Survivors of sex trafficking and exploitation in most instances face trauma, drug abuse disorders, and other issues that leave them reluctant to seek support from law enforcement officers. Boston has a long history of helping juvenile and adult victims of commercial sexual exploitation by ensuring that they are treated with dignity while getting various services to rebuild their lives. Sex trafficking is a complicated crime that requires special attention across many areas. For instance, there is a necessity for prosecutors, victim advocates, and support staff to comprehend the survivors' issues and decide the best outcomes for all the victims.
Boston has enacted the Safe Harbor Act of 2008 that comprises numerous services for sexually exploited people. These survivors are provided services to reduce trauma and hastening rehabilitation, paving ways for excellent results. The program is funded by the New York State Office and Department of Social Services. The Safe Harbor Act provides a calm and neutral place for survivors to be interviewed and undergo medical and psychological assessments by a multidisciplinary team. Safe Harbor Mentoring has been created to empower survivors to recognize their strength and develop healthy and constructive relationships (Williams, 2017). To achieve this, the interdisciplinary team offers programs that involve improving social and emotional skills, increasing positive engagement habits, and strengthening civic participation by creating a constructive relationship with other people in schools and neighborhoods across Boston.
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There are numerous barriers to accessing services, and victims have difficulties due to cultural and language issues resulting from different racial backgrounds. Victims may not understand the assistance if the resources' information is not provided in their native language. Also, some survivors may be illiterate in their native languages, making it harder to develop trust (Russell, 2019). Cultural differences make it hard to offer services resulting in culturally inappropriate services, insensitive investigations, or misinterpretation of behaviors or acts.
Additionally, stigma linked with sex trafficking and exploitation increases the difficulties in identifying victims. Both international and national victims of sex trafficking are less likely to disclose cases of commercial sex exploitation, particularly to law enforcement, due to shame and fear of the responses. The victims are also rigid when it comes to committing to mental health treatment. Survivors find it hard to voluntarily participate in the treatment process due to low motivation to therapy because of family pressure.
In Boston, there are inadequate resources to offer intensive case management and after-care services for long periods. There is also no training on how to get survivors` trust, no effective outreach techniques, cultural competencies, or confidentiality. The present organization does not meet the needs of services because there is no secure housing, affordable medical care, and qualified translators or interpreters.
Week 10: Sexual Health
The spread of HIV/AIDS in the contemporary world has become rampant due to changes in individuals' lifestyles. This chronic disease interferes with the body's aptitude to combat infections. In Boston, various agencies, programs, resources, and support exist for individuals living with HIV/AIDS. There are multiple community-based settings and clinics across Boston for persons living with HIV/AIDS (PLWHA). Some of the agencies concerned with PLWHA include Boston Living Center, Boston Medical Center, Commonwealth Land Trust, and Community Servings Inc. The agencies either directly offer or coordinate access to welfare counseling, housing pursuit and advocacy, and home-based amenities. The majority of agencies are subsidized to deliver medical case management for PLWHA.
Additionally, various programs exist in Boston that aid in the coordination of clinical and support services. The programs include AIDS Action, Fenway Health, Victory Programs Inc., and Justice Resource Institute. The various programs take a comprehensive strategy in HIV/AIDS prevention and care, which has aided in reducing new HIV/AIDS diagnoses in Boston by over 42% (Lightner et al., 2020). The programs have helped the public health department in Boston save more than $1.8 billion in AIDS-related medical care costs. Subsequently, resources have been provided by the ministry of health that aids in HIV/AIDS counseling and testing. The HIV Clinic in Boston, Massachusetts General Hospital, offers comprehensive and multidisciplinary care to PLWHA. The support available entails providing antiretroviral therapy, preventative care for PLWHA, and facilitating side effect management for patients who need treatment and utilize contemporary agents in PLWHA.
The theme of resilience and impact often transverses among the Boston community. The federal funding towards HIV/AIDS helps PLWHA and the community as a whole as it increases awareness and aids learners to always observe measures in avoiding contracting the ailment. A decrease in the number of HIV infections has been witnessed in the community. The spread and effectiveness of the HIV/AIDS programs, agencies, and resources have been felt in various Boston economic sectors. The community has been progressing commendably due to the efforts and measures to combat the deadly ailment.
