What Would Foucault Say? Applying the Theoretical Lens of Power/Control and Stigma through a Qualitative Interpretive Meta-Synthesis of Runaway Girls

Qualitative studies have examined runaway youth and their choices to leave home, their involvement living on the streets, and their lived experiences as stigmatized youth. For the present study, a Qualitative Interpretative Me-ta-Synthesis (QIMS) was conducted to synthesize the data from these various studies. A systematic search located qualitative research that focused on girls who were or had been runaways. They were synthesized in this analysis. The themes of power/control and stigma are analyzed with a Foucaultian lens with an eye toward informing social workers of their roles in the power/control structures that create stigma for runaway youth.


Literature Review
The concept of power/knowledge is introduced to describe the forms of social control that have been used to maintain control over society through the creation of these social norms (Foucault, 1980). The following review examines Foucault's conceptualization of power/knowledge to provide a theoretical foundation for the synthesis of the runaway experience.
Power/knowledge Power, according to Foucault (1980) is created and explored in all aspects of society and individual life from school to work to social gatherings. It is "power tokens or stars can be used to purchase extra benefits are also common in group home settings. Doing this within the group creates a hierarchy where those who do well have the most and those who do poorly have the least. Using these methods will force conformity as they all seek to be like each other. Conformity leads to normalization (Foucault, 1977).
Power is about more than repression or correction though. While both are components of power, real power must be more than a negative force; it must also be a productive conduit to meet the needs of society (Foucault, 1984b). Power is balance of tolerance with punishment and repression. Power "needs to be considered as a productive network which runs through the whole social body much more than as a negative instance whose function is repression" (Foucault, 1984b: p. 61).
Research informing social workers who assist this population contributes meaningful insight into meeting their needs. This study seek to broaden the social work understanding of the experiences of runaway youth by creating a body of evidence that advances social work practice in positive and affirmative ways.
To further this goal, this research sought to answer the following question: How do the experiences of runaway girls inform social work practice in assisting this population?

Methods
Qualitative Interpretive Meta-Synthesis (QIMS) was developed by Aguirre and Bolton (2014)  ers, 2020). The detailed outline provided by Aguirre and Bolton (2014) was utilized in this study. The results of this study are separated into two articles to allow a richer synthesis of the findings. A comprehensive outline of the QIMS procedure and steps is provided in the other article (see : Crawford, 2021). A condensed outline is presented here. The QIMS requires a systematic search of the literature in order to capture all of the available qualitative articles on the subject. For this study, the researcher used Google Scholar, Social Work Abstracts, and Criminal Justice Abstracts. Search terms included in the search "female", "foster" and "offender". Additionally, the phrase "runaway youth" was added to narrow the search to articles about runaways. Screening criteria comprised the following: 1) English language articles, 2) peer-reviewed, 3) qualitative or mixed methods, 4) participant quotes used in the article, 5) and sampled females who were, or had been previously, runaways. The Quorum chart provides a step-by-step analysis of the process (see Figure 1) for selecting the 10 articles that are included in this QIMS.
Eight studies are represented in the 10 articles with a total sample of 122 individuals. Some studies included both males and females. For these, the researcher examined only the results from the females for the synthesis. While all studies had to be published in English, geography was not a criterion for inclusion. Studies were global, coming from the United States, Israel, Australia, and Canada. Demographic information is included in Table 1.  In a QIMS, the original themes and subthemes are extracted intact from the articles (see Table 2) in order to maintain the integrity of the original research (Aguirre & Bolton, 2014). Forty-three themes were pulled from the 10 articles.
Comparison across the studies allows for the synthesis of the original themes and subthemes creating new overarching themes that encompassed the narrative each of the articles.

Results
Analysis of the ten articles resulted in six themes: power and control, stigma, physical needs, safety, belonging, and acceptance (see Table 3). The themes of physical needs, safety, belonging, and acceptance are analyzed and presented in a separate article (Crawford, 2021). Presentation and discussion of two themes of stigma and power and control are presented below with accompanying quotations.

