I NEED THIS TODAY 07/18/2020 BY 6PMPlease no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recom

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Please no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recommendation regarding treatment. APA format also requires headings. Use the prompt each week to guide your heading titles and organize the content of your initial post under the appropriate headings. Remember to use scholarly research from peer-reviewed articles that is current. Please follow the instructions to get full credit for the discussion.

Each classmate’s document is attached.


your classmates’ postings.


to your classmates’ postings.

Respond in one or more of the following ways:

  • Share a new insight or perspective you learned or thought of in terms of advocacy in reading your colleague’s portfolio
  • Share with your colleague how you think power, or privilege, or oppression may impact or influence the target problem at institutional, community, or public policy levels.
  • Share a suggestion or new insight with your colleague about collaboration to influence public policy.


Classmate (J. Cosme)


Classmate (S. Danziger)


Classmate (J. Herring)

Required Resources

Pirog, M. A., & Good, E. M. (2013). Public policy and mental health: Avenues for prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 1-79). Thousand Oaks, CA: SAGE.

Multicultural and Social Justice Counseling Competencies. (2015). Retrieved October 27, 2015, from http://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=20

Document: Faculty Spotlight: Dr. Christie Jenkins (Word document)

Optional Resources

Substance Abuse and Mental Health Services Administration (SAMHSA): Prevention of Substance Abuse and Mental Illness. Retrieved from https://www.samhsa.gov/prevention

