Show Posts

This section allows you to view all posts made by this member. Note that you can only see posts made in areas you currently have access to.


Topics - ZenAgent

Pages: 1 [2] 3 4 ... 7
16
The Troubled Teen Industry / AAPP Annual Conference 2009
« on: February 23, 2009, 02:58:45 PM »
http://alien.dowling.edu/~cperring/aapp-capconf.html

ASSOCIATION FOR THE ADVANCEMENT OF PHILOSOPHY & PSYCHIATRY

 

CALL FOR ABSTRACTS

21ST ANNUAL MEETING

May 16 & 17, 2009

San Francisco, California

 

THEME: Philosophical Issues in Child and Adolescent Psychiatry

 

Conference Co-Chairs:

Christian Perring, Ph.D., Dowling College, NY

Lloyd Wells, M.D., Ph.D., Mayo Clinic, MN

 


Child and adolescent psychiatry has had relatively little philosophical attention, yet it is rich with theoretical, conceptual, ethical, and social issues.  Children and adolescents are still undergoing significant psychological development and they occupy very different social roles from adults, so their experience of emotional and cognitive problems is very different from that of adults.  A central issue is whether we should conceive of childhood mental disorder in the same way as adult mental disorder, and how we should acknowledge the differences between children and adults in our classification schemes.  It is generally acknowledged that family dynamics can play a major role in the development of a child's emotional problems, and many in the field have argued that the family should be the central unit of treatment.  Yet the trend in psychiatry is to move towards a more individualistic or atomistic understanding of mental disorder, and this places child and adolescent psychiatry potentially in tension with the rest of the field.  Philosophical discussion has the potential to illuminate and even resolve some of the theoretical disputes.  Furthermore, ethical issues have been especially prominent in the treatment of children and adolescents, from the disputes about the potential over-diagnosis and resulting needless treatment of childhood ADHD and depression, to alarming claims that some antidepressants can cause suicidal behavior in young people.  In medical ethics, there has been growing awareness of the need to recognize the rights of children, and the importance of sometimes letting them participate in treatment decisions.  The task of determining criteria for the competence of young people is especially challenging when they have mental disorders.  This AAPP conference will provide the opportunity for psychiatrists, psychologists and philosophers to address these and related issues.

 

Possible topics for presentations:

 

•          Should child and adolescent psychiatry have a different diagnostic scheme for mental disorders from adult psychiatry?

•          The role of the medical model and competing approaches in categorizing mental disorders of youth

•          The conceptual relation between family problems and child psychopathology

•          The medicalization of normal problems of childhood and adolescence

•          Epistemic and conceptual problems in diagnosing mental disorders of infants and very young children

•          The conceptual legitimacy of the diagnostic categories of conduct disorder and oppositional defiant disorder

•          Psychiatry's reaction to the relation between eating disorders and increasing social pressures on young people to conform to impossible standards of beauty

•          The ethical responsibilities of psychiatrists in prescribing medications to young people when there have been reports of potential increasing risk of suicide

•          Ethical issues in genetic testing of children for mental disorders

•          Children's capacity to consent to psychiatric treatment or research

 

Presentations will be strictly limited to 20 minutes, followed by 10 minutes for discussion.  

 

Abstracts will be blind reviewed, so the author's identifying information should be attached separately.

 

Abstracts should be 500-600 words in length and should be sent via email by November 15, 2008 to Christian Perring at [email protected]. Notices of acceptance or rejection will be distributed on January 1, 2009

17
Peninsula Village / An Attempt to Hide Pegler's Misrepresentation?
« on: December 08, 2008, 03:29:20 PM »
PV's addy has changed to:  http://www.peninsulavillage.org/pv-home.cfm

If you run that on the Wayback Machine, you'll find PV's history starting Sept. 25, 2006.  Run www.peninsulavillage.org and the archive goes back to 1999.  What's the difference between the Sept. 25, 2006 cache and the previous cache on Aug. 20, 2006?  

Pegler's credentials.

Sept. 25, 2006:

Bob Pegler, CAS
Community Relations and Recovery Services Manager

Education:
# Certified Addiction Specialist
# Certified ROPES Facilitator


Other:
As Community Relations and Recovery Services Manager, Bob is responsible for the management of the Peninsula Village Chemical Dependency Recovery Program, Family Support Groups, Activity Therapy, and all Alumni and Community Relations projects. Bob also oversees the Admissions Department. Bob facilitates weekly recovery groups and chemical dependency education groups with the outdoor cabin groups as well as the Admission and Assessment Units. Bob is one of the founding staff members at the Village and is a member of the Village Leadership Team.



August 20, 2006:

BOB PEGLER, CAS
Program Manager, Residential Services

Education:
# Certified Addiction Specialist
# Certified ROPES Facilitator

Professional Affiliations/Licensure:
# American Psychological Association & Appalachian Psychoanalytic Association
# Licensed Psychologist/Health Service Provider, Tennessee


Other:
As Program Manager, Bob is responsible for The Boys and Girls Cabin Program, as well as Activity Therapy Services. He has a background working with adolescents in treatment settings for over 20 years. He was one of the founding staff at Peninsula Village in 1986. He has a background as an Activity Therapist, and has specialized in Addiction Therapy since 1984, when he helped in creating the Youth Chemical Dependency Unit at Peninsula Hospital. He lives with his family in Knoxville, and has two adolescents of his own.

On Staff at Peninsula Village Since: 2004




The vanishing degree again.  He was listed on PV's website as a licensed psychologist and health service provider for two years.  He is not and never has been licensed in the state of TN for anything, not even addiction treatment.   Pegler does not have a degree in Psychology.  PV is trying to sweep their fraudulent past under the rug.

18
Peninsula Village / One More Gone
« on: December 08, 2008, 03:08:16 PM »
Kim West, longtime PV Intake Services Coordinator, is no longer employed by the program.

19
Peninsula Village / Your Taxes Pay for Peninsula Village
« on: November 29, 2008, 10:36:01 PM »
I'll ask Act.da to host this document, but for now here's the teaser.  This is a lawsuit brought by a teen placed in PV by the DCS asking reimbursement of his social security funds used to pay PV.  It gets much, much worse.  Act.da, this is a smoking gun we've been looking for!  I'll give you a call, there are other cases we can review.  I have no idea how these documents suddenly appeared and I refuse to say anymore.  Never question serendipity.  No wonder TN DCS refused to cooperate with an investigation...      

BEFORE THE TENNESSEE STATE DEPARTMENT OF EDUCATION

IN THE MATTER OF:

R.G.

VS.

TENNESSEE DEPARTMENT OF CHILDREN'S SERVICES                      

CASE NO. 02-41


FINDINGS OF FACTS:  CONCLUSIONS OF LAW AND FINAL ORDER


Excerpt, emphasis added)


The breakdown of cost associated with the student's stay at Peninsula Village indicates that Social Security benefits were not used to pay for educational and related services,  The total cost of services provided to the student by Peninsula Village was $89,096.50 (see Exhibit 54).  Of this amount, $42,785.25 was paid by TennCare for medical or treatment services. (Id.)  The remaining $46,311.25 was paid by taxpayers of the State of Tennessee, with $6,411.20 reimbursed from the student's Social Security benfits which were supplied by the taxpayers of the United States of America.

In the final analysis, the student was in DCS custody because of the student's delinquent behaviors.  Absent those behaviors, DCS would not have been forced to place the student in Peninsula Village.

...Upon reviewing the relevant Social Security Administration Regulations it does not appear that the purpose of the Social Security benefits was to create a savings account for juvenile delinquents but was intended to pay living expenses.

