“Involuntary Enrollment” aka “Teen Transport” aka “Being Gooned”
This blog post is designed to address, in a non-judgemental and fact-based manner, the subject of non-consensual enrollments in behavioral healthcare settings for underage minors and the escorted transports which are often utilized to facilitate those enrollments. This is a controversial topic, and for many, an extremely distressing topic - understanding the terminology, parameters, and varying perspectives is necessary for parents to be able to make informed decisions.
First, let’s start with the language because it matters. “Involuntary Enrollment” is a phrase most likely used by professionals who work with adolescents receiving treatment, even if that treatment is residential and/or is initiated against their will. “Teen Transport” is used to describe when a student is taken to that treatment by a paid 3rd party (i.e. not a family member and not the program). “Being Gooned” is most often utilized by former or current students, colloquially, relating to the act of being transported against one’s will, and often implies being woken up in the middle of the night by a couple large humans (the “Goons”) and then transported directly to a treatment program.
Last year I wrote a blog, 11 Lies About Wilderness Therapy, #3 was:
Wilderness Therapy programs only enroll kids who have been transported.
- WRONG. Just like there are different levels of treatment for residential treatment programs, there is a continuum of care for wilderness therapy programs. Some wilderness therapy programs have a 90% enrollment via transport, others have very few involuntary admits and still others have none. This is something to ask a wilderness therapy program about as the family is investigating admission for a family member.
- (Note: another option that can be considered is called assisted enrollment, which provides the student and the parents with a knowledgeable chaperone to travel with the enrollee to the program location.)
I want to delve into this answer because like all the topics on this website it could be its own book.
The topic of teen transports has received much attention in the past year, in part due to the success of recent books and social media campaigns which are designed to raise awareness around these topics. As I connect with colleagues, professionals, and people who have experienced these decisions as unwilling participants, I am aware that there are as many perspectives on these practices as there are individuals who have experienced them. Here are a few ways to consider the experiences you read and hear about.
Everyone tells their own story.
I hear stories of relief from parents who truly feared for their child’s health and safety. I also hear stories from former clients who readily admit that a transport and an involuntary enrollment actually saved their lives. I also hear stories of trauma as the former students reflect on the negative impacts of transport and involuntary enrollment. And some of these stories are all about the same event, as two people can experience events vastly differently, and it is important that all of these perspectives are heard and fully understood (Side note, many historical experiences of former students involve the threatened use or use of zip ties or handcuffs. AMATS “Standards of Professional Excellence” prohibits transporters from threatening restraint to coerce a client, though the association does not forbid mechanical restraint altogether https://www.amats.org/about-amats.)
Time does not always heal.
Family systems are complex and dynamic. Perspectives change with time, and the lens through which one sees an event in one era is not always the same when viewed through the lens of history and experience and perspective. Additionally, one person in a system can evolve and grow and do the work and other members might not.
*Success* for one is not always the same for another.
I was speaking to a parent recently who wrote a series of blogs for me and asked how their child was doing. “They are paying taxes. Holding a job. Calling me regularly, living with roommates and going to therapy weekly. I believe this is a success and makes all the (treatment) programs worth it.” She went on to share that her adult child was speaking about the multiple trips to treatment programs as a failure and a nightmare. This mother went on to say, “but they are alive and living an honest life.” These two vastly different perspectives on the outcomes and results of treatment can both be true at the same time.
There is a growing supply of focused research plus ongoing studies within the industry. And like everything else in this blog, there is a fair amount of nuance to the research and where things are going. To learn more about this, listening to these two episodes from Will White, Ph.D. podcast, Stories from the Field: Demystifying Wilderness Therapy will give you more context about the research, what it means, and speaks to the potential conflicts within the research, Research: Transporting Young People to Wilderness: Part 1 and Part 2.
The following three examples share how interventions and transports have evolved from what was common in the 1980s or as recently as the early 2000s:
1. ARISE Intervention
The ARISE intervention is a family systems model of intervention which is one of the tools that can be used to assist teens with choosing treatment at any level. The key to ARISE is you have a trained interventionist, usually a clinician, and it is a process, not an event. The goal of this model is that all pieces of the system are getting work done and not about singling out one person’s behavior (aka the Identified Patient or IP). In this model, even if the individual does not go to treatment, the family will still be doing their own therapeutic work. (This blog shares the 6 key differences between ARISE and a typical intervention.)
2. Assisted Enrollments
This means that the family has another professional assisting with getting their child to a treatment program. The adolescent knows he or she is going to treatment on the day of travel, not the middle of the night. It is not a surprise. This can be done for many reasons and can be the child’s choice because they may feel parents are not the best people to travel with. “Assisted Enrollment” DOES NOT necessarily mean “Involuntary Enrollment” - it may simply be a voluntary enrollment that is also supported and facilitated by a third party.
3. Teen Transports | Involuntary Enrollments | Being Gooned
Yes, Teen Transports are still done and sometimes needed. However, the use of zip ties and phrases like “you can come the easy way or the hard way” are not OK (and never have been). Not every company has the same screening techniques for the “agents,” the people you will interact with at your door. The proper policies and procedures are being examined Parents and professionals, do your homework if you are using this model. Standards are evolving but this is still a highly unregulated area so transport companies are not all the same. They do not have the same ethics and standards. If you receive a referral from a professional for a teen transport company, ask why that one, how often the professional uses that person/company. Question the professionals' process and knowledge of other options. If you as a parent are not comfortable with transport, voice that concern. It is also of note that these transports are not always done in the middle of the night anymore and quality agents are trained in de-escalation.
Using only teen transports to get a teen to treatment without first having the tough conversations might be lazy or impulsive, is often counterproductive, and can cause lasting damage.* If there is a health and safety emergency, talk through options with the transport professionals, but also the treatment facility and your family therapist(s), etc. With the rates of anxiety and depression in teens skyrocketing in the US, if the teen is too anxious or the family system is too fragile, perhaps the messy process of communication about what is ahead should the teen not opt into treatment with a transport is your process. Go through your process, and involve your teen as much as you possibly can. Empowerment and agency are key to treatment success.
Sending your teen to treatment out of the home is not a first step, it is a last resort. You are not sending your child away to be fixed, you are providing needed physical space so that the family system can get “unstuck”; you are going to have to do your work too. And this first step can color the rest of the process for you and for your child for years to come. So get ready to do couples therapy, find an individual therapist, go on a trauma retreat and work with a parent coach or you will not find the success and positive outcomes you are in search of.
There are more and more treatment programs that will not take a student who has been transported. Find out the facts. Review this blog to learn the top 10 questions to ask a teen transport company who do “assisted enrollments” or “goon” a teen.
* Unless the health and safety of the teenager (or family members) are at risk!
About the Author
Jenney Wilder M.S.Ed launched All Kinds of Therapy in 2015, as the only independent online directory for the Family Choice Behavioral Healthcare Industry. With an impressive case of ADHD and her starter career in the '90s in Silicon Valley, the dream for creating a website with features like side-by-side comparison and an integrated newsletter was born. Jenney stopped counting treatment centers and all types of schools that she has visited when she hit 500 many years ago. Jenney has a Masters in Special Education from Bank Street College (NY) and a Bachelors of Arts focused on History from Wheaton College (MA).
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