Exploring the Role of Occupational Therapy With Women Leaving the Sex Industry

BACKGROUND AND PURPOSE: The sex industry involves commercial sexual performances, merchandise, and favors in exchange for money (McCray et al., 2011). Many women who grew up in stressful home environments pervaded by childhood abuse, family drug and alcohol use, low education and socioeconomic status, or stress find themselves drawn to this occupation (Anklesaria & Gentile, 2012). The financial benefits of this work may feel like their only option to make a solid income (Preble, 2015). Involvement in the sex industry exposes women to risks of physical and sexual violence (Anklesaria & Gentile, 2012).

After leaving the industry, many women struggle with behavioral, psychological, physical, and mental health conditions, as well as with addictions, poor health management, stigma, and difficulty adjusting to society and building relationships (Wilson & Butler, 2014). The purpose of this study was to identify supports for and barriers to occupational participation and health for former female exotic dancers leaving the industry and to determine the presence of occupational deprivation and imbalance as they work toward rebuilding their lives.

METHOD: For this study, a phenomenological qualitative design was used. After approval by the institutional review board, recruitment was initiated via a snowballing method. The principal investigator initiated recruitment through an organization called Strip Church. Participants were six female former exotic dancers aged 18–65 who had left the sex industry at least 6 mo before implementation of this study. These women were residents of five different states and were able to read, write, and speak English. Once verbal consent was obtained, participants were administered a nine-item demographic questionnaire followed by a 20-item semistructured interview. Each interview lasted about 1 hr. The demographic questionnaire and semistructured interview were developed on the basis of literature review findings.

After the interviews were conducted they were transcribed verbatim, and field notes were used to summarize the interview. Descriptive coding was used for first-cycle coding and inductive coding during data collection to determine five common themes.

RESULTS: The results of this study indicate that former sex workers may benefit from occupational therapy based on the range of psychosocial needs of the women identified in this study. It is important for health care professionals to acknowledge and have an accurate understanding of the life experiences of former sex workers before, during, and after participation in the industry in order to address their underlying health issues. The identified factors leading to entering the industry and the barriers to leaving demonstrate a need for occupational therapy services within a preventive model through education and candid discussion. It is essential for the profession of occupational therapy to continue advocating for its role in the mental health sector based on the findings of these women’s needs for building self-esteem, promoting participation in meaningful occupations, and developing healthy relationships.

CONCLUSION: The well-being of former sex industry workers is a complex topic necessitating thorough evaluations and the creation of client-centered interventions that address their psychosocial needs. Occupational therapy services may benefit this population by promoting participation in meaningful occupations, community reintegration, employment pursuit and acquisition, self-esteem, positive coping skills, and financial management.

References

Anklesaria, A., & Gentile, J. P. (2012). Psychotherapy with women who have worked in the “sex industry.” Innovations in Clinical Neuroscience, 9(10), 27–33.

McCray, K., Wesely, J. K., & Rasche, C. E. (2011). Rehab retrospect: Former prostitutes and the (re)construction of deviance. Deviant Behavior, 32, 743–768. https://doi.org/10.1080/01639625.2010.514224

Preble, K. M. (2015). Creating trust among the distrustful: A phenomenological examination of supportive services for former sex workers. Journal of Aggression, Maltreatment and Trauma, 24, 433–453. https://doi.org/10.1080/10926771.2015.1022291

Wilson, B., & Butler, L. D. (2014). Running a gauntlet: A review of victimization and violence in the pre-entry, post-entry, and peri-/post-exit periods of commercial sexual exploitation. Psychological Trauma: Theory, Research, Practice, and Policy, 6, 494–504. https://doi.org/10.1037/a0032977