Effects of the Integrated Care Program 'Asja' for Actual and Potential Adolescent Female Victims of Sexual Exploitation

AbstractAdolescent girls who are at risk of, or have experienced, sexual exploitation (female SEC) often face complex and multifaceted challenges, including trauma-related symptoms, psychosocial difficulties, unstable home environments, and adverse developmental trajectories. To mitigate further harm and support positive development, integrated care targeting multiple domains—such as trauma, psychosocial functioning, and systemic factors—is essential. However, few integrated care programs have been systematically evaluated, and none within a quasi-experimental design. This study examined the effectiveness of the Dutch Asja residential integrated care program using a before-and-after design. A sample of 39 to 55 adolescent girls admitted between 2020 and 2025 (Mtreatment days = 234.98; Sd = 117.01) was assessed using linear mixed-effects models with random intercepts. Outcomes included self-reported measures (Strengths and Difficulties Questionnaire) and clinician-rated assessments (Health of the Nation Outcome Scales for Children and Adolescents). Results indicated significant improvements in key domains, including reductions in self-reported emotional and behavioral problems, hyperactivity, and clinician-assessed emotional and social difficulties. Total problem scores from both adolescents and healthcare professionals also showed significant declines over time. At discharge, 75.4% of the adolescents reported high levels of treatment-goal attainment, and 53.6% indicated no immediate need for follow-up care. These findings provide preliminary evidence for the effectiveness of the Asja program. Future research should focus on reducing unplanned discharges and addressing methodological challenges such as attrition and the high complexity inherent in integrated care for this vulnerable population.