The troubled-teen industry is booming.
Some parents turn to Teen Help and other companies that run strict behavior modification facilities in remote areas throughout the globe.
Other parents pay $2,000 to $9,000 a month to less constricting "emotional growth" schools that try to do what they think conventional therapy cannot: salvage their out-of-control teen-agers.
Why parents send their kids to teen help
The South Carolina Department of Social Services examined records earlier this year at Teen Help's Carolina Springs Academy. Here are reasons some parents gave for enrolling their adolescents in the company's program:
Girl, 16. Last fall missed 21 of 58 school days due to illness, depression. "Was skipping school and lacked motivation. ... Was in who's who in the 9th grade and then 'gave up."'
Girl, 14. "Has a history of running away with guys. ... Reportedly does not do drugs but runs with guys who do. She was diagnosed with chlamydia and treated ... There were no psychological records in the file."
Girl, 14. Previously lived at Teen Help's Jamaica program. "There is a possible history of physical abuse by the grandfather. ... No other information in file. There was no signed contract, no referral sheet, nothing."
Boy, 17. "Was behind in school when placed. Failed math last year and cut classes and stopped attending this year."
Boy, 17. Previously lived at Teen Help's Czech program. "Was placed after two years of family therapy, drug rehab. ... Failed his junior year in high school, continued to abuse alcohol, began growing marijuana, had no respect for authority, no future plans. Parents felt he was a potential danger to himself and others. Reportedly has a short attention span. ... There is a history of bad verbal abuse by dad."
Girl, 17. Previously lived at Teen Help's Czech program. "There was a referral sheet from Teen Help. This form stated that 'she is just doing her own thing all the time and mom and dad have not a clue how to deal with her.' They reported that she is 'ready to fly off the handle at the drop of a hat.' ... Stays out late and sleeps all day if possible. ... She failed nearly all classes in 9th and 10th grades."
Girl, 17. "She was placed because her parents wanted her away from her boyfriend."
Girl, no age given. "The child was placed because she 'made poor choices in friends.' She invited friends into the house and they robbed the house. They took guns and jewelry. Her parents had a psychic come and tell them who robbed the house. (She) was involved with gang members. ... She has been pregnant twice a 'few years ago.' She had abortions both times."
Boy, 16. "Hospitalized three times in the past 5 years for depression. Probable diagnosis: severe depression, bipolar disorder. He has been in and out of therapy many times. He has been on medication since first grade. Has history of two attempted suicides."
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The number of emotional growth schools has tripled since 1990, said John Reddan, executive director of the National Association of Therapeutic Schools and Programs. There are now as many as 500 such programs in the United States, 150 of them represented by the association, he said.
There may be as many as 1,500 other alternative facilities for struggling teens, ranging from wilderness schools and military-style boarding academies to church camps.
Emotional growth programs are less rigorously structured than behavior modification programs but share many common elements. They generally feature a combination of group and one-on-one therapy, status levels for a student to pass through, restricted freedoms and an educational component.
Different philosophies govern how much or how little the emphasis is on behavior, emotions or education.
This has led to a new industry of "educational consultants" who follow the varying programs and advise parents what programs might fit with their child's particular problems.
The growth has come despite evidence that teens are less troubled these days than a decade ago.
Federal statistics show that the crime rate among teens has decreased for seven straight years. And teen suicide peaked in 1988 and has declined steadily since, according to government statistics.
But high-profile calamities such as the Columbine High School killings fuel the perception of youth in crisis.
Reddan said that without the alternative programs, "kids are going to jail, or going to a hospital or are going to die."
"They're all filled," educational consultant George Posner, a Cornell University education professor, said of the alternative programs. In contrast, he said, "the hospitals aren't."
In the aftermath of Columbine, "requests for services from families are up considerably," said Tom Barrett, director of mental health services for the Colorado Department of Human Services.
"We have gotten calls from parents who are concerned now about the behavior of some of their children."
The American Academy of Child and Adolescent Psychiatry said calls to its referral service more than doubled in the first five months of 1999 compared with the same period a year ago.
Economic forces are contributing to the success of the alternative programs.
Keith Krull, an emergency care coordinator in Denver for Columbia HealthOne, a large medical care provider, said that the number of beds in traditional hospital psychiatric units has decreased significantly. A major reason, he said, is the trend in medical insurance toward managed care and shorter stays in hospitals.
"Certainly, the length of stay has been cut a tremendous amount," he said.
Barrett said that as managed care has become a health industry standard, one goal of mental health providers was "to develop more programs in the community so that fewer kids would need to be hospitalized."
But three psychiatric treatment facilities in metropolitan Denver have closed in recent years, Krull said.
Entrepreneurs have spotted the trend away from traditional psychiatric care for defiant teens to alternatives and jumped in.
"There's a lot of people out there with money to invest," Posner said.
"Also, there's a lot of people out there who have mental health backgrounds and who have found that the standard types of outpatient and inpatient facilities are no longer really viable."
At the same time, more Americans in this prolonged economic boom can afford to send their teens to private reform programs.
"There's no question that in most of our programs the kids that are coming in are from middle class and upper-middle class backgrounds," Reddan said.
"We have a lot of parents who are worried sick about their children and are willing to make any kind of sacrifice to try to turn their kid around," educational consultant Lon Woodbury said.
The trend toward alternative programs worries some mental-health professionals.
"Part of adolescence is being unpleasant enough that you (parents) want them to leave home," said psychologist Robert Karlin of Rutgers University in New Brunswick, N.J. "Part of the job of adolescence is to be defiant to some degree."
"What the research tells us is that the majority of kids who do in fact engage in acting-out behaviors -- the irresponsibility, perhaps some alcohol and drug use, academic underachievement and so on -- do kind of get their act together eventually," said psychologist Dr. Eric Nelson of Tulsa.
The Columbine tragedy shouldn't push more parents to seek drastic measures, said Margaret Singer, psychology professor emeritus at the University of California at Berkeley.
Parents' most important job, she said, is "very early on getting the child bonded through love and caring. They must put in tremendous amounts of time showing the kid how to do the simplest task. Praising them for good stuff. Being interested in the kid and not just paying attention when the kid fouls up."
None of the educational consultants interviewed by the Denver Rocky Mountain News forecast a drop in demand for the new breed of teen intervention programs.
"Twenty years ago, if parents had a kid that was self-destructive, they'd go to police, health and welfare, counselors and say, 'Do something,"' Woodbury said. "Now, more and more they're coming to realize that if it is going to be done right, we'll do it ourselves."
Reddan said the challenge is to show which programs work and which don't. He hopes to organize independent, scientific research of the programs, going beyond most current claims of success by various programs that are from internal research only.
But he said he had little doubt about the final results.
The alternative programs, he said, are "helping kids immensely."
