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''Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids'' is a
non-fiction Nonfiction, or non-fiction, is any document or media content that attempts, in good faith, to provide information (and sometimes opinions) grounded only in facts and real life, rather than in imagination. Nonfiction is often associated with be ...
book by
Maia Szalavitz Maia Pearl Szalavitz (born March 29, 1965) is an American reporter and author who focuses on science, public policy and addiction treatment. Early life and education Maia Szalavitz was born March 29, 1965. She was raised in upstate New York. She ...
analyzing the controversy surrounding the
troubled teen industry The troubled teen industry is a term used to refer to a broad range of youth residential programs aimed at struggling teenagers. The term encompasses various facilities and programs, including youth residential treatment centers, wilderness progra ...
. The book was published February 16, 2006, by
Riverhead Books Riverhead Books is an imprint of Penguin Group (USA) founded in 1994 by Susan Petersen Kennedy. Writers published by Riverhead include Ali Sethi, Marlon James (novelist), Marlon James, Junot Díaz, George Saunders, Khaled Hosseini, Nick Hornby, ...
. Szalavitz focuses on four programs:
Straight, Incorporated The Drug Free America Foundation (DFAF) is a 501(c)(3) nonprofit organization founded in 1976 by former US Ambassador Mel Sembler, his wife Betty Sembler (), and Joseph Zappala as Straight, Inc., renamed The Straight Foundation, Inc. in 1985 and ...
, a copy of the Straight Inc. program called KIDS, North Star wilderness boot camp, and the
World Wide Association of Specialty Programs and Schools The World Wide Association Of Specialty Programs and Schools (WWASPS or WWASP) was an organization based in Utah, in the United States. WWASPS was founded by Robert Lichfield and was incorporated in 1998. WWASPS stated that it was an umbrella org ...
. She discusses the background, history and methodology of the troubled-teen industry, including techniques drawn from
attack therapy Attack therapy was one of several pseudo-therapeutic methods described in the book ''Crazy Therapies''. It involves highly confrontational interaction between the patient and a therapist, or between the patient and fellow patients during group the ...
and
Synanon Synanon is a US-founded social organization created by Charles E. "Chuck" Dederich Sr. in 1958 in Santa Monica, California, United States. It is currently active in Germany. Originally established as a drug rehabilitation program, by the early ...
. She uses first-person accounts and court testimony in her research, and states that no evidence exists proving that these programs are effective. The book also includes advice for parents and an appendix with additional resources on how to get responsible help for teenagers. The book received positive reviews in
academic journal An academic journal or scholarly journal is a periodical publication in which scholarship relating to a particular academic discipline is published. Academic journals serve as permanent and transparent forums for the presentation, scrutiny, and d ...
s, literary journals, and in the media.
Psychologist A psychologist is a professional who practices psychology and studies mental states, perceptual, cognitive, emotional, and social processes and behavior. Their work often involves the experimentation, observation, and interpretation of how indi ...
Steve K. D. Eichel reviewed the book for ''
Cultic Studies Review The International Cultic Studies Association (ICSA) is a non-profit anti-cult organization focusing on groups it defines as "cultic" and their processes. It publishes the ''International Journal of Cultic Studies'' and other materials. History ...
'' and called it a "must read", psychologist and
psychiatrist A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
Robert John McAllister described it as "an excellent and informative book on the subject of the 'troubled-teen industry' " in his book ''Emotions: Mystery Or Madness'', and a review in ''
Psychology Today ''Psychology Today'' is an American media organization with a focus on psychology and human behavior. It began as a bimonthly magazine, which first appeared in 1967. The ''Psychology Today'' website features therapy and health professionals direct ...
'' described Szalavitz's work as "a meticulously reported and thoughtful investigation". The book also received positive reviews in ''
Publishers Weekly ''Publishers Weekly'' (''PW'') is an American weekly trade news magazine targeted at publishers, librarians, booksellers, and literary agents. Published continuously since 1872, it has carried the tagline, "The International News Magazine of B ...
'', ''
Booklist ''Booklist'' is a publication of the American Library Association that provides critical reviews of books and audiovisual materials for all ages. ''Booklist''s primary audience consists of libraries, educators, and booksellers. The magazine is av ...
'', and ''
Newsday ''Newsday'' is an American daily newspaper that primarily serves Nassau and Suffolk counties on Long Island, although it is also sold throughout the New York metropolitan area. The slogan of the newspaper is "Newsday, Your Eye on LI", and f ...
''. The book later led to an investigation into the troubled-teen industry by the
United States House Committee on Education and Labor The Committee on Education and Labor is a standing committee of the United States House of Representatives. There are 50 members in this committee. Since 2019, the chair of the Education and Labor committee is Robert Cortez Scott of Virginia. Hi ...
of the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
, and Representative George Miller held hearings on the matter in October 2007 and April 2008.


