“No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.”
Usual definitions of torture include the use of practices such as solitary confinement, non-medical application of psychiatric drugs, unprovoked beatings, starvation, and verbal abuse as means to change a person’s behavior. Many Americans are reluctant to support the use these techniques even on criminals, much less teenagers with behavioral problems. Unfortunately, this is exactly what is being done on a large-scale basis as “tough-love” programs have become a booming industry. These programs come in several varieties, including boot camps, “therapeutic” boarding schools or academies, and wilderness programs. At the cost of several thousand dollars per month (up to $40,000/year), these schools supposedly provide a climate where troubled teens can continue their regular education while receiving treatments designed to improve their behavior.
In the philosophy of these schools, reform involves two goals: to break kids down through strict discipline and routine, then to build them back up through self-examination and therapy of various sorts. Usually, only the former is accomplished. So successful is the breaking down process that former inmates of these institutions often suffer symptoms of post-traumatic stress syndrome, even years after being freed. Ex-students call themselves, with good cause, “survivors”.
A reasonable estimate is that at any given time, several thousand American teenagers are enrolled in such a program. Sometimes these teens are incorrigible delinquents, who commit petty crimes, do drugs, and make life miserable for their parents. Parents send them to “tough love” programs out of worry that the kid is jail-bound. But just as often, parents enroll their kids in these programs because of more banal worries -- that their kid has had premarital sex, experimented with alcohol and pot, or merely because the teen is defiant and talks back. One of the common factors is that teens sent to these programs seem to suffer disproportionately from ADD, depression, anxiety, and substance abuse problems.
The “breaking down” process can begin in the teen’s own bedroom. Some schools offer an “escort service,” involving captors who arrive at the family’s house at night, abduct the kid (putting them in handcuffs if necessary), and flying them to the school.  Often, the kids aren’t warned by their parents that they have been enrolled in these programs. Once at the school, kids are isolated from outside communication; even contact with the parents is usually severed for at least several weeks. Even after contact with parents is restored, letters to or from the teen will be read, and sometimes edited, by the school’s staff, and telephone calls are monitored.
Most of these schools use a “point” system for evaluating the progress of a student. One cannot “graduate” until one accumulates enough points. Points are taken away as punishment for minor infractions, prolonging the teen’s stay.  Earning points requires submitting to the school’s philosophical understanding of what constitutes a therapeutic advance: admitting that one is flawed, has problems, deserves to be in the institute, and can only improve by being determined to change and doing as the counselors/teachers say. “Focus” seminars are a key tool to facilitate this change at many places. In these sessions, groups of students are led by dynamic teachers who verbally abuse and humiliate individuals -- for example, by requiring that the teen admit his or her faults, followed by harsh critiques from their peers. Failure to find faults in oneself, or to make admissions of one’s wrongdoings, is answered with punishment -- which can involve taking away points, solitary confinement, or worse. Some students resort to inventing past wrongdoings to avoid punishment for not having anything to share.
Students are expected to follow a myriad of rules, and unreasonable punitive measures are doled out for even slight deviance. Rooms are to be kept spotless. Eyes aren’t to wander. Speaking or laughing out of turn is forbidden. Several survivors and their parents, writing of their experiences in on-line forums, paint a grim picture of this extreme regimen of discipline:
“I laughed once when everybody had just gotten into bed and I was grabbed from behind [by] staff by the neck and arm . . . my face was smashed into the wall and then [I was] dragged 15 feet to a confinement cell.”
“At dinner we would, like jail, have a certain time and a certain way to eat and afterwards go straight into exercise . . . I remember it making a lot of us sick but we wouldn’t say anything or we would have more punishment.”
“[My daughter] was severely punished with isolation and seclusion for a week for describing her maltreatment in a group therapy session. She was drugged with an injection of five milligrams of Haldol by force while six people held her down. During this episode she told staff that she could not breathe and nearly died from asphyxiation. After the ordeal she became unconscious and blacked out. The staff left her in this small, cold, concrete room. No one monitored her. In the morning she was lethargic and staff kicked her until she woke up. She was then faced with the horrifying side effects of a Haldol overdose -- facial contortions, drooling, inability to swallow, blindness and severe back pain.” 