DCS is the prevailing party.  

It is so ordered.




JAMES STEPHEN KING
ADMINISTRATIVE LAW JUDGE

DATED:  April 21, 2003



If anyone else wants to look into this, one of the contracts between TN DCS and PV  is Contract No. H2026

20
Peninsula Village / PV Protest in Raleigh NC 11/22/08
« on: November 22, 2008, 08:44:06 AM »
At 8:45 a.m. Act.da and will take our positions to protest PV's abuses at a gathering of PV programees and toadies.  We'll try to post a couple of times today as the protest goes on.  We have A/V gear to document any psychodramas or high comedy.

21
Peninsula Village / Request For a $100,000 Miracle.
« on: October 20, 2008, 02:14:55 AM »
http://onehundredthousandonedollarbills ... oseph.html

Don't send a buck, send info and links to survivor stories to this poor soul.  PV profits off parents like this, but when the money isn't coming in, this boy will be outside the admissions building with a garbage bag full of his possessions.

This mom based her decision to go with PV on their website:
Quote from: "MiracleforJoseph"
...I wept with a feeling that "this was the place". This is the place where my son can get help. Please take place in a miracle for Joseph.


"God will provide" is an unacceptable IOU at PV. Was this mom's "feeling that 'this was the place'" based on it's price?  "The more expensive the program, the more successful"?

Does PV, which describes itself as "specializing in treating adolescents who have not been successful in other treatment settings", a last ditch effort, sound like a good fit for this kid?

    "He was suspended for various offenses till finally he was expelled from school after only a month."[/list]

      "He is drinking alcohol and using drugs. He has taken to hang out with friends that use drugs and alcohol that basically have no ambition in life but to party."[/list]

        "His behavior has escalated to the point where he: lies, curses, disrespects authority, is extremely oppositional, very defiant and contentious.  He is depressed. He has anxiety. He is very compulsive. He thinks he deserves everything with little or no effort on his part. He can't seem to find happiness or experience joy ; even when it is all around him. He is very often irritated and lashes out at me. He doesn't know why."[/list]

        He's a teenager.  This mom probably didn't describe her son as "extremely oppositional, very defiant" until a PV clinician explained ODD to her.

        Nowhere does this mom mention trying other forms of treatment.  She went with a"gut feeling" the PV website gave her.  PV does give gut reactions: 1999's E.Coli outbreak, or last year's mystery GI viral outbreak (rumored to be Norovirus) which caused Blount County to quarantine Peninsula Village.

        Desperate parents placing a child in a program that promises miracles.  How is this mother going to handle it if PV only makes him bitter and fails to deliver a different kid?  She's literally begging on line to fund PV, which has no reliable studies proving success and an apparently high relapse rate post discharge.


        http://onehundredthousandonedollarbills ... oseph.html

        A Miracle for Joseph

        Friday, August 22, 2008
        A Miracle For Joseph
        I am putting out a Call--For A Miracle.
        I ask you to be part of it.
        It is simple and real.
        I ask you to contribute $1.00 to the
        Miracle for Joseph--

        FOR RIGHT NOW, I have been told by the Staff of the Peninsula Village that they cannot guarantee that mail for Joe will be secured because mail goes out into too many hands. I will be setting up a fund so please wait till I have a chance to to set it up. Thank You. Joe's Mom Myra Marvez


        I know that there is much need in the world. I know that most of you give of your time, talents and money to causes that appeal to you. I too, give of my time, talents and money in the sphere of my influence. Yet, something really huge has crossed my path that I know that without the help of 100,000 family, friends and strangers help, I won't be able to achieve. I know that there are over ONE BILLION people who use the internet on a regular basis. Knowing this makes me feel confident that an appeal to 100,000 people will be realized. I want everyone to know that this is going directly to the Peninsula Village. It is for real. I thank you.

        This is my story.

        My son Joseph is in a place called the Peninsula Village. It is a non profit, 12 to 15 month residential treatment center for teens. It is located in Louisville, Tennessee. Our family was forced to make the difficult decision to send him away to get the help that he needs. We are very fortunate that his Father has good Federal BC/BS health insurance that is covering the initial stay at the treatment center. This is due to the fact that the doctors are paid from a nearby hospital. The teens start the program in a place called THE UNIT. The UNIT is very clinical and difficult for the teen because they are basically locked down for the first 4 to 6 weeks (or more) in a environment that forces them to reflect on the reasons for which they are there. After earning and progressing to the next stage they go into a cabin program where they learn to live without electricity, indoor plumbing, or running water. Joseph is still in the UNIT. Our Fear is that the Insurance Company will stop paying as soon as they feel that his treatment is no longer necessary. They will decide that using any rational they can. If Joseph had a deadly disease --that particular insurance would cover it till there was either a cure or a death. The way I see it, Joseph does have a deadly disease.

        Despite our greatest efforts as parents-- Joseph has chosen to take a walk on the wild side. He has gone in a direction that has influenced him to make really bad decisions. He was suspended for various offenses till finally he was expelled from school after only a month. (Nov 2007) He is drinking alcohol and using drugs. He has taken to hang out with friends that use drugs and alcohol that basically have no ambition in life but to party. He has an anger deep inside of him that causes him to see life as a dark place with no hope. Since there is no hope--there is no reason to do good. His behavior has escalated to the point where he: lies, curses, disrespects authority, is extremely oppositional, very defiant and contentious. He is depressed. He has anxiety. He is very compulsive. He thinks he deserves everything with little or no effort on his part. He can't seem to find happiness or experience joy ; even when it is all around him. He is very often irritated and lashes out at me. He doesn't know why. Gratefully , There were those occasions that I could see the good kid that was hidden inside of all the bad behavior.

        Perhaps I spoiled him by giving him too much. Perhaps I didn't do enough for him. Perhaps I failed him in some way. Perhaps I should have done or not done this or that for him so that now he would be ok. I have beat myself up wanting, wishing and hoping that he would change. I have come to see that a prophet is without honor in his own home. I cannot help him. I cannot do for him what Peninsula Village can do for him. I looked at many residential treatment centers looking for help months prior to sending him to PV. When I saw their website--I wept with a feeling that "this was the place". This is the place where my son can get help. Please take place in a miracle for Joseph. I only ask for ONE DOLLAR and the price of a stamp and envelope. Forgive me, I do ask one more thing, Please forward the email you received to all of your friends and family and ask them to send it to their friends and family.

        ANY CONTRIBUTION IS TAX DEDUCTIBLE

        I am asking you to help me save my son. Help me to be able to pay the Peninsula Village when the insurance is terminated. That can be at any time. Please look at my Joe's pictures. Please care enough to participate in this Miracle For Joseph. Please send ONE DOLLAR to the address above in Joseph Lance Zamora's name. He does have a kind heart and a good heritage to fall back on. I know that if he is able to stay the entire year, he will make the changes that will enable him to be a good member of society.

