Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids

by Maia Szalavitz

The troubled-teen industry, with its scaremongering and claims of miraculous changes in behavior through harsh discipline, has existed in one form or another for decades, despite a dearth of evidence supporting its methods. And the growing number of programs that make up this industry are today finding more customers than ever.

Maia Szalavitz's Help at Any Cost is the first in-depth investigation of this industry and its practices, starting with its roots in the cultlike sixties rehabilitation program Synanon and Large Group Awareness Training organizations likeest in the seventies; continuing with Straight, Inc., which received Nancy Reagan's seal of approval in the eighties; and culminating with a look at the World Wide Association of Specialty Programs-the leading force in the industry today-which has begun setting up shop in foreign countries to avoid regulation. Szalavitz uncovers disturbing findings about these programs' methods, including allegation of physical and verbal abuse, and presents us with moving, often horrifying, first-person accounts of kids who made it through-as well as stories of those who didn't survive. The book also contains a thoughtfully compiled guide for parents, which details effective treatment alternatives.

Weaving careful reporting with astute analysis, Maia Szalavitz has written an important and timely survey that will change the way we look at rebellious teens-and the people to whom we entrust them. Help at Any Cost is a vital resource with an urgent message that will draw attention to a compelling issue long overlooked.

Genres: Nonfiction, Psychology, Mental Health, Politics, History, Crime, Parenting

336 pages, Hardcover

First published February 16, 2006

About the author

Maia Szalavitz is an award-winning author and journalist who covers addiction and neuroscience. Her next book, Unbroken Brain (St. Martins, April, 2016), uses her own story of recovery from heroin and cocaine addiction to explore how reframing addiction as a developmental disorder could revolutionize prevention, treatment and policy.

She's the author or co-author of six previous books, including the bestselling The Boy Who Was Raised as a Dog (Basic, 2007) and Born for Love: Why Empathy Is Essential-- and Endangered (Morrow, 2010), both with leading child psychiatrist and trauma expert Bruce D. Perry, MD, PhD.

Her book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids, is the first history of systemic abuse in "tough love" programs and rehabs and helped spur Congressional hearings, GAO investigations and proposed legislation to regulate these groups. She also co-wrote the first evidence-based consumer guide to addiction treatment, Recovery Options: The Complete Guide, with Joe Volpicelli, MD, PhD. (Wiley, 2000).

Currently, she writes a bi-weekly column for VICE on drugs and addiction. From 2010 to 2013, she wrote daily for TIME.com and she continues to freelance there and for other publications including the New York Times, Scientific American Mind, Nature, New York Magazine online, Pacific Standard, Matter, Nautilus, and The Verge.

Szalavitz has won major awards from organizations like the American Psychological Association, the Drug Policy Alliance and the American College of Neuropsychopharmacology in recognition of her work in these areas.

She lives in New York with her husband and a Siamese shelter cat.

Reviews

[Andrew · Rating 5 out of 5]

"It was amazing" is not anyway I would ever describe this book to someone. This was an awful, awful read. I had trouble reading more than half a chapter without being urged to set the book down, conduct a prison raid at the nearest facility, and then burn the place down to cinders. I knew even before picking up this book that there were places like this; I had no idea it was torture bad (acts that would constitute war crimes.) Kidnapping, falsifying records, abuse, negligent homicide... all to a sweet tune of millions of dollars profit a year and with little legal accountability. People with high blood pressure issues probably shouldn't read this.

[Andrew Vachss · Rating 5 out of 5]

Any parent considering a "tough love" program must read this first; any judge considering a "boot camp" sentence must read this first, and any politician voting to fund one of these programs should be carefully scrutinized.

[Susan · Rating 3 out of 5]

This was an eye opener for me. This book illustrates first off how little is known about these programs. I work in the field (adolescent residential) and still held a lot of misconceptions about these programs. While these types of programs represent the exact opposite of my theoretical framework, I have known people who have gone through them, with mixed results. I admit, I have at times questioned my own practices in comparison with the claims of efficacy of such programs. After reading this, however, I am embarrassed at my naivete. I had thought of the boot camp/wilderness programs as being overused, extreme, and even benignly ineffective. I had not thought of them as being abusive, or as deliberately causing harm.

