‬‭and support to‬ ‭approximately 20,000 young people, adults and families annually and responds to more than‬ ‭15,000 crisis calls (Woods Homes, n.d.). Woods Homes is based in Calgary but also operates in‬ ‭Lethbridge, Strathmore, Fort McMurray, Cold Lake, Grande Prairie and Lac La Biche and‬ ‭provides 40+ programs and services that fall under these pillars: in-home and counselling‬ ‭services, therapeutic campus care, foster care, therapeutic foster care, parented group homes,‬ ‭community group care, specialised group care, housing, hub services and learning centres‬ ‭(Woods Homes, n.d.).‬ ‭Safe Houses‬ ‭Safe houses for sexually exploited youth, also known as shelters, are specialised‬ ‭short-term facilities that must be secluded and securely isolated from external influences, with‬ ‭round-the-clock staffing by alert personnel (Government of Alberta, 2010). Safe houses offer‬ ‭various supports, including access to family communication, medical experts, Children and‬ ‭Youth Services staff, childcare professionals, mentors with firsthand street experience, and a case‬ ‭coordinator. The purpose of safe houses is to evaluate the youths physical and emotional health,‬ ‭substance use, risk of self-harm, potential involvement in sex work, family dynamics, and‬ ‭significant relationships (Government of Alberta, 2010). This assessment guides the selection of‬ ‭intervention services required and identifies the most suitable assistance for the child.‬ ‭49‬ ‭The Zebra Child Protection Centre‬‭. This non-profit organisation in Edmonton‬ ‭comprises over 50 professionals from six organisations: Alberta Health Services (AHS), the‬ ‭Child at Risk Response Team (CARRT), Edmonton Police Services (EPS), Children’s Services,‬ ‭RCMP, and Zebra staff and volunteers (Zebra Child Protection Centre, 2023). Additionally, they‬ ‭have off-site partnerships with Alberta Crown Prosecution Services, Alberta Education, Alberta‬ ‭Justice, and the Child & Adolescent Protection Centre. The team at Zebra provides support for‬ ‭sexually abused youth by offering a 24-hour crisis response team, medical and forensic‬ ‭interviewing services, development of a child safety plan, provision of clothing, pyjamas, and‬ ‭mental health and medical care, and referrals to community support services (Zebra Child‬ ‭Protection Centre, 2023).‬ ‭Beyond the initial intake, the Zebra Child Protection Centre provides advocacy and‬ ‭support services, including care calls and emotional support for caregivers, specialised support‬ ‭for court proceedings such as emotional support animals and recorded forensic interviews, and a‬ ‭child-friendly court waiting room funded by Zebra (Zebra Child Protection Centre, 2023).‬ ‭Moreover, the 2023 Zebra Centre Child Protection Impact Annual Report found that the majority‬ ‭(52%) of youth were referred to the organisation because of sexual abuse (Zebra Child Protection‬ ‭Centre, 2023).‬ ‭The Reset Society of Calgary.‬‭This agency operates‬‭24/7, providing comprehensive,‬ ‭long-term programming for females aged 16 and above who have experienced sexual‬ ‭exploitation or trafficking (Reset Society of Calgary, n.d.). They also offer specialised programs‬ ‭for pregnant women, women with children, and those facing co-occurring challenges such as‬ ‭addiction, trauma, and homelessness, collaborating with agencies nationwide (Reset Society of‬ ‭Calgary, n.d.). This program includes a three-phase continuum of services to support girls and‬ ‭50‬ ‭women exiting sexual exploitation, including i-EXIT, EXIT, and community support services‬ ‭(Reset Society of Calgary, n.d.).‬ ‭Phase one, i-EXIT, is an on-site 30-day rapid-exit program that provides a safe place for‬ ‭the exit of sexual exploitation and assesses the immediate needs of victims (Reset Society of‬ ‭Calgary, n.d.). The goal of i-EXIT is safety and stabilisation. Phase two, EXIT, is a 12-month or‬ ‭more program that offers 24/7 supportive housing, therapeutic recreational activities, life-skills‬ ‭training, Indigenous activities and curriculum, and referral to community-based supports (Reset‬ ‭Society of Calgary, n.d.). The goal of EXIT is to promote healing. Phase three, community‬ ‭support services provide ongoing life-skills training that includes education and employment‬ ‭development, positive parenting and relationships, therapeutic recreation, positive lifestyle‬ ‭habits, nutrition, and women’s health issues that are individually tailored for each individual‬ ‭(Reset Society of Calgary, n.d.). The goal of community support is to promote independence and‬ ‭empowerment.‬ ‭Programming‬ ‭All of the group homes and safe houses listed above offer different types of‬ ‭programming, such as community and educational programming and counselling. Various‬ ‭agencies in Alberta also offer programming for sexually exploited youth, including youth who‬ ‭have been sexually abused and trafficked, such as McMan Youth, Family & Community Services‬ ‭Associations of Calgary, Boys and Girls Club of Calgary, Trellis Society, Calgary Communities‬ ‭Against Sexual Abuse, Saffron Centre, and the Sexual Assault Centre of Edmonton.