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D I S M A N T L I N G T H E M Y T H S

PROSTITUTION

WHAT IS PROSTITUTION?

• Prostitution: sex for money, drugs, and housing or any other compensation • Workers in the sex trade

Retrieved at http://www.huffingtonpost.com/2014/03/12/sex-trade-study_n_4951891.html

PROSTITUTION & TRAUMA

How does Prostitution relate to trauma?

• Trauma: direct exposure to death, threatened death, actual or threatened, serious injury, or actual or threatened sexual violence (DSM-5)

Retrieved from http://www.centura.org/trauma-network/

SEX TRADE

What constitutes the sex trade? • Street-prostitution • Brothels • Massage Parlors • Escort Services • Strip Clubs • Pornography

(Farley, et al., 2003)

H T T P S : / / W W W . Y O U T U B E . C O M / W A T C H ? V = J V D 3 T J J A F 3 C

PRETTY WOMAN TRAILER

PROMINENT MYTHS OF PROSTITUTION

•Prostitution is… • A choice • A reasonable

vocation • Safe, if regulated • Sexually Fulfilling • Empowering

Both retrieved from http://www.sexworkeurope .org/users/turnoffthebluelig ht

UNDERSTANDING CHOICE

• History of Sexual Abuse • 70 to 80 involved in the sex trade have a

childhood history of sexual abuse. (Ward & Roe-Sepowitz, 2009; Hom & Woods, 2013; Surratt, Kurtz, Chen, & Mooss, 2012; Taylor,

2011; Roe-Sepowitz, Hickle, Cimno, 2012).

• Greater risk of a myriad of physical, emotional, and mental ailments in the future (Igelman, et al., 2007) • Victimization-revictimization cycle

(Ward & Roe-Sepowitz, 2009; Hom & Woods, 2013; Surratt, Kurtz, Chen, & Mooss, 2012; Taylor, 2011; Fitzpatrick, et. al, 2010)

Retrieved from https://castinglargeshadows.files.wordpress.com/2015/02/bewellandlive.jpg

UNDERSTANDING CHOICE

• Financial Concerns: • Often no alternate

source of income (Roxburgh, Degenhardt, & Copeland, 2006)

• “Easy” and only way to make big money (Strega, Casey, & Rutman, 2009; Roe-Sepowitz, Hickle, Cimno, 2012)

Copyright © Unitewomen.org – Equality for All.

UNDERSTANDING CHOICE

• Social/Financial Paradox (Nolot, 2014; Jackson, Bennett, & Sowinski, 2007).

• Family pressure to provide/Guilt and Shame • Children of their own/Unfit to Parents

Stolen AwayCopyright © 1995. Soon-Duk Kim. All Rights Reserved.

© P R O S T I T U T I O N R E S E A R C H & E D U C A T I O N , S A N F R A N C I S C O 2 0 0 8 W W W . P R O S T I T U T I O N R E S E A R C H . C O M

PROSTITUTION’S HIERARCHY OF COERCION

UNDERSTANDING SEX WORK

• Physical Harm • Physical violence is

commonplace within the dynamics between pimps, johns, and the sex worker. (Hom & Woods, 2013; RoeSepowitz, Hickle, Cimno, 2012; Ward & Roe-Sepowitz, 2009)

• In study across 9 countries: (Farly, et al, 2003) • 71% Physically Assaulted • 63 % Raped • Mortality Rate 40% Higher

than the national average (Prostitution Research and Education)

The Wolves. Mural Copyright 2013. Tanya Wischerath.

UNDERSTANDING SEX WORK

• Physical Harm (cont.) • Increased risk of STIs

• In a study of sex workers in Miami, researchers found that the violent victimization and severe mental health issues faced by those in the trade only further increase the risk of contracting HIV (Surratt, Kurtz, Chen, & Mooss, 2012)

UNDERSTANDING SEX WORK

• Physical Harm (cont.) • Pregnancy • The unprotected sex will lead to a higher

chance of pregnancy. • Abortion • Often women in the trade, especially if

under the control of a pimp will also be coerced into receiving an abortion, which has the potential to have a dramatic impact on the woman.

(Hom & Woods, 2013)

UNDERSTANDING SEX WORK

• Substance Abuse • Research indicates

anywhere from 60- 85% of sex workers identify substance addiction as a problem (Farley, Lynne, & Cotton, 2005; Ward & Day, 2006)

• Vicious cycle (Strega, Casey, & Rutman, 2009; Taylor, 2011)

Self- Medication

Money for Substance

Prostitution

UNDERSTANDING SEX WORK

“Social Support” • No healthy

social/familial (Jackson, Bennett, & Sowinski, 2007)

• Pimp/sex worker community might be only source of social support (Hom & Woods, 2013; Jackson, Bennett, & Sowinski, 2007)

