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Helen Taylor didn’t feel like she had much choice. A registered
nurse and mother of five, Taylor was caring for a sick parent and studying
for a law degree when her seventeen-year-old daughter Grace* was raped
at a party and fell into a deep depression. (Grace is not the daughter’s
real name). Taylor, who lives in Thousand Oaks, California, knew she
couldn’t handle Grace’s needs by herself. She took Grace
to a therapist, who recognized the overwhelming nature of Taylor’s
other responsibilities and suggested that Taylor place her daughter
in residential treatment. Mother and daughter both agreed that a full-time
care facility was a good idea, and Grace, who had always been a well-adjusted,
bright girl, was willing to do whatever the therapist suggested in
order to get better. Taylor asked a neighbor for advice, and after
a little research and a tour of the facility, decided on a treatment
center in Utah called Provo Canyon School. When Grace entered in December,
2003, the school promised therapy mixed with outdoor sports, dances,
and other recreational activities.
Less than a month later, says Taylor, Grace came home covered in bruises,
gaunt and traumatized by her experiences. On one of the worst nights,
says Taylor,  staff forcibly injected Grace with the antipsychotic
drug Haldol for supposed insubordination. Grace’s only crime,
she told Taylor, was telling staff she needed to use the bathroom.
Grace awoke to a kick the next morning and found herself lying on a
hallway floor, her vision blurred and her facial muscles severely contorted.
Worse still, Taylor says that Grace, a rape victim and voluntary patient,
was forced to submit to strip searches on several occasions and was
sexually assaulted by Provo Canyon staff—only compounding Grace’s
emotional despair. Provo Canyon did not return phone calls seeking
It's a Big Business
Despite horror stories like this one, there is big business
in residential treatment centers like Provo Canyon: there were
43,365 admissions to
RTCs in 1997, and 27,642 patients under care in RTCs at that
time, according to a 2000 report by the United
States Surgeon General's office.
Private residential treatment centers can cost as much as a year in
college; they’re mostly the province of well-off parents. However,
some insurance companies will cover treatment at schools accredited
by Joint Commission for Accreditation of Healthcare Organizations (JCAHO),
an independent, nonprofit organization that inspects and accredits
nearly 16,000 health care facilities in the United States. But JCAHO’s
standards are geared mainly toward monitoring surgical and pharmacological
procedures. And so RTCs, which are more like boarding schools than
traditional hospitals, can become accredited under standards that have
little to do with the daily programs and activities practiced in them.
Many RTCs are not accredited at all.
Some residential treatment programs have amassed a disturbing number
of complaints from kids and parents who, like the Taylors, allege that
the schools physically and mentally abuse their students. Recent articles
in the New York Times and the UK Guardian document abuses at treatment
centers abroad including Tranquility Bay School in Jamaica. Controversy
has arisen in Tranquility Bay amid the death of a student, parent custody
battles, and allegations of unlawful incarceration. Lawsuits have been
brought against the Worldwide Association of Specialty Programs and
Schools (WWASPS), an affiliated group of private residential treatment
centers and schools that manages Tranquility Bay. And there are many
complaints about other RTCs on websites run by watchdog groups, parents,
Most RTCs use a religious "tough love" approach to treatment,
doling out points for “appropriate behavior” and imposing
consequences—ranging from the loss of phone privileges to solitary
confinement and physical punishments, according to survivors.
In recent years, government agencies in other countries have begun
to crack down on these American-owned programs; authorities in Costa
Rica, Mexico and the Czech Republic have shut down at least four WWASPS
programs thus far. But in the United States, regulators have been less
assertive. In 2003, Congressman George Miller of California asked the
United States Department of Justice (DOJ) to investigate a growing
number of allegations against WWASPS, but to date the DOJ has taken
no action. In Utah, State Office of Licensing Director Ken Stettler
proposed legislation that would have established stricter licensing
requirements for teen treatment centers, but it didn’t fly with
lawmakers. As Stettler told the Salt
Lake Tribune in April 2004, many Utah legislators felt that his
office was “empire building” when it proposed instituting
licenses for the paid “escort services” that private treatment
centers use to transport teens to their facilities, even though there
are many complaints against them.
