To explain the development of the troubled teen industry and the autocratic therapeutic community... more To explain the development of the troubled teen industry and the autocratic therapeutic community (ATC) movement, this article explores the rapid diffusion of Synanon-type programs in the United States since the early 1960s. Instead of tracing a history back through self-help programs similar to Synanon, a history of therapeutic violence in experimental group therapy settings suggests a new genealogy and perspective. This line of inquiry highlights the central importance of delinquency treatment methods and programs that originated during World War II, originally called the "total psychotherapeutic push method" and then renamed, "guided group Mark M. Chatfield is a PhD candidate in the Department of History at the University of Florida. His dissertation examines the origins and development of the troubled teen industry in the United States. He thanks several people who contributed to this article: the two anonymous reviewers for their thorough, challenging, and constructive suggestions; Joe Spillane, who provided helpful comments during the revision process; and Claire Clark, who first provided encouragement to present this research at the Alcohol and Drugs History Society conference in Mexico City. The author also wants to acknowledge the anonymous person many years ago who referenced the book, The Highfields Story, in an online chatroom and mentioned the historical importance of the rehabilitation center at Fort Knox. Their first breadcrumbs, freely and anonymously given, sparked a pathway of research questions that led to this article.
This exploratory study examined perceptions of care quality within parent-pay youth treatment pro... more This exploratory study examined perceptions of care quality within parent-pay youth treatment programmes such as therapeutic boarding schools, residential treatment centres, wilderness therapy programmes, and intensive outpatient programmes. Reflecting on their personal experiences as youths, 214 adults reported on a total of 75 different treatment settings. Two indices developed for this study measured par-ticipants' perceptions of quality of experience and the totalistic programme characteristics of their care settings. Regression analyses and ANOVA tests of means indicated a negative relationship between totalistic programme characteristics and quality of experience index scores. Significant relationships were not found between quality of experience and forcible transport, intake decade, or the amount of time in treatment.
Recent annual estimates suggest that in the United States, approximately 57,000 young people are ... more Recent annual estimates suggest that in the United States, approximately 57,000 young people are placed by their parents into some type of residential treatment program. Parent pay programs are exempt from federal safety standards and some states provide little or no regulatory oversight. Federal investigations revealed a nationwide pattern of institutional abuse across multiple facilities, and some professionals have noted 'cruel and dangerous uses of thought reform techniques' within such programs (U.S. House of Representatives 2007, 76). This article summarizes qualitative research based on interviews with 30 adults who lived for an average of 20 months within a 'highly totalistic' youth program. The concept of totalistic treatment was operationalized and measured with seven key identifiers found in the literature. Twenty-five different programs of four general types were represented: therapeutic boarding schools, residential treatment centers, wilderness/ outdoor programs, and intensive outpatient programs. To organize qualitative findings, three themes explaining the experiences, immediate effects, and long-term impacts of treatment help to reveal implicit meanings woven throughout the interviews. By understanding a wider range of experiences associated with totalistic programs, efforts to improve quality of care and strategies to prevent harm may be improved. Harm prevention efforts would benefit from the analytical perspectives found in theories of coercive persuasion and thought reform.
To explain the development of the troubled teen industry and the autocratic therapeutic community... more To explain the development of the troubled teen industry and the autocratic therapeutic community (ATC) movement, this article explores the rapid diffusion of Synanon-type programs in the United States since the early 1960s. Instead of tracing a history back through self-help programs similar to Synanon, a history of therapeutic violence in experimental group therapy settings suggests a new genealogy and perspective. This line of inquiry highlights the central importance of delinquency treatment methods and programs that originated during World War II, originally called the "total psychotherapeutic push method" and then renamed, "guided group Mark M. Chatfield is a PhD candidate in the Department of History at the University of Florida. His dissertation examines the origins and development of the troubled teen industry in the United States. He thanks several people who contributed to this article: the two anonymous reviewers for their thorough, challenging, and constructive suggestions; Joe Spillane, who provided helpful comments during the revision process; and Claire Clark, who first provided encouragement to present this research at the Alcohol and Drugs History Society conference in Mexico City. The author also wants to acknowledge the anonymous person many years ago who referenced the book, The Highfields Story, in an online chatroom and mentioned the historical importance of the rehabilitation center at Fort Knox. Their first breadcrumbs, freely and anonymously given, sparked a pathway of research questions that led to this article.
This exploratory study examined perceptions of care quality within parent-pay youth treatment pro... more This exploratory study examined perceptions of care quality within parent-pay youth treatment programmes such as therapeutic boarding schools, residential treatment centres, wilderness therapy programmes, and intensive outpatient programmes. Reflecting on their personal experiences as youths, 214 adults reported on a total of 75 different treatment settings. Two indices developed for this study measured par-ticipants' perceptions of quality of experience and the totalistic programme characteristics of their care settings. Regression analyses and ANOVA tests of means indicated a negative relationship between totalistic programme characteristics and quality of experience index scores. Significant relationships were not found between quality of experience and forcible transport, intake decade, or the amount of time in treatment.
Recent annual estimates suggest that in the United States, approximately 57,000 young people are ... more Recent annual estimates suggest that in the United States, approximately 57,000 young people are placed by their parents into some type of residential treatment program. Parent pay programs are exempt from federal safety standards and some states provide little or no regulatory oversight. Federal investigations revealed a nationwide pattern of institutional abuse across multiple facilities, and some professionals have noted 'cruel and dangerous uses of thought reform techniques' within such programs (U.S. House of Representatives 2007, 76). This article summarizes qualitative research based on interviews with 30 adults who lived for an average of 20 months within a 'highly totalistic' youth program. The concept of totalistic treatment was operationalized and measured with seven key identifiers found in the literature. Twenty-five different programs of four general types were represented: therapeutic boarding schools, residential treatment centers, wilderness/ outdoor programs, and intensive outpatient programs. To organize qualitative findings, three themes explaining the experiences, immediate effects, and long-term impacts of treatment help to reveal implicit meanings woven throughout the interviews. By understanding a wider range of experiences associated with totalistic programs, efforts to improve quality of care and strategies to prevent harm may be improved. Harm prevention efforts would benefit from the analytical perspectives found in theories of coercive persuasion and thought reform.
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