‬ ‭McMan Youth, Family & Community Services Association of Calgary.‬‭This‬ ‭comprehensive child and family advocacy agency in Calgary offers various support services,‬ ‭including educational programming, housing support, community and skill development groups,‬ ‭51‬ ‭counselling, addiction treatment, mental health programs, and Indigenous-specific programming‬ ‭(McMan, n.d.). They create individualised care plans tailored to the specific needs of youth and‬ ‭families and provide education on prevention and interventions that promote healthy choices and‬ ‭development. Their programs are accessible to youth aged 12-18 and families referred under‬ ‭PSECA or CYFEA voluntarily or through referrals from parents, youth, community members, or‬ ‭schools (McMan, n.d.). Additionally, they collaborate with law enforcement for youth‬ ‭apprehended under PSECA and CYFEA (McMan, n.d.).‬ ‭For example, the Collaborative Outreach Preventing Exploitation (COPE) Program is a‬ ‭voluntary program offered by McMan Services that provides support to youth at risk of or‬ ‭experiencing sexual exploitation by helping youth build and maintain healthy relationships, make‬ ‭informed decisions for the future, navigate education, counselling and related resources and‬ ‭increase the youth’s self-efficacy and independence (McMan, n.d.).‬ ‭Boys and Girls Club of Calgary (BGCC).‬‭This has been‬‭an established community‬ ‭program since 1939, which supports vulnerable children and youth in Calgary and offers housing‬ ‭and shelters, community clubs and camps, education and job skills training, Indigenous‬ ‭initiatives, and community-based care support (Boys & Girls Club, n.d.). The Boys and Girls‬ ‭Club (BGC) operates not only in Calgary but across various communities in Canada to help‬ ‭youth build confidence, acquire skills, and succeed.‬ ‭Hera‬‭. Another intervention program provided by the‬‭Trellis Society, Hera, is intended for‬ ‭females aged 13 to 17 at risk of sexual exploitation or experiencing sexual exploitation using a‬ ‭therapeutic approach. This program academically follows the Calgary Board of Education and‬ ‭runs year-round, Monday through Friday, except for spring and summer break (Trellis Society,‬ ‭n.d.b.). The goal of this program is to help girls at risk of sexual exploitation develop skills,‬ ‭52‬ ‭move forward in a positive direction, heal in a therapeutic environment, re-examine their lives,‬ ‭and safely connect with the community.‬ ‭Calgary Communities Against Sexual Abuse (CCASA).‬‭This program serves as a‬ ‭central crisis and educational resource for sexual abuse in Calgary. CCASA’s focus is on offering‬ ‭tailored services to victims, their families, and the community, delivered through safe and‬ ‭accessible interventions such as crisis support, counselling, educational programs, outreach‬ ‭initiatives, assistance in police and court matters, as well as a volunteer and leadership program‬ ‭(CCASA, n.d.). For example, The Calgary Sexual Assault Response Team (CSART) is a support‬ ‭service offered by CCASA for individuals who have been sexually assaulted within the past‬ ‭seven days (168 hours) (CCASA, n.d.). CSART is available 24/7 to anyone 12 and up through‬ ‭any Calgary emergency department and for youth under 12 through the Alberta Children’s‬ ‭Hospital (CCASA, n.d.).‬ ‭Saffron Centre.‬‭This non-profit charitable organization‬‭works with those impacted by‬ ‭sexual violence in Sherwood Park and provides specialized education, counselling programs and‬ ‭assistance navigating the criminal justice system (Saffron Centre, n.d.). The Saffron Centre’s‬ ‭goal is to support those impacted by sexual violence, including sexual exploitation, assault, and‬ ‭abuse and create safer communities through preventive education, as well as healing through TIC‬ ‭(Saffron Centre, n.d.).‬ ‭Sexual Assault Centre of Edmonton (SACE).‬‭This organization‬‭offers various‬ ‭programs for youth impacted by sexual assault, including counselling, for ages three to 17.‬ ‭Moreover, SACE requires that before seeking counselling, incidents of sexual abuse or assault be‬ ‭reported to either law enforcement or child welfare agencies without the necessity of charges or‬ ‭convictions being involved. SACE offers different types of counselling based on the individual’s‬ ‭53‬ ‭age and interests (Sexual Assault Centre of Edmonton, n.d.a.). For example, play therapy is a‬ ‭common form of counselling used for children at SACE because it allows children to express‬ ‭and “play out” their feelings by using therapeutic toys and tools (Sexual Assault Centre of‬ ‭Edmonton, n.d.b.). In play therapy, the primary objectives include boosting the child’s‬ ‭self-esteem and strengthening their coping abilities. This approach facilitates the client’s‬ ‭development of problem-solving skills, creativity, communication abilities, emotional‬ ‭expression, and understanding of relationships, choices, and available resources (Sexual Assault‬ ‭Centre of Edmonton, n.d.b.).