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CASES OF CHILD NEGLECT AND ABUSE AT

PRIVATE RESIDENTIAL TREATMENT FACILITIES

HEARING

BEFORE THE

COMMITTEE ON 

EDUCATION AND LABOR

U.S. HOUSE OF REPRESENTATIVES

ONE HUNDRED TENTH CONGRESS

FIRST SESSION

HEARING HELD IN WASHINGTON, DC, OCTOBER 10, 2007

Serial No. 110–68

Printed for the use of the Committee on Education and Labor

(

Available on the Internet: 

http://www.gpoaccess.gov/congress/house/education/index.html 

(II)

COMMITTEE ON EDUCATION AND LABOR 

GEORGE MILLER, California, Chairman

Dale E. Kildee, Michigan, Vice Chairman 

Donald M. Payne, New Jersey 

Robert E. Andrews, New Jersey 

Robert C. ‘‘Bobby’’ Scott, Virginia 

Lynn C. Woolsey, California 

Rube ́n Hinojosa, Texas 

Carolyn McCarthy, New York 

John F. Tierney, Massachusetts 

Dennis J. Kucinich, Ohio 

David Wu, Oregon 

Rush D. Holt, New Jersey 

Susan A. Davis, California 

Danny K. Davis, Illinois 

Rau ́l M. Grijalva, Arizona 

Timothy H. Bishop, New York 

Linda T. Sa ́nchez, California 

John P. Sarbanes, Maryland 

Joe Sestak, Pennsylvania 

David Loebsack, Iowa 

Mazie Hirono, Hawaii 

Jason Altmire, Pennsylvania 

John A. Yarmuth, Kentucky 

Phil Hare, Illinois 

Yvette D. Clarke, New York 

Joe Courtney, Connecticut 

Carol Shea-Porter, New Hampshire 

Howard P. ‘‘Buck’’ McKeon, California, 

Ranking Minority Member 

Thomas E. Petri, Wisconsin 

Peter Hoekstra, Michigan 

Michael N. Castle, Delaware 

Mark E. Souder, Indiana 

Vernon J. Ehlers, Michigan 

Judy Biggert, Illinois 

Todd Russell Platts, Pennsylvania 

Ric Keller, Florida 

Joe Wilson, South Carolina 

John Kline, Minnesota 

Cathy McMorris Rodgers, Washington 

Kenny Marchant, Texas 

Tom Price, Georgia 

Luis G. Fortun ̃ o, Puerto Rico 

Charles W. Boustany, Jr., Louisiana 

Virginia Foxx, North Carolina 

John R. ‘‘Randy’’ Kuhl, Jr., New York 

Rob Bishop, Utah 

David Davis, Tennessee 

Timothy Walberg, Michigan 

Dean Heller, Nevada

Mark Zuckerman, Staff Director 

Vic Klatt, Minority Staff Director 

(III)

C O N T E N T S 

Page

Hearing held on October 10, 2007 .......................................................................... 1

Statement of Members: 

Altmire, Hon. Jason, a Representative in Congress from the State of 

Pennsylvania, prepared statement of .......................................................... 132

McKeon, Hon. Howard P. ‘‘Buck,’’ Senior Republican Member, Committee 

on Education and Labor ............................................................................... 5

Prepared statement of ............................................................................... 6

Miller, Hon. George, Chairman, Committee on Education and Labor ......... 1

Prepared statement of ............................................................................... 3

American Bar Association recommendations .......................................... 7

Alliance for the Safe, Therapeutic, and Appropriate Use of Residential Treatment (ASTART), statement of .............................................. 132

Letters submitted for the record .............................................................. 11

Questions for the record submitted to Dr. Pinto .................................... 26

Questions for the record submitted to Mr. Kutz ..................................... 27

Questions for the record submitted to Ms. Moss .................................... 27

Statement of Witnesses: 

Bacon, Bob, father of Aaron Bacon ................................................................. 41

Prepared statement of ............................................................................... 43

Harvey, Cynthia Clark, mother of Erica Clark Harvey ................................ 38

Prepared statement of ............................................................................... 40

Kutz, Greg, Managing Director, Forensic Audits and Special Investigations Unit, Government Accountability Office ............................................ 30

Prepared statement and the GAO report, ‘‘Residential Treatment 

Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth,’’ Internet address ..................................... 32

Responses to questions for the record ..................................................... 32

Lewis, Paul, father of Ryan Lewis .................................................................. 34

Prepared statement of ............................................................................... 36

Moss, Jan, executive director, National Association of Therapeutic Schools 

and Programs ................................................................................................ 44

Prepared statement of ............................................................................... 46

Additional materials submitted ............................................................... 50

Responses to questions for the record ..................................................... 64

Pinto, Ph.D., Allison, research psychologist and assistant research professor, Louis de la Parte Florida Medical Health Institute, University 

of South Florida ............................................................................................ 75

Prepared statement of ............................................................................... 77

Additional materials submitted ............................................................... 81

Responses to questions for the record ..................................................... 79

(1)

CASES OF CHILD NEGLECT AND

ABUSE AT PRIVATE RESIDENTIAL 

TREATMENT FACILITIES 

Wednesday, October 10, 2007

U.S. House of Representatives 

Committee on Education and Labor 

Washington, DC

The committee met, pursuant to call, at 10:33 a.m., in room 

2175, Rayburn House Office Building, Hon. George Miller [chairman of the committee] presiding. 

Present: Representatives Miller, Kildee, Payne, Woolsey, 

Hinojosa, McCarthy, Tierney, Kuchinich, Wu, Bishop of New York, 

Sarbanes, Sestak, Loebsack, Hirono, Altmire, Clarke, McKeon, 

Petri, Castle, Platts, Kline, Boustany, and Kuhl. 

