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     The troubled teen industry has a precursor in the drug rehabilitation program called Synanon, founded in 1958 by Charles Dederich.

     In 1912, Helen T. Devereux, a special education teacher, founded the first Devereux school in Philadelphia. She began to acquire properties and expand her operation until she officially established the Devereux Foundation as a nonprofit organization in 1938. It expanded through the years to 13 U.S. States and is one of the oldest nonprofit providers of behavioral healthcare in the United States. The organization markets itself as a behavioral health organization that works with developmental disabilities, emotional and behavioral disorders, and mental illnesses. Its operations now include psychiatric hospitals, residential treatment centers, group homes, respite care, supported living, foster care, special education, and vocational education.

Throughout the years, the survivors tell a different story about Devereux – many alleging abuse, neglect, and horrible conditions. A review of DHS records across multiple states corroborated the survivors’ stories with multiple violations and, in some cases, the removal of children from facilities.

     Founded in 1915, The Sonia Shankman Orthogenic School, also known simply as the Orthogenic School or informally as the O’School, is a residential treatment center a day school, and a therapeutic school for children and adolescents typically classified as emotionally challenged. The Orthogenic School specialized in the treatment of youth with behavioral and emotional problems.

The well-known and controversial psychoanalytic theorist Bruno Bettelheim served as director of the Orthogenic School during the mid-20th century (1944 to 1973). During the time he spent there the school became relatively well known for treating children with autism, a field in which Bettelheim studied. He was considered the pioneer of milieu therapy with his work at the school.

     In the 1940’s Mr. and Mrs. Bert Brown found the Brown Schools in San Marcos, TX. Mr. Brown was an accomplished writer at the time and Mrs. Brown was a former school teacher. Their goal was to establish a school for “children who had not developed normally.” In a newspaper article, Mr. Brown later stated that the school started as an experiment with a dozen children and had almost miraculous growth.

     The beginning of Wilderness Therapy. During his undergraduate studies at BYU, Larry Dean Olsen was promised $90 to teach survival skills without modern gear to his fellow students. After an influx of students showed up for his month-long course, the school increased his pay to continue these courses. The university noticed that the students had unexplained improvement in their school performance after the course. This caused the university officials and Olsen teamed to start offering these excursions to failing BYU students. For the failing students, they were offered a chance of readmission if they learned survival skills and went on the month-long backpacking trip through the Utah desert with Olsen. These experimental expeditions are what many believe gave birth to the wilderness program industry. Most directly: One BYU student, Steve Cartisano, dropped out of BYU and used many of Larry Dean Olsen’s ideas to establish several problematic troubled teen wilderness programs – which, in turn, spinoff wilderness programs began to open up.

     In 1967, Mel Wasserman and his wife Brigitta founded CEDU Educational Services, Inc in California. Mel Wasserman had previously sponsored recovering addicts at nearby Synanon and highly regarded Charles E. Dederich. The name, CEDU, was thought to be an acronym for “Charles E. Dederich University.” Several Synanon acolytes worked at CEDU such as Bill Lane who was one of Synanon’s first and youngest members. In fact, Dr. Frank Seixas wrote an endorsement letter of CEDU in 1972 which acknowledged that Mel Wasserman had experience with Synanon and modeled CEDU’s “therapy” after it. When Synanon later fell out of favor in the public eye due to its criminal activities, Mel Wasserman would claim that the name CEDU had nothing to do with Synanon and instead stood for “See yourself as you are and do something about it.

The average time that children would attend CEDU was 2.5 years. The program did not believe in the use of medicine or most traditional therapy. Punishment such as hard labor, isolation, attack group sessions, etc was often used. At least three times a week, students were required to attend “rap”  sessions – which were attack pseudo-psychology sessions led by untrained staff. These were very similar to Synanon’s “Game.” Students also were required to attend multi-day workshops called “Propheets” – similar to Synanon’s “The Trip.”

