Troubled children, a troubling industry
Little is known about largely unregulated therapeutic programs or the perils they pose
By Jonathan Osborne and Mike Ward
AMERICAN-STATESMAN STAFF
Sunday, July 13, 2003
If you can't find the village it takes to raise a child, you can buy one.
For a price, parents are increasingly turning to corporate America to solve the most personal and, at times, irritating of family problems: the rebellious son or daughter. Home is being replaced by wilderness camps, therapeutic boarding schools, residential treatment facilities, drug rehabilitation clinics, emotional growth facilities and the occasional self-esteem enhancement program.
Whatever parents think they might need - or can be convinced they need - to turn their child into a model teenager is for sale. And for as much as $10,000 a month, someone will promise to try to make everything right.
Many times, they do. Children with serious emotional or psychological problems are treated, made whole and move on.
Sometimes, the child is raped, beaten or, in the worst cases, killed.
And there is little parents can do to determine which program is more likely to lead to which result.
The booming fix-your-kid industry - a market estimated to be worth $60 billion a year - had roots in Central Texas in the 1940s and has blossomed into a multitiered, intricately faceted web of choices.
The business is so big that it has spawned offshoots such as "escort" companies, which will send men and women to your home, often in the dead of night, to haul your child to a facility that could be thousands of miles away.
And some of the places that children are taken are so controversial that former clients have their own "survivors" groups on the Internet, where they share horror stories.
Meanwhile, virtually no one is watching over the industry as it continues to grow. Some experts estimate as many as three programs open each month across the country.
Some parents who rely on these businesses are undoubtedly just trying to shift a burden, but most feel they have done everything in their power, and now feel powerless.
"You're trying to be a good parent. . . . You're trying to do everything conceivable to address the issues of the kid that you love and, on the other hand, you know that they're self-destructing in front of your eyes," said David Richart, a professor and director of the National Institute on Children, Youth and Families at Spalding University in Louisville, Ky. "There's a tendency for parents to jump at any solution that seems halfway credible."
Industry supporters insist the problems are overblown, the criticisms too harsh.
"Obviously, working with troubled children is not without its challenges," said Howard Falkenberg of Austin, spokesman for the Brown Schools, a leader in the industry. "I think it's important to remember that this business exists because young people and families need our services."
There are no agreed-upon definitions for the many types of facilities, no uniform standards of care, no minimum requirements to start a program in many states, few inspections or investigations and even fewer examples of sanctions for malfeasance.
Given that many programs are used by state social workers, including in Texas, who are trying to find places to treat those in the government's care, the paucity of stringent government oversight does not surprise some who question that apparent conflict.
When publicity or regulators spotlight problems, some programs have moved to Mexico, Central America or the Caribbean, a trend that has prompted a U.S. State Department warning to parents.
Others simply close, such as the On Track wilderness program in Mason County, where 17-year-old Chase Moody died in October while being restrained by counselors.
On Track was a part of the Brown Schools, a corporation that perhaps more than any other company, is emblematic of the industry, both good and bad.
The birth of a trend
In 1933, when Bert Brown stepped off the train in Austin with his wife and two children, he had two ragged suitcases and 60 cents in his pockets. Brown soon opened one of Austin's first rest homes, caring for the mentally disturbed. It quickly became a home for children who were waiting, often in a jail cell, for a bed to open up at a state school.
Then he took in a lonely 10-year-old red-haired girl.
"She had been in a home for forsaken and neglected normal children," Brown later recalled. "She was so defeated and unhappy. We made her feel, I believe, for the first time in her life that someone cared for her."
But a few months later, government officials came and took the little girl away to a home for delinquents. The Browns were devastated. And that evening, they decided to open a school for troubled children.
A few years later, Brown leased the old Spring Lake Hotel in San Marcos for $400 a month. A concept was born.
In the 60 years since, the Brown Schools has expanded, contracted, gone public, then private again, changed names, turned over ownership nearly a half-dozen times and leapfrogged corporate headquarters from Austin to Boston to Nashville, Tenn. The company doesn't currently have a corporate headquarters, but its operational offices, including the human resources department, remain in Austin.