I NEED THIS TODAY 07/18/2020 BY 6PMPlease no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recom
COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Social Change Portfolio J Herring Contents Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy INTRODUCTION Advocating for Minority Adolescents in Sanford, Florida The phrase school-to-prison pipeline is now trite, overused, and watered down, although the seriousness of the practice remains a real concern. Across the country, suspensions and expulsions from school, referrals to alternative schools, and school-based arrests have increased, especially among minority students, which blurs the line between the education and criminal justice systems. The consequences adolescents face for their behavioral issues address only the behavior but not the cause of the behavior. The socioeconomic disadvantage of minority adolescents can have significant adverse effects on their mental health, including depression and behavior problems, anxiety disorders such as posttraumatic stress disorder, and a range of other adjustment difficulties. Many minority adolescents also experience “compounded community trauma” which has been defined as the experience of children when they witness violence in both their homes and their neighborhoods. Additional factors that increase the risk for mental illness for minority youth are neighborhood exposure to violence, repeated experiences of discrimination, and chronic exposure to racism. As a result, early interventions for minority adolescents, intended to maximize their effective coping in these disadvantaged and at-risk environments, can be advantageous for their future mental health. Thus, effective adovacation that push for early prevention and intervention are essential to reduce the burden of mental disorders for minority adolescents (El Bouhaddani, et. al., 2019). PART 1: SCOPE AND CONSEQUENCES Advocating for Minority Adolescents in Sanford, Florida The conditions in which a person is born, grows, lives, and works have a significant impact on his health, both physical and mental. Sanford is the County Seat of Seminole County, Florida. Sanford has an African American population of 30.5%. The high school and its cluster schools reflect the dichotomy that exists within the community of Sanford. While Seminole High (where I once taught English Language Arts) was awarded the Silver ranking in 2015 by US News & World Report, the percent of disadvantaged students who were determined proficient was 46.5%, whereas the proficiency of non-disadvantaged students was 74.5%. In addition, the suspension and graduation rates for students of color are disproportionate when compared to white students. Sanford became the center of national and international media attention following the February 2012 fatal shooting of Trayvon Martin, a 17-year old African American high school student. However, when the marches and protests dissipated, so did the care and concern of the youth in Sanford. They were left with the invisible scars from the overt racism they faced and continue to face for looking, acting, and existing like Trayvon Martin. These children need effective mental health care to teach them coping and anger management strategies and tools, not expulsion from school. The mental health needs of minority adolescents are not well served: they are treated less frequently, and when they are treated, the services they receive are less frequently and adequate. Recent studies show that 6.6% of ethnic minority children and youth receive services compared to 20% of white children (Yasui, 2014). The result of insufficient mental healthcare for minority adolescents is that they are more likely to engage in problematic behaviors later in life, such as increased depression, anxiety, engagement with deviant peers, involvement with violent crime, poor academic performance, school dropout, drug and alcohol abuse, unsafe sex, and unemployment (Alegria, Vallas, & Pumariega, 2010). Therefore, my goal is to push for effective adovacation that provides resources for early prevention and intervention to reduce the prevalence of mental disorders for minority adolescents. PART 2: SOCIAL-ECOLOGICAL MODEL Advocating for Minority and Adolescents in Sanford, Florida One cannot deny that disparities exist in the mental health care arena, much like in general healthcare. Strategies to lower or remove discrepancies involve improving access to care, improving quality of care, and reducing the stigma associated with mental healthcare. Because of these discrepancies, some of the risk factors exist. However some risk and protective factors for minority adolescents are common for all adolescents, as this is an important time for physical, emotional, and mental development. However, if this stage of development does not occur in a safe, supportive environment, then a mental disorder may occur. Individual Some of the risk factors on the individual level for adolescents include having low self-esteem, insecure attachment, difficult temperament (poor concentration, inflexibility, low positive mood), poor social skills, and extreme need for approval and social support. Although effective treatments exist for many mental disorders, unfortunately, over half of adolescents in the U.S. who need mental health treatment never receive it. Further, compared with their white counterparts, growing evidence indicates that racial/ethnic minority adolescents are more vulnerable to mental disorders but less likely to use mental health services. Minority adolescents’ underutilization of mental health services is exacerbated by their tendency to withdraw prematurely from treatment. Adolescents will not fully benefit from mental health services if they terminate treatment early (Yasui, 2007). Another risk factor is the idea that minorities may also receive inferior care because there may be little to no diversity among the mental healthcare workers who have a decreased understanding about the different mental health needs across minority groups. This insufficient or lack of diversity begets cultural insensitivities that lead to negative health outcomes, including lower treatment retention rates (“Understanding barriers to minority mental health care,” 2018). On the other hand protective factors include having physical development, high self-esteem, academic achievement, emotional self-regulation and good coping and problem-solving skills on the individual level. Sufficient mental healthcare programs must be in place to teach minority adolescents how to implement such protective factors. Family Some risk factors on the family level are parental depression, parental divorce, poor parenting, negative family environment, child abuse, parent(s) with mental disorders, and sexual abuse. When taking a closer look at the negative family environment factor, one cannot ignore that African American umemployment rates are typically double that of Caucasian Americans. In addition, African American men working full time only earn 72 percent of the average salary of their white male peers and 85 pecent of the earnings of white women (“Ethnic and racial minorities & socioeconomic status,” 2008. With this information, it is not hard to understand why mental health disorders may occur, as hierarchical needs are not being fulfilled. Protective factors on the familial level include strong family structure with clear expectations, limits, rules, and monitoring on the family level. Adolescents must feel connected to and supported by their families, specifically their parents. Parents must be able to provide a stable home environment through sufficient employment, adequate housing, and sufficient access to medical and mental healthcare. School and Peers Risk factors at this level are the environment in which the minorities receive their education and their level of academic achievement. African-Americans and Latinos are more likely to attend high-poverty schools than Asian-Americans and Caucasians (National Center for Education Statistics, 2007). This results in a higher dropout rate, as the schools lack valuable resources, teachers with lowered expectations, and less rigorous curricula. In order to combat these risk factors, schools must provide mentors for support and the development of skills and interests. School systems must begin to see the connection between adequate mental healthcare and academic achievement. A protective factor is to implement evidence-based interventions for disruptive behavior versus disciplinary actions that might suspend the child from school. This only places the child back into a dysfunctional home, where he will not receive the proper care for his mental and emotional needs. Community When it comes to minorities, the aforementioned risk factors are heightened because socioeconomic barriers prevent access to care. It must be understood that socioeconomic defines more than the ability to attain proper education, financial stability, and a perception of social class. It also emcompasses the opportunities and privileges afforded to people within their community. When a community has high poverty rates, high unemployment rates, several locations that encourage risky behaviors (e.g. liquor stores, high-interest payday loan businesses), then there is little to no emphasis placed on education, proper healthcare, and positive social connections. Community protective factors provide opportunities for engagement within the school and community to create and reinforce positive norms, enforce expectations for positive behavior, and promote psychological safety (O’Connell, Boat, & Warner, 2009). While these are community protective factors, they begin in individual homes with the community providing the resources and support to prevent the perpetuation of abuse and dysfunction. PART 3: THEORIES OF PREVENTION Advocating for Minority Youth in Sanford, Florida Albert Bandura’s social learning theory is popular among current prevention programs. According to Bandura, learning is acquired and shaped by positive and negative reinforcements (rewards and punishments), as well as by observation of other people’s behavior (Johnson, 2018). This theory is based on the idea that people can predict the consequences to certain behaviors and earn the rewards or endure the punishments. Bandura recognized the potential for using modeling as a way of directing and changing behavior. This theory can serve as a framework for a mental health awareness program for minority youth as it emphasizes “using the team or buddy approach, teaming individuals, small groups, families, and even communities, in which new health related behaviors can be modeled and reinforced, helping to set new norms” (Johnson, 2018, p. 579). In this way, peer mediation and group therapy principles can