Date of Graduation

Spring 5-14-2020

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


Biological Science

First Advisor

Mary Katherine Donnelly, DNP, MPH, ACNP-BC, ANP-BC, CNL



Problem: Commercial sexual exploitation of children (CSEC) is a critical human rights and public health issue. Abundant evidence shows that sexually exploited youth are at high risk for medical and psychiatric problems, manifest fright and isolation, and have substantial trauma mitigation needs. A short term residential therapeutic home (STRTP) was created in Northern California to provide holistic care to teens victims of sexual exploitation. A therapeutic team is necessary to provide the medical and mental health requirements of STRTP residents.

Context: This evidence-based change of practice project was conducted at a 15-bed STRTP in Northern California that will house sexually trafficked female youth. To support the medical needs of youth, the STRTP is partnered with a local community health center and a school of nursing to train therapeutic living counselors (TLCs) to help teens increase their adherence to their medication regimens. Evidence supports that a nurturing environment, higher levels of self-esteem, and an internal locus of control is associated with increased adherence to medication regimens. This training focuses on TLCs because they provide 24/7 care to teens and are vital to promoting medication adherence among teens.

Interventions: The project goal is to provide a safe and patient-centered environment where teenagers can avoid triggers of trauma. The intervention was to develop an evidence-based educational program for the TLCs to promote teens' self-esteem and increase internal locus of control. A training process was designed to help TLC meet five measurable learning objectives: (1) Increase their knowledge in signs and symptoms of complex trauma, (2) trauma-informed approach (3) behaviors consistent with internal locus of control, (4) behaviors related to self-esteem, (5) patient-centered care approaches. Evidence suggests that understanding complex trauma and patient centered and trauma informed approaches will improve teens’ adherence to medication regimen. The training program consists of a PowerPoint presentation, an educational video, group discussions, and visual props to reinforce learning.

Measures: Evaluation of the training program uses pre- and post-survey questionnaires on the five training objectives. Responses to pre-survey inquiries will be compared to the post-survey questionnaires to determine if TLCs improve their knowledge.

Results: The results of these pre and post surveys are pending since the training related to TLCs has not yet been conducted. From evidence reported in the literature and the results of a related medication protocol training carried out at the STRTP, it is anticipated that pre-test and post-test will improve.

Conclusion: Results for this project cannot be reported because the TLC training has not yet taken place. The training was postponed because of the COVID-19 pandemic and sheltering in place order. However, evidence supports that improving TLCs’ knowledge on trauma informed approaches, teens' internal locus of control, teens' self-esteem, and patient-centered approaches will increase teens' participation and adherence to their medication regimens.