Linking the Roads Working with Youth Who Experience Homelessness & Sexual Violence © National Sexual Violence Resource Center 2014. All rights reserved. This project was supported by Grant No. 2009-TA-AX-K042 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women. The content of this publication may be reprinted with the following acknowledgement: This material was reprinted, with permission, from the National Sexual Violence Resource Center’s publication titled Linking the Roads: Working with Youth Who Experience Homelessness and Sexual Violence. This guide is available by visiting www.nsvrc.org. Linking the Roads Working with Youth Who Experience Homelessness & Sexual Violence Rural communities are unique and can shape the ways in which services are designed and delivered to youth who are homeless. This guide has three aims: (a) to provide an overview for the intersections between identity, trauma experiences, and resiliency among youth who are homeless; (b) to highlight core skills and techniques for advocates; and (c) to discuss how to tailor these skills in order to improve services for youth who identify as lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ). “The last national count of homeless people found that 7 percent of homeless people live in rural areas” (National Alliance to End Homelessness, 2010, p. 1). Homeless youth are individuals under the age of 18 who lack parental, foster, or institutional care. (National Coalition for the Homeless, 2009). Definitions vary when it comes to the age of homeless youth, but can include people between the ages of 12 and 24. The most common estimate of homeless youth in the United States is 1.7 million (Hammer, Finkelhor, & Sedlak, 2002). Approximately 380,000 of those youth are under the age of 18 and are homeless for more than one week and 131,000 of those youth experience homelessness for more than one month (Cray, Miller, & Durso, 2013). Section One Risk Factors for Homeless Youth Conservatively estimated, 110,000 LGBTQ youth experience homelessness in the United States each year (National Alliance to End Homelessness, 2014) A CASE STUDY: Devon, who is 16 years old, was kicked out of her home after coming out to her mother and father as bisexual. Prior to being kicked out, she faced arguments and verbal abuse from her parents about being gay. For a month afterward, she lived with different friends because she was unsure of where else to go, and she thought her parents might change their minds and let her come home. After being sexually assaulted by one of her friend’s family members, she moved into an abandoned barn a mile from her hometown with a few other people, and has been living there for the past three months. She rarely attends school; after coming out, her classmates physically and verbally harassed her. Sometimes, Devon uses drugs and alcohol to help numb the physical and emotional pain she has endured in the past four months. There are adults who live nearby and offer clothes and food to Devon in exchange for sex and drugs. With winter quickly approaching, Devon has been having sex with the adults in order to receive food and clothes that she can use for the upcoming winter. The report Identifying and Serving LGBTQ Youth: Case Studies of Runaway and Homeless Youth Program Grantees (Burwick, Oddo, Durso, Friend, & Gates, 2014) provides additional factors, particularly for youth who identify as LGBTQ. These are only a few of the many risk factors that contribute to youth homelessness: Poverty “Rural homelessness is the result of poverty and a lack of affordable housing. Research shows that the odds of being poor were between 1.2 to 2.3 times higher for people in non-metropolitan areas than in metropolitan areas” (National Coalition for the Homeless, 2009). Fewer job opportunities, lower incomes, working multiple jobs to make ends meet, and high unemployment rates are all ways in which youth and their family might experience poverty within their rural community. Poverty can lead youth and families to homelessness and frequent moves throughout different shelters and housing systems. In particular, poverty and homelessness can cause stresses (lack of finances, lack of education, lack of supportive parents and other adult figures) within the family that could lead youth to being abandoned and/or neglected by family members. In 2005, 15.1 percent of rural Americans were living in poverty compared with 12.5 percent of non-rural Americans (National Coalition for the Homeless, 2009). WHERE IT’S COMMON Rural homelessness is prominent in regions that are primarily agricultural, and in areas where economies are based on declining industries such as mining, timber, or fishing. Rural homelessness also can be higher for regions experiencing growth in industries that attract more workers than jobs available, and areas near urban regions that attract new businesses and higher-income residents, increasing taxes and living expenses (National Coalition for the Homeless, 2009). Unsafe Conditions Without the basic safety and protection housing provides, the unstable and unsafe living conditions of homelessness can make youth vulnerable to sexual victimizations and sexual exploitations (National Sexual Violence Resource Center [NSVRC], 2010). Others might experience failed foster care, juvenile justice, and/or mental health systems (National Child Traumatic Stress Network [NCTSN], 2007). According to the most recent national prevalence study, many youth experience violence — with 71.1% of women and 58.2% of men first experiencing contact sexual violence, physical violence, or stalking by an intimate partner before age 25 (23.2% of female victims and 14.1% of male victims before age 18). (Breiding et al., 2014) LGBTQ youth might experience physical and emotional abuse, including sexual assault, by family members and others, after coming out. This could lead to being forced out of their homes or leaving on their own, fearing that it is too dangerous for them to stay (Quintana, Rosenthal, ?? Krehely, 2010). Family Issues Some youth homelessness can be a reflection of family structure. Youth might experience rejection, neglect, and conflicts between parents, stepparents, and other family members based on adults’ personal beliefs and values. Youth also might experience substance abuse within the family, sexual violence, and/or physical abuse from family members. Homeless youth are five times