In 1999, the Brown Schools - which is owned by a California investment firm - bought the California-based CEDU programs for about $72 million to expand its rapidly growing business.
It eventually grew to 19 schools and residential centers in eight states and Puerto Rico, including three in Austin, serving 25,000 youth a year with 2,000 employees - 1,000 of them in Texas.
The Brown Schools was a model for success and a training ground for executives who moved on to run or start other similar companies.
Now, in the wake of Moody's death, the company is downsizing and recently sold six of its facilities - a move they say was unrelated to the Moody tragedy.
"They got into being all things to all people," said Marguerite Sallee, who until April was president and chief executive of the Brown Schools.
'Therapeutic' programs
As a school of socially acceptable behavior, the Ascent wilderness camp's location might seem a bit odd.
Nestled in an Idaho mountain clearing, enveloped by the peaceful whisper of the wind blowing through towering pines and firs, Ascent is in the uppermost tip of the Idaho Panhandle, for years a nesting place for folks with anti-government, nonconformist tendencies. It is not far from Ruby Ridge, where federal agents confronted survivalist Randy Weaver and his family on a bloody day in 1992.
Billed as a "therapeutic wilderness program," Ascent is much like dozens of other such boarding schools across the United States. It offers a regimented outdoor experience designed to curb teenagers' errant behavior by jerking them from their normal world and turning their focus to positive, self-help patterns of behavior.
It is also one of four Brown Schools programs in northern Idaho - part of the CEDU family of services - each offering specialized treatment that mirrors the growing behavior-modification industry across the United States.
At Ascent, the focus is on six to eight weeks of intervention and adventure therapy for 13- to 17-year-olds. At Northwest Academy, it's up to two years of academics and life skills for 17- and 18-year-olds. At the Rocky Mountain Academy outside nearby Bonners Ferry, the program focuses on leadership and emotional growth for college-bound 16- to 18-year-olds. And at the adjacent Boulder Creek Academy, 12- to 16-year-olds with special needs and learning disabilities can stay up to two years. "By the time they come here, these kids are enough to drive the Pope into Al-Anon," said Roger Rinn, director of the Ascent program. "We don't fix them. We give them an opportunity to fix themselves."
For parents, that opportunity can be pricey.
At Northwest Academy, for example, it's $5,600 a month. At Ascent, the price is about $16,500 for an average 46-day stay.
For that, Ascent students get a dawn-to-dusk regimen of activities, counseling and physical-endurance exercises - all designed to build self-esteem and self-perspective - that begin before breakfast and end with lights out at night. Wood is chopped to build fires, meals are cooked and cleaned up, mountain camps are staked and packed up, tall wooden towers are scaled, friendships are built.
For most of the students, that regimen is an abrupt change from lives of anger, abuse, depression or drug addiction.
"Most are like a 4-year-old in the frequency they conflict with their parents," Rinn said. "They're real sweet. You want to reach out and hug them. But you just have to learn they will reach in your back pocket and steal your wallet if you do."
Changed children
"I'm a rich kid gone bad. I'm a rich kid gone bad."
The sarcasm is coming from a scraggly T-shirt-clad teenager lounging on a well-worn sofa in the main hall of CEDU High School, home to one of the Brown Schools' emotional growth programs in California.
The "rich kid gone bad" is among several dozen who have filed into the hall for the day's next activities.
The teenagers here, whose problems can include Internet addiction, drugs and promiscuity, often come from wealthy Hollywood parents, chief executives and real estate moguls from across the country. Most are white.
They're also savvy: Forbes magazine featured the CEDU (pronounced "see-do") programs in an article last year titled "When Rich Kids Go Bad."
The school sits on a cliffside in the San Bernardino Mountains in Running Springs, Calif., about two hours east of Los Angeles. Much of the school's activities take place in a mansion that served as the former vacation home to actor Walter Huston.
Therapy here focuses on holding one another accountable, admitting guilt and moving on, and expressing emotions. The program is designed to help the students learn self-control.
"I was a pretty wild kid. I was going 60 mph," said Bill Valentine, CEDU's director. "These kids are going 160 mph, and the highway's a lot more dangerous than when I was growing up."
It's difficult to gauge the sincerity level of many of the students enrolled here. Some can rattle off their personal stories, including every sordid detail, as if reciting a well-practiced monologue.