Staff present: Tylease Alli, Hearing Clerk; Jeff Appel, GAO 

Detailee; Sarah Dyson, Investigative Associate, Oversight; Patrick 

Findlay, Investigative Counsel; Denise Forte, Director of Education 

Policy; Ruth Friedman, Senior Education Policy Advisor (Early 

Childhood); Ryan Holden, Senior Investigator, Oversight; Lamont 

Ivey, Staff Assistant, Education; Thomas Kiley, Communications 

Director; Ann-Frances Lambert, Administrative Assistant to Director of Education Policy; Danielle Lee, Press/Outreach Assistant; 

Alex Nock, Deputy Staff Director; Joe Novotny, Chief Clerk; Rachel 

Racusen, Deputy Communications Director; Dray Thorne, Senior 

Systems Administrator; Margaret Young, Staff Assistant, Education; Michael Zola, Chief Investigative Counsel, Oversight; Mark 

Zuckerman, Staff Director; James Bergeron, Minority Deputy Director of Education and Human Services Policy; Robert Borden, Minority General Counsel; Cameron Coursen, Minority Assistant 

Communications Director; Kirsten Duncan, Minority Professional 

Staff Member; Taylor Hansen, Minority Legislative Assistant; Victor Klatt, Minority Staff Director; Alexa Marrero, Minority Communications Director; Susan Ross, Minority Director of Education and 

Human Services Policy; and Linda Stevens, Minority Chief Clerk/

Assistant to the General Counsel. 

Chairman MILLER [presiding]. A quorum being present, the investigative hearing of the Committee on Education and Labor titled 

‘‘Cases of Child Neglect and Abuse in Private Residential Treatment Facilities’’ will come to order. 

Pursuant to Committee Rule 12(a), any member may submit an 

opening statement in writing which will be made part of the perVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
2

manent record, and I will recognize myself, followed by the senior 

Republican member, Mr. McKeon, for an opening statement. 

I want to welcome everybody to today’s hearing on cases of child 

neglect and abuse at private residential treatment facilities. For a 

number of years now, I have been deeply concerned about the allegations of child abuse in private residential treatment programs, 

which are often referred to as boot camps or wilderness programs 

or behavior modification facilities. These allegations range from neglect to torture, a word I do not use lightly. 

Today, we will hear about neglect and abuse cases where the outcome was the worst one imaginable, the death of a child. We will 

hear testimony from parents of children who died, and I thank 

them for joining us today and for having the courage to speak publicly about their ordeals. 

It is estimated that hundreds of private residential treatment 

programs operate nationwide. The programs are governed for the 

most part by a weak patchwork of state regulations. In many 

states, these programs operate without regulation, licensing or accreditation of any kind, despite often exorbitant prices of tuition. 

Parents often send their children to these programs when they 

feel they have exhausted their alternatives. Their children may be 

abusing drugs or alcohol, attempting to run away or physically 

harm themselves, or otherwise acting out. They send their children 

to these programs because the promises of staff members to be able 

to help children straighten out their lives. 

In far too many cases, however, the very people entrusted with 

the safety, the health and the welfare of these children are the 

ones who violate the trust in some of the more horrific ways imaginable. We are aware of stories where program staff members have 

forced children to remain in seclusion for days at a time, to remain 

in so-called stress positions for hours at a time, to undergo extreme 

physical exertion without sufficient food or water. 

And, today, we will hear evidence of even more horrifying stories 

of the children denied access to bathrooms, forced to defecate on 

themselves, or children forced to eat dirt or their own vomit, of 

children paired with older children, their so-called buddies, whose 

job it essentially was to abuse them. There is only one word for this 

behavior, and that is inhumane. 

This nightmare has remained an open secret for years. Sporadic 

news accounts of specific incidents have built a record that should 

never have been ignored, but shamefully it was and the federal 

government has completely failed to grasp the urgency of this situation. 

In 2003, I urged then Attorney General John Ashcroft to begin 

an immediate investigation into reports of child abuse at private 

residential treatment programs. The attorney general refused, as 

did his successor, Alberto Gonzales. 

I also then wrote Secretary of State Colin Powell asking him to 

investigate the treatment of children in facilities located overseas 

but serving American children and operated by U.S. companies. 

Secretary Powell’s response was insufficient. 

We will learn today that a number of these programs actually operate on federal land, yet no federal agency, not the Bureau of 

Land Management nor the Department of Interior, no one, has 

3

thought to review problems associated with these federal tenants, 

despite repeated incidents of injury or death of a child. 

No federal agency keeps official data about the number of children enrolled in private residential treatment programs, despite 

the fact that children are typically transported across state lines, 

sometimes even by force, in order to be enrolled in the programs, 

and I believe that that is an outrage. 

In late 2005, I asked the Government Accountability Office to 

launch an investigation of private residential treatment programs. 

The GAO agreed, and I am pleased that the GAO has devoted its 

significant resources to this important issue. 

Today, the GAO will present case studies of programs where 

death has occurred. Next year, GAO expects to release an industrywide review, thus providing us with a comprehensive look at the 

industry. 

In the past, it has been estimated that anywhere from 10,000 to 

20,000 children are enrolled in these programs at any one time. I 

am sure that there are programs staffed by caring professional and 

competent staff members who do help to improve children’s lives, 

yet there are clearly a number of programs staffed by untrained, 

unlicensed, poorly paid staff members who simply cannot be entrusted with the child’s welfare. 

As a result, without regulation, the industry as a whole will continue to present unacceptable risks to children it serves. That is 

why in 2005 I proposed legislation to provide resources to states to 

help them create licensing standards for private residential treatment programs. The legislation would also boost the oversight of 

facilities overseas operated by U.S. companies. 

This hearing, as well as the ongoing work by GAO and by the 

committee’s investigative staff, will help determine if it is the appropriate legislative response or if the situation demands something else. 

One thing is clear, however, that in light of the findings we will 

hear today, Congress must act and it must act swiftly to ensure the 

wellbeing of children participating in these programs. We can all 

agree we have no mandate more urgent than keeping children safe. 

I would like to thank all of our witnesses for joining us today. 

We will look forward to your testimony and working with you to 

put a stop to these abuses. 

And now I would like to yield to Congressman McKeon for his 

opening statement. 

[The statement of Mr. Miller follows:]

Prepared Statement of Hon. George Miller, Chairman, Committee on 

Education and Labor 

Good morning. 

Welcome to today’s hearing on ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities.’’

For a number of years now, I have been deeply concerned about allegations of 

child abuse in private residential treatment programs, which are often referred to 

as ‘‘boot camps,’’ ‘‘wilderness programs,’’ or ‘‘behavior modification facilities.’’

