Objective

Shared decision making (SDM) has been proposed as a method to improve treatment adherence, placement stability, and other youth-centric outcomes for children who have been victims of commercial sexual exploitation (CSEC). This project seeks to characterize service providers’ perspectives on the adoption and implementation of SDM into treatment and placement planning decisions.

Method

Sixteen key stakeholders who provide services for youth who have experienced CSEC in a Southern city, as well as adults who survived exploitation as children, were individually interviewed. These interviews focused on stakeholders’ perspective on the appropriateness and contextual considerations regarding implementing this model to engage youth in decision-making conversations. Interview transcripts were qualitatively analyzed using group-based inductive content analysis.

Result

While all participants acknowledged the philosophical importance of including youth in decision-making, perspectives varied on how this philosophy could be operationalized. Trauma-bonds to offenders, distrust in service systems, and policy and time constraints were discussed as potential barriers to implementation. Perceived benefits to applying this model included encouraging youth empowerment, helping youth develop decision-making skills, and strengthening relationships between youth and providers. Implementation considerations mirrored those seen in other medical and behavioral health settings, including extensive training, fidelity monitoring, enforcement through policy and legislation, and ultimately resetting the culture of services to be maximally youth inclusive.

Conclusion

Participants supported the use of SDM to standardize the inclusion of youth in treatment and placement planning decisions. However, there exist challenges in defining exactly how to adopt this approach, and how to implement broad-scale cultural change within the service-providing community.

中文翻译：

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利益相关者对实施共同决策以增强遭受商业性剥削的青年的看法

客观的

共享决策 (SDM) 已被提议作为一种方法，以改善遭受商业性剥削 (CSEC) 的儿童的治疗依从性、安置稳定性和其他以青年为中心的结果。该项目旨在描述服务提供商在治疗和安置计划决策中采用和实施 SDM 的观点。

方法

为在南部城市经历过 CSEC 的青年以及在儿童时期幸存下来的成年人提供服务的 16 名主要利益相关者接受了单独采访。这些访谈侧重于利益相关者对实施该模式以使青年参与决策对​​话的适当性和背景考虑的观点。使用基于组的归纳内容分析对访谈记录进行定性分析。

结果

虽然所有参与者都承认让青年参与决策的哲学重要性，但对于如何实施这一理念的观点各不相同。对罪犯的创伤纽带、对服务系统的不信任以及政策和时间限制被讨论为实施的潜在障碍。应用这种模式的预期好处包括鼓励青年赋权、帮助青年发展决策技能以及加强青年与提供者之间的关系。实施方面的考虑反映了其他医疗和行为健康环境中的情况，包括广泛的培训、忠诚度监测、通过政策和立法执行，并最终重新设置服务文化以最大限度地包容青年。

结论

参与者支持使用 SDM 来规范将青少年纳入治疗和安置计划决策。然而，在准确定义如何采用这种方法以及如何在提供服务的社区内实施广泛的文化变革方面存在挑战。