more likely to report incidences of child sexual abuse when compared with youth living in stable homes (Ray, 2006). All of these factors could cause youth to leave their homes, whether by their own choice or by force from family members. Section Two Sexual Violence & Youth Homelessness In 2002, a report on sexual abuse among youth who had run away from home found that 21-40 percent of homeless youth had been sexually abused, compared with 1 to 3 percent of the general youth population (U.S. Department of Health and Human Services [HHS], Administration for Children & Families, 2002). The report also found that one in three of those youth had been forced to perform a sexual act against their will (HHS, 2002). While sexual violence often is a cause for youth to leave home, it also is a potential consequence of living on the streets, where youth face heightened risks for multiple victimizations of sexual exploitation, rape, and sexual assault after leaving home (NSVRC, 2010). Being homeless or marginally housed often is unsafe and requires youth to develop critical survival and coping skills. Homeless youth in unsafe and under-resourced situations often have to do extreme things in order to meet their daily survival needs. This is at a time when most youth are provided for by their families or caregivers. The need for food, shelter, and safety exposes youth to ongoing threats and possible victimization (Larkin Street Youth Services, 2009). A GREATER RISK for LGBTQ Youth ?Homeless LGBTQ youth are victims of 7.4 more acts of sexual violence during their lifetime than their heterosexual homeless peers (National Alliance to End Homelessness, 2009). ?Among LGBTQ homeless youth, trauma experiences can be connected to negative responses from family, peers, and others pertaining to the youth’s sexual orientation or gender identity (Burwick et al., 2014). ?LGBTQ homeless youth are more likely than heterosexual homeless youth to report being asked by someone on the street to exchange sex for money, food, drugs, shelter, and clothing (Cray et al., 2013). ?Surveys have found that LGBT youth are more than three times as likely to have engaged in survival sex (Cray et al., 2013). Youth might experience violence from adults, criminals, pimps, or other homeless youth through the relationships and social networks they create for survival (NCTSN, 2007). Even if they are aware of the problematic aspects of these relationships, they could be reluctant to leave based on other dangers they might face without them. Homeless youth also might experience incarceration due to family conflicts and/or survival crimes (stealing for food, drugs, alcohol, etc.), or nonattendance at school due to harassment and discrimination (Quintana et al., 2010). There is a constant risk for sexual exploitation and victimization when trying to survive day-to-day on the streets, and some homeless youth might engage in survival sex — exchanging sex for food, clothes, drugs and/or shelter — to meet these basic needs (National Alliance to End Homelessness, 2009). With histories of physical and sexual abuse, neglect, and abandonment, youth often learn to use their bodies to meet their physical and psychosocial needs, and they sometimes are coerced to take sexual and safety risks to gain shelter and safety from the streets (National Alliance to End Homelessness, 2009). Engaging in sex as a means of survival increases exposure to potential trauma for these youth and increases their vulnerability to violence, rape, and exposure to disease (Cray et al., 2013). Homelessness in youth also can lead to the development of serious physical, mental, and emotional health issues, substance abuse, and can affect normal development — particularly for youth who identify as LGBTQ (Burwick et al., 2014). Lives filled with instability, stress, and trauma after experiencing sexual violence at home and/or prior to homelessness, can increase a young person’s risk of anxiety, depression, post-traumatic stress disorder, and suicide. Early experiences of sexual violence can lead to difficulties in establishing positive and trusting relationships with others. Trauma experienced prior to homelessness can have lasting effects that youth cope with while living through the new trauma of being without stable housing. Gender identity, sexual orientation, race, ethnicity, and cultural values also can affect how youth react to the traumas experienced prior to their homelessness and to the traumas they experience during homelessness. In rural communities, advocates have the ability to support services for homeless youth with a greater sense of connection to the community and its residents. These connections can build caring relationships with youth, establish expectations for the youth to feel supported and encouraged, and help establish belief in youth, letting them know that their stories are valued (Bernard, n.d.) With these concepts in mind, this guide focuses on the advocacy skills that help youth build resiliency and lessen the traumas they have experienced. INFOGRAPHIC There is no one formula for the lived experiences that youth face when they have struggled with housing. Like all survivors, the majority of their lived experiences do not happen in our presence. Understanding the ways in which sexual violence affects an individual’s ability to make social connections, function, and live in this world is complicated by struggles with housing, which add another level of complexity. If youth are worried about where they are going to sleep at night or if it is going to be safe, this adds to a lack of ability to focus on other things in their life — such as healing past trauma — because they are living through a current trauma. Downloadable infographic with citations is available at http://tinyurl.com/infographic-homeless-youth. Homeless Youth & Sexual Violence NUMBER OF HOMELESS* YOUNG PEOPLE 550,000 per year 380,000 are younger than 18 170,000 are ages 18-24 *Homelessness lasting longer than one week 1 in 5 idenity as LGBTQ Young people who are homeless also are often sexually assaulted. You can help by listening to youth who have been harmed by homelessness and sexual violence. Your support can make a positive difference in their lives over time. RUNAWAY YOUTH 1 IN 3 RUNAWAYS have been forced to perform a sexual act against their will 12.4 TO 13.9 YEARS OLD was the average age range of first leaving home 46% OF LGBTQ YOUTH