Saturday, July 29, 2017

Are Victims of Institutionalized Abuse "Survivors"?

Are Victims of Institutionalized Abuse "Survivors"?
By Angela Smith, HEAL National Coordinator/Co-Founder


Merriam-webster.com defines "Survivor" as living after someone has died (i.e. family survives death of parent in obituaries), as living or existing after a disaster (i.e. someone survived an earthquake, car crash, etc.), or continuing to function or prosper despite hardships (i.e. Trump filed bankruptcy multiple times and later became president).  Sources: https://www.merriam-webster.com/dictionary/survivor, http://connect.legacy.com/profiles/blogs/who-to-include-in-the-obituary, https://www.usatoday.com/story/news/world/2016/08/26/italy-earthquake-posta/89426564/, and https://www.washingtonpost.com/politics/2016/live-updates/general-election/real-time-fact-checking-and-analysis-of-the-first-presidential-debate/fact-check-has-trump-declared-bankruptcy-four-or-six-times/

Have victims of institutionalized abuse survived an industry and conditions where others have died?  Yes.

One of the most documented abusive segregated congregate care youth facilities has been the Dozier School for Boys where over 100 corpses of children have been found buried in mostly unmarked graves on the property.  The Dozier School was a residential "character training" program in Florida before it was finally closed down in 2011.  See: http://www.smithsonianmag.com/smart-news/archaeologists-finally-know-what-happened-brutal-reform-school-180957911/   But, that's just one facility.  So, what's the number? 

There's no record of the number of children killed in treatment/institutional settings.  The best estimate available is from the Hartford Courant, which reports: "A 50-state survey by The Courant, the first of its kind ever conducted, has confirmed 142 deaths during or shortly after restraint or seclusion in the past decade. The survey focused on mental health and mental retardation facilities and group homes nationwide.  But because many of these cases go unreported, the actual number of deaths during or after restraint is many times higher.  Between 50 and 150 such deaths occur every year across the country, according to a statistical estimate commissioned by The Courant and conducted by a research specialist at the Harvard Center for Risk Analysis.  That's one to three deaths every week, 500 to 1,500 in the past decade, the study shows."  Source: http://www.charlydmiller.com/LIB05/1998hartfordcourant11.html   This was the last legitimate study by a legitimate research specialist on this issue to HEAL's knowledge and would suggest a minimum of  975 deaths of children due to restraint and isolation (3750 restraint and isolation related deaths, if we include all age groups of the study referenced) in institutional settings in the last 25 years.  While the Dozier School for Boys opened in 1900 and closed in 2011 with over 100 children's dead bodies buried in unmarked graves around the facility "over the years".  (Source: http://www.npr.org/2012/10/15/162941770/floridas-dozier-school-for-boys-a-true-horror-story )  So, why not go back 100 years and apply the modern statistics?  That would suggest 3,900  deaths of children in institutional care as a result of restraint and isolation (not including other deaths in care, such as overmedication or medical neglect) since 1917.  And, that's just the number of institutionalized kids that have died as a result of institutionalized abuse (restraint and isolation) while institutionalized.  In addition, 43 adjudicated children and youths have died while in detention centers in a 4 year (2002-2005, last available data) survey of US juvenile detention centers, but, not all centers reported/participated in the study, so again, the number of deaths in detention may be much higher.  (source: https://www.bjs.gov/content/dcrp/tables/juvtab5.cfm ) And, that would suggest 11 adjudicated juvenile deaths per year in detention.  It is likely that even more than that have been killed in institutional settings as a result of institutionalized abuse with thousands more committing suicide after having been through that trauma.  And, if you want to get really "crazy", consider this....  Let us say that at the "best" segregated congregate care facility there are 0 deaths and at the "worst" (i.e. Dozier) there have been 100 deaths due to malfeasance (restraint, isolation, medical neglect, overmedication, etc.) and take the average death toll over a 100 year period to be 50 per facility.  The CDC reports there are 2,250 such facilities in the US.  (Source: https://www.cdc.gov/nchs/data/nsrcf/NSRCF2010SelectedSurveyParticipants_091409.pdf )  Then, over a 100 year period, you have an average of 112,500 malfeasance related deaths, or 1,125 deaths annually in institutional care due to malfeasance, across all demographics.  If 26% of those deaths are of youth (as the Harvard research suggests), then it would amount to roughly 292 deaths of youth in institutional care annually.  This would make the death toll over a 25 year period for youth in segregated congregate care 7,300.  But, medical malpractice accounts for 210,000-440,000 medical negligence/malfeasance deaths in the US annually according to a Journal of Patient Safety study in 2013.  (Source: https://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals )  While these numbers are staggering, they do not even touch on the post-institutionalization suicides of those traumatized by abusive and negligent care in segregated congregate care facilities.

Is the segregated congregate care industry a "disaster"?  Well, how does merriam-webster.com define "disaster"?  A "disaster" is a sudden calamitous event bringing great damage, loss, or destruction according to https://www.merriam-webster.com/dictionary/disaster  For the individuals subjected to being terrorized in their own homes in the middle of the night, taken by strangers to an undisclosed location, held incommunicado and mistreated before earning their levels and mistreating those of lower status as a means of "progress" as defined by the behavior modification arm of the segregated congregate care industry, they may consider their experience to be disastrous or a disaster.  And, arguably, it is a legitimate view to hold of an industry that even the Surgeon General claims is ineffective at best, and at worst harmful. Source:  https://profiles.nlm.nih.gov/ps/access/nnbbjc.pdf  (page 10 of .pdf and page 160 of document)  Given the loss of liberty and dehumanization that accompanies segregated congregate care, many would argue the loss and damage to the individual is devastating and may rise to the level of disaster, when considering annual death tolls and other harms  (i.e. rapes, permanent mental or physical injury, etc.), certainly suggest it is not unreasonable to see the segregated congregate care industry as a disaster to those unfortunate enough to have experienced it firsthand.  So, Yes, it is a disaster depending on your point of view.