CEDU would later branch out and open up multiple schools in California and Idaho until their closure in 2005. Multiple CEDU spinoff programs were created by former staff and students and some continue to operate to this day using the same structure and methods as the original CEDU.

     Founded in 1979, Universal Health Services, Inc. (UHS)  provides hospital and healthcare services. It is based in King of Prussia, Pennsylvania. In 2020, its annual revenues were $11.6 billion.

In 1983, UHS purchased Qualicare, Inc. for more than $116 million. The purchase included 11 acute care hospitals and four behavioral health hospitals.

In 2000, UHS purchased Provo Canyon School.

On July 10, 2020, the US Department of Justice announced a $122 million Fraudulent Claims case with “Universal Health Services, Inc., UHS of Delaware, Inc.(together, UHS), and Turning Point Care Center, LLC (Turning Point), a UHS facility located in Moultrie, Georgia, have agreed to pay a combined total of $122 million to resolve alleged violations of the False Claims Act for billing for medically unnecessary inpatient behavioral health services, failing to provide adequate and appropriate services, and paying illegal inducements to federal healthcare beneficiaries.” From the announcement: “The government alleged that, between January 2006, and December 2018, UHS’s facilities admitted federal healthcare beneficiaries who were not eligible for inpatient or residential treatment because their conditions did not require that level of care, while also failing to properly discharge appropriately admitted beneficiaries when they no longer required inpatient care. The government further alleged that UHS’s facilities billed for services not rendered, billed for improper and excessive lengths of stay, failed to provide adequate staffing, training, and/or supervision of staff, and improperly used physical and chemical restraints and seclusion. In addition, UHS’s facilities allegedly failed to develop and/or update individual assessments and treatment plans for patients, failed to provide adequate discharge planning, and failed to provide required individual and group therapy services in accordance with federal and state regulations.

Of the $117 million to be paid by UHS to resolve these claims, the federal government will receive a total of $88,124,761.27, and a total of $28,875,238.73 will be returned to individual states, which jointly fund state Medicaid programs.”

In November 2010, UHS reached an agreement in May to acquire Psychiatric Solutions, Inc. for $3,1 billion.

In September 2012, UHS and its subsidiaries, Keystone Education and Youth Services LLC and Keystone Marion LLC d/b/a Keystone Marion Youth Center agreed to pay over $6.9 million to resolve allegations that they submitted false and fraudulent claims to Medicaid. Between October 2004 and March 2010, the entities allegedly provided substandard psychiatric counseling and treatment to adolescents in violation of the Medicaid requirements. The United States alleged that UHS falsely represented Keystone Marion Youth Center as a residential treatment facility providing inpatient psychiatric services to Medicaid enrolled children, when in fact it was a juvenile detention facility. The United States further alleged that neither a medical director nor licensed psychiatrist provided the required direction for psychiatric services or for the development of initial or continuing treatment plans. The settlement further resolved allegations that the entities filed false records or statements to Medicaid when they filed treatment plans that falsely represented the level of services that would be provided to the patients.

On December 7, 2016, Buzzfeed published a report detailing questionable practices within UHS psychiatric facilities. The report includes allegations of holding nonthreatening patients against their will, manipulative misinterpretation of patient testimonies to fit guidelines to involuntary confinement, aggressive staff layoffs and understaffing in hospitals, needless patient deaths due to understaffing and misprescription of medication, “violating a patient’s right to be discharged or holding a patient without the proper documentation”, and unnecessary extension of stay times to the maximum Medicare payout. UHS denied the conclusions of the report. UHS stock fell approximately 12% after publication.

According to Buzzfeed investigative reporter Rosalind Adams, UHS responded to the report by hiring “a global PR firm that offers specialized crisis management services… UHS didn’t just implement a crisis PR plan. It also fired an employee that the company believed to have spoken to a reporter; it sued a former employee it alleges leaked damaging internal surveillance videos; it threatened to sue other employees; at least one facility held a series of town hall meetings to warn employees from speaking with us; it conducted “in-depth interviews” with nearly two dozen staff, then distributed a public apology that two of them signed; it enlisted one of the most powerful law firms in the United States; it built multiple, high-production-value websites specifically designed to overcome the reputational damage that our reporting might cause.”