One unique aspect of our community about the HIV/AIDS pandemic is the cooperation and collaboration between the private and public sectors in combating the disease. The United States government has played a critical role in ensuring the success of reducing HIV infections. The United States Department of Health and Human Services, the Center for Disease Control and Prevention, and Amnesty International have all collaborated in helping the Boston community come victorious by providing resources to be used in hospitals, homes, and organizations to aid PLWHA (Cahill et al., 2017). The National Institutes of Health and the Administration for Children and Families have also offered various competitive and mandatory grants designed to enhance families' social and economic welfare affected by HIV/AIDS.
However, Boston lacks sufficient support in winning the war against HIV/AIDS. The citizens do not effectively back the government in fighting the disease as some are ignorant of observing the measures put in place by the government. Some patients do not routinely take antiretroviral drugs, which reduces their immunity, and most succumb to the disease. The increase in the death rate of such victims has risen in recent years in Boston as the government and private entities emphasize adhering to eradicating HIV/AIDS. Subsequently, individuals should get tested to determine their HIV status and help reduce its spread. Using condoms during sexual intercourse and being faithful to one partner will significantly reduce the risk of contracting HIV/AIDS.
Week 11: Atypical Sexual Behavior
Sexual activities that are not normal and commonly occur in society are referred to as atypical sexual behaviors. These behaviors are typically driven by paraphilia, which entails a recurring sexual fantasy and desire to participate in unusual sexual involvements (Joyal & Carpentier, 2016). An accepted agreement lacks among professional medical experts as to the etiology of the diverse types of paraphilia. Various clusters of personality traits exist which correlate with atypical sexual behavior. For medics who specialize in treating sexual-related issues, atypical sexual behaviors are without clear information regarding the causes, making it difficult to formulate change strategies to avert such behaviors. Atypical sexual behavior arises due to mental disorders. Disorders make the person a grave peril to other persons' psychological and bodily well-being, dangerous to a population's life hood.
Some of the characteristics of paraphilic disorders are found not only in individuals with atypical sexual interests but also in individuals with diverse mental disorders. However, atypical sexual behaviors can manifest in healthy individuals. Subsequently, persons of interest who might possess these behaviors often feel distressed, anxious, or combating stress or depression—individuals with a strong sexual desire or behavior that entails another individual's psychological distress. Also, people who cannot communicate effectively and account for their legal consent are likely to be victims of atypical sexual behavior.
In averting atypical sexual behavior, individuals should engage and extend foreplay to enhance adequate lubrication of the sexual organs during intercourse. The essentials of arousal in women and men have diverse differences and similarities. Women necessitate a satisfactory sexual foreplay duration for lubrication to be conventional. Insufficient sexual foreplay is a crucial source of arousal disorder in females. In achieving a desirable foreplay indulgence, individuals ought to embrace perceptive behavior, which entails flirting, seduction, and seduction (Gammelgaard, 2016). Although human perceptiv e behavior is influenced by tradition and culture, it necessitates precise human sexual attraction and mating approaches.
However, significant changes have emerged in how paraphilia has been conceptualized. Particular paraphilic disorders are regarded as mental disorders. Some do not warrant clinical intervention—the nature of the paraphilia and whether the paraphilia results in distress or injures others. Individuals whose sexual behaviors are undesirable should always embrace foreplay, which triggers physiological and physical responses that turn sexual involvements enjoyable. However, atypical sexual behaviors during sleep are often harmful to intimate partners and patients. This phenomenon during sleep has been associated with shame, guilt, or depression. Individuals should engage in regular physical exercise, eating a balanced diet, and drinking a sufficient amount of water. These activities assist in reducing paraphilic disorders.
Atypical sexual behaviors are classified into two universal types: non-coercive paraphilia, where the partners involved are willing participants, and coercive paraphilia, where individuals are sexually stimulated by imaginations or desires to exert pain, either emotional or physical, on other individuals. Psychotherapists might have varying notches of enthusiasm and proficiency in working with these individuals predominantly if they encompass coercion. Mostly, non-coercive paraphilia is dangerous only if it bothers the individual's significant other. It serves as an ancillary for human contact and is harmful or turned into the only technique an individual requires to achieve sufficient sexual pleasure. Coercive paraphilia can undoubtedly be hazardous if an individual turns out to be a violent fantasy or not a willing accomplice. For a precise diagnosis to be ascertained concerning whether paraphilia has deliberated a disorder or merely sexual variation, the medic should decide whether it is a distress aspect or impairment. Atypical sexual behavior derails and humiliates individuals who fall victim to the action.