Do victims of institutionalized abuse continue to function and prosper despite those hardships?  Here's where it gets tricky.  Some of our fellows believe there are survivors of institutionalized abuse, but, that the majority are victims because they do not meet the third definition (the basis of the question above), and clearly are not able to function and prosper subsequent to their segregated congregate care experiences.  Many of our best and brightest, including Jon Martin Crawford and Nick Romano, are no longer with us, though they showed the most promise in regards to intellect, ability, and business acumen.  Many are unable to take slight criticism, shut down in the face of adversity or conflict, and cannot function in any job where they are not in control and able to avoid correction or, even guidance, in performing assigned tasks.  This makes for high unemployment rates and can be understood when you look at criticism or correction as a PTSD trigger (particularly for those who experienced what is called "positive peer pressure" aka "Attack Therapy" aka "Confrontation Therapy" (in which in a group setting, an individual is targeted by the group and torn down for hours non-stop with insult after insult, correction after correction, criticism after criticism, which is clearly traumatizing and should be considered a form of excessive bullying...often being scolded for minor infractions such as not making the bed perfectly or not folding laundry per program standards...) leaving many survivors and victims, unable to function and prosper by society standards.  However, "2 out of 3 ain't bad" and even if unable to function and prosper due to PTSD or related issues, defining these victims as "survivors" fits within the accepted understanding of the term "survivor".

So, what can survivors of institutionalized abuse do to better function and prosper with PTSD?  First, they need to recognize their PTSD and begin learning to manage triggers and develop healthy coping strategies.  There is no cure for PTSD.  Trauma is both physical and mental and the body and mind are hard-wired to recognize trauma and use trauma experiences to protect the mind and body from future trauma.  A trigger is an event (as simple as a look, as complex as an environment) that reminds the mind and body of the trauma and ignites a protective response which often includes hyper-vigilance (what others perceive as "over-reacting") to stop the triggering event to protect the individual with PTSD from additional harm.  It is up to survivors of trauma to recognize their PTSD and to learn to manage triggers and develop healthy coping strategies to better function (and prosper) in life.  Many acknowledge this is often easier said than done.

Survivors must communicate to their friends and family that they have PTSD and need their social support system to avoid triggering them to the best of their ability.  Friends and family of those living with PTSD must never pressure their loved one with PTSD to get help, treatment, or the like.  One reason is because "help" and "treatment" are most likely trigger words for survivors of institutionalized abuse.  Friends and family must be patient and supportive of their loved ones with PTSD and let individuals with PTSD be the first to mention help or treatment and give them complete authority and empowerment to choose or refuse treatment in their own time and when they feel ready.  Love is not selfish and if you truly love someone with PTSD, you will be patient and supportive, not add pressure, trigger episodes, and demand a "quick fix".  There is no "quick fix".  And, accepting that reality is necessary both for people living with PTSD as well as their loved ones.  For tips on how to support a loved one with PTSD (and how to manage your own PTSD/triggers), visit: https://www.helpguide.org/articles/ptsd-trauma/helping-someone-with-ptsd.htm

In addition, survivors of institutionalized abuse will only be retraumatized, even in a non-abusive institutional setting, if reinstitutionalized according to the report by the Anna Institute available here: https://www.theannainstitute.org/Retraumatization%20with%20chart.ppt.   So, if you want your troublesome family member with PTSD to "go away and get help" so they aren't such a bother, you are triggering their PTSD and actually creating setbacks to their recovery.  It is of vital importance when helping and supporting anyone with PTSD that you be patient, a good listener, and make the person with PTSD feel safe and empowered.  Once they feel safe and empowered (confident to accept or refuse any assistance without feeling like they are disappointing their support system when refusing unhelpful or harmful treatment or triggers), loved ones with PTSD may seek help for learning to better manage triggers or develop healthy coping strategies.  But, until they feel safe and empowered, any pressure, demands, or the like will only make matters worse.  This is one reason HEAL does not recommend treatment to survivors of institutional abuse.  We believe that every survivor must come to that decision in their own time and on their own when they feel safe and ready to accept or refuse treatment or help without fear of reprisal or judgment from family members who, often mistakenly, believe that there is help to be found in the mental health industry.  However, we do suggest that survivors with PTSD begin to learn about PTSD, managing triggers, and healthy coping strategies so they can progress towards a more functional and prosperous life.

PTSD sufferers who are not survivors/victims of institutionalized abuse, may find various treatments and treatment settings helpful.  This, unfortunately, is not so with survivors of institutionalized abuse, particularly in "therapeutic" settings, where any similar setting is a major trigger of their PTSD.  It is a heartbreaking reality that institutionalized abuse makes getting legitimate help damaging and next to impossible for survivors.  But, there is hope...  Survivors of institutionalized abuse can recognize their PTSD, learn about managing triggers, and adopt healthy coping strategies.  It all begins with feeling safe.  And, a survivor is only going to feel safe when they don't perceive any threats.  Perceived threats act as triggers and therefore cause setbacks.  It is important to give voice to those small feelings of apprehension when interacting with others so the triggers don't compound into flashbacks and outbursts.  For example, many survivors of institutionalized abuse would prefer a corner table or booth when going out to eat.  They prefer to have their back to the wall in such a situation and a "bird's eye view" of the entire establishment.  But, because they often don't feel empowered (or feel embarrassed or ashamed --which they shouldn't), they remain quiet when going out to dinner and sit in uncomfortable and awkward silence in such situations, sometimes having a violent outburst over "nonsense" and leaving the situation in a fit of hostility, leading to more feelings of shame and embarrassment.  You don't have to announce to the world that you have PTSD and special needs.  You simply need to say to the host (in the restaurant example), "I would prefer a corner table.  I would be more comfortable with a bird's eye view of the restaurant."  Hosts and waiters are happy to accommodate such requests and I've never had a problem getting my needs met by voicing them simply in any given situation (with the exception of while enrolled in segregated congregate care).  So, there are ways to learn to communicate your needs simply, manage your triggers, and develop healthy coping strategies.  If you feel triggered, give yourself permission (empowerment) to walk away from a situation that is making you uncomfortable.  This includes ending calls that may be triggering for you.  If your family is pressuring you to get "help" and that is a trigger, tell them they are triggering you and that you do not feel safe when they say those things.  Share with them the guide here: https://www.helpguide.org/articles/ptsd-trauma/helping-someone-with-ptsd.htm  And, let them know that just because they don't yet understand PTSD, they can still learn how to help you and that it doesn't help at all when you are triggered.
 
Compassion, empathy, love, patience, and a willingness to meet the needs of loved ones with PTSD is the best medicine.  And, survivors can actively create a safe space for themselves and in their relationships while developing confidence (empowerment) to voice their needs and manage their triggers effectively.  Without that feeling of safety, healing and progress are not possible.  And, that's where it must begin.