‬ ‭54‬ ‭Conclusion‬ ‭It is crucial to identify effective treatment models and intervention programming aimed at‬ ‭protecting sexually exploited youth in group homes because once identified, more preventative‬ ‭programming can be made available for those at risk and factors of effective programming can‬ ‭be implemented elsewhere. The exploration of treatment models and intervention programming‬ ‭has provided a more in-depth understanding of what works to help sexually exploited youth;‬ ‭from TIC to legislative reforms, there are promising avenues for supporting and protecting‬ ‭sexually exploited youth in group homes. Additionally, exploring the relationship between risk‬ ‭factors, ACEs, and the CWS served to develop a better understanding of how these factors‬ ‭contribute to and exacerbate incidents of youth sexual exploitation.‬ ‭Additionally, this paper afforded me the chance to delve into instances of youth sexual‬ ‭exploitation in group homes, aiming for a deeper understanding of the extent of this crime in‬ ‭Canada and Alberta and how intervention services facilitate healing. It also allowed me to‬ ‭contribute to the existing literature by synthesising Canadian perspectives and comprehensively‬ ‭understanding this issue, allowing me to provide my insights and recommendations to further aid‬ ‭in combating youth sexual exploitation.‬ ‭55‬ ‭Discussion‬ ‭This paper conducted an integrative literature review of programs that service youth in‬ ‭group homes experiencing sexual exploitation or at risk of sexual exploitation. The first section‬ ‭of the paper was dedicated to addressing the research question about risk factors associated with‬ ‭youth sexual exploitation and how intervention methods reduce these risks by enhancing‬ ‭protective factors (what are the risk and preventative factors associated with youth sexual‬ ‭exploitation?). The most common risk factors associated with youth sexual exploitation were‬ ‭running away from home (living on the streets) (Fedina et al., 2019; Greeson et al., 2019; Wright‬ ‭et al., 2021) and instances of sexual abuse (Laird et al., 2020; Mercera et al., 2023). However,‬ ‭protective factors can help mitigate these risks by promoting resilience. The protective factors‬ ‭that provided the most resilience and decreased the risk of sexual exploitation in youth were‬ ‭protective and supportive relationships (Buchanan, 2014; Heerde & Hemphill, 2016; Mercera et‬ ‭al., 2023).‬ ‭Youth in group care face numerous risk factors that increase the risk of sexual‬ ‭exploitation. Therefore, this paper sought to compile a list of successful programs in group‬ ‭homes and other services developed for victims of sexual exploitation and youth at risk by‬ ‭promoting protective factors and decreasing risk factors and answer the second research question‬ ‭– What intervention and prevention programs are available for sexually exploited youth in group‬ ‭care in Alberta? For instance, group homes that emphasise the importance of positive‬ ‭relationships, create a safe and culturally sensitive environment, offer access to support‬ ‭networks, such as counselling, educational training and family reunification programs,‬ ‭strengthen community connections, and address the trauma that many youth in group homes‬ ‭face, reduce their desire or need to run away because they feel safe, empowered, and welcomed.‬ ‭56‬ ‭These group homes not only reduce the risk of youth running away but also youth engaging in‬ ‭risk-taking behaviour, risky sexual behaviour, instances of sexual abuse, and mental health‬ ‭problems. Hence, the need for holistic approaches that address the multifaceted needs of these‬ ‭vulnerable youth is paramount. This includes providing therapeutic interventions and addressing‬ ‭housing, education, and employment opportunities to support their long-term recovery and‬ ‭reintegration into society.‬ ‭This paper was also able to answer the third and final research question – What are the‬ ‭themes and patterns of effective treatment models and interventions for sexually exploited youth‬ ‭in group homes? The key takeaway is that TIC is at the heart of most successful treatment‬ ‭models and intervention and prevention programs, including TCI. The importance of TIC cannot‬ ‭be overstated because it effectively and sensitively recognises and responds to the impact of‬ ‭trauma on individuals, particularly youth. In Canada, including Alberta, most group homes use‬ ‭TIC methods to train staff using TCI. This method prepares staff to deal with a crisis by‬ ‭promoting safety, building a trusting staff-youth relationship, addressing trauma and empowering‬ ‭choice. Although most group home services use TCI methods, interventions take on many‬ ‭different approaches, including specialised programs, such as Eleanor’s House, and prevention‬ ‭education, such as Hera.