The trouble with the 'troubled teen' label and the behavioral modification industry behind it

  • More than 50,000 teenagers are sent away to “tough love” or “behavioral modifications” programs across the country each year.
  • Paris Hilton has led a charge against these programs which seeks legislative changes to the way these programs operate and the mechanisms which regulate them.
  • A new lawsuit counters the industry’s claim that things have changed since revelations of abuse cropped up sporadically in years past.
  • Kenneth R. Rosen is the author, most recently, of “Troubled: The Failed Promise of America’s Behavioral Treatment Programs,” which was published last month by Little A.
  • This is an opinion column. The thoughts expressed are those of the author.  
  • Visit the Business section of Insider for more stories.

To some, it might seem idyllic: 160 acres in the Wyoming hinterlands, nothing but mountains, plains, and the endless possibilities that come with reconnecting to Mother Nature through meaningful farmhand work, answering only to the fruits of one’s labor.

Trinity Teen Solutions claims to offer what its name suggests: a solution for teens who’ve fallen into trouble, struggled with depression or anxiety, or have exhibited erratic behavior their parents might call “out of control.” To the great misfortune of the young women (aged 12 to 17) admitted to the working ranch — which, according to the program’s website, offers “a family-style atmosphere” that “enables true healing and empowers girls to have successful and healthy futures” — they may indeed be treated like problems in need of a solution.

A new class-action lawsuit paints a different picture

A class-action lawsuit filed in November of last year in the District Court of Wyoming by five former clients of the program paints a starkly different picture than one of empowering therapy — a vignette which comes as no surprise to those who have watched the billion-dollar behavioral modification and “tough love” treatment industry boom over the last several decades. 

The complaint alleges that clients of the program were “subjected to or threatened with food and sleep deprivation, physical punishment, emotional abuse, and humiliation, to include, but not limited to, being leashed to other exploited girls, staff members, and/or farm animals, carrying around a folding chair as punishment for twenty-four (24) hours a day for months on end, forced silence for weeks at a time, being forced to run up and down a massive hill covered in sharp rocks and rattlesnakes, being forced to eat only small quantities of cold kidney beans for weeks at a time, participation in ‘group therapy’ without a licensed therapist with the sole purpose of staff and other exploited girls degrading and humiliating the participant, to force compliance with mandated labor assignments.”

Angie Woodward, the director of Trinity Tee Solutions, said in an email the program plans to file a motion to dismiss. “The allegations in the lawsuit remain unproven and are disputed,” Woodward wrote.

“Tough love” or “behavior modification” programs ranging from wilderness therapy programs to residential treatment centers exist in large numbers today. Utah alone is home to roughly 100. An estimated more than 50,000 teenagers are in such programs across the country today. 

The troubling truth is that despite half-hearted federal and state investigations, many programs remain open and employ therapeutic techniques similar to what is alleged in the Trinity lawsuit. As survivors of these programs have aged into their late-twenties and early-thirties, their claims of abuse and neglect are only now being heard, thanks in part to celebrity awareness.

But if we are to look honestly at the troubled teen industry, we must label the term “troubled” itself as a proximate, not an ultimate, cause for the failure of the industry to appropriately address teens in need of help. 

There are many ultimate causes, but perhaps the easiest ones to identify are the lack of state and federal policy regulating these programs and the language used to discuss, encourage, and impel these types of non-evidence-based treatments. The failure of duty to care for so-called “troubled teens” begins with language.

Euphemistic language doesn’t solve the problem

The suit’s allegations counter a narrative touted by the industry in recent weeks: that since allegations were made against a similar program in Utah — which Paris Hilton attended more than a decade ago — and since separate accusations of abuse, neglect, and emotional harassment by similar programs were detailed in my recent book, the industry has changed. 

Many in the industry argue that for all the recent media and legislative efforts across the country to further regulate and investigate programs for teenagers in despair, the programs have morphed into something positive. They are not the programs that my book and Hilton’s documentary sought to underscore as troubled, industry professionals told me. They had improved.

One podcast, vaguely called Wilderness Therapy & Residential Treatment Center Journey, touted all the ways in which wilderness therapy — which many industry professionals prefer to call “adventure therapy” — had sought to end the kidnapping of teenagers as a way to transport them to its programs. These programs often use other euphemisms besides “adventure therapy” — they call the kidnapping of children from their beds at the behest of parents, “transportation” or “interventions.” Likewise, they say they don’t employ “solitary confinement,” but rather “calming rooms,” a term used in the past by a Utah-based program.

Meanwhile, a website for parents who are seeking treatment options for their children was quick to publish posts about how “there were no treatment plans in the early days” when Hilton was sent away, but now there were.

A licensed clinical social worker, in an email thread shared among a “task force” looking to further study the “in-home intervention” methods of snatching children from their beds to bring them to these programs, said he wouldn’t engage with criticism of the industry in part because my “lingo” didn’t align with his priorities. Perhaps because I wasn’t myself an industry professional, but a journalist and someone who had experienced these programs first-hand, my views were skewed and therefore invalid.

The industry says programs have changed. But lawsuits keep coming. 

The industry claims these programs have changed, yet fresh lawsuits, like the one in Wyoming, still arise. And the people tasked with caring for troubled teens are sometimes no less troubled than the teens themselves, with many staffers’ lacking a background in childcare or clinical psychology. In many cases, staffers have only met the criteria of recent job postings which only require counselors to have graduated high school and be 21 years of age or older.

When seeking to discuss my latest work — dispelling the myth that behavioral treatment programs for teenagers help children who are struggling — a “certified parent coach” listed one of his qualifications as his “male voice, which works well with both female and male parents.” 

A former education consultant, who created a website for parents seeking alternative therapeutic treatment, allows programs to list their services (for an undisclosed fee) without vetting the veracity of the treatments offered or the credentials of the staff to treat minors which, without due diligence, legitimizes harmful programs.

An owner of a program in the South, who wrote to me in seeking a dialogue about how the programs and this moment might manifest positive changes in the industry, said he believes “there are serious moral deficits in the way that business is run, in how [the industry] operates and advertises, the idea of placement outside the home being more effective than an IOP [intensive outpatient programs], and the practice of transporting adolescents.”

He did not wish to speak on the record because “my entire social circle would be significantly impacted if I gave a blanket statement that contributed to the closure of their companies. I fully own that there is a need for self-preservation.” 

Despite this, he had said that he was excited about “an opportunity to manifest a totally different industry,” one which “does force parents to listen to their children, and provides local resources, and doesn’t guilt trip them on to a 200k carousel.” 

From where I sat, even this correspondence amounted to nothing more than another set of “promises,” more rhetoric aimed at slowing what momentum there was for change in order to allow the dust to settle. 

Language is everything. Intention is used to determine the difference between murder and homicide, abuse and neglect, and it should likewise be used to determine whether harmful practices were implemented despite the most well-meaning staff at these programs.

In the middle of all the wordplay, the “troubled teens” — as they’re still called — continue to be placed in these programs and subjected to suffering which lasts well into adulthood.

Kenneth R. Rosen is the author, most recently, of “Troubled: The Failed Promise of America’s Behavioral Treatment Programs,” which was published last month by Little A.

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