Tuesday, July 25, 2017

HEAL Book Review: "Mental Health Inc: How Corruption, Lax Oversight, and Failed Reforms Endanger Our Most Vulnerable Citizens by Art Levine"


HEAL Book Review: "Mental Health Inc: How Corruption, Lax Oversight, and Failed Reforms Endanger Our Most Vulnerable Citizens by Art Levine"

By Angela Smith, HEAL National Coordinator/Co-Founder

Author and Journalist Art Levine was kind enough to send me the manuscript of his soon to be released exposé titled "Mental Health Inc: How Corruption, Lax Oversight, and Failed Reforms Endanger Our Most Vulnerable Citizens".  You can learn more about the book at www.mentalhealthinc.net,  https://www.scribd.com/user/9995978/Art-Levine-Mental-Health-Inc, and https://www.barnesandnoble.com/w/mental-health-inc-art-levine/1124110816?ean=9781468308372.

I have read the manuscript in its entirety and for a mainstream look at the issues with institutionalized abuse of children, youth, veterans, the elderly, prisoners, and the disabled, it is an excellent read.  If you are looking to introduce a novice to many of the major issues with fraud, abuse, and corruption in the mental health industry and government agencies, this book may be the best place to start.

This book does not address the socio-economic conditions of the vast majority of individuals labeled, marginalized, and systematically broken to be easier to manage and control that is the true underlying problem that must be addressed in order to reduce, if not eliminate, mental distress and ineffective or "unhealthy" coping strategies.  For a look at arguments and studies showing the environmental and social factors that create misery and mental distress that could be relieved by improving the human condition through progressive economic change and basic human rights or, if not changed, result in self-medication (drug abuse/addiction), see: http://www.huffingtonpost.com/johann-hari/the-real-cause-of-addicti_b_6506936.html

Levine does a stellar job in exposing fundamental problems, including cover-ups and a "let them die" attitude towards veterans and anyone "the powers that be" deem to be "unfit" and worthy of sterilization and long-term extermination.  (see: http://www.esquire.com/news-politics/politics/news/a56482/tennessee-sterilize-inmates/, https://www.washingtonpost.com/blogs/govbeat/wp/2014/09/26/following-reports-of-forced-sterilization-of-female-prison-inmates-california-passes-ban/, http://www.newsweek.com/one-way-end-opioid-epidemic-let-them-die-639272) Not only do they sterilize or force/coerce sterilization of inmates (even in California, even now), it happens in other institutional settings.  HEAL interviewed one young African American woman who sued the residential treatment center in Texas where she was placed for forcibly sterilizing her without her consent and against her will.  This is actually happening and if you study social justice movements and the systematic oppression and persecution of poor communities, you will begin to understand that their life experiences tell them daily they are targeted and oppressed and that it is not Schizophrenia or Paranoia, but, trauma-informed living after witnessing the firsthand and repeated abuse and repression of their communities and themselves.  (see: https://youtu.be/LBGRfqdD6JU)  Of course, those who radically adhere to neo-liberalism, prefer to blame those living in poverty for their circumstances because blaming social and economic inequality is perceived as a threat to the almighty status quo and labeling people who dare to speak out about social and economic injustice as "crazy" (see: http://www.huffingtonpost.com/2015/04/30/bernie-sanders-socialist_n_7182752.html, http://thehill.com/blogs/ballot-box/presidential-races/284011-trump-sanders-is-crazy-as-a-bed-bug, http://www.independent.co.uk/news/world/americas/us-politics/donald-trump-mental-illness-signs-yale-psychiatrist-dr-bandy-lee-dangerous-us-president-goldwater-a7700816.html (Sanders and Trump have both been labeled as "insane".  Some pundits calling for Trump to be institutionalized in a psych hospital.  But, because of the socio-economic status of both, it only rises to the level of libel or hyperbole.  But, when you don't have money and fame backing you, the powers that be find it all too easy to marginalize and/or institutionalize dissidents.)) so they can be marginalized and dismissed by the sleeping majority has proven an effective tool in squashing dissent and coercing or forcing "treatment" (institutionalization) on those individuals neutralizes the threat they pose to the "system".  Levine does not make these arguments in his book.  I've included them here to hopefully provide additional insight and nuance to the overall discussion of the topics covered in Levine's work.

I've been working in the field of child and family advocacy for over 20 years and while I tend to live in a world of perpetual outrage, "Mental Health Inc" served to confirm my most disconcerting concerns about the entire field of mental health and the corruption by big money from the pharmaceutical industry which coerces and bribes providers to drug all problems away and not look at underlying causes of distress or ways to alleviate the stress without the use of dangerous pharmaceutical drugs.

Levine writes, "...the current mental health system is such a fiasco that even having health insurance doesn't ensure good -- or even safe outcomes."  Levine goes on to point out that the majority of the industry is engaging in "scientific fraud" and reports, "...so many people have been damaged by a mental health system that doesn't work and is too often run like a racket."

"Mental Health Inc" provides anecdotal personal accounts of institutionalized abuse and malfeasance along with mostly well-researched documentation showing the systemic problems within the mental health industry.  Like many others, Levine wanted to offer some hope or positive outlook and in so doing, may have been too quixotic in some of his recommendations for "good treatment" options.  This is one of the primary issues I found with Maia Szalavitz's writing as well. (See: https://www.barnesandnoble.com/w/help-at-any-cost-maia-szalavitz/1101076791)  Like Szalavitz, Levine wants to offer hope for recovery and mental illness management, but, appears to have looked in the wrong places for some of his treatment suggestions. 

Levine does a great job of promoting empathic or empathetic treatment providers and it is empathic/empathetic providers that are the only professionals HEAL would recommend.  However, in Chapter 11, Levine also recommends Trauma-Focused Cognitive Behavioral Therapy (CBT) and EMDR therapy, among other questionable and experimental therapies.  For criticism of CBT and Eye Movement Desensitization and Reprocessing (EMDR), see: https://www.psychologytoday.com/blog/the-justice-and-responsibility-league/200903/four-drawbacks-cognitive-therapy, http://www.whywesuffer.com/cognitive-therapys-flawed-premise/#more-2090, https://www.madinamerica.com/2013/05/cognitive-behavioral-therapy-the-good-the-bad-the-limitations/, https://thepsychologist.bps.org.uk/volume-22/edition-5/moving-beyond-cognitive-behaviour-therapy, http://www.theness.com/index.php/emdr-science-or-pseudoscience/, https://www.quackwatch.org/01QuackeryRelatedTopics/emdr.html, https://www.myptsd.com/c/threads/emdr-lashback-when-emdr-goes-wrong.1388/, and http://www.skeptic.com/eskeptic/14-05-21/.