Woman in Greek Prostitution. Photo by Angelos Tzortzinis Copyright © 2013

N E F A R I O U S : M E R C H A N T O F S O U L S

NEFARIOUS

COUNSELING SEX WORKERS

• Mental Health Concerns: • 68% of sex workers met PTSD

criteria • Trauma related disorders

include: • post-traumatic stress disorder, • dissociative disorder, • intense anxiety or a mood disorder, • and further resulting often in

multiple other mental health and general stability issues

(Ward & Roe-Sepowitz, 2009; Hom & Woods, 2013)

(Farley, et al. 2003)

Retrieved from http://vvnw.org/home/images/PTSD_Pag

es/ptsd_brain.png

COUNSELING SEX WORKERS

• Mental Health Concerns (cont.): • Additionally, the population of sex

workers has been found to portray a higher concentration of serious mental illness, often linked to occurrences of intimate partner violence and childhood sexual abuse.

(Ward & Roe-Sepowitz, 2009; Hom & Woods, 2013)

COUNSELING SEX WORKERS

• Mental Health Concerns (cont.): • Suicidality: • Research indicates that

suicidal thoughts, ideation, and planning will increase after a traumatic event (Krysinka, Lester, & Martin, 2009).

• Those with PTSD symptoms were found almost 15 times more likely to attempt suicide than those without PTSD (Jackson, Bennett, & Sowinski, 2007).

Retrieved from https://henryehooper.files.wordpress.com/2014/06/ptsd-cover.jpg

COUNSELING SEX WORKERS • Mental Health Concerns (cont.): • Suicidality: • The chances only increase as co-occurrence of

other disorders and substance abuse problems begin to factor in (Jackson, Bennett, & Sowinski, 2007).

• Hom and Woods also report that first-line service providers to those taken out of trafficking indicate depression and a deep despair that can be accompanied by suicidal ideations; this is further darkened by the shame and guilt associated with sexual assault and victimization (2013).

COUNSELING SEX WORKERS

• Current Research: • Substantial research in the

area of treatment for sex workers is still needed!

• Two major themes in current research: • Working through past

traumatic experiences • Cultivating new and healthy

relationships (Ward & Roe-Sepowitz, 2009)

Retrieved from https://philadelphiabookgallery.files.wordpress.com

COUNSELING SEX WORKERS

Other Treatment Considerations: • Co-occurring disorders • Substance abuse • Problems with parenting • Perception and stigma of

prostitution • Job training • Revictimization • Trauma symptoms • Shelter (Ward & Roe-Sepowitz, 2009; Taylor, 2011)

“Skirt of Sacrifice”2000PastelArtist: Autumn BurrisCopyright ©

2000. Autumn Burris.

WHAT TO REMEMBER

• Current Research (cont.) • Holistic Treatment

Options • Physical • Mental • Emotional • Spiritual needs

(Hom & Woods, 2013)

Retrieved from www.richs.com

WHAT TO REMEMBER

• Current Research (cont.) • The importance of • validating the

individual, • helping foster a sense

of autonomy, • remaining full of grace

and patience, • and recognizing and

responding to the full effect of the trauma on the survivor.

(Hom & Woods, 2013) Retrieved from Pinterest. Original Source Unknown.

COUNSELING THEORIES

• Current Research (cont.) • Trauma-based Treatment • Empirically-Based

Treatment for PTSD (Taylor, 2011) • Cognitive Behavioral

Therapy • Desensitization and

reprocessing • Exposure Therapy

COUNSELING THEORIES

• Feminist Therapy • Revolves around the idea of

societal oppression of women • Acutely addresses violence

against women and empowers them to understand their worth and value separate from what they have been told by the men in their lives or culture as a whole

(Murdock, 2013; Cleman, 2005)

Retrieved from http://www.historylearningsite.co.uk/wp- content/uploads/2015/05/Feminism.jpg

COUNSELING THEORIES

• Additional positive aspects of feminist theory include focus on: • Personal strengths, • Collaboration between the

professional and the client, affirmation of the unique perspective of a woman, expansion of alternative life choices, • And promotion of healthy, mutually

beneficial female relationships. (Murdock, 2013; Cleman, 2005)

P R O V I D E D B Y A Z I Z A N S A R I

QUICK COMIC RELIEF MOMENT

GROUP THERAPY

• Research Support for Group Work, as it: • encourages mutual aid, • dispels myths about sex work and abuse, • validates emotions, • empowers individuals to take control of their lives • allows for a safe and stable environment to foster

community and speak freely. (Clemans, 2005; Hickle & Roe-Sepowitz, 2014; Ward & Roe-Sepowitz, 2009; Velazco, 2011; Roe-Sepowitz, Hickle, & Cimno, 2012)

GROUP THERAPY

• Other group considerations: • Psychoeducational: • Debunk myths • Provide instruction • Redirect with healthy

guidance (Clemans, 2005; Hickle & Roe-Sepowitz, 2014; Ward & Roe-Sepowitz, 2009)Retrieved from http://www.psychotherapist.org/cegrpdrawing_bf8.gif

