A California foster parent initially feared the worst when a teenager at risk of being sexually trafficked ran away from her home a few years ago. In the past, the girl had crossed a highway in the dark, without her phone.
This time, however, the teen texted to say she was staying with an “alternative caregiver.” This trusted adult had been granted a special license by San Francisco’s child welfare agency to take her in when things weren’t going well in a foster home or she needed another safe space. The next day, the teenager went to school, and then returned home to discuss her feelings.
This account and others like it represent a new approach to caring for foster youth who’ve been subjected to commercial sexual exploitation. In the Bay Area’s Family and Me program, referred to as FAM, foster youth select an “alternative” to their primary caregivers. They also receive $3,000 a year to use as they please for unmet needs — from self-care items and concert tickets to groceries, clothing and transportation.
In a recently released evaluation of the Family and Me program, the Human Rights Center at UC Berkeley School of Law found positive results for youth and their caregivers. The experimental model of foster care is needed, report authors stated, because too often child welfare systems fail to serve young people who are sexually exploited, leading to cycles of running away, arrests and homelessness.
“Youth participating in FAM experienced a range of complex mental health challenges, including anxiety, depression, trauma-related symptoms, and difficulties with emotional regulation,” the evaluation, released in December, found. But the program “mitigated some of these challenges by strengthening trusted relationships, improving access to therapy, and supporting alternative forms of healing such as peer mentorship and wellness activities.” That additional support reduced post-traumatic stress symptoms and “contributed to improved quality of life, stability, and resilience.”
From 2023 to 2025, the UC Berkeley researchers followed 10 young adults involved in the state-funded program, which was created by the Bay Area’s Freedom Forward nonprofit — a group that works to prevent sexual exploitation of young people in the region. In dozens of interviews with young people, caregivers and social workers, they found that being connected to another adult allowed participants to avoid psychiatric hospitalizations and placement disruptions. Many received ongoing support even after they left foster care.
The young people reported “increased trust, autonomy, and a sense of belonging.” Access to “flexible funds” increased their independence and sense of dignity, the researchers found. “Many expressed that these resources made them feel empowered to make choices about their lives.”
Caregivers also benefited, receiving “critical respite and emotional support” that reduced burnout and helped sustain placements in their homes.
In an interview, Julie Freccero, the Human Rights Center’s senior director and the lead author of the report, described challenges these young people face, how the FAM program helped them, and why one assumption about trafficked youth is wrong. She hopes the state will expand the program and institutionalize the alternative caregiver role.
“It was a small sample size, but I think we saw really transformative results,” Freccero told The Imprint.
This conversation has been lightly edited for brevity and clarity.
Can you begin by telling me about what life for sexually exploited youth in foster care looks like?
For young people who have experienced exploitation, many have a long history of involvement in the child welfare system. They have some of the highest rates of placement changes and the longest stays in foster care. They’re often placed in group homes or congregate care facilities, and often out of state, and their placements change a lot. Often their placements are terminated because they leave a placement and aren’t allowed to come back after a certain number of days, or there are a lot of strict rules that don’t work well for this community of youth.
And so they bounce around a lot. They’re cycling through different placements, through periods of time unhoused completely. All of these moves really disrupt protective factors against exploitation, such as continuity of services at school, and their relationships with the trusted adults that are around them. We have a child welfare system that’s really kind of exacerbating the harm for these youth that it is trying to prevent.
Why is group care so unsafe for these sexually exploited youth?
There’s a lot of issues with congregate care, where often there’s trafficking and recruitment that happens directly at the group home. There are also challenging dynamics where it’s hard for these young people who have increased trauma symptoms and acute mental health needs to be in more of a group housing situation with others with similar needs.
In general, with family-based care, there’s more attention to youth, which means more protection. But in addition to that, nurturing relationships with relatives, mentors and other supportive adults is really important. Having that person work with the primary caregiver in a family-based care situation really created longer-term stability.
“We have a child welfare system that’s really kind of exacerbating the harm for these youth that it is trying to prevent.”
— Julie Freccero
How did having an “alternative caregiver” help young people in the program?
The alternative caregiver was someone who was chosen by the young person themselves to provide a different place for them to stay overnight if there was tension in the home. If they wanted to run away, or leave for any reason, they had this other safe place to stay.
We found it dramatically prevented a lot of episodes when they would have run away, or experienced homelessness, or have their placement terminated. They were spending fewer nights in dangerous and unsafe situations.
What lessons can child welfare systems derive from a model of care based on alternative caregivers such as these?
The youth described them as being like their family — they started calling them “auntie” or “mom” or their best friends in the world — and said that they trusted them. They were the only ones who would keep their secrets. It was important to have these emotionally safe, consistent relationships that they really relied on.
There were a lot of assumptions among partners that most of these youth just wouldn’t have anybody, and maybe that was a reason why they were more vulnerable to exploitation. But that was actually not the case. Almost all the young people in the pilot had someone they could name for this role. And the key learning was really that — once you remove those financial and practical barriers to support — they do have adults that are ready to step into this role.
We should be investing in programs such as FAM that are going to be there for them after they exit traditional foster care, so that there’s still a network of relationships that youth can access.
The other major part of the pilot was money given to both young people and their caregivers. How were those funds used?
The goal at the start was for the money to be used for enrichment activities, extracurricular activities, wellness needs and bonding activities — so they could have the money to travel to see family, go to a concert with a family member, or go out for meals.
But what we ended up seeing was that the majority of spending was on basic needs such as food, clothing and transportation. That just really highlighted how much basic needs are still going unmet for these young people.
“Once a young person has been abused or exploited or has lost a sense of control in their lives, incorporating youth voice and agency is so important for healing.”
— Julie Freccero
What difference did that money make?
One example that was really powerful was when a young person really needed a reading specialist and the county education department wasn’t paying for it, and there were no child welfare funds for this. Another young person used it for a cap and gown for graduation and for getting family members to the graduation. Things that might seem small, but really fostered joy, self-esteem and normalcy.
The money also helped caregivers. We had a young person who wanted to live with her grandfather, and he received specialized training about how to work with a young person who had been exploited. He was able to visit her every day at the group home where she was staying.
That relationship really progressed, and then the youth started really advocating with her Seneca Family of Agencies counselor to live with her grandfather, and so they used some of the flexible funding for him to get a bigger apartment with an extra bedroom, and she moved in with him. He’s still her primary caregiver, and it was just so valuable to her safety and overall well-being and stability.
What can be learned from this model of providing cash to foster youth for everyday things that may be lacking in their lives?
Putting the resources directly into the hands of young people, their relatives or their support system seems so simple. But it’s actually a huge fundamental shift for the child welfare system. Rather than having money driven by the placement, this really allows resources to go toward each young person in a way that is actually going to support their long-term healing and stability.
We hope that the state doesn’t lose sight of flexibility and the youth-centered nature of this model. Once a young person has been abused or exploited or has lost a sense of control in their lives, incorporating youth voice and agency is so important for healing.
