Customer Reviews

Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids

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(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
http://www.isaccorp.org/wwasps.html. 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.

I wanted to give this book to everyone I knew, so that they could understand things I couldn't put into words before, but now after calming down a bit, because the expose caused quite a rise in me and even stirred me to anger at the injustices children like Aaron Bacon had to endure, I realize that, unfortunately, not everyone will want to explore such a terrifying subject.

I found the book extremely informative, and I thought that Maia efficiently used her research to link programs from Synanon to The Seed to STRAIGHT, Inc. and then on to the burgeoning industry of teen-help programs now being marketed for teens which do not disclose their methods and which also encourage parents to attend program "seminars" in which tactics used to "break you down" and "build you up" are used to create rapid change. She outlines this more thoroughly in her book.

The most disconcerting part for me is that the long-term effects of these programs have not been documented or studied and are in most part anecdotal. I am worried about the potential for PTSD in teens and have found personally that once removed from a program such as this, life does not fit into the binary perspective the program instills in you.

The other disturbing part is how many programs are in the same names of people who ran previous programs shut down for child abuse and other issues, and how they continue to evade any consequences for their actions.

I believe in the case of the program I attended (in Jamaica) the staff was genuinely trying to help me as I was a problematic child. The problem is that many of these staff no longer work for the program, and I am left to wonder if the tactics they were using were used because they honestly felt they were "helping", if they were simply uneducated on what processes they were engaging in at the encouragement of the seminar facilitators and people more largely in influence behind the scenes, or if they were simply used because they knew that the "coercive persuasion" or "encounter group" seminars would produce quick results as they draw from tactics more commonly know as brainwashing. These results were incumbent on graduating four seminars and staffing many other seminars, even after graduation of the program was complete.

Because children are sent to these programs and told that this is the only way their parents will accept them back into their families, they conform to it's values without questioning, trusting their parents know what is happening to them and are thoroughly educated on the matter (although this is not always the case, it was the case with me). The long term effects of being changed through subtle and not-so-subtle methods and reshaped in the form of the program are not known and have reportedly led to many psychological problems in people detained in these programs. If a child has no reason to question, they will adopt the new values and beliefs of the program without questioning and then will often find that these new belief systems don't hold up in real life under close scrutiny. They may even find, like I did, that there is no similar structure in society and that they are flailing, searching for something to take it's place and eventually even turning back to the same behaviors which they were sent to the program with, only worse. And this is assuming they even had problems with drugs and other such behaviors when they were sent to these programs. Often times, teens are told that since they are in the program, they are "meant to be there" because they had to have done something to deserve being there, even if in reality, they have not done anything out of line and it is merely a custody battle between parents or faulty judgment on their part concerning proper diagnosis. Even if the children have done something mild, such as smoking a joint or sneaking out of the house, they are told, once in these programs, that they are "liars", "master manipulators", "attention-whores" and other such lump-all terms. Obviously, if they ended up being sent there, they deserved it. This is called "mystical manipulation".

Very well-researched book, definitely it is heavily weighed in opposition to these programs but with rightful cause, as the returns aren't all in on the consequences of sending children away to unregulated "schools" with unlicensed "counselors" and "educators". What returns we do have are shocking.

The flyers parents are handed when referred to these programs often do not reflect the reality of the living circumstances and staff employed therein. Parents, however, are told to ignore any protests they receive from their children; that they are only "manipulating" in order to try to get home. Even if the children really are being abused, the parents are told to ignore this; it's simply a lie because the teens want to manipulate the parents into sending them home.

Although some teens do try to manipulate their way home, many are just telling the truth, and because of the disintegrating relationship they have had in the past with their parents, they are not trusted and these programs justify and capitalize on this loophole, or catch 22.
There are many more issues discussed and outlined in the book, and some solutions are given.

Not every child who misbehaves needs a "behavior modification" or "therapeutic" community. These terms themselves are misleading. Research before you ever send your children away, especially to a "wilderness camp" or a foreign country outside of U.S regulation. Check out credentialed websites aimed at educating consumers (as these are consumer businesses selling a "product"; your reformed child) before you invest. Don't take in the returns after the fact.

