Commentary — Our Story and Experience with Many Therapeutic Programs

My wife and I are among those “bad parents” (according the HEAL) who put their teenager in a therapeutic program. Yet we know our son would not be alive today had we not. Yes, we experienced a poorly managed program first, and then we experienced a really great program.  Had we stopped seeking help for our son after the initial program we put him in, perhaps we would be on the “shut ’em all down” bandwagon too, but we searched further and found the answer.  We found a program that was tough but loving, strict but relational, and who put as much emphasis on helping us become better parents as they were interested in helping our child.

As any parent in that situation can attest, the stress through it all can be so severe, it can tear down the family and relationships.  Any parent would rather die than to see their child self-destroying.  To see your son or daughter going further and further downhill is more than a parent can bear. Our son was into doing just about every self-destructive thing one could imagine, culminating in threats of suicide.  We cannot just allow that to happen — something had to be done.  And short of staying at his side every moment of every day, we had no choice but to seek professional help. All of this was made worse by the shadow of my sister, who had similar problems as a youth and which carried throughout her life.  She fought addictions  and went through 16 rehab programs before dying from the abuses she was committing to her own body.  We could not allow that to happen to our own child who was demonstrating similar tendencies.
After enrolling our son in a program in Texas (he was not forced — he chose to go because he could see himself falling off a cliff), we loved the program and staff so much that we shut down our advertising agency and moved there. We began helping the organization and learned all the ins and outs of its operation, as well as the industry as a whole.  For the past several years, we’ve not only helped that organization grow, but we now help a number of others in their marketing and to help match parents/kids with the right programs.  
Here is what we have found how these programs operate:
1) Most therapeutic homes are a labor of love — Most therapeutic programs are started by kids (now grown up) who were helped by a similar program or by parents who saw a need for a good program. They often set aside their corporate lives and jobs to take on living with and helping troubled kids 24/7. Most make very little money, or have had to put their life savings into the program, with little chance it will ever be paid back.  They went back to school to get advanced degrees for dealing with kids and therapy, and they struggle through all of the legal issues and licensing.  They work unbelievable hours, and they deal with both immature, enabled teens and aggressive or passive parents.  Their program has stated tuition rates, but they often take on helping kids for much less, paying for the added cost out of their own pockets. Most will say something like, “We will never turn anyone down, regardless of what the parents can pay, if it is clear that we can help turn around the teenager.” And far too many take that too far, running themselves and their program into bankruptcy.
2) Most, if not all, therapeutic program directors wouldn’t have a clue how to “brainwash” a teen — Those who say kids are being brainwashed in these programs give them far too much credit as being advanced psychologists, while at the same time they give them far too little credit for the sound counsel they do provide. Most therapeutic programs operate much like a well organized family would operate, but with an understanding that certain things from a child’s past can trigger inappropriate behaviors. The behaviors are red flags, nothing more.  As in society, the child needs to learn that certain behaviors are simply not acceptable, and if they are not stopped early in life, they will lead to much more severe penalties in the later years. The number of adults in prison, or who have died from self-destructive activities, is what the parents and the program are trying to avoid by giving the teen counsel, discipline and real-life consequences as a minor, so the consequences aren’t deathly or destructive as an adult. Do some programs take that too far? Yes.  Do some also not go far enough? Yes. So the discerning parent needs to find a program that is right for their child. No one program is the perfect situation or solution for every child. When a mismatch occurs, or if both parents aren’t in synch about the need for enrolling their teen, that’s when we have problems, and people cry “foul.”
3) Some programs are more advanced than others — It is easy for the leaders of programs to begin thinking that because they helped one child who had a specific behavioral issue, that they can help all children with a similar issue.  They sometimes forget their own teaching that behaviors are the outward demonstration of an inward frustration or loss.  Such frustrations can be very deep — deeper than their training covers.  The program may not have particular expertise in dealing with that specific issue, so they really have no business taking in kids with that issue.  But all programs that aren’t in it for the money just want to help the kid, regardless, so the parents are the ones who need to be discerning.  As a parent, rather than thinking about finding a program near your home, or one that is the lowest in cost, consider that you’ll be throwing your money down the drain if the program doesn’t specialize in the specific issue you are dealing with in your teen. Difficult psychological issues require a counselor with advanced training and years of practice and expertise.  Just as if you wouldn’t want to have a brain operation by an intern or someone with just a “First-Aid” certificate, you wouldn’t want your teen who is cutting, is extremely depressed, or is anorexic in the hands of a less than experienced practitioner.  These are life and death issues.  Just because the program or the directors have been in it for many years, it doesn’t mean that the one who will be counseling your teen has the right kind of experience to bring about a change to wholesome and positive thinking. Get to know the counselor who might be dealing with your teen, and demand a minimum number of hours with that counselor each month, since some programs stretch their counselors far too thin with an overwhelming client load.