‬ ‭Moreover, based on the findings, the protective factor that provided the most resilience‬ ‭and decreased the risk of sexual exploitation (protective and supportive relationships) was‬ ‭incorporated in effective treatment models across Alberta, including Trellis Society, Heritage‬ ‭Family Services, Hull Services, Woods Homes, and others. Therefore, numerous agencies and‬ ‭services agree on the importance of strengthening supportive relationships. These supportive‬ ‭57‬ ‭relationships can take on many forms, including those with the environment, community, peer‬ ‭groups, and parents or other adults who act as role models.‬ ‭In summary, while there are positive initiatives and resources available for sexually‬ ‭exploited youth in group homes in Alberta, there remain gaps and areas for improvement,‬ ‭including the lack of comprehensive education programs. Therefore, continued research,‬ ‭advocacy, and investment in evidence-based practices and interventions are needed to enhance‬ ‭the well-being of these vulnerable youth in Alberta. Ultimately, a society that prioritises the‬ ‭protection, resilience and support of its most marginalised members is a more just and‬ ‭compassionate society for all. Thus, educational programs should be accessible in all areas of‬ ‭Alberta and not only in cities or large towns.‬ ‭In addition, for future studies, these findings will influence research because they show‬ ‭that an emphasis needs to be placed on online sexual exploitation because the use of the Internet‬ ‭and Internet-related sexual exploitation drastically increased. Therefore, education programs that‬ ‭teach youth about the risks involved with the Internet are crucial because of this dramatic‬ ‭increase. Youth should be taught about the dangers of the Internet, such as connecting with‬ ‭strangers online and sending sexually explicit messages. Youth should also be educated about‬ ‭online predators, grooming tactics, and safe online behaviour to help protect them from potential‬ ‭dangers because there are individuals who use the Internet to exploit and harm young people.‬ ‭These findings also show that an emphasis needs to be placed on Indigenous youth in‬ ‭group homes experiencing sexual exploitation because they are vastly over-represented in the‬ ‭CWS and are more likely to be sexually exploited. This is not new information, but Indigenous‬ ‭youth remain over-represented despite various changes to the CWS and increased intervention‬ ‭58‬ ‭and protection services. For instance, In Alberta, 7,872 youth were in out-of-home care in 2019,‬ ‭5,775 of whom were Indigenous (Saint-Girons et al., 2020).‬ ‭59‬ ‭References‬ ‭Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhi & J.‬ ‭Beckmann (Eds.),‬‭Action-control: From cognition to‬‭behavior‬‭(pp. 11-39). Springer.‬ ‭Ajzen, I. (1991). The theory of planned behaviour.‬‭Organisational Behaviour and Human‬ ‭Decision Processes, 50‬‭(1), 179-211.‬‭https://dio.org/10.1016/0749-5978(91)90020-T‬ ‭Allen, B. & Waterman, H. (2019). Stages of adolescence.‬‭American Academy of Pediatrics.‬ ‭https://www.healthychildren.org‬ ‭Anglin, J. P., Saint-Girons, M. & Trocmé, N. (2023). Residential care for children and youth in‬ ‭Canada: Making sense of the mosaic. In K. J. Whittaker, L. Holmes, F. J. Del Valle & S.‬ ‭James (Eds.),‬‭Revitalizing residential care for children‬‭and youth: Cross-national trends‬ ‭and challenges‬‭(pp. 75-90). Oxford University Press.‬ ‭https://dio.org/10.1093/oso/9780197644300.003.0006‬ ‭Association of Alberta Sexual Assault Services. (2020). Summary of key findings: Prevalence of‬ ‭sexual assault and childhood sexual abuse in Alberta.‬‭Malatest.‬‭https://aasas-media-‬ ‭library.s3.us-west-2.amazonaws.com/AASAS/wp-content/uploads/2020/01/Prevalence-of‬ ‭-Sexual-Assault-Childhood-Sexual-Abuse-Summary-of-Key-Findings_FINAL.pdf‬ ‭Baird, K., McDonald, K. P., & Connolly, J. (2020). Sex trafficking of women and girls in a‬ ‭southern Ontario region: Police file review exploring victim characteristics, trafficking‬ ‭experiences, and the intersection with child welfare.‬‭Canadian Journal of Behavioural‬ ‭Science‬‭,‬‭52‬‭(1), 8-17.‬‭https://doi.org/10.1037/cbs0000151‬ ‭Baker, A. J. L., & Calderon, P. (2004). The role of group homes in the child welfare continuum‬ ‭of care.‬‭Residential Treatment for Children & Youth,‬‭21‬‭(4), 39-58.‬ ‭https://doi.org/10.1300/J007v21n04_05‬ ‭Baker, C. N., Brown, S. M., Wilcox, P., Verlenden, J. M., Black, C. L., & Grant, B.-J. E. (2018).