These allegations range from neglect to torture—a word that I don’t use lightly. 

Today, we will hear about neglect and abuse cases where the outcome was the 

worst one imaginable: the death of a child. We will hear testimony from the parents 

of children who died. I thank them for joining us today and for having the courage 

to speak publicly about their ordeals. 

4

It is estimated that hundreds of private residential treatment programs operate 

nationwide. The programs are governed by a weak patchwork of state regulations. 

In many states, these programs operate without regulations, licensing, or accreditation of any kind, despite the often exorbitant price of tuition. 

Parents often send their children to these programs when they feel they have exhausted their alternatives. Their children may be abusing drugs or alcohol, attempting to run away or physically harm themselves, or otherwise acting out. They send 

their children to these programs because of the promise that staff members will be 

able to help children straighten their lives out. 

In far too many cases, however, the very people entrusted with the safety, health, 

and welfare of these children are the ones who violate that trust in some of the most 

horrific ways imaginable. 

We have heard stories where program staff members forced children to remain 

in seclusion for days at a time; to remain in so-called ‘‘stress’’ positions for hours 

at a time; or to undergo extreme physical exertion without sufficient food and water. 

Today, we will hear even more horrifying stories, of children denied access to 

bathrooms and forced to defecate on themselves. Of children forced to eat dirt or 

their own vomit. Of children paired with older children—so-called ‘‘buddies’’—whose 

job it is, essentially, to abuse them. 

There is only one word for these behaviors: Inhuman. 

This nightmare has remained an open secret for years. Sporadic news accounts 

of specific incidents have built a record that should never have been ignored, but 

shamefully was. 

The federal government has completely failed to grasp the urgency of this situation. 

In 2003, I urged then-Attorney General John Ashcroft to begin an immediate investigation into reports of child abuse at private residential treatment programs. 

The Attorney General refused, as did his successor, Alberto Gonzales. 

I also wrote to then-Secretary of State Colin Powell asking him to investigate the 

treatment of children in facilities located overseas but serving American children 

and operated by U.S. companies. Secretary Powell’s response was insufficient. 

We will learn today that a number of these programs actually operate on federal 

land. Yet no federal agency—not the Bureau of Land Management, not the Department of the Interior, no one—has thought to review problems associated with these 

federal tenants, despite repeated incidents ending in the injury or death of a child. 

No federal agency keeps official data about the number of children enrolled in private residential treatment programs, despite that fact that children are typically 

transported across state lines—sometimes even by force—in order to be enrolled in 

the programs. 

This is an outrage. 

In late 2005, I asked the Government Accountability Office to launch an investigation of private residential treatment programs. The GAO agreed, and I am pleased 

that GAO has devoted significant resources to this important issue. Today, the GAO 

will present case studies of programs where deaths occurred. Next year, GAO expects to release an industry-wide review, thus providing us with a comprehensive 

look at the industry. 

In the past, it has been estimated that anywhere from 10,000 to 20,000 children 

have been enrolled in these programs at any one time. 

I am sure that there are programs staffed by caring, professional, competent staff 

members, who do help to improve children’s lives. Yet there are clearly a number 

of programs staffed by untrained, unlicensed, poorly paid staff members who simply 

cannot be entrusted with children’s welfare. As a result, without regulations, the industry as a whole will continue to present unacceptable risks to the children it 

serves. 

That is why, in 2005, I proposed legislation to provide resources to states to help 

them create licensing standards for private residential treatment programs. The legislation would also boost oversight of facilities overseas operated by U.S. companies. 

This hearing, as well as the ongoing work by GAO and by the Committee’s investigative staff, will help determine if that is the appropriate legislative response or 

if the situation demands something else. 

One thing is clear, however: In light of the findings we will hear today, Congress 

must act, and it must act swiftly, to ensure the well-being of children participating 

in these programs. We can all agree that we have no mandate more urgent than 

keeping children safe. 

I’d like to thank all of our witnesses for joining us today. We look forward to your 

testimony and to working with you to put a stop to these abuses. 

Thank you. 

5

Mr. MCKEON. I thank the chairman for yielding. 

Today’s hearing will explore a difficult topic. The facilities we 

will be looking at receive no federal funding and, therefore, are not 

regulated by the federal juvenile justice legislation under this committee’s jurisdiction. Nonetheless, the allegations of mistreatment 

raise a number of serious questions. 

I want to recognize the families who are here today and thank 

them for their willingness to share their personal stories. The loss 

of a child is something no parent should have to endure. 

I also want to take the opportunity to recognize the Government 

Accountability Office for its work in this area. Often on issues like 

these where our jurisdiction as federal lawmakers may be uncertain, the GAO’s work can help provide clarity. This includes an 

analysis of how these programs are funded and regulated and what 

efforts are in place currently at the state level, but also perhaps 

at the federal level to ensure the safety and effectiveness of the 

programs. 

We will also hear today from a researcher in this field and, on 

behalf of practitioners, the National Association of Therapeutic 

Schools and Programs, who can offer perspectives on the regulatory 

framework in place as well as steps that can be taken to improve 

upon current requirements to protect the youth in these facilities. 

As I understand it, the work of the GAO has focused on the question of whether allegations of abuse and death at these residential 

treatment facilities are widespread and on providing a review of 

the case studies. The GAO was unable to differentiate between 

public and private programs in determining how prevalent these 

allegations are, which demonstrates how difficult it may be to address this issue at the federal level. 

It seems to me that the question of how widespread these alleged 

incidents of mistreatment are is critical. Of course, even one incident of abuse or, worse, the loss of life is unacceptable. 

But before we consider federal intervention, we need to better 

understand the breadth of the problem so we can determine the 

best way to protect the youth in these programs. We need to take 

a step back to evaluate what an appropriate federal role would be, 

if any, in regulating these programs. This requires that we first understand current federal involvement, an area I hope we will explore today. 

Many of these facilities have been established to serve children 

who are deeply troubled, whether they are suffering from drug addiction or severe emotional or behavioral problems. Many of the 

youth who enter these facilities are placed there by their parents 

as a last resort. 

