The Troubled Teen Industry: Where Child Abuse Is the Norm

Photo by Christian GAFENESCH on Unsplash

Many people are unaware of the Troubled Teen Industry (TTI) and how it operates - I did not know much about it either up until recently. My curiosity to learn more about the TTI came from noticing that many, many domestic and inter-country adoptees* and fostered children have been placed (and are currently being held) in these facilities and programs all over the United States.

Most of my research is informal and based on many hours spent on advocacy websites, watching documentaries, reading news articles, and listening to survivor stories. I decided to write about what I found because more public awareness is necessary in helping to stop the widespread, systemic abuse that is occurring.

*Non-adopted children who are deemed to have “behavioural” problems are placed as well. Adopted and non-adopted neurodivergent children and children with mental health disabilities tend to be overrepresented in facilities and programs that fall under the TTI.

What is the Troubled Teen Industry (TTI)?

The Troubled Teen Industry is made up of privately run, for-profit and not-for-profit residential homes or programs, including group homes, treatment centers, and programs (boot camps, wilderness, behaviour modification, leadership, etc.). These programs seek to reform children’s behaviour, usually through drastic and abusive means. Most of the time, they are marketed as boarding schools, therapeutic boarding schools or specialty programs. However, they are largely unregulated, meaning they are “not licensed mental health programs or accredited by reputable accrediting organizations,” according to the Breaking Code Silence Movement.

Why Are Children Being Sent Away?

Children being sent away are usually having some difficulty at home or school and may be survivors of various types of traumas. Parents choose to send their children away for different reasons. In the best-case scenario, it is out of desperation and fear for their children's future. But other times, it is a way of relinquishing their parental duties (and the challenges that come with parenting) to paid staff far away from where they live. Most parents are generally under the impression that sending their children away will be beneficial in the long run. Fostered children are usually placed because there are no other placements available or because they are deemed to need more structure or supervision.

Who Is Sent Into the TTI?

Children of different racial, cultural, and economic backgrounds are sent into the TTI. Although these facilities are quite expensive, children are not only attending these programs through private arrangements. According to the American Bar Association, children can be placed by schools, local governments, mental health providers, and refugee settlement agencies. Fostered children or those in juvenile justice systems, refugee, and migrant children can also be placed. Certain children are overrepresented in the TTI, including adoptees, fostered children, neurodivergent, and those who are psychiatrically disabled. The exact number of children placed is not available because facilities are not required to track the number of children and the duration of their stays. However, the estimate is between 120,000 and 200,000 children who are placed in some type of facility. Based on survivor stories, the duration of the stay can vary significantly, from weeks to months to several years. Children are often placed in one program (or facility) after another.

Reasons For Being Placed

Some of the survivors have shared they were sent into TTI due to behaviours their parents believed were “at-risk.” For example, smoking, drinking, doing drugs, having sex, running away, regularly sneaking out of the house to party or repeatedly accessing sexually explicit content online. Their parents were concerned because they might have been skipping school, getting low grades, being expelled, or getting in trouble with the law.

Other reasons could be that children were sent away due to psychiatric disabilities or mental health conditions, such as depression, anxiety, PTSD, schizophrenia, addiction, eating disorders, and other mental health conditions.

Fostered children or migrant children could be sent away for some of the same reasons, including a lack of foster homes or group homes that would accept them if they had a history of fighting with other children - this was the case for 16-year-old Cornelius Frederick. Frederick was killed by asphyxiation from eight adult staff members holding him down for 12 minutes. The reason? He threw a piece of bread at another resident in the cafeteria.

What’s also not uncommon is conversion therapy, which is still legal in various US states, where children who are gay, bisexual or trans are sent away to be “cured”. The goal is to force them to become heterosexual or cis-gender, usually by physical and psychological abuse.

What Happens in TTI?

While residential facilities and programs promise to provide a supportive environment to support the needs of the children - they are inherently trying to reform the child by forceful, coercive, and abusive means.

First of all, the children are usually taken from their beds in the middle of the night (“gooned”) and transported to these facilities. When they arrive, they are stripped of any autonomy (including bodily autonomy), meaning they cannot go to the bathroom or change their clothes without being surveilled, sometimes with the use of surveillance technology.

What seems to unite the facilities is their approach to trying to change the children’s behaviour, which is done through reward systems. The children must follow the rules to move up the reward system; when they do, they can earn certain privileges and “graduate” from the program. The thing is, the rules are excessively stringent, severe and downright abusive. When the children do not comply, they are routinely punished by being physically assaulted, deprived of food and water (for weeks and months), restraint and seclusion confinement, and harsh physical labour. It is also common for children to be sexually assaulted and abused by staff.

There usually tends to be an emphasis on either physical endurance or manual labour (or both). For example, children are forced to perform harsh manual labour at ranches. At wilderness programs, children are forced to survive outdoors in harsh conditions for months. While other residential programs might focus less on these two aspects, there is usually a degree of both required.

It is very hard for children to progress through the program, so many end up staying for more months than originally planned, sometimes being bounced around between facilities and programs.

In some facilities, such as the now-defunct Academy at Ivy Ridge featured in Netflix’s The Program: Cons, Cults and Kidnapping, the rules are usually supported by various seminars and forced participation in “circles” to brainwash students to comply with their rules. In the film, journalist Maia Szalavitz traces some of the tactics used at Ivy Ridge to Synanon (Tender Loving Care), a cult that originated in California in the 1950s. Director and Ivy Ridge survivor, Katherine Kubler portrays how the approach to modifying the children’s behaviour was to subjugate and control them by taking their power and autonomy away. Other survivors also speak vividly about how their sense of self was meant to be erased.