The book does a good job of illustrating specific cases of abuse, negligence, and malpractice that takes place in many of these programs, as well as illustrating the fear-mongering and manipulation that has made them lucrative (ie, "Your child will die if you don't admit them here" and so on). I especially appreciated the explanation of the psycho-social mechanics of brainwashing. While the book admittedly feels very anecdotal, it is the lack of (or disregard for) statistical data regarding these programs that the author notes as being a primary problem.

I would recommend that any parent considering such a program for their child read this book first. It won't help parents decide what kind, if any, treatment their child needs (and in fact, I feel that the author's concern for the problems of both adolescents and their parents is a bit half-hearted. She may be too tolerant in what she considers "normal teenage behavior." Then again, maybe I'm a bit jaded myself.) Nevertheless, reading this book should discourage any parent from even thinking of seeking such treatment for their child, which is the author's main objective.

**Finally, it is an interesting book to read in tandem with COME BACK, as the mother and daughter utilized one program specifically mentioned, reportedly with positive results. I was not a big fan of COME BACK, but after reading this, I am tempted to re-read it, just for contrast.

[Beth Peninger · Rating 3 out of 5]

A friend at work, who is apparently VERY passionate about this topic, plopped in front of my desk one day and asked if I would read this book. I took on the challenge. It's not a book I would ever pick up on my own and read but he is passionate about the subject matter and I am curious enough to read about it so I didn't mind. I'll admit I was dreading reading it, wondering how many weeks it would take me to get through it but Szalavitz did a good job of making all the stats and all the stories easy to read and not laborious. It wasn't bad at all and at times I read through it quickly as the particular testimony she was sharing to support the book's title was engaging.
I noticed that one reviewer of this title said that the book was obviously one-sided but still a good read. Um. Duh? Just from the title alone you kind of know what stance the book is going to take on this controversial topic.
The troubled teen industry makes big money off of parents fears. Is that one-sided of me to say? Maybe, maybe not. I actually felt that way long before the book was put in front of me. Parents, and I am one so I can say this with experience, need to get a grip and not freak out so easily or early! As I read the book I thought back to the few instances of my growing up years that can be attributed to mere curiousity (I took two drags of a cigarette and that was all I needed to do to know I didn't want to smoke, etc) and if my parents had freaked out and taken me to a troubled teen "treatment" center I would have been labeled and told I WAS a druggie etc etc. Now does two drags of a cigarette a druggie make? I think we all know the answer to that rhetorical question. So is the book one-sided? You bet. It calls out the money making machine of wilderness programs, "treatment centers" both in the U.S. and overseas (for American children because we are the only nation stupid enough to fall for the scam - please note that other countries don't struggle with this, just us. UGH.)and the like. And the book offers compelling testimony and factual evidence of the scam that it is and the physical and emotional harm that it deals out to families. It's a real eye-opener for people who aren't real familiar with this method of "curing" a "troubled teen". The reality is that 99.9% of the teens in these programs are NOT troubled when admitted but are when they finally escape. We must do better by our children, parents take the time to listen and NOT freak out, take the time to connect with your kid and NOT let the schools or other people do it for you.
Our children deserve better than our own fears and insecurities causing them undo harm in multiple ways.

[Jacob · Rating 5 out of 5]

As someone who went through the Troubled Teen Industry (TTI), including two programs specifically mentioned in this book, Maia Szalavitz's take is completely accurate and I pray more parents heed her warning. The TTI is a huge, huge problem in the United States and the industry is second to none at pulling the wool over the eyes of parents and the public alike. Nothing in this book is exaggerated, in fact, it is often understated. DO NOT SEND YOUR KIDS TO A TTI PROGRAM.

