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Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids Hardcover – February 16, 2006

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Product Details

  • Hardcover: 336 pages
  • Publisher: Riverhead Hardcover; First Edition edition (February 16, 2006)
  • Language: English
  • ISBN-10: 1594489106
  • ISBN-13: 978-1594489105
  • Product Dimensions: 6.2 x 0.9 x 9.2 inches
  • Shipping Weight: 1 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (46 customer reviews)
  • Amazon Best Sellers Rank: #537,782 in Books (See Top 100 in Books)

Editorial Reviews

From Publishers Weekly

This important book takes the troubled-teens industry to task, exposing the "extremely harsh, perhaps even brutal tactics [companies use to] keep [kids] in line." For $2,000 a month and more, a program will take an oppositional teen to a lockdown facility or a wilderness boot camp for however long it takes to break him or her. Parents pay more than an Ivy League tuition for their children to undergo some "out-of-line" punishments (use of "stress positions," brainwashing, etc.), and, says Szalavitz, there's no evidence that these facilities cure anything. Indeed, many teens suffer post-traumatic stress disorders for years; some actually die in these facilities. Szalavitz, a freelance journalist and senior fellow at, has written a courageous—if horrifying—study of the tough-love industry, focusing on four key players: Straight Incorporated, North Star Expeditions, the World Wide Association of Specialty Programs and the KIDS program. These hugely profitable businesses are largely unregulated by legal, medical or ethical codes, avoiding accountability for failure by blaming the victim. With a useful appendix discussing when and how to get responsible help for a troubled teen, this book, filled with first-person accounts, should be required reading in Parenting 101. (Feb.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Scientific American

In 1958 a residential treatment program for heroin addicts, called Synanon, initiated a radical methodology to break the addiction cycle. Using "attack therapy"in an environment of "tough love," counselors forced drug users to alter their self-destructive behaviors. Such methods became so popular that in 1982 counselors Phyllis and David York argued in their bestseller Toughlove that families should also embrace harsh measures. Hundreds of tough love–style residential programs have since emerged. Yet no scientifically supportable evidence has ever shown that these methods are effective. In fact, some data suggest they may do harm.

In Help at Any Cost, Maia Szalavitz, a senior fellow of the Statistical Assessment Service at George Mason University, shows how "abusive, dehumanizing practices that reformers of mental hospitals and prisons have attempted to stamp out for centuries" have been repackaged and sold to desperate parents. "Thousands of well-meaning, caring, and intelligent parents have been taken in by a business that uses exaggerated claims of risk to teens to sell its services." All of this has amounted to a multibilliondollar industry. This is a story, she says, "of splintered families; of parents convinced by program operators that extreme, even traumatically stressful treatments are their children’s only hope." Homing in on several leading programs, Szalavitz carefully documents cases of reckless punishment that physically and psychologically hurts youths. Military-style boot camps and wilderness programs that pursue extreme "rehabilitation" measures have left teens dead of illnesses and dehydration, spawnin numerous lawsuits. Such "professional" programs operate nationally and charge college-equivalent tuitions. Yet there is no regulatory oversight or medical or legal evaluation of the quality, competency or effectiveness of such programs, even though they assume responsibility for the lives of minors.

Citing a draft consensus report by the U.S. National Institutes of Health, among other studies, Szalavitz says such programs simply do not work. The evidence that exists "offers no reason to believe that group detention centers, boot camps, and other ‘get tough’ programs do anything more than provide an opportunity for delinquent youth to amplify negative effects on each other."

Szalavitz concludes her book gently with practical guidance for parents of troubled teens, including ways to get more sophisticated help. Ultimately, she urges parents not to yield to desperation and to recall the leading principle of medical ethics: "First, do no harm."

