In 1986, I was an unemployed IV drug user, living in New York City with my cocaine-dealer boyfriend. I had dropped out of Columbia University and felt, at 23, that my life was over. My only solaces were heroin and cocaine, but even these were failing to blot out my misery as the consequences of my drug use became increasingly obvious. I was scary-skinny. My complexion was grayish green. I had tracks all over my arms and legs. I had difficulty finding a usable vein.

But I didn’t see any alternative. Everything I heard about addiction treatment terrified me, especially an article I read in The New York Times Magazine about a bracingly tough program called KIDS. The article detailed how the program’s teenaged and young adult participants were subjected to brutal emotional attacks, a complete lack of privacy, and daily humiliations like being constantly followed by a person whose hand never left their back belt loop.

Horrified, I wrote a letter to the magazine’s editor, which was published. It began: “Remember cults? Remember brainwashing?” and suggested that such treatment was unlikely to be successful. I knew for sure that it wasn’t for me. I took drugs to avoid emotional pain and shame, and so I didn’t see how public humiliation would help me.

I avoided treatment for another two years, finally recognizing that I was an addict when I considered sleeping with someone whom I despised, just to get drugs. I entered a hospital detox program, and from there went to a 28-day rehab that was mostly gentle in its approach.

Because I’d seen how kindness and compassion could work, I grew all the more suspicious of programs whose core assumption is that addicts are immoral creeps whose only hope for recovery is punishment and “tough love.” I became immersed in the research on addictions and their treatment, eventually co-authoring the first research-based guide to addiction treatments for consumers.1 I also began writing about addiction and treatment for many popular publications, ultimately winning the American Psychological Association’s award for a nonpsychologist’s contributions to the study of addiction.

For the past three years, I have focused my research on the “troubled-teen industry,” which is made up of programs that claim to target a wide range of bad behaviors in adolescents. By calling their programs “schools” or “camps,” many avoid the regulations that govern mental health facilities and drug treatment centers. I was shocked to discover the disconnect between this largely unregulated industry and the scientific research on addictions and adolescents. As I report in my most recent book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids, tough love is not only cruel, but also counterproductive.

Badly Behaved and Ineffective

At any given time, 10,000 to 20,000 teenagers are held in tough love programs. Over two dozen teens have died in them since 1990. Just this January, a 14-year-old boy died after a few hours in a Florida boot camp, where guards punched and kicked him and shoved ammonia in his face when he couldn’t complete the required exercise. Courts and regulators have documented these programs’ abuses, which include keeping teens in outdoor dog cages, hog-tying them, depriving them of sleep and food, isolating and restraining them for extended periods, and holding them for days in stress positions such as stomach-down on the floor, with their hands behind their backs.

Their suffering is for naught, suggests a recent state-of-the-science consensus report by the National Institutes of Health. The report concludes that programs that seek to help kids by using fear and tough treatment “appear ineffective.”2 The Justice Department came to a similar conclusion about “boot camps” for kids and lists them on its Web site under “what doesn’t work.” One of the studies that the Justice Department reviewed found that whereas 50 percent of juvenile detention inmates were rearrested after their release, 72 percent of boot camp participants were.3

Where did the idea that you have to hurt people to help them come from? One of this misguided idea’s roots is a group called Synanon, which had an enormous influence both on mainstream American addiction treatment and on a number of programs for teens. Synanon was founded in 1958 by an Alcoholics Anonymous member named Chuck Dederich, who thought that AA wasn’t tough enough. He founded a community of people committed to emotionally and sometimes physically attacking each other in order to produce the honesty he thought necessary for recovery. When a heroin addict joined and successfully kicked his addiction, Dederich and his followers began to live communally and marketed Synanon as an addiction cure.

Because heroin was then a huge problem in the inner cities, Synanon soon attracted major media attention. State officials from across the country came to visit and learn about this exciting new “cure.” Had they waited for the research results before copying Synanon, they would have learned that the program only looked successful. Its toughness weeded out everyone but those who were most committed to getting and staying clean – people for whom probably any program would have worked. A study conducted for the state of New Jersey in 1964 found that only 10 to 15 percent of participants stayed in Synanon for more than a few months and actually quit drugs.4

Ultimately, Synanon shut down after Dederich directed a resident to place a poisonous snake in the mailbox of an attorney who had begun winning civil suits against the group. Dederich and the others involved were convicted of conspiracy to commit murder.

Synanon’s Legacy

But this didn’t deter those who continued to believe in the tough approach to teen treatment. For the past three decades, various versions of tough love have been promoted, debunked, shut down, and then reopened under new names. In 1971, a program called The Seed received federal funding to test the Synanon method as a way of preventing and treating teen drug problems. It enrolled thousands of teens and garnered massive media attention and political support. But by 1974, a congressional investigation concluded that The Seed’s tactics were “similar to the highly refined brainwashing techniques employed by the North Koreans in the early 1950s.”

These days, “emotional growth boarding schools” like those associated with the World Wide Association of Specialty Programs and Schools (WWASPS) still market confrontational tough love tactics for troubled teenagers. WWASPS is currently linked to five programs; eight others have been shut down following abuse reports. Some wilderness programs, which have kids trek through rough terrain as part of their treatment, also use Synanon-style “therapy” groups.

These programs sell continually because parents are terrified by teenagers’ misbehavior. They sell because the media hypes those fears, as do government agencies involved in the war on drugs. They also sell because the idea of evidence-based mental-health care is only a very recent innovation. Even now, many people think that anecdotes of success are sufficient evidence to support the use of a therapy or program. Lack of regulation also plays a role.

And so the troubled-teen industry continues to tout its sadistic methods as proven effective. Until federal regulation sets some basic safety rules, and until parents become informed that breaking kids doesn’t fix them, these programs will continue to be dangerous, parents will continue to be misled, and troubled teens will rightly fear treatment. We must recognize that tough love not only doesn’t help, but actually hurts.

1 Volpicelli, J. & Szalavitz, M. Recovery Options: the Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (New York: John Wiley & Sons, 2000).

2 “Preventing Violence and Related Health-Risking Social Behaviors in Adolescents: an NIH State-ofthe- Science Conference Statement,” National Institutes of Health (October 2004). http://consensus.nih.gov/2004/2004YouthViolencePreventionSOS023html.htm.

3 Sherman, L.; Gottfredson, D.; MacKenzie, D.; Eck, J.; Reuter, P.; and Bushway, S. “Preventing Crime: What Works, What Doesn’t, What’s Promising,” Department of Justice (1998). http://www.ncjrs.gov/works/.

4 Mitchell, D.; Mitchell, C.; and Ofshe, R. The Light on Synanon: How a Country Weekly Exposed a Corporate Cult – and Won the Pulitzer Prize (New York: Wideview Books, 1980).

MAIA SZALAVITZ is a journalist who covers health, science, and public policy. Her most recent book is Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead Books, 2006). She is a senior fellow at Stats.org, a media watchdog organization that investigates coverage of science and statistics, and writes the “Health Patrol” column for Psychology Today. She has written for The New York Times, The Washington Post, Newsday, Newsweek, the Village Voice, and other major publications.

Read more stories by Maia Szalavitz.