‬ ‭60‬ ‭The implementation and effect of trauma-informed care within residential youth services‬ ‭in rural Canada: A mixed methods case study.‬‭Psychological‬‭Trauma: Theory, Research,‬ ‭Practice, and Policy, 10‬‭(6), 666-674.‬‭https://doi.org/10.1037/tra0000327‬ ‭Bell, T. (2011).‬‭A survey and literature review that‬‭reveals best practices for working with‬ ‭sexually exploited youth‬‭[Masters thesis, University‬‭of Fraser Valley]. Public Safety‬ ‭Canada.‬‭https://www.publicsafety.gc.ca/lbrr/archives/cnmcs-plcng/cn000042150630-‬ ‭eng.pdf‬ ‭Bick, J. & Nelson, C. A. (2016). Early adverse experiences and the developing brain.‬ ‭Neuropsychopharmacology, 41‬‭(1), 177-196.‬‭https://doi.org/‬‭10.1038/npp.2015.252‬ ‭Bigby, C., Knox, M., Beadle-Brown, J. & Bould, E. (2014). Identifying good group homes:‬ ‭Qualitative indicators using a quality of life framework.‬‭Intellectual and Developmental‬ ‭Disabilities, 52‬‭(5), 348-366.‬‭https://doi.org/10.1352/1934-9556-52.5.348‬ ‭Bill C-27,‬‭An Act to amend the Criminal Code (child‬‭prostitution, child sex tourism, criminal‬ ‭harassment and female genital mutilation),‬‭2nd Sess,‬‭35th Parl, 1997‬ ‭Bitton, M. S., & Rajpurkar, S. (2015). Therapeutic crisis intervention system in residential care‬ ‭for children and youth: Staff knowledge, attitudes, and coping styles.‬‭Children and Youth‬ ‭Services Review‬‭,‬‭56‬‭, 1-6.‬‭https://doi.org/10.1016/j.childyouth.2015.04.009‬ ‭Boulier, M. & Blair, M. (2018). Adverse childhood experiences.‬‭Paediatrics and Child Health,‬ ‭28‬‭(3), 132-137.‬‭https://doi.org/10.1016/j.paed.2017.12.008‬ ‭Bounds, D. T., Otwell, C. H., Melendez, A., Karnik, N. S. & Julion, W. A. (2020). Adapting a‬ ‭family intervention to reduce risk factors for sexual exploitation.‬‭Child and Adolescent‬ ‭Psychiatry and Mental Health‬‭,‬‭14‬‭(1), 1-12.‬‭https://doi.org/10.1186/s13034-020-00314-w‬ ‭61‬ ‭Boscoville (2023, May 26).‬‭Penguin-Polaris, finally ready for its big deployment.‬ ‭https://www.boscoville.ca/pingouin-polaris-enfin-pret-pour-son-grand-deploiement/‬ ‭Boys & Girls Club. (n.d.).‬‭How we help.‬‭https://www.bgccan.com/en/how-we-help/‬ ‭Brend, D. & Sprang, G. (2020). Trauma-informed care in child welfare: An imperative for‬ ‭residential childcare workers.‬‭International Journal‬‭of Child and Adolescent Resilience,‬ ‭7‬‭(1), 154-165.‬‭https://doi.org/10.7202/1072595ar‬ ‭Brend, D., Fréchette, N., Milord-Nadon, A., Harbinson, T. & Colin-Vezina, D. (2020).‬ ‭Implementing trauma-informed care through social innovation in residential care‬ ‭facilities serving elementary school children.‬‭International‬‭Journal of Child and‬ ‭Adolescent Resilience, 7‬‭(1), 222-232.‬‭https://doi.org/10.7202/1072600ar‬ ‭Buchanan, A. (2014). Risk and protective factors in child development and the development of‬ ‭resilience.‬‭Open Journal of Social Sciences, 2‬‭, 244-249.‬ ‭https://dio.org/1‬‭0.4236/jss.2014.24025‬ ‭Calgary Communities Against Sexual Abuse. (n.d.).‬‭Support services.‬ ‭https://calgarycasa.com/support-services/‬ ‭Canadian Heritage. (2024, February 26).‬‭Government‬‭of Canada introduces legislation to‬ ‭combat harmful content online, including the sexual exploitation of children.‬‭Government‬ ‭of Canada.‬‭https://www.canada.ca/en/canadian-heritage/news/2024/02.html‬ ‭Carsley, S. & Oei, T. (2020).‬‭Interventions to prevent‬‭and mitigate the impact of adverse‬ ‭childhood experiences (ACEs) in Canada: A literature review‬‭. Public Health Ontario.‬ ‭https://www.publichealthontario.ca/-/media/documents/a/2020/adverse-childhood-experie‬ ‭nces-report.pdf?la=en‬ ‭62‬ ‭Casassa, K., Knight, L. & Mengo, C. (2021). Trauma bonding perspectives from service‬ ‭providers and survivors of sex trafficking: A scoping review.‬‭Trauma, Violence, & Abuse,‬ ‭23‬‭(3), 969-984.‬‭https://doi.org/10.1177/1524838020985542‬ ‭Centres for Disease Control and Prevention (2019).‬‭Adverse childhood experiences prevention:‬ ‭Resource for action.‬‭https://www.cdc.gov/ACEs-Prevention-Resource_508.pdf‬ ‭Cornell University. (2022).‬‭Therapeutic crisis intervention‬‭system: Residential childcare project‬ ‭(7th ed.).‬‭https://rccp.cornell.edu/downloads/TCI_7_SYSTEM%20BULLETIN.pdf‬ ‭Criminal Code,‬‭RSC 1985, c C-46‬ ‭Development Services Group, Inc. (2015).‬‭Risk factors‬‭for delinquency.‬‭Office of Juvenile‬ ‭Justice and Delinquency Prevention.‬‭https://www.ojjdp.gov/mpg/Risk%20Factors.pdf‬ ‭Dimitropoulos, G., Lindenbach, D., Devoe, D. J., Gunn, E., Cullen, O., Bhattarai, A. & Arnold,‬ ‭P. D. (2022). Experiences of Canadian mental health providers in identifying and‬ ‭responding to online and in-person sexual abuse and exploitation of their child and‬ ‭adolescent clients.‬‭Child Abuse & Neglect‬‭,‬‭124‬‭, 105-448.‬ ‭https://doi.org/10.1016/j.chiabu.2021.105448‬ ‭Eenshuistra, A., Harder, A. T. & Knorth, J, E. (2019). One size does not fit all: A systematic‬ ‭review of training outcomes on residential youth care professionals’ skills.