I hope this book will aid parents in educating themselves before the fact, and that it will help people who have survived these programs, healthy or unhealthy, connect the pieces.
Many children have lost their lives unduly because parents, unfortunately, were uninformed and trusted individuals who weren't to be trusted, with their children's safety.

Updated to add:

When I posted this review, I didn't want to mention much about my own personal experiences. Now I am livid. I remember a boy coming over to Tranquility Bay from his program (which has now been shut down) in Samoa. "You're lucky over here," he said, "you don't get duct-taped and beaten".
I am lucky, I thought as I waited in line for food, raising my hand so that I could sit, talk or stand. "I'm lucky," I thought, as I was praised in TASKS seminars for giving "feedback" to my peers such as "you're a user, a manipulator, a drama-queen, you just want men to want you, etc." As I beat a towel against that wall that was supposed to reflect how angry I was at my parents, as I fake-screamed to show my "rage" and what they'd done to me in order to please the large, bespectacled group facilitator.

My first experience of "group" where we girls sat in a circle and "shared" our "experience" was one of complete shock. I was staring at the mountains and the sky, watching a bird fly over head, when the group facilitator, whom I had trusted, launched into me. "So, how are you, Kyrsten?" I explained my thoughts about beauty and change. All at once, hands shot up into the air. "You're not paying attention, you're avoiding, you're a master manipulator, you're a liar." My peers faces were angry with accusation. I knew in my heart I wasn't lying, and they were acting completely irrationally.

Another such experience came when a girl I had gone to the hospital with entered the program. One of my friends, she said, had killed herself. Tears started pouring down my face. I hadn't cried in months. In group the next day, I decided to voluntarily share how upset I was. One by one, the girls launched into me yet again. "You're lying, you're just avoiding how you really feel by focusing on the suicide, you're feelings aren't real." And so it went. My feelings weren't real. People could judge my character just by looking at me, they said. They knew me. Without ever having known me. I was criticized for writing eloquently. "You're avoiding" they would say, demeaning my poetic descriptions of how I felt, required written work for the seminars.

I am so lucky I was resilient, that I could change myself to suit their needs until my parents pulled me out. My journal of the first month in the program reflects what's really going on. My fear. The sense of being trapped. The completely arbitrary rules.

After three months, my journal entries were laced with program jargon. A binary happiness I had to adapt to fit in. To move up in the program.

I am livid. We will tell our stories. You may have managed to use Communist techniques to brainwash us into temporary conformity, but we are not silent anymore.

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. I fully believe that my daughter and our family were helped by the program she attended, but that doesn't diminish my belief that there is potential for great harm to occur to individual children within individual programs because of a lack of regulatory oversight of these programs. I was particularly impressed with the way Ms. Szalavitz applied her knowledge of both individual psychological forces and sociocultural factors to help the reader understand how even the most egregious programs can flourish and how both parents and kids who have been involved with them can defend them.

As reported by Ms. Szalavitz, the teen behavioral health industry is a billion-dollar a year enterprise, in spite of the fact that a 1999 report by the Surgeon General stated that "there is only weak evidence for their (residential treatment centers) effectiveness" and that "it is premature to endorse (their) effectiveness." Further, in 2004, the NIH concluded that scare tactics used in boot camp type programs "don't work and there is some evidence that they may make the problem worse rather than simply not working." Ms. Szalavitz importantly notes that in spite of a mountain of evidence of demeaning and damaging abuses which have occurred to children in a variety of residential programs in the U.S., both state and federal governments have largely refused to provide oversight to ensure our children's safety. Proposed federal legislation intended to do just that has languished because of a lack of bipartisan support.

Above all, I found Ms. Szalavitz' book to be a heartfelt plea to gather more evidence and do more research to find out what interventions will be truly efficacious for our troubled teens while also embracing the primary tenet of medicine to "Do No Harm." Our society would do well to follow her suggestions in this regard.