run away because of family rejection of sexual orientation or gender identity Rates of major depression, conduct disorder, and post-traumatic stress disorder are 3 TIMES HIGHER among runaway youth HOMELESS YOUTH PERCENTAGE REPORTING SEXUAL ABUSE 1% TO 3% of youth in the general population 21% to 42% of homeless youth 1 IN 3 TEENS ON THE STREET WILL BE LURED INTO PROSTITUTION WITHIN 48 hours of leaving home MORE THAN 1 IN 3 HOMELESS YOUTH ENGAGE IN SURVIVAL SEX. OF THEM: 82% trade sex for money 48% trade sex for food or a place to stay 22% trade sex for drugs LGBTQ YOUTH ARE 3X MORE LIKELY TO HAVE ENGAGED IN SURVIVAL SEX 32% of homeless youth have attempted suicide Section Three Core Skills for Helping Youth All of the traumas youth experience while homeless, along with the traumas they have experienced prior to homelessness, have an impact on their needs when seeking services and trusting relationships. Seeing youth as valued individuals with unique lived experiences will help build relationships that allow youth to tell their stories, including the many ways they identify and move through the world. Here are ways in which to build trusting and supportive relationships with youth: 1. Meet their physical and emotional needs The physical safety needs of homeless youth can include shelter, food, clothing, medical and mental health care, transportation, and other basic needs. Among the general population of homeless youth, these needs often are met by turning to friends and relatives for assistance with basic necessities, however, not every youth has access to friends and relatives for this assistance (Cray et al., 2013). Shelter might involve transitional housing or emergency shelter services. It is important to place youth in safe and appropriate housing and/or shelter based on their gender identities and the information they share with you during the initial intake process. Having protocols and procedures about protecting youth privacy and being able to explain these policies directly to youth will help establish the appropriate safety they need for shelter and while seeking additional services. Food often is sparse for homeless youth. Asking the following can help determine the next steps in meeting this basic need: Are you hungry? Have you eaten anything recently? Does the agency keep food readily available to share with youth? Is there an organization in the community that provides food to those in need? If so, does the agency refer the youth to them? Do youth already have places they can go for food? WORKING TOGETHER Youth ?Youth’s identity (strengths, gifts, hopes, beliefs) ?Basic needs (food, clothing, shelter, etc.) ?Lived experiences Advocates ?Professional experience & training ?Strengths-based approaches (listening, providing options, systematic updates/changes, etc.) THE MIDDLE GROUND Youth are not their trauma Clothing might be a concern for some youth. They might not have the resources or ability to obtain clothing other than what they currently are wearing. Do they have adequate clothing to stay warm and feel safe? If not, does your agency have clothing (from donations, fundraisers, etc.) to give them, or is there another organization in the community that might be able to provide clothing? Medical and mental health needs are important to address. Youth who are homeless often develop greater medical and mental health needs due to lack of food, exposure to the weather, irregular sleep patterns, exposure to sexual and physical violence, and exposure to drugs and alcohol. Many times, homeless youth use drugs and alcohol as a means of survival and to self-medicate for the trauma and pain they have experienced (NCTSN, 2007). The use of drugs becomes a risk factor for transmission of diseases. While homeless, there is limited access to prevention and treatment for sexually transmitted diseases, HIV, dental problems, malnutrition, infections, and other health problems. Mental health difficulties can be a driver and effect of homelessness (Cray et al., 2013). In her Neurobiology of Sexual Assault webinar, Dr. Rebecca Campbell explains how serious traumatic experiences, including sexual violence, change brain chemistry and behavior (Campbell, 2012). As a result of these traumas, survival skills, and the homelessness they experience, many youth become hypervigilant, impulsive, develop depres-sion and/or PTSD, and have difficulty making appropriate choices (NCTSN, 2007). Past abuse (physical and sexual) can make a medical exam or procedures even more traumatic. There can be significant long-term medical and mental health concerns and needs for youth who have experienced sexual violence prior to and during homelessness. Advocates need to be aware that medical care can become a trigger for past abuse. It can be difficult for youth to take care of their own bodies or be aware of their physical needs if they have learned to block out feelings to cope with abuse or neglect. Making sure your agency/organization has the medical and mental health resources and/or partnerships and referrals available to provide information and care to youth will help ensure that their medical and mental health needs can be met. Things to consider: Can someone at the agency assist youth with finding a safe place to stay? Does the agency’s space offer a friendly, safe, and welcoming environment for youth? Are advocates available to accompany youth to HIV testing and/or other STI screenings? Does your agency offer basic hygiene needs (toothbrush, toothpaste, shower, shampoo, soap, etc.)