I was sent away in 2006 after coming out as gay to my parents. I was taken by two big men, in the middle of the night right before my 13th birthday, and brought to a wilderness program in Idaho (cough cough - it's mentioned in the book), then, 90 days later, to an equally abusive program in Utah. While in Idaho I witnessed a child die and had to drag his body to the road. Later, a staff member made me eat 8 ounces of salt for fun. I was puking, losing control of my body, and crawled to a cow pond to desperately drink water. I then got worms. Rewind to before that incident, we could all see the worms in cows poop and had asked staff what would happen if we got them. They said we would be sent back to level one of the program because we would only get worms if we were "out of control." So, I spent the next roughly 60 days pulling worms out of my poop so staff wouldn't find out. THAT is how abusive and terrifying these programs are

[BG45 · Rating 4 out of 5]

War crimes are a specific set of crimes which if done to uniformed prisoners of war, are against the Geneva Conventions. However, some acts of torture which would be described as such if it happened to a uniform soldier of a nation, are not considered such when done by a facility to "help" teens. This is not a book for the faint of heart.

Beatings, sleep deprivation, psychological and sexual abuse. Nothing is beyond the scope of possibility in the Troubled Teen Industry. The worst part is, parents usually feel they're doing the right thing for their child...maybe the gay can be "prayed away"? Maybe the disobedient child can be made to "be obedient"? And so people spend tens of thousands of dollars to send their children to "treatment"; literally paying people in ski masks to drag their child out of the house in the middle of the night and bundle them away, parental rights given to an abusive facility.

Most of these facilities in the United States remain dangerously unregulated (with Montana and Utah providing two of the locations where the worst can go unchecked as there are little to no regulations in place). Several such programs also relocate to foreign countries to avoid scrutiny.

A good companion film to this book would be Kidnapped for Christ, where an Evangelical filmmaker examines a troubled teen residential facility in the Caribbean.

[Michelle · Rating 5 out of 5]

A disturbingly true account of the teen help industry, and the morally repugnant "therapies" they use. You owe it to the children who have died in these sorts of camps read this book now!

[Caitlin · Rating 4 out of 5]

Horrifying reveal of the Tough-Love industry, and the pain they put children through. Anyone thinking of sending their children to residential care needs to read this book first.

[Fionnuala · Rating 4 out of 5]

Last year I watched a couple of good documentaries on this topic, and it's been on my radar for a while. I knew the vague idea behind such places, and that they were not a good idea, to put it mildly. (To be honest, with everything that's come out over the years about these places, I doubt anyone with a braincell and access to Google could think otherwise.) As is often the case with things like this, though, I had no idea just how terrible it actually was. This book is absolutely shocking.

I've long said that teenagers get the worst end of the stick. I think out of all age demographics, they are the most reviled. So many people absolutely loathe teenagers. When we think of issues like child abuse, there's a clear gap when it comes to teens. All the pull-your-heartstrings campaigns show little children, often below the age of five but certainly below the age of ten. They're cute and vulnerable and sympathetic. There's rarely a teen in these campaigns, and that absence is reflective of real life. You won't see any pictures like mine in such campaigns: in my mid-teens, dressed in alternative fashion, glaring at the camera and completely dead behind the eyes. I wasn't sympathetic, because I was angry and uncooperative and I demanded better from the adults around me and called it out when I didn't get it. I was an unsympathetic victim, and every adult in my life was all too eager to tell me why the abuse I was suffering was my fault. If I just behaved, if I just got over it, if I just stopped being so difficult, if I just did this or did that it would stop my parents abusing me. I would say that I'd worry that if my parents had the money and were American they might have considered something like this, but the blunt truth is that they did most of it at home for free.

And this is what I mean -- like them, programmes like this think they're doing it for the teen's own good. Tough love is apparently what teens respond to, as if they're all dogs to be trained. (And even then, everyone knows you don't train a dog by starving him and threatening him with pain and violence and withholding water and medical care.) Leaving aside the blatant fact that these programmes have money-making at their heart rather than any altrustic desires to save the children, you don't need to torture and abuse kids to make that money. There's something about teenagers that makes people forget they're children still learning and growing, and instead warps them into full adults who are just choosing to be difficult and bratty. The fact that places like the ones described in this book exist is testimony to the fact that society treats teenagers like shit, and it's killing them.