Power and control
The theme of power and who controlled that power emerged from many of the articles as the youth discussed different aspects of their lives.  (Peled & Cohavi, 2009: p. 744).
The idea that the youth needed the power to control their lives was evident in three distinct areas: Living Rules, System Rules, and Legal rules.
Living Rules. The participants discussed why the rules of various places they stayed generated impediments to their success. One teen said, "I want to do my    (Maassen, Pooley, & Taylor, 2013: p. 62). Another added, "I don't actually mind doing chores… but on Sunday I get really angry and pissed off, coz it's like Sunday… I just want to sleep and chill" (Maassen et al., 2013: p. 62). Chores in the facilities were not the only complaints. Curfew was a concern, especially for those youth who were already 18 or over. One teenager described curfews thusly: Curfews are stupid. The night time curfews are way too early. Stops me doing my own thing. I'm going all the way out to Morley tonight and I had to check in for the 5:00 pm curfew. By the time I get back to Morley I'll have to come back to make (the night) curfew (Maassen et al., 2013: p. 62).
Another teen stated, "Now that I'm 18 the curfews like are still the same when I was 17. I can go to pubs now, I wanna stay there … and go clubbing and not have to worry about being home at a certain time" (Maassen et al., 2013: p. 62).  (Maassen et al., 2013)  Survival and identity experimentation (MacDonald, 2013)  Caring for self: (Williams et al., 2001) Safety  Displacement and disconnection in dangerous places (Berman et al., 2009)  The homeless teenage need for safety: (Maassen et al., 2013)  Initial risk: Family violence (Mann et al., 2007)  There is a home: Extinction of the self (Peled & Muzicant, 2008)  There is no home: Vulnerability and being different (Peled & Muzicant, 2008)  Youth violence: Rape, rage, retaliation (Mann et al., 2007)  Youth violence: Escalation (Mann et al., 2007)  Dangerous/desperate pathways (Mann et al., 2007)  Learning from experience (Martinez, 2006)  Childhood victimization and lessons learned (Wesley & Wright, 2009)  Struggling with the cycle of violence (Wesley & Wright, 2009) Belonging  Negotiating spaces of belonging (Berman et al., 2009)  Tenuous connections amid spaces of hope (Berman et al., 2009)  The homeless teenage need to belong (Maassen et al., 2013)  Youth resources: Connectedness (Mann et al., 2007)  Creating new affiliations (Martinez, 2006)  Outside the home: School and friends and Helping professionals (Peled & Cohavi, 2009)  There is no home: Vulnerability and being different (Peled & Muzicant, 2008)  There is a home: The ideal home; The actual home as a prison; The home as a women's prison (Peled & Muzicant, 2008)  Divine intervention (Williams & Lindsey, 2006)  Role of prayer (Williams & Lindsey, 2006)  Participation in traditional and non-traditional religious practices (Williams & Lindsey, 2006)  Youth supports and advocacy: Counselling services (Mann et al., 2007) Acceptance  The homeless teenage need for self-actualization (Maassen et al., 2013)  Youth resources: Identity (Mann et al., 2007)  The home: Mother, father, and siblings; The extended family; and The girl (Peled & Cohavi, 2009)  And still there is a home (Peled & Muzicant, 2008)  Personal relationship with God or a higher power (Williams & Lindsey, 2006)  Finding meaning and purpose in life (Williams & Lindsey, 2006)  Meaning and purpose to life (Williams et al., 2001) Overall, the rules felt oppressive to the teens. Michelle said, "I felt like I was suffocating" (MacDonald, 2013: p. 432) and Shane noted that they did not want to be treated "like kids, not babysat" (MacDonald, 2013: p. 432). Another participant added that the rules created new problems: "It's like people are more rebellious… It's because of the rules. There are so many rules" (Maassen et al., 2013: p. 63).