be utilized to help the adolescents learn and adapt new behaviors, thus helping reduce the chances of depression, drug-use, and/or expulsion from school. In addition to school, the social learning theory can also be applied in the home-setting. Bandura believed that children learn vicariously by observing their surroundings, so if family violence is present in the home, then the children are at risk for imitating these behaviors. They are also at a higher risk for developing mental health disorders (Abbassi & Aslinia, 2010). According to the theory, once mental health professionals learn more about the home and school ennvironment, then they can put curricula in place that will prevent cycles of abuse, mental health disorders, suicidal ideation, and antisocial behaviors. PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS Advocating for Minority Youth in Sanford, Florida Conducting research with minors in a school setting for preventive purposes and investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. This is because prevention specialists may be tempted to impose their values on this marginalized group (Hage & Romano, 2013, p. 39), although they do not have any shared experiences. Another reason mental health professionals must exercise caution is because of the historial mistreatment of ethnic minorities in a medical research setting. Historical events may bring about skepticism about the real purpose of a prevention program. The well-known Tuskegee Experiment, where over 600 African American men were intentionally injected with syphilis and not given antibiotics, which would cure them. Instead, they were given placebos, aspirin, or herbal suppliments, so the medical community could observe the disease’s natural progression in the body. As a result, the men either died, went blind or insane or incurred severe health problems due to the untreated syphilis (Green, et.al., 2013). While the Tuskegee Experiment is not an isolated incident, it does serve as a symbol of how minorities can be taken advantage of under the guise of programs of help and prevention. In addition to the exploitative research and prevention programs, there is also evidence of medical and mental health-related programs that are designed to support racist ideology. In other words, these programs are designed to show the “physical, intellectual, and emotional inferiority of minorities to justify slavery, discriminatory immigration policies, and educational segregation” (Alvidrez & Arean, 2002, p.104). Because of the aforementioned, mental health professionals must work hard to establish rapport, especially building trust, with the minority youth they are aiming to help. They must also work carefully to validate the experiences of people who may be culturally different from them. Informed consent and confidentiality are especially important with this population of adolescents because they do not have the legal right to consent, nor do they have the emotional maturity to understand the benefits and the possible dangers of participating in mental health programs. They must also understand the confidentiality has its limitations and it must be broken in some cases. Mental health professionals must understand that many minority adolecents seek validation and acceptance. If they feel these needs are being met in a therapeutic setting, but they disclose information that must be shared, then the trust that has been established may be irretrievably broken. In addition to informed consent and confidentiality, collaboration are some of the the core ethical considerations that should be taken into account when working with minority adolescents. The type of change defined in this proprosal will require systemic change; therefore, ethical considerations indicate that not only should the target population be involved in the prevention plan, but also their individual families, entire communities, and the entire school (Hage & Romano, 2013). This type of collaboration will promote trust and prevent opposing values being placed on the adolescents. PART 5: ADVOCACY Advocating for Minority Youth in Sanford, Florida Advocacy in mental health serves to promote the voice of clients, represent their interests, and encourage collaboration in decision-making. Because inequities and disparities for mental health and medical health coverage abound between minorities and their caucasian counterparts, minorities, especially adolescents, may find it difficult accessing quality mental health care. For this reason, in order to advocate for the minority youth in Sanford, Florida, certain barriers at the institutional, community, and public policy levels must be identified and dismantled. The Multicultural and Social Justice Couseling Competencies (MSJCC) provides guidance through an outline in which counselors may follow in order to identify resources and implement change. The institutional level includes schools and community programs that provide specific services and programs for adolescents. A barrier at this level is being able to provide adequate financial resources for mental health programs. The Florida Legislature created the Florida Education Finance Program (FEFP) to fund public education in a manner that would “guarantee to each student in the Florida public education system the availability of programs and services appropriate to his or her educational needs.” Funding for the FEFP combines state funds – primarily generated from sales tax revenue – and local funds – generated from property tax revenue (“Florida’s K-12 funding formula,” 2016). Many schools that service the needs of minorities are located in low-income neighborhoods, which means they do not generate enough property taxes to provide funding for extra programs, such as one that provides mental health care for the adolescents that attend the school. Any extra money the school receives is likely to go towards building maintenance, classroom resources, or academic remediation resources. Mental health care is not high on the priority list for any principal. Another barrier that was a common trend during my time as a classroom teacher is transportation. While the students may express the desire to participate in several programs offered by the school, the lack of transportation was a hindrance. However, it is feasible to expect school administrators to allocate funds for buses (gas and driver) when the building is falling apart or the school does not have adequate teachers. Mental health is not high on the priority list. The community in which these adolescents lives also set the level of importance in which mental health and mental health care is placed. According to concepts listed in the MSJCC, these values either have a positive, empowering influence or a negative, oppressive influence (Multicultural and Social Justice Counseling Competencies, 2015). As previously stated, the property taxes have a direct impact on the amount of financial resources available to certain communities. These poorer communites have residents who mostly live paycheck to paycheck, only meeting basic needs of living—food, water, shelter, and clothes. Mental health care is seen as an unattainable luxury reserved for more financially stable residents. The first step in overcoming this obstacle is the acknowledge that it exist. Oftentime, people are expected to “overcome” or “rise above” their circumstances, even when they are not provided the proper tools in which to rise above. When community leaders, such as the city council, school board, and even church leaders acknowledge the disparity of resources between the residents, then interventions may be implemented. Another barrier that likely carries the most opportunity for intervention is at the public policy level. This level involves state and federal laws and policies that directly impact communities and how well they are able to grow and thrive (Multicultural and Social Justice Counseling Competencies, 2015). Poor health outcomes for minority health, especially when it comes to mental health care, is apparent when it comes to Florida’s general population. Documented research shows that minority populaitons experience higher rates of illness and death from health conditions such as heart disease, stroke, specific cancers, diabetes, HIV/AIDS, mental health, asthsma, hepatitis, and obesity (“Minority health and health equity | Florida Department of Health,” 2020). For this reason, the Office of Minority Health was established established in 2004 by the State Legislature 20.43(9), which works alongside the Department of Health to provide consultation, training services, program development and implementation, and other necessary resources to address all of the healt needs of Florida’s minority populations statewide. References Abbassi, A., & Aslinia, S. D. (2010). Family violence, trauma and social learning theory. (Undetermined). Journal of Professional Counseling: Practice, Theory & Research, 38(1), 16–27. Alegria, M., Vallas, M., & Pumariega, A. J. (2010). Racial and ethnic disparities in pediatric mental health. Child and adolescent psychiatric clinics of North America, 19(4), 759–774. https://doi.org/10.1016/j.chc.2010.07.001 Alvidrez, J., & Areán, P. A. (2002). Psychosocial treatment research with ethnic minority populations: Ethical considerations in conducting clinical trials. Ethics & Behavior, 12(1), 103-116. https://doi.org/10.1207/s15327019eb1201_7 El Bouhaddani, S., van Domburgh, L., Schaefer, B., Doreleijers, T. A. H., & Veling, W. (2019). Psychotic experiences among ethnic majority and minority adolescents and the role of discrimination and ethnic identity. Social Psychiatry and Psychiatric Epidemiology, 54(3), 343–353. https://doi-org.ezp.waldenulibrary.org/10.1007/s00127-019-01658-1 Florida’s K-12 funding formula. (2016, April 30). Fund Education Now. https://fundeducationnow.org/ Gary, A. F. (2005) Stigma: barrier to mental health care among ethnic minorities, Issues in Mental Health Nursing Green, B. L., Maisiak, R., Wang, M. Q., Britt, M. F., & Ebeling, N. (2013). Participation in health education, health promotion, and health research by African Americans: Effects of the Tuskegee syphilis experiment. Journal of Health Education, 28(4), 196-201. https://doi.org/10.1080/10556699.1997.10603270 Hage, S., & Romano, J. L. (2012). Ethical and professional issues in prevention. In Best practices in prevention (pp. 39-46). SAGE Publications. Johnson, E., Amatetti, S., Funkhouser, J., & Johnson, S. (2018). Approaches to the prevention of alcohol use and abuse. Alcohol use among Adolescents, 103(6), 61- 88.  Minority health and health equity | Florida Department of Health. (2020, April 24). Florida Department of Health. https://www.floridahealth.gov/programs-and-services/minority-health/index.html O’Connell, M. E., Boat, T., & Warner, K. E.. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press; and U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2009). Yasui, M. (2014). Minority youth: Needs for mental health services grow with population. The University of Chicago School of Social Service Administration Magazine, 22(2).