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 it...by 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. Some success stories need to be carefully evaluated given such restrictive settings in general have harmed many, and widespread abuse or quakery passing as therapy appears rampant...some youth being to think mistreatment is acceptable or that their parents are aware of such mistreetment. How would a young teen know whether or not brutal confrontation is not real therapy? Forced exercize? Forced Labor? Isolation? Futher, at this point in time no independent data exists to suggest these facilites actually work. They sure do make a heck of a lot of money and some parents take what they can get, even if it just means essentially incarcerating your child for a few years...
Ms. Szalavitz concerns are valid, the stories are real and, while a few may succeed (why they succeed is up for debate- it appears to be many simply grow up), how many youth must be mistreated, abused, harmed, traumatized for the sake of convinced and unrelinquishing parents who swear by their particular child's program and irrationally support self-regulation w/o examining the reprecussions- the well being of many youth.

At present time a group of concerned mental health professionals formed ASTART. The Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START) is sponsored by the Department of Child and Family Studies of the University of South Florida. The Alliance now includes leaders in psychology, psychiatry, nursing, mental health law, policy and family advocacy, as well as individuals with direct program experience as director, evaluator, parent or participant in such programs.
SEE A START FACTSHEET- TIPS FOR PARENTS on Residential Treatment
[http://cfs.fmhi.usf.edu/projects/ASTART.htm]

I just finished reading this riviting book. Maia interviewed our family and many other families while doing research for this book. She has told our story accurately and has postulated questions that are important for our society to answer about what we will and won't allow to happen to our youth, even if they misbehave. Whether you agree with the books conclusions or not, the stories she tells are real. We know many of the people she talks about. These things are happening today, and we need to look at it, be aware and have a voice in the future of our youth. I would not say that this is an unbaised report, but it is well documented and the conclusions are valid and supportable. Maia takes a stand, without apologies. But, she arrived at that stand after much objective research.

Besides a headline here and there about deaths or extreme abuse at "programs for troubled teens" the scope of the problem with these programs and exploitation of families, especially their vulnerable teenagers, has gone largely under the media radar. It is from under the radar this industry is growing like a cancer. One umbrella corporation operates about 30 programs and seems to plan to go public. The profits from this black scam are huge.

It is stunning to me that a minor who has commited no crime, (often the opposite - is suffering from some trauma or abuse) can be "escorted" (kidnapped) across state lines and locked up in a *licensed* (or unlicensed)troubled teen facility for an indeterminate length of time without *any due process* at all, no way to contact friends, extended family, get legal help or report abuse. All of this is supposed to be part of "milieu therapy" and at the heart of the treatment is a type of Primitive behavior modification that is nearly universal among these programs. The system aims to break a teen by stripping them of any BASIC comforts, like using sugar or wearing shoes and closing them off from the world. Teens will either succumb to the mind control or they will play the very twisted game despite their moral compunction. They are constantly put in a double bind, i.e. commonly they are forced to rat on each other at level 3 or 4. They are told that if they behave according to the bizarre standards set by these behavior modification system earn points to get privileges and move to another level, usually 4 levels, at which point they are considered "graduated." The system in its details is extremely Orwellian and staff don't need to get physically abusive when they have control over the souls of these kids. In fact, graduation happens when the funds for treatment run out and the b.m. system is simply manipulated capriciously to hold a student back until that time.

These kids having been snatched without a shred of their former lives, are unable to contact anyone but parents, and even then, the contact is monitored just in case the teen complains. The teen is the problem always. The teen is manipulative if s/he complains about anything. The teen is always responsible for his/her behavior no matter what abuse/trauma/medical issues are likely to have caused the behavior.

I do not claim that some of these teens are struggling and in need of help along with their families. Maia's book goes into this issue very well.However, no kid, no matter if they're behavior is nightmarish, should be subject to a form of control only comparable to those held at Guantanomo. This issue raises the questions of a minor's constitutional rights vs. parental rights.

Due process is paramount at state run institutions where the institution's professional team can override a parent's right to institutionalize their child. Parent's cannot assess their children's emotional problems. If a minor should be admitted to a facility, considered a last straw measure, s/he is closely monitored by the facility staff and the standard nearly universally is "shortest length of stay and closest to home". In most states private institutions are required to uphold the same ethical standards as public instutitions. This is why there are only a few states in which these programs exist - because they can, legally.

