Taken from their homes in the middle of the night, put into isolation, denied food and water, forced to do hard labour and undergo “attack therapy”... This is the reality for up to 120,000 young people in the United States who are housed in facilities meant to help “troubled teens”. People on social networks, notably TikTok, have begun sharing their experiences in these programs to raise awareness of the issue.
The “troubled teen industry” in the United States is a multi-billion dollar industry dating back to the 1960s that includes for-profit boarding schools, treatment centres and wilderness camps that are advertised as therapeutic programs for teenagers experiencing problems with behaviour, mental health, alcohol or drug dependence, eating disorders and more.
But in reality, some of the young people who were in these programs say they are full of emotional and physical abuse that cause a lifetime of trauma. The hashtag #BreakingCodeSilence dedicated to drawing attention to the troubled teen industry has more than 320 million views on TikTok.
‘There were bars on the only windows and at night they locked us in so we could not try to escape’
Lee (not her real name) is an adjunct professor and nonprofit professional focused on human rights who was in a wilderness therapy program for three months in 2007. The program, New Horizons Youth Ministries (NHYM), had locations in Indiana, the Dominican Republic and Ontario, Canada and practised “Christian milieu therapy” and “culture shock therapy”. The program’s methods and patterns of abuse have been described in a documentary and memoir.
Lee believes her parents were deceived about the true nature of the program, and that they sent her there so that she would conform to their conservative Christian beliefs, about which they had frequent disagreements. She told the FRANCE 24 Observers team about her experience:
The idea is that they'd shock us and psychologically destabilize us by putting us in a remote wilderness location where we could not escape or get help from the outside. Then they forced us to submit to and participate in their program. When any of us were hesitant or resisted, they quickly punished and humiliated us, often in front of each other. The overwhelming sense of powerlessness and pain psychologically forced us to comply.
We did not have adequate food, and I lost weight quickly until I was unhealthily thin. They controlled exactly what, when and how much we ate, and this was sometimes used as a punishment and manipulation tactic to get us to “break”. They often did not allow us access to privacy or proper personal hygiene care either, such as showers and free access to toilets.
There were eight of us girls packed into one room in a small cabin in the woods. There were bars on the only windows and at night they locked us in so we could not try to escape. No toilet, we had to use a bucket.
During the day, we did religious programming, ‘therapy’ sessions and hard labour; imagine a group of kids hauling heavy logs on our backs for hours. It didn’t matter if you were tired or felt sick, we had to keep going or suffer worse. Every night I was too exhausted and psychologically defeated to think seriously about escaping. It was just about surviving.
The programs often use methods such as “attack therapy” or “milieu therapy”, methods that were popularised in the 60s and 70s as alternatives to traditional psychiatric treatment. In attack therapy, a patient is confronted and verbally abused or humiliated by their therapist and other patients in order to “break” them to force them to comply and exhibit good behaviour. Milieu therapy involves putting patients in a community setting for a number of months.
Attack therapy and other “tough love” methods have been largely discredited by psychologists. While elements of milieu therapy may be beneficial to certain individuals in carefully monitored settings, some for-profit residential treatment centres practice it unregulated, which has in the past led to harmful outcomes, abuse, or even death. A website has been created to document the 191 deaths that have occurred, either by accident or suicide, at teen treatment programs in the United States since 1971.
“Code silence” refers to a common punishment used in these types of programs where the “patient” is socially isolated and not allowed to speak. The young people in these camps are regularly isolated from other participants and kept from contacting their friends and family back home.
An association called Breaking Code Silence was created in March to provide support to survivors and bring attention to the troubled teen industry. The movement has gained traction after US celebrity Paris Hilton spoke out about her experience in these facilities and began lobbying for federal steps to ensure children weren’t abused in them.
One of the central practices used to bring adolescents into these programs is essentially a form of kidnapping, where parents agree to have their child taken involuntarily from their home, sometimes even in the middle of the night.
“I think that part of the selling point in pulling the kids in really preys on the fear of the parents,” Dr. Vanessa Hughes, director of Breaking Code Silence, told the FRANCE 24 Observers team. “If your child doesn't get help right now, they're going to end up dead or on the streets. We hear that over and over, and that’s terrifying to a parent. I think that there's a message that if you try to bring your child here by themselves, they're going to get away or they're going to run away or whatever else.”
This sets the stage for the child’s entire experience in the treatment program, making it nearly impossible for them to achieve a level of comfort and vulnerability with any mental health professionals there, according to Dr. Hughes.
