Exploring The Troubled Teen Industry
A Surface Look at Programs, Concerns, and Potential Reforms
The Troubled Teen Industry (TTI) is a network of private, for-profit programs designed around the concept of helping troubled teenagers improve their lives through strict routine, rigid structure, psychological treatment, and education.
This Industry is made up of many different types of programs including, but not limited to, wilderness therapy programs, residential treatment centers, therapeutic boarding schools, drug rehabilitation centers, therapeutic religious schools, educational consultants, and juvenile transportation companies that focus on using non-traditional approaches to therapy and mental health care for teenagers in crisis.
One concept that needs to be considered when debating the TTI is what is being bought and sold in the name of helping teenagers minimize negative and maladaptive behavior development during adolescence. This is a hugely lucrative industry. In government funding alone, programs receive over $23 billion annually.
Many state governments send children, especially those in the foster system, to out-of-state programs using funding from sources including Medicaid and Medicare. There are no records on how much is spent privately on the industry through means such as parents paying fees and tuition for their children to attend TTI programs, but it is thought that more money is spent privately in this industry than is provided by government funding. This could easily be a $100 billion or more industry, but this is unknown due to the lack of recordkeeping and oversight. It is estimated that around 120,000-200,000 students reside in TTI facilities in the United States at any given time.
One of the most significant problems within this industry is how it is affecting the long-term mental health of the adolescents who attend these programs.
In the 1950s, German psychologist Erik Erikson developed his theory of psychosocial development, which involves eight stages of development, each with a crucial crisis that must be resolved in order for the associated aspect of human development to be solidified and self-actualized. In what he referred to as the identity vs. role confusion stage, an adolescent between ages twelve and eighteen must overcome the obstacle of figuring out who they are and what their place is in the world. Teenagers spend this period of development testing boundaries and coping techniques while in a state of self-discovery. When this crisis is resolved in a healthy way, it will lead to security in an individual’s sense of self and confidence in who they are as an adult individual as they move into the next stage of development.
When an adolescent becomes stuck in a position of role confusion, this can impact their psychosocial relationships with others and themselves. This may present as commitment issues, increased issues with mental health, a diminished sense of self, and a lack of self-confidence. If this confusion is not resolved, it can carry these issues over into the next stage, impacting the healthy development that should be occurring during that stage. Sometimes, in the case of children who have experienced significant trauma, some of these issues may already exist as one begins to enter the identity vs. role confusion stage. Because these issues often deal with identity and sense of self, the identity crisis may begin earlier than normal for these children, leaving them in a state of role confusion much earlier in this phase with maladaptive habits that have already solidified within the ego. Maladaptive behaviors are patterns of behavior that develop in response to significant stressful stimuli and affect how a person adapts to and overcomes difficult changes.
When adolescents are sent to TTI programs, there are a variety of reasons, usually based on dangerous, maladaptive behavior, and because these behaviors can mildly to severely impact an individual’s ability to function in a healthy way, they are many times the main factor in seeking psychological and therapeutic intervention. Parents are usually the ones who assess these behaviors in their children and make the decision of whether interventions are needed, by looking at these behaviors and comparing them to what behaviors society expects from adolescents and desired behaviors parents want their children to exhibit, and this comparison is often the deciding factor in choosing these programs. If the individual assessing the child’s behavior determines that maladaptive behaviors are affecting the child or family dynamic enough, they may choose to send a child to one of these therapeutic programs with the intention of helping the child develop healthy behaviors and break their maladaptive habits.
Another common reason for this may be the potential for a child to gain a criminal record due to deviant or delinquent behavior patterns, and a significant number of affluent children are offered TTI programs instead of punishment within the juvenile justice system. TTI programs offer a solution for treating maladaptive behaviors when other solutions have not been effective.
One tactic these programs use to encourage parents to send their children to them is deceptive marketing. As defined in the Oxford Dictionary, deception means “giving an appearance or impression different from the true one; misleading”. Manufacturers in the United States are required to follow strict regulations and guidelines with oversight from the Federal Trade Commission (FTC) when marketing their products. According to the FTC, advertisements for products “must be truthful, not misleading, and, when appropriate, backed by scientific evidence.” The way companies market their products and the claims they make about those products are closely monitored by the FTC, specifically for deception. The FTC has also begun to crack down on for-profit colleges that use deceptive marketing.
However, unlike product manufacturers and other types of for-profit schools that have significant monitoring and oversight, TTI programs have no such supervision or requirements on how they may market or operate their programs. In addition, most states completely exempt religious boarding schools from licensing and from oversight that may be required by states for other, non-religious schools. A significant portion of TTI programs claim to be religiously based but provide no religious services, practices, or education. Furthermore, there are no scientific studies or research that provide evidence that these programs are effective treatment options for troubled youth. Many adolescents come out of these programs with more issues with mental health than they had going in.
The abusive practices these programs utilize are extremely detrimental to students and in some cases, lead to the deaths of children. Deaths within these programs from physically or emotionally abusive and neglectful practices have reached over 300 since 1971.
Charles “Chase” Moody, 17, was sent to On Track, a wilderness program run by the Brown Schools group of TTI programs in Texas, on October 8, 2002. Within six days, he was dead. Chase had been told to go to bed and stop speaking with other students, but he continued talking. After being told a second time to be quiet and go to sleep, he again continued talking. Chase was then physically dragged from his tent by three staff members before being restrained face-down in the dirt by all three for over 50 minutes, the entire time it took a sheriff’s deputy to arrive. When he finally pulled up to the field site, Deputy Harold Low witnessed Chase being held, still chest-down on the ground, under three staff members. After handcuffing one wrist, Low turned Chase face-up and noticed he was covered in vomit and not breathing. Chase’s official cause of death was ruled as traumatic asphyxiation by the Travis County Medical Examiner, meaning when he was restrained, the pressure on his body caused him to vomit, he then choked on his own vomit. Texas had already banned face-down restraint techniques in the state.
The long-term effects on children who survive these programs are vast. These include many mental health issues including depression, anxiety, complex Post-Traumatic Stress Disorder, insomnia, suicidal ideation, and many more. These often have significant impacts on the survivor that can last for life. Many survivors report lengthy periods of homelessness and unemployment after their TTI experiences. They may also have difficulty with higher education, caring for their own children, or being a productive member of society due to the lifelong emotional and physical scars inflicted on them during their time in the TTI.
