Table 2.

The current MDT model & perceived importance & barriers to youth voice.

Perspectives on the Inclusion of Youth Voice in the Current MDT Model
Benefits of Interdisciplinary Collaboration
“…I like that MDT creates a more collaborative case management approach, so we can do wraparound services for a client and fill gaps as a team instead of as an organization…. I really like that resource-sharing, collaborative process as well.“ (Participant 16, Other)
“But what the MDT process has done is brought diverse groups together and is at least focusing on the problems and the needs and the possible solutions. So it may not solve any problems yet, but it’s at least focusing on them, identifying them, and bringing people together to at least talk about them in order to get the solutions.” (Participant 1, Legal)
Absence of Youth Voice in the Current MDT Model
“Well, I think it’s important, because all of us are sitting around talking [at the MDT meeting] and we don’t really know. It’s hard to get youth to open up about this topic. Like I said, most of the ones I talk to are not even identifying that there’s a problem, so they just kind of want to be left alone. They don’t really want to give their voice on it, or they’ll give voice… but never really talk about themselves… So I think it is important and necessary and great. I think it’s talked about a lot more than it’s done.” (Participant 6, Social Services)
Absence of Youth Voice outside the Current MDT Model
“As a whole, I don’t see a lot of children really being the center of what they want at all. It seems like it would be up to the social worker or the case worker… to make decisions for them, so the child at the mercy of someone else’s control. And that could be a really great social worker, but they’re not involving them in the process - they’re just being handled.” (Participants, Social Services)
“So, ideally… you’re supposed to get the children’s voice and the children’s input. I don’t think it really happens as much as people would like for it to happen or think that it happens. I think that most of the time treatment plans are being made by the provider without a lot of input from the clients themselves, which is good and bad.“ (Participant 6, Social Services)
Perspectives on the Importance of Youth Voice Inclusion
Improve Rapport Building with Youth
“I think it’s important because it helps build rapport, if they think you’re listening. Most teenagers don’t like people to make decisions for them.“ (Participant 7, Social Services)
“I think it is very important to have the youth’s input because we have no idea what that person has gone through. And to understand where they are and where they’ve been is a very big part of the healing process… So I think we have to establish the rapport and we first have to identify and recognize that they are victims.” (Participant 10, Social Services)
Helping Youth Regain Autonomy & Control over their Lives
“It’s important because they’re used to being under control - so now let them have their control back - and let them lead their own lives. I don’t want anybody to tell me how to live mine, so.” (Participant 13, Survivor)
“I think it’s something that we’re going to need to do because right now, what we have is children who are put into placements that they don’t agree with, and therefore, they run away from those placements. Then it puts them at further risk. We have children who are bonded to their traffickers and feel that that’s where they get their autonomy - that they don’t have autonomy outside of that. So anything we can do to get their buy-in would be helpful for them to start making decisions that we view as safer and healthier decisions for them to make.” (Participant 15, Medical)
Essential to Youth Empowerment & Growth
“I think the more we can help them have their own voice heard, the better. And that will empower them moving into adulthood because if they’re not feeling it now, it’s going to be really hard when they’re out on their own as an adult in society that expects to be able to have a voice - they’re not going to feel empowered to have that voice as an adult. It’s important to build it now.” (Participant 2, Legal)
“So giving children choices really does make them feel heard - they have a voice - and they end up making decisions for themselves…it helps them grow and develop. It’s an opportunity to build life skills that they’re probably not getting at home…” (Participant 5, Social Services)
Risking Re-traumatization
“I think that we should incorporate their voice more. We should recognize the trauma that they’re going through. Sure, they have gone through a trauma, but is the trafficking - that’s the one that they’re not going to identify as the trauma. The trauma they’re going to identify is their time in jail or their time being forced to go to some group home, or a hospital - even when they don’t think they need to be hospitalized - or, you know, being arrested or having to tell their story and not doing that over and over again. So I think the biggest thing is recognizing the harm that we can do unintentionally.” (Participant 3, Legal)
Perceived Barriers to the Inclusion of Youth Voice
Trauma-bonds
“We ask for their input, but sometimes you can tell they’re guarded… so sometimes we don’t get full participation because they realize “I don’t want to get that perpetrator in trouble” - who they may be running back to.” (Participant 10, Social Services)
Distrust in Service Providers
“You know, they don’t trust the adults. Because they’ve never really had someone care about them. So I know that the adults are trying their best to include the children’s voices… but it’s a traumatic experience, and you know… they don’t want to trust anyone at this point.” (Participant 12, Survivor Advocate)
Lack of a Standard Process for Engaging Youth
“I think we all intend for youth to be engaged, but either (1) they’re currently missing so there’s no way to engage them in the process, or (2) we don’t have the right structure to bring them in and ask them as a group. So, whoever is their case manager really guides that or whether or not they’re engaged.” (Participant 16, Other)
“It depends on the case manager, and it depends on the day and generally, no”. (Participant 16, Other)
Well-meaning Paternalism
“I think that’s one of the difficult things is that most people in the caring professions do have a little bit of a tendency to feel like we know what’s best and to want to sort of say, ‘well, what’s best for you is to stay in a safe environment where there’s no cell phones, and no traffickers, and no contact’ and that everything else is a compromise that we’d probably need to start learning how to do. But then we worry that it’ll be a foster home that the child continues to run away from.” (Participant 15, Medical)
“Don’t just sit in a room with a bunch of professionals and speculate why this kid is running away. I feel like they really need to listen to these children, who are victims. And I don’t feel they listen to them enough. I feel like they feel they’re children, they don’t know what’s best for themselves, and we make all these decisions.“ (Participant 7, Social Services)