After her daughter’s ordeal, Helen Taylor mounted a letter-writing
campaign to inform Stettler and other state and federal legislators
of Grace’s experiences at Provo Canyon, but to date she has only
received a couple of terse replies. She feels that these legislators
are taking reports of child abuse in their state very lightly and that
the police are clearly acting in league with abusive schools. Local
police routinely come out to help Provo Canyon deal with attempted
escapes, for example, but have not investigated the children’s
charges of abuse. “This is political corruption at its worst,” Taylor
Parents like Taylor commonly assume that there is more government
oversight than actually exists within the treatment industry. On the
contrary, kids incarcerated in a juvenile prison may have more protection
from abuse than kids voluntarily enrolled in private treatment centers.
The DOJ routinely shuts down juvenile prisons when abuse occurs, but
it has yet to investigate the private RTCs. The industry is not well
regulated, most facilities operate without accreditation or a license,
and some take unfair advantage of distressed parents. Some families
have experienced problems with the enrollment contracts, discovering
too late that they signed away too much authority or waived too many
of their legal rights regarding disputes with the schools.
Parent Watchdog Groups
Survivors and parents have formed watchdog groups and mounted education
campaigns to warn other families about the risks. Some are listed below.
Other parents are pressing lawmakers to step in: Helen Taylor has developed
an email list for updates on her attempts to contact legislators, while
another person launched Fornits, a web forum with an extensive teen
treatment section allowing survivors and parents to air their frustrations,
tell their stories, and strategize the legal and criminal investigation
of abusive facilities. Many people now in their forties post messages
at Fornits documenting the long-term emotional devastation that results
from time they spent in RTCs as teenagers.
Even parents whose children were well served at residential programs
are wary of the teen treatment industry because of the big money involved.
Linnea Soderlund, a parent who sent her teenage son to two different
residential programs primarily for what she called “out-of-control
behavior,” says that parents should proceed with extreme caution
when selecting a residential program. “Consultants and programs
are happy to take thousands of dollars from you in exchange for the
hope of saving your kid,” Soderlund wrote me in an email. She
in close touch if you place your child in a treatment program,” because
parental vigilance is the best protection against abuse.
Soderlund also counsels parents to seek expert diagnosis when determining
whether to send a child to residential treatment. “I would urge
anyone considering residential treatment to obtain a physical exam
and complete psychological evaluation before making any plans for treatment,” she
wrote. While she said that the psychological evaluation was a large
expense not covered by insurance, she was “immeasurably thankful” that
she got one for her daughter. “This is the only way to determine
what the issues are and what is at stake,” she wrote.
Karen Stanton, another parent who has enrolled a child in residential
treatment and was particularly happy with the results, agrees that
it’s crucial to screen both the child and the school. Her son,
Peter, was diagnosed with dyslexia at a young age, and she and her
husband had tried numerous treatments including therapy, Ritalin, summer
programs, and a private school for students with learning disabilities.
Nothing worked, she said, until she found an educational consultant
who reviewed Peter’s test results, talked to his teachers and
therapists, and helped find programs that were tailored to his specific
needs. Stanton says that their consultant was “expensive, but
totally worth the money.” Stanton added, “We were desperate
when we went to her.”
Several parents we spoke with reported using educational consultants
with good results, but here again, parents must be careful. Some consultants
accept financial rewards for enrolling kids in specific programs, so
bias could be a problem. It is important to ask about any commercial
ties between your consultant and the schools so that you can evaluate
their recommendations accordingly.
Experts are Skeptical
Unfortunately, even if a parent finds a suitable, non-abusive program,
the long-lasting results are difficult to predict.
Dr. Oscar Bukstein, an associate professor of psychiatry at the University
of Pittsburgh School of Medicine who specializes in children’s
psychiatric disorders, says that even when kids make progress in these “tough-love” residential
programs, they very often have trouble reincorporating the skills they
learn into their home lives. “When kids get back to their original
situation, they start to slip back,” he said. “If anything,
the center is probably a safe holding place until kids mature out of
[their behavior problems].”