Many survivors are beginning to share their stories in internet forums, and some are attempting to file lawsuits. But it is likely that an even greater number are remaining silent. After all, these schools employ textbook brainwashing techniques -- physical isolation, cutting off communication with peers and family, strict discipline, lack of privacy, constant indoctrination to the school’s version of reality, and punishment for not accepting this reality. Historically, these techniques have been used to successfully turn hardened soldiers into zealots for their enemies, or to gain allegiance of normal adults to cults; children, especially those who may be mentally ill, are especially susceptible. Furthermore, the impossibility of escape or ability to control one’s environment is also likely to induce learned helplessness. Beginning with Martin Seligmann’s work on dogs, psychologists have come to understand that both animals and humans can enter the state of helplessness -- characterized by depression, submissiveness, and apathy -- when they suffer stresses that they cannot predict or control.  This process is increasingly being understood as a factor in the development of mental illness, and helps to explain why survivors of these schools report suffering from emotional problems that they did not have before their “treatment”.
A look at the group of people who own and operate these facilities does nothing to dispel the hope that all these abuse allegations are false. The founders of these schools, and architects of their behavior modification programs, are not psychiatrists, clinical psychologists, or in some cases, even college graduates. Nepotism runs deep. The World Wide Association of Specialty Programs (WWASP), based in Utah, is one of the largest corporations in this line of business, and is run by Ken Kay and Robert Lichfield. Ken Kay’s son, Jay, runs the WWASP school in Jamaica, called Tranquility Bay.  Robert Lichfield’s brother, Narvis, ran a WWASP associated school in Costa Rica until it was closed due to claims of abuse.  Lichfield’s brother-in-law owns Majestic Ranch, another Utah school.  Such familial ties secure a web of secrecy and denial.
Troubling as the questionable nepotistic practices may be, even more disturbing are the political alliances the schools’ owners are making. Lichfield personally contributed tens of thousands of dollars to Utah Republicans in the 2002 and 2004 elections. In 2004, the Salt Lake Tribune reported that Lichfield contributed $30,000 to the gubernatorial campaign of Marty Stephens just six days after Stephens, as House Speaker of the Utah state legislature, helped kill legislation that would have established state regulation of specialty schools such as Lichfield’s.  Lichfield also contributed heavily to the 2004 Bush-Cheney campaign. The more WWASP can shore up support in Utah’s government, the more it can avoid regulation or investigation by state officials. And the more WWASP can gain support of congressmen or others on the national political stage, the less likely it is that the federal government will take action.
WWASP has also used its financial power to go on the offensive against its critics. In 2003 they initiated a lawsuit against Parents Universal Resource Experts (PURE), a group that provides free advice on parenting, after PURE began warning parents of the allegations of abuse by WWASP schools. A jury in summer 2004 decided against WWASP in that case, but that didn’t stop the corporation from suing International Survivors Action Committee (ISAC)’s director, Shelby Earnshaw, in early 2005 for similar reasons. [8,9] Other schools are also familiar with the tactic of silencing critics through lawsuits. In April 2005, Missouri’s Thayer Learning Center filed a lawsuit against Timothy Rocha, a former employee who only worked there for two weeks before quitting and reporting incidents of child abuse at the school to police. 
For institutes that bill themselves as “therapeutic”, there seems to be a paucity of proper medical staff at some of these schools. The website for Tranquility Bay, for instance, lists only one M.D. associated with the school: an optometrist. Spring Creek Lodge (another WWASP school) has added a disclaimer to its website admitting it has no mental health professionals on staff.  Some schools list no counselors, physicians, or nurses on their websites at all.
Even when medical staff appears to be associated with these schools, they are acting at the margins of clinical legitimacy. There have been few well-conducted studies on the efficacy of these institutes. The 2001 Surgeon General’s report on Youth Violence concluded that programs of the type described above are not effective in reducing subsequent criminal activity.  In October 2004, a panel from the National Institutes of Health studying youth violence noted several characteristics of ineffective treatment programs, including not being based on empirically sound theory, using fear-based strategies, and being poorly supervised.  The Association of Child and Adolescent Psychiatric Nursing also strongly warned against programs that used punitive measures, restricted children’s communication with parents, and otherwise failed to adhere to proper therapeutic guidelines, in a declaration in 1998. 
Some parents voice a lot of support for these schools, crediting them with positive change in their children. But, as described above, the behavior modification methodology of these schools depends on brainwashing tactics and induction of learned helplessness. The docility of the young people graduating from these programs may be interpreted as progress by parents, but is more likely to be interpreted as depression or sequelae of abuse by psychiatrists. It must also be noted that parents are often lied to, or otherwise kept in the dark, about what occurs at these institutes. And what’s more, some schools have established “focus seminars” for parents, to mirror what their children are experiencing. Karen Lile, a mother who underwent such a seminar, describes the session in an on-line essay as intensive group brainwashing. 