Background

Teenagers have been participating in
tough love Tough love is the act of treating a person sternly or harshly with the intent to help them in the long run. Description Bill Milliken described tough love through the expression, "I don't care how this makes you feel toward me. You may hate m ...
behavior modification Behavior modification is an early approach that used respondent and operant conditioning to change behavior. Based on methodological behaviorism, overt behavior was modified with consequences, including positive and negative reinforcement continge ...
programs by force or coercion since the 1960s. Many of these programs take place in the wilderness in the style of military
recruit training Military recruit training, commonly known as basic training or boot camp, refers to the initial instruction of new military personnel. It is a physically and psychologically intensive process, which resocializes its subjects for the unique deman ...
(also known as boot camps) and the teenagers are subjected to rigid discipline, including mandatory marches,
physical abuse Physical abuse is any intentional act causing injury or trauma to another person or animal by way of bodily contact. In most cases, children are the victims of physical abuse, but adults can also be victims, as in cases of domestic violence or wo ...
,
solitary confinement Solitary confinement is a form of imprisonment in which the inmate lives in a single cell with little or no meaningful contact with other people. A prison may enforce stricter measures to control contraband on a solitary prisoner and use additi ...
, and deprivation of food and sleep. These programs have little to no oversight from the United States federal or state governments. Teenagers' claims of abuse at these facilities have not been investigated because the programs are not regulated.


Author

Maia Szalavitz is a senior fellow at the Statistical Assessment Service (stats.org), a
media Media may refer to: Communication * Media (communication), tools used to deliver information or data ** Advertising media, various media, content, buying and placement for advertising ** Broadcast media, communications delivered over mass el ...
watchdog Watchdog or watch dog may refer to: Animals *Guard dog, a dog that barks to alert its owners of an intruder's presence * Portuguese Watch Dog, Cão de Castro Laboreiro, a dog breed * Moscow Watchdog, a breed of dog that was bred in the Soviet U ...
organization which monitors news coverage of statistics and science. She has served as a researcher for journalist
Bill Moyers Bill Moyers (born Billy Don Moyers, June 5, 1934) is an American journalist and political commentator. Under the Johnson administration he served from 1965 to 1967 as the eleventh White House Press Secretary. He was a director of the Counci ...
, a part-time contributor to ''
Psychology Today ''Psychology Today'' is an American media organization with a focus on psychology and human behavior. It began as a bimonthly magazine, which first appeared in 1967. The ''Psychology Today'' website features therapy and health professionals direct ...
'', and has written articles for ''
The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'', ''
The Washington Post ''The Washington Post'' (also known as the ''Post'' and, informally, ''WaPo'') is an American daily newspaper published in Washington, D.C. It is the most widely circulated newspaper within the Washington metropolitan area and has a large nati ...
'', ''
Reason Reason is the capacity of consciously applying logic by drawing conclusions from new or existing information, with the aim of seeking the truth. It is closely associated with such characteristically human activities as philosophy, science, ...
'', and ''
The American Prospect ''The American Prospect'' is a daily online and bimonthly print American political and public policy magazine dedicated to American modern liberalism and progressivism. Based in Washington, D.C., ''The American Prospect'' says it "is devoted to ...
''. Szalavitz is the co-author of ''Recovery Options: The Complete Guide'' with Joseph Volpicelli, and ''The Boy Who Was Raised As a Dog'' with
Bruce D. Perry Bruce D. Perry is an American psychiatrist, currently the senior fellow of the Child Trauma Academy in Houston, Texas and an adjunct professor of psychiatry and behavioral sciences at the Feinberg School of Medicine in Chicago. A clinician and re ...
.