This book is meticulously researched and lays out the facts clearly and unflinchingly. It's backed by data (unlike these programmes) and tells the stories of several teens to illustrate just what goes on in these places. It also provides a nuanced look at the parents, profiling both those who were genuinely duped and realised their mistake, and those who were duped and then doubled down. At the time of writing, these programmes had not yet had the negative publicity we take for granted now; the parents were genuinely scammed and taken advantage of when they were desperate and vulnerable. I cannot imagine the lives that have been ruined and the relationships that have been destroyed by incidents like this. I rarely use the word, but programmes like this, and the people who run them and contribute towards them in any way -- financially, working there, recommending and defending them -- are evil. I can't think of anyone who shouldn't read this book.

[K. · Rating 4 out of 5]

I have long enjoyed Maia Szalavitz’s work for the New York Times, so when she appeared as a commentator in Katherine Kubler’s documentary “The Program” about abuse at an alternative school and I learned she’d written a whole book on the subject, I was interested. This book taught me a lot, though it also left me feeling saddened and unsettled.

Szalavitz describes the evolution of the “troubled teen” industry and provides some interesting analysis of the way adults view adolescence as a pathology. The length of this list of deaths at these facilities is just shocking. I was hoping to learn that some kind of regulatory measures would have been taken since this book came out in 2006, but it seems that is largely not true and things remain in a chaotic state.

Most other media I’ve seen depicts survivors of these “alternative schools” as uniformly disgusted and angry about their experience, so I was surprised to hear from people who (at least temporarily) believed their programs had been beneficial and even went on to become employees themselves. Their testimony drew a link between cults that are voluntarily joined by adults, and these programs that children are forced into but still often successfully brainwashed by.

This book was also notable for its depiction of the terrible emotional toll taken on parents who made the mistake of sending their beloved child to one of these programs. Of course some parents are just assholes who knew exactly what they were doing, and we don’t hear from them. And of course most media on this subject focuses on the trauma inflicted upon the children, as it rightly should, because not all parents fully repent and even the ones that do still did something horrible to their own child. But the story of the Bacon family really touched me, because it shows how thoroughly and maliciously the degenerates who run these programs will lie to parents. I’m not sure exactly how Aaron Bacon’s parents could have seen through lies that included false marketing materials, false information from an in person meeting with the owners of North Star, and testimony from other kids who had been manipulated.

The author also made some interesting connections between these programs and drug rehabilitation from Synanon to AA. She explains that the “tough love” philosophy is the most common in both alternative schools for troubled children and drug rehabilitation programs for adults. When she asked why we should believe that in alternative schools, children of all temperaments and backgrounds would respond equally well to one form of treatment, it made me wonder if we should explore the idea more that different types of people would respond better to different types of drug rehab. AA could be right for one person, inpatient rehab for another, and hell maybe Synanon for another (not really lol) Though rehab is another industry where people are so desperate for positive results, they're vulnerable to buying snake oil.

Szalavitz sums up a main contributor to the continued existence of these programs when she writes “Despite the fact that government statistics show that levels of youth violence, suicide, drug use, pregnancy, and overall mortality have all decreased drastically in recent years, the media constantly reiterates the idea that each generation's challenges are worse than the last's. This continuous fear-mongering alienates parents from their children.” (from the Introduction)

I decided to check for updated statistics here, and the trends are mostly still positive or neutral. I found that the rate of violent crime committed by juveniles has declined by 70% since 2005, drug use has remained consistent, teenage pregnancy is at a record low of 13.5 births per 1,000 teen girls (as opposed to about 40 per 1,000 in 2005). The overall mortality rate for teens was 65 per 100,000 in 2005, decreased to 48 in 2015, but was back up to 59 as of 2022. Hard to say how much COVID and associated societal disruption led to this increase. However, the concerning trend is that since 2007, teen suicide has increased 62% from 6.8 deaths per 100,000 young people to 11 deaths per 100,000.