I NEED THIS TODAY 07/18/2020 BY 6PMPlease no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recom
COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy The LGTBQ Youth Community in Memphis, Tennessee S Danziger Contents Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy INTRODUCTION The LGTBQ Youth Community in Memphis, Tennessee For many who identify themselves with the LGBTQ community coming out as an adolescent can be a painful process. They risk family rejection and as a result are much more likely to suffer from depression and suicide attempts. Moreover, the prejudice that they experience from society at large can lead to substance abuse and engaging in risky sexual behavior as methods of coping. Some other negative aspects of coming out can be discrimination in school and a feeling of not belonging or being ostracized from the spiritual home (Murray, Pope, & Willis, 2017). The focus of this portfolio will be the youth in this community and how to best support them. This can be especially challenging considering that Tennessee is part of the “Bible Belt” and has a history of intolerance. ­­­­­­­­­ PART 1: SCOPE AND CONSEQUENCES The LGTBQ Youth Community in Memphis, Tennessee The target problem that will be addressed is the rate of mental health issues in the LGTBQ youth community. For the purpose of this portfolio, the scope of mental health issues will include, but not limited to; depression, anti-social behavior, risky sexual behavior, suicide risk behaviors, alcohol and drug addiction. Growing up in the South has memories attached to it, just as all regions do. The typical ones that come to mind are football, Church on Sundays, minding your manners and dating your heterosexual high school sweethearts. The South historically does not bring up images of tolerance for those who did not fit the mold. That being said, growing up under the LGBTQ umbrella in the South has gotten progressively better over the years and this is something that as Southerners we can be proud of. However, the GLAAD organization also reports that people in the South are more uncomfortable with the LGBTQ community then the US as a whole (glaad.org). This of course trickles down to the younger generation and that has a negative impact. The result being that coming out can be a risky and scary prospect to an adolescent, which in turn has an effect on the mental health of the LGBTQ youth of my community here in Memphis. What is being shown statistically is that there is a relationship between teens that are coming out as LGBTQ to their parents, being rejected and mental health issues. The result is a marked increase in depression and suicidality because of this experience. Moreover, this situation can also lead to some of the issues mentioned above such as risky sexual behavior and drug or alcohol abuse (Rusow, Goldbach, Rhoades, et al 2018). While on the national level, gay rights have improved greatly the numbers of LGBTQ youth who are struggling with mental health are still rising. The consequences of these situations are multifaceted and impact many areas of the community. The first causalities of course, are the families that are either broken or even destroyed by abending a child for being who they are. The child who is now cast out of their home may have no other place to live other than a shelter which may or may not be a safe place. Typically, though the youth will decide to live on the streets and live as homeless which impacts their ability to remain healthy both mentally and physically. Secondly it impedes their ability to attend let alone be successful in school or hold down a job. The teens can also be at a higher risk for drug and alcohol abuse which can increase crime in the community. This in turn impacts the neighborhoods and communities. In other words, the impact is felt throughout the community when a child is rejected. The goal is offering services for both teens and their parents that can offer educational and counseling services. These services can then be used to guide teens in the coming out process and support the parents once their teen has come out. Then hopefully the rise in mental health issues and suicide can be prevented. PART 2: SOCIAL-ECOLOGICAL MODEL The LGTBQ Youth Community in Memphis, Tennessee The main risk factor that LGBTQ youth face when coming out is rejection. Looking at this issue from the social – ecological model, is that the risk is a concern at all levels. When a youth comes out as LBGTQ they are risking rejection from family, friends, their community and their cultural affiliation. Moreover, the chronic stress of knowing that they may be rejected or ostracized once they do come out that can be one of the factors that lead to negative mental health outcomes (Taylor, 2019). There are other risk factors that these youth face such as victimization, discrimination, self-blame and substance abuse. What is important for the adults supporting LGBTQ youth is knowing what protective factors are necessary to mitigate these dangers. The first protective factor comes from the individual, and that can be gained from feeling pride and a strong sense of self. The development of self-esteem and self-identity ties into having resilency when there is negative feedback about being a part of the LGBTQ community (Murphy & Hardaway 2017). Moreover, these protective factors help shield the youth from negative mental health issues, substance abuse and homelessness. A risk that is taken by an LGBTQ youth when coming out to their family is being rejected. This rejection leads to higher rate of homelessness and suicidality which is a major public health heath issue for the youth in this community (Rusow, Goldbach, Rhoades, et al, 2018). The most important protective factor for teens is acceptance of their LGBTQ status by their family. The statistics demonstrate that this acceptance leads to higher levels of self confidence, physical and mental health. Moreover, teens who remain at home in a safe environment are significantly more protected from depression, substance abuse, suicidal ideation, self-harm and of course homelessness (Taylor, 2019). During the stage of life that is adolescence, the peer group and the school setting are frequently the same. When a teen comes out the importance of their peer group and school community cannot be downplayed. Similar to the teen who is accepted by the family, the teen who is accepted by their peers has a lower risk and is more protected from depression, suicidal thoughts and substance abuse. Again, they also report a higher level of self esteem, better physical health and a higher level of achievement in school. Interestingly, LGBTQ youth who have friends are less likely to suffer from the effects of victimization, that is not to say that they will not encounter it, it is just less painful and inflicts less damage. In terms of the school setting, when the school sets the tone for being open and accepting of their LGBTQ youth it does have a tendency to trickle down to the student body (glaad.org). For example when there is a Gay Straight Alliance Club on school property, it is a strong example of the school being a safe place for their LGBTQ youth. This can lead to a better sense of belonging and less victimization for the youth who has come out. Secondly, when the school teaches inclusive curriculum about the LGBTQ community as a whole this also leads to a feeling of inclusion and safety (Taylor, 2019). The issue of culture and community for LGBTQ youth is complicated, because it is dependent on how the youth defines those words. If a youth defines themselves as part of a minority, for example as a African – American, Asian – American, Latino or Jewish and they feel pride and connection to their heritage then their culture and community could be a protective factor for them. LGBTQ youth who felt pride in their culture had a statistically better chance of graduating high school, not facing substance abuse and not being homeless (Murphy & Hardaway, 2017). However, the flip side of this is that youth in these minorities were less likely to come out to their families because they would face rejection from their familes and their communities (Sue & Sue, 2016). Therefore they make the choice to stay connected to who they are in one aspect, but hide their sexuality because the consequences are too great. From the greater community stand point the change has to come from all of us, from the community as a whole. While steps are being made, such as gay marriage being legalized in 2015 and the latest ruling of the Supreme Court which bans discrimination based on sexual orientation or gender identity. These changes are important, but changes must also be made on the local and state level. However, just as importantly are the shifts in attitudes that are necessary in every home that have negative or discriminatory attitudes toward the LGBTQ community as a whole. Until that is done the battle will not be won. PART 3: THEORIES OF PREVENTION The LGTBQ Youth Community in Memphis, Tennessee This portfolio works to establish the betterment of LGBTQ youth in Memphis, Tennessee. The goal is offering services for both teens and their parents that can offer educational and counseling services. These services can then be used to guide teens in the coming out process and support the parents once their teen has come out. Then hopefully the rise in mental health issues and suicide can be prevented. In other words, to address the fact there is a problem a work to create interventions to solve that issue before it becomes a public health issue. Within the realm of prevention there is one theory that most directly works with goal stated here, that is the Ecological Theory. That theory addresses that health requires a multilevel approach and is not flat, so to speak. More tightly defined, that can be said to mean that the levels are; Intrapersonal Level where the person’s individualities are what drives the process Interpersonal Level where people’s processes within primary groups such as friends and family give support, identity and definition of roles. Community Level, which include institutional factors, community factors and public policy. Within these are norms of society, recommended behaviors and government policies (cancercontrol.cancer.gov) A second important aspect is that within this Ecological model, we influence those around us. Of course the modern example being wearing of masks. Should the