Contents

In ''Help at Any Cost'' Szalavitz investigates the teen rehabilitation industry and focuses on four programs:
Straight, Incorporated The Drug Free America Foundation (DFAF) is a 501(c)(3) nonprofit organization founded in 1976 by former US Ambassador Mel Sembler, his wife Betty Sembler (), and Joseph Zappala as Straight, Inc., renamed The Straight Foundation, Inc. in 1985 and ...
, a copy of the Straight Inc. program called KIDS of Bergen County, North Star wilderness boot camp, and the
World Wide Association of Specialty Programs and Schools The World Wide Association Of Specialty Programs and Schools (WWASPS or WWASP) was an organization based in Utah, in the United States. WWASPS was founded by Robert Lichfield and was incorporated in 1998. WWASPS stated that it was an umbrella org ...
. Some of these programs cost parents over
US$ The United States dollar (symbol: $; code: USD; also abbreviated US$ or U.S. Dollar, to distinguish it from other dollar-denominated currencies; referred to as the dollar, U.S. dollar, American dollar, or colloquially buck) is the official ...
2,000 per month. She discusses the history of the troubled-teen industry and its origins in a controversial group founded in 1958 called
Synanon Synanon is a US-founded social organization created by Charles E. "Chuck" Dederich Sr. in 1958 in Santa Monica, California, United States. It is currently active in Germany. Originally established as a drug rehabilitation program, by the early ...
. Synanon claimed that it could cure addiction to
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
, and its methodologies such as
attack therapy Attack therapy was one of several pseudo-therapeutic methods described in the book ''Crazy Therapies''. It involves highly confrontational interaction between the patient and a therapist, or between the patient and fellow patients during group the ...
, forced confessions, and imposed powerlessness spread throughout the United States. After a
rattlesnake Rattlesnakes are venomous snakes that form the genera ''Crotalus'' and ''Sistrurus'' of the subfamily Crotalinae (the pit vipers). All rattlesnakes are vipers. Rattlesnakes are predators that live in a wide array of habitats, hunting small anim ...
was placed in the mailbox of an attorney suing Synanon, the group's founder was convicted of
conspiracy A conspiracy, also known as a plot, is a secret plan or agreement between persons (called conspirers or conspirators) for an unlawful or harmful purpose, such as murder or treason, especially with political motivation, while keeping their agree ...
to commit murder. Synanon later went bankrupt, but Szalavitz maintains that it influenced organizations related to the troubled-teen industry. Szalavitz notes that according to a 2004 statement released by the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
, teen programs using "fear and tough treatment" are not successful and evidence shows that they can worsen existing behavioral problems. Many of the children that enter these programs have
mental illness A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
, and have a history of prior
trauma Trauma most often refers to: *Major trauma, in physical medicine, severe physical injury caused by an external source *Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic inju ...
and
abuse Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other t ...
. Szalavitz uses first-person accounts from teenagers that participated in these programs, and asserts that the programs have potentially serious negative consequences, including
post-traumatic stress Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a ...
and deaths. An emotional story in the book recounts the death of 16-year-old Aaron Bacon. Bacon had a treatable
ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
, and died after being out in the wilderness in
Utah Utah ( , ) is a state in the Mountain West subregion of the Western United States. Utah is a landlocked U.S. state bordered to its east by Colorado, to its northeast by Wyoming, to its north by Idaho, to its south by Arizona, and to it ...
for weeks while in the care of the group North Star. Bacon lost in 20 days, but was called "gay" and a "faker" when he complained of abdominal pain, and was punished by North Star supervisors—his sleeping bag and food were taken away from him. The individuals responsible for Bacon were charged with
negligent homicide Negligent homicide is a criminal charge brought against a person who, through criminal negligence, allows another person to die. Examples include the crash of Aeroperu Flight 603 near Lima, Peru. The accident was caused by a piece of duct tape ...
, but did not serve any jail time. In addition to these first-person accounts, she also incorporates court reports and testimony in her research. Szalavitz highlights controversial practices used by these tough love teen industry programs which the
Geneva Convention upright=1.15, Original document in single pages, 1864 The Geneva Conventions are four treaties, and three additional protocols, that establish international legal standards for humanitarian treatment in war. The singular term ''Geneva Conven ...
banned as being too extreme for
prisoners of war A prisoner of war (POW) is a person who is held Captivity, captive by a belligerent power during or immediately after an armed conflict. The earliest recorded usage of the phrase "prisoner of war" dates back to 1610. Belligerents hold priso ...
. She states that there is no evidence that any of the programs are effective. Portions of the book are addressed to parents and provide resources and advice on how to select better choices instead of programs in the tough love teen industry, and the book includes an appendix aimed at educating parents on how to find help for their teenagers.