Richard Lipkin

Customer Reviews

Maia's book goes into this issue very well.
Elisabeth H. Feldman
The most valuable part of the book is at the end, when she advises parents of troubled teens about the types of real, authentic, help that is available.
Just me
The more I read about the abuse of teenagers in the "troubled teen industry," the more worried I become.
Anne Rice

Most Helpful Customer Reviews

77 of 82 people found the following review helpful By Kyrsten E. Bean on February 20, 2006
Format: Hardcover
(It appears my review vanished, so I am reposting it)

I was interviewed by Maia for this book, and because of this received an early copy. When I read the book, it took me a while because it is a very heavy, traumatizing subject matter and it brought back many memories of methods used in the program I attended myself. The book is very informative and supports the actions of helpful websites such as
[...] It also discusses the different methods of thought control or coercion used in these programs further outlined in books such as "Cults in Our Midst" by the late Margaret Singer. I found that after reading this book I wanted to catch up on seven years of articles concerning the program and found, in retrospect, that there are now many things lacking in a program I once believed had "saved my life".

Although I find it time consuming and devastating to try and rethink about everything I was taught to believe while in the program, this book led me to reconsider my perspectives, which were in favor of the program I attended in 1997. The program pitted me against my own parents on the issue of graduating the required TASKS seminars. My parents are known for having left the controversial seminar they attended and have publicly spoken out concerning this seminar.

I also received a much appreciated follow-up on the people who were in the same 48 hours documentary which aired in October of 1998 that my family appeared on when I was removed from the program in March of that year.
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32 of 32 people found the following review helpful By Sue Hall on July 24, 2006
Format: Hardcover Verified Purchase
Maia Szalavitz' Help At Any Cost is a carefully researched and well-reasoned analysis of the development of "tough love" programs formerly and currently operating in what she calls the "troubled teen" industry, also known as the "behavioral health" industry. I believe the book is destined to become a landmark volume on this topic, and I applaud the author's efforts to bring the issue of institutional child abuse onto the national stage where attention to and debate about this topic is sorely needed.

My perspective as a reviewer is first, as a mother of a daughter who spent nine months in a residential treatment center in Utah in 2005 for treatment of profound depression and suicidality. Secondly, I am a practicing pediatrician and a former master's level social worker. I have personally read nearly every reference which Ms. Szalavitz has used for documentation. I found this book to be written in a very even-handed fashion, especially considering the incendiary nature of the topic and the damning evidence of continuing abuses which continue to be revealed on nearly a daily basis in small, regional publications throughout the country.

It was critically important that Ms. Szalavitz' present the natural evolution of the "teen help" programs as descended from The Straights, because although some of the programs she has thoughtfully dissected are no longer in existence, many of their basic tenets and operational principles have been passed down to new generations of programs. Beliefs such as that all kids are "manipulators" and are therefore not to be trusted, and that kids who arrive in treatment programs must have done something bad and therefore do not deserve respect, are rampant, including in the "good" program which my daughter attended.
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28 of 29 people found the following review helpful By MMS on May 9, 2006
Format: Hardcover
Having survived a facility in MT and heard from recent graduates describing the same type of mistreatment I endured at a facility that is touted as one of the best by Educational Consultants and parents alike, I have found that Ms. Szalavitz has hit the nail on the head with regard to the wide spread ignorance of educational consulants, of parents, and ultimately of those who run many facilities in this industry- all at the high cost of harming many youth in the process.(I suggest that at times this ignorance has been willful, as in my case)

While educational consultants may believe they know, parents may claim they know, few actually do until their children live then it's too late. It simply is impossible to know what kind of program your getting given the wide spread approach of youth as manipulative, the involuntary institutionalization of many youth (some for minor offenses), and the lack of access to advocates and lack of unrestricted access to parents. Surely this type of approach is a breading ground for trouble, reasonably so- what ever happened to real care and empowerment?

Given these facilities are unregulated, often states have extremely stringent requierments when it comes to invesitgating child abuse. Call CPS at any state and ask their policy on unregualted facilities vs. regualted, you'd be suprised what you find out. With the exception of Michigan and Ohio to my knowledge, the way most states handle unregualted facilities in terms of child abuse differs a great deal. Enough so that I would not feel comfortable considering sending my child to an unregulated facility.

This list goes on and on with regards to problems within these facilites.
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