This committee has held a series of hearings this year to examine how we can improve our juvenile justice system. Our efforts 

have focused on identifying effective strategies that prevent juvenile delinquency and encourage healthy child development. Although these privately funded programs are not currently governed 

by the juvenile justice statute under our jurisdiction, I hope we can 

examine this issue through the broader context of juvenile delinquency prevention in order to understand how existing programs 

can meet the needs of troubled youth. 

6

Once again, let me thank the witnesses for being here to help 

shed light on these facilities, the role they play in serving troubled 

youth and the efforts at the state and local level to ensure safety. 

I yield back the balance of my time. 

[The statement of Mr. McKeon follows:]

Prepared Statement of Hon. Howard P. ‘‘Buck’’ McKeon, Senior Republican 

Member, Committee on Education and Labor 

I thank the gentleman for yielding. 

Today’s hearing will explore a difficult topic. The facilities we will be looking at 

receive no federal funding, and therefore are not regulated by the federal juvenile 

justice legislation under this Committee’s jurisdiction. Nonetheless, the allegations 

of mistreatment raise a number of serious questions. 

I want to recognize the families who are here today and thank them for their willingness to share their personal stories. The loss of a child is something no parent 

should have to endure. 

I also want to take the opportunity to recognize the Government Accountability 

Office for its work in this area. Often on issues like these, where our jurisdiction 

as federal lawmakers may be uncertain, the GAO’s work can help provide clarity. 

This includes an analysis of how these programs are funded and regulated, and 

what efforts are in place currently—at the state level, but also perhaps at the federal level—to ensure the safety and effectiveness of the programs. 

We will also hear today from a researcher in this field and, on behalf of practitioners, the National Association of Therapeutic Schools and Programs, who can 

offer perspectives on the regulatory framework in place, as well as steps that can 

be taken to improve upon current requirements to protect the youth in these facilities. 

As I understand it, the work of the GAO has focused on the question of whether 

allegations of abuse and death at these residential treatment facilities are widespread, and on providing a review of case studies. The GAO was unable to differentiate between public and private programs in determining how prevalent these allegations are, which demonstrates how difficult it may be to address this issue at the 

federal level. 

It seems to me that the question of how widespread these alleged incidents of mistreatment are is critical. Of course even one incident of abuse or worse, the loss of 

life, is unacceptable. But before we even consider federal intervention, we need to 

better understand the breadth of the problem so we can determine the best way to 

protect the youth in these programs. We need to take a step back to evaluate what 

an appropriate federal role would be, if any, in regulating these programs. This requires that we first understand current federal involvement, an area I hope we will 

explore today. 

Many of these facilities have been established to serve children who are deeply 

troubled. Whether they are suffering from drug addiction or severe emotional or behavioral problems, many of the youth who enter these facilities are placed there by 

their parents as a last resort. 

This Committee has held a series of hearings this year to examine how we can 

improve our juvenile justice system. Our efforts have focused on identifying effective 

strategies that prevent juvenile delinquency and encourage healthy child development. Although these privately-funded programs are not currently governed by the 

juvenile justice statute under our jurisdiction, I hope we can examine this issue 

through the broader context of juvenile delinquency prevention in order to understand how existing programs can meet the needs of troubled youth. 

Once again, let me thank the witnesses for being here to help shed light on these 

facilities, the role they play in serving troubled youth, and the efforts at the state 

and local level to ensure safety. I yield back the balance of my time. 

Chairman MILLER. I thank the gentleman for his statement. 

Without objection, all members will have 14 days to submit additional materials and questions for the hearing record. 

[The American Bar Association Recommendations, submitted by 

Mr. Miller, follow:]

7

American Bar Association Recommendations

February 12, 2007

RESOLVED, That the American Bar Association urges state, territorial, and tribal legislatures to enact laws that require the licensing, regulating, and monitoring 

of residential treatment facilities that are not funded by public or government systems, but are privately-operated overnight facilities that offer treatment to at-risk 

children and youth under age 18 for emotional, behavioral, educational, substance 

abuse, and social issues and problems, including strenuous athletic, mental health, 

and tough love programs. This legislation should: 

1. Require licensure of, or otherwise regulate, private residential treatment facilities by defining clearly which programs must comply with the statute and impose 

minimum legal requirements to operate and maintain them, including standards regarding staff qualifications and residents’ physical and emotional safety, educational, mental health, and other treatment needs. 

2. Require government monitoring and enforcement of the operational standards 

outlined in the statute. 

3. Promote the preferred use of appropriate in-home and community-based prevention and intervention programs for at-risk children and youth by requiring enhanced governmental support that provides families with better access to these programs. 

FURTHER RESOLVED, That the American Bar Association urges the Congress 

to enact legislation that would assure the safety of American children and youth 

placed in U.S-owned, but foreign-based unregulated private residential treatment 

facilities by requiring U.S. federal agencies to work with foreign governments to 

monitor such facilities regularly. 

Report: The ABA Youth at Risk Initiative and Relevant ABA Policy 

In August 2006, American Bar Association (ABA) President Karen Mathis 

launched the ABA Youth at Risk Initiative geared towards youth ages 13 to 19 who 

are at risk of entering juvenile and criminal justice systems. Many of these youth 

and families face problems that elevate this risk, including serious unmet mental 

health needs, serious emotional or behavioral problems, bad peer choices, and gang 

involvement. 

They require the use of proven, ‘‘evidence-based’’ services including appropriate 

in-home services that resolve these problems with the youth’s family and in the 

community.1 Also in August 2006, the ABA House of Delegates approved a recommendation urging state, territorial, and tribal governments to ensure that ‘‘community mental health systems serving youth are reinvigorated and significantly expanded to provide greater access to troubled youth and their caretakers.’’

The ABA has long supported appropriate government regulation and oversight of 

residential facilities serving children and youth. In 1979, the House of Delegates approved the Institute of Judicial Administration/American Bar Association Juvenile 

Justice Standards, in which the ABA called for ‘‘the provision of a safe, humane, 

caring environment, and access to required services for juveniles’’ with the ‘‘least 

possible restriction of liberty’’ necessary and a ‘‘careful adherence to legal rights’’ 

(Standard 1.2, Standards Relating to Correctional Administration). The standards 

also encouraged governments and independent agencies to assure the protection of 

juveniles’ substantive and procedural rights and pertinent laws and regulations 

were ‘‘continuously complied with’’ (Standards 1.2, 1.3, Standards Relating to Monitoring). 

