188 – Building an MDT for Victims of Child Sex Trafficking

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Dr. Sandie Morgan and Dave Stachowiak speak with Lieutenant Joe Laramie about the difference between multidisciplinary teams for child abuse and sex trafficking, the challenges associated with MDT, and the direction we need to move forward with. Joe is the program manager with the National Criminal Justice Training Center of Fox Valley Technical College working in the Missing and Exploited Children’s and the Internet Crimes Against Children Training and Technical Assistance Programs. With more than 30 years of child protection, investigation, and training experience he sheds light on this topic with a fresh perspective.

Key Points

  • MDT, or multidisciplinary team, accentuates that approaches with collaborative work are more beneficial than individual work.
  • The main difference between an MDT for child abuse and an MDT for child sex trafficking is the expanded team members in trafficking investigations.
  • Challenges of MDT include scheduling time and location, professional attitudes, forensic interviewer training, the role of a victim advocate, and medical evaluations.


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Dave: [00:00:00] You’re listening to the Ending Human Trafficking podcast. This is episode number 188, Building an MDT for Victims of Child Sex Trafficking.

Production Credits: [00:00:10] Produced by Innovate Learning, maximizing human potential.

Dave: [00:00:31] Welcome to the Ending Human Trafficking podcast. My name is Dave Stachowiak.

Sandie: [00:00:36] And my name is Sandie Morgan.

Dave: [00:00:38] And this is the show where we empower you to study the issues, be a voice, and make a difference in ending human trafficking. Sandie, you’ve been empowering me for eight years of learning new things on this topic and we will be down that road again today because the acronym MDT is in the title of this episode. I have absolutely no idea what that is and I’m guessing some in our listening community also, do not know what that is. So, this is going to be an education for all of us today, I believe.

Sandie: [00:01:07] Good, I always love it when I can teach you something new.

Dave: [00:01:11] We have, as always, an expert with us today that is going to really help open up the doors and help us to even learn more about this complex issue. I’m pleased to welcome an expert to the show today and that is Lieutenant Joe Laramie. He is the program manager with the National Criminal Justice Training Center of Fox Valley Technical College working in the Missing and Exploited Children’s and the Internet Crimes Against Children training and technical assistance programs. He retired in 2010 from the Glendale Missouri Police Department with more than 30 years of child protection investigation and training experience. During his time with the Glendale PD, he was Police Juvenile Officer and child abuse investigator, a D.A.R.E. officer, and in 2001 created the Greater St. Louis Internet Crimes Against Children (ICAC) Task Force. He is nationally known as a speaker on the topic of online child exploitation, child sex trafficking, and technology related protections for youth families and professionals. Lieutenant Laramie, we’re so, glad to welcome you to the show.

Joe: [00:02:15] Well thank you so, very much. I’m really excited to have this opportunity today.

Sandie: [00:02:20] We should start right at the beginning with putting Dave out of his misery here and let’s talk about what is an MDT, and why is that the best process?

Joe: [00:02:32] Well for the law enforcement officers who listen in, MDT does not stand for a mobile data terminal. That’s the computer that you normally see in police cars. It stands for multidisciplinary team. And truly, multidisciplinary teams have evolved over the last 35, maybe 40, years to address child abuse investigations and they are pretty much the standard all across the United States and in foreign countries as well. They’re building out team approaches to investigating child abuse and exploitation. And it all boils down to it doesn’t take away each individual discipline; so, that’s law enforcement, that’s Child Protective Services, it’s the prosecution, and that’s the forensic interviewer, the child at the center, the medical staff, the child advocate, and mental health. They are all part of the team and each of them has their own role, but as they work to an investigation a review of the situation and the incident of the abuse, their collaborative work is so, much better than their individual work.

Sandie: [00:03:52] That’s really powerful that collaborative work is more beneficial than all of our little individual. So, when we come together it sort of amplifies the team experience.

Joe: [00:04:07] Oh, absolutely. And it reduces trauma to the victim, it provides- well I don’t want to say one-time interview of the victim because they’re still going to be multiple interviews of the victim, but it certainly reduces the number of times that the victim has to tell their story.

Sandie: [00:04:23] Okay. So, what’s the difference between an MDT for child abuse and an MDT for child sex trafficking?