Connie discussed the rules at one facility as being the reason she knew she could not stay. This began with them demanding that she turn over cell phone, which she considered her life line. She summarized: They were going to take away my cell phone even. Like, I said that was a very emotional weekend for me as well. Like I, I just realized what happened to me. [She had been raped.] I needed my phone in case I needed to talk to somebody. I couldn't have them take my phone away from me. (Mann et al., 2007: p. 54-55) Connie could not understand the reasoning behind needing to give up her cell phone. In her mind, the rules personified the workers who were "bitches" who wanted to control her life (Mann et al., 2007: p. 55). To her, the rules stymied her efforts to make positive change in her life and created a system of power that took away her ability to control the choices that she made. When asked if she thought anything could have been different at the home to make it more amenable to her staying, she replied: No. At that point for me, I needed to be with family. I needed to be around people. I needed to be around a good environment. No, the group home wasn't a home, it was an office building. It had actual offices in it… You, you, you were on military time basically, and it was, it's not something [pause]. No. It's not a home (Mann et al., 2007: p. 55).
System rules. Structural rules within the system created many setbacks for the youths in the studies. These obstacles often presented as power dynamics that were designed to stop youth from attempting to live on their own. Annie described the difficulties in accessing assistance that would be available to her as an adult. "When you are 16 or 17 you are in limbo… [Public assistance] is impossible to get… How are we supposed to manage being in school when we don't have a place to live?" (MacDonald, 2013: p. 432).
Because the system denied these benefits to youth, many turn to other professionals within the system for help. This often did not lead to positive results.
Casey described her experience of seeking help through a social worker: No one will rent to a 16 year old. If you are 16 you are discredited. Landlords told me I need to get a co-signer and to ask my social worker to co-sign. But my social worker told me to find someone else to co-sign… Who am I going to find? (MacDonald, 2013: p. 433) Connie also described her experience in accessing help through the profes- I went to Children's Aid because my mom was trying to bring me home after running away when I was too young to be gone. And I had three months exactly before I was 16… I noticed the people at Children's Aid were very rude, very rude to me. Like, they're like, "Sorry you have to go home." Because my parents are very well spoken. (Mann et al., 2007: p. 54) Accessing this professional help brought with it news concerns for youth as well. "I was really worried [my parents] would find out where I am or that my information would be shared with them. I just want to be left alone" (Claire) (MacDonald, 2013: p. 432). Terry echoed these concerns: I have talked to people in authority, the school counsellors or somebody who I thought would listen to me and not go tell anybody. And every time I turned around I was telling those people how I was feeling and my stepmother was always finding out exactly everything I said word for word. So I just don't talk to people about my problems anymore. (Williams et al., 2001: p. 248) For those who are able to find some assistance, problems still arose. Casey discussed not being able to find housing, even when she was receiving some financial assistance. She resorted to living the only place she could find: Everyone in this rooming house was doing crack. I mean the dealer lived in the building and he knew when it was check day [when people would receive their checks from social assistance]. You wouldn't even see your money, it would just be handed over to the crack dealer… there was no way you were going to pay the rent. (MacDonald, 2013: p. 433) Legal rules. In many ways, Connie's story revealed the numerous legal impediments to youth seeking services. Too often, these presented as concerns regarding who has the power and control over the lives of young people. Connie recounted the following story of a call to the police when she sought help to escape abuse: I've called the cops on my stepdad for the time he attacked me, and I had a goose egg on my head. I had nasty welts all over my body, and including like ones on my hips, where between my pants and my shirt it was often noticed. I called the cops the night that happened actually, and they didn't do anything for me (Mann et al., 2007: p. 53).
This experience led her to conclude that calling the police was not a way to seek help. She also spoke of a rape when she was younger and had never reported to the police because of her previous negative experience. Connie described her reasoning for not telling the police about the rape: Because [the police] would be, they wouldn't believe me… I don't talk to cops really because they, they never did anything for me during like domes-tics for, with my family. And they always just brought me right back to my home, my house and said to smile and get used to it basically, until I turned 16 and could do something about it (Mann et al., 2007: p. 53).
