“Generally, parents reach out to these institutions when their child has reached a point where the child’s behavior is destructive, or they are a threat to themselves or even others. Sometimes a child has a mental illness and is in need of higher-level of care treatment for the purpose of safety and intensive treatment,” explains Erin Rayburn, LMFT and founder of Evergreen Therapy. While the established purpose is to help kids and in turn their families, a number of former participants say this is not the reality. Attendees, including celebrities like Paris Hilton and Paris Jackson, say they’ve suffered physical and sexual abuse, isolation, and inhumane living conditions. We look at concerns about the Troubled Teen Industry, the mental health impact of these experiences on teens, and alternatives to get help for an adolescent who needs it.
Understanding the Troubled Teen Industry
The youth treatment programs that make up the Troubled Teen Industry got their start in the early 1900s, with schools and residential centers offering programs to help adolescents. While the specific focus can vary, most facilities offer to help deal with teens for infractions ranging from being disrespectful and using drugs, to disciplinary and mental health issues. Staff offer parents a path to help their children address their problems and find solutions to cope with their issues. “A lot of the goals are to treat mental illness and addiction issues in teens while providing an environment that fosters support by containing dangerous behaviors and providing supportive care,” Rayburn notes. Experts say they have seen success with some treatment centers. Staffing and execution of the program are key. “While some of these ’troubled teen’ centers do not execute their programs well or have unfortunate incidents occur, many of the institutions are ethical and good at their job,” Rayburn states. “Where these centers get a bad rap is an issue that occurs frequently. Sometimes these types of institutions begin to take on clients that are challenged with issues beyond the program’s scope of practice." A lack of guidelines in the industry allows this type of situation to occur. Federal regulations don’t exist, and there is no concrete set of rules implemented by each state. “Certainly, a lack of clear regulation, oversight, appropriate resources, or a high standard of care will result in poor outcomes even with good intentions. If you don’t have well-trained mental health professionals or a healthy functioning system, it’s unrealistic to expect that putting young people into that system would work,” notes Peggy Loo, PhD, Licensed Psychologist, Director of Manhattan Therapy Collective. In addition, attendees point out that treatment is short-term and short-sighted. Even with caring staff, a well-executed program, and a supportive environment, without a long-term outlook, it’s hard to maintain treatment. “The life teens return to after discharge never looks like what they had in a treatment setting—and yet they’re expected to somehow maintain any progress they made. This is a setup for eventualfailure,” Dr. Loo adds. Another concern is the day-to-day activities. Each facility structures its own program, and its own measurements of success. Sometimes a one-size-fits-all approach is put in place and doesn’t meet the needs of each child. “I think that’s one of the biggest problems with these schools, is they’re not specialized enough. So, they use pseudo-science, or these really made up, not evidence-backed strategies to get people to conform and modify their behavior,” explains Emily Oldenquist, a TTI survivor. While in a treatment program, her behaviors were labeled as positive or negative, and assigned points. Doing something positive, like agreeing to wash the dishes, garnered 250 points. Refusing to do the task could subtract 1000 points. At the end of the day, her total decided whether she could talk to other people, be given additional snacks, or have extra time to call her parents. “Every single behavior from the way I held my posture, to the amount of eye contact I gave, to the way that I made my bed, determined if I would have really basic human rights at the end of the day,” Oldenquist notes.
The Impact on Teens
After dealing with the death of her mother and living in an abusive home, the court system sent Kayla Muzquiz to her first group home at 12 years old. She was there as a part of the foster care system, to receive therapy to deal with the trauma she’d endured. Instead of help, she says she found “a lockdown facility that used isolation [and] seclusion rooms, physical restraints, psychotropic medication and peer intervention techniques that made the environment very cutthroat,” she states. “These environments deteriorate social and psychological development through isolation and an overuse of pharmaceutical medication or physical force to change behavior.” Muzquiz shuttled between facilities in North Carolina, Utah, and Texas. She couldn’t get approval to stop treatment and go live with her grandparents, so she stayed in the system until she was 18. She says she survived years of abuse and is now advocating for change. So is Oldenquist. She dealt with sexual assault, mood disorders, and was hospitalized multiple times. Once she reached the state maximum of hospitalizations, long-term care was recommended. At age 15, her parents gave her a choice—get on the plane to head to a school in Utah for treatment, or they’d have someone forcibly put her on the plane. With no other choice, she went. She spent three years at the facility. Although she feels like going saved her life because it kept her from suicidal ideations, she paid a heavy price. “I left the program with PTSD, a lot of shame, distorted social skills because I really didn’t have the opportunity to practice them, [and] subpar academic education because I had to teach myself a lot of things. I also experienced a lot of medical neglect,” Oldenquist states.
Treatment Alternatives
Methods exist to help parents and children deal with difficult family dynamics. Experts recommend allowing your child to choose a therapist with whom they feel comfortable. It gives a child the feeling that their voice matters. Also, seek out family therapy. The household dynamic can significantly contribute to your child’s behavior. You can also try an outpatient program that will allow your child to live at home. As your teen receives help, the family can continue to work towards healing. If your family determines that a troubled teen program is the best solution for your family, know what to look out for. “If the program promises to treat such a wide range of disorders or struggles, that’s a red flag. These programs should be really specialized in what your child is struggling with. A place that promises to deal with anything from autism to schizophrenia is not the place for your child,” Oldenquist notes. Muzquiz says that even while addressing behavioral issues, your child needs your support. “Ask your child to share their thoughts more often and give them control every now and then. All in all, just be there for them,” Muzquiz concludes.