More recent ABA resolutions have addressed similar and related issues. In 2004, 

an ABA resolution encouraged the use of law to ensure foster care children have 

‘‘uninterrupted education access’’ (August 2004). The ABA has also called for an increase in funding and financing ‘‘for public mental health services so that * * * juveniles with mental health or emotional illness or disorders can obtain the support 

necessary to enable them to live independently in the community, and to avoid contact with the criminal and juvenile justice systems.’’ (February 2004). In 1990, the 

ABA passed a resolution supporting juveniles’ right to physical safety ‘‘to be protected from abuse, physical violence, and sexual assault while in foster custody’’ 

(August 1990). 

In August 2004, the ABA approved Standards for the Custody, Placement and 

Care; Legal Representation; and Adjudication of Unaccompanied Alien Children in 

the United States. The standards state that unaccompanied alien children in residential facilities must always ‘‘be treated with dignity, respect and special concern 

for [their] particular vulnerability as a child’’ (III.B). They are ‘‘entitled to a reasonable right of privacy’’ including ‘‘the ability to talk privately on the phone without 

automatic monitoring; to receive and send uncensored mail; and to meet privately 

with attorneys and other visitors’’ (III.K). The standards also state that unaccomVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00011 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
8

panied alien children must be protected ‘‘from all forms of physical, sexual or mental 

violence, injury or abuse, as well as neglect, abandonment, maltreatment and exploitation’’ while in residential care (III.L). United States citizen children and youth 

placed by their parents or others in purportedly ‘‘therapeutic’’ unregulated private 

residential facilities require and deserve no less protection. 

This is by no means the first time the ABA has called for the protection of American children from harm in the international context. Indeed, the safety of American 

youth who might be placed in foreign-based facilities is also related to earlier concerns for children addressed by the House of Delegates. In August 1997, the Association endorsed U.S. ratification and full implementation of the Hague Convention 

on Jurisdiction, Applicable Law, Recognition, Enforcement and Co-operation in Respect of Parental Responsibility and Measures for the Protection of Children, which 

calls for protection of children who cross national borders. In February 1991, the 

ABA urged U.S. ratification of the Convention on the Rights of the Child (now ratified by over 190 nations but not the U.S.) which contains several provisions focused 

on the protection of children who cross national borders. Much earlier, the ABA’s 

call for the U.S. ratification of the Hague Convention on Civil Aspects of International Child Abduction (of which the U.S. is a party) demonstrates another instance of the ABA’s concern for children’s welfare when they are victims of international care and custody disputes. 

Unregulated Private Residential Treatment Facilities 

Since the early-1990s, parents have been placing their children and youth in unregulated private residential treatment facilities at an increasing rate. Hundreds of 

U.S. and foreign-based facilities have opened in the last ten years. It is estimated 

that these facilities serve between 10,000 and 14,000 American youth per year.2 Despite research on the efficacy of community-based and family-centered intervention 

and prevention programs and treatment, thousands of parents bypass available public systems and send, at their own expense, their ‘‘troubled’’ children and youth to 

unregulated private residential treatment facilities. 

As relayed in numerous newspaper articles and exposes, many children and youth 

enrolled in these programs are not afforded basic and fundamental rights and protections. Public media accounts share disturbing reports by youth and parents describing inferior treatments, educational access violations, and instances of mental, 

physical, and sexual maltreatment, neglect, and abuse.3 The Bazelon Center for 

Mental Health Law collected the following documented accounts (through media and 

Bazelon Center investigations and interviews) that represent only a fraction of the 

abuses children and youth have experienced: 4

• Limitations on the ability to contact parents for extended periods of time; 

• Overuse of medication to control behaviors. In some cases children and youth 

were permanently disfigured because of over-medication; 

• Confiscation of children’s and youths’ shoes to prevent them from running away; 

• Use of physical restraint techniques that last for hours at a time. The overuse 

of restraints has led to the death of some children and youth; and 

• Sexual abuse by facility staff members, in some instances having young girls 

exchange sexual favors for food. 

Despite egregious abuses, these facilities continue to grow in number and size. 

The industry is booming and reportedly worth over a billion dollars.5 A parent may 

pay between $3,000 and $5,000 dollars a month to send their child or youth to an 

unregulated private residential treatment facility and not be able to monitor his or 

her progress because of rules limiting family contact.6 The industry prospers on 

promises to modify troublesome behaviors and to make ‘‘bad’’ kids good. Its financial 

sustainability is assured by frequent deceptive advertising on the internet that market facilities as offering an array of mental health and educational services that are 

often not available or provided by unqualified staff.7

In 2005, Representative George Miller (D-CA) asked the U.S. Government Accountability Office (GAO) to conduct a comprehensive investigation of unregulated 

private residential treatment facilities in light of repeated reports and allegations 

of child abuse and fraud. In August of 2005, the Children’s Welfare League of America also called upon the GAO to conduct such an investigation, but it has not yet 

done so. 

Regulation, Oversight, and Monitoring of U.S.-Based Unregulated Private Residential Treatment Facilities 

The first part of this recommendation calls for state legislatures to pass laws that 

require states to license, regulate, and monitor unregulated private residential 

treatment facilities for children and youth. First, the recommendation encourages 

state legislators to define clearly which programs must comply with the law. Many 

9

unregulated private facilities have easily avoided state licensure and monitoring by 

claiming exemption in vague exceptions to state licensure requirements. For example, one facility skirted state oversight by designating itself as a ‘‘boarding school’’ 

rather than a residential treatment facility, despite its lack of educational services.8

Many state laws include broad provisions regarding oversight of residential treatment facilities that are easily avoided by programs that chose to designate themselves as something else, e.g., a ‘‘boot camp’’ or ‘‘boarding school.’’