There is no doubt that these programs are carefully executing atrocities of tremendous proportion - the severe torture (thought reform) is so insidious because families and sometimes staff are manipulated to serve their profiteering . Secrecy about their business practices along with extremely aggressive marketin and very clever financial manipulation keep this monster going. When I refer to Orwellian, I mean it literally in this case - Orwell focused on the use of words for power, control and manipulation. The marketing of these programs is pure propoganda in the classic sense.


There are some kids who say that the program saved their lives... What to make of these reports is difficult due to the nature of the "treatment" and the struggles of the particular teen. Even if there are some "successes" the damage done instead of "success" is so disproportional, it's absurd to consider.

And why is it that despite the lack of evidence that this "approach" works, parents keep forking over fortunes for this treatment?

There are a few exceptions in the troubled teen industry. There re programs based on the simple notion that kids will step up to the plate when they feel seen, respected and cared for. I would guess they represent 10% of what's out there. However, the aggressive marketing of all the other programs would make it hard to find these exceptions.

I say all of this as a mother of a 18 yr. old and a former marriage and family therapist. I am aware of "evidence based therapy" and all the developmental and family issues that swirl around "the adolescent."

Please read her book and pass it on!

Elisabeth,
No. California

This book is impeccably researched. The author supports her position with clear, cogent facts and flawless reasoning.

It's no wonder that the "educational Consultants" are up in arms over this book. Szalovitz has written a clear and compelling indictment of boot camps, therapeutic schools and residential treatment centers and the harm they do to our children and families.

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.

Szalovitz understands that many teens need help and she has outlined approaches that families can take to seek real help, as opposed to the traumatizing, dangerous methods in use by so many charlatans who masquerade as therapists and helpers.

This is a book that should be considered Must reading for any parent of an "at risk" teen ; school personnel; therapist and psychologist, social workers and sociologist; as well as judges and legislators in state and federal government.

The author has done a wonderful job of explaining this complicated issue with clarity, accuracy and compassion.

I do hope it will be widely read by all who find themselves in a position of working with teen's and their families; as well as those responsible for passing and enforcing laws to protect them from the brutal abuse and gross negligence, that takes place in these Boot camps, unregulated teen warehouses, and hellish wilderness "adventures".

It is also worth noting, there are good valid suggestions provided for finding real and appropriate help, and for determining what kind of help is needed - if any.

**For those critics who say the supportive, positive reviews come from those with no first hand experience with the issues involved - they could not be more mistaken**

Please understand I and others, who have had a great deal of experience with this "industry" feel this is an extremely accurate and very important book.

For those who wonder how anyone who had been through such abusive programs, could ever endorse such treatment - read the book. They are true believers - and very hostile to any criticism of their faith.

Being a student at one of these "programs" for near the entire year of 1999, this book helped me heal more than anything else has. It described situations and feelings we all went through there, things I had blocked out. Maia is a hero for all of us survivors: telling our story, making people aware of the injustices that continue to go on against America's youth. Her detailed accounts of individual incidents and informative sections on related general areas, including POW's and brainwashing, brought the whole book together as an informative masterpiece about a great injustice of this day and age.

The power and precision, the devastating brilliance of this book is reflected wholly in the lengths that the tough love industry will go to in order to discredit it.
I cannot praise MS Szalavitz highyl enough for the clarity of her arguments and the honestly of her position
well done.

I was a student in a behavior modification school, which I believe was more abusive than I let myself believe for the past 9 years. For the past year or so I have been struggling with this part of my life, feeling like no one could possibly understand what I can't seem to describe. It took place long ago but for some reason it impacts my life today. Reading this book has given me much insight into why I feel so ambivalent towards a program that turned me into a bigger basketcase than I was before. If you have experienced abuse in a program in any shape or form this is going to be difficult to read, but possibly encourage you to help those who are being sent to these programs day after day. We can't get back what we lost there but we can try to save other kids by telling our stories.