Reception

In his book ''Emotions: Mystery Or Madness'', psychologist and
psychiatrist A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
Robert John McAllister highly recommended ''Help at Any Cost'', and called it "an excellent and informative book on the subject of the 'troubled-teen industry' ", and "important reading for any parent who is considering sending a teenager to a tough love program, a boot camp, or a wilderness program." In a review of the book in ''
Library Journal ''Library Journal'' is an American trade publication for librarians. It was founded in 1876 by Melvil Dewey. It reports news about the library world, emphasizing public libraries, and offers feature articles about aspects of professional prac ...
'', Linda Beck commented: "This book is excellent owing to its whistle-blowing approach: it exposes an unregulated industry and alerts adults to the severe harm inflicted by these 'schools.' " She called the book "chilling" and "Highly recommended for public libraries." In a review in ''
Mother Jones Mary G. Harris Jones (1837 (baptized) – November 30, 1930), known as Mother Jones from 1897 onwards, was an Irish-born American schoolteacher and dressmaker who became a prominent union organizer, community organizer, and activist. She h ...
'', Nell Bernstein highlighted the sources given for parents at the back of the book, commenting: "''Help at Any Cost'' winds up with an appendix that helpfully outlines "evidence based" alternatives to the tough-love approach." Steve Weinberg of the ''
St. Louis Post-Dispatch The ''St. Louis Post-Dispatch'' is a major regional newspaper based in St. Louis, Missouri, serving the St. Louis metropolitan area. It is the largest daily newspaper in the metropolitan area by circulation, surpassing the ''Belleville News-Dem ...
'' gave the book a positive review, and described Szavalitz as "a talented, relentless investigator". He noted: "Her outrage surfaces frequently as children die, as once-loving families are atomized and as troubled-teen entrepreneurs escape criminal prosecution while using legal maneuvers to prevail in civil court lawsuits seeking damages", and characterized ''Help at Any Cost'' as "an important book about an industry that sometimes helps troubled youth but causes harm way too often." A review in ''
Psychology Today ''Psychology Today'' is an American media organization with a focus on psychology and human behavior. It began as a bimonthly magazine, which first appeared in 1967. The ''Psychology Today'' website features therapy and health professionals direct ...
'' called the book "An alarming exposé of the burgeoning business of boot camps and drug rehab centers that promise to reform troubled teens", and described Szalavitz's work as "a meticulously reported and thoughtful investigation". Vanessa Bush of ''
Booklist ''Booklist'' is a publication of the American Library Association that provides critical reviews of books and audiovisual materials for all ages. ''Booklist''s primary audience consists of libraries, educators, and booksellers. The magazine is av ...
'' characterized the book as "a revealing, at times horrifying look at the troubled-teen industry." ''
Publishers Weekly ''Publishers Weekly'' (''PW'') is an American weekly trade news magazine targeted at publishers, librarians, booksellers, and literary agents. Published continuously since 1872, it has carried the tagline, "The International News Magazine of B ...
'' noted: "With a useful appendix discussing when and how to get responsible help for a troubled teen, this book, filled with first-person accounts, should be required reading in Parenting 101", calling the work "a courageous—if horrifying—study of the tough-love industry". Karen Karbo, author of ''The Stuff of Life'', gave the book a positive review in ''
Newsday ''Newsday'' is an American daily newspaper that primarily serves Nassau and Suffolk counties on Long Island, although it is also sold throughout the New York metropolitan area. The slogan of the newspaper is "Newsday, Your Eye on LI", and f ...
'', writing: "Maia Szalavitz's brisk investigation of America's so-called "tough love" treatment programs, which bill themselves as the last hope for out-of-control, drug-taking teens, would be the stuff of a bad TV movie, if it weren't so smart, well-researched and even-handed." Mark Sauer of ''
The San Diego Union-Tribune ''The San Diego Union-Tribune'' is a metropolitan daily newspaper published in San Diego, California, that has run since 1868. Its name derives from a 1992 merger between the two major daily newspapers at the time, ''The San Diego Union'' and ...
'' noted: "Some of the stories reveal physical and psychological abuse that rivals tales from Iraq's
Abu Ghraib Prison Abu Ghraib prison ( ar, سجن أبو غريب, ''Sijn Abū Ghurayb'') was a prison complex in Abu Ghraib, Iraq, located west of Baghdad. Abu Ghraib prison was opened in the 1950s and served as a maximum-security prison with torture, weekly exe ...
."