These schools appear to be quite profitable, and some are being gobbled up by large health care corporations. Provo Canyon School of Utah, subject of several lawsuits over abuses occurring at the institute, is owned by Universal Health Services, the 3rd largest health-care company in the United States. WWASP’s annual gross earnings are estimated to be at least $70 million. One group monitoring abuses at these schools, HEAL (Human Earth Animal Liberation), maintains a list on their website of 85 schools that they suspect of being abusive; clearly there are many companies that see economic potential in this field. 
Indeed, one of the most disgusting aspects of private “therapeutic education” is that it exemplifies how unfettered entrepreneurship can exploit good intentions and trample rights in pursuit of profit. Could a more perfect market exist for the venture capitalist? The demand is huge, since there is no shortage of parents worried sick about the behavior of their teenage children. The profit is considerable, since proprietors can get away with charging tuitions comparable to the best colleges. Since parents often allow schools to hold children until the school deems them ready for release, all the school has to do is invent a reason why the child’s change is not complete in order to continue receiving tuition payment. Regulation can be fended off from government officials by claiming the noble cause of treating unmanageable teens, or if that doesn’t work, by hiding under the protection of religious freedom and rights of parents to determine what’s best for the kids. These schools attempt to brainwash parents, thus ensuring a reliable source of glowing testimonials.  And complaints from dissatisfied customers can be negated by simply labeling the aggrieved teen as “manipulative”, or someone who refused to give the treatment a chance.
Some may defend these schools on the notion that families have the right to choose such extreme options for change. This argument ignores the fact that often the decision is made to send a child to these schools without the child’s consent, or without even the child knowing the parents are considering this option. Also, the parent’s decision may be based on misleading advertising, or a lack of valid information about the programs.
The mainstream media has been mostly silent on this issue. Perhaps the most attention these schools have received was when, on national television, Dr. Phil sent a child to Provo Canyon School. “Tough love,” the code-phrase for “child abuse,” appears to have a lot of entertainment value. Despite the relative lack of media attention, grassroots efforts to close these schools or gain more regulation have begun to pay off. In 2003, Congressman George Miller (D-CA) demanded that Attorney General John Ashcroft open a federal investigation into these schools. Ashcroft refused, but Miller has continued his efforts by introducing, in April 2005, a bill into Congress that would establish more oversight of these schools. The “End Institutional Abuse Against Children Act” would supply states with funding to regulate and license residential treatment programs, and would establish federal penalties for abuse within such institutions.  This bill, H.R.1738, is currently in the House Education and the Workforce committee.
There are three approaches to minimizing the damage done by behavior modification institutes. The primary approach, of course, is to directly challenge the right of these schools to operate without tight government regulation. Even the mere existence of such schools is an affront to human dignity, and we must support initiatives such as Rep. Miller’s bill. As a second approach, we should educate our peers who are parents, or will be parents, of teenagers. Surely it is not an easy task to raise rebellious teens, and parents hate for others to meddle in family affairs; but parents desperate for an effective approach to reforming their children make easy prey for the misrepresentative advertising of these institutes. Finally, there is a cultural component to this fight; myths of absolute personal responsibility run deep in our nation, as does sympathy for strict discipline. Despite the mounting scientific and clinical evidence demonstrating the long-term dangers of corporal punishment, many individuals still accept the classic principle, “spare the rod, spoil the child.”
Ending this form of institutional abuse should be an urgent issue for American progressives, since the trend is likely to grow worse. The current political climate is very favorable to privatization of education, “tough love” or zero-tolerance stances on juvenile justice, and very hostile to anything that looks like government meddling in parents’ care of their kids. It would be a sad state of affairs if preventing child abuse became a partisan issue, with those opposed to these forms of schools dismissed as “anti-family” or encroaching on constitutional rights; but we must be prepared for that possibility, and to force this issue into national consciousness.
Joshua Chiappelli is a medical student in Philadelphia who conducts independent research on the subjects of authority and power.
 Varney, "J. Tough love school sent to timeout," Inside Costa Rica, June 26, 2003.
 Liles, K. Breaking the vow of secrecy.
 Human Earth Animal Liberation, www.heal-online.org.
 Representative Miller Introduces Legislation to Curb Child Abuse in Residential Treatment Programs. Press release from George Miller’s website, April 20, 2005.
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