? Do youth need assistance with making medical and mental health appointments? Helping LGBTQ Youth LGBTQ homeless youth are less likely to have access to familial support. Since this kind of care might not be available to them, they are more likely to be self-reliant for meeting their basic needs (Cray et al., 2013) Intake forms can ask questions in a way that avoids assumptions and informs youth about the agency’s LGBTQ-friendly environment and policies. Variations of these questions can include: What name would you like to be called? How do you identify? What gender pronoun would you prefer? Do you identify with a specific sexual orientation? Be sure to ask these questions to all clients, and not just those who you think might be LGBTQ. Having policies, procedures, and intake paperwork that explain inclusion/acceptance and safety up front gives all youth a learning experience before a difficult situation. If a hurtful and difficult situation occurs, it allows a chance to process and demonstrate empathy and ability to stay in the community and participate in creating a safe space for all. The safest environments for LGBTQ youth have established policies that express intolerance and harassment/bullying are unacceptable, such as: “This is a space that welcome and celebrates everyone, no matter their race, ethnicity, gender, gender expres-sion, sexual preference, political affiliation, religious/nonreligious beliefs.” Provide sleeping areas that establish a sense of safety for all gender expressions. This can be done by having policies in place that allow for individuals to sleep in areas that match their self-identified gender expressions. Provide private sleeping areas for individuals as needed. Youth who identify as LGBTQ often are fleeing from situations where they were rejected based on their sexual orientation or gender identity. LGBTQ youth and transgender youth, in particular, often have difficulty accessing quality medical care. Finding and/or training medical care providers to be responsive to the unique needs of LGBTQ youth can include understanding the terminology that relates to their identity, developing a basic understanding of addressing LGBTQ youth by their preferred first name and pronoun in accordance with their gender identity or expression, and creating a welcoming and safe environment where they are treated the same as non-LGBTQ youth patients (Cray et al., 2013). 2.Create space for them to express their self-idenitities Become familiar with their vocabulary, the unique issues that homeless youth face, and all of the identities they embrace. It will help create a space for building trusting relationships and sharing stories. “Language can inform and liberate, or it can shut someone out or hold them down” (NSVRC & Pennsylvania Coalition Against Rape [PCAR], 2012, p. 1). Talking About Gender & Sexuality (NSVRC & PCAR, 2012) and The Process of Coming Out (NSVRC & PCAR, 2012) provide an array of terms, language, and background information on the journey a young person might take when openly discussing their gender orientation and identity. These guides can help your agency incorporate mindful approaches for meeting youth who identify as LGBTQ where they are when it comes to the language and terms they use when describing their experiences. Things to consider: • Do intake forms allow youth to express their gender and sexual orientation? • Does the agency/organization have artwork/posters that represent different races, ethnicities, cultures, gender expressions, and sexual orientations? • Does the agency have activities and/or a space where youth can go to express themselves? (i.e. a safe room that includes crafts, art, music, etc.) • Do youth have opportunities to co-facilitate activities, classes, and groups and/or volunteer for events? • Do youth have access to materials, activities, classes, and groups in their language so that they can express themselves in their native language? 3. Understand the Impact of Trauma Recognize, understand, and support the emotional, mental, social, and physical effects of trauma. Be mindful of how this affects the youth’s life and future plans. Understanding the impact that traumas and sexual violence can have on youth development can help support their resiliency and capabilities. In order to do this, it is important to be open to listening to youth describe their experiences in their own words and on their own timeline. This honors them and how they identify. When given space to tell their own stories within a safe and trusting relationship, youth might find that they not only get their basic needs addressed, but also find an even stronger sense of self. Things to consider: • How does trauma affect their ability to build skills and plan for everyday living in the present and in the future? • Traumas, old and new, often can affect a youth’s sense of hope for building and maintaining relationships. Are there ways to support youth in building this capacity? • There is no standard process for healing. Rather, it is individualized and can look different each time youth come for services. Attend to their present needs each time you interact with them, while keeping aware of their past traumas. • Are there trauma-informed policies and procedures (NSVRC & National Sexual Assault Coalition Resource Sharing Project [RSP], 2013) that reflect inclusion, non-hostile language, emotional and physical safety, and cultural acceptance — including specific language for youth who identify as LGBTQ? Homeless youth might not readily disclose past traumatic experiences with sexual violence. Create inclusive space (NSVRC & PCAR, 2012) and use a trauma-informed approach, and youth will be more likely to feel safe and comfortable sharing their stories. 4. Honor Survival Skills In order to survive without stable housing, youth often develop specific coping and survival skills that help them stay alive or feel safer. These survival skills can occur in multiple forms, including but not limited to: denial, minimization, dissociation, compliance/over-pleasing, self-blame, lying, believing that abuse was consensual, confusion, or avoiding talking about the past. Survival sex (exchange of sex for food, clothing, drugs/alcohol, and/or shelter) often is a survival skill. Homeless youth often will use these coping mechanisms in an attempt to prevent further harm. Youth might not be able to stop using a defense mechanism until they have learned and feel empowered to use other coping skills. This process can take a long time and rarely happens in a linear fashion. Honoring these survival skills will help youth on their path to resiliency. 