The Unregulated, Billion-Dollar “Tough Love” Industry


Many anguished parents with troubled kids put their faith in strict residential rehab programs. Based on a philosophy of “tough love,” they seem to offer a safe respite from the streets — promising reform through confrontational therapy in an isolated environment where kids cannot escape the need to change their behavior, says Maia Szalavitz, author of a book on the “troubled-teen industry,” in the Washington Post. At the same time, during the ’90s, it became increasingly common for courts to sentence young delinquents to military-style boot camps as an alternative to incarceration.

Lack of government oversight and regulation makes it impossible for parents to investigate such “behavior modification centers,” “wilderness programs” and “emotional growth boarding schools.” There is little data to support these institutions’ claims of success. Still, a billion-dollar industry promotes such tough-love treatment. Some 10,000 to 20,000 teenagers are enrolled each year. A patchwork of lax and ineffective state regulations is all that protects these young people from institutions that are regulated like ordinary boarding schools but that sometimes use more severe methods of restraint and isolation than psychiatric centers. There are no qualifications required of the people who oversee such facilities. Nor is any diagnosis required before enrollment. If a parent thinks a child needs help and can pay the $3,000- to $5,000-a-month fees, any teenager can be held in a private program, with infrequent contact with the outside world, until he or she turns 18.


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