How Does The Abuse Happen?

Abuse thrives in isolation: children are very vulnerable since they have extremely limited contact with the outside world for the duration of their stay. As they move up the reward system, they may get some privileges. However, there is no access to technology and very limited contact (or no contact) with family members for the duration of their stay. Any written letters are censored, and phone calls to their family are monitored by staff. If children do not comply with the rules, they can be punished by not being allowed any contact with families for the duration of their stay.

Why Are Children Being Placed in Facilities?

Parents often feel reassured because these facilities have developed persuasive arguments and captivating marketing that prey on feelings of helplessness and fear - and offer them a solution. Parents are sometimes referred by educational consultants or mental health providers who may (or may not) receive payments for referrals. They might also be referred by other parents in their community who have sent their children to these facilities in the past.

Facilities, such Academy at Ivy Ridge in The Program: Cons, Cults and Kidnapping are usually situated in picturesque locations, in the middle of nature. Program photos feature children doing outdoor activities and attending themed events - living a wholesome, innocent, outdoor life. The children look festive and are smiling back at the camera.

Besides the convincing marketing, some parents are genuinely convinced that sending their children to such facilities will help their children with whatever problem they have. Furthermore, some parents believe that “tough love” is the best approach to modify children’s behaviour, especially if the child is engaged in harmful, illegal, or potentially dangerous activities.

Families of fostered children or children in the juvenile system are not given a say in their child’s placement - sometimes children are placed without their families even knowing. The reasons for their placement vary but it is likely because they cannot be placed elsewhere and their social service agency has business relations with these facilities.

The Troubled Teen Industry: A Billion-Dollar Industry

The behavioural health industry is worth billions of dollars. The cost of placing children in residential homes and programs varies but it can be as high as US$1,200 per day per child. The vast majority of placements are through local and state government health agencies and programs, meaning that private pay is relatively small. For example, Sequel, a highly profitable behavioural health company, owned facilities in over 40 states in 2017, worth over $400 million, making a revenue of $200 million. Over 90% of Sequel’s business came from government contracts (Medicaid and Medicare). Behavioural healthcare companies, like Sequel, focus on keeping expenses low, partly by hiring fewer staff than required. In addition, the staff tend to be college-age, underqualified, low-paid, and poorly trained. In addition, facilities are strategically located in remote or economically depressed areas, so that they create jobs and contribute to the local economy.

In the case of Sequel, there are countless reports on many types of abuse (including resulting in death) inflicted upon the children. While Sequel closed quite a few facilities as a result of abuse allegations, and cuts to government contracts, it was purchased by Vivant, another operator of RTCs. This is classic: when a facility closes, a new one is opened in another location, under a new name and new client-facing leadership. This way, accountability is evaded and business continues as usual.

What Are The Impacts Of Being Placed?

Many, many children have died within these facilities from medical neglect (overmedicated, undermedicated, injuries), physical abuse, and suicide. Survivors have lifelong trauma (C-PTSD), depression, and anxiety from the various forms of abuse experienced while forcibly living in these conditions (which often do not meet sanitation standards). Many survivors report feeling abandoned, betrayed, and deeply hurt by their parents (caregiver, social worker, or other person in charge) decision to send them away, usually without notice or prior conversations.

Institutionalization also means they were cut off from their families, friends, and their communities meaning that reintegration into society and living a “normal life” can be very challenging. It is especially difficult for survivors who do not have family or access to support and resources. Survivors have extremely high rates of suicide and drug overdose after being released from programs.

Survivor Activism: Believing Survivors

People who have been placed in facilities that fall within the TTI, called survivors, have been speaking out about the abuse for quite some time. Thanks to social media campaigns like #BreakingCodeSilence (now a registered organization), more and more survivors are coming forward and sharing their stories. The most well-known survivor and activist is Paris Hilton, an American celebrity. Hilton has used her stardom to spread awareness about the TTI and bring about policy changes at both state and national levels in the US and internationally. Hilton has also founded a charitable organization dedicated to “advocacy, storytelling, and philanthropic investments”. It was precisely Hilton’s public “coming out” that inspired Meg Appelgate to create Unsilenced, a platform dedicated to ending institutional child abuse through advocacy and resources. Unsilenced’s website provides very detailed and thorough information and resources for survivors, activists, and professionals (attorneys and policymakers). For example, they provide an explanation and timeline of the TTI, a list of programs, practical support for survivors such as reporting abuse, requesting records, sharing a survivor story, finding an attorney, and a guide to taking legal action. What’s also impressive is their program archive of over 100,000 documents from over 3,200 facilities across the US and beyond.

Better Options Than TTI

The popularity of these facilities and programs raises many important questions about how we treat children, our expectations of children, and how profit is being prioritized over care.

Besides greater regulation and oversight, parents need to have (or consider) better options for their children’s health and safety. Public funds need to go toward community-based programs for children living under state care, instead of institutionalizing them. Or better yet, providing accessible resources for families and communities so that children do not have to be placed in foster care (or residential care) in the first place.

For more information about TTI, TTI prevention, survivor resources, and resources for professionals, visit Unsilenced.