        I will keep posting the amounts received and letters from Joe. If more money is sent than needed for Joseph; of course it will be available for other teens needing financial help.
        THANK YOU SO VERY MUCH FOR YOUR HELP
        JOE's Mom.... Myra
        661 246-6503

        August 27th, 2008
        I wrote an email to my friends and family. It was basically asking them to contribute $1.00 to the Miracle FOR Joseph Fund. I also asked them to forward it to their friends and family. It wasn't till I actually got a few responses that I said, yikes... I didn't tell them the donations might come in ONE DOLLAR AT A TIME. I had asked the women who does admissions if they would accept donations on behalf of Joseph before we actually sent him there. She said it had never been done before but that they would work with us. Well, It wasn't till later that I had the inspiration in the middle of the night to ask 100,000 people to send one dollar. I never ran that by her and just sent the email. SO, now tomorrow I will call and tell her. I guess if they want it sent to a different place; they'll tell me.
        Joseph spoke to his Father on Tuesday. He was very upset. According to his Dad, he was really venting out. He started to mention something about Melissa (his Dad's girlfriend during our divorce) but quickly clammed up saying he didn't want to talk about it. I hope that he opens up. There is so much that happened during that time frame 8 years ago when he was only 7. I know he harbors many things from that time still unable to let go. He's never been one to express his feelings even when he was that young.
        I had a marvelous person write to me offering to send my email to a 1000 people from his church. I was so grateful and began to feel so good about asking for $1.00. Anyone can give a Dollar. I ask no more; truly. I believe that there are at least 100,000 kind people out there that would give a dollar and that that dollar would not be a hardship for them. I also received an email from a man that was ...... unkind....I'll just say to put it simply. He would not participate in Joseph's Miracle. I told him he should have just deleted my email. I'm only going to focus on the positive. At times, panic does fill me thinking that the insurance will deny the claim before Joseph has truly had time to participate in all levels of the program. He's still in the UNIT. I imagine it must not be fun. Nothing to do but think. He is in school. The teacher goes to the UNIT...there is no escaping the UNIT. He has to earn his way out. It's been a month; lets see how long it takes him to get it. That's always been his shortcoming...he seems not to get it till you put the squeeze on him and even then-- he reverts when you let go. I love you JOE... your Mom, Myra
        Posted by Joseph by Mom at 1:49 PM
        Labels: Joe, Miracle, ONE DOLLAR, Peninsula Village
        0 comments:

        22
        Peninsula Village / PV Counselor does a dance!
        « on: October 02, 2008, 02:54:06 PM »
        PV counselor Lauren Messer shakes her booty.  ::OMG::

        http://www.youtube.com/watch?v=rSe4Ot35_VQ

         :jerry:  :jerry:

        23
        Peninsula Village / Peninsula wants your comments
        « on: August 31, 2008, 12:29:54 AM »
        http://www.peninsulabehavioralhealth.org/pbh-cares.cfm

        Would you like to share a positive comment about your experience as a patient, or as a family member of a Peninsula patient? Or, perhaps you’d like to recognize one of the caregivers at Peninsula who has been especially kind or helpful to you. We’d like to hear from you today, and we’ll be glad to pass along your feedback.

        Our goal at Peninsula is to exceed your expectations in providing excellent patient care. As we continue to identify ways to enhance your experience, help us recognize and reinforce those individuals that helped achieve this goal.


        They only want positive comments?   Well..."I'm positive Peninsula Village engages in deceptive marketing regarding the nature of their program, and has no reliable studies to back up their claim of 'a record of success in helping treatment resistant adolescents achieve lasting change'.  I'm positive PV admits kids who are in no way treatment resistant or even require residential treatment - PV admits anyone who can pay the tuition, to quote Clark Poole, and throws one and all into the same milieu,"  


        What Peninsula's all about:

        http://www.peninsulabehavioralhealth.org/pbh.cfm

        Peninsula
        Values Statement

           
        Working together in service to God, our values are:

            * Integrity
            * Quality
            * Serving the Customer
            * Caring for and Developing our People
            * Using the Community's Resources Wisely

        24
        Peninsula Village / Peninsula/Covenant Income Tax Filings
        « on: August 30, 2008, 04:41:17 PM »
        Being non-profit means total disclosure.  

        PV:
        http://www.fornits.com/pv/Peninsula%20T ... 202005.pdf

        Covenant:
        http://www.fornits.com/pv/Covenant%20Ta ... 202005.pdf

        And their full-time, in-house lobbyist.  More to follow on this guy...

        http://www.fornits.com/pv/Covenant%20-% ... Report.pdf

        25
        Peninsula Village / Getting Records From PV - URGENT
        « on: August 23, 2008, 09:25:56 PM »
        I strongly encourage ALL PV survivors to obtain their records from the program.  Call PV at 800-255-8336 and ask for Deborah Montooth in records, and ask for a release form to fill out.  When you get it, check every record they offer to provide, and add "all treatment notes/restraint log entries" to the "additional records" line.

        There is a statute of limitations - however, if your records have never been reviewed to see if PV deviated from the standards of practice of adolescent psychology, it changes things.  I'm not a lawyer, but if you're suffering PTSD after Peninsula's "treatment", that treatment needs to be reviewed by a forensic psychiatrist.  It's possible the psychiatrist will determine PV deviated from the standards of practice and did harm through negligent or abusive treatment.

        No promises, but if a psychiatrist says "yes, PV's treatment was detrimental" the date he makes this decision is when the statute is tolled - a new statute of limitations starts, if you consider the psychiatrist's finding of fault with PV as "date of discovery"  Ask for an extraordinary appeal - it's wrong to give a program survivor 1-2 years to file against an abusive program.  How long does it take to decompress after the experience?  Plus, survivors are young when they leave - re-integrating takes time, resuming education is an issue - when does a survivor have the time or desire to address what he/she went through and enter a legal fight?  Some survivors have told me it takes two or three years to quit denying what happened to them in a program, the strong emotions flood in when the frozen memories thaw.  Conveniently for the industry, the malpractice laws in most states are geared toward simple medical malpractice, not mental health.  It's time to set some precedents, folks, we need to start making extraordinary appeals using date of discovery and consideration for the young ages of survivors upon release from programs.

        The records from PV are expensive - it's an attempt to discourage you from getting them.  If the money is an issue, contact me and I'll try to help.  It is VERY important to get your records, and if you haven't been out of PV for a long time, don't read them when they arrive - I'm serious, the level of over-documentation and possibly damaging revelations in the records could do you harm.  If you do have to read them, please do it slowly and carefully and back off if you start getting depressed.  It's like going back to PV, your daily actions while there are detailed by four different groups - treatment team leaders (psychologist and his sidekick), the staff psychiatrist, the family therapist, and almost hourly notes by the counselors on your unit.  You've already been in PV, you don't want to go back to the place, even in your mind.

        26
        The Troubled Teen Industry / Parental Choice Over Legitimate Need
        « on: July 27, 2008, 11:31:51 PM »
        Quote from: "Lon Woodbury"
        What About the Parents?

        In this worst-case scenario, parents would lose the options now provided from the parent-choice network, and in reality, would have almost no options in the matter of residential placement when needed for their own child. In this scenario, responsibility would be taken from parents and turned back to "professionals".



        Lon describes this as a "worst-case scenario"?  Taking responsibility out of the hands of parents who want to "warehouse" their kids and Ed Cons motivated by profit like Sue Scheff (and Lon) sounds like a good start.  I guess the parents could still hire an industry-stooge "independent professional" to accommodate their wishes.

        I'm familiar with one parent who angrily told an evaluation team at a hospital he didn't care if their diagnosis didn't show the need for residential treatment, he wanted an RTC and he was going to place his kid in one regardless of professional opinion because his family had the money to make it happen.

        And he got his wish, despite a diagnosis stating there was no need for an RTC.  Within 1200 miles and two hours by air, his kid had gone from not requiring residential treatment following a twenty day evaluation to absolutely requiring it upon arrival at an RTC before any tests had been done.  Within a day, the RTC team had cooked up the usual ODD/Borderline Personality Traits and set up a year's worth of treatment for cash payments.  Easy money, and the RTC never bothered to look at the records from any previous treatment.