The author’s point is certainly true, but it’s not all media hype; I think as we age, we become alienated even from our own childhood selves, and lose the capacity to put ourselves in the shoes of an adolescent. And then I think we must address that technological change is hurtling forward at an exponential rate, raising the possibility that the ubiquity of cellphones, social media, and recently AI really will pose unprecedented challenges for today’s children. That said, there is an enormous amount of sentiment right now about the downfall of America’s youth, with intellectuals and average people both worried that today’s children are sexualized, overstimulated, and morally corrupted by what they view on their phones. You even have articles positing that perhaps one of the changes in society largely viewed as positive, the increased emphasis on mental health, may have gone too far. I can’t help but feel bad for today’s young people- if these ideas are correct they’re doomed to a lonely, empty existence, and if they’re wrong, they’ve been castigated over nothing.

I also checked into whether these facilities still exist. Luckily, WWASP is defunct. And Maia Szalavich’s book helped prompt a Congressional investigation in 2007. But according to this report, at least 1,591 of these facilities still exist in the US as of 2021, with about 50,000 children living in one. This company alone, Sequel, runs at least 30 facilities. A 12 year old boy died at Trails Carolina, a “wilderness camp,” just a few months ago.

If you want to learn more about a particular person’s experience with these “alternative schools,” check out “The Program” documentary on Netflix, where Maia Szalavitz provided some commentary. I was really impressed with Katherine Kubler’s resilience and her desire to make a difference for the children still stuck in these terrible boot camps.

[Danielle · Rating 5 out of 5]

Probably the best book out there on why the entire troubled teen industry is a load of crap. Maia Szalavitz is an excellent writer who makes a damning case against so-called “therapeutic” boarding schools, wilderness camps, and Synanon-inspired organisations like Straight Inc - and against the war on drugs (and lesser recognised war on youth) in general. She very skillfully and respectfully tells the stories of the victims in a way that makes you feel angry and called to action. The stories of Aaron Bacon’s death at a North Star wilderness camp and of Lulu Corter’s trial against Miller Newton’s KIDS program - which kept her captive for 13 years - are especially riveting.

WWASP may be history, but make no mistake - schools and camps like the ones in this book are still out there, and still abusing kids. I wish more people would read exposès like this, but sadly most of the people who need to read this book will not be the ones reading it. If you are a parent considering sending your child to a troubled teen facility, however, I implore you to read this before making any decisions. More information on the industry can be found on reddit, at r/troubledteens, where many activists and watchdogs (including Szalavitz herself) post up-to-date info on the latest iterations of these abusive scams.

[Alex Novack · Rating 4 out of 5]

I think that all parents considering sending their kids away to the troubled teen industry should read this book. As a participant in a wilderness therapy program, this book left me sobbing. I can relate to this book and I'm sure so many other survivors can too. While I appreciated the evidence, personal interviews, court cases, etc, I felt like the chapters focused extensively on one or two examples instead of a variety of different cases, programs, and examples. Overall, a well-thought-out, informative read.

[Jean · Rating 4 out of 5]

The subtitle pretty accurately describes the content: "How the Troubled Teen Industry Cons Parents and Hurts Kids." If you ever had the slightest urge to use the big tough love strategy on your kid, i.e. ship him/her off to a boot camp type place, this book is a must read. Ultimately it seems tough love at least of this sort does nothing but hurt the children and enrich the camp operators. Horrifying worst case examples that demonstrate how few rights children have.

[Almostsinglemom · Rating 4 out of 5]

To be fair- I lived this. I was in Provo canyon school. I was the « identified patient ». No one paid attention to the abuse in families of origin, no one paid attention to the medical neglect (I, as an adult, now have only 38% lung function measured in FEV1 because they failed to treat me.)

We (the kids) are trapped and helpless.

[The American Conservative]

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

Read our full review here:
http://www.theamericanconservative.co...

[Kathleen · Rating 4 out of 5]

A clearly biased account, but what a story it tells! I could have done with a little more objectivity, especially towards the end (the trial is uncomfortably anger-fueled), but otherwise this was a chilling look at what is essentially a scam industry. This book is worth picking up.