Aftermath

''Help at Any Cost'' succeeded in bringing attention to deaths related to
medical neglect In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness and ...
and
child abuse Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
in the troubled-teen industry. On October 10, 2007, the
United States House Committee on Education and Labor The Committee on Education and Labor is a standing committee of the United States House of Representatives. There are 50 members in this committee. Since 2019, the chair of the Education and Labor committee is Robert Cortez Scott of Virginia. Hi ...
of the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
held a full committee investigative hearing chaired by Representative George Miller on "Cases of Child Neglect and Abuse at Private Residential Treatment Facilities". The
Government Accountability Office The U.S. Government Accountability Office (GAO) is a legislative branch government agency that provides auditing, evaluative, and investigative services for the United States Congress. It is the supreme audit institution of the federal govern ...
presented findings from an investigation into the troubled-teen industry, and parents of teens who died under care of these organizations testified at the hearing. Maia Szalavitz attended the hearing as well. After the book's publication, Szalavitz continued to write about the controversy surrounding the troubled-teen industry for Statistical Assessment Service, ''The New York Times'', ''The Washington Post'', ''Reason'', and ''The American Prospect''. The House Committee on Education and Labor held additional hearings on the matter on April 24, 2008, again chaired by Representative George Miller.


See also

*
Troubled teen industry The troubled teen industry is a term used to refer to a broad range of youth residential programs aimed at struggling teenagers. The term encompasses various facilities and programs, including youth residential treatment centers, wilderness progra ...
*
Élan School Élan School was a private, coeducational, and controversial residential behavior modification program and therapeutic boarding school in Poland, Androscoggin County, Maine. It was a full member of the National Association of Therapeutic Schools ...
*
Judge Rotenberg Educational Center The Judge Rotenberg Center (founded in 1971 as the Behavior Research Institute) is an institution in Canton, Massachusetts, United States, for people with developmental disabilities, emotional disorders, and autistic-like behaviors. The center ...
* ''
Scared Straight! ''Scared Straight!'' is a 1978 American documentary directed by Arnold Shapiro. Narrated by Peter Falk, the subject of the documentary is a group of juvenile delinquents and their three-hour session with actual convicts. Filmed at Rahway Stat ...
''


Notes


References

* * * * * * * *


Further reading

* * *


External links


Help At Any Cost ~ by Maia Szalavitz
official website * (Video of discussion with author) * {{Good article 2006 non-fiction books Popular psychology books Parenting advice books Riverhead Books books Books about child abuse Therapeutic boarding schools World Wide Association of Specialty Programs and Schools