The first part of the recommendation also encourages states to establish and enforce standards for licensure that assure the safety, health, and well-being of children and youth placed in these facilities. This standards requirement intends to 

combat the human rights violations and abuses that have occurred at so many facilities that remain unregulated by state law. Only a handful of states have proposed or passed comprehensive legislation that establish standards to monitor and 

regulate private residential treatment facilities for children and youth. 

For example, in 2005, the Utah legislature passed a law that expands state licensing requirements to all residential treatment programs, including ‘‘therapeutic 

schools.’’ 9 The Utah law requires the Utah Department of Human Services, Office 

of Licensing to establish health and safety standards for residential treatment licensees that address client safety and protection, staff qualifications and training, 

and the administration of medical procedures and standards. The new law also empowers the licensing office to revoke licenses if covered residential programs fail to 

meet the law’s standards or engage in conduct that poses a substantial risk of harm 

to any person. Any facility that continues to operate in violation of the law is guilty 

of a misdemeanor, if the violation endangers the welfare of clients. The law also requires the licensing office to designate local government officials as residential treatment facility inspectors who are charged with conducting compliance assessments. 

Finally, the first part of this recommendation encourages state legislatures to assure families access to in-home and community-based prevention services that have 

proven effective instead of unregulated private residential treatment facilities that 

have not shown their efficacy.10 Studies show that community mental health programs for children and youth with significant mental health and behavioral problems are more effective and less costly.11 In 1999, the U.S. Surgeon General, in his 

report on mental health, found that admissions to residential treatment facilities 

had been justified on the basis of community and child protection. These justifications, however, do not stand up to research scrutiny. Seriously violent and aggressive children and youth do not improve in these settings and community interventions that target change in peer associations are highly effective at reducing aggressive behaviors. Moreover, children and youth who need protection from themselves 

(i.e., who attempt suicide, persistently run away, or abuse drugs) may require a 

brief hospitalization for an acute crisis, but subsequent intensive community-based 

services may be more appropriate than a residential treatment facility.12

In 2003, the U.S. President’s New Freedom Commission on Mental Health called 

for better systems of care to detect early childhood emotional disturbances and provide prevention and intervention services to prevent these problems from worsening.13 A year later, the National Institutes of Health, State of the Science Conference—Preventing Violence and Related Health Risking Social Behaviors in Adolescents issued a statement affirming that ‘‘scare tactics’’ used at ‘‘get tough’’ programs and boot camps don’t work and in fact may make children’s and youths’ behavioral problems worse.14 Finally, communities all over the country have begun to 

implement evidence-based community programs for at-risk children and youth, such 

as treatment foster care, wraparound services, multisystemic therapy, and functional family therapy. 

Regulation, Oversight, and Monitoring of Foreign-Based Unregulated Private Residential Treatment Facilities 

The second part of this recommendation calls upon the federal government to 

oversee the operations of U.S.-owned unregulated private residential treatment facilities that are located abroad. To avoid state regulation and monitoring, many U.S. 

companies have opened private residential treatment facilities in the Caribbean or 

overseas. Some of the most egregious human rights violations against American 

children and youth have occurred in foreign-based unregulated facilities where they 

are restricted from communicating with family.15

To respond to these abuses, in 2004, the U.S. Department of State issued a fact 

sheet on privately-owned overseas behavior modification facilities stating that some 

facilities ask parents to sign contracts giving staff broad authority to take any action deemed necessary to assure children’s and youths’ progress in the program.16

The fact sheet also warns that children’s and youths’ communication privileges and 

10

contact with family and the outside world may be restricted. Finally, it warns parents that: 

The Department of State has no authority to regulate these entities * * * and 

does not maintain information about their corporate or legal structures or their relationships to each other or to organizations in the United States. The host country 

where the facility is located is solely responsible for compliance with any local safety, health, sanitation, and educational laws and regulations, including all licensing 

requirements of the staff in that country. These standards may not be strictly enforced or meet the standards of similar facilities in the United States. The Department of State has, at various times, received complaints about nutrition, housing, 

education, health issues, and methods of punishment used at some facilities. 

Prior to enrolling their minor children in such overseas ‘‘Behavior Modification 

Facilities,’’ the Department of State strongly recommends parents/guardians visit 

the facility and thoroughly inform themselves about both the facility and the host 

country’s rules governing it and its employees. 

In the 109th Congress (2005), Representative Miller (D-CA) proposed the ‘‘End Institutional Abuse Against Children Act,’’ 17 which requires the U.S. Department of 

Justice to coordinate with foreign countries to investigate and inspect foreign-based 

private residential treatment facilities, periodically. The proposed legislation also requires the justice department to issue protection and safety rules for foreign-based 

programs and requires the U.S. Department of State to report any abuses of American children and youth. 

Conclusion 

In February 2006, then ABA President-Elect Karen Mathis held a planning conference for her Youth at Risk Initiative. Sixty child welfare and juvenile justice experts participated in the conference and recommended that the ABA encourage the 

passage of legislation that: 

Prohibit[s] the operation of unlicensed, unregulated residential treatment facilities 

that operate programs whose efficacy has not been proven empirically, such as boot 

camps, tough love, and ‘‘scared straight’’ programs, and require the closing of such 

facilities. The law should provide for such facilities to be replaced with: better access 

to preventative services, with a focus on family involvement and community-based 

resources wherever possible; and carefully regulated ‘‘residential treatment facilities’’ that are reserved for youth whose dangerous behavior cannot be controlled except in a secure setting. 

These recommendations are a step towards achieving these goals. State and federal legislators have begun to take action in light of the abuses that have befallen 

children and youth placed by their parents in unregulated private residential treatment facilities. However, there is no comprehensive collection of data available 

about the number of programs that exist or the extent to which they are licensed, 

monitored or regulated. In many states there is a paucity of regulatory oversight 

or monitoring for these programs and as of yet, there is no federal guidance on the 

issue. It is time for the ABA to respond to these problems. The ABA must educate 

itself on the issues relating to this disturbing trend and encourage change that emphasizes the regulation, monitoring, and evaluation of unregulated private residential treatment facilities.

Respectfully submitted by Dwight Smith, Chairperson, Commission on Youth At 

Risk, February 2007. 