"I would go in and out of being suicidal," said one 18-year-old. He said he was angry and anti-social, dressed in black and preferred his computer and delivery pizza to human interaction or his family.
"I hated being alive."
His experience at CEDU, he said, has saved his life and allowed him to open up to others. Brown Schools officials cite him as one of their success stories, one of the many they've served.
Another is a thin, 17-year-old brunette from New York. She says she had slipped from making straight A's to abusing drugs and having sex promiscuously. Her grandparents mortgaged their home so she could attend CEDU, something she said she is grateful for.
"I know how I got myself here," she said. "And I know in some ways, it probably saved my life. I didn't care about myself. I bet I probably would've run away by now. I could probably be, like, prostituting myself."
The rocky road
Much like its clientele, the Brown Schools' road to success was not trouble-free.
As a private company, much of its financial and operational information is unavailable to the public.
However, in courthouses and file cabinets in regulatory agencies around the country, the company has left a paper trail that at the very least offers a glimpse into the unpleasantries of the business.
During the past decade, Brown has been sued for such things as wrongful death and injury to allegations of fraud. Its facilities have weathered hundreds of citations for human rights and licensing violations, as well as at least five deaths that came after children were physically restrained in a manner widely considered dangerous.
Falkenberg said, "It is very easy for an allegation to be made and for something to be reported and for that not to be the facts of the matter when everything's said and done."
In Virginia, a Brown Schools residential treatment center was written up for more than 100 licensing and civil rights violations over a two-year span beginning in January 2001. The citations included using improper physical restraints, withholding mail as punishment, forbidding teenagers from using the toilets, denying them meals, physically abusing them, injecting residents with drugs to control them, allowing rampant sexual activity and having many clients run away.
"It was being heavily ignored," Sallee said. During her tenure, Sallee replaced the center's management and re-evaluated the staff; eventually, the citations began to taper off.
The Brown Schools' Texas facilities have been cited dozens of times for similar violations. Most recently, On Track was cited 28 times in connection with Moody's death. The company appealed. A criminal investigation is ongoing.
Laurel Ridge, a former Brown Schools residential treatment center in San Antonio, was nearly closed after a 17-year-old died after a brutal restraint in 1997. It remained open, even after Rochelle Clayborn's death garnered nationwide publicity. Randy Steele, a 9-year-old from Nevada, died at Laurel Ridge three years later.
Allegations in court filings include:
o At a West Florida psychiatric treatment center, a 13-year-old girl said she was raped by a staff member. Brown denied the claim and, earlier this year, closed the center, citing funding issues.
o At a Tulsa, Okla., treatment program for young sex offenders, police investigated claims that a 17-year-old boy was sexually assaulting other male students. The boy was later charged in eight attacks and was sent to prison.
o In northern Idaho, the parents of two students involved in a riot - including 17-year-old Kevin Accomazzo, who suffered a broken arm - alleged fraud and misrepresentation by CEDU in their programs. CEDU officials denied the claims but later settled at least one of the cases - after the company was acquired by Brown.
But most parents trying to place a child know little about a program's past other than what its promoters tell them.
"Parents are scared and freaked out when they make the decisions on a school. They are looking for a solution, any solution," said Todd Reed, a Sandpoint, Idaho, attorney who represented Accomazzo's family in the lawsuit. "The desired solution doesn't always work out."
A troubled industry
Brown's past problems are in part representative of the industry as a whole.
A year ago today, 14-year-old Ian August of Dripping Springs died during a hike at a Utah wilderness program. Another youth died this year at a treatment center in South Carolina.
Abroad, programs in Mexico and Jamaica have faced allegations of abuse and neglect.
And a therapeutic boarding school in Costa Rica was closed after its teenage students rioted over conditions.
The director of that school is the subject of a criminal investigation, but in this business, penalties for disobeying the rules are rare. In the past five years, few wilderness camps or residential treatment centers in Texas have had their licenses revoked, even though they have been cited for hundreds of violations - many of them serious, some repeatedly.
When Moody died in October after struggling with three counselors while being restrained at the Brown Schools' On Track facility, there were no fines levied, although On Track was cited 28 times. And regardless, the maximum fine would have been just $100.