Connie also revealed concerns about education. She wanted to continue her schooling but had difficulty getting to school every day because of her living arrangements and lack of transportation.
Right now, there's a high, high rate of people getting kicked out by the principal. Like I might be kicked out soon because, um, I missed a lot of school last semester… Now I'm on contract. I got, I'm assigned on con-tract… Um, which means, I, I, because I had missed so much school, for a semester and had failed all my classes, they had signed me a contract where, uh. The conditions are if I miss, I believe, more than five days for the rest of the year, I could get kicked out… And then um, if I, uh, if I'm not passing every single one of my four classes, by midterm, when marks are due, then I can get kick, I will get kicked out (Mann et al., 2007: p. 57).
The lack of power the girls had over their lives provided them with the impetus to take control over the decisions that they could manage to make. As Chelsea stated: "I'm really glad that I'm not living with either of my parents anymore because it means that, yeah, I might move a couple of more times, but at least it's in my control" (Berman et al., 2009: p. 424). This control often manifested in the first decision to run. Dana described the choice the run in the following way: [Girls] run away because things are so bad for them at home that they are prepared to gamble everything… they have no hope. There is nothing to protect them and no one to protect them (Peled & Cohavi, 2009: p. 745).
In describing her own decision to leave home, Dana said, "it's like running away was the only choice I had left" (Peled & Cohavi, 2009: p. 745). She went on to discuss her reasoning: Ah, [short silence] everything, home… when your mother shouts all the time what an idiot you are and how ugly you are and what a whore you are and stuff, you feel that this is ruining your self-esteem. And you want someone to treat you differently, properly… to appreciate you, to love you [whispers] and you leave (Peled & Cohavi, 2009: p. 745).
Faith ran "because I try to get away from the situation that I am at… to feel like I'm more in control of myself… at least I am getting away from that problem. Running away was like my problem-solving thing" (Martinez, 2006: p. 80). Jennifer explained that "kids run away cause either that are hurt, something is not right in the home and they don't know how to deal with it, or don't want to tell people" (Martinez, 2006: p. 81). Sara and Junie also knew they had to leave home in order to escape abuse. Sara described an alcoholic father who physically abused both her and her mom (Wesley & Wright, 2009) Yeah, [my mom] used to hit me a lot. I just thought that maybe she didn't love me, you know. And I just thought she didn't love me, because she always on me and I was a really good student, and I did everything she wanted at home, so I couldn't understand why she was always hitting me (Wesley & Wright, 2009: p. 230).
Overall, many of the participants described their difficulty at home and the struggle they had once they made the decision to leave. In addition to the structural concerns regarding power and control, the youth also described instances of stigma that altered their lives.
Stigma Stigma is a closely related theme to the concerns of power and control. Connie described the system as not trusting her because of her age and her runaway status. In describing her search for assistance, she discussed the stigma faced from professionals who required her to have an adult with her: Like I didn't have one adult I trusted… Because who was I gonna get? I didn't have any adults I trusted. Who, who am I gonna, I've been screwed over by my own parents? I'm gonna trust some adult receiving checks and making sure I get the money? Making sure I have rent? (Mann et al., 2007: p. 58).
Stigma often originated at home. Eden said that her family hates her and ''treats her like dirt… I didn't have a family that I could live with'' (Peled & Muzicant, 2008: p. 449). Hagar described feeling "totally, totally alone… I didn't have warmth, I didn't have love, I didn't have anything" (Peled & Muzicant, 2008: p. 449). One participant described her home community as one where stigma began as people talking about each other: "There is too much gossip. Like people, they just talk shit" (Berman et al., 2009: p. 424). When Ruby told her mother of the sexual abuse she had endured, she responded by shaming Ruby: "But she didn't ever believe me. She said I was a whore. She said I deserved it'' (Wesley & Wright, 2009: p. 222). Yvonne talked about the feelings of stigma overwhelming her: There's not very much to be pleased with myself with. I'm hoping that everything will go for the better in the future instead of having to go through this shit every day, every day, nonstop. It gets very depressing to me (Williams et al., 2001: p. 243).