        Quote from: "Lon Woodbury"
        What About the Parents?


        In general, the more options parents have to choose from, the better choices they are likely to make. This is part of what in this country we call freedom, that is, as some have stated in other issues, "Freedom is choice!"

        What about the kids' right to freedom and choice?  A little due process, an outsider to evaluate the parental choices being made about their lives?  Woodbury believes the ability to pay gains "more options".  There are many stories of parents "using" the industry for their own selfish needs, to protect themselves from criminal charges of abuse, etc., and plenty of Ed Cons profiting from offering options and enabling parents to make "choices" that benefit the parent to the detriment of the child.

        "What about the parents?" is a good question.  Woodbury's answer is illogical, profit motivated, typical industry spin.

        27
        Bratter still loves quoting Bratter.
         
        Confrontation-A potent psychotherapeutic approach with difficult adolescents
        Adolescent Psychiatry,  1/1/2008  by Bratter, Thomas Edward,  Sinsheimer, Lisa

        Abstract
        http://findarticles.com/p/articles/mi_q ... 1322/pg_12

        This chapter describes the use of confrontation at the John Dewey Academy, a college-preparatory therapeutic boarding school. The treatment utilizes caring confrontation and positive peer pressure within a therapeutic community setting. The authors discuss the conceptual basis for the use of confrontation, drawing upon the literature about therapeutic communities. They offer a rationale for the efficacy of this psychotherapeutic approach in a population of bright adolescents who are resistant to traditional treatment. They illustrate the use of confrontation with an extended excerpt from a therapeutic group. Countertransference issues related to the use of confrontation are also discussed.

        Toward a definition of clinical confrontation


        Nunberg (1955) provides a reasonable definition of confrontation when he proposes the psychoanalyst "[call] the patient's attention to his inner conflicts, the sources of which are not known to either of them, and asks him to be helpful in discovering the unknown, the repressed. Thus, from the very beginning, the aims of the analyst are opposed to those of the patient, to the wishes of his repressing ego" (p. 123). Nunberg disagrees with Devereux (1951), who explicitly states that confrontation "yields no insight, and merely focuses the attention of the patient on something which he perceived but failed to register-or refuses to acknowledge openly" (p. 69).

        Carkhuff and Berenson's (1967) definition has stood the test of time. They report that confrontation helps the person understand:

        himself, his strengths and resources, as well as his self-destructive behavior....It is a challenge to... become integrated....It is directed at discrepancies... between what the client says and does...and between illusion and reality....It implies a constructive attack upon an unhealthy confederation of miscellaneous illusions, fantasies, and life avoidance techniques in order to create a réintégration at a higher level of health (p. 171).

        Confrontation in self-help therapeutic communities


        During World War II at Henderson Hospital in the Belmont Social Rehabilitation Unit in England, Rapoport (1960), a sociologist, was the first to describe group psychotherapy to be "reality confrontation." Shankman (1978) provides a description of the self-help therapeutic community (TC), as illustrated by Casriel (1963); Bratter (1978); Bratter, Collabolletta, Fossbender, Pennacchia, and Rubel (1985); Glaser (1974); Sugarman (1974, 1986); and Yablonsky (1965), in which recovered persons act as catalysts and responsible role models:

        The TC might best be described as a school which educates people who have never learned how to live or feel worthy without hurting themselves and others. The therapeutic community helps people who have tried again and again to get what they wanted from life and have continually defeated themselves. The principle combines the basic and universal human values of knowledge, love, honesty, and work, with the dynamic instrument of intense group pressure, in order to recognize and help correct personality defects which prevent people from living by these values. The results lie in rehabilitation so that the individual may reenter his or her community as an independent and productive person (p. 156).

        When describing self-help peer psychotherapy, Van Stone and Gilbert (1972) candidly describe the brutality of confrontation in residential therapeutic communities that are run by recovering addicts. Confrontations needed to be harsher in these adult communities than they would be with teenagers, and justifiably so:

        [Confrontation is] a kind of group therapy in which each member is...presented with candid, personal facts regarding every observable behavior or attitude recognized by the group as being self-defeating or dishonest. If the member.. .attempts to explain or deny any observation, he is ridiculed.. .and insulted as his fellow members hammer away at the distorted ideas that he offers in support of his damaging behavior patterns. Intellectual insight or genetic self-interpretations are derided as an escape from responsibility for current behavior. Honesty, trust in the group, realistic self-assessment, appropriate emotional release, and changed behavior, in particular, are rewarded by sympathetic counsel and encouragement from fellow members (p. 585).

        The professional community initially characterized confrontation as cruel. Maslow (1967), the progenitor of humanistic psychology, recognized the effectiveness of confrontation after attending groups at Synanon, the first exaddict-administered therapeutic community. He wrote, "people are ...tough.... They can take a.. .lot... .I've suggested that a name for this might be 'no crap therapy.' It.. .cleanfs] out defenses [and] rationalizations." (p. 28). Ruitenbeek (1970) agrees with Maslow, describing the essence of this technique as an "insistence upon total honesty....No rationalizations...are allowed" (p. 166). The clinical challenge of confrontation is to help the youth commit to accept responsibility by converting noxious emotions into constructive acts via the internalization of positive values. Self-respect and success become positive addictions.

        Confrontation is painful because it penetrates protective barriers. Using a psychoanalytic orientation, Adler (1985) defines confrontation as an attempt to "gain a patient's attention to inner experiences or perceptions of outer reality of which he is conscious or is about to be made conscious" (p. 122). Sifneos (1991) cautions that the therapist who uses confrontation needs to:

        "be convinced that the patient is able to withstand [much] stress... .[Effective] confrontation must be based on the therapist's observation about a series of paradoxical behavioral patterns, contradictory statements....It must motivate him to look at himself from a different point of view" (pp. 374, 382). Cohen (1982), who reconciles confrontation and psychoanalysis, provides a comprehensive synthesis when he contends that "confrontation analysis is a method of investigating, analyzing, and evaluating human behavior in the context of interpersonal interaction. It.. .contains a theoretical framework within which to understand the evolution, maintenance, and modifications of personality dimensions" (p. xv).

        Countertransference issues


        Collabolletta, Gordon, and Kaufman (1998) stress that the therapist's intent determines whether the confrontation is therapeutic or an abuse of power: "When the psychotherapist's intent is to promote change, this kind of confrontation becomes caring and constructive." When the intent is to prevent a student from engaging in destructive, dangerous, and deceitful acts, compassionate confrontation becomes the most potent expression of responsible concern. A skillful confrontation provides prima facie proof of the therapist's care and emotional investment.

        The therapist needs to be mindful of potential countertransferential contamination when using this technique. Only the confronter knows personal motivations; thus, one must understand the psychodynamics before confronting. Unresolved countertransferential issues can provoke cruel confrontations. Giovacchini (1985) notes that adolescents can arouse disruptive countertransference reactions because of the intensity of their neediness and defiance, and warns that countertransference may destroy the treatment relationship, or it may lead to therapeutically beneficial insights. The therapist can feel jealous that these adolescents have emancipated themselves from middle-class restraints. Or, more likely, be disgusted by cruel and feel a need to punish the offender. Consultation with colleagues or a supervisor can minimize the likelihood of acting out a destructive countertransference reaction.

        Sequence and principles of confrontation


        Bratter (2003) asserts that "there are two sequential phases to confrontation: first, the unlearning of dysfunctional attitudes and acts and, second, learning healthy responses. Confrontation can penetrate the permissive and indulgent attitudes of families that [created] the psychopathology of alienation, deceit, irresponsibility, and self-absorbed behaviors" (p. 140).