‬‭Children and‬ ‭Youth Services Review, 103‬‭, 135-147.‬‭https://doi.org/10.1016/j.childyouth.2019.05.010‬ ‭Farragher, B. (2002). A system-wide approach to reducing incidents of therapeutic restraint.‬ ‭Residential Treatment for Children & Youth‬‭,‬‭20‬‭(1),‬‭1-14.‬ ‭https://doi.org/10.1300/J007v20n01_01‬ ‭63‬ ‭Farrington, D. P., Loeber, R. & Ttofi, M. M. (2012). Risk and protective factors for offending. In‬ ‭C. B. Welsh. & P. D. Farrington (Eds.),‬‭The oxford‬‭handout of crime prevention‬‭(pp.‬ ‭46-69). Oxford University Press.‬ ‭Fedina, L., Perdue, T., Bright, C. L. & Williamson, C. (2019). An ecological analysis of risk‬ ‭factors for runaway behaviour among individuals exposed to commercial sexual‬ ‭exploitation.‬‭Journal of Child & Adolescent Trauma,‬‭12‬‭, 221-231.‬ ‭Government of Alberta. (n.d.).‬‭Child intervention‬‭information and statistics summary‬‭.‬ ‭https://open.alberta.ca/child-intervention-information-and-statistics-summary-update‬ ‭Government of Alberta. (2010).‬‭Protection of sexually‬‭exploited youth and children.‬ ‭https://open.alberta.ca/dataset/fc15acf7-7531-45c0-8ffa-d3044e907df7/protection-of-sexu‬ ‭ally-exploited-children-and-youth.pdf‬ ‭Government of Alberta. (2014).‬‭Protection of sexually‬‭exploited children: Policy manual.‬ ‭https://open.alberta.ca/dataset/a59db361-f689-4dc9-9dd1-da753927fe35/protection-sexua‬ ‭lly-exploited-children-psec-policy-manual-revised-august-2014.pdf‬ ‭Government of Alberta. (2021).‬‭Child intervention‬‭information and statistics summary‬‭.‬ ‭https://open.alberta.ca/dataset/de167286-500d-4cf8-bf01-0d08224eeadc/cs-deaths-of-chil‬ ‭dren-youth-or-young-adults-receiving-child-intervention-2021-04.pdf‬ ‭Government of Alberta. (2023).‬‭Child intervention‬‭information and statistics summary‬‭.‬ ‭https://open.alberta.ca/dataset/de167286-500d-4cf8-bf01-0d08224eeadc/cs-child-interven‬ ‭tion-information-and-statistics-summary-2022-2023-q4.pdf‬ ‭Government of British Columbia (2024, February 15).‬‭Preventing sexual exploitation of children‬ ‭and youth.‬‭https://www2.gov.bc.ca/gov/content/safety/crime-prevention/‬ ‭community-crime-prevention/exploitation‬ ‭64‬ ‭Government of Canada. (n.d.a.).‬‭Age of consent to sexual activity.‬ ‭https://www.justice.gc.ca/eng/rp-pr/other-autre/clp/faq.html#:~:text=Canada's%20age%2‬ ‭0of%20consent,legally%20agree%20to%20sexual%20activity‬‭.‬ ‭Government of Canada. (n.d.b.).‬‭Statistics on sexual‬‭assault.‬ ‭https://www.justice.gc.ca/eng/rp-pr/csj-sjc/ccs-ajc/rr06_vic2/p3_4.html‬ ‭Government of Saskatchewan. (2023).‬‭Child Welfare‬‭Statistics.‬ ‭https://www.saskatchewan.ca/residents/family-and-social-support/putting-children-first‬ ‭Greeson J. K., Treglia D., Wolfe D. S., Wasch S., Gelles R. J. (2019). Child welfare‬ ‭characteristics in a sample of youth involved in commercial sex: An exploratory study.‬ ‭Child Abuse & Neglect‬‭,‬‭94‬‭, 104038.‬‭https://doi.org/10.1016/j.chiabu.2019.104038‬ ‭Harris, M., & Fallot, R. (2001). Envisioning a trauma‐informed service system:‬‭A vital paradigm‬ ‭shift. New Directions for Mental Health Services, 2001‬‭(89), 3-22.‬ ‭https://doi.org/10.1002/yd.23320018903‬ ‭Hay, M. (2004). Commercial sexual exploitation of children and youth.‬‭BC Medical Journal,‬ ‭46‬‭(3), 119-122.‬‭https://bcmj.org/commercial-sexual-exploitation-children-and-youth‬ ‭Heerde, J. A. & Hemphill, S. A. (2016). The role of risk and protective factors in the‬ ‭modification of risk for sexual victimization, sexual risk behaviors, and survival sex‬ ‭among homeless youth: A meta-analysis.‬‭Journal of‬‭Investigative Psychology and‬ ‭Offender Profiling‬‭,‬‭14‬‭(2), 150-174.‬‭https://doi.org/10.1002/jip.1473‬ ‭Heidinger, L. (2022).‬‭Profile of Canadians who experienced‬‭victimisation during childhood,‬ ‭2018‬‭(Catalogue No. 85-002-X). Statistics Canada.‬ ‭https://www150.statcan.gc.ca/n1/pub/85-002-x/2022001/article/00016-eng.htm‬ ‭Hull Services.‬‭Safe directions.‬‭https://hullservices.ca/services/safedirections/‬ ‭65‬ ‭Joshi, D., Raina, P., Tonmyr, L., MacMillan, H. L. & Gonzalez, A. (2021).‬‭Prevalence of adverse‬ ‭childhood experiences among individuals aged 45 to 85 years: A cross-sectional analysis‬ ‭of the Canadian longitudinal study on ageing.‬‭CMAJ‬‭Open, 9‬‭(1), 158-166.‬ ‭https://doi.org/10.9778/cmajo.20200064‬ ‭Katz, M. B. (1986). Child-saving.‬‭History of Education‬‭Quarterly‬‭,‬‭26‬‭(3), 413-424.‬ ‭https://doi.org/10.2307/368247‬ ‭Kimber, M., & Ferdossifard, A. (2021). Children’s exposure to trafficking, sexual exploitation‬ ‭and community-based violence in Canada: A narrative summary and policy perspective.‬ ‭Child Abuse & Neglect‬‭,‬‭119‬‭.‬‭https://doi.org/10.1016/j.chiabu.2020.104790‬ ‭Laird, J. J., Klettke, B., Hall, K., Clancy. E. & Hallford, D. (2020). Demographic and‬ ‭psychosocial factors associated with child sexual exploitation: A systematic review and‬ ‭meta-analysis.