Bukstein also says that some parents send their kids to residential
treatment too early, without first considering other and potentially
better options. He says therapy and community-based intensive treatment
centers that provide more than just an hour a week of counseling are
good options for overwhelmed parents, and that generally kids don’t
need “tough love” to be treated effectively. “You
have to model appropriate behavior,” he said, “but intimidation
doesn’t model appropriate behavior—being tough and consistent
doesn’t entail being mean and abusive.”
Listening to adults who were sent to RTCs as teenagers,
you often hear a much harsher judgement of these programs. Said
one, "these toughlove
programs are not merely ineffective, but often totally devastating
to the children and families taken in by their marketing experts."
Many adult survivors want the programs shut down
The late Dr. Loren Mosher, Clinical Professor of Psychiatry at the
University of California at San Diego School of Medicine and former
Chief of the Center for Studies of Schizophrenia at the National Institutes
of Mental Health, agreed that residential centers aren’t effective
at training patients to function in their normal environment. “If
those programs are not continued after they get back,” he said, “the
learning they received is gone within three weeks to six months.” Mosher,
who is best known as the founder of Soteria, a revolutionary treatment
center for schizophrenics that eschewed medication and placed patients
in a shared living situation with non-medical-professionals, said that
any effective treatment should involve the whole family. “Anything
that doesn’t,” he said, “is probably a waste of time.” He
advocated straightforward family counseling, which is widely available
and which, he said, usually costs a whole lot less than residential
“I don’t think there’s much out there to tell parents
about where you draw the line between normal teenage acting-out and
serious behavior problems,” said Barbara Huff, Executive Director
of the Federation of Families for Children’s Mental Health. While
she says there are no easy answers to this question, guidance counselors
at the local schools, private therapists, and other professionals can
help identify children with behavior problems early on and can also
work with families to find appropriate solutions.
And above all, experts agree, parents should avoid giving in to embarrassment
or despair that keeps them from seeking appropriate help close to home. “We
all fear the stigma that is attached to ‘troubled teens,’” said
Dawn Martin-Rugo, a parent who enrolled her daughter in a wilderness
program and a therapeutic boarding school. “We want to protect
our teen and ourselves from the judgments of others, but it is important
to get over this fear as quickly as possible—everyone knows someone
who has a child who has “fallen apart.’” Common sense
and community support are your best protections against the false promises
offered by unscrupulous people who stand to profit from selling you
an expensive residential program.
IIf your children or your friends’ children
run into trouble, consider these tips from other parents and mental
- Get a ‘reality check’ from school officials, teachers,
family, and friends to help assess the seriousness of the child’s
- Explore local options first, and look for a therapy program that
works with the whole family, not just the teen.
- Invest in physical and psychological assessments that will define
the child’s problem and point to appropriate remedies.
- Hire an educational consultant who works only for the family (and
does not receive a commission from schools).
- Investigate the schools in person, and also check with the parent
watchdog groups (listed below) to avoid the worst offenders.
- Ask a lawyer to review enrollment contracts before signing them.
- And finally, stay in contact with the child throughout their stay
in a residential facility so that you can move them out quickly at
the first sign of trouble.
Resources for Parents
NoSpank.net is the work
of a group called Parents and Teachers Against Violence in Education.
The site provides a good collection of documents and news articles
from a range of sources.
Survivors Action Committee is a nonprofit, independent watchdog
organization. Their site includes a list of warning signs to help
parents avoid abusive programs, as well as a list of schools with
the most damaging track records.
The Straights is a website
created by a father named Wesley Fager, who has been campaigning for
reform of residential treatment programs since 1989 when his son was
abused in one. His site includes his book and information about other
books on the subject.
Personal testimonials from survivors and their families can be found
Educational Consultants Association (IECA) has a "find a
consultant" feature on their web site, as well as some general
information about working with a consultant.
Here are well researched, recent news articles: from
the NY Times, January 2003 " Parents
Divided Over Jamaica Disciplinary Academy". and from the British
Guardian an article published last summer also looks at the Tranquility
Bay program in Jamaica. And "Drug
Mistreatment" from Mother Jones Magazine documents how courts
and schools often force parent to put kids into treatment who may not
actually need it.