        Bratter (1977, p. 170) lists seven principles of confrontation psychotherapy:

        1. Attack the malignant and dysfunctional aspects of behavior.

        2. Penetrate the facade of justification of behavior.

        3. Force individuals to accept responsibility for behavior.

        4. Help persons evaluate their behavior.

        5. Assist individuals to be aware and to anticipate the consequences and payoffs of their behavior.

        6. Challenge persons to mobilize their resources.

        7. Define a direction so that persons can continue their growth and development.

        How confrontation facilitates change in adolescents

        Confrontation is a potent psychotherapeutic process designed to help the adolescent not only to recognize (and change) the self-destructive aspects of behavior but also to acquire skills that help actualize potential. In a group setting, peers offer insight and suggestions, thus providing the catalytic conditions necessary for selfexploration and improvement. Confrontation pierces the formidable protective armor of denial, deceit, and distortion. Meeks and Bernet (1990) note "accurate confrontation is much easier in the inpatient setting than it is in the treatment of outpatient adolescents" (p. 578). Johnson (1985) views confrontation as supplying an "observing ego" (p. 255). Brook (1996) believes that confrontation helps adolescent "group members...to confront denial and accept responsibility for their actions" (p. 258).

        Bratter (1972) describes the therapeutic thrust of a confrontation-group orientation:

        Using a confrontation-teaching-interpretative-reasoning approach, the group demonstrates to the [member] the irresponsible and self-defeating aspects of...behavior [and]...begins to understand the consequences of his acts and attempts to become more responsible to himself, others, and society. Emphasis is placed on the eigenweit (the relation to one's self)-i.e., the immediate experience. The individual must acknowledge his perceptions of the conflict, the problem, his irresponsibility, etc....

        The individual, gaining the candid opinions and admonishments of his peers regarding the more destructive elements of his behavior, considers a new orientation and behavior (p. 309).

        Confrontation can:

        • * Expedite a behavioral change-i.e., stop dangerous and dysfunctional behavior.

          * "Force" the adolescent to be accountable for attitudes and acts.

          * Help students understand future consequences and payoffs for current behavior.

          * Mobilize personal talents to actualize potential.


        Confrontation utilizes provocative questions to stimulate self evaluation. Do your attitudes and acts help you to achieve your intermediate and long-term goals? How do others view you? Do you have self-respect? In addition, the therapist must elicit reactions from the confronted and group members about their reactions to the confrontation. Garner (1970) urges the therapist to ask frequently, "What do you think or feel about what I told you?" (p. 231).

        Helping each other while helping the self

        To minimize the impact of negative countertransference reactions, since a significant age differential exists between adolescents and the group leader, peers are encouraged to do most of the confronting. Volkman and Cressey (1963), among the first to recognize the importance of self-help confrontational psychotherapy groups, write:

        The most effective mechanism for exerting group pressure on members will be found in groups so organized that criminals are induced to join with noncriminals for the purpose of changing other criminals. A group in which criminal "A" joins with some non-criminals to change criminal "B" is probably more effective in changing criminal "A" (p. 139).

        Brager (1965) notes increased self esteem in group members when they confront peers to better themselves. Reisman (1965) labels this treatment dynamic as "the helper principle," and notes that the helper often gains more from the helping process than the person being helped. Positive peer pressure traces its antecedents to self-help psychotherapy. Hurvitz (1970) reports that when peers are active,

        they focus on the presenting problem, and assume that by following principles and methods of their movement, they will help each member solve his specific problem....They may ridicule and attack each other with great hostility and they may provoke aggressive and hostile feelings; however, peers regard such attacks and provocations as other's expressions of concern and concern (p. 44).

        Use of confrontation at the John Dewey Academy

        Bratter, Sinsheimer, and Kaufman, in chapter 7 of this volume, have described the population and treatment philosophy at the John Dewey Academy (JDA). As they have said, JDA youth are "immune to traditional therapeutic and teaching techniques. They have erected formidable barriers and defenses which need to be cracked before they will think rationally... .Peers confront each other by demanding that each member accept accountability for immature, irresponsible, illicit, and self-destructive acts" (p. 73).

        Compassionate confrontation: Rebutting the critics

        When entering the John Dewey Academy, most students possess toxic attitudes that reduce others to objects to satisfy voracious narcissistic needs, self-entitlement, and self- aggrandizement. Both traditional therapeutic approaches and the administration of psychotropic medicine have proven ineffective. No chemical imbalance exists. Many Dewey youth have a virulent attitude that renders psychotherapy ineffective which explains why recidivism rates are high.

        Critics contend that confrontation is controversial, counter therapeutic, and cruel punishment which often brutalizes persons-in-treatment. Confrontation attempts to modify irresponsible, impulsive, immature, stupid and self-destructive behavior. Confrontation penetrates denial, distortion, and dysfunctional attitudes. Critics protest, furthermore, that the use of confrontation is prompted by a negative countertransference reaction. Confrontation has been labeled "attack therapy" for pejorative reasons. Opponents of "attack therapy" do not understand is that confrontation has proven effective to eradicate malignant, dangerous, vicious attitudes and acts. While some critics condemn confrontation to be "cruel," they need to remember that Dewey students have engaged in dangerous, often death-defying behavior which demands heroic intervention. Unless the therapist can persuade the youth to avoid a collision course with disaster, there can be profoundly serious consequences. The primary goal of psychotherapy is to preserve life, so desperate and heroic treatment interventions are required for this difficult-to-treat population. When viewed from this humanistic perspective, confrontation connotes caring by the therapist who attempts to convince the adolescent to become more responsible, responsive, and respectful.

        Similar to other medical procedures, there are abuses of confrontation psychotherapy which the authors acknowledge and condemn. The authors, therefore, do not minimize the noxious impact of confrontation when done for the wrong reasons.

        There are similarities between the psychotherapist who confronts, the radiologist who medicates, the surgeon who operates, and the psychiatrist who prescribes psychotropic medication. Stated simply, these procedures are subject to abuse. In addition, each procedure attempts to attack malignancies. If the truth be known, confrontation is more benign than other medical approaches. The surgeon, radiologist, and psychiatrist do more physical and permanent damage under the guise of medical treatment than does the therapist who confronts. Interesting, these professions escape criticism because the end is thought to justify the means. There are more malpractice suits against medical professionals than psychotherapists who confront.

        Confrontation psychotherapy: A Case study


        As an illustration, we present an excerpt of our group process. Prior to attending JDA, Jason had been diagnosed as having schizoaffective disorder and had been prescribed a cocktail of psychotropic medications, including amphetamines, antidepressants, and anxiolytics. Jason's father died when he was twelve, and his mother was in remission from a brain tumor. He witnessed several people jumping to their deaths from the World Trade Center towers during the 9/11 terror attacks. Two years ago, Jason learned he had the same hereditary cardiac condition that caused his father's premature death, and he underwent the implantation of a pacemaker-defibrillator.

        Considering his history, post-traumatic stress disorder might have been a more appropriate diagnosis. Regardless of diagnosis, however, this boy had clear explanations for his choice to suppress his feelings and for his decision not to trust others. He struggled with a continuing sense of abandonment and betrayal, stemming from his father's sudden death. During the 18 months that he was at JDA, he remained closed off from other students and staff. The following is a fragment of a group session in which first the group leader and then the other members of the group confronted Jason on his behavior and their reactions to it. Before convening this group and implementing this confrontation, the group leader discussed the treatment impasse extensively with colleagues. The intent of this confrontation was to precipitate a crisis, forcing Jason to change or to leave.