A UK subsidiary, Cygnet Health Care, was the subject of a BBC investigation that found that staff had been taunting, provoking, and scaring vulnerable people. It runs 140 mental health services across the UK. 85% of its services are “rated good or outstanding by our regulators”. New admissions were banned at Cygnet Acer clinic after the Care Quality Commission found it unsafe to use. A patient hanged herself, others self-harmed, ligature points were found where patients could hang themselves and too many of the staff were untrained to deal with the highly vulnerable patients at the clinic.

The company bought four inpatient units which were previously operated by the Danshell Group in 2018. All four were condemned by the Care Quality Commission which raised concerns about patients’ “unexplained injuries” and high levels of restraint in 2019.

     Ralph Tyler, who first brought Bettelheim to the University of Chicago, stated in 1990 that he assumed Bettelheim had two PhDs, one in art history and the other in psychology, and in some of his writings Bettelheim himself implied that he wrote a dissertation on the philosophy of education. A 1995 article in the UK’s The Independent stated that Bettelheim “despite claims to the contrary, possessed no psychology qualifications of any sort.” A 1997 article in the Chicago Tribune stated, “But when the directorship of the Orthogenic School became available, he evidently gambled that because of the war no one would be able to check on his credentials. . . when his transcript was posthumously examined, it showed that he had taken but three introductory courses in the field.”

Later directors and some counselors at the Orthogenic School see Bettelheim merely as using corporal punishment even though he stated that such was counterproductive, while many but not all residential students report seeing rage and out-of-control violence on Bettelheim’s part. Richard Pollak’s 1997 biography of Bettelheim states that two separate women reported that Bettelheim fondled their breasts and those of other female students at the school while he was ostensibly apologized to each for beating them.

A 1990 Chicago Tribune article reported: “Of the 19 alumni of the Orthogenic School interviewed for this story, some are still bitterly angry at Bettelheim, 20 or 30 years after leaving the institution. Others say their stays did them good, and they express gratitude for having had the opportunity to be at the school. All agree that Bettelheim frequently struck his young and vulnerable patients. What is equally significant is that none of Bettelheim’s successors at the Orthogenic School now contradicts these reports.”

This same article reported abusive treatment, such as:

-That Bettelheim pulled an adolescent girl out of a shower and hit and berated her in front of dormitory mates.

-That he summoned another teenage girl from a toilet stall for a thrashing,

-That he did not allow a male student to take asthma medication, on the theory that asthma was psychologically caused.

-Ronald Angres wrote in a Commentary magazine essay, “I lived for years in terror of his beatings, in terror of his footsteps in the dorms-in abject, animal terror.

     Provo Canyon School was founded in 1971 by Dr. Robert Crist and Jack Williams. Initially, it was a boys-only school with a campus located in Provo, Ut. Later, they expanded to open a girls’ program in nearby Orem, UT (which later moved to Springville, UT in the mid-2000s). Provo Canyon School has been marketed as a residential treatment center for children between the ages of 8-18. Throughout the years, Provo Canyon School has changed hands several times. Charter Medical Corporation bought Provo Canyon School in 1986. After filing bankruptcy, Charter would eventually sell the school to Universal Health Systems (UHS) in 2000. Under UHS, Provo Canyon School would spend many years as a member of the National Association of Therapeutic Schools and Programs (NATSAP) before they canceled their own membership.

