Deadly Rehabs That Target Kids - Page 2

By Maia Szalavitz 01/06/11

How "tough love" rehabs prey on desperate parents seeking help for addicted children. Plus: Four things every parent should do before sending a teen to treatment.

Mount Bachelor Academy, the Oregon home for troubled teens, was
shut down for abuse.

(page 2)

The first warning sign was the insurance question: lying to parents about a program being covered when it is not is obviously not a good sign. And although insurers will often do anything to avoid paying, sometimes they actually have sound, evidence-based reasons to reject a type of treatment. Second, professional programs do not ignore phone messages or require intensive efforts for parents to get through to key staff. But the most disturbing aspect of that description is the arbitrary exercise of power and forced, meaningless labor. Although many addiction programs still see their role as “breaking people down,” in order to fix them, there’s no proof that this helps anyone get better.

Making people feel powerless, and fostering blind obedience are, in fact, generally viewed as antithetical to promoting mental health: research shows that the “learned helplessness” that comes from having no control over your life can lead to depression and even post-traumatic stress disorder, not recovery. Indeed, creating learned helpless in animals by placing them under uncontrollable stress until they stop trying to escape is a commonly used experimental model of depression. (If a drug restores an animal's struggle to get free, it typically helps human depression, too.)

These methods are also harmful to program staff. They basically create conditions that encourage the abuse of power, even situations that can lead ordinarily kind people to behave poorly.

Straight Inc. gagged teens with Kotex and put them through a “spanking machine” and restrained children until they urinated or soiled themselves before it was finally shut down in seven states during the ’80s and ’90s. 

Consider what happened in just several days in the notorious Stanford Prison Experiment. There, ordinary young adults (prescreened to exclude psychiatric disorders) were asked to play the roles of guards and prisoners, in a mock jail in a university basement. Within days, the guards were humiliating the prisoners by making them urinate in buckets and forcing them to do meaningless tasks. The experiment got so far out of hand so fast that the researchers had to shut it down long before they’d intended.

A program with an unaccountable leader and a belief that “breaking people” will help them is a similar if inadvertent setup. With no checks and balances, counselors may easily come to believe they can do no wrong and that even sleeping with patients will help heal them. A race to the bottom typically ensures, as in the Abu Ghraib dynamic.

That may sound far-fetched, but it has happened literally thousands of times in “tough love” rehabs in the U.S. and around the world. Straight Inc. gagged teens with Kotex and put them through a “spanking machine” and restrained children until they urinated or soiled themselves repeatedly before it was finally shut down for intensive abuse in all seven states in which it operated during the ’80s and ’90s. Its offspring, KIDS, produced virtually identical abuse in three states. Both programs kidnapped teens and even some adults who tried to escape. Tens of thousands of teens (and their families) were harmed.

And as recently as 2009, the state of Oregon shut a tough-love boarding school, the ironically named Mount Bachelor Academy, which had been forcing girls to do lap dances as part of its humiliation-based treatment. The staff was so sure it was doing the right thing that they initially did not even outright deny some of its extreme tactics when state investigators paid a call.

How can parents avoid being taken in by these harmful programs? I have four recommendations that I am confident will help:

1. Do not rush into making a decision. Stay calm, no matter how nerve-wrung you may feel at the knowledge that your child needs detox and recovery. With rare exceptions, run from any program making threats your kid is at imminent risk of harm or death if treatment decisions aren’t made immediately. If someone is injecting drugs or actively suicidal, immediate hospitalization for safety may be necessary—but even then, there’s no reason to make instant decisions about long-term care.

2. Ask people you trust about the situation—and read up on the scientific literature, not just popular material about the illness. If addiction is indeed a disease, why would you leave its care to amateurs, rather than doctors? If an MD recommended treating your child’s cancer by having someone abduct them from their bedroom at 3 a.m. and put them in the woods for a month, would you even entertain the idea? Why should treatment for mental disorders be different?

3. Be aware that in the vast majority of cases—particularly for youth—treatment at home is probably as effective as (and far less risky) than residential rehab. Research on addictions and mental illness suggests that compassion, connection and kindness are the keys to recovery, not toughness. The entire mental health field has been moving away from inpatient treatment and toward “care in the community,” not simply because inpatient treatment is more expensive (though it certainly is) but because people are typically happier and healthier when treated at home, surrounded by loved ones.

4. Realize that any program that cuts your child off from you and the outside world, that sees its charges as liars and manipulators and that believes “toughness” is essential is basically a case of abuse waiting to happen. Establishing boundaries and clear rules without dehumanizing or humiliating people is possible. But doing so requires professionalism, critical thinking, oversight, checks and balances—none of which the con artists who run “tough love” programs have in stock when parents come running. This fact sheet from the Federal Trade Commission specifically for parents of troubled teens gives very helpful background information on the licensing, accreditation and other regulatory requirements that separate legit youth rehabs from the other kind.

Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006). 

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Maia Szalavitz is an author and journalist working at the intersection of brain, culture and behavior.  She has reported for Time magazine online, and is the co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered, and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids. You can find her on Linkedin and  Twitter.