5. Be Attentive and Available Keep your mind open, flexible, and alert. Be attentive to words being used by youth (both what is being said and the words that are chosen) and pay attention to their feelings. Really listening can help you understand their strengths and support them in identifying their needs and options. Feelings can be expressed through words, phrases, tone, and even silence. In many cases, youth might use generalizations. Be aware of the implied and symbolic meaning of their words by offering feedback and asking clarifying questions. Sharing interpretations can help lead to clarification, as well. Using open-ended questions and paraphrasing will help assure youth that you are listening and understanding what they are saying. In order to respond appropriately and to communicate your interest, it is useful to have some phrases that could be helpful. You probably will want to add other phrases to these lists; they are a guide to encourage you. Survival Skills Providing the opportunity to build upon an individual’s strengths that are embedded in survival skills can help them recognize and meet their current needs while developing positive goals for the future. Survivor Skill = Strength Minimization - Self-awareness Dissociation - Ability to connect with others Compliance/over-pleasing - Ability to read people/have insight Blaming self - Ability to take ownership of feelings/actions Lying - Creativity Belief that abuse is consensual - Earnst To establish your willingness to listen: • Tell me about yourself. • Why do you say that? • What did you do when he/she said/did that? • What makes you feel that way? To recognize the person behind the words & hear/acknowledge feelings: • How does that make you feel? • How did you feel when that happened? • Why is that important to you? • What kind of feelings are you having right now? • What do you wish could be different? • What do you think you can do about feeling that way? To help a person discover what is going on: • Can you tell me when you began to have these feelings? • Where did all of those feelings go? • What ideas have you already considered? • What are your reasons for saying that? • What do you think you can do? • What are some other ideas you can try? • Who else can you talk to/go to if this happens again? To begin the decision-making process: • How would you like to feel? • What do you want to do? • What are some of your choices? • What are your plans right now? To offer ideas, information, or insight: • Have you ever tried/thought about ______? • Did you know __________? • Have you considered __________? • How do you feel about me saying that? Things to consider: • Give individual attention. Remove outside distractions. Tune in to the youth and the youth alone. Be patient when they are talking. • Provide inclusive, trauma-informed space to ensure that youth feel safe and comfortable sharing their stories. • Try to understand not only the words that are spoken, but also the person in front of you. Remember, the words are important, but give feedback on what you are hearing. This will clarify communication. • It’s okay to say, “I don’t know” and, “Let me get back to you on that” in order to provide them with the most appropriate resources and information to best meet their needs. Providing support, resources, information, and ideas will allow youth to be able to make their own choices. • Self-care and debriefing with a supervisor and/or other staff member is important. Doing so helps you gain skills and rejuvenates you for the next appointment. • Do not avoid conflict or be discouraged by it. Conflict is natural. See conflict as an opportunity to deepen your relationship with youth. Those of us in a helping role have the opportunity to show that conflict does not have to equal violence or disconnection, but instead can be respectful, healing, and bring us closer together. • Stay with them through conflict. When conflict arises, youth might appear over-reactive or under-reactive — or both. It becomes helpful to understand past traumas and experiences in order to comprehend how and why they navigate through conflicts the way they do. • Sometimes, they might use “inappropriate” language. Again, it is important to meet them where they are; allowing them to express and explore their feelings is part of that journey. If you need to discuss inappropriate language, determine if it needs to be at a follow-up meeting or at a time when they are not upset or needing to vent. • Check in with youth after a conflict or disagreement, and be consistent with them in addressing concerns by always allowing them to have space to make decisions. This can mean that they need some space/time to calm down before they can resolve a conflict. The most important thing is staying present and waiting until they are available to talk, process, and/or plan. Demonstrating this process can help them understand how they can have a conflict and work through it while keeping a relationship intact. Section Four Resiliency Many youth who have experienced homelessness can feel powerless because of the traumas through which they have lived. Building caring, trusting relationships leads to focusing on strengths rather than traumas. By helping youth focus and believe in their strengths, you provide them with opportunities for making their own decisions and giving voice to their choices, all while they are being heard (Bernard, n.d.). Creating space for freedom and choice assists homeless youth in defining their own goals, objectives, and tasks in a setting that feels safe and helpful. Helping them identify their options encourages them to make decisions that facilitate progress toward their self-selected goals. Valuing their right to choose and believing that choice (partnered with support and formal opportunities to build skills) instills ownership of the process and the outcomes — ultimately supporting their empowerment and resiliency. Ways to Support Freedom and Choices 1. Create a welcoming environment where nondiscrimination and non-harassment policies are implemented and communicated to all youth. Listen and ask open-ended questions when working with youth. Youths’ perception and ability to build trust begins with first impressions. For youth who identify as LGTBQ, the initial contact is especially important. If they believe the staff and agency are not welcoming on initial contact, they are less likely to trust, disclose that they are LGBTQ, and continue to seek services. Including information about their rights as an individual, ground rules for services, and their right to confidentiality of services establishes trust and confidentiality with heterosexual homeless youth and homeless youth who identify as LGTBQ, and is a critical first step in providing services. “At our best, we can honor the incredible devellopmental wisdom that propels a young person to seek love and belonging, respect, mastery, challenge, xand meaning. We can nurture a youth’s innate potential for social competence, problem solving,xautonomy, and hope.” (Ryan & Hoover, 2005). 