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

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

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.

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 t

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.

(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 progr