majority of an interpersonal group set the example of wearing masks, then the reciprocal causation can be that others do and that moves to other interpersonal groups. Within the scope of this portfolio, and the prevention of mental health issues with LGBTQ youth, this Ecological Theory model fits quite well. The first step for a youth to come out begins with themselves, the Intrapersonal Level. Their own characteristics, knowledge, personality and beliefs will be some of the driving factors in how to handle their own personal situation. Is their belief in themselves strong enough that they will be able to withstand possibly being ostracized from their peer group for example? On the Interpersonal Level, does the youth have connections to friends or peers who are also LGBTQ that provide support and help them define their identity before, during and after the coming out process? Lastly, at the Community Level, what has been done and what is being done to change the homophobic behavior in the Memphis community? What legislation is on the table at the local and state level? What steps are being take on social media to change the homophobic attitude that is still prevalent in our community. The Ecological Perspective Theory is successful in numerous situations as a theory because it does employ the three levels mentioned of intrapersonal, interpersonal and community level. Moreover, researches subscribe to this theory because of its ability to combine different levelts of country (community), family structure (interpersonal) and intrapersonal. Thus making it a sound theory (Perry & Wadsworth 2017). An evidence based program typically can be demonstrated in balance sheets and number of success stories. For the argument of the portfolio, evidence based program will be reliant on the published information of the organization OUTMemphis. The organization offers a to LGBTQ youth Health & Wellness offerings that have grown through donations and community support. From its inception in 2009, the program has added; sexual health, mental health, intimate partner violence, spiritual health and substance abuse (outmemphis.org). Moreover the program has increased in the numbers of community members it can service on a daily basis. PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS The LGTBQ Youth Community in Memphis, Tennessee While all LGBTQ have a history of being subject to mental health issues, the subgroup of transgender youth has had an even tougher road. The term transgender can be defined as a person who is gender incongruent, in other words their gender identities do not match their sex assigned at birth (Anderssen, Sivertsen, Lønning, et al, 2020). As mentioned previously, LGBTQ youth have higher rates of depression and suicidality. Moreover, they also are faced with issues such as risky sexual behavior and drug or alcohol abuse (Rusow, Goldbach, Rhoades, et al 2018). Youth who are transgender face additional situations of being stigmatized and bullied because they do not conform to their assigned birth sex. As a result, they have even more significant rates of isolation, loneliness, victimization and discrimination which in turn leads to higher levels of mental health problems (Weinhardt, Xie, Wesp, et al 2019). A prevention program that would address the specific problems that transgender youth face would include two specific mechanisms. The first mechanism would be teaching the community at large, and the family specifically that the respecting of gender variance with acceptance and flexibility is critical. Moreover, that being cisgender is not the defining characteristic of a person (Weinhardt, Xie, Wesp, et al 2019). The second mechanism is the teaching of educators that children who are trans need support within the educational systems. How teachers should appropriately react to the transgender child and protect them from peers, administrators and the system itself who may not be advocating appropriately (Murray, Pope, & Willis 2017). This in turn would set the example for the children within the classroom and therefore normalize the experience of being transgender. Prevention programs also bring within them ethical considerations that must be dealt with appropriately. One of the first ethical dilemmas that can be brought up is that of informed consent. Prevention programming typically involves large groups, so who does provide the program the consent (Hage, & Romano, 2013)? This issue can be especially sensitive when dealing with youth, and specifically transgender youth when parents may feel that it is not their consent to give depending on the age of the child, even though legally they have the right up until the age of eighteen. A second issue to consider is confidentiality. Confidentiality is a cornerstone of the therapeutic relationship, so how does that factor into a prevention program? Moreover, prevention programs can and do frequently deal with sensitive issues. How to balance intervening with a prevention program for an individual when it would be a breach of confidentiality is an ethical dilemma (Hage, & Romano, 2013)? In the case of a transgender youth, if a counselor knew that a child was having a difficult time in class and the parents were unaware it would be breaking the confidentiality to speak to them. Moreover, there was program within the school for parents of transgender kids to help learn to be an advocate. Therefore, it would be in the best interest of the child speak to them, because they could be engaged in the program and better protect their child. Lastly, stakeholders are critical to the consideration of a prevention program. A stakeholder is a person or organization who has a vested interest in the success of the program. For the transgender youth, those can be parents, educators, LGBTQ organizations, community leaders and legislators. All have reason to make sure that this subgroup is protected from isolation, bullying, victimization and discrimination. PART 5: ADVOCACY The LGTBQ Youth Community in Memphis, Tennessee Advocacy basically can be defined as representing and defending the cause or group for which you stand for. In the case of this portfolio, that would be the LGBTQ youth of Memphis, Tennessee. According to the Multicultural and Social Justice Counseling Competencies (2015), institutional barriers have been defined as social institutions that are in our society such as schools, churches and organizations within the community. This is demonstrated for LGBTQ youth as bullying in schools, being ostracized from churches and being made to feel unwelcome at many organizations within the community. The community realm is defined in the Competencies (2015) as the normative values, and regulations of the society that can be either empowering or harmful and stifling to the growth and development of the group in question. There is evidence presented in this Portfolio that LGBTQ youth is not empowered by society and their ability to grow is stifled by what is concerned “normal”. This is evidenced by the high rates of risky sexual behavior and drug or alcohol abuse and other mental health issues (Rusow, Goldbach, Rhoades, et al 2018). Lastly is the public policy level which is concerned with local, state and federal policies and laws that standardize or effect the development of human growth. In this realm the LGBTQ community as a whole has made great strides with the legalization of same sex marriage, more protection against discrimination, better laws for same sex couples to adopt and spousal rights. While these are all enormous steps, they have yet to really make the necessary impact on the daily lives of LGBTQ youth. This is where the importance of advocacy would step in. Now that the levels have been defined, how best to advocate at each of them? Within institutions advocacy is worked on through a number of different avenues. The first one being antidiscrimination policies that are strictly enforced and specifically created to protect the LGBTQ youth. These are in the schools, churches and community organizations. Secondly, there is LGBTQ training for staff that works to teach them about norms within that community. Lastly, there is the establishment of gay-straight alliances which are a protective factor for the LGBTQ youth and a teaching tool for straight youth (Watson, Varjas, et al 2010). Within the community, the task of addressing the stigma of homosexuality is much more difficult. One tactic is to bring together different groups and essentially create Gay Straight Allianaces within them. Many times people fear what they do not understand, and this is no different with the LGBTQ community. By creating these alliances, the members can then go back to their own part of the world and share their knowledge, therefore lessening the stigma and unknown. Hopefully then paving the way for changing the norms of values of society. The last area is that of public policy. As mentioned above, in this area the LGBTQ community has made great strides. However, more needs to be done as there are many states, especially Tennessee where there are laws on the books that legalize discrimination. As always in a democratic society the best way to change what is unsavory is to change the lawmakers by voting them out of office. For a marginalized group this can mean finding other groups that share their viewpoint and joining forces to create a grassroots effort to back a candidate. Moreover, it can be important for the LGBTQ community to put forth a candidate who is gay, queer, bisexual or transsexual for example to help normalize and remove the stigma. Using the platform of the candidacy as a way of displaying that though they are a member of the LGBTQ community, they are also a member of the community at large. Advocacy is needed at every level, until the community that is being advocated for is fully protected. For the LGBTQ youth, that means safety in schools, churches and community organizations. That moves on to the removal of all stigmas and discriminations that are normative within society and just as importantly through laws. Advocacy cannot end till the rights and freedoms of the marginalized groups are completely protected. References Anderssen, N., Sivertsen, B., Lønning, K. J., & Malterud, K. (2020). Life satisfaction and mental health among transgender students in Norway. BMC Public Health, 20(1), 138 https://cancercontrol.cancer.gov/brp/research/theories_project/theory.pdf https://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=20 Caputi, T. L., Smith, D., & Ayers, J. W. (2017). Suicide Risk Behaviors Among Sexual Minority Adolescents in the United States, 2015. JAMA: Journal of the American Medical Association, 318(23), 2349–2351. https://www.glaad.org/ https://gaycenter.org/programs/mhss/yes.html Hage, S., & Romano, J. L. (2013). Best practices in prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 32-46). Thousand Oaks, CA: SAGE. Murphy, J., & Hardaway, R. (2017). LGBTQ adolescents of color: Considerations for working with youth and their families. Journal of Gay & Lesbian Mental Health, 21(3), 221–227 Murray, C., Pope, A., & Willis, B. (2017). Sexuality counseling: Theory, research, and practice. Thousand Oaks, CA: Sage  Nutt, A.E. (5 C.E., Autumn 2018). Survey finds widespread feelings of fear and rejection among LGBTQ teens. Washington Post, The Perry, J. M., & Wadsworth, S. M. (2017). Work and Family Research and Theory: Review and Analysis From an Ecological Perspective. Journal of Family Theory & Review, 9(2), 219–237. https://www.outmemphis.org/ Rusow, J. A., Goldbach, J. T., Rhoades, H., Bond, D., Lanteigne, A., & Fulginiti, A. (2018). Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services. Child Psychiatry & Human Development, 49(4), 643–651 Sue, D. & Sue, D. (2016). Counseling the Culturally Diverse. John Wiley & Sons, Inc. Taylor, J. (2019). Mental Health in LGBTQ Youth: Review of Research and Outcomes. Communique, 48(3), 4–6 Watson, L., Varjas, K., Meyers, J., & Graybill, E. (2010). Gay-Straight Alliance Advisors: Negotiating Multiple Ecological Systems When Advocating for LGBTQ Youth. Journal of LGBT Youth, 7(2), 100–128 Weinhardt, L. S., Xie, H., Wesp, L. M., Murray, J. R., Apchemengich, I., Kioko, D., Weinhardt, C. B., & Cook-Daniels, L. (2019). The Role of Family, Friend, and Significant Other Support in Well-Being Among Transgender and Non-Binary Youth. Journal of GLBT Family Studies, 15(4), 311–325 Winkel, G., Saegert, S., & Evans, G. W. (2009). An ecological perspective on theory, methods, and analysis in environmental psychology: Advances and challenges. Journal of Environmental Psychology, 29(3), 318–328
I NEED THIS TODAY 07/18/2020 BY 6PMPlease no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recom
COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Social Change Portfolio J. Cosme Contents Below are the titles for each section of the Social Change Portfolio. To navigate directly to a particular section, hold down and click on the desired section below. [Please note that in brackets throughout this template you will see instructions about information to include in each section. Please delete the instructions that are found in brackets, including this message, and replace the bracketed instructions with the relevant content for each section]. Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy INTRODUCTION Social Change in Action: Prevention, Consultation, and Advocacy Sex trafficking is the exploitation of any person by means of sexual exchange by way of transporting them from one place to another against their will. The victim is coerced and recruited by a trafficker in a variety of ways, provided for in some small way, transported to a different location, harbored against their will and then made to give sexual favors to the trafficker’s clients. For the victims who are not rescued or who do not escape, they are trapped in sexual slavery. They are provided food, clothing and many times travel by force of their traffickers, even abroad, to fulfill the requests of the clients they serve. Victims are targeted when in distress, having low self-esteem, being a run-away or just being naive to manipulation. Both boys and girls are victims of this global health crises with girls entering the trade, generally, at 12-years-old and boys as young as 11-years-old, generally (U.S. Department of Justice, National Center for Missing and Exploited Children, United Nations Office on Drugs and Crime, n.d.). My goal for this target population is to regain self-efficacy and rebuild their lives to become positive contributors of social change in their communities to help prevent the spread of this plague. PART 1: SCOPE AND CONSEQUENCES Social Change in Action: Prevention, Consultation, and Advocacy I will be focusing on the target health problem of sex trafficking in Phoenix, AZ. Sex trafficking is most prevalent in the United States (Fortune, 2020), contributing to a billion dollar industry (Niethammer, C., 2020) and is the second largest industry in the world. Arizona is a hotspot for traffickers because of an ideal climate, many major sporting attractions that make maneuvering with victims seemingly undetectable and connection to five different U.S. borders not including Mexico, leaving traffickers and their victims various points of entry and escape. The Polaris Project (2020), a non-profit that operates the National Human Trafficking Hotline, details there are three top trafficking tiers which are sex trafficking, labor trafficking and sex and labor trafficking. Labour trafficking, as you can imagine, is when a trafficker lures an unassuming victim to prospects of a better life through employment, details of which are never true, only to hold onto the victims credentials so they cannot escape once arrived. Victims are enslaved, forced to work under illegal conditions, under paid or not paid at all, beaten, raped and many times killed for fear from the trafficker of revealing the operation. Of these three tiers, there has been a 25% increase in cases from 2017 to 2018. There have been 23,078 survivors identified, 10,949 human trafficking cases, 5,859 potential traffickers and 1,905 suspicious businesses. A screening tool called QYIT (Quick Youth Indicators for Trafficking) was validated (Children and Youth Services Review, 2019) and found that homeless youth were the most susceptible to become trafficked. For an estimated year and a half, 307 participants were assessed with results being 66.7% (20) had been sex trafficked, 46.7% had been labor trafficked and 16.7% had experienced both forms of trafficking (Children and Youth Services Review, 2019). Completely thorough estimates of trafficking victims cannot be known because of the unscrupulous nature of the crime (Farrell, McDevitt, & Fahy, 2010; Farrell & Pfeffer, 2014; Farrell & Reichert, 2017; US Department of State, 2002, US Department of State, 2006). All forms of trafficking are heinous, however, child sex trafficking is especially horrific for obvious reasons and therefore has been my focus. There are endless mental and physical consequences in all of these circumstances (Greenbaum, J., & Bodrick, N., 2017) and they must be vindicated by reform. In Arizona specifically, the local government agencies and non-profit organizations have taken a stand to become a model for the rest of the country to stand, fight and disband all forms of trafficking. These offices make a loud voice to be heard throughout the state that trafficking will not be tolerated here and for that I am grateful. There is a task force comprised of police, social workers, public agencies and other resources that make up a coalition against trafficking in Arizona as a preventative measure, they can be found here: https://www.phoenix.gov/district2site/Documents/City%20of%20Phoenix%20COMPASS%20Plan.pdf. Overall, human slavery never ended, it just sounds different. Whether labour or sex or both, people are not free and are living their days in misery and grief. Preventative measures will only help those in need if it is a collective effort. Education on what the signs are, what numbers to call, how to help and how to stay vigilant is a great start of fighting this global problem. PART 2: SOCIAL-ECOLOGICAL MODEL Social Change in Action: Prevention, Consultation, and Advocacy For women and children, risk factors are early teen pregnancy that leads to fistulas for girls. This medical condition plagues a young women, many times for the rest of her life and leaves her with a stigma of being tainted and unclean forever damaged goods. For women, they are left with unwanted pregnancies, forced abortions or death in child birth because of so much trauma and stress. These all would be biophysical risk factors (American Mental Wellness Association, 2020). There is also the burden of addiction to hard drugs. These women and children are drugged by their captors in order to cooperate and ‘perform’ so many times they become addictive to the substances and then start ‘needing’ them to survive. If they are allowed to survive and be set free, they are many times junkies and addicts, destitute and lost. They no longer fit in with peers their same age and are among a community that shuns them. Only the fortunate ones will be supported in a community that is knowledgeable and understanding, having the resources and education that fits them with compassion and empathy to help those until they can help themselves. The goal is to educate these women and young girls to understand that what they went through is an abnormality, a treacherous mishap and not all men behave this way. These would be social risk factors (American Mental Wellness Association, 2020). The goal here is to have them avoid thinking that the kind of men that abused them are the very men they should pick as mates. The goal is to help them see the positive aspects a male partner can bring, such as peacemaker, provider, protector and friend. With a supportive family structure, these women and children will hopefully have the tools to restructure their lives with positivity and balance. It is also important to assess what kind of family structure these clients are coming from and dealing with. In no way should a client be replaced into a family structure that is in any way a threat to their psychological or physical wellbeing. This would be considered a biophysical risk factor (American Mental Wellness Association, 2020). A great way to reacclimatize themselves into society is through education. Going back to school is a great way to distract with positive influences, become involved in extracurricular activities that stimulate them mentally and physically and also to make friendships they can trust. Depending on their cultural background, all or some of these different aspects of readjusting may take a different path or need to be approached more creatively. However, depending on their unique circumstances, family support and determination, there are many avenues of reform to choose from. PART 3: THEORIES OF PREVENTION Social Change in Action: Prevention, Consultation, and Advocacy Human sex trafficking is literally a cancer embedded in our global society. One attempt that might prove successful is to combat it with structured theory(s) to help the individual strategically outline a method of success. This theory can also translate to effected communities at large. Greater numbers of trafficked survivors come from communities rooted in cultural norms that promote, advance and make trafficking an all too easy and common occurrence. Implementation of specific theories to plan, develop