4) Like different families have different beliefs and rituals, different programs operate differently — There is no standard for the way therapeutic programs operate.  They all do their own thing.  There isn’t even a model or manual to go by or to choose from.  Some are constantly seeking ways to improve, while others are happy with continuing to do things the way they always have (because it is working).  Usually, the larger the program, the more likely they will be stuck in their ways.  Part of that is due to standardizing things to avoid legal jeopardy, and part is due to the larger programs being run or overseen by even larger institutions.  But even as there are different programs, there are kids from different situations who are perfect fits for those programs.  The key is in matching up the kids with the right programs.  That’s why my wife and started a service to help parents find the right program. We visit the programs and meet with the staff, so we know who they operate. Again, rather than concluding that all programs are bad because they cannot be all things to all people, we think that each program has its own niche and purpose and that’s fine as long as they adhere to some basic standards.  We are privileged to regularly match up teens who would do very well in each type of program.  Efforts like HEAL (who are trying to shut down all therapeutic programs because the founder apparently experienced a bad one) are like someone who goes through a divorce and therefore concludes that the opposite sex is ALL bad.  They may have chosen wrong to begin with, leading to the divorce, but it doesn’t mean that there isn’t a perfect match for them out there somewhere.  The goal is to find that perfect match — it’s just foolish to denounce the whole gender because of one failure.
5) It costs more than you might think to run a therapeutic program — One of the big complaints we see among the opponents of therapeutic programs is the fees that they charge  — they say they are too much.  Some think that it must be a highly profitable venture — which leads to mistrust of the program’s motives.  In fact, it isn’t unusual for a program to charge several thousand dollars a month, while some of the lower cost programs charge $1,000-$2,000.  So, let’s put this fee into perspective.  For instance, have you been in a hospital lately?  We’re talking $2,000 a day in a hospital.  And how much would it cost to hire a babysitter to watch your teen and keep them out of trouble around the clock?  Add it up…maybe $7 per hour, times 24 hours a day, times 30 days a month.  That comes to $5,040 per month.  Now, to get the same help within a therapeutic program (which is required to watch your teen 24/7), add the facilities, training, food, your child’s education, transportation, administration, electricity, maintenance, insurance, entertainment, and on and on.  But then you might say, “The program doesn’t have a staff member for each resident!”  But neither are those staff members paid $7 per hour.  If they are salaried, and their medical insurance is paid, they are more likely paid $30-$40 per hour. So, adding it all up, the industry average baseline cost for caring for a teen is around $6,200/mo.  Programs that are charging more are likely making a profit (unless they have a very high-end staff made up of psychologists, which are very expensive).  Programs that are charging less are either supplementing the cost out of their own pockets, they have donors who are helping, or they are a part of a larger institution (such as large nonprofit or church) who is supporting it.  The bottom line reality is that few programs are profiting from this work — they do it because they love to help teens. One of the biggest complaints we see in negative reviews from kids who were in programs is that they feel their parents were “ripped off” by the program. Sometimes that is because the parents used the child’s college fund to pay for it.  But these kids can’t conceptualize the math we just went through.  They have no idea what the real world costs.  The monies spent by the parents were a necessity because the child was not able to manage their own actions, not because they were “ripped off.”  But the funds rarely line the pockets of anyone — they are applied to staff, food, housing, insurance, etc.
6) Regulation solves few problems…it just adds problems and causes programs to close — Some critics say that programs set up shop in states like Utah or Missouri to get around excessive regulations. Well, yes, that’s true.  But it doesn’t mean they are automatically bad programs. The regulations in some states like California are now so excessive, they simply make it impossible to open any kind of therapeutic program in the state. For instance, requiring a full-time nurse on staff, individual rooms for every child, not being able to differentiate based on gender, and other excessive, costly and even foolish regulations are more likely designed to shut down programs than to make them better.  Programs therefore locate in states where such regulations are more reasonable, and where parents have more authority over their own children. As more regulations are added (HEAL is trying to influence more regulation state by state and in the federal government), we’ll see more and more of the smaller programs shut down, which will be a real shame, because those programs are doing a real good job and are very much needed.
