The “troubled teen industry” is vast, and like all industries there are some shady characters and practices from the past, and even the present. Here are two key pieces that I want anyone reading this blog or visiting this website to understand:
- NOT ALL TREATMENT PROGRAMS ARE THE SAME, NOR DO ALL PROGRAMS BELONG IN THE SAME CATEGORY, but some media outlets have chosen to lump them all together as the quickest way to sell a book, get a download, or make a quick buck.
- I also FIRMLY believe that some children (now adults) were psychologically and/or physically hurt in some programs in the early years of the troubled teen industry (many of these places have closed down).
What I know from my previous work as a Therapeutic Placement Consultant, having visited 500+ schools, boarding schools, wilderness therapy, residential, and transitional treatment centers for teens and young adults is that taking a client out of the home, and engaging with comprehensive clinical or academic interventions, can assist with bringing a family back together. I also know it does not always work - mental health, trauma, and substance abuse in a family system is complex and the process is not a straight line with a bow at the end.
Here is a list that is by no means exhaustive of the half-truths and incomplete narratives that are thrown out in the media. If you are a family looking at a program who chooses not to have their information shared on this website (we require programs to answer 30+ questions), ask the treatment program who licenses them, under what national accrediting body, are their clinicians licensed, etc. If they can not answer easily -- please seriously reconsider your options. There are programs out there that are unlicensed or poorly managed, and these programs are not reflective of the quality of options which exist.
1. Wilderness Therapy Programs are NOT
2. Not all troubled teen programs are owned by the same people that owned them 5 years ago.
These are businesses. Most are for-profit and several are non-profit. They are bought and sold, and while they may retain a name it is possible they have completely changed or updated their practices - many times for the better, and sometimes not. This website requires ALL advertisers to disclose their ownership. Regardless of how the company is set up, who works ownership changes with the programs and what you see in a review might have changed in the last 6 months. ASK THE PROGRAM. There are professionals (therapeutic consultant/interventionist) whose job it is to know this information and any treatment program worth its weight will be willing and able to have a very uncomfortable conversation about its history, ownership, and operation. If they do not RUN AWAY, do not walk.
3. Not all troubled teen programs welcome regulators/accreditation bodies on campus.
If a treatment program does not have a state and national accreditation I would not send my child there. I know the programs that do not have that and I do not pursue them as advertisers (see #8).
4. Enrollment in a program includes some amount of risk. Even fully-accredited programs with impeccable safety records represent some level of risk.
- Mental health and addiction and recovery are not straight lines. There are troubled teen programs that are transparent.
- There are treatment programs that cost a lot of $ and there are some that cost significantly less $. I can not tell you this will work and this will not, but I do know that not every troubled teen treatment program does TREATMENT using outcomes-based treatment approaches.
5. Not all troubled teen programs commit to ongoing training of staff.
A boy died at a treatment program in Michigan. I am sick when I hear about children dying in treatment. The child’s death was due to improper restraint and the investigation revealed that the restraint did not align with the level of behavior. There were 3 different treatment programs operating out of the location. I do not know this treatment program. I do have an advertiser on this website that is owned by the parent company. I do know that there are several questions parents or caregivers must ask as part of their investigation process into a program, “When are restraints done?” “What is the training that is done for staff and therapists?” “How many restraints were given in the last 6 months vs. the 6 months before?” Ongoing training is the quickest way to weed out a shady teen treatment program vs. one that has structure.
6. Not all online reviews are up to date.
- Online reviews are the quickest way for a former family or former client of the program (underage or 18+) to slam a program. When timely, this feedback can be important - but many online reviews make me cringe because the feedback is often out of date and off base in terms of the evolution of best practices, clinical approaches, or even ownership. As a result, online reviews - both good and bad - can be very misleading. If you read something online about a troubled teen treatment program that makes you cringe, call the treatment program and have a REAL conversation about the information. There are 3 reasons to have this conversation:
- If your child enrolls, it will not be a straight line of being connected and happy with the program. This is the first of many times you will be having uncomfortable conversations with the program and professionals. See how they do. See how you feel after. It is an opportunity -- not a predicament.
- If you do not like their answer -- find another treatment option.
If you do not find anything negative, that is weird too. No treatment program has 100% former happy clients.
7. Not all online reviews are wrong.
Online reviews are the quickest way for a former student, family or caregiver to grab a treatment program and drag them through the mud again and again. I am not here to invalidate their experience as right vs. wrong. I read reviews on Google, Yelp, and Psychology Today daily and I must tell you many I applaud many of them. There are former clients who use their smarts, wits and power to organize a hive of impressive magnitude. And like #6, call the program and make them answer your questions. The program will not be able to speak directly about specific clients -- HIPAA compliance provides former clients confidentiality. What you can ask for is to speak to a family that enrolled who was NOT happy with the program.
8. Troubled Teen Programs are not all the same.
- As a parent, if it sounds too good to be true, WALK AWAY. If a program is offering 90% success, question reality. Ask about the ownership of the program. If a program is too inexpensive they might not be paying their staff a living wage or their staff to student ratio is not the same as more comprehensive options. If they can not share with you a redacted treatment plan from another client -- RUN away.
- Not all aspects of this “troubled teen” field is pretty - and many of the accusations leveled against it (poor training, lack of clinicians, lack of licensure or oversight) is historically true. However, things have improved dramatically in the last 20 years, with major advances in the last 10 years. Licensed programs have licensed clinicians & educators. NATSAP is moving towards 100% national accreditation compliance within the next few years. If a program does not have people from the state coming in to assess regularly and a national accrediting body -- find out why. Sophisticated programs are ready, willing & interested in allowing outside accrediting bodies on the campus. (Lear)
9. Treatment of teens in wilderness therapy and residential programming has VASTLY changed since the GAO in 2007.
- The history of the industry is not perfect or without flaws. It is (mostly) full of good-intentioned people (not always clinicians or educators) who wanted to do good things and whose practices sometimes hurt students and along the way many of them, and the industry at large, have hidden from this reality.
- This list is one piece of the puzzle in shedding light on previous mistakes so that the field can move forward, continuing to grow and evolve, with transparency and integrity.
- Another piece of the puzzle is that professional associations have begun to mature, evolve, and change.
- NATSAP has adopted the policy that ALL members are to be nationally accredited by 2023.
- NATSAP treatment programs all have ongoing treatment plans.
- The Outdoor Behavioral Healthcare Council actively contributes to industry-wide outcomes research and has created a comprehensive accreditation process for member organizations.
If you have additional feedback on this, please comment below. This is by no means an exhaustive list and I welcome a dialogue.