In addition, the last couple of chapters of "Mental Health Inc" seem to suggest that Schizophrenia is a biological rather than environmental/socially-caused form of mental distress.  Levine has written in-depth articles expanding on that debate and draws no definitive conclusions, because the science is simply not in nor complete for such conclusions.  For example, read his Huffington Post article here: http://www.huffingtonpost.com/art-levine/abilify-is-top-selling-us_b_6282684.html  Arguments can be made on either side, but, HEAL would remind readers that the mental health industry was born out of the eugenics movement in the United States (see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579550/, http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.90.2.277?journalCode=ajp, http://www.law.harvard.edu/students/orgs/jlg/vol311/211-236.pdf. etc.) and that as referenced above, sterilizing the "unfit" (particularly people of color) remains a goal of most segregated congregate care facilities, programs, and prisons.  Beyond this, it is easy to label someone as "delusional", "paranoid", and "schizo" when their life experience is so foreign to the professional class/upper middle class life experience that those "professionals" engage in delusional and damaging denial of the actual cause(s) of mental distress in poor people and see them as needing to be controlled through chemical lobotomies so they don't make trouble for the "status quo".  Even if they don't consciously make the choice using that language, their entire profession has been built on that primary purpose and it can't be ignored when discussing what's wrong with this industry.  You don't have to be a person of color to be given a chemical lobotomy, just ask human and civil rights activist, Abbie Hoffman.  (see: http://www.heal-online.org/different.htm)  Oh, you can't, because he's dead.  And, he was labeled after being literally spied on (tapped phones, being followed, the works) by law enforcement who found him to be a "national security threat" because he was charismatic, white, and willing to adopt the class struggle and anti-war agendas alongside African American activists (who were similarly targeted and harassed).  For more on this, see other blog entries regarding this with the title: A BRIEF HISTORY OF INSTITUTIONAL ABUSE IN THE UNITED STATES OF AMERICA, ( a multi-part and ongoing series which begins here: http://heal-online.blogspot.com/2014/07/a-brief-history-of-institutional-abuse.html).  Was Abbie Hoffman paranoid?  No.  Did he have a rational understanding of his life experience?  Yes.  Did that fit with the status quo?  No.  So, he was labeled and neutralized through chemical lobotomy by so-called "caring professionals".  You can't even start a "revolution" when revolutionaries are identified, targeted, and neutralized regardless of whether that "revolution" is peaceful or not.  And, the affluent certainly have a vested interest in these methods which they may see as a more humane alternative to death camps.  But, that's not saying much.

Speaking of death camps, Levine does mention the Dozier School for Boys where over 100 corpses of children have been found buried in mostly unmarked graves on the property.  The Dozier School was a residential "character training" program in Florida before it was finally closed down in 2011.  See: http://www.smithsonianmag.com/smart-news/archaeologists-finally-know-what-happened-brutal-reform-school-180957911/  However, he goes on to mention an estimate provided by SIA (www.sia-now.org) that there have been a maximum of 300 institutional deaths of children (including suicides following abusive/coercive treatment) over the years.  This was a gross under-estimate and not based on any legitimate fact gathering by SIA "researchers".  This may seem a small matter, but, grossly misrepresenting the number of deaths in institutional care or as a result of institutionalized abuse is wholly irresponsible and hurts efforts of those of us who care enough to get our facts straight, understand problems with current laws and legislation, and put in the time to get things right.  By misrepresenting the number of victims by providing such a low estimate, SIA helps further marginalize the call for reform by suggesting too few people are affected to have it reach the level of national concern. 

So, if it isn't a maximum of 300 dead child victims of institutional abuse (including suicides following institutionalization), what's the number?  There's no record of the number of children killed in treatment/institutional settings.  The best estimate available is from the Hartford Courant, which reports: "A 50-state survey by The Courant, the first of its kind ever conducted, has confirmed 142 deaths during or shortly after restraint or seclusion in the past decade. The survey focused on mental health and mental retardation facilities and group homes nationwide.  But because many of these cases go unreported, the actual number of deaths during or after restraint is many times higher.  Between 50 and 150 such deaths occur every year across the country, according to a statistical estimate commissioned by The Courant and conducted by a research specialist at the Harvard Center for Risk Analysis.  That's one to three deaths every week, 500 to 1,500 in the past decade, the study shows."  (Source: http://www.charlydmiller.com/LIB05/1998hartfordcourant11.html ) This was the last legitimate study by a legitimate research specialist on this issue to HEAL's knowledge and would suggest a minimum of  975 deaths of children due to restraint and isolation (3750 restraint and isolation related deaths, if we include all age groups of the study referenced) in institutional settings in the last 25 years.  While the Dozier School for Boys opened in 1900 and closed in 2011 with over 100 children's dead bodies buried in unmarked graves around the facility "over the years".  (Source: http://www.npr.org/2012/10/15/162941770/floridas-dozier-school-for-boys-a-true-horror-story)  So, why not go back 100 years and apply the modern statistics?  That would suggest 3,900  deaths of children in institutional care as a result of restraint and isolation (not including other deaths in care, such as overmedication or medical neglect) since 1917.  In addition, 43 adjudicated children* and youths have died while in detention centers in a 4 year (2002-2005, last available data) survey of US juvenile detention centers, but, not all centers reported/participated in the study, so again, the number of deaths in detention may be much higher.  (source: https://www.bjs.gov/content/dcrp/tables/juvtab5.cfm) And, that would suggest 11 adjudicated juvenile deaths per year in detention.  It is clear that many more than that have been killed in institutional settings as a result of institutionalized abuse with thousands more committing suicide after having been through that trauma.  And, that's just the number of institutionalized kids that have died as a result of institutionalized abuse (restraint and isolation) while institutionalized.  And, if you want to get really "crazy", consider this....  Let us say that at the "best" segregated congregate care facility there are 0 deaths and at the "worst" (i.e. Dozier) there have been 100 deaths due to malfeasance (restraint, isolation, medical neglect, overmedication, etc.) and take the average death toll over a 100 year period to be 50 per facility.  The CDC reports there are 2,250 such facilities in the US.  (Source: https://www.cdc.gov/nchs/data/nsrcf/NSRCF2010SelectedSurveyParticipants_091409.pdf )  Then, over a 100 year period, you have an average of 112,500 malfeasance related deaths, or 1,125 deaths annually in institutional care due to malfeasance, across all demographics.  If 26% of those deaths are of youth (as the Harvard research suggests), then it would amount to roughly 292 deaths of youth in institutional care annually.  This would make the death toll over a 25 year period for youth in segregated congregate care 7,300.  But, medical malpractice accounts for 210,000-440,000 medical negligence/malfeasance deaths in the US annually according to a Journal of Patient Safety study in 2013.  (Source: https://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals)  While these numbers are staggering, they do not even touch on the post-institutionalization suicides of those traumatized by abusive and negligent care in segregated congregate care facilities.