Joe: [00:04:32] Well I think the biggest difference is the members. It’s still the same type of process where people can come together, they can talk about the situation that they’re familiar with, they’re part of their investigation, the things that they need other people to help them with. But we’ve expanded out a team in the trafficking investigation to include people that you may not have even thought of before. We’re going to add foster families to the mix. And when we talk about teams, it doesn’t mean that teams all sit in the same room and talk about everything in front of everyone. So, I don’t want anybody to think that when the team comes together that this is all inclusive, everybody gets to know what everybody else is doing kind of thing. There are times when the foster family of a trafficking victim, it’s possible that the victim, the survivor, does not have a foster family, they have a regular family but many times they do have a Foster family. So, the school should be involved, the non-government organizations where they are providing services to the survivor. So, this person who has been trafficked is now receiving extra services, sometimes it’s housing, sometimes it’s mental health, sometimes it is support, sometimes it’s medical, all of those things come together, and non-government organizations oftentimes provide those. And then the last one that, in especially in the law enforcement and prosecutor world, seems so, wrong is the defense attorney for the victim, not the defense attorney for the trafficker. But the defense attorney for the victim that the person is someone who can provide very critical information to bring a holistic approach to how are you going to be addressing the victim’s needs.

Sandie: [00:06:42] So, legal representation, a legal advocate for the child, for the victim, is a key part of building this multidisciplinary team.

Joe: [00:06:54] Absolutely and that that legal representation could be the guardian ad litem that the court assigns to the victim or it can be like I said that defense attorney that’s been working with this person, someone who’s been representing this person in previous situations. You know sadly to say that the trafficking victim is someone who is often part of the criminal justice system and that person may have been arrested in previous situations and other times so, they may already be part of the criminal justice system in the juvenile court system.

Sandie: [00:07:35] So, they’ve been part of maybe being on probation or something along those lines?

Joe: [00:07:43] Sure. I think that the greatest majority of trafficking victims do come from a welfare system of some kind, whether it’s the welfare system meaning they are in foster care, they’re being provided services to child protective services, or even in other cases where they’ve been part of the criminal justice system where they’ve been arrested for various offenses.

Sandie: [00:08:07] Well and one of the things that we’ve talked often about on this podcast is now being put in the system doesn’t cause trafficking but being in the system means that somebody somewhere noticed that things weren’t really safe or stable in a home environment. And so, some kind of services were offered, or the child was removed from the home for their own safety and then that brings a little different light to this. So, I really get ruffled because I work a lot with child welfare folks when I go to meetings and people say well you know we’re just producing trafficking victims. And I really believe that what we are doing is modifying how we approach that. And that’s why the multidisciplinary team is so, important, so, we have all the players on the same page or in your situation sitting around the same table.

Joe: [00:09:09] Sure. So, that there is that coming together to all work in the same direction to provide the needs of this victim.

Sandie: [00:09:18] So, tell me a little bit because it sounds like a dream and we have all the right people around the table, but there must be some challenges.

Joe: [00:09:27] Oh so, there are some major challenges. First of all, the biggest challenge is that those who are typically used to working child abuse cases work them very differently than cases that involve trafficking. And most of it starts with just the time that is needed. And I’m not talking about the amount of time, although that can be a large amount, but I’m talking about when is this victim going to disclose or be identified because typically human trafficking victims don’t disclose they are found and identified as a trafficking victim. So, is it Monday through Friday between 8 and 5:00 when most child advocacy centers are open? And the answer to that is no, it doesn’t happen during those periods of time. So, one of the biggest challenges is the time and the location. Some of the other challenges revolve around attitudes. I always say that the child abuse victim-survivor is when they’ve been identified and they’re surviving that child abuse victim is typically thought of as the poor child that somebody did something to. That human trafficking victim-survivor is often thought of as a kid who’s just a troubled kid who just wanted to go out and do this. And so, sometimes we forget that this is a kid. This isn’t just an angry kid, this is a kid who has suffered a lot of trauma.

Sandie: [00:11:15] You bring up a really good point in how we approach these two different audiences because the child abuse victim someone reported and that’s at the point where we are removing them from that abuse. But the trafficked kid looks like they’re surviving on the street or something like that. And so, we have all these preconceived notions about maybe homelessness or gang activity. And how are we doing in educating these professional people who need to be part of this multidisciplinary team? You come from a law enforcement background, so, how is your discipline responding to this now? Is it pretty nationally recognized or do we still need to work on that?