        Leader: Jason, recently adults have asked if I think you are organically damaged since you refuse to heed repeated warnings not only to change but also to become a contributing member of the community. I admit that for the first time I mentioned that perhaps they are right and I am wrong. Maybe you are damaged goods and are incapable of changing. You might be the first student in our twenty-year history who needs medication to function. I intend to recommend to your mother that you be evaluated by a psychiatrist who specializes in pharmacology.

        Jason: I am not. You know damn well I'm not crazy and don't need that crap.

        Leader: I no longer know what to think. What I do know is that you have been here for eighteen months, but haven't changed much. You still isolate. You still refuse to relate. You still don't trust anyone. You still are stubborn. But to your credit, you finally have started to do well academically. I think you hide in your academics by claiming you need to study six or seven hours a day.

        Jason: Yes, but...

        Leader: Yes period. Your classmates complain that you're a drag and a drain. They don't want to waste their time and energy reaching out to you and having you reject them. Ask them.

        Jason: I've been talking to people. (He lists five students.)

        Mary: Big deal. They are new students. None have been here longer than three months. What about us? We know you much better than they do. They don't know how to confront you. So you continue to play stupid games.

        Laurie: I have no idea who you are. When you feel uncomfortable and threatened, you shut down. When my father died abruptly from a heart attack, just like your father, you never even said you were sorry. This is why I stopped pursuing you.

        Jason: I don't want to talk to you because you don't want to talk to me.

        Leader: That's a very mature response. You're right, but do you know why?

        Jason: No.

        Leader: You lie. You know damn well. Everyone is frustrated and weary. They have extended themselves by sharing experiences and confronting you. What have they gotten from you? Only silence and sarcasm. So they finally said to themselves, 'Fuck him. He's simply not worth it.' You quit. No, that's wrong. You never tried.

        Allie: Tom's right. I quit six months ago. I gave you the benefit of the doubt that, underneath your defenses, you were caring. I don't believe that any more. You talk in a monotone. I cannot remember when I felt you cared. You are the most frightened and self-absorbed person I've ever met. I know why. When I came I was too scared to care. I had a damn good excuse. I had several abusive relationships with guys. I felt sorry for myself and saw myself as the victim. I was confronted that it was my choice. I chose to remain with these abusive jerks when I should have rejected them! It was scary to trust because I feared the worst. Yeah, I got hurt once or twice. I was knocked down. But I got up and tried again. And you know what? Today, I have the best friends I ever had.

        Laurie: I don't blame Allie for not giving a damn. No one trusts you. You are nineteen. You continue to treat your mother like she's the enemy! You abuse your younger sister. None of us care whether you leave or stay. I pity you. You are too scared to be human. You are a poor excuse for a person.

        Eddie: Jason, it's really that easy. You lack the guts to venture forth. You're a coward. I'd lie if I said I care because I don't. Blame yourself. But what frightens me is that I know if you don't do it at JDA, you never will. You will never be in an environment which is so caring and safe.

        Paul: Eddie's understating your problem. Several of us believe you have major guilt, but lack the integrity to take accountability. Fuck your fears. Take accountability. Things can't get much worse.

        Shirley: Do you know what I think the problem is?

        Leader: No. Tell us.

        Shirley: Jason does not believe you will expel him. You've threatened so many times to expel him that he thinks he's immune.

        Eddie: Shirley's right. Jason knows you like bright students, so he's gambling since he has not done anything expellable, you'll let him graduate.

        Leader: Jason, if this is what you think, your reality testing is flawed. Complete the next two weeks and then go home for the holidays. Think about what you will want to do with your life. And then write a ten-page essay why I should readmit you. Include in this document your guilt and what you will change.

        Allie: Why wait? He thinks you are bluffing. He's not going to change. For the next two weeks, he will do nothing.

        Leader: You're right, Allie. Jason, leave in three days. I will give you seventytwo hours to make arrangements because I doubt your mother will permit you to return home. My guess is that all the New York City homeless shelters are filled because it's cold, but I suggest you call them.

        Paul: We're wasting our time. We have confronted you many times but you ignored us. You have made commitments to change, but you never have. You continue to joke and act nonchalant. You've done this for six months, so I agree with what Tom said at the beginning of the group. Maybe you just don't get it! I believe you lack the guts to come out from behind all the barriers you have erected. You will be a lonely guy who becomes bitter because no one will be knocking at the door asking you to let us in. Maybe you should watch Dickens' "Christmas Carol." You could become Scrooge.

        Susan: I've kept quiet because I tried many times to reach out to you, but you always gave me shit. You continue to be obnoxious and confront others about dumb shit which tells everyone to stay away. I know when I confront kids rather than connecting with them, they get the message to stay away.

        Leader: Sadly, I doubt if this group will have much impact. You have heard all this shit many, many times. This may be the last group you attend at John Dewey. I won't shed any tears if you do not return, other than we failed to help you in your time of desperate need. But Scrooge changed when he was much older than you are. Unfortunately, Scrooge is a fictional character. Maybe you ought to read Dickens when you go home. Unless you change by letting the sun shine in, you very well could become Scrooge. It would be tragic if you were to live a wasted life because you have been blessed with awesome intelligence. You could have been great. You could have improved the quality of life. But you won't unless you get the guts to show you care. It's late, but there still is time. The next month will be the most important in your life, because the decisions you make will influence you until you die. I hope for your sake, and that of society, you finally make the right decisions because this may be your last chance. Enough. I don't want to waste any more time. I end abruptly because I do not want to have closure. I hope you are scared because I am scared for you! You can win, but time is a precious commodity, which you lack.

        Case follow-up

        Following this group, Jason enrolled in a four-week wilderness program in an attempt to earn readmission to Dewey. During his stay at the wilderness program, Jason received notification of early-decision admission to a prestigious college of engineering, as well as word that he had been awarded a substantial scholarship.

        While in the wilderness program, Jason was admitted early decision to a prestigious engineering college. We thought this would provide the incentive for him not only to return to John Dewey but also to confront his fears. However, when he returned from the wilderness program, Jason remained intransigent. He engaged in provocative behavior, which forced his expulsion for safety reasons. He "played" with the fire alarm. He "played" with the stove, turning it on and off. He asked the dean of students if he could set fires by using his bow and drill, a skill he had learned in the wilderness. His intent seemed obvious-rather than leaving school voluntarily, Jason wanted to be expelled. It seemed certain that the behavior would escalate if he were allowed to remain. The decision to expel Jason was in keeping with the treatment principle that there are consequences for behavior. Students, parents, and staff were notified before any action was taken, and no one disagreed with the decision to expel him.

        The president was faced with the dilemma of whether, and how, to report Jason's behavior to the engineering college. One option would have been to hide behind the shield of confidentiality, but it was felt that unsafe behavior does not warrant confidentiality. Additionally, notification was justified because Jason dropped four courses, which, if not explained, would have resulted in his acceptance being rescinded. Finally, there was the importance of maintaining a relationship with this college so others could attend.

        At the same time, the president was aware of his reactions to Jason, which included disappointment, betrayal, anger at not being appreciated for convincing the college to grant a generous scholarship, and rage at being placed in a most uncomfortable position. He knew no one would criticize him if he urged the college to rescind admission, but knew this consequence was extreme since the family could not afford to pay tuition. It is dubious if Jason would have attended college. After careful consideration, the president wrote a letter to the dean of admissions at the college, explaining the reasons for the expulsion, reviewing the factors in Jason's background that have made it difficult for him to succeed academically and socially, and recommending that he reapply to JDA and complete a postgraduate year before attempting college. Included in the letter were the following statements.