Yvonne continued, describing the stigma she faced in different professional settings. "These other hospitals didn't care, didn't care at all. All they cared about was throwing your butt in a room and locking you up somewhere, or restraining you" (Williams et al., 2001: p. 249). Kameka's story of a counselor concurred with Yvonne's negative experience in the hospital. Kameka said, "[the counselor] was like, 'I know what you're doing. You know you aren't hurting anybody but yourself,'" (Williams et al., 2001: p. 248), which felt like blaming and stigma to Kameka. Stigma then extended into the lived experiences of the young women as they survived on the streets. Shahaf reported, "If an adult person saw me outside at three o'clock in the morning, they would say, 'She's probably a whore.' They won't even try to understand" (Peled & Muzicant, 2008: p. 453).
Through this stigma, however, the young women reported a strong desire to overcome the barriers and prove wrong the stigmatized images painted of their lives. Sally said, "Everything that I've been through has affected me, has made me stronger," while Kameka reported, "If it wasn't for that community breaking me down the way it did, I don't think I would be as strong as I am now" (Williams et al., 2001: p. 242).

Discussion
The concepts of power, control and stigma are discussed thoroughly by Foucault (1977Foucault ( , 1978Foucault ( , 1980 in many of his works. To Foucault, the power/knowledge structure of a society created a system of control over the lives of the individuals in that community (Foucault, 1977). Stigma is integral to a successful power structure (Foucault, 1977(Foucault, , 1978. The themes of power/control and stigma identified above will be discussed using a Foucaultian lens as described in a theoretical comparison on homeless sexual minority youth (Crawford, 2018).
Power and control Foucault (1980Foucault ( , 1984a described the power structures that establish societal norms as necessary agents to create control within the society. Power is an ever-present mechanism in life, exerted at all levels of society to force conformity to the expected norms (Foucault, 1977(Foucault, , 1978. From the themes identified above, several examples of structural power that society uses to create and enforce norms may be found. The description of youth suffocating from the oppressive rules identified the feelings that the youth expressed. Rules at placements created systems of control over what the youth could and could not do and even regulated the timing of those decisions. Daily chores, bedtimes, waking times, eating times-all converged to create a regimented life that structured the day of the youths in the facility in a way that left them with little power or control to make their own decisions (Maassen et al., 2013). Connie described an educational system intent on applying rules in a uniform way that ignored the circumstances of her life. To her, the system was designed to make her fail, forcing her back home (Mann et al., 2007). Connie's labored discussion of leaving a placement that denied her access to her phone is another example of a structural use of power to control those with whom she could have contact.
According to Foucault (1978), institutional structures that provide services to individuals create systems of power by which those in need must conform to the established norm in order to be deemed worthy of services. Those outside of the norm are identified and then corrected through institutional processes (Foucault, 1980). While deviance from the norm is often legally punished, other measures of coercion exist. These other measures were evident in the girls' sto-ries.
Institutional rules may be implemented that force conformity to expected roles regarding age. For instance, Annie described a system of "limbo" when she attempted to access services because she was not old enough to receive support (MacDonald, 2013: p. 432). Social workers are often a part of the power structure that enforce the institutional rules that create the oppressive mechanism for conformity. Casey identified an example of this when her social worker told her to get a co-signer, likely fully knowing that would not be possible for Casey to do (MacDonald, 2013).
Other examples of professionals using institutional power structures to attempt to force them into acquiescence can be found in the girls' stories. When she reached out to the police for help, Connie reported they turned a blind eye and sent her home to her parents (Mann et al., 2007). This was done despite the fact that she reported to have physical bruising and welts from the abuse. Because of the stigma from this experience, she did not seek help after a rape.