As stated above, most of the information in Art Levine's "Mental Health Inc" is well-researched and invaluable.  Even though a couple of his suggestions or sources are questionable, overall, it is a great read and one HEAL would heartily recommend.

[Coming Soon: The HEAL Report youtube series interview with "Mental Health Inc" author, Art Levine.  See: https://www.youtube.com/user/HEALwantsTEENliberty]

* Corrected on July 28th, 2017, formerly read 86 which was a calculation error in reading the death total tables from the BJS. 

Tuesday, May 23, 2017

Overweight People Don't Need Government Sponsored "Fat Camp"!


Overweight People Don't Need Government Sponsored "Fat Camp"!
by Angela Smith, HEAL National Coordinator
 

I am overweight and have struggled with weight issues for most of my life.  I had control of my weight when I was in my early 20s.  But, I began taking hormonal birth control (Depo Provera) in my mid-20s and I gained nearly 90 pounds in 6 months without having changed my diet (vegetarian) or my exercise regimen (walked 2 miles every morning).  Not only did the hormonal birth control cause weight gain, fatigue, breakouts, and abnormal hair-growth, it also stunted my sex drive.

Many people with PTSD and trauma, particularly victims of sexual assault and abuse (like myself), often struggle with weight because our bodies want protection and in our society no one supposedly wants to get physical with fat people.  So, we use weight as a coping mechanism.  "Intensive Behavior Modification Therapy" is not going to help those of us struggling with our weight because it focuses solely on changing behavior, often through confrontation (aka "attack therapy"), ridicule, and aversive/abusive therapies instead of addressing the trauma or underlying causes of weight problems.  Some of which include adverse reactions to behavior modifying/psychotropic drugs.

I'm currently losing weight and have lost 20 pounds this year.  Here's how I am doing it:

1.  I figured out what my goal weight should be for my age and height.  According to the CDC, my goal weight/healthy weight is between 122-164 pounds.  (Yes, I currently am considered "obese" by the CDC standards and NO, I don't want to be put in fat camp or any other behavior modification program using Social Security dollars as current legislation is seeking to do.  More on this below.)  You can figure your "healthy weight" here: https://www.cdc.gov/healthyweight/assessing/  (Click on BMI Calculator link and enter your current height and weight, it will tell you if you are "obese" and what your "healthy weight" range should be.)

2.  I set my goal weight at 130 pounds and wanted to know the number of calories that are needed to maintain a weight of 130 along with the average amount of activity I do per day.  So, I found the following site: http://caloriecontrol.org/healthy-weight-tool-kit/assessment-calculator/  and entered in my sex, height, goal weight, and activity level and hit "Re-Assess My Goal" button.  This gave me the number of calories I needed to maintain my goal weight each day.  I set my activity level to "sedentary" and depending on my level of activity on any given day I figure out how many calories I burn to decide how much over the maintenance calories I can eat on that day or at the end of the week. 

3.  So, to figure out how many calories are burned by a given activity (i.e. 30 minutes of yard work), you can use www.google.com and enter in "How many calories do I burn doing 30 minutes of yard work or 1 hour of yard work?" and you may find this page: http://www.webmd.com/parenting/features/calorie-burners#1  or a number of other pages.  And, the same can be done for any activity.  If I do 1 hour of yard work, I can guess at about 200-400 calories were burned, and if I need to lose weight, give it the lower end of 200 to minimize any chance of "over-eating".  Given my goal weight and my activity level, I should only be eating about 1750 calories per day.  I do my best to keep it at 1500 during the week depending on my activity level.  And, yes, this is different than the average 2000-2500 you read on most food packages.  But, those food packages are not based on you, your lifestyle, or your weight.  They are national averages boosted, in my opinion, to keep people fat. 

I didn't learn how to calculate my healthy weight, healthy calorie intake, or healthy activity level in any primary or secondary school courses, including Health classes.  I was never taught how simple it is to manage my weight or how to understand metabolism, activity rates, and caloric intake.  And, even when I've joined weight management groups and organizations (haven't been part of any for many years), they never provided me with this simple information on how to figure it out.  No doctor I've visited ever sat down with me and looked at this issue simply and no nutritionist explained it to me in simple terms because they all wanted me to keep paying them to tell me what to do instead of how to figure out how to take care of myself.  Behavior modification programs do not help, they make things worse.  I know that for a fact too because I am a survivor of abusive/aversive behavior modification and I would never want anyone to go through that, especially not for being overweight when compassion, love, time, and basic health information and tools can address the issue effectively.

This is why I do not support HR 1953, the Treat and Reduce Obesity Act of 2017, which will divert Social Security funds to paying for overweight people to be placed in "intensive behavior modification therapy".  That is abuse.  It is awful.  And, no one should support it, period.  If you agree, please join me by signing the petition at: http://petitions.moveon.org/sign/oppose-hr-1953-treat?source=c.tw&r_by=9710095

Friday, May 5, 2017

Fix Your Family, Help Your Teen


Fix Your Family, Help Your Teen
By Angela Smith, HEAL National Coordinator


HEAL is a well established children's rights and consumer advocacy network that has been organizing to stop fraud and institutionalized abuse for over 15 years.  We have a network of families and individuals who volunteer to help in these efforts.  And, because of our time working in this field, we have identified what the segregated congregate care (a.k.a. behavior modification, troubled teen or teen help) industry uses to define and often demonize youth while encouraging parents to avoid accountability and responsibility by writing large checks often to fraudulent and abusive providers that spirit away their youth to labor camps and pharmaceutical testing facilities masquerading as boarding schools and treatment programs. 

We shall examine the common caricatures these modern day orphanages[1] use to identify and define youth.  In addition, we will provide suggested conversations between parents/caregivers and their teens that can assist with addressing the identified problems at home with some basic communication skill building so you can avoid the high cost, abuse, and untimely death often associated with institutional care and private, unlawful imprisonment.

There are three common caricatures used by the industry to demonize youth.  They go by many names and descriptions, but, HEAL has simplified it to "the brat", "the escape artist", and "the rebel".   (HEAL would never define any youth by a single characterization, nor any human being for that matter.  The terms here are our understanding of how the industry defines, labels, and dehumanizes youth.)  "The Brat" is often defined as a do-nothing, entitled, demanding youth who respects no one and values nothing.  "The Escape Artist" is often defined as a poorly focused dreamer that is "addicted" to drugs, electronics, gaming, or fantasy.  And, "The Rebel" is often defined as defiant, obstinate, full of potential and always angry.  Sometimes youth exhibit mixtures of all three, but, the industry often treats them as nothing more than animals that need to be broken[2] and programmed with no regard for the youth or the life experiences that may have resulted in questionable behavior and acting out. 

