In the Netherlands, thirteen organizations offer specialized care services for commercially and sexually exploited (CSE) girls who are underage. Quality and effectiveness of these services have only sparsely been evaluated, while existing quantitative measures of treatment success mainly include the perspective of professionals. As a result, minimal insight exists as to whether current practices are sufficiently tailored to the needs of CSE girls. We carried out an ethnographic Participatory Health Research project with the objective to gain insight in CSE girls’ care experiences needs, and understand what they think contributes to good care. We worked with 27 girls from three residential youth facilities using a range of creative methods. Girls discussed their need for privacy and self-determination in a highly surveilled environment that aims to shield them from exploitative relationships with boys and men. Protective rules and measures impact their ability to build trusting, reciprocal relationships with group leaders, as well as their opportunities to make mistakes and learn without consequences. Girls wanted care that centered on their individual needs, and did not see their victimization as defining those needs. They called for group leaders to be responsive to their sometimes conflicting values by providing both a protective and autonomous space for care delivery. Navigating this complexity is a balancing act for professionals caring for CSE girls. The perspectives reported in this paper will be integrated in the measurement protocol of a broader N = 1 effectiveness study.