[Mira · Rating 5 out of 5]

Oof. This is a scathing and horrifying and unfortunately page-turning expose of schools designed to break “troublesome” children into submission. It’s a few decades old, but I can’t imagine this line of thinking and abuse has gone away.

[Leslie Jonsson · Rating 5 out of 5]

GReat, upsetting, true to life

[Megan Harms · Rating 5 out of 5]

So infuriating but so important. Would recommend to everyone!

[Katie · Rating 4 out of 5]

The stories in here are mind-blowingly horrifying. The account of the gruesome death of Aaron Bacon in a wilderness program is particularly sickening. One really surprising thing was how many of the subjects mentioned here got pulled into these programs after a sibling had been in one, even if they didn't actually have substance abuse or other serious issues. Some kids had nothing wrong with them except awful parents, but some actually had good parents who were manipulated into thinking that a program would be helpful. These programs still exist, kids in them have fewer rights than prisoners, and they can be subject to torture that would literally be characterized as war crimes if they were used on POWs. While they've continued to make headlines over the last 20 years, not much has changed.

I've read a couple of other books on the troubled teen industry, including Troubled: The Failed Promise of America's Behavioral Treatment Programs and I See You, Survivor: Life Inside (and Outside) the Totally F*cked-Up Troubled Teen Industry. This is definitely the best one I've read- the most comprehensive, journalistic, and well-written, and unlike the other books, it actually has resources on alternatives to the abusive programs described in the books and information on how to evaluate a program's claims. This book is almost twenty years old, but unfortunately, this is still an issue, so I think most of the information is still valid- the only thing is that marijuana was illegal in every state when the book was written, so it falls under "illegal drugs" when now it doesn't always.

[Julia Kitlinski-Hong · Rating 5 out of 5]

As a former student that was in a therapeutic boarding school decades ago, this book was incredibly validating. The real life examples of students helped me show my own parents how abusive the Troubled-Teen Industry (TTI) is and put into words the trauma I endured at my own school. The author's in-depth research helps shed light on a horrific industry that is just beginning to get attention and it's a must-read if you want to understand the TTI and it detrimental effects on teens. Thank you Maia for writing this book.

[Marie · Rating 5 out of 5]

This book should be required reading for any parents whose children are on the cusp of teenage hood, for any teachers of preteen or teens and any therapists, psychiatrists or psychologists treating or interacting with teenagers. At times it was a horrifying read but the horror comes from the fact that it’s non fiction, real, and STILL unbelievably relevant.

[Laila Refaat · Rating 2 out of 5]

Well, the stories of the victims are really touching. My heart goes to all of them. This book is important to read however I have two big concerns. First, the author's writing style is very boring and extremely redundant. Second, the author unfortunately gives too much credit to Psychiatry. Please read, Butchered By Healthcare, written by Robert Yoho.

[B Jansen · Rating 4 out of 5]

Without a doubt a necessary commentary on the troubled-teen industry. The book gives insight into the industry and gives a good run-through of the past. Besides, at the end it has tips for parents who seek help with their troubled teens. This book could be a start to enable parents to see that their children are priceless and should be loved an protected at any cost, without the need for tough.

[Marsha Fouts · Rating 4 out of 5]

This book was interesting especially if you work with at risk or mentally ill youth. Parts of it made me angry. It definitely shines a strong light for a need for more stringent and consistent regulation for residential treatment facilities.

[Cheryl Clearwater · Rating 4 out of 5]

great set of guidelines in back of book for evaluating in-patient programs for adolescents

[Lauren · Rating 4 out of 5]

I wish there was less characterizing people their weight or body type, but it was the early 2000s.

[nia · Rating 4 out of 5]

deeply insightful but also devastatingly sad

[Nicola Payette · Rating 5 out of 5]

Compelling

This is a dramatic look into a world most do not even know existed. Compelling, insightful, and so very raw.

[Melissa]

NY Times