Unlike many other troubled teen programs, the use of medication was encouraged. One of the founders, Dr. Crist,  was a psychiatrist and was directly responsible for the medicating of children at the school. Many survivors of Provo Canyon School have alleged that they were inappropriately and often over-medicated during their time at the school. The use of injectable medication for the purpose of sedating or calming children has also been confirmed. In 2019, a public records request revealed that a 14-year-old foster care child was injected 17 times – including with Haldol – and restrained over 30 times in just a 3 month period

Allegations of abuse have plagued Provo Canyon School since its inception and continue to the current day. In its early years, children were punished with methods such as the “hair dance” where children were pulled around a room by their hair, solitary confinement, forced to stand facing a wall for hours, etc. After a lawsuit in the 1980s, they were forced to change their methods slightly. They were no longer allowed to do the “hair dance” and were told that solitary confinement should no longer be used as punishment. Many survivors of Provo Canyon School – including most notably Paris Hilton – would later publicly state that the use of solitary confinement as punishment has continued throughout the years. Dozens of survivors have come forward from throughout Provo Canyon School’s operation to make allegations of physical, emotional, and sexual abuse. In fact, police, DHS,  and court records detail alarming allegations of rape, physical abuse, and harsh punishment that appear to corroborate the survivor stories.

Many spin-off programs came out of Provo Canyon School since its inception including but not limited to:

• World Wide Association of Specialty Programs (WWASP)

• Discovery Academy

• Logan River Academy

• Silverado Academy

     Fast forward to 1999, the NATSAP is created. The National Association of Therapeutic Schools and Programs (NATSAP) is a United States trade organization of therapeutic schools, residential treatment programs, wilderness programs, outdoor therapeutic programs, young adult programs, and home-based residential programs for adolescents and young adults with emotional and behavioral difficulties. It was formed in January 1999 by the founders of six programs within the so-called “troubled teen industry,” and its board of directors consists of program owners and educational consultants. Ironically, all but one of those founding six programs have been shut down in the ensuing years for a variety of reasons, including child abuse, neglect, licensing violations, and successful class-action lawsuits. NATSAP is not an accrediting or licensing body. In order to be members, schools and programs are required to be in full compliance with NATSAP’s published Ethical Principles and Principles of Good Practice. However, in United States House Committee on Education and Labor hearings in October 2007, NATSAP Director Jan Moss stated that the organization had no process for checking up on this compliance, nor correcting any programs that stray from these guidelines.

     HEAL (Human Earth Animal Liberation Mission) first appeared at UW in 2002 as a registered student organization and later became COPE Ministries – a registered nonprofit church in the state of Washington. HEAL is headed by the Reverend Angela Smith who is a survivor of the infamous Provo Canyon School.  The HEAL Mission is an effort in victim and consumer advocacy and has been since 2002. Over the course of two decades, Rev Angela Smith has built a large program database, assisted program survivors in reporting crimes, and brought awareness to the abuses of the troubled teen industry.

     Sequel Youth and Family Services is a private for-profit firm based in Huntsville, Alabama that runs a nationwide system of residential treatment, private pay residential, therapeutic group homes, community-based programs, and alternative education services in the United States. Sequel operates programs out of over a dozen states catering to troubled teens, foster children, and children with a variety of mental health issues. There have been a large number of reports of abuse and official actions taken against Sequel facilities.

In September 2009, Sequel Youth and Family Services acquired Three Springs Inc. (TSI), an operator of youth behavioral health facilities based in Huntsville, Alabama.

In mid-2019, the firm closed Mount Pleasant Academy and Red Rock Canyon School both in St. George, Utah after press reports of sexual abuse and a riot at the Red Rock Canyon facility. Ten members of staff at the Red Rock Canyon School had been charged with child abuse.

In 2019, the state of Oregon brought home all foster children it sent to out-of-state Sequel facilities.

In April 2020, a child, Cornelius Fredericks, was killed by staff at the now-closed Lakeside Academy in Kalamazoo. As a result of the death, the company lost its license to operate in the state and the facility was closed.

In February 2021, the company announced it would close the Clarinda Academy in Iowa. The school, which operated under a contract with the Iowa Department of Human Services, faced charges of rape of children, beatings, and indefinite use of solitary confinement.

In March 2021, a staff member at the Falcon Ridge Academy in Virgin, Utah was arrested on charges of sexual battery. This school is designed to help girls suffering from the results of sexual trauma.

