Help at Any Cost [BARGAIN PRICE] (Hardcover)

~ (Author) "ADOLESCENCE STRIKES FEAR in the hearts of even the best parents-and raising a teenager, even in ideal circumstances, involves many conflicts and constant worry..." (more)
Key Phrases: North Star, Paradise Cove, Miller Newton (more...)

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 Stats.org, 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. --This text refers to an alternate Hardcover edition.

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 --This text refers to an alternate Hardcover edition.

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Product Details

• Hardcover: 336 pages
• ISBN-10: 1594489106
• ASIN: B000H5ULRU
• Product Dimensions: 9 x 6.2 x 1.2 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.2 out of 5 stars  See all reviews (28 customer reviews)
• Amazon.com Sales Rank: #1,093,164 in Books (See Bestsellers in Books)

Customer Reviews

Most Helpful Customer Reviews

45 of 47 people found the following review helpful:

5.0 out of 5 stars A much needed look at the "teen-help" industry..., February 20, 2006

By	Kyrsten E. Bean - See all my reviews (REAL NAME)

This review is from: Help at Any Cost (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
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... Read more ›

16 of 16 people found the following review helpful:

5.0 out of 5 stars A plea to "Do No Harm"..., July 24, 2006

By	Sue Hall (Southern California) - See all my reviews (REAL NAME)

This review is from: Help at Any Cost (Hardcover)

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.

14 of 15 people found the following review helpful:

5.0 out of 5 stars Well Done!, May 9, 2006

By	MMS (New York, NY United States) - See all my reviews

This review is from: Help at Any Cost (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 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]