and sustain community programs have proven effective (National Cancer Institute, 2005). A theory that would provide introspection and prevention would be the theory of planned behavior, which focuses on “behavioral intention, attitude, subjective norm and perceived behavioral control” (National Cancer Institute, P. 16, 2005). This would be especially useful to implement into the education system with the hopes of eliminating runaway youth. Giving these young adults insight into how their decisions most likely will play out in the real world quite possibly may deter many from making hasty decisions that could affect their lives forever. Runaway and homeless youth, youth that drop out of high school or receive their GED are more likely to become sex trafficked (Greeson, Treglia & Wasch, 2019). It is common that youth cannot foresee how their immediate behaviors have long lasting affects not only for them but for their communities at large. It would be helpful and preventative in some respects to give them the big picture and their part in it. Playing out scenarios with questions to be answered by them, followed up with researched responses and statistics of outcomes would be sobering in the very least. Suggested questions and conversation starters could be as follows: If you ran away, where would you go? How would you support yourself until you graduate? Provide a detailed account of how to get and sustain housing, food, supplies and transportation. Unfortunately for those youth who must leave their homes for their own health and safety and are placed into a shelter or foster care agency, they too are at great risk for commercial sex trafficking. 98% of children who had been sex trafficked had a background of foster care and were trafficked and abused while being in the care of the state (University of Nebraska at Lincoln, 2013). The majority are female, Latino, high school drop outs or have acquired their GED (Greeson et al., 2019) and a longer sex history, involvement with authorities and a history of violence (Varma, Gillespie, McCracken, Greenbaum, 2015). Many high school graduates do not know how to balance a checkbook, apply for an apartment, write a letter or access resources available to them in their community to help sustain themselves if an emergency arose. It is important not just to point out these areas of lack, but to give them the knowledge and present them with introspection as to sort out a better plan if leaving their current situation is a must. Providing them with all of the statistics and areas of concern that face them if they were to venture out into the world predestined, would at least pre-warn them of dangers that face them. Research shows that through stages of the precaution adoption process model, with its 7 stages, it advances an individual from being unaware of an issue with decisions and outcomes reflecting that, to maintenance of the circumstance having been fully aware of the outlying influences (National Cancer Institute, 2005). According to the U.S. Department of Health and Human Services (2018) evidence-based research has found significant results with runaway and trafficked children while implementing the following: Advocates and health personal will identify and unify with medical providers and their resources in the community to form alliances to help survivors of trafficking. Advocates and medical personnel will seek to minimize barriers for survivors to get necessary healthcare Success is measured by efforts to reduce isolation and to improve options for safety, health and healing Healthcare personnel should screen potential victims privately and be fully receptive and attentive while doing so Go beyond yes or no questions Assume possible victims are not comfortable with disclosure, therefore, take more time with them explaining the confidentiality process Inform potential victim of their right to speak alone with the Dr. Make it effortless for potential victim to speak alone with doctor by having signs throughout clinic/care facility of one patient at a time Look for red flags and know what to say and do for potential victim Confidentiality is a necessary must to understand and implement throughout the medical relationship; Dr. should give contact information with minimal information on it but the receiver knows it is a helpline Universal Education for all resources involved to be on the same page and readily available to understand various situations of healing; willing to help Empowerment / altruism; others find strength in helping others Promote harm reduction for those in abuse Warm referral; having connection to local advocacy program (let them use Dr. phone to call if safer) Identify strengths of potential victim; how they survived, took care of, helped friends survive (empower) Know latest terms of youth; street language communicated amongst themselves as code Healthcare professional needs to be comfortable talking about sex with youth Consider that boys can be victims too; mindful of language – do not assume boys cannot be victims, therefore treat necessary assessment questions with dismissive attitude (boy will instantly know this is not a safe/knowledgeable person to talk to/confide in. PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS Social Change in Action: Prevention, Consultation, and Advocacy The population I chose to work with is children survivors of sex trafficking and the subgroup would be those children whose cultures sustain/enforce it. Children under this subgroup are exposed and victimized by this crime at an increasing rate (Mourtada, Schlecht and DeJong, 2017). The reason human sex trafficking is so globally prevalent is because child marriage is the loop hole to keep this syndicated crime organization constantly fueled. Cultural norms from around the globe allow, more girls than boys, to become the spouse to an adult. There are countries on every continent that houses the practice of child marriage as legal and, sometimes, common. Kenya, Sri Lanka, Nepal and India are the top contenders for the most child marriages globally, leaving Africa and Asia to be the biggest proponents of child marriage (UNICEF, 2014). Most of the reasoning behind these practices are tradition and religion but poverty and ignorance also play their part (Millett-Barrett, 2019). By ignorance, I mean a poverty stricken household in Africa might send their adolescent child off to live with a distant uncle for a better way of life. That uncle might have alternative notions toward the girl or might get propositioned later by someone else for a price that can not be refused. There is no communication between the uncle and the child’s parents because her parents fo not have a phone/electricity. The parents may not find out the child has been sold off for months or even years. In the Middle East, various emirate states might have child marriage banned under their civil codes. However, all emirate states are all under Shari Law which is also enforced by federal law since 2005, which allow child marriage. In all emirate states, Muslims and non-Muslims are held by these laws. The Quran, the Bible of the Middle East, indicates that Muhammed married his bride at the tender age of nine-years-old. For them adolescents for boys are twelve-years-old and for girls it is nine-years-old. These are the ages considered old enough to be wed because if it was suitable for the prophet, who can argue differently? In America, there are several states that allow minors to marry with their parental/guardian consent. For those living in the US but come from cultures outside of the US with the normal custom of child marriage at ages 14-years-old and below, the child needs not to consent, only parental signatory in front of a judge and a clerk to take the check. This is permitted because the US government, as it stands today, feels they need not interfere in the traditions and customs of those born outside their borders, even though those same customs are illegal on paper for US-born citizens. For example, if a Saudi man living in the US wanted a child bride, all he would have to do is go to Saudi Arabia or whichever country of his choosing that permits such a practice, obtain legal documents of marriage and to travel abroad, come to America with his documentation and have his child bride living with him here and no authority could arrest him. The girl would be helpless in a tangled system. In Arizona, where I live, prior to 2006, there was no legal minimum requirement to marrying children. A bill was presented to ban child marriage for those under 18-years-old, but some republican lawmakers thought that would be too restrictive (azcentral, 2020). Today, the minimum age of consent in Arizona is 16-years-old only with parental consent. There are still many concerns with marrying at such a young age. Of course, not all children are the same, leaving those without the body structure to bare children at extreme physical disadvantage when carrying a child and giving birth. Fistulas are common among bodies not mature enough to handle childbirth. Mentally, children of all ages struggle with the challenges of marriage and the responsibilities therein. Scientifically, the cerebral cortex is not developed within a human being until they are twenty-five-years-old that impacts their decision making capabilities. This is why car insurance is always higher for those who are under this age. I find it ironic how one can be unfit to vote until they are eighteen-years-old on matters that affect their lives and their communities for only four years, but can be given the platitude of making a decision that will last them, potentially, their whole life. The mechanisms that might have some significance in this community would be awareness of current literature that supports the physical, mental and emotional long-lasting adversities and negative affect that will last a lifetime (Hage, S., & Romano, J.L., 2013). Community support is another huge strategy in gaining recognition from parents and children alike. Many collectivist cultures rely strongly on cultural norms and need a sense of belonging to their community. When something is introduced that goes against the norm of the community, it is readily rejected as the people do not want to feel like or be treated like an outcast. Outside of counseling, community outreach to spread awareness to the matter, to get the community talking about the varying dangers that surround child marriage with proof and examples, experiences and lives lost can make a difference (Vera, E. M., & Kenny, M. E., 2013). Regarding ethical guidelines regarding this topic, I always pondered what to do in conflict between ethical demands and legal parameters. According to the American Counseling Association (2014) a counselor’s duty