Executive summary 

1. Summary of the Recommendation 

This recommendation encourages efforts to require the licensing, regulating, and 

monitoring of residential treatment facilities that are not funded by public or government systems, but are privately-operated overnight facilities that offer treatment 

to at-risk children and youth for emotional, behavioral, educational, substance 

abuse, and social issues and problems, including strenuous athletic, mental health, 

and tough love programs. 

2. Summary of the Issue Which the Recommendation Addresses 

This recommendation addresses the lack of government oversight and monitoring 

of private unregulated residential treatment facilities by outlining aspects of government regulation that should be instituted to impose minimum legal requirements 

to operate and maintain these facilities, including standards regarding residents’ 

physical and emotional safety. 

11

3. Explanation of how the proposed policy will address the issue 

This resolution calls attention to the problems that face thousands of children and 

youth who are sent to private residential treatment facilities that are not regulated 

or monitored by government. It encourages such regulation and promotes the use 

of community-based services to ensure that these children and youth receive appropriate assistance that meets their educational, mental health and other treatment 

needs in a physically and emotionally safe environment. By bringing the ABA’s influence to bear on the entities that should oversee these programs, this resolution 

will encourage greater awareness, increased knowledge, improved laws and policies 

for these children and youth at risk. 

4. Summary of Any Identified Minority Views or Opposition 

No opposition to this recommendation has been identified. 

ENDNOTES

1 ‘‘Evidenced-based’’ refers to intervention and prevention programs that have been carefully 

assessed to determine their long-term positive outcomes. 2Pinto, A., et. al., Exploitation in the Name of ‘Specialty Schooling:’ What Counts as Sufficient 

Data? What are Psychologists to Do? Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida, 2005. <http://www.nospank.net/pinto.htm>. 3Gorenfeld, J. ‘‘No More Nightmares at Tranquility Bay?’’ AlterNet, January 2006; Dibble, S. 

‘‘Scrutiny Increased on Centers for Teens,’’ The San Diego Union Tribune, January 2005; Rowe, 

R. ‘‘Tranquility Bay: The Last Resort,’’ BBC News-World Edition, December 2004; Labi, N. 

‘‘Want Your Kid to Disappear?’’ Legal Affairs, July/August 2004; Kilzer, L. ‘‘Desperate Measures,’’ Denver Rocky Mountain News, July 1999. 4The Bazelon Center for Mental Health Law. Fact Sheet: Children in Residential Treatment 

Centers. Washington, DC. <http://www.bazelon.org/issues/children/factsheets.rtcs.htm>. 5 Chen, M. ‘‘At Some Youth ‘Treatment’ Facilities, ‘Tough Love’ Takes Brutal Forms.’’ The New 

Standard, November 2005. 6Szalavitz, M. ‘‘The Trouble with Tough Love,’’ Washington Post, January 2006. 

7Pinto, A., Specialty Schooling, 2005. 

8 ‘‘Desperate Measures,’’ July 1999. 

9Licensure of Programs and Facilities, Utah Senate Bill 107 (2005). 

10 Bazelon Center. Fact Sheet; see also U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of 

Mental Health, 1999, 169-171. 11Surgeon General, Mental Health, 1999, 169-171; McKechnie, M. Children’s Mental Health 

System in Oregon—Past, Present and Future. Portland, OR: Juvenile Rights Project, Inc., 2004. 

<http://www.jrplaw.org/MentalHealth.htm>; Chamberlain, P. ‘‘Treatment Foster Care.’’ Washington, DC: Juvenile Justice Bulletin, U.S. Department of Justice, Office of Justice Programs, 

Office of Juvenile Justice and Delinquency Prevention, 1998. 12Surgeon General, Mental Health, 1999, 169-171. 13President’s New Freedom Commission on Mental Health. Achieving the Promise: Transforming Mental Health Care in America. Washington, DC, 2003. <http://

www.mentalhealthcommission.gov/reports/Finalreport/FullReport.htm>. 14 National Institutes of Health. Preventing Violence and Related Health Risking Social Behaviors in Adolescents: an NIH State of the Science Conference Statement. Rockville, MD: U.S. 

National Institutes of Health, 2004. 15See, e.g., Bay, Gorenfeld, J. ‘‘No More Nightmares at Tranquility Bay?’’ AlterNet, January 

2006; Rowe, R. ‘‘Tranquility Bay: The Last Resort,’’ BBC News-World Edition, December 2004. 16 U.S. Department of State. Fact Sheet: Behavior Modification Facilities. Washington, DC: 

U.S. Department of State, 2004. <http://travel.state.gov/travel/tips/brochures/brochures—

1220.html>. 17 End Institutional Abuse Against Children Act, H.R. 1738, 109th Cong. (2005). 

[Letters submitted for the record follow:]

October 15, 2007. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: As the mother of a 17 year old son who went through 

an exemplary wilderness program for eight weeks at the beginning of 2007, and is 

now in his sixth month of an 18 month program at a top notch therapeutic boarding 

school, it was with great interest that I watched the approximately two hour hearing referenced above. I want to commend the House Committee on Education and 

Labor for taking up this important matter. Nothing could possibly be more important than the safety and welfare of our children, especially when we are seeking 

help for them to overcome serious problems. 

12

Our particular story began in August 2006 just prior to our son starting his junior 

year in high school. Throughout August, we discovered that our son had been leading a double life, having successfully hidden his drug abuse from us. I refer to a 

‘‘double life’’ because our son did not ditch school, always maintained a grade point 

average of at least 3.0, was not disrespectful to any large degree, participated in 

family life, was not out until all hours, etc. We discovered that most of his drug use 

was done (sometimes daily) at our local public high school in our upscale Southern 

Orange County, California neighborhood in the bathroom during school hours, and 

went completely undetected. Nevertheless, when it became apparent that our son 

was troubled more than what we considered to be within the range of normal adolescence angst, we took immediate action to get to the source of the problem. When 

he admitted to drug use, we took him to an adolescent psychologist, and a local drug 

education program followed by an intensive outpatient program through a hospital. 

