therapeutic community

After just starting my 2nd quarter back in school after 16+ years since I last attended I wanted to share a few pieces that I was really proud of from the quarter that actually start to show a change of pace and rhythm in thought after all these years. Finished with an “A” in English comp, first time I think that letter ever showed on the board with me my entire life, so feeling accomplished and appreciative for the chance to continue this education journey. This was an argumentative essay on a topic near and dear to both my wife and myself. Thanks so much for reading. -S

            There is a hotly debated though rarely seen battle for the freedom from, and recognition of, ongoing systemic child abuse done knowingly at the hands of privatized institutions known as Therapeutic Communities (TC’s). Their purported goal is to take the disenfranchised attendees while they are in their formative teenage years and reroute them from a destructive path through life. The perfect client is primarily from an affluent or privileged family able to afford the exorbitant cost of this outsourced fostering which takes place in a boarding school setting which allows them to function under the pretense of educational establishments. In fact, there is a multilayered industry complete with expensive “educational consultants” and “transport agents” who very precisely go about the process of removing a prospective charge from their family environment and relocate them to isolated facilities scattered both nationally and internationally. What is baffling, is that there is a seemingly lopsided agreement on the distress that these programs cause by virtue of treatment methodologies that many suggest were originally developed by the CIA as part of their interrogation and brainwashing research. With such a resounding recognition on the lips of each survivor of these programs who tells their tale, how is it that they still exist? I’d like to explore the ins and outs of what makes these programs tick because I believe the concept that parents are sold on of a happier and more satisfied adult through personal understanding is not misplaced—but the current manner that is used to facilitate growth is unacceptable and MUST be changed.

            The sales pitch for the “Troubled Teen Programs” (TTP) to parents is concise and overwhelming in opportunistic advantage when presented to parents in situations where they are afraid for the health and wellbeing of their child or children. By offering a well regimented schedule including extra-curricular activities, schooling, access to a therapeutic component and family workshops, TTPs offer to provide an articulated course in productive living which will be adopted by the now healthy minded youth and improve their overall approach to life, making them happier and healthier, body and mind. However, as documented in a congressionally reviewed study by the United States Government Accountability Office (GAO) entitled “Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth” the promises made are rarely delivered on and often are nothing but fluffed wording to entice desperate families to make a costly mistake in sending away their child. To quote, “GAO found thousands of allegations of abuse, some of which involved death, at residential treatment programs across the country and in American-owned and American-operated facilities abroad between the years of 1990 and 2007…For example during 2005 alone, 33 states reported 1,619 staff members involved in incidents of abuse in residential programs. GAO could not identify a more concrete number of allegations because it could not locate a single Web site, federal agency or other entity that collects comprehensive nationwide data.” This seems wildly incongruous with the stated mission of safely guiding teens to a more productive path.

            The GAO study continues by citing specific deaths at the hands of the multiple wilderness based programs such as Catherine Freer which commonly act as the gateway to longer term residential locations. Two of clear note in the study include:

• Female, 15, cause of death dehydration. Showed signs of illness for 2 days such as blurred vision, vomiting water, and frequent stumbling. Collapsed and died while hiking. Lay dead in the road for 18 hours. Program brochure advertised staff as highly trained survival experts.
• Male, 15, cause of death internal bleeding. Head-injury victim with behavioral challenges who refused to return to campsite. Restrained by staff and held face down in the dirt for 45 minutes. Died of a severed artery in the neck. Death ruled a homicide.

I note the inconsistency with the marketed literature from the female victim’s program as intensely indicative of the overall industry approach to such—present parents with what they know they want to hear, not the real story which would note the incompetence of staff or their unwillingness to raise their own standards to such a level as to meet with their stated qualifications. In an open statement before congress the head of the National Association of Therapeutic Schools and Programs (NATSAP) which “oversees” at least 180 programs nationally as the accrediting party—more on that to come—stated to congress in 2007 that “we are committed to working with Congress, the states, other organizations, and parents to ensure that regulations and legislation provide for realistic and workable therapeutic programs that meet the highest standards of care.” Her statement was directly resulting from investigative media and the GAO study noted above into the alarming rates of abuse at the facilities licensed by NATSAP, however, no further oversight committees were formed, no legislation passed, nothing changed.

            Why so much abuse? The program methodologies approved for use include the use of restraints which as noted by Sean Hennessey, a direct care staff coordinator at a program describes as, “….pinning a kid to the ground until they stop fighting and start crying, it’s barbaric if you think about it.” One question I would ask the reader is whether the above scenario enacted in the home with a teenage child and parents would be construed as acceptable practice or viewed as overly disciplinarian. Moreover, many programs ascribe to behavior modification techniques and tactics—while it is not critical to this paper to delve deeply into those techniques to share a suggestion for necessary changes to be made in this field I would like to note to the reader that these methods include sleep deprivation, repetitious exercises, hard manual labor, starvation, and Pavlovian conditioning designed to break the spirit and personality of a grown adult, hence why they are often also used during interrogations by the CIA. Overall program philosophy in practical application is massively divergent from what is presented to parents, something that despite a lack of transparency in communication between child and family should be readily apparent based on what is most commonly the first interaction with teen and program, the transport process.