2. Provide youth with options and resources to make empowered decisions, and honor their choices. Treat youth as the experts of their own situations, where they are free to assess their needs and goals. For example, homeless youth might engage in survival sex in order to meet their basic needs. Discussing options and choices and providing information could give youth knowledge that will help lead them to future decisions (i.e. they could become ready to speak to family members about their gender expression and seek medical services, but might not be ready to return home). “In working with transient youth, we assume that sexual activity and possible abuse and victimization, or the threats thereof, are elements of each young person’s life. We also assume that [they] may not perceive [their] sexual activity as abusive or exploitative, even though it may be. For example, many LGBTQ youth who are homeless have sex so they have a place to stay, but few perceive this as exploitation. Because transient youth may not perceive [it as] that they have been abused or exploited, and therefore may or may not directly ask for help, our goal is to educate each young person about healthy and unhealthy sexual practices, sexual rights, avoidance of abuse and exploitation, and how to access medical care, counseling and/or advocacy, if needed. By approaching it in this way, the youth chooses how to characterize and address their own sexual situations, rather than having it defined by others,” said Michelle Hall, Director of Transitional Living at The Oasis Center, Nashville, Tenn. (personal communication, January 6, 2014). 3. Ensure patience and flexibility when setting goals and timelines. This scenario portrays ways to infuse flexibility when working with youth: Leuk is a 19-year-old who loves to dance and sing, and has been coming to the local LGTBQ youth center for the past month. He does not have a permanent place to live, and has been couch-hopping with different “friends” for the last several months. Most of the time, his “friends” are people he meets that day. He doesn’t have a regular job, but most nights he dances at The Club for tips. He uses the money to keep himself clothed in dance attire and, occasionally, to get a hotel room. One day, staff at the youth center notice that Leuk seems less animated than usual. Leuk usually spends his time waiting for a shower and lunch by trying new dance moves and choreography, but today he seems withdrawn and quiet. Staff checks in with him to ask if he is feeling OK. Leuk replies that he is and denies being sick. Staff notices that Leuk has a difficult time making eye contact and has little energy in his voice. They ask to speak with Leuk in the office, and gently tell Leuk that they notice he is unusually quiet and sad. Leuk continues to report that he is fine. Staff reminds Leuk that they care about him and are here to talk with him if he needs anything, or if he is in a situation where someone is hurting him. Leuk mumbles “OK” and leaves the center for the day. In the next couple of weeks, staff continues to notice changes in Leuk. He comes to the center less often and, when he does visit, he quickly eats, showers, and leaves. They notice that the clothes he is wearing are much pricier than what he used to wear, and that his cellphone is a more expensive model. Each time staff has a chance, they check in with Leuk. In private, they mention that some young people had recently visited The Club and encountered a man who offered to make them famous in videos. Members of staff are direct with Leuk and say they are concerned that someone might be asking him to do things for which he feels badly. When Luek denies this, they do not push the issue, but remind him that they are here for him if he needs help. Members of staff continue to work with Leuk to find a permanent safe place for him to live, and recently have been working to connect him with a local dance troupe as a volunteer. Section Five Collaboration Collaborating with local organizations and establishing partnerships within your rural community will enhance your availability to provide services tailored to youth who experience homelessness. Through working with partners, we can look at ways in which we can provide services that are confidential and respectful of the rights of the youth. We can better meet the needs for transportation and isolation, as well as basic needs for food and shelter. The Listening to Our Communities: Assessment Toolkit (NSVRC & RSP, 2014) focuses on key tools and skills for conducting community assessments in order to strengthen services for sexual assault survivors. This assessment can be tailored to help determine the needs of homeless youth who have experienced sexual violence traumas within their rural communities. Ways to build relationships within the community include: 1. Partner with other youth-appropriate organizations and LGBTQ-specific organizations in your community. Creating Inclusive Agencies (NSVRC & PCAR, 2012) offers ideas and techniques for ways to seek out and collaborate with such programs. Partnering with programs that provide supportive and nurturing environmentsfor youth who identify as LGBTQ will help improve the long-term outcomes for these youth while also creating strong and substantial relationships within the local community (Larkin Street Youth Services, 2009). Developing relationships with LGBTQ-focused community agencies can provide opportunities for networking and referrals. This is a great step toward creating comprehensive services.Collaborating with these programs will enhance your agency’s ability to appropriately address the needs of anyone who comes through the door, including homeless youth who identify as LGTBQ (Larkin Street Youth Services, 2009). Youth Input A Web-based survey of more than 500 LGBT youth found that the services they most strongly desired were LGBT-specific sexual health educations, LGBT peer support and guidance programs, and assistance with dating and relationship issues (Cray et al., 2013). These partnerships might include: • Local social service and mental health agencies for longer-term therapy, advocacy, and intervention • Local child advocacy center to help provide additional individual, group, and family counseling • Local health services that are tailored to young people (Planned Parenthood, free clinics, free screenings, etc.) • Youth centers or other centers/programs that offer youth