Just finished Maia Szalavitz’s powerful 2006 expose Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids.

Szalavitz looks at several networks of “tough love” programs for teens, including networks of residential treatment centers and wilderness programs, and finds truly shocking abuses leading to injury, PTSD, and death. This is a painful read for many reasons. Reading the chapter on the death of Aaron Bacon at the North Star wilderness program came close to making me physically ill, not only because of the horrific injuries he sustained but because of the way he was treated throughout his weeks-long, deadly ordeal: His parents, who had thought they were sending him to a much gentler program, were discouraged from writing him tender letters of love, so the last words he received from them were cold and punitive; the other teens in the program were forbidden from helping him, even from sharing their food with him as he starved; the counselors assumed he was faking and trying to manipulate them. And so he died, after stumbling and falling for days on a forced march even though he was unable to control his bowels. I almost wrote that he died alone, but of course the greater horror is that he died surrounded by other people who watched and even mocked his agony.

Szalavitz doesn’t solely recount horror stories, although those stories–based on interviews with program survivors, parents who sent their kids to the programs, and former staffers; medical records; and court records, among other sources–are shocking enough. She explains clearly the ways in which this style of “treatment” program is designed almost like a machine to produce abuse: The teens are consistently characterized as liars and manipulators, and their own parents are urged to reflexively disbelieve anything they say. Then they’re isolated and kept from communicating with anyone in the outside world who hasn’t received this “everything they say is a lie” conditioning. These two practices make reporting abuse basically impossible.

Meanwhile confrontational, “tough love” methods not only provide an obvious cover story for cruelty, but actively damage the consciences and empathy of the teens and the untrained young people who supervise them. Toward the end of the book Szalavitz notes that one reason people who were put through these programs may have trouble forming relationships later is that they were taught that gentleness is harmful and harshness is helpful. This is the softer version of the suppression of empathy which allowed people to stand around and watch Aaron Bacon die.

The book includes an appendix with caring, specific guidelines for parents whose teens are genuinely troubled (although Szalavitz notes that the abusive programs often prey upon worried parents whose kids aren’t actually troubled!). Obviously this section is out of date now, but it offers a starting point and, more importantly, a framework for thinking about treatment decisions.

There are all kinds of smaller themes in the book–I’ve barely scratched the surface here–including the role of sexual humiliation, the creation of complicit participants in the parents and staff, the creation of an image of the lying and manipulating teen which can then be applied indiscriminately to all complaints, the confluence of seemingly incompatible philosophies and movements (explicit moral relativism and anti-drug hysteria, for example), and the colossal failure to protect on the part of institutions ranging from psychiatry to law.

And there’s one other recurring theme: Republican money men. Although “tough love” programs have penetrated both Democratic and Republican establishments at the local levels, the big donors from these programs seem to favor the GOP. Szalavitz has followed up on this story over the years. Here’s a recent piece she did on Mel Sembler, Romney backer and co-founder of the abusive treatment center Straight Inc.:

When the national political press writes about Republican financier Mel Sembler—a major Romney donor who formerly chaired the finance committee for the party (and the candidate himself)—it typically fails to mention his involvement in abusive addiction treatment and reactionary drug policy. For example, this recent Daily Beastpiece on his fundraising simply notes that the Florida shopping mall magnate switched his political affiliation away from the Democrats in 1979 because of his opposition to marijuana use. What it doesn’t mention is that he also founded a rehab that “treated” some 50,000 American teens with a dehumanizing daily routine often involving beatings, days on end of sleep deprivation, brutal restraints that often left youth wetting or soiling themselves, public humiliation (including misogynistic and homophobic insults), lack of privacy and other human rights violations including kidnapping and false imprisonment of both adults and youth. Nor does it detail how that organization—Straight Incorporated—morphed into the Drug Free America Foundation (DFAF), a group that now fights to ensure that drug policy remains harsh and punitive.

Continued here, with links to other articles.

Help at Any Cost is a sad and angry book, but it’s a book which is, ultimately, written in defense of love.