In addition, at his request, he transferred schools so he could get away from his negative peer group. I cannot adequately express the hell we went through for six 

months frantically trying to get local help for our son. To say that we were in a 

state of shock, confusion, exhaustion and fear would be an understatement. Although our son managed to stay off drugs, we could see that his life was still not 

working; his grades began to fall, he seemed depressed, and appeared to need more 

help than we were able to find for him locally. When we came across a communication he had with a friend that indicated that although he had stayed away from 

substances, he missed them, he still identified with that way of life, and he was considering returning to using drugs, we knew we had to look for a different intervention. 

Finding a safe, effective residential program proved difficult at first. The personnel at the local drug education program suggested a small boys program in Utah. 

When we investigated the program and called parents whose children were at the 

program, we determined that it would not be an appropriate placement for our son. 

We were then referred by our psychologist to a marketing representative of a particular company that ran a number of programs in different states. She tried to convince us over the phone that we should send our son to one of their programs. Feeling uncomfortable with the limited choices that we were uncovering, I went on the 

internet and found an educational consultant. I called the consultant who spent a 

great deal of time explaining options to me, and then gave me other families he had 

worked with to call as a reference. I finally felt like I found someone who knew this 

industry well and would be diligent in finding a placement for our son. What still 

bothers me to this day is that as well read, involved people, my husband and I had 

no idea where to turn when we needed help for my son. We had to learn by trial 

and error about the options available, and could have very well made a terrible mistake. 

Sending our son out of state for treatment was one of the hardest decisions my 

husband and I have ever had to make. We are so grateful that through our educational consultant we were able to place our son in two superb programs. We believe with all our heart that our son’s life was saved by these programs, and if you 

spoke directly to him, he would say the same thing. He was never in any physical 

or emotional danger while in the wilderness or at his school. Quite the contrary—

he has been helped by highly competent, dedicated, trained and educated professionals who have mentored him with skill, honesty, love, understanding and compassion. The wilderness program has an incredibly high staff to student ratio, uses 

the highest quality equipment and communication systems, makes sure the participants are well fed and hydrated, checks their feet for frost bite daily (my son was 

in Utah during the winter), and watches the students’ physical health (my son had 

a case of shingles when he was there and he was immediately put under the care 

of a physician who prescribed antibiotics). The clinical staff at the wilderness program are nothing less than brilliant, and they got through to my son with counseling, activities in the great outdoors, assigning books for him to read, having him 

do written assignments, etc. They included our family every step of the way with 

weekly family phone sessions and written communications, as well as two visits 

while our son was there. In March, our son left the wilderness to become a student 

at a therapeutic boarding school. He has continued on his journey of self-discovery, 

is taking a full load of college preparatory classes, will graduate high school, and 

we anticipate that he will go on to college after completing the program. He is rediscovering his talents and passions, and wants a different, better life for himself. Last 

week, I spoke to his college counselor at his boarding school for over an hour. I am 

so grateful for this because with the kind of substance abuse in which our son was 

involved, we very well could have been talking to law enforcement, hospital emergency personnel or even to a morgue instead of a college counselor. Although no one 

can predict the future, we feel so much hope and confidence for our son’s life. 

13

After watching the hearing, and listening to the anguished stories of the parents 

who testified and the wrenching information brought out in the case studies that 

the Government Accountability Office (GAO) presented, there is no doubt in my 

mind that regulation, oversight, licensing and monitoring are needed. As Mr. 

McKeon so rightly stated, there are ‘‘bad actors’’ in every industry. The programs 

that deliver unsound, unsafe, abusive, neglectful, and sometimes even fatal, services 

to our children should be held accountable for their appalling actions. My heart goes 

out to the parents whose children died, and I understand that they shared their stories to prevent other families from having their children put in perilous situations. 

That being said, I hope that the more extensive industry-wide review that the 

GAO is preparing to present in early 2008 will include information on the many 

wonderful, clinically sound programs that have not only saved countless lives, but 

have given the teens the tools they need to have the opportunity to live full, productive and joyous lives. I encourage the Committee to take a bi-partisan approach 

(what could be more bi-partisan than our children?) in delving deeper into this issue 

in a careful, deliberate manner. We need sensible legislation, not legislation that 

could throw the baby out with the bath water and hamstring credible programs 

from helping our youth. There are programs that are operating ethically and effectively, and they should be consulted as a resource for safe standards and appropriate regulation. I’m sure that the ethical programs do not see it as a benefit to 

the industry to have substandard, dangerous programs in operation. 

The most disappointing facts to come out of the hearing is that the criminal justice system has not properly prosecuted the wrongdoers, and that the Forest Department wasn’t even aware that one of the programs in question was in arrears on its 

rent and that its permit had expired eight years ago. These examples prove that 

legislating regulation is just the start; making sure that the initiative is backed by 

funding and training for those charged with oversight, is the only way to make a 

real difference. 

I realize this communication is lengthy; however, this issue is of the utmost importance to me. Please do not hesitate to contact me if you would like any other 

information. 

Respectfully, 

MARLA KAUFMAN. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER:

I am requesting that these comments be placed on the Official Record regarding 

the October 10, 2007 House Committee on Education and Labor hearing on cases 

of child abuse and neglect at residential treatment centers. 

My daughter and our family were the grateful recipients of the highly professional 

services of a therapeutic boarding school and a wilderness program. She was heavily 

into drugs and alchohol, and was eventually date raped, after dropping out of High 

School. We chose, after much research to not have her be part of the ‘‘system’’ that 

gives her a number and wants her to be like everyone else. We chose a wilderness 

program that had a great reputation with the backing of many educational 

conslutants. After this program, we sent her to a therapeutic emotional growth 

boarding school. To put this into perspective, we saved her life and have our independent, strong, willful, and beautiful daughter with us today. No, she is not the 

perfect person that we all envision as parents, however she is not branded after 

being in a ‘‘system’’. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

The majority can be effected by the few, so, I am requesting that your Committee 

defer from drafting a bill until complete due diligence is done on the complete impact of the entire situation, which is your responsibility, is known. 

Sincerely, 

GREGG HEYNE. 

14

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I request that these comments be placed on the Official 

Record regarding the October 10, 2007 House Committee on Education and Labor 

hearing on cases of child abuse and neglect at residential treatment centers. 

I am the parent of a child who has completely turned his life around as a result 

of both having a ‘‘wilderness’’ experience with highly trained and skilled psychologists