activities (YWCAs, YMCAs, recreation centers, churches, community clubs, etc.) • Local law enforcement and legal system professionals who understand working with LGBTQ communities • Transitional housing programs • Education and workforce development programs • Other centers/programs outside of service area if there is a lack of agencies within local community 2. Tailor outreach to reach youth in their living environments, which could differ from LGBTQ youth in your community. Youth who experience homelessness learn about services by word of mouth. Effective outreach for LGTBQ youth may include specific research and community assessment to find the areas where these youth have been known to stay while homeless (Cray et al., 2013). This outreach might look like: • Join with other centers to provide outreach to areas outside of your service areas. • Partner with schools and public libraries for outreach (often, schools and libraries are the only places a youth can go for shelter in the daytime.) • Consider technology-based outreach via social media platforms such as Facebook, text messages, and cellphones, keeping in mind safety and confidentiality. • Reach out to local bars and centers in other counties and cities close to your location. • Provide information about services that are available to homeless youth, including partner agency’s services. This will build trust and comfort to encourage youth to seek assistance. Highlighting programs with specific LGBTQ services in outreach materials (brochures, newsletters, media) also will help communicate a welcoming environment and demonstrate the agency’s knowledge around LGBTQ-specific needs (Cray et al., 2013). 3. Provide advocacy and accompaniment to youth. Many times, youth who experience homelessness are unable to access services that require parent or caregiver permissions and/or assistance. Providing advocacy and accompanying youth (upon their request and acceptance) for community health services, schools, the workforce, child protective services, etc. can reinforce current community partnerships, as well as foster new partnerships. Section Six Checklists for Building Resilient Relationships ?Create a safe and welcoming space ?Create space for freedom and choice ?Honor youths' survival skills ?Be aware of their personal traumas and feelings ?Recognize and support their feelings ?Value their choices and right to choose ?Stay attentive and available ?Listen ?Offer options and resources instead of advice ?Ask open-ended questions ?Be patient and flexible ?Meet their basic needs: • Shelter/safe place to stay/optional housing • Food • Clothing • Medical • Mental health ?Believe in youth and their strengths ?Believe in yourself: "We, too, need the protective factors of caring and respectful relationships and opportunities to make decisions; without these, we cannot create them for youth.” (Benard, n.d.) Checklist 2: Connecting With Youth Who Identify as LGBTQ & Experience Homelessness and Sexual Violence ?Understand the terminology that relates to their identity ?Develop a basic understanding of addressing LGBTQ youth by their preferred first name and pronoun based upon their gender identity or expression ?Meet their basic needs • Shelter/safe place to stay/optional housing: Provide options that allow youth to stay in safe places based on their self-identified gender expressions and orientation • Food • Clothing • Medical and mental health: Provide options, resources, and referrals of providers who are knowledgeable around the specialized medical and mental health care needs of LGTBQ youth, understand the terminologies and lived experiences of LGBTQ youth, and offer medical and mental health care services in a welcoming and safe environment ?Create a safe and welcoming environment • Display the agency/organization’s zero-tolerance policy and policies for treating/valuing everyone’s identity in visible places • Use affirming gender language or gender-neutral language • Place LGBTQ-friendly posters, images, magazines, newsletters, and local LGBTQ youth centers/services information in areas throughout the agency/organization • Include space for individuals to be able to contact the local LGBTQ center and/or for the local center to visit on a regular basis ?Create space for freedom and choice ?Honor their survival skills ?Be aware of their personal traumas and feelings ?Recognize and support their feelings ?Value their choices and right to choose ?Stay attentive and available ?Listen ?Offer options and resources instead of advice ?Ask open-ended questions ?Be patient and flexible ?Believe in youth and their strengths ?Believe in yourself “Everyone has strengths and the capacity for transformation” (Benard, n.d.) Section Seven Conclusion Building supportive and trusting relationships with homeless youth — especially those who identify as LGBTQ — can make significant, positive differences for their future and help ease the impacts of traumas they’ve experienced. Building relationships with these youth takes time. Working in partnership with them, supporting their freedom in determining their own needs and options, and collaborating with community partners can help lead them toward more positive experiences. By treating youth with respect and honoring them for their unique characteristics, they are viewed as individuals who are not defined solely by their traumas. Section Eight Publication Information About the Author — Taylor Teichman Taylor Teichman is Special Projects Assistant at the National Sexual Violence Resource Center, where she is responsible for supporting the planning, development, and management of specific grant project activities and materials within the Special Projects Department. Prior to joining NSVRC, she worked for a dual domestic violence and sexual assault program as an education advocate. National Sexual Violence Resource Center The National Sexual Violence Resource Center, founded by the Pennsylvania Coalition Against Rape in July 2000, identifies, develops, and disseminates resources regarding all aspects of sexual violence prevention and intervention. NSVRC activities include training and technical assistance, referrals, consultation, systems advocacy, resource library, capacity-building, integrating research findings with community-based projects, coordinating Sexual Assault Awareness Month, cosponsoring national conferences and events, and creating Web-based and social