            Regarding the “sensitive ethical issues related to involuntary treatment of adolescents…” as documented in a paper published by the Child Youth Care Forum (CYCF) where the transport process was investigated to determine whether it was supportive in nature of the goals of treatment it is important to understand what that transport looks like. For Heather Lamberton at the age of 15 it was two male plainclothes individuals flashing falsified police badges at her while she was at home wearing just a t-shirt and underwear. She was handcuffed and refused time to put on pants before being bundled into a car and subsequently a hotel where she was forced to bed down next to a male stranger who would not explain what their destination was nor why she was being detained. The following day she was delivered to her program where she would spend the next 2-years in hard manual labor, no parents present to say goodbye or explain what was happening. Aside from the illicit nature of presenting as police officers and kidnapping a child what is shocking is that the study from CYCF supports the process by relaying a finding that “…transported youth were more likely to have larger decreased [sic] in mental health symptomology than non-transported youth suggesting that being transported did not have a negative impact on treatment outcomes.” In what sort of a well governed and managed industry are illegal activities researched and regarded as non-detrimental when they involve the degradation of the mental health of children and accept a certain amount of loss as normalized?

            One of the few articles I was able to find that was supportive of the current program approach to treatment lists details of a study conducted at the request of Aspen Education Group and says their findings show, “Troubled teens with serious emotional and behavioral issues not only improve during treatment at a private therapeutic residential program but they maintain their healthier outlooks and functioning long after leaving the program.” While the statistics used seem to suggest the legitimacy of how the study was conducted including multi-year follow ups I am skeptical considering that the two parties responsible for the study include Aspen (one of the world’s largest program operators) and NATSAP who purports to be the licensure group overseeing 180+ programs as their national trade association. It raises concerns when the only pro-program documentation that can be found is published by the association that takes its earnings from the fees assessed to its member organizations which are the programs in question, there is a degree of hypocrisy and self-interest apparent that casts legitimacy into doubt.

           Taking all of the above into consideration it is apparent that current TTP operation is a long way from where it should by all rights be. To my original point, I would advocate that TTPs be forced by extensive national/international, state, and local oversight committees to abide by clearly defined regulations prohibiting the use of transport agents, restraints, and behavior modification techniques when working with children. Annual reporting should be made to a single centralized branch of the government responsible for ensuring the safety and conditions of children, any deviation or violation from the established protocols established should be met with actual legal ramifications rather than simple fines. These schools are exorbitantly costly, up to the tune of $6,500 a month per student, despite minimal overhead, and I believe it is important that rather than hit the deep coffers these kinds of rates make available, punitive action in the form of legal recrimination would be far more effective. Communication lines should be fully accessible and available between children and families at all times, not monitored phone calls as low as once a week or month as is currently the case. This would enjoinder much clearer transparency and allow clear accountability in the event a suspect case was emerging.

            The dream that these programs sell is one that I would buy off on were the other parameters more effectively in place through a trustworthy organization to manage and oversee universally with adequate staffing and documented funding in place. Parents that choose to send their children to these programs are often at their wits end and devastated by watching the challenges of behavioral and mental health issues materialize. They are as much victims in many ways as the children themselves and it is heartbreaking to learn more about an industry that is so domineered by pariahs that they choose to prey on a tear-stained mother or hand wringing father. No good parent wants their child to suffer, much less to the tune of thousands of dollars and misinformation. The changes I’ve suggested would change the entire dynamic within the industry and demand better and more successful treatment methods be used in gentler fashion with a highly vulnerable segment of the population. Stop abusing children in the name of the almighty dollar.

Works Cited

“GAO; Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth.” USA Government Accountability Office. Published: October 10^th, 2007.

“NATSAP; Aspen Education Group; Teen Therapeutic Residential Programs Can Have Lasting Positive Effects, New Study Says.” Biotech Business Week, Atlanta, 2007, p. 433.

 “State Licensure and Oversight Necessary.” Health & Medicine Week, 2007, p. 766.

Tucker, Anita, et al. “The Role of Transport Use in Adolescent Wilderness Treatment: Its Relationship to Readiness to Change and Outcomes.” Child & Youth Care Forum, vol. 44, no. 5, 2015, pp. 671–686., doi:10.1007/s10566-015-9301-6.

Waldman, Annie. “Kids Get Hurt at Residential Schools while States Look on.” ProPublica, Dec 15 2015, Proquest. Web. 8 Mar 2019