is to prevent harm to the client, while acting in correlation to current laws (I.1.c). However, if those laws are in direct conflict with the child’s welfare but the children/parents themselves cannot see the conflict because of cultural norms, this is where I would have to seek guidance from peers/supervisors. Regarding confidentiality, of course I would explain to the client my obligation to keep all exchanges, verbal or written, electronic or otherwise strictly prohibited from anyone outside of maybe insurance personnel. However, with the exception of harm, whether to self or another, I would remain a closed diary. In these situations, confidentiality would be stressed because the very nature of the business would be under duress; client confiding in me abuse. Parents/spouse may be causing said abuse. Above all else, the client’s welfare must come first and foremost while acting within legal parameters. I still may need supervision, because as I said, the nature of these conversations is difficult at best. PART 5: ADVOCACY Social Change in Action: Prevention, Consultation, and Advocacy Advocacy across all spectrums is of dire need for the population of survivors of sex trafficking and prevention. This is a domain that does not have to exist. Countless efforts are already in place for the prevention and advocacy of this marginalized group, but still, more has to be done to eradicate it completely. On the individual and client level, this group needs to be understood on a micro and macro level. Most of these survivors are young girls, limited education, and no resources of their own. They have been duped into a system of unforgiveness and hardship so by the time they come to counseling, they should not be expected to detail every event for the counselor to understand their story. Every story will be different but the broad outline is the same. An undeserved youth was mistreated in the worst way and now have to pick up the pieces to their lives. Becoming knowledgeable on who is targeted, where they are picked up and by whom, where they go and what becomes of them are all questions to be sought after before the client comes in. Variations will exist of course, but the underlying story will be the same – they were targeted for profit. These children and young adults need special attention. According to Chisolm-Straker, Macias-Konstantopoulos, Landerholm, Marjavi & Douglas (2018) the attitudes and belief systems of each client may be different considering culture, values, community status and experiences. Considering from whence they came, the counselor should be knowledgeable of the experiences of underprivileged youth and the biases they face for having a very unique history. According to MJSCC (2015) It is important to note to the client their strengths and value and work with them from their strongest point – wether that be an optimistic mindset to how they managed to get out of that world or possibly helped their friends out. That takes courage and determination – all highlights. At the community level, school in particular, one barrier for this marginalized group is that not enough faculty and friends know the signs of one who could be trafficked. Yes, there are trafficked girls still going to school every day and they are distinct from their peers. Not realizing a problem exists is a bigger problem than the problem itself. There needs to be after school programs easily accessible for these youths if they can’t or don’t want to go home to escape to, people who understand that work there are assets. At the public policy level there needs to be legislature that mandates minimum age requirements for marriage and dating which is enforced and enforceable by local authorities including school officials. Much of the experiences these trafficked girls go through have been launched by a sexual history that started in high school or even middle school. These experiences give them false courage to explore the dangers of the unknown beyond their school fence. There needs to be more monitoring of online chats also because much of the conversation is initiated through fictional online personas. The community involvement needs to be more involved by knowing who their children are. From councilman to neighborhood watch, people should know who their neighbors are, who lives on their block, in their neighborhoods and when they see a young girl with a much older man, it should be understood why intervening to strike up a conversation could mean the difference between this girl being trafficked or going home that day. Currently, the consensus is mind your own business or that’s not my problem. It’s everyone’s problem when the child comes up missing or dead and then the community is left with a grieving family, loss of work, dependency on the government, tax dollars going toward death arrangements etcetera. In Arizona where I live, they are so strict on trafficking of any kind and that’s progress, but much still has to be done. Injustices towards these young people are happening at the local, state and federal level by the very people creating, enforcing and sustaining the laws that are supposed to be protecting them. Public policy is so important to pay attention to because through loop holes is how these young people get abused and keep getting abused with little power from anyone to stop the perpetrators. Voting appropriately by citizens is vital at the local and federal level to make sure candidates have these issues on their radar and have action plans to fight back against this infestation. Counselors also need to be knowledgeable of multicultural backgrounds of clients and know how to address them, what their cultures deem acceptable, what the goals are, the type of lifestyle they came from and are expected to go back to. Questions like is it appropriate for a young, single woman to be alone with a male counselor? Is it culturally respectful to look this client in the eye or expect that in return? There are nuances to any relationship but cultural variations along with an already sensitive topic needing discussion can brew mismanagement and discomfort. According to MJSCC (2015) counselors should do all they can to make known the different aspects of culture, expectation, stigma, community stance and parental consent as much as possible before even seeing the client. Even if the counselor is wrong on some aspects, a thorough investigation of the client’s culture can go a long way in a session and prove to the client that they care, are well versed within their traditions and customs and make the client feel more prone to trust and open up with someone who obviously took the initiative to know as much as possible about them. There are resources available at the local, state and national levels for trafficking survivors such as: Office of the Arizona Attorney General 2005 N Central Ave Phoenix, AZ 85004 602-542-2123 TRUST Training and Resources United to Stop Trafficking 1-844-TRUSTAZ (1-844-878-7829) [email protected] Department of Justice * Office of Justice Programs OVC Office for Victims of Crime 810 Seventh Street NW., Second Floor Washington, DC  20531 Phone: 202–307–5983 References 2018 U.S. National Human Trafficking Hotline Statistics. (2020, February 13). Retrieved from https://polarisproject.org/2018-us-national-human-trafficking-hotline-statistics/ American Counseling Association (2014). 2014 ACA Code of Ethics. Retrieved from https:// www.counseling.org/Resources/aca-code-of-ethics.pdf American Mental Wellness Association: Risk and Protective Factors. Retrieved from: https:// www.americanmentalwellness.org/prevention/risk-and-protective-factors/ Contact Us. (n.d.). Retrieved from https://ovc.ojp.gov/contact Chisolm-Straker, M., MD, MPH, Macias-Konstantopoulos, W., MD, MPH, Landerholm, M., MSW, Marjavi, A., & Douglas, V. (2018, December 3). Health & Human Trafficking Sym- posium | November 2018 | Part 4: Identifying Trafficking Survivors. Retrieved from https:// www.youtube.com/watch?v=HHB8FZp1J0c Gardiner, D. (2018, April 12). Arizona Gov. Ducey signs laws on child marriage, state dinosaur, egg expiration dates. Retrieved from https://www.azcentral.com/story/news/politics/ arizona/2018/04/12/arizona-gov-ducey-signs-laws-child-marriage-state-dinosaur- sonorasaurus-egg-expiration-dates/509474002/ Greenbaum, J., & Bodrick, N. (2017). Global Human Trafficking and Child Victimization. Pediatrics, 140(6). doi: 10.1542/peds.2017-3138 Greeson, J., Treglia, D., Wolfe, D. S., & Wasch, S. (2019). Prevalence and Correlates of Sex Trafficking among Homeless and Runaway Youths Presenting for Shelter Services, 91-100. http://dx.doi.org.ezp.waldenulibrary.org/10.1093/swr/svz001 Hage, S., & Romano, J. L. (2013). Best practices in prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 32-46). Thousand Oaks, CA: SAGE. Hotline Statistics. (n.d.). Retrieved from https://humantraffickinghotline.org/states https://fortune.com/2019/04/14/human-sex-trafficking-us-slavery/ https://www.phoenix.gov/district2site/Documents/ City%20of%20Phoenix%20COMPASS%20Plan.pdf Lillie, M. R. (2013, October 10). An Unholy Alliance: The Connection Between Foster Care and Human Trafficking [Pdf]. Lincoln: OLP Foundation. Millett-Barrett, Jennifer (2019) “Bound by Silence: Psychological Effects of the Traditional Oath Ceremony Used in the Sex Trafficking of Nigerian Women and Girls,” Dignity: A Journal on Sexual Exploitation and Violence: Vol. 4: Iss. 3, Article 3. DOI: 10.23860/ dignity. 2019.04.03.03 Mourtada, R., Schlecht, J., & DeJong, J. (2017, November 14). A qualitative study exploring child marriage practices among Syrian conflict-affected populations in Lebanon. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688503/ Multicultural and Social Justice Counseling Competencies. (2015). Retrieved October 27, 2015, from http://www.counseling.org/docs/default-source/competencies/multicultural-and-social- justice-counseling-competencies.pdf?sfvrsn=20 Niethammer, C. (2020, February 4). Cracking The $150 Billion Business Of Human Trafficking. Retrieved from https://www.forbes.com/sites/carmenniethammer/2020/02/02/cracking- the-150-billion-business-of-human-trafficking/#24e67df14142 Varma, S., Gillespie, S., McCracken, C., & Greenbaum, V. J. (2015). Characteristics of child commercial sexual exploitation and sex trafficking victims presenting for medical care in the United States. Child Abuse & Neglect, 44, 98–105. https://doi-org.ezp.waldenuli brary.org/10.1016/j.chiabu.2015.04.004 Vera, E. M., & Kenny, M. E. (2013). Social justice and culturally relevant prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 1-59). Thousand Oaks, CA: SAGE. United Nations Children’s Fund, Ending Child Marriage: Progress and prospects, UNICEF, New York, 2014.


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