‬‭JAMA Network Open, 3‬‭(9).‬ ‭https://doi.org/10.1001/jamanetworkopen.2020.17682‬ ‭Lee, B. R. & Thompson, R. (2008). Comparing outcomes for youth in treatment foster care and‬ ‭family-style group care.‬‭Children and Youth Services‬‭Review, 30‬‭(7), 746-757.‬ ‭https://doi.org/10.1016/j.childyouth.2007.12.002‬ ‭Little Warriors. (2019).‬‭Annual report 2018.‬ ‭https://littlewarriors.ca/wp-content/uploads/2019/01/2018-Annual-Report.pdf‬ ‭MacKay, R. (2007).‬‭Bill C-22: An Act to amend the‬‭Criminal Code (age of protection) and to‬ ‭make consequential amendments to the Criminal Records Act‬‭. Library of Parliament.‬ ‭https://lop.parl.ca/staticfiles/PublicWebsite/LegislativeSummaries/PDF/39-1/c22-e.pdf‬ ‭66‬ ‭MacKay, R. (2014).‬‭Legislative Summary of Bill C-26: An Act to amend the Criminal Code, the‬ ‭Canada Evidence Act and the Sex Offender Information Registration Act, to enact the‬ ‭High Risk Child Sex Offender Database Act and to make consequential amendments to‬ ‭other Acts.‬‭Library of Parliament.‬‭https://lop.parl.ca/staticfiles/PublicWebsite/‬ ‭Home/ResearchPublications/LegislativeSummaries/PDF/41-2/c26-e.pdf‬ ‭Heidinger, L. (2022).‬‭Profile of Canadians who experienced‬‭victimisation during childhood,‬ ‭2018‬‭(Catalogue No. 85-002-X). Statistics Canada.‬ ‭McDonald, K. P. (2023).‬‭Building a specialized model of care for youth at risk of sexual‬ ‭exploitation in the child welfare system: A systematic review and exploratory program‬ ‭evaluation‬‭[Doctoral dissertation, York University].‬‭York University Repository.‬ ‭https://hdl.handle.net/10315/41457‬ ‭Mckellar, K. & Sillence, E. (2020). Chapter 2 - Current research on sexual health and teenagers.‬ ‭In K. Mckellar & E. Sillence (Eds.),‬‭Teenagers, sexual‬‭health information and the digital‬ ‭age‬‭(pp. 5-23). Academic Press.‬‭https://doi.org/10.1016/B978-0-12-816969-8.00002-3‬ ‭McMan. (n.d.).‬‭About COPE.‬‭https://mcmancalgary.ca/cope/‬ ‭Mercera, G., Kooljmans, R., Leijdesdorff, S., Heynen, T. & Amelsvoort, T. (2023). Risk and‬ ‭protective factors for sexual exploitation in male and female youth from a cross-cultural‬ ‭perspective: A systematic review.‬‭Trauma, Violence,‬‭& Abuse, 0‬‭(0)‬‭.‬ ‭https://doi.org/10.1177/15248380231201815‬ ‭Mlyakado, B. P., & Li, J. C.-M. (2022). Explaining the help-seeking intentions of adolescents‬ ‭subject to sexual exploitation in tanzania: An application of the theory of planned‬ ‭behaviour.‬‭Journal of Interpersonal Violence‬‭,‬‭37‬‭,‬‭17-18.‬ ‭https://doi.org/10.1177/08862605211023494‬ ‭67‬ ‭Mlyakado, B. P., Li, J. C.-M. & Jia, C. X. (2023). Online sexual exploitation of adolescents in‬ ‭Tanzania: Explaining help-seeking intention using the theory of planned behaviour.‬ ‭Children and Youth Services Review, 154‬‭, 107-129.‬ ‭https://doi.org/10.1016/j.childyouth.2023.107129‬ ‭Murillo, J. (2023).‬‭Examination of relationships among‬‭sexual exploitation, sex, and ACEs‬ ‭among youth in the legal system‬‭[Honors thesis, Texas‬‭Christian University]. Texas‬ ‭Christian University Repository.‬‭https://repository.tcu.edu/‬ ‭National Academies of Science, Engineering, and Medicine. (2020). Normative adolescent‬ ‭development. In F. N. Kahn & R. Graham. (Eds.),‬‭Promoting‬‭Positive Adolescent Health‬ ‭Behaviors and Outcomes: Thriving in the 21st Century‬‭(pp. 25-44). The National‬ ‭Academic Press.‬‭https://doi.org/10.17226/25552‬ ‭Nunno, M. A., Leidy, B. D. & Holden, M. J. (2003). Evaluating and monitoring the impact of a‬ ‭crisis intervention system on a residential child care facility.‬‭Children and Youth Services‬ ‭Review, 25‬‭(4), 295-315.‬‭https://doi.org/‬‭10.1016/S0190-7409(03)00013-6‬ ‭Pollock, J. N., Ouédraogo, M. A., Trocmé, N., Hovdestad, W., Miskie, A., Crompton, L.,‬ ‭Campeau, A., Tanaka, M., Zhang, C., Laprise, C. & Tonmyr, L. (2024). Rates of‬ ‭out-of-home care among children in Canada: An analysis of national administrative child‬ ‭welfare data. Health Promot Chronic Disease Prevention Journal,‬‭44‬‭(4).‬ ‭https://doi.org/10.24095/hpcdp.44.4.02‬ ‭Prada-Ramallal, G., Takkouche, B. & Figueiras, A. (2017). Diverging conclusions from the‬ ‭same meta-analysis in drug safety: Source of data (primary versus secondary) takes a toll.‬ ‭Drug Safety, 40,‬‭351–358.‬‭https://doi.org/10.1007/s40264-016-0492-z‬ ‭68‬ ‭Pritchard, K. (2018). Residential care. In P. Kostouros & B. Thompson (Eds.),‬‭Child and youth‬ ‭mental health in Canada: Cases from front-lines settings‬‭(pp. 153-178). Canadian‬ ‭Scholars.‬ ‭Reid, J. A., Haskell, R. A., Dillahunt-Aspillaga, C., & Thor, J. A. (2013). Contemporary review‬ ‭of empirical and clinical studies of trauma bonding in violent or exploitative‬ ‭relationships.‬‭International Journal of Psychology‬‭Research‬‭,‬‭8‬‭(1), 37.‬ ‭Reset Society of Calgary. (n.d.).‬‭EXIT Program.‬‭https://resetcalgary.ca/programs/‬ ‭Robert Wood Johnson Foundation. (2013).‬‭Adverse childhood experiences‬‭(ACEs).