Week 12: Violence and Coercive Sexual Behavior
The topic that I chose regarding people living in violent situations is domestic violence. Domestic abuse has been a subject of debate for the past years. It can be either be physical, sexual, emotional, physical, economic, or psychological actions or threats that can impact individuals. It includes acts that surround intimidation, terrorizing, manipulation, humiliation, injuries, or wounding someone. The aspect can happen to any person regardless of age, religious background, sexuality, race, gender, among others. It also affects individuals of all socioeconomic and educational levels.
Domestic abuse is a fundamental public health issue, and currently, it affects more than 3 million women and 900,000 men and results in homelessness, injuries, or even deaths. Economically, it costs billions of dollars in health care expenses and loss of productivity among the working population. The impacts of domestic violence can be devastating if left untreated. The emotional and physical implications of continued abuse can be severe and sometimes end up in homicides. Treatment and improving social support to the victims can enhance prognosis.
The National Domestic Violence in Boston offers immediate support and guidance to the victims. The organization also provides free support via live chat on their website between 7 am to 4 pm. Another program in the area is Haven, which offers support groups, counseling, workshops, safety planning, resource referrals, and a supportive environment. These programs have trained advocates that are knowledgeable on domestic violence situations, safety, and other options. They also assist victims with housing, legal, and healthcare assistance. These organizations also provide shelter and mental health assessments for the children and other family members. National Domestic Violence and Haven also offer safety planning. If the victims are in immediate danger or planning to leave the perpetrators, hotline advocates are available to handle safety plans either physically or over the phone.
The agencies also provide information about their rights to victims. If victims have any queries or whether to notify law enforcement officers or school, the advocates offer all forms of guidance. Advocates find solutions if the victim wants to move out of state, have children with the perpetrators, or any other challenging issues. The agencies also offer solutions on restraining orders, civil or criminal matters, and ways of keeping children safe. The advocates sometimes work with the victim to find a reasonable attorney.
Federal authorities handle domestic violence cases. The Victims of Crime Act offers services to more than 10 million victims of all forms of violence through 5,000 service organizations such as domestic violence shelters, rape crisis facilities, and child abuse treatment services. A violence state assistance program offers to fund crisis interventions, therapy services, interpretations, needs evaluations, and after-service activities that assist victims in dealing with the trauma. Also, at the federal level, there is the Family Violence Prevention and Services Act. The policy assists victims in areas such as emergency housing, crisis hotlines, counseling, and other programs for all domestic violence survivors across the country. The service that does not currently exist in Boston is training for victim service providers. These volunteers do not have enough resources and expertise to address the unique requirements of young individuals. There should be a policy solution that fosters prevention and intervention techniques and provides invaluable education and services for all victims.
Week 13: Sexual Difficulties and Therapeutic Interventions
Based on what I have learned, the therapist does not utilize cognitive behavioral therapy for the victims who require mental treatment. Cognitive-behavioral therapy (CBT) is a type of mental intervention that successfully treats various issues such as eating disorders, marital problems, substance abuse disorder, anxiety, depression, and severe mental illness. Many research studies suggest that CBT leads to significant enhancement in body functioning and overall quality of life (Dobson & Dobson, 2018). The therapy is based on the principle that mental problems are non-helpful and alter thinking patterns, and make a person develop learned patterns of harmful behaviors. The second principle is that individuals suffering from psychological issues can develop coping mechanisms, which relieve mental problems.
CBT is utilized to treat several issues. It helps victims manage symptoms of psychological problems, stop relapse of psychological conditions, learn strategies for coping with challenging life circumstances, and assist victims in identifying the means of managing emotions. The therapy also helps people living with mental illness resolve relationship disputes and learn effective ways of communication (Fernández-Álvarez & Fernández-Álvarez, 2019). Also, the therapist enables a person to overcome emotional trauma that relates to abuse or violence, how to cope with a medical condition, and manage chronic physical symptoms.