        Please be advised.. .if I thought Jason were "too dangerous" or "too sick," not only would I notify _____college, but also would refuse to give him the option to return to Dewey....Jason's refusal to comply is motivated by fear to trust others and to be emotionally vulnerable, not defiance. The only time Jason cried was when he was confronted about his reluctance to trust.. .because he feared friends would abandon and betray him... .If permitted to attend college, I suggest Jason be required to continue psychotherapy. He needs to resolve his fear of intimacy, not because he is a threat to safety. Jason and his mother will receive a copy of this letter, so hopefully both will communicate with you. I warned Jason that [college] may rescind his acceptance....

        I would be willing to accompany Jason for a conference, with anyone you think makes sense, to discuss options. Undeniably, Jason is a disappointment, but I hasten to mention that several have graduated in Jason's position needing to do more work therapeutically. In college, they excelled. His prognosis remains guarded....! conclude...by stating that he has learned much.

        The president would have been wrong to suggest rejection essentially because the decision is that of the college, not the preparatory school. To recommend rejection would have been an abuse of psychotherapeutic power. Post hoc, the president knew that had he become retaliatory, his motivation would have been revenge for Jason's disrespect and lack of appreciation regarding his advocacy, which had resulted in Jason's being awarded a $160,000 four-year scholarship. Had he urged that Jason be rejected, which was warranted, Jason's future would have been ruined, because without a scholarship, it would have been impossible for him to attend college. The president retained his therapeutic integrity by reporting what happened, but refraining from recommending any action. The college decided to continue to extend its offer of admission and a scholarship, and Jason plans to completed the required work and attended. Subsequently, he attained a 3.8 average which puts him on the dean's list. The president assumed an aggressive advocate stance, advocating that he become a resident assistant in the dorms. Jason has visited the John Dewey Academy six times during the year because he wants to "give back" to the school which helped him mature. He has forgiven the president and now recognizes the confrontations were expressions of concern.

        Discussion

        It is premature to know whether Jason will be a "success" or a "failure." Undeniably, Jason was helped by confrontation because he excelled and was admitted by a college of quality. How much has this adolescent grown, and what the quality of his interpersonal relationships will be, has not been determined. Judicious handling of this complicated situation has avoided the preclusion of future educational, professional, and social successes.

        This kind of confrontation is justified when the adolescent remains intransigent or engages in extremely dangerous behavior. Alexander (1950) describes a patient who was irritating and engaged in regressive behavior. When the patient complained that no one liked him, rather than commiserating, Alexander opines that no one liked him because he was unpleasant. Subsequently the patient established a positive treatment alliance. Hearing the truth from a caring professional enabled the patient to trust and to move forward. Corwin (1991) labels this kind of intervention heroic: "When such statement is made, it is an emergency situation....The analyst knows it, the patient is...aware....But both know the moment it is uttered that it may have a prophetic significance for the patient....It implies that a psychic reaction must lead toward the establishment of a working alliance" (p. 83). We have utilized this sort of radical intervention for six seniors in past years, all of whom eventually returned to graduate. We believe Jason will not be an exception.

        Critics contend that confrontation is controversial, counter therapeutic, and cruel punishment which often brutalizes persons-in-treatment. Confrontation attempts to modify irresponsible, impulsive, immature, stupid and self-destructive behavior. Confrontation penetrates denial, distortion, and dysfunctional attitudes. Critics protest, furthermore, that the use of confrontation is prompted by a negative countertransference reaction. Confrontation has been labeled "attack therapy" for pejorative reasons. Opponents of "attack therapy" do not under-stand is that confrontation has proven effective to eradicate malignant, dangerous, vicious attitudes and acts. While some critics condemn confrontation to be "cruel," they need to remember that Dewey students have engaged in dangerous, often death-defying behavior which demands heroic intervention. Unless the therapist can persuade the youth to avoid a collision course with disaster, there can be profoundly serious consequences. The primary goal of psychotherapy is to preserve life, so desperate and heroic treatment interventions are required for this difficult-to-treat population. When viewed from this humanistic perspective, confrontation connotes caring by the therapist who attempts to convince the adolescent to become more responsible, responsive, and respectful.

        Conclusion

        We have described a confrontation as a key aspect of a non-medically oriented residential therapeutic community. In our view, confrontation in the context of residential treatment is a potent psychotherapeutic tool that produces not only the acquisition of prosocial values but also behavioral improvement. Since these changes are internalized, long-term prognosis is quite good. Although we have no long-term systematic follow-up, anecdotal data confirm a less-than-ten-percent recidivism rate, which, to the best of our knowledge, is unmatched at any other residential treatment program. Bratter et al. (2006) contend "critics claim that confrontation psychotherapy is painful and simplistic. But they cannot explain how and why adolescents, who were extreme casualties, improve in a confrontational treatment milieu with escalating expectations for intellectual excellence and moral integrity [that] can be achieved without compromising one for the other" (p. 14). Confrontation as a psychotherapeutic technique has a long history in self-help therapeutic communities. In our experience, it can also be very effective in promoting change in adolescents who are resistant to other treatment approaches. Clearly, confrontation warrants further study.

        References

        Adler, G. (1985), Borderline Psychopathology and Its Treatment. New York: Jason Aronson.

        Alexander, F. & French, T. (1946), Psychoanalytic Therapy. New York: Ronald Press.

        Brager, G., (1965), The indigenous worker: A new approach to the social work technician. Social Work, 10: 33-40.

        Bratter, T. E. (1972), Confrontation group psychotherapy with affluent, alienated drug abusing adolescents. Psychother.: Theory, Res. & Pract., 9: 308-313.

        Bratter, T. E. (1977), Confrontation groups: The therapeutic community's gift to psychotherapy. In Proceedings of the First World Conference on Therapeutic Communities, ed. P. Vamos & J. J. Devlin. Montreal, Canada: Portage Press, pp. 164-174.

        Bratter, T. E. (1978), The four 'Rs' of the American self-help therapeutic community: Rebirth, responsibility, reality and respect. In Proceedings of the Third World Conference on Therapeutic Communities, ed. J. Corelli, I. Bonfiglio, T. Pediconi, & M. Collumb. Rome: International Council of Alcoholism and Addictions Press, pp. 434-448.

        Bratter, T. E., Collabolletta, E., Fossbender, A. J., Pennacchia, M. C, & Rubel, J. R. (1985), The American self-help residential therapeutic community: A pragmatic treatment approach for addicted character-disordered individuals. In Alcoholism and Substance Abuse: Strategies for Clinical Intervention, ed. T. E. Bratter & G. G. Forrest. New York: Free Press, pp. 461-507.

        Bratter, T. E. (2003), Group psychotherapy with gifted, self-destructive, drug-dependent, unconvinced adolescents. Group, 27: 131-146.

        Bratter, T. E., Bratter, C. J., Coiner, N. L., & Steiner, K. M. (2006), Motivating gifted, defiant, and unconvinced students to succeed at the John Dewey Academy. Ethical Human Psychology and Psychiatry, 8: 7-16.

        Brook, W. (1996), Adolescents who abuse substances. In Group Therapy with Adolescents, ed. P. Kymissis & D. A. Halpern. Washington, DC: American Psychiatric Association, pp. 243-264.