Children learn what they live and live what they learn.[3]  So, if a child or youth on the surface appears to be a "brat", "escape artist", or "rebel", often they have learned this way of life from their primary caregivers/parents.  And, this is one of the main selling points of the segregated congregate care industry.  They point out that parents have failed in every respect and are left with hiring someone to break and program their teen to fix the identified problems since the parents clearly have not and will not invest the time and patience to address the issues with empathy, compassion, and acceptance of their own responsibility.  It is easier to blame the kid and send them to "brat camp".[4] But, doing so is wrong and will hurt not just the family coffers, but, those subjected to being orphaned and abused as well.  It simply is too costly in every way to be reasonably considered an option.  So, what do you do?

(P=Problem  S=Solution  C=Conversation Starter)

P: HELP!  MY CHILD IS A BRAT!

S: So, it seems your teen is entitled, demanding, appreciates no one, and is both ungrateful and unwilling to be bothered with the expectations of others.  First, we need to examine each of the characteristics above and determine to what extent they are truly present.  If they do not feel any sense of responsibility for themselves, their belongings, the family home, or their own room, that is a problem.  Responsibility is a learned skill or behavior.  Is it possible you have not raised them to be responsible?  Or, are you expecting them to be responsible before they are developmentally ready for that life lesson?  One article suggests that personal responsibility is learned in college[5], so, it may be unreasonable to demand a teen be as responsible as you may expect at their age and stage of development.  There is no fast-forward to responsible adulthood and segregated congregate care results in infantilization and regression, not maturity and responsibility.

Someone who acts entitled is immature and may be suffering from infantilization in the home.  Have you spent time teaching your child basic life skills from the time they were born and appropriate to their developmental stage?  By the time a youth reaches high school age, they should be able to basically take care of themselves.[6]  But, they won't if they don't know how and if doing so has been used to degrade or punish rather than include and uplift. 

In working class households, there is no hired help and chores are a part of everyday life for every family member.  Parents are often working 40+ hours per week at fairly demanding jobs often where labor laws are regularly violated.  This means they work without breaks or through breaks, sometimes off the clock, and under duress that they will be replaced if they demand better from their employers.  When these parents get home they are usually tired, irritable, and would love to relax.  But, often that is not an option and they must spend 2 to 6 hours cleaning the home, doing minor repairs, fixing dinner, and helping children with homework or any other activities.  Their children see this from the time they come home from the hospital as infants.  Children in these families often follow their parents around and ask if they can help or try to copy their parents because children live what they learn and learn what they live.  If your teen rejects personal responsibility as "beneath them", it is likely a class issue and involves neglect or unreasonable expectations on the part of the parent(s)/primary caregiver(s).

If your teen has grown up watching you go to socials, parties, and fun activities like golf or tennis and has never seen you do a single household chore, then expecting they act differently is completely unreasonable.  If your child remembers you saying you are off to work and sees you grab your golf clubs and give them a wink, they don't think your work is serious and don't associate your work with their life of luxury.  They don't think you work at all, most likely.  Or, that you only work when you feel like it.  So, why would you expect them to act any different?  How do you fix this?

C:  Sit down with your teen and start your conversation with this: "It seems I may have given you the wrong impression about my work and our family lifestyle.  (If you had a luxurious upbringing as well, explain that here by saying: As you may already know, I was also raised in the lap of luxury and did not have many expectations placed on me regarding household chores or taking care of my belongings...  If you did not have a luxurious upbringing, let your child know about your own developmental years and acknowledge that you did not want them to have the same hardships you had as a child and may have failed to teach them basic life skills as a result.)  You are almost an adult and will be off to college or some other independent adventure very soon.  Regardless of where I have failed you to this point, I want to take time to help you prepare now for independent living.  (Acknowledge things your teen has done well or currently does well here, maybe by saying something like: I'm impressed that every morning you shower, dress yourself, and put yourself together to go to school.  I'm so pleased with the good grades you have earned.  And, you are very talented when it comes to (singing, tennis, science, etc.).  Before you are off to independence, I want you to have some additional skills such as balancing a checkbook, preparing your own meals, navigating strange/unfamiliar towns/places, doing laundry, organizing your schedule and basic housekeeping.  I can personally help you learn all of these things or any that you do not already know and I'd like to invite you to accompany me to my work, chores, and activities so you can get a better idea of the big picture and how we maintain our current lifestyle.  (If you bring your teen to your work, they will see you in action and understand that you have responsibilities and do actually work, not just play golf all day.  Ask them to help you with a minor work project (preparing presentation folders, answering phones, or any task they could reasonably handle).) If you gather up old/used clothes from your closet for donation to Goodwill, then make a day of it and have your teen do it with you.  This will teach them a sense of work ethic and charity which appear to be your major complaints at the moment.  If they need help with life skills you don't have, consider learning these skills together.  Take a cooking class together if you both don't cook.  There are many easy and fun solutions if you just take a breath, stop hating your teen, and start parenting with patience and love.

P: HELP!  MY CHILD IS AN ESCAPE ARTIST!

S: So, your child is a poorly focused dreamer, spends too much time with games/electronics, abuses drugs, and/or lives in a "fantasy world".  Your teen may be too smart for his school.  Depending on your economic class, if you are not comfortably middle class or higher in the economic chain, your child's school may be using the same disgusting behavior modification techniques as are engaged in at most segregated congregate care schools and programs.  One school behavior modification procedural manual states: "In response to a question regarding what public schools should do with intelligent, highly motivated, and/or efficient children, Sulzer and Mayer suggested: [emphasis added] “Certainly it would be possible to slow response ratio in other ways: yell at the student when he hurries [commit verbal abuse], ignore him altogether [neglect], flunk him, keep reminding him to slow down, feed him tranquilizing drugs and all kinds of other possibilities.”12"[7]  So, if most schools are treating intelligent children from working class backgrounds like this, then it is no wonder that a youth in that situation would want to escape. 