The underlying aspect of CBT is that thoughts and feelings play a crucial role in behaviors. The therapy's main objective is to teach individuals that, while they cannot alter each dimension of the world around them, they can manage how they interpret and handle things within their surroundings. Therapists have realized that it is an effective way of managing mental illness because it helps people become aware of the negative and unrealistic feelings that affect their thoughts and moods (Dobson & Dobson, 2018). Individuals will be able to begin engaging in healthy thinking behaviors. It is also a practical short-term treatment choice, especially for victims that require quick psychological attention. It also assists victims with particular kinds of emotional distress that do not work with psychotropic treatment. CBT has also been demonstrated to help a patient overcome a broad range of maladaptive and less costly forms of therapy. At the end of the treatment, the patient will learn coping skills that can be beneficial in the future.
There are unique strategies that therapists use to handle patients who need help. Therapists assist patients in identifying negative thoughts. The process will result in self-discovery and knowledge that are vital in the treatment process. Healthcare professionals support patients while they practice new skills. Patients will utilize these coping strategies in real-world situations. For instance, an individual with a drug abuse disorder will begin practicing new skills and rehearse ways to deal with social circumstances that could trigger a relapse. Medical practitioners also assist patients with goal setting, which is an essential step in recovering from mental conditions and helping victims enhance their health and life (Dobson & Dobson, 2018). On the other note, CBT is structured. The therapy does not focus on underlying unconscious resistances to change compared to other techniques. It is best-fit for patients who are more comfortable with a structured and focused approach in which the therapist takes an instructional duty.
Week 14: Wrap It Up
For the past 14 weeks, there are some of my perceptions and perspectives have remained the same. What has not changed is that sex and sexuality are influenced by many variables such as media, culture, and religion. For instance, the media influence the perception of sex by oversexualizing women and masculinizing males in adverts, music films, TV, and movies. Women may be affected to copy these behaviors or even exaggerate their sexuality to appeal to men. Women may also lack confidence when comparing themselves with those in the media, which creates an unhealthy perception of sexuality. There are also perceptions of heterosexual attraction. For instance, society dictates that boys should play with trucks and girls should play with dolls. These make members of LQGBTQ+ feel less confident about sexuality because of hyper-sexualization.
What has shifted my perceptions and perspectives on sex and sexuality is that sex can be a commodity for trade and sale. During the past 14 weeks, I have realized that sex trafficking and exploitation have become a common aspect of society. Young girls and men have become coerced into prostitution, exploited sexually, or other forms of sexual abuse and slavery. Many young people are forced to marry or have sex with male combatants. I have also realized child trafficking has become widespread in my state.
References
Cahill, S., Taylor, S. W., Elsesser, S. A., Mena, L., Hickson, D., & Mayer, K. H. (2017). Stigma, medical mistrust, and perceived racism may affect prep awareness and uptake in Black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts. AIDS Care , 29 (11), 1351-1358. https://doi.org/10.1080/09540121.2017.1300633
Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy . Guilford publications.
Fernández-Álvarez, H., & Fernández-Álvarez, J. (2019). Commentary: Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry , 10 . https://doi.org/10.3389/fpsyt.2019.00123
Gammelgaard, J. (2016). Seduction and the problem of translation in the context of sexual abuse. La séduction à l'origine , 79-94. https://doi.org/10.3917/puf.dejou.2016.02.0079
Joyal, C. C., & Carpentier, J. (2016). The prevalence of Paraphilic interests and behaviors in the general population: A provincial survey. The Journal of Sex Research , 54 (2), 161-171. https://doi.org/10.1080/00224499.2016.1139034
Lightner, J. S., Shank, J. R., McBain, R., & Prochnow, T. (2020). The social network of medical case managers, housing providers, and health department staff in the Ryan White HIV/AIDS program: A Midwest case study. PLOS ONE , 15 (8), e0238430. https://doi.org/10.1371/journal.pone.0238430
Russell, A. B. (2019). Finding a safer harbor: mandating health care clinics to intervene in child sex trafficking by amending the Safe Harbor Act. Family court review , 57 (1), 136-150.
Williams, R. (2017, April). Safe harbor: State efforts to combat child trafficking. Denver, CO: National Conference of State Legislatures.