In July 2021, the state of California brought home all foster children it sent to out-of-state Sequel facilities.

     The Community Alliance For the Ethical Treatment of Youth (CAFETY) was an advocacy group for people enrolled in residential treatment programs for at-risk teenagers. The group’s mission includes advocating for access to advocates, due process, alternatives to aversive behavioral interventions, and alternatives to restraints and seclusion for young people in treatment programs. CAFETY was founded in 2006 by Charles King and Kathryn Whitehead, with the goal: “to create a forum for youth advocacy and support designed to develop and shape youth-guided policies and practices with a specific emphasis on the ethical treatment of youth with behavioral, emotional, and mental health problems in institutional settings”. By July of that year, CAFETY had 118 members and 8 core group members from across the United States, including at least one medical professional.

From late 2007 through 2008, a broad coalition of grassroots efforts, prominent medical and psychological organizations that included members of CAFETY, provided testimony and support that led to the creation of the Stop Child Abuse in Residential Programs for Teens Act of 2008 by the United States Congress Committee on Education and Labor.

In support of this effort, Jon Martin-Crawford, a member of the group’s Board of Directors and Kathryn Whitehead, the group’s Executive Director, appeared at a hearing before the United States Congress Committee on Education and Labor on April 24, 2008, where they described abusive practices they had experienced at the Family Foundation School and Mission Mountain School, both therapeutic boarding schools.

On February 19, 2009, CAFETY co-sponsored a press briefing on Capitol Hill in an effort to raise awareness of youth maltreatment in residential care.

CAFETY and its members also held a teens’ rights rally held in Gainesville, Florida. At the rally, Chris Noroski, vice president of CAFETY, stated that while he was at The Family Foundation School in Hancock, New York, he was mentally and physically abused, stating “For seven months of the time, I carried buckets of rocks back and forth”.

CAFETY, along with the American Psychological Association, Bazelon Center for Mental Health Law, American Academy of Child and Adolescent Therapy, and the American Bar Association was a major supporter of the bill H.R 911, “Stop Child Abuse in Residential Programs for Teens Act”, which was introduced in the U.S. Congress in 2009 and passed in the House of Representatives, but was not acted upon in the Senate and did not become law.

CAFETY dissolved in 2014.

     In 2021 Paris Hilton and Breaking Code Silence Senior Government Coordinator, Caroline Cole, testify at a state Senate committee hearing at the Utah Capitol in favor of the bill that would require more government oversight of youth residential treatment centers and require them to document when they use restraints. The measure passed unanimously following emotional testimony from Hilton and several other survivors.

     After this Senate bills begin to be passed in various states regarding residential treatment centers for youth.

     Caroline Cole, the former Legislative Director of Breaking Code Silence, and Paris Hilton travel to Washington DC to unveil the Accountability for Congregate Care Act (ACCA). The Accountability for Congregate Care Act will lay the groundwork for what Hilton and Cole refer to as a “bill of rights” for young people in congregate care facilities that will ensure they are safe from institutional abuse, neglect, and coercion.

     Sens. Patty Murray, D-Wash., and Ron Wyden, D-Ore., sent letters Thursday to the heads of four of the largest companies and organizations operating residential treatment facilities across the country — Vivant Behavioral Healthcare, Universal Health Services, Acadia Healthcare and Devereux Advanced Behavioral Health — requesting information about each location and program they operate.

The senators asked for documentation on policies for restraining children or placing them in seclusion, the training provided to employees and the number of maltreatment and abuse incidents over the past five years. They also asked for details on contracts, funding sources, complaints and inspections, how the companies spend their money, and how the companies ensure that children in their programs get a proper education.

     With so much opportunity to teach our youth about themselves, their emotions, and the world so that they can address their issues and gain the skills to become amazing people. We must stop, take a step back, and look at the history and current events that keep these programs from succeeding and address them. We must uplift the positive teachings and attributes of these programs so that we can make a change and create a better environment for our vulnerable youth.