"We have a lot of kids in our care who are a challenge to care for, and it's our philosophy to work with these facilities to try to bring them up to the standards," said Geoffrey Wool, a spokesman for the Texas Department of Protective and Regulatory Services. "We'd rather work with them . . . and know that there are places for these children instead of punish these facilities and force them out of business."
But some advocates suspect the system in Texas is bogged down by what amounts to a conflict of interest: The Department of Protective and Regulatory Services also oversees Child Protective Services, which depends on these facilities to house troubled children who are either removed from their homes or orphaned.
At any given time, of the 6,000 beds available in Texas facilities, about 1,500 are filled with Child Protective Service placements, Wool said.
"The state has a conflict of interest because it both licenses and relies on the care in the residential treatment centers," said former state District Judge Scott McCown, who in his time as a judge became familiar with residential treatment centers and other youth-oriented programs and is now executive director of the Center for Public Policy Priorities.
Wool said his bosses see it differently: "Who better to regulate these facilities than the people who are actually placing children there?" he said. "We have a vested interest in making sure that these facilities provide a minimum standard of quality and that the children who are in these facilities are getting the care and treatment that they need."
Still, some treatment providers have said for years that the state does not pay enough to provide the necessary care for troubled youth. The rates run to more than $100 a day for the most challenging cases, a fraction of the cost of many private facilities.
McCown acknowledges that may be the case.
"What do you do if you don't want to pay a reasonable rate?" McCown said. "You ease up on regulations."
The alternative, he said, is to "pay decent rates to take care of the kids, then you hold people accountable."
A need to regulate
For decades, parents have been looking to outsiders to fix their troubled teens - from traditional military academies in the east, popular for decades, to wilderness-experience camps that began springing up in the 1960s, to boarding schools that were popular in the 1970s, to psychiatric-therapy centers that were popular in the 1980s, to emotional-growth and behavior-modification programs that replaced them in the 1990s - as insurance stopped paying for residential care.
Perhaps the greatest problem for parents contemplating such a desperate move as sending a child away: There is no foolproof way to compare the various programs' track records.
"Parents have too little information available to them before they place their children in these facilities," said Jerry Boswell, president of the Citizens Commission on Human Rights of Texas. "That should change."
Independently verifying the claims, or even checking the schools' credentials, can be a catch-as-catch-can exercise for parents, thanks to spotty and conflicting oversight and regulation by different states - something that even some of the larger companies complain about.
The Brown Schools for years pushed Idaho lawmakers to establish regulations for wilderness programs and this year succeeded. Ascent will be one of the first wilderness camps licensed in the state.
"We'd prefer they'd be the same standards nationwide. It generally upgrades the industry to have regulations," Falkenberg said. "It does the industry no good to allow operators who aren't interested in adhering to regulations to provide quality care. It's too easy in an unregulated environment for that care to be subpar."
Few initiatives have been launched to strengthen or standardize regulation - or even categorize programs the same from state to state, so parents can compare programs more easily.
"It's extremely confusing to categorize programs because there really are no clear written, explicit standards about what constitutes a certain program and what kind of services you will get," said Michael Conner, an Oregon-based licensed psychologist and educational consultant who is one of the foremost experts on treatment options available for troubled youth. "The right program with the right child can be miraculous. The wrong child and the wrong program is a very dangerous mix."
Andy Anderson, executive director of the National Association of Therapeutic Schools and Programs, a trade group with 113 members in 26 states, admits the business can be confusing, regulations aside: "There's as many different types of wilderness programs as I have fingers and toes."
Anderson said his organization, which includes many of the Brown Schools' programs, is designed to encourage the industry to adopt a code of ethics and then live by it.
But Conner said there are some programs that operate outside of what anybody would consider best practices, charging very little money for and providing slipshod care.
"The problem is there's no standards for a lot of these programs - that's what make its most difficult," he said.
"Acceptable window of loss - I find that term very offensive - but there's a few programs that look at students in terms of acceptable windows of loss," Conner said. "Free market solutions to protect children are inherently dangerous. "The State Department has warnings on programs outside the country," Conner said. "What we don't have are warnings about programs inside this country."
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