Joe: [00:12:00] Oh I think we have a long way to go. I think we have a really long way to go to break down the personal responses to this victim. I always say the kid that needs your help the most is the one that’s the most difficult to help, and often just not nice to authority. So, you have this law enforcement officer who comes across a young person and what has the background be? Well, the background has been being that this young person oftentimes has been part of the system and has been failed by the system, and this law enforcement officer is going to come in and going to rescue them. Well, they don’t see that as a rescue. They see that I’m going to be in trouble and they’re going to look down upon me. I had an opportunity last week to be in a meeting where there were some young people who talked about the idea of law enforcement not recognizing that these are kids who need help, instead of just trying to fix it for them. Cops or fixers, you know they want to come in, they want to make it quick, and they want to move this situation to be settled. And it’s a hard process to break down the barriers that are in place. So, law enforcement’s struggling at times with that level of communication. This kid is not going to be this sweet young person that makes it easy to help. They’re going to oftentimes be angry and have their guard up. And so, law enforcement needs to not take it personally and to think in terms of what is this kid gone through? What’s made this child angry? What’s made this child suspicious? What has made this child feel that you’re not going to be their advocate? And to be able to have those conversations a little bit more at length is part of the process.

Sandie: [00:14:11] So, when we’re talking about those kinds of conversations, I think the professional training that people are looking for is forensic interviewing skills. So, how do you implement that in building your MDT so, everybody’s on the same page?

Joe: [00:14:28] Well the forensic interviewer is someone who’s specially trained to interview those who have been abused and the child advocacy centers are typically the location where these interviews will take place and sometimes they’re child advocacy center staff and sometimes even law enforcement is trained in doing forensic interviews. But we have found that it’s a very different interview of a young person who’s been sexually or physically abused than it is to be interviewing basically a teenager who has been trafficked. So, the interview process is all a bit different and I know that the National Criminal Justice Training Center we do training called F.I.T., forensic Interview training, for child sex trafficking victims. We do training around the country for those who have been trained already in doing forensic interviewing because we know that it’s a different skill set and requires a different process. The forensic interviewer that does a regular child abuse interview really wants to do it one time, really wants to get in and do that interview one time so, that there isn’t any additional questioning of whether or not it was a bad interview. So, when it goes to court the defense attorney doesn’t claim that this child was influenced. But we know that a single interview of a trafficking victim is probably not going to happen. It’s going to require multiple interviews because of the process of addressing the trauma bond that takes place, the process of just breaking down those barriers that are going to be in place to get more and more information to get that victim to feel like they can disclose more and more. So, there will be multiple interviews. But the other problem is, where is the interview going to take place? Is it going to take place in the Child Advocacy Center, which is designed as a child-centered place? In other words, the interview rooms are made for small children typically. So, you go in and it’s all happy and then they have stuffed animals around and all of those are designed to make a young person feel comfortable and relaxed when they’re being interviewed about sexual or physical abuse. But that’s not a conducive environment to an interview with a trafficking victim. So, this Survivor is going to come into that room and they’re already going to set off bells and whistles that you know you’re treating me like a child. So, we have to figure out another method. Where is that interview going to take place? And is the Child Advocacy Center forensic interviewer the best person to do that interview? All of those need to be discussed and solidified the plan of action long before the interviews take place. Where’s it going to be? Who’s going to do it? What time of day is it? Has this person been fed? Have they slept? It’s a completely different process when we’re talking about a trafficking victim.

Sandie: [00:17:55] Wow. So, is there a checklist somewhere that I can just use?

Joe: [00:18:00] Well I wish that I could tell you that there’s a checklist that goes through the process of how to identify when is the best time. There are resources that Health and Human Services have. They have some really good trafficking resources and there are a variety of other organizations which Wichita State University has their combating human trafficking Lotus Anti-Trafficking Model, that provides great benefit to looking at this from the victim’s side instead of from the prosecution side.

Sandie: [00:18:38] And that’s really the point of this approach is it is a victim-centered approach. And so, the interviewing process, this kind of transition really, it’s pushing a rope instead of pulling it because a lot of policies and procedures and working with kids they’re already in place and you come in and you want to change it. That’s going to take time.