A final example of power and control over the youths' lives incorporated two additional aspects of Foucault's conceptualization of the power and control mechanisms in society: biopolitics and the panopticon (Foucault, 1977(Foucault, , 1978. Foucault (1978) described the concept of biopolitics as the state encroaching further and further into individual lives to monitor conformity thus creating classes of individuals who find favor and acceptance within the system and those who do not. The panopticon represents the structural model by which the state monitors individuals (Foucault, 1977(Foucault, , 1984b. The panopticon is not a punishment; rather, it is a system of social control to assess the needs of individuals and monitor compliance (Crawford, 2018).
Several youth discussed various rules related to losing their privacy at places where they resided. Claire and Terry retold stories of their private conversations with professionals being given to their parents or others in authority. They felt violated and without rights to privacy (MacDonald, 2013;Williams et al., 2001). One participant for Maassen et al. (2013) said this of living in a facility for homeless youth: "Having privacy is kinda hard seeing [as] they come in every hour, it's really hard" (p. 64).
This lack of privacy accomplished two things. First, the stigma of being a street kid was enforced so that if they would choose to go home, the professionals at these facilities would no longer be able to subject them to the encroachment on their privacy. More than this, however, the loss of privacy at this young age began to accustom the youth to allow the state access to information about their lives, furthering the goal of biopolitics and expanding the reach of the panopticon. Stigma The conceptualization of stigma through a Foucaltian lens allowed the researcher to analyze the power and control structures discussed above and examine how they converged to create social norms and expectations (Crawford, 2018;Foucault, 1984a). The creation and enforcement of social norms though biopolitics is accomplished through stigma with normalization creating a system of judgement through which power is derived (Foucault, 1980). Reward for conformity is a form of stigmatization for those who do not conform which is the goal of normalization (Foucault, 1977).
Stigma was ever-present in the youths' lives. MacDonald (2013) discussed the vulnerability and stigma the participants experienced because of their age. This interpretation missed the mark though. The youth may be more vulnerable because of their age; however, the stigma is derived from the power structures that establish norms that youth are supposed to remain at home and follow rules. Living apart from their parents, especially on the streets, was deemed a wrong choice and was thereby stigmatized. In the MacDonald (2013) study, one participant reported being ignored by the police after an assault because the police were too busy to deal with a street kid.
On being treated like an unwanted street kid, one participant said "they treat you like you're one stereotype" (Maassen et al., 2013: p. 64). The notion that street kids are unwanted and always bad was a constant theme of the youth discussions. When Shahaf described the judgment of being called a whore for being out late, she exemplified the societal stigma faced by the youth. The youth often took these stigmatizations personally. Yvonne reported that after living on the streets, "there's not very much to be pleased with myself with. I'm hoping that everything will go for the better in the future instead of having to go through this shit every day, every day, nonstop. It gets very depressing to me" (Williams et al., 2001: p. 243).
Stigma was not a new experience for many of the youth once they began living on the streets. For many youth, their stigmatization began at home years before they left. Other studies found that stigma often contributes to a decision to leave home by youth. Conflicts over sexual orientation or religion, for example, were common areas of stigma related to running away (Williams & Lindsey, 2006). Estimates ranged from 30 to 40 percent of youth who left home due to rejection by family (Ryan et al., 2000). Results of the present study appear to corroborate these findings. Shahaf's painful retelling of her choice to leave home after years of abuse that she described as ruining her self-esteem gave voice to the stigma faced by many of the girls in the studies. For example, Sara, Jennifer, and Junie all told stories about stigma at home that pushed them to leave (Martinez, 2006;Wesley & Wright, 2009).
Tamara and Eliza discussed abuse at home that began as name-calling and shaming, but grew into physical and sexual abuse (Wesley & Wright, 2009). Physical or sexual abuse experienced at home linked to shame and stigma in multiple studies across the analysis (Martinez, 2006;Peled & Cohavi, 2008;Peled & Muzicant, 2009;Wright et al., 2012). Dana retold the story of her father telling her that he beating her so that she would be ugly so that boys would not like her (Peled & Muzicant, 2008). Shahaf said that after her grandmother took her in "she'd watch me with a look as if to say 'you're not worth anything…' You know, the thing that hurts the most is when people you love, or rather loved, behave toward you as if you are trash" (Peled & Cohavi, 2009: p. 743).