‬ ‭https://www.rwjf.org/content/rwjf-web/us/en/search-results.html?k=ACES‬ ‭Saffron Centre. (n.d.)‬‭Sexual assault support & resources.‬‭https://www.saffroncentre.com/‬ ‭Saint-Girons, M., Trocmé, N., Esposito, T. & Fallon, B. (2020). Children and youth in‬ ‭out-of-home care in Canada in 2019.‬‭CWRP information‬‭sheet E, 211.‬ ‭https://cwrp.ca/sites/default/files/publications/‬ ‭Sanchez, R. V., Speck, P. M., & Patrician, P. A. (2019). A concept analysis of trauma coercive‬ ‭bonding in the commercial sexual exploitation of children.‬‭Journal of Paediatric‬ ‭Nursing‬‭,‬‭46‬‭, 48-54.‬‭https://doi.org/10.1016/j.pedn.2019.02.030‬ ‭Savage, L. (2024).‬‭Online child sexual exploitation:‬‭A statistical profile of police-reported‬ ‭incidents in Canada, 2014 to 2022‬‭(Catalogue No. 85-002-X).‬‭Statistics Canada.‬ ‭https://www150.statcan.gc.ca/n1/pub/85-002-x/2024001/article/00003-eng.htm#r14‬ ‭Sexual Assault Centre of Edmonton. (n.d.a.).‬‭Child‬‭and youth counselling.‬ ‭https://www.sace.ca/sace-services/child-and-youth-counselling/‬ ‭Sexual Assault Centre of Edmonton. (n.d.b.).‬‭Play‬‭therapy.‬ ‭https://www.sace.ca/learn/play-therapy/‬ ‭69‬ ‭Sinclair, R., Duval, K., & Fox, E. (2015). Strengthening Canadian law enforcement and‬ ‭academic partnerships in the area of online child sexual exploitation: the identification of‬ ‭shared research directions.‬‭Child & Youth Services‬‭,‬‭36‬‭(4), 345-364.‬ ‭https://doi.org/10.1080/0145935X.2015.1096588‬ ‭Schwickrath, Q. D. (2021).‬‭Beginning with the need‬‭for connection and safety: Examining how‬ ‭group home child and youth care counsellors in Alberta experience the enactment of‬ ‭trauma-informed care‬‭[Master’s thesis, University‬‭of Calgary]. Prism.‬ ‭http://hdl.handle.net/1880/113214‬ ‭Sommer, L. (2011). The theory of planned behaviour and the impact of past behaviour.‬ ‭International Business and Economic Research Journal, 10‬‭(1), 91-110.‬ ‭https://doi.org/10.19030/iber.v10i1.930‬ ‭Substance Abuse and Mental Health Services Administration. (2014).‬‭Trauma informed care in‬ ‭behavioral health services: A treatment protocol (TIP) SERIES 57‬‭. HHS Publication No.‬ ‭(SMA) 14-4816.‬‭https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf‬ ‭Sutton, D. & Burczycka, M. (2024).‬‭Dating violence‬‭against teens aged 15 to 17 in Canada,‬ ‭2009 to 2022‬‭(‭C ‬ atalogue No. 85-002-X). Statistics‬‭Canada.‬ ‭https://www150.statcan.gc.ca/n1/pub/85-002-x/2024001/article/00004-eng.htm‬ ‭Trellis Society. (n.d.a.).‬‭Eleanor’s house.‬‭https://www.growwithtrellis.ca/youth-programs/‬ ‭housing-shelters/eleanors-house‬ ‭Trellis Society. (n.d.b.).‬‭Hera.‬‭https://www.growwithtrellis.ca/youth-programs/‬ ‭education-employment-support/hera‬ ‭Trocmé, N., Fallon, B., MacLaurin, B., Chamberland, C., Chabot, M. & Esposito, T. (2011).‬ ‭70‬ ‭Shifting definitions of emotional maltreatment: An analysis child welfare investigation‬ ‭laws and practices in Canada.‬‭Child Abuse & Neglect, 35‬‭(10), 831-840.‬ ‭https://doi.org/10.1016/j.chiabu.2011.05.015‬ ‭Trocmé N., Esposito, T., Nutton, J., Rosser, V. & Fallon, B. (2018). Child welfare services in‬ ‭Canada. In L. Merkel-Holguin, J. D. Fluke, & R. D. Krugman (Eds.),‬‭National systems of‬ ‭child protection:‬‭(pp. 27-50). Child Maltreatment,‬‭8, Springer, Cham.‬ ‭https://doi.org/10.1007/978-3-319-93348-1_3‬ ‭Turpel-Lafond, E. M. (2016). Too many victims: Sexualized violence in the lives of children and‬ ‭youth in care: An aggregate review.‬‭Representatives‬‭for Children and Youth.‬ ‭https://rcybc.ca/sites/default/files/documents/pdf/reports_publications/rcy_toomanyvicti‬ ‭msfinal.pdf‬ ‭University of Southern California. (2019).‬‭Organizing‬‭your social science research paper: Types‬ ‭of research designs‬‭.‬‭https://libguides.usc.edu/writingguide/researchdesigns‬ ‭Van Duijvenvoorde, A. C. & Crone, E. A. (2013). The teenage brain: A neuroeconomic approach‬ ‭to adolescent decision making.‬‭Current Directions‬‭in Psychological Science‬‭,‬‭22‬‭(2),‬ ‭108-113.‬‭https://doi.org/10.1177/0963721413475446‬ ‭Watson, P. (2019). How to screen for ACEs in an efficient, sensitive, and effective manner.‬ ‭Paediatric Child Health, 24‬‭(1), 37-38.‬‭.‬‭https://dio.org/‬‭10.1093/pch/pxy146‬ ‭Woods Homes. (n.d.).‬‭About.‬‭https://www.woodshomes.ca/about-us/‬ ‭Wright, E. R., LaBoy, A., Tsukerman, K., Forge, N., Ruel, E., Shelby, R., Higbee, M., Webb, Z.,‬ ‭Turner-Harper, M., Darkwa, A., & Wallace, C. (2021). The prevalence and correlates of‬ ‭labor and sex trafficking in a community sample of youth experiencing homelessness in‬ ‭Metro-Atlanta.‬‭Social Sciences, 10‬‭(2), 32.‬‭https://doi.org/10.3390/socsci10020032‬ ‭71‬ ‭Zebra Child Protection Centre. (2023).‬‭Zebra Child & Youth Advocacy Centre Impact Report.‬ ‭https://static1.squarespace.com/static/57680868cd0f687b1283dc75/t/66158362a44cad26c‬ ‭7aadcfb/1712685930312/2023+Impact+Report+web.pdf‬