networking resources. Contributors The National Sexual Violence Resource Center wishes to thank Michelle Hall, Director of Transitional Living at Oasis Center in Nashville, Tenn., for agreeing to be interviewed and providing insight into OASIS’ programs and services for working with homeless youth. NSVRC contributors include Eric Stiles, Sally J. Laskey, Donna Greco, Erica Rich, Karen Litterer, Kelly Wilt, Angeline Binick, and Katherine Taylor. Section Nine Additional Resources FORGE • Services Outside of the Box: http://www.avp.org/storage/documents/Training%20and%20TA%20Center/2011_FORGE_Services_Outside_the_Box.pdf The National Network for Youth • NN4Y Fast Facts: Public Awareness Guide: http://www.nn4youth.org/system/files/FactSheet_Public_awareness_0.pdf National Alliance to End Homelessness • National Recommended Best Practices for Serving LGBT Homeless Youth: http://www.lambdalegal.org/sites/default/files/publications/downloads/bkl_national-recommended-best-practices-for-lgbt-homeless-youth_0.pdf • An Emerging Framework for Ending Unaccompanied Youth Homelessness: http://b.3cdn.net/naeh/1c46153d87d15eaaff_9zm6i2af5.pdf • Supporting Homeless Transgender and Gender Non-Conforming Youth: http://b.3cdn.net/naeh/5fff4ce6d4c4eec3ae_8bm6bxepg.pdf National Gay and Lesbian Task Force • The Lesbian, Gay, Bisexual and Transgender Youth An Epidemic of Homelessness: http://www.thetaskforce.org/downloads/HomelessYouth.pdf Section Ten References Bernard, B. (n.d.). The foundations of the resiliency framework. Retrieved from https://www.resiliency.com/free-articles-resources/ the-foundations-of-the-resiliency-framework/ Breiding, M., Smith, S., Basile, K., Walters, M. L., Chen, J., & Merrick, M. T. (2014). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization — National Intimate Partner and Sexual Violence Survey, United States, 2011. Retrieved from the Centers for Disease Control and Prevention: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm Burwick, A., Oddo, V., Durso, L., Friend, D., & Gates, G. (2014). Identifying and serving LGBTQ youth: Cases of runaway and homeless youth program grantees. Retrieved from the U.S. Department of Health and Human Services, Office of The Assistant Secretary for Planning and Evaluation: http://aspe.hhs.gov/hsp/14/lgbt-rhy/rpt_lgbtq_rhy.pdf Campbell, R. (2012, December 3). The neurobiology of sexual assault [Webinar]. Retrieved from the U.S. Department of Justice, National Institute of Justice: http://nij.gov/multimedia/presenter/presenter-campbell/Pages/welcome.aspx Cray, A., Miller, K., & Durso, L. E. (2013). Seeking shelter: The experiences and unmet needs of LGBT homeless youth. Retrieved from Center for American Progress: http://www.americanprogress.org/wp-content/uploads/2013/09/LGBTHomelessYouth.pdf Hammer, H., Finkelhor, D., & Sedlak, A. J. (2002). Runaway/throwaway children: National estimates and characteristics. Retrieved from the National Criminal Justice Reference Service: https://www.ncjrs.gov/pdffiles1/ojjdp/196469.pdf Larkin Street Youth Services. (2009). Best practices for meeting the needs of lesbian, gay, bisexual, transgender and questioning homeless youth. Retrieved from http://www.larkinstreetyouth.org/wp-content/uploads/3_LGBTQ_Homeless_Youth_Brief.pdf National Alliance to End Homelessness. (2009). Homeless youth and sexual exploitation: Research findings and practice implications. Retrieved from http://b.3cdn.net/naeh/c0103117f1ee8f2d84_e8m6ii5q2.pdf National Alliance to End Homelessness, (2010). Fact sheet: Rural homelessness. Retrieved from http://www.endhomelessness.org/page/-/files/1613_file_Fact_Sheet_rural_2_2_2010.pdf National Alliance to End Homelessness. (2014). LGBTQ youth. Retrieved from http://www.endhomelessness.org/pages/lgbtq-youth National Child Traumatic Stress Network. (2007). Trauma among homeless youth. Culture and Trauma Brief, 2(1). Retrieved from http://www.nctsn.org/sites/default/files/assets/pdfs/culture_and_trauma_brief_v2n1_HomelessYouth.pdf National Coalition for the Homeless. (2009). Rural homelessness. Retrieved from http://www.nationalhomeless.org/factsheets/rural.html National Sexual Violence Resource Center. (2010). Opening the door: An advocate's guide to housing and sexual violence. Retrieved from http://www.nsvrc.org/sites/default/files/nsvrc_publications_guides_opening-the-door-an-advocates-guide-to-housing-and-sexual-violence.pdf National Sexual Violence Resource Center & National Sexual Assault Coalition Resource Sharing Project. (2013). Building cultures of care: A guide for sexual assault services programs. Available from http://www.nsvrc.org/publications/nsvrc-publications-guides/building-cultures-care-guide- sexual-assault-services-programs National Sexual Violence Resource Center, & National Sexual Assault Coalition Resource Sharing Project. (2014). Listening to our communities: Assessment toolkit. Retrieved from http://www.nsvrc.org/publications/nsvrc-publications-toolkits/listening-our-communities-assessment-toolkit National Sexual Violence Resource Center & Pennsylvania Coalition Against Rape. (2012). Sexual violence & individuals who identify as LGBTQ information packet. Available at http://www.nsvrc.org/publications/nsvrc-publications-information-packets/sexual-violence-individuals-who-identify-lgbtq Quintana, N. S., Rosenthal, J., & Krehely, J.. (2010). On the streets: The federal response to gay and transgender homeless youth. Retrieved from the Center for American Progress: http://cdn.americanprogress.org/wp-content/uploads/issues/2010/06/pdf/lgbtyouthhomelessness.pdf Ray, N. (2006). The lesbian, gay, bisexual and transgender youth: An epidemic of homelessness. Retrieved from the National Gay and Lesbian Task Force: http://www.thetaskforce.org/downloads/HomelessYouth.pdf Ryan, C. A., & Hoover, J. H. (2005). Resiliency: What we have learned. Reclaiming Children and Youth, 14(2), 117-118. Retrieved from http://reclaimingjournal.com/sites/default/files/journal-article-pdfs/14_2_Ryan_Hoover.pdf U.S. Department of Health and Human Services, Administration for Children and Families (2002). Sexual abuse among homeless adolescents: Prevalence, correlates, and sequelae. Retrieved from http://www.acf.hhs.gov/sites/default/files/opre/sex_abuse_hmless.pdf National Sexual Violence Resource Center • 877-739-3895 • resources@nsvrc.org • www.nsvrc.orgNational Sexual Violence Resource Center • 877-739-3895 • resources@nsvrc.org • www.nsvrc.org