Social Work Response Social workers must be cognizant that they play a significant role in the development of structures that underpin the power mechanisms that create stigma in society. According to Foucault (1977), actors for the state may serve in helping positions for those in need; they still, however, represent the apparatus of power. An example of this was found from the social worker telling Casey to find a co-signer (MacDonald, 2013). A better response may have been recognizing the structural stigma against allowing a young person to rent an apartment and working within that system to create opportunities for young people to demonstrate their ability to meet the terms of a lease contract. In doing so, the social worker empowers the young person and helps to ease the stigma of an unaccompanied youth.
Structural issues within individual agencies have also created an impediment to the access of services. A lengthy discussion of rules that inhibit the use of services demonstrated that the need for rules that meet the needs of the youth while recognizing their autonomy is important. Social workers should seek to recognize the one-size-fits-all rules within their agencies and identify methods to allow those rules more malleability. Obviously, some rules are necessary. While Connie may have felt that the prohibition on cell phones was unwarranted, the responsibility of theft and resulting confrontations because of theft could well explain the need for such a policy. In circumstances where policies feel inhibitory to the youth, every opportunity to explain the reasoning for the policy should be taken. Even in situations where policies appear to be in place for good reason, social workers should seek to understand the youth's concerns. From that exchange, service providers may find the need for revising policies.
Social workers should seek to recognize the power of language both as a mechanism of control and of stigma. Categorization of members in society as those within the normalized structure and those outside of that system creates a dichotomous view of the world. Youth living on the streets are on the outside of that view (Bessant, 2001;Evans, 2011). Bessant (2001) noted that stigmatized individuals are made visible so they may not enter society unnoticed. A participant for Maassen et al. (2013) described being called a street kid as an experience that left her feeling helpless and worthless. When working with populations who have been marginalized, social workers should take precautions ensure the language they choose does not create further stigma.
Caution should also be taken, however. The stories recounted here and in the articles reviewed came only from the perspective of the youth. Key details regarding decisions made by those in power may have been omitted or changed in the re-telling of the events. Despite this caveat, we live in the world as we perceive it, and these youth perceived the oppressive forces of the institutions with which they were involved. This becomes their truth then, and it is one we must consider as social workers. Limitations All studies have limitations and should be noted when considering their findings. Qualitative studies are not generalizable, and a synthesis of qualitative work, like that presented here, remains not generalizable. The value of a synthesis like this is that is collects many more voices and experiences than a single study would, allowing for broader thematic analysis. We note that ten studies are included in this synthesis. QIMS require stringent inclusion criteria to ensure that included articles are on the same topics, which enhances the synthesis (Aguirre & Bolton, 2014). Quantitative studies, which may have considerably larger samples and be generalizable, are excluded from the synthesis by the nature of QIMS (Aguirre & Bolton, 2014). Despite the limitations inherent qualitative work, the inclusion of voices often not heard in the literature is important and provides a depth of understanding not possible in quantitative work.

Conclusion
This study revealed the myriad concerns that girls face when they run away from home. In many ways, social workers are aware of most of these concerns. One should not be surprised that living on the streets is unsafe for teenage girls. The study also revealed ways that the system failed to protect the girls through power, control, and stigma. Social workers role in these systems cannot be dismissed. While social workers are often involved in meeting the needs of runaway youth, they should be cognizant of the concerns that were revealed in this study before they take a one-size-fit all approach to their work. More times than may be realized, the girls may have the answer all along. Williams et al. (2001: p. 242) summarized it well with this quotation from Sally: "I can do just about anything if I put my mind to it". The social worker's job sometimes is simply to clear the path.

Conflicts of Interest
The author declares no conflicts of interest regarding the publication of this paper.