GROUP THERAPY

• Other group considerations (cont.): • Facilitator should demonstrate a

spirit of positivity and consistency with her group members • Co-facilitator who has walked

through the sex work path can • be helpful in building rapport, • modeling healthy behavior

changes, • and bringing an extra level of

authenticity to the group dynamic

(Clemans, 2005; Hickle & Roe-Sepowitz, 2014; Ward & Roe-Sepowitz, 2009)

PROSTITUTION EXITING PROGRAMS

Esuba (Ward & Roe-Sepowitz, 2009)

• Currently incarcerated prostitutes • “Psychoeducational

therapy group designed to heighten awareness of abuse and violence while teaching anger management and communication skills”

SWAT (Strega, Casey, & Rutman, 2009)

• Inpatient program • Peer-based model

for sex workers Substance abuse treatment programs • Psychoeducational

workshops (health, legal and safety issue) • Therapeutic

treatment

EXAMPLE: THISTLE FARMS

• Residential Program/Social Enterprise • Therapy • Medical Care • Free Education • Job Training

Retrieved from thistlefarms.org

BIBLE AND PROSTITUTION

• Notable Prostitutes in the Bible • Rahab (Joshua 2) • Gomer (Hosea) • Proverbs’ warning

against harlots

Retrieved from https://en.wikipedia.org/wiki/Rahab

Retrieved from https://nikkipruitt182.wordpress.c om/2013/10/31/why-did-hosea- marry-a-prostitute/

JESUS AND PROSTITUTES

• Luke 7: 36-50 • A Sinful Woman Forgiven • “for she loved much”

“For She Loved Much” Art & Photo by Tia Poissant

REFERENCES

• Antonopoulou, C. (2006). Symptoms of post-traumatic stress disorder in victims of sex-related trafficking. Inernational Psychology Bulletin, 10 (4), 32-37. Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland. Child Abuse Review, 19, 387-404.

• Fitzpatrick, M., Carr, A., Dooley, B., Flanagan-Howard, R., Flanagan, E., Tierney, K., White, M., Daly, M., Shevlin, M., & Egan, J. (2010). Profiles of adult surviviors of severe sexual, physical, and emotional institutional abuse in Ireland. Child Abuse Review, 19: 384-404.

• Hom, K., & Woods, S. (2013). Trauma and its aftermath for commercially sexually exploited women as told by front-line service providers. Issues in Mental Health Nursing, 34, 75-81.

• Igelman, R., Taylor, N., Gilbert, A., Ryan, B., Steinberg, A., Wilson, C., & Mann, G. (2007). Creating more trauma-informed services for children using assessment-focused tools. Child Welfare, 86(5), 15-33.

• International Labor Office. (2009). The cost of coercion. Geneva, Switzerland. • Jackson, L., Bennett, C., & Sowinski, B. (2007). Stress in the sex trade and beyond: Women working in the sex trade talk about

emotional stressors in their working and home lives. Critical Public Health, 17(3) 257-271. • Krysinska, K., Lester, D., & Martin, G. (2009). Suicidal behavior after a traumatic event. Journal of Trauma Nursing, 16(2), 103-

110. • Maddox, T. (2011). Modern-day slavery: A problem that can’t be ignored. The CNN Freedom Project. Retrieved from

http://thecnnfreedomproject.blogs.cnn.com/2011/03/04/modern-day-slavery-a-problem-that-cant-be-ignored/ • Nolot, B. (Producer & Director). (2014). Nefarious: Merchant of Souls. (Documentary). United States of America: Exodus Cry. • Roe-Sepowitz, D., Hickle, K., Cimno, A. (2012). The impact of abuse history and trauma symptoms on successful completion of

a prostitution-exiting program. Journal of Human Behavior on the Social Environment, 22, 65-77. • Roxburgh, A., Degenhardt, L., & Copeland, J. (2006). Posttraumatic stress disorder among female street-based sex workers in

the greater Sydney area. Australia. BMC Psychiatry, 624-12. • Strega, S., Casey, L., & Rutman, D. (2009). Sex workers addressing treatment. Women’s Health & Urban Life, 8(1), 42-53. • Surratt, H., Kurtz, S., Chen, M., & Moss, A. (2012). HIV risk among female sex workers in Miami: The impact of violent

victimization and untreated mental illness. AIDS Care, 24 (5), 553-561. • Taylor, O. (2011). The sexual victimization of women: Substance abuse, HIV, prostitution, and intimate partner violence as

underlying correlates. Journal of Human Behavior in the Social Environment, 21, 834-848. • Ward, A., & Roe-Sepowitz, D. (2009). Assessing the effectiveness of a trauma-oriented approach to treating prostituted

women in a prison and a community exiting program. Journal of Aggression, Maltreatment, & Trauma, 18, 293-312.