So, let’s summarize:
Are there bad programs out there?  Yes; but they are few and far between.  They tend to be the lower cost programs who simply don’t have qualified staff because they cannot afford them.  We hope and pray they will either improve, or shut down.  We know that we will never refer anyone to them. We are also working hard to help some of these “lone ranger” programs learn from each other how to better operate and help the teens in their care, because even a less than perfect program is still needed. 
Are programs getting rich off convincing parents that they need to put their teen in their program?  No.  And in fact, programs generally don’t go out trying to convince (nor coerce) parents to put a teen in their program (as HEAL suggests). Rather, programs sit back and wait for parents to inquire.  In fact, some of the programs we work with provide free training materials, seminars and pay for radio programs for parents in an effort to help them keep their kids out of such a program.  That’s their goal, to have fewer kids who would need such a program. That doesn’t sound like a smart way for them to get rich (which is what HEAL says is the motivation of all these programs).  What it does sound like is people who care about teens and want to see them live a fulfilling and productive life.
Are ALL programs abusing and torturing kids, as HEAL claims?  Absolutely not.  There are many ways to anonymously report abuses. Any such reports will lead to a program being shut down. Government officials do not overlook such reports today. They investigate them fully.  Out of thousands of programs and homes, there are a few reports each year of suspected abuse, lack of oversight, or mishandling an unruly teenager, but it is often due to a burned out staff member, a falsified report of a vindictive teen, an unfortunate accident, a teen who was not being monitored closely enough, or an otherwise good staff member who simply went off the deep end from the stress of it all.  Even in the most perfect situations, this is still a people industry, run by people, and people are not perfect all the time.  If they make a mistake — which is very rare — they need to pay the consequences, and maybe the program needs to be reorganized or shut down, but it doesn’t mean that the whole industry is bad.  The industry is needed now, and it will be needed even more tomorrow.
Will more regulation help? Probably not. It will just lead to the smaller programs shutting down.  You cannot regulate a program to be more loving or caring or concerned about kids.
The bottom line is that the therapeutic industry for teens is doing an awesome job.  It is doing it often at a financial loss, and with the right motivation — to show love and guidance to teens, helping them get on the right track in life.  The industry should be congratulated and thanked, not villainized.
Oh, you might ask how our own son is doing today.  He’s doing very well.  He still is an independent thinker (not a robot, as HEAL suggests) but he’s making better choices.  In fact, he’s training right now to work in — you guessed it — in a therapeutic wilderness program.  He wants to help other teens, just like he was helped. Now, that’s a great result, and worth every penny we spent.  He’s completely off all drugs and our relationship with him is now stronger than ever, which a few years ago we thought would never be possible. I would publicly acknowledge and thank the therapeutic program that helped him, but sadly, I don’t want to bring the wrath of the HEAL people down on that program.  Too bad that a few people with nothing else to do in life can do so much damage to a great industry.
Though we would love to sign this, and ask you to contact us for help should you need it, we cannot because we’ll be attacked.  All we can offer is to ask you to do your homework before placing your teen in a program. Visit the place and meet the staff and counselors. If you’re not comfortable, get out of there and find another. Don’t allow the “we’d love to help your teen” zeal of the program staff or directors be your deciding factor. Determine if it is the right fit. Ask to talk to other parents who have had a teen in the program with the same symptoms and issues as your teen. Don’t just go by the parents they refer to you, which may be of kids with much different issues. Most of all, as much as possible find a way to convince your teen that they need to go there. If not, and if they are forced, they’ll drag their feet much longer and have to be in the program many more months to gain the same benefit as a teen who agrees to go.
This is going to be the hardest thing you’ve ever done as a parent.  Don’t allow the fear mongering of HEAL to get in your way. If you feel you need to find a program, or your child’s counselor says it is necessary, start your search and don’t stop until you find the one solution that will work best for your teen. If it is the right program, you’ll look back later and, like us, say it is the best decision you have ever made (and your teen will thank you).