        Carkhuff, R. R. & Berenson, R. G. (1967), Beyond Counseling and Therapy. New York: Holt, Rinehart and Winston.

        Casriel, D. (1963), So Fair a House: The Story of Synanon. Englewood Cliffs, NJ: Prentice-Hall.

        Cohen, A. I., (1982), Confrontation Analysis: Theory and Practice. New York: Grune & Stratton.

        Corwin, H. A. (1991), Therapeutic confrontation from routine to heroic. In Confrontation in Psychotherapy, eds. G. Adler & P. G. Myerson. Northvale, NJ: Jason Aronson. pp. 69-94.

        Devereux, G. (1951), Some criteria for the timing of confrontations and interpretations. Intl. J. Psychoanal., 32:19-24.

        Gans, J. S. & Weber, R. L. (2000), The detection of shame in group psychotherapy: Uncovering the hidden emotion. Intl. J. Group Psychother., 50:381-396.

        Garner, H. H. (1970), Psychotherapy: Confrontation Problem-Solving Technique. St Louis: Warren H. Green.

        Glaser, F. B. (1974), Some historical and theoretical background of a self-help addiction treatment program. Amer. J. Drug & Alcohol Abuse, 1:37-52.

        Giovacchini, P. (1985), Countertransference and the severely disturbed adolescent. Adolescent Psychiatry, 12:449-467.

        Hurvitz, N. (1970), Peer self-help groups and their implications for psychotherapy. Psychother. Theory, Prac. Res., 7:41-47.

        Johnson, S. M. (1985), Characterological Transformation: The Hard Work Miracle. New York: Norton.

        Kaufman, G. (1989), The Psychology of Shame: Theory and Treatment of Shame-Based Syndromes. New York: Springer.

        Maslow, A. H. (1967), Synanon and eupsychia. J. Humanistic Psychol., VII:21-32.

        Meeks, J. E. & Bernet, W. (1990), The Fragile Alliance: An Orientation to the Psychiatric Treatment of the Adolescent. Malabar, FL: Krieger Publishing.

        Nunberg, H. (1955), Principles of Psychoanalysis. New York: International Universities.

        Reisman, F. (1965), The "helper" therapy principle. Social Work, 10:27-32.

        Ruitenbeek, H. (1970), The New Group Therapies. New York: Avon Books.

        Shankman, S. (1978), Criteria and factors affecting admission into and completion of the therapeutic community program. In Proceedings of the Third World Conference on Therapeutic Communities, ed. J. Corelli, T. Bonfiglio, T. Pediconi, & M. Collumb. Rome: Centro Italiano di Solidarieta, pp. 156-160.

        Sugarman, B. (1974), Daytop Village: A Therapeutic Community. New York: Holt, Rinehart, and Winston.

        Sugarman, B. (1986), Structure, variations, and context: A sociological view of the therapeutic community. In Therapeutic Communities for Addictions: Readings in Theory, Research and Practice, ed. G. De Leon & J. T. Ziegenfuss. Springfield, IL: Charles C. Thomas, pp. 65-82.

        Van Stone, W. W. & Gilbert, R. (1972), Peer confrontation groups: What, why, and whether. Amer. J. Psychiat., 129:581-591.

        Volkman, R. & Cressey, D. R., (1963), Differential association and the rehabilitation of drug addicts. Amer. J. Soc., 69:131-141.

        Yablonsky, L. (1965), The Tunnel Back: Synanon. New York: Macmillan.

        Thomas Edward Bratter is President and Founder of The John Dewey Academy in Great Barrington, Massachusetts.

        Lisa Sinsheimer, M.D. is a psychiatric consultant and Admissions Coordinator at The John Dewey Academy in Great Barrington, Massachusetts.

        Copyright Analytic Press 2008
        Provided by ProQuest Information and Learning Company. All rights Reserved

        28
        The Troubled Teen Industry / Smoke and Mirrors
        « on: July 13, 2008, 09:58:48 AM »
        One of many problems PV has that the FTC should look into.  Deceptive, fraudulent, shenanigans.  Next we'll look at the new PV program director Bob Pegler's qualifications.  I heard Pegler threw some stooge out of the private PV Parents Forum for asking about Bob's questionable academic claims.  You simply DO NOT QUESTION THE PROGRAM, OR THE DIRECTOR OF THE PROGRAM!  The PV Parents Forum has got to be full of people like Ned Flanders - "My boy got the booty juice again, yep -per-ooni".  If you're paying $100,000 a year, you avoid thoughts like "these PV clowns are clueless hillbilly quacks", and "I've pissed away $100k in exchange for my kid's undying hatred", or "Mother of God, so this is deviant peer influence - the kid went to PV for depression and came out a homicidal rapist meth cooker".  Golly gee willickers.

        It's really good of the FTC to show an interest, but licenses, certifications and accreditations don't mean a program isn't abysmal.  PV has all the bells and whistles - JCAHO, SACS, TN state licensure, and it's still a backwater hellhole with good PR.

        From the WATE-TV forum on mental health:

        PV Parent

        The FTC has posted a list of questions to ask before making a placement:

        http://www.ftc.gov/bcp/edu/pubs/consume ... pro27.shtm

        Peninsula Village does have accreditation and licensure, but the JCAHO certification is a result of PV being a "satellite" of Parkwest.  Number eleven is an interesting question for Peninsula Village:

        "How do you define success? What is your success rate? How is it measured?"

        WATE-TV has referred to the "amazing success" rate of PV, but what determines that success? 

        PV cites an "outcome study" done in 2004.  From the PV Parents Introduction:

        "The last outcome study used a 3-year database of Village alumni.  It was found that 91% of the program graduates are either currently in high school, graduated from high school and are taking college courses, or have completed their GED.  Sixty-nine percent of the adolescents admitted due to drug or alcohol addiction are abstaining from drugs and alcohol.  This data also suggested a strong link between length of stay and success post discharge.  100% of the adolescents who stayed at the Village twelve months or longer are currently in school and have not returned to inpatient treatment, are sober and attending twelve step meetings"

        That sounds impressive until you analyze the database PV used for this "outcome study".  First, "program graduates" excludes all the kids who were unsuccessful in treatment, or were forced to leave when financial resources ran dry.  Limiting participants to "alumni" greatly reduces the accuracy of this study.

        Next, you have to consider the database of the study.  It was based on a mail-in survey.  From PV:  "The survey was mailed to 125 Peninsula Village students' families whose young person had been discharged from the program fro a minimum of six months and a maximum of thirty-six months. Forty-one participants or 33% of the surveys were returned completed"

        Only forty-one of the surveys were returned out of 125 - 67% of those contacted would not respond.  Considering the limited participants selected and the minimal input received, I don't see how PV can boast of "success".  What has been seen on forums where former PV patients post their stories is a high rate of relapse into addiction on returning home.  One high-profile patient familiar to WATE-TV viewers relapsed shortly after release from Peninsula Village.

        Parents beware - the "outcome study" showing PV's "success" is a joke, meant to play on desperate parents who aren't going to take the time to look closely at the database used.  For a more concise list of questions to ask about a program you're considering for your teen, check ISAC's list:
         
        http://www.isaccorp.org/warningsigns.asp

        Peninsula Village fails on the majority.




        29
        Peninsula Village / THE NEW STAFF
        « on: March 06, 2008, 03:04:15 PM »
        http://www.peninsulavillage.org/pv-staff.cfm

        No psychiatrist on board yet.  There's Jean Bolding, ready to mollycoddle some rapists and send former patients to jail for life.  Woe unto ye, PV.

        Pages: 1 [2] 3 4 ... 7