‘Sometimes they left us for days, without food, water, cover or supplies’
Although Lee was not “kidnapped”, she experienced frequent periods of isolation and punishment:
The most traumatic “wilderness therapy” experience there I had was forced isolation in a remote area. They said horrible and degrading things to me, and before taking me via boat and dropping me on a very small island in the middle of a lake. I was stranded there alone. Sometimes they left us for days, without food, water, cover or supplies. I remember the first time I was left alone in outdoor isolation for 24 hours: it poured rain, and I was thoroughly soaked, shivering cold, hungry, thirsty and scared. After a while, I felt crazy; I screamed to myself because no one could hear me.
The worst part of the program for me was not the physical or sexual abuse; those traumas are horrible and still haunt me to this day, but at least the bruises and bodily wounds healed. The psychological abuse is by far the hardest to recover from. Unless you’ve been through it, you cannot understand what it is like to be brainwashed as a child in that context, the breaking down of your willpower punctuated by degradation and humiliation. It’s dehumanizing and so confusing. It makes it hard to do basic life activities and to feel safe with other people, even years later. This is why survivors so often stay hidden in silence or even talk favourably about their program after suffering extensive abuse there. Our minds were comprehensively manipulated.
Troubled teen programs often promise to use “tough love”, a strong community and character-building activities to help young people in crisis. The programs may describe attack therapy methods as honest confrontation and feedback during group therapy sessions. While the treatment programs may attract parents and look attractive on paper, the reality is often much different, according to Dr. Hughes.
“There are some programs that talk about having equine therapy and horses, but in reality, there are survivors who didn’t even get to leave the building or go outside for months on end,” she explained. “A lot of what’s marketed is just really good treatment, but that doesn’t seem to be what is applied.”
Moreover, many troubled teen programs purport to treat a vast array of issues – from eating disorders to substance abuse to serious mental illness – all in one setting, with one approach. “I think it’s indicative that these places are actually not offering what they are selling.”
New Horizons Youth Ministries was shut down in 2009, having had its license revoked by the state of Indiana, but some of its property has been taken over by another “therapeutic boarding school for struggling teens” called Crosswinds, which has claimed in a statement that it is not affiliated with, and does not use similar methods as NHYM.
Though it’s difficult to estimate exactly how many “troubled teen” programs there are – and how many of them are using dangerous, abusive methods – many other youth wilderness and therapeutic programs are still operating using the same types of “therapies”.
A multi-billion dollar industry with little regulation
Parents pay thousands, sometimes tens of thousands, of dollars a month to send their children to these treatment programs. New Horizons Youth Ministry, for example, charged between $3,000 and $6,000 a month in 2006. Parents have been encouraged to take out loans, refinance their homes or sell their assets to afford fees that can total to up to $150,000.
The industry makes billions of dollars a year, and is hard to regulate because different US states have different laws about childcare and treatment facilities. Some religious programs are exempt from licensing requirements in certain states due to religious freedom legislation, making it extremely easy for them to be established, and harder to be shut down. In 22 states, it’s not legally required for private schools to be registered with the state, allowing these types of programs to operate under the radar, without inspections or standards to uphold.
“When facilities are shut down, they often pop up under another name,” Dr. Hughes said. “You can just open up a building, hang a shingle and say, ‘Hey, we're going to help your kids’. And the money flows because the need is there. Because there aren't alternatives in the community for these families who are stressed.”
This lack of regulation often means that staff members are unqualified, needing little more than a high school diploma. Many programs have no full-time medical or mental health professionals on site, using only temporary doctors who make quick diagnoses and do not follow up with patients.
Survivors deal with long-term psychological impacts
Dr. Emmanuel Monneron is a psychiatrist and activist against the troubled teen industry. He told the FRANCE 24 Observers team that these unregulated treatment programs can have severe long-term consequences for survivors compared with evidence-based, outpatient therapy to treat common issues in adolescents.
A lot of the young people who are sent to these programs already have a history of psychological trauma. Extracting a vulnerable young person from his community, removing all links with their friends, family, all support systems can impact psychological and emotional health and lead to depression or anxiety disorders. There is the use of restraints, isolation, violence and emotional abuse. These stressors are repeated daily, sometimes for years. And so, this gives rise to post-traumatic stress disorder complexes, which are linked to repeated stress factors and which often result in hypervigilance, and reliving syndromes with flashbacks and nightmares.
Dr. Monneron added that long-term institutionalisation itself can be harmful to adolescents, impacting cognition due to decreased stimulation and independence for making decisions. This makes it difficult for survivors of the camps to return to daily life. The experience may also make people less likely to seek psychological care from other sources after leaving the program.
I left with C-PTSD (complex post-traumatic stress disorder) due to the program. After years of healing with therapy and getting in contact with other survivors, I’m finally able to talk about it more, but it’s difficult. There are hundreds of thousands of survivors and children currently being abused by the troubled teen industry. I’m speaking out for myself, for my own healing and freedom, but more importantly, for them: I never want anyone else to go through what I did.