The other possibility is that some other form of abuse, besides institutional abuse, is involved.  Most people, including children and youth, divert their attention and seek to escape when reality has traumatized them and they don't know how to cope.[8] [9]

There is yet one other possibility, and that is that they are again learning what they live and living what they learn.  If the parent(s) or primary caregiver(s) get home from work and turn on the television (computer, handheld device, or game system) where they remain ignoring and avoiding their own household duties and responsibilities every night, then it is unreasonable to expect children in that home to do otherwise.  In fact, in such homes, it is often that the parent/caregiver(s) will tell a child from an early age to go watch television and leave the adults alone.  And, when children obey this into their teen years to their own developmental detriment, it is truly unfair and unjust to punish them for doing as they've been both told and taught.

Regardless of which of the above three are most likely occurring, institutionalization in segregated congregate care is the same as taking someone from the proverbial frying pan and throwing them in the fire.  If you take a trauma victim and force them into a situation where they are constantly triggered, they will not improve or recover and actually regress deeper into fantasy.  The same is true for individuals suffering milder forms of these abuses in their current school.  We've met many victims of institutional abuse who were "escape artists" that have manufactured grandiose fantasy worlds to explain their compounded trauma including some who believe they are the second coming of Christ, some who believe they are the anti-Christ, and even some who believe they are both Christ and anti-Christ in one.  One victim believed every song written by Bob Dylan was about them, even though they weren't even born when those songs were written.  One victim believed they could control the brightness of electric lights with their mind.  You might say they must have always been "crazy" or clearly "schizo".  But, the reality is that they were not making such claims nor believing such things before being institutionalized.  If you speak to them, they will tell you that they believe the suffering they endured while institutionalized is proof that they are specially chosen by God, Satan, the Universe, or Bob Dylan's lyrics to expose the suffering of the world and bring about transformative destruction or peace, depending on their interpretation and fantasy development.  But, given their lack of skill or knowledge of politics and society at large, they introduce themselves as specially chosen ones and wander the world trying to convince everyone that their fantasy is the true reality.  This is not a future any parent would choose for their child.  And, it can be avoided in most cases by avoiding institutionalization and focusing on getting the family and teen back on track.

C:  First, you'll need to determine which reality you are dealing with here.  Is your teen escaping because they attend a school that is not respecting their intelligence?  This is something you may be able to determine simply by asking your teen if they feel school is stupid, pointless, or bullsh*t?  If they feel school is stupid, it is likely because the school is not respecting nor nurturing your child's natural talent and intelligence.  You may want to consider home-schooling or enrolling your teen in high school courses at the local community college.[10]  Your teen can earn high school and college credits from the same coursework which will jumpstart their college education and put them in an environment that is both challenging and rewarding.   This may be enough to get them excited about learning again and with some support will help them choose to achieve rather than avoid education/education goals.  This is less expensive and far more valuable and rewarding than any segregated congregate care, including most boarding schools. 

But, if your child has been traumatized and is using escape to avoid trauma triggers, you may need to do a bit more than simple positive redirection as is suggested in the paragraph preceding this one.  Trauma can include normal trauma/stress like the death of a loved one, divorce, moving, big changes to school or home, and extraordinary trauma like targeted and excessive bullying, abuse, and rape.[11]  Children and teens feel helpless when traumatized and this helplessness can result in a virtual shutdown or closing off from a "reality" which is too traumatic and overwhelming for them to handle.  The worst thing anyone could do to a traumatized youth is create more trauma by marking them as damaged, sending them away to live with abusive strangers in strange and unfamiliar places, and exposing them to constant new stimuli which will increase the feeling of helplessness likely leading them to feel suicidal or risking their life to physically escape the institution/program/etc.  This is the exact opposite of what a true professional would advise who specializes in treating trauma.  No legitimate mental health professional engaging in ethical treatment practices (that do not involve receiving kickbacks for institution referrals from the institution (common problem)) would ever recommend taking a trauma victim and compounding their trauma by spiriting them away as a damaged animal to be broken and programmed by any institution.  Many victims of institutional abuse become self-medicating or fantasy-focused (large movie/fiction collections, constant gamers, etc.) and spend their lives retreating and avoiding a world that tortured instead of nurtured them when it was most needed.  Institutionalizing trauma victims makes them victims for life and does not help them learn positive coping skills.

If your teen has experienced overwhelming trauma (overwhelming to them, not necessarily objectively overwhelming), they may have Post Traumatic Stress which is common when children experience many forms of trauma or chronic trauma like neglect and poverty.  You are going to need to help your teen overcome their trauma or at least learn to manage their Post Traumatic Stress.  You are going to need to let your teen, in this case, be the decision-maker when it comes to any treatment or treatment providers.  And, you will have to be patient and wait for them to be ready for it.  Forcing treatment on a trauma victim who already feels helpless just makes them feel more helpless.  To heal, they must feel that they matter and that they have the power and responsibility to manage their own affairs with your support.  One guide we recommend at HEAL for helping a loved one cope with Post Traumatic Stress is available here: https://www.helpguide.org/articles/ptsd-trauma/ptsd-in-the-family.htm.   You are going to need all of these skills and tips to gently help your teen heal from trauma.  Once they learn to manage their triggers, then encourage and support them to get "back on track".  If they have been traumatized at school, but, feel safe at home, ask them if they want to switch to a home-school option and take a break from the pressures of the social demands of school life.  When they are ready, find out if they have any extracurricular interests and let them know they can take guitar, swimming, or any other lessons when they are ready.  If they tell you they want to go back to a school environment, consider the community college option mentioned above and ask them what they think would be best.  The most important thing with a trauma victim is that they feel empowered and supported, not helpless, useless, and judged.  If you treat your traumatized teen with patience, kindness, empathy, love, and support, then they will be okay in the long run.  If you send them away, expect a lifetime of pain and regret.

P: HELP!  MY CHILD IS A REBEL!

S: So, your child is defiant, obstinate, full of potential, and always angry.  Well, the problem may be you.  Offended?  Then, the problem is most likely you.  But, it all depends on what you mean by defiant and "always angry".  For one, your teen may be angry with you and that's why you perceive them as being angry all the time.  But, it is highly unlikely that they are "always angry".  Find out why they seem angry and if they are angry with you, find out why by asking them.  If you find yourself cutting them off, refusing to listen, and becoming defensive, consider yourself the obstinate one.  And, remember that children live what they learn and learn what they live.  If you shutdown communication with your teen whenever they say anything you don't agree with or like, then you are the problem.  You need to learn some basic communication skills.  Here are some resources you can check out and practice for better communication with your teen: https://www.thebalance.com/communication-skills-list-2063779 and http://www.apa.org/helpcenter/communication-parents.aspx.

When a parent claims a teen is defiant, it usually indicates that the parent feels disrespected by the teen's disobedience.  Are your expectations reasonable?  Do you show your teen respect?  With rebellion, the issue is usually with ignorant and arrogant parenting styles coupled with frustrated and sometimes angry teen responses.  Obedience should not be the goal of parenting, period.  The goal is to prepare children for responsible independent living when they reach the age of majority.  Obedience to authority figures is not a legitimate life skill.  Certainly, it isn't when you are talking about blind or unquestioning obedience to questionable authority figures.  A father who raped his daughter enrolled her in a residential treatment program after she reported the rape to the authorities to avoid being prosecuted.  It took more than 2 years of her story never changing through three different institutional settings before a therapist actually made the effort to ask the authority the teen reported the rape to years ago whether the statements were true.  The law enforcement authorities said they had been trying to find the teen for years and had no idea where she had been sent.  But, they confirmed everything and the teen was released and her father rightfully prosecuted and sent to prison.  But, certainly the father in this situation should not be obeyed.  And, only unreasonable people would believe otherwise.  This article is not for the unreasonable parent.  We know there are bad parents out there, we've met many of them.  But, for those who we believe can and will do what is best for their children, we believe this article will be helpful.

So, assuming you are a reasonable parent who is experiencing unusual levels of defiance and anger from your youth, what do you do?

C:  Many articles on the subject of rebellion and defiance suggest most youth do not exhibit extreme rebellion or defiance.  In fact, it usually only becomes a problem when the parent is confused about how best to support their child as they mature into independent adulthood.

"[T]he primary goal of the teen years is to achieve independence. To do this, teens must start pulling away from their parents — especially the parent whom they're the closest to. This can feel like teens are always at odds with parents or don't want to be around them the way they used to.

As teens mature, they start to think more abstractly and rationally. They're forming their moral code. And parents of teens may find that kids who previously had been willing to conform to please them will suddenly begin asserting themselves — and their opinions — strongly and rebelling against parental control.

You may need to look closely at how much room you give your teen to be an individual and ask yourself questions such as: "Am I a controlling parent?," "Do I listen to my child?," and "Do I allow my teen's opinions and tastes to differ from my own?""[12]

The above excerpt is from http://kidshealth.org/en/parents/adolescence.html# and the entire article offers great tips for parents and parenting teens.  Of course, the solutions offered include learning about teens/development, better communication, empathy (remember your own teen years?), picking your battles, respect your kid's privacy, and make appropriate rules. 

HEAL has received calls from parents who considered shipping their kids off to institutions for the following reasons:

1.  Parents taking extended European trip and wanted a "kennel" they could place their kid(s) because they didn't want to leave them at home alone and didn't want to bother extended family (i.e. grandparents) to care for the kids while the parents are on an extended 3 month vacation.

2.  Parents upset that 17 1/2 year old daughter spoke on the telephone with a boy her own age from school.  Daughter went to a co-ed school.  Parents did not ask daughter why she was on the phone with a boy nor whether it involved any school projects or tasks.  The younger sibling had tattled that the older sister broke the house rule of no contact with boys outside of school/church until college.  And, without any communication or inquiry as to why the call occurred in the first place, the parents were looking at institutionalizing their nearly grown daughter.

3.  Catholic parents upset that son brought home Torah (Jewish Bible/5 Books of Moses) from the library.  Jewish literature was not allowed in the home.  The youth was doing a class assignment that required he bring home that book.  This rule violation was enough, even with the reasonable explanation, for the parents to consider shipping their son off to an institution.

We could go on and on with examples like these.  The first one was most likely narcissistic parent(s) who would rather brag they sent their kids to "boarding school" then provide nurturing in-home care that would permit their youth to stay in their own familiar community and surroundings while parents go on vacation.  These parents did not want to postpone their vacation nor take their children with them even though such a trip would be invaluable to youth and look great on college applications. 

The second two were what we would consider unreasonable rules and expectations.  We've spoken to parents who would love their only problem to be that their child brought home a Jewish book or talked on the phone with a classmate.  It is insane to consider institutionalizing a teen because they talked to a friend on the phone or brought home a book you didn't like.

So, we take the "defiant", ODD (Oppositional Defiance Disorder), obstinate, and angry allegations against teens with a grain of salt at HEAL.  Generally, risky behaviors are really about poor coping mechanisms after trauma and parents who are concerned about risky behaviors should follow the advice for the Escape Artist above.  Regardless, communication skills are necessary regardless of what type of problem you are dealing with and should be the focus of your efforts before you consider how you want to address the problem(s).

We often suggest parents dealing with "rebellion" sit down with their teens and negotiate a contract that both find reasonable regarding expectations and privileges.  This will help prepare the teen for other negotiations in life and give them the sense that you respect them and want to support them as they transition to independent adulthood. 

Institutionalization conditions youth to being institutionalized and many either stay in mental institutions or find themselves in jail because they learn helplessness and fear independence and autonomy because they have been severely punished for both while institutionalized.  It is best to avoid enrolling youth in segregated congregate care whether it is labeled treatment, boarding school, group home, orphanage, boot camp, or something else.  A little common sense, communication, love, and patience will solve most problems. 

Or, enroll your kid in a program run by neo-nazi survivalists in Idaho or Mexican gangs in Tijuana/Baja.  Maybe send them to a "Christian" program run by ex-cons in VA or a "Mormon conversion center" masquerading as a treatment program in Utah.  Many of the programs Dr. Phil recommends have been closed after youth deaths, so, maybe listen to him?  He lost his license after sleeping with a teen patient, but, he's trustworthy, right?[13]

Teen programs will tell you anything you want to hear because they want to exploit your children and take your money.  I, Angela Smith, have been a children's rights and consumer advocate for 25 years.  I have a certificate in child development from the Kent School District in Kent, WA, an AA Degree from Highline Community College, a BA from the University of Washington, and I am currently on hiatus from law school where I successfully completed my first year and passed the California "Baby Bar" exam.  I have worked as an educator and youth advocate for over 20 years.  And, I have never been arrested, let alone convicted, for any crime.  I have been sued once in my life by an institution on the HEAL watch-list but that suit was withdrawn by the program before the court could rule in our favor.  I have cared for many children in both school and home care settings and no child has ever died, been raped, been exploited, been maimed, or otherwise abused while in my care.  The same cannot be said for most, if not all, segregated congregate care facilities and programs.

You may also find our parenting guide at www.heal-online.org/parent.htm useful.  Good luck!
 

[7] http://www.heal-online.org/ebook.pdf   (page 9) and Sulzer, Beth and G. Roy Mayer. “Behavior Modification Procedures for School Personnel”. The Dryden Press Inc. Hinsdale, IL. © 1972. (p. 132)