Polonsky: Are all tough-love programs this bad, or are you just focusing on the worst of them?

Szalavitz: Some may not be as bad as these two; I wasn’t able to research every one of them. But it’s clear the industry attitude is that troubled teens are not people in pain, but manipulative liars who deserve rough treatment. Their philosophy inevitably leads to abuse, whether it’s as mild as ignoring someone’s emotional needs or as severe as ignoring a medical condition.

Polonsky: There are hundreds of similar programs in the United States today. You focus on just four in your book. Why those four?

Szalavitz: I always knew Straight Incorporated had to be in the book, because it was the first heavily publicized tough-love program. It started in Florida, but at its peak it had facilities operating in eight states.

In Straight you spent twelve hours a day sitting on hard chairs and flapping your arm to be called on. If you didn’t get called on, you’d never advance in the program and get to go home. And when you did get called on, you had to have a good confession to make about how terrible you’d been before entering the program, or else you’d be attacked verbally. If you didn’t comply, if you didn’t pay attention, if you didn’t say what they wanted to hear or you mouthed off, they would literally throw you on the floor and restrain you, with somebody sitting on your torso and restricting your breathing, another person sitting on your legs, two more people sitting on your arms, and sometimes somebody holding down your head. This would all be done by your fellow participants, which is not the way restraint is handled in any legitimate psychiatric institution. People had limbs broken.

Polonsky: And this restraint was administered as punishment?

Szalavitz: Yes. Sometimes people were restrained from running out the door, but more often it was done as punishment for violating all manner of rules. Straight also heavily restricted access to the bathroom, so kids would wet and soil themselves. It’s all part of the humiliation strategy employed by many of these programs: an exercise of power and demonstration of the teens’ helplessness.

Polonsky: And what about the other three programs: KIDS, North Star, and WWASP?

Szalavitz: North Star, of course, was the wilderness program in which Aaron Bacon died. KIDS was founded by Miller Newton, who had been Straight’s national clinical director and a charismatic leader within Straight. He falsely claimed to be a psychologist. (He did eventually get a degree from a correspondence school.) KIDS was like Straight, only worse.

The World Wide Association of Specialty Programs is the biggest tough-love organization currently in operation. It’s similar to Straight in that you gradually work your way up by confessing and verbally attacking other teens. Their “curriculum” includes confrontational weekend seminars, where they sometimes make young girls dress up as hookers to humiliate them. Newcomers are assigned “buddies” who monitor them and have the power to punish them, even though these buddies are not staff, or even adults.

After being released from these programs, many teens immediately return to dangerous behavior, and some are so traumatized that they are unable to function in a college environment. Others can’t afford to go to college because their parents have spent their entire college fund on WWASP. The overseas programs cost about three thousand dollars a month, and the ones in the United States cost four to five thousand a month. And there are additional charges on top of that, such as for bringing the kid to the program in handcuffs.

Polonsky: What kind of teen gets sent to a place like WWASP?

Szalavitz: Anyone who has annoyed the hell out of his or her parents, who is mouthy and disappointing and maybe isn’t doing well in school or is using drugs. Many teens with depression or serious mental disorders end up there. WWASP seems to take anyone. There are no restrictions. Even a child who has never smoked pot and gets straight As will be accepted as long as the parents believe the child’s behavior requires drastic action. A WWASP official told the press that 70 to 80 percent of their students are not hard-core drug users or criminals; they just have trouble communicating with their parents. Paul Richards, a WWASP graduate I interviewed for my book, had never even smoked cigarettes. But most of the boys and girls are somewhere in the middle. Maybe they were smoking pot every weekend, or they took acid.

Polonsky: How do parents find out about these programs?

Szalavitz: In the eighties and nineties many parents were referred to them by ToughLove, a nationwide network of support groups for parents of troubled teens. The couple who founded ToughLove had written a book in which they told how they’d refused to bail their daughter out of jail, and they claimed that this was what had saved her. To its credit, the ToughLove network eventually denounced Straight Incorporated, but only after recommending it to parents for years.

Nowadays parents might get referrals from so-called educational consultants, who are not required to have licenses and who often get kickbacks from programs for giving referrals. An “educational consultant” could easily be another WWASP parent who will get a thousand dollars or a free month in the program for their own child in return for a referral. Then you have school guidance counselors and psychologists and other professionals with whom the tough-love programs cultivate relationships. And of course, if you search for “troubled teens” on the Internet, multiple WWASP-sponsored websites come up.

Polonsky: Do parents have any idea what’s really going on in these programs?

Szalavitz: Phil Elberg, an attorney who successfully sued Miller Newton and the KIDS program, liked to say that it was the parents who really belonged to the KIDS cult, not the children. In most of these programs, the parents proselytize to other parents and meet in groups and encourage each other to stay strong and be tough. If the parents weren’t convinced that tough love works, these places couldn’t operate.

There’s enormous pressure for parents to take the tough-love approach. After an article I wrote about the troubled-teen industry appeared in the Washington Post, I got dozens of e-mails from parents who didn’t want to send their children to these programs, but everybody was telling them it was the only way and that they were hurting their son or daughter by not doing it.

Polonsky: Don’t the teens inform their parents of what’s going on?

Szalavitz: They try to, but the parents are told to expect complaints and treat them as lies or attempts at manipulation. And almost all communication is monitored, with discipline for kids who complain. Also the programs teach the kids that it’s all their fault, so most of them come out saying that. Unfortunately, that’s exactly what many parents want to hear. It’s hard for parents to accept how much harm they have done to their children by placing them in these programs. I have talked to parents who were horrified when they discovered how bad it really was. They spend years trying to make up for it. Some, however, prefer to stay in denial.

I would say the vast majority of parents who send their children to these programs are devoted mothers and fathers who would honestly prefer to have their child at home. Most would likely have chosen family therapy were it more widely available and had they known that research supported it over these programs. A large percentage of these parents are in the middle of a divorce. Their children are acting out, unhappy, and vulnerable. That’s why family therapy makes the most sense. But the parents don’t want to think the divorce is what’s causing their son or daughter to rebel or take drugs.

Many parents are simply fooled. Unless you’ve been told otherwise, you’d think these programs are run by experts who have some knowledge you don’t. Aaron Bacon’s parents are smart, well-intentioned, and kind. They were in no way negligent; they asked all the right questions, consulted all the right authorities. But they were lied to. It could happen to anybody.

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