Joe: [00:19:04] Absolutely. And then we’re talking about protocols that sometimes are restrictive to bringing if you think in terms of an environment that is like a child advocacy center that’s really designed as a child friendly place and then you bring in a teenager who has a history of criminal activity, who is not using polite language, and may have been involved in activities that would typically make them not welcome in a child advocacy center because maybe they were involved in the process of trafficking. Not necessarily am I saying that they were a trafficker, but they could have been involved in the process of trafficking just because of the coercion and the trauma bonding that was taking place during their experiences. So, all of these create protocol issues for child advocacy centers. There are some child advocacy centers that will not let you show an image of a child that has been abused to that child. But in some cases, in the investigative process that’s a good way by someone who is trained to do so, but it is a good way to get that person to discuss their victimization.

Sandie: [00:20:35] So, it’s very complicated because we’re at a crossroads where we’re trying not to undo what we’ve done in one field but launch a little different direction so, that we can be more effective in working with commercially sexually exploited children. What about medical evaluation? You know my background is nursing so, I’m always interested in how the medical community participates in this process.

Joe: [00:21:06] Well every victim of exploitation that is served by a child advocacy center should be able to get a medical evaluation. And that’s part of the process, and that’s not something that they have to have insurance for it should be something that’s covered. And so, the other thing that happens is that medical personnel are used to documenting. That’s just part of what they do, so, they will document their contact with this person. And if this victim is used to going to a doctor and used to telling the doctor things that they wouldn’t tell other people, particularly about their medical history and situations, then that medical staff can actually be a first responder and an identification of a trafficking victim and can be critical to the process especially in places like emergency rooms and urgent care facilities.

Sandie: [00:22:10] And that’s so, important. I’ve done a lot of training for emergency rooms and urgent care centers and we’ll put links in the show notes to some of those podcasts because health care providers they’re frontline, they are frontline for identifying this population. So, the other part of your bio as far as Internet crimes and the role of the Internet in this and your job, how could you apply that to what we’re talking about?

Joe: [00:22:44] Well the communication that takes place between the trafficker and the victim can often start right there in social media. And then the sale of this victim can go online as well. We’re finding that trafficking is not being marketed out on the street, it’s being marketed on the Internet. Even though backstage has been shut down, there are plenty of places they came about to fill in the gap when backstage was shut down by the government. So, the technology is helping facilitate the distribution of information and marketing for victims.

Sandie: [00:23:30] One of the things I always want people to remember is that there are a lot of free resources for prevention for your own children. And one of my favorites is Net Smartz from the National Center for Missing and Exploited Children. And that every child is not being recruited every day. And some of that fear I just wanted to spell that and help people look at how they can become part of building a safe community. And kids who don’t live in a situation where someone’s monitoring and you know has good parental supervision, in the community, we can all take care of the kids who aren’t getting that. And I’m really excited to realize that the crimes against children and the Internet Crimes Against Children are part of these multidisciplinary teams that serve the victims and help build the process for their disclosure, their restoration, and their reintegration. And I can’t thank you enough for helping us really better understand the difference between multidisciplinary teams for child abuse and sex trafficking and helping us understand the challenges and the direction we need to go to move to the next level.

Joe: [00:24:58] Sandie, thank you so, much for your advocacy on this issue and for you’re asking me to be part of it.

Sandie: [00:25:04] Well I can’t wait till we finally get to meet in person, don’t know when that will be, but we’d love to stay in touch and learn from your experiences, your background in law enforcement is always valuable for so, many of us that are more from the victim service side of things. We need to understand what you guys are thinking and it’s a really valuable resource and I want to thank you for your transparency especially.

Joe: [00:25:32] Well, thank you very much.

Dave: [00:25:34] Thank you so, much to you both so, much I’ve learned from this conversation Sandie. I love especially the distinction between the child abuse situations and trafficking, you know so, much for us to think about and we are inviting you to really take the first step as well as you’ve heard in this episode so, many links and resources that are available will have all of those in the notes. You also, can reference on the Website a starting point for you especially if this is perhaps one of the first episodes you’re pulling up from us. If you hop online over at endinghumantrafficking.org, you can download a copy of Sandie’s book, The Five Things You Must Know, a quick start guide ending human trafficking. That’s going to teach you the five critical things that we’ve identified over the years that you should know to join the fight against human trafficking and get access by just going over to endinghumantrafficking.org. And also, coming up in early 2019 March 1st and 2nd, the next Ensure Justice conference. If you would like to learn more and register early, ensurejustice.com Is where to go. As always you can reach out to us too with questions feedback@endinghumantrafficking.org is how to do that. And Sandie, we will be back again in two weeks.

Sandie: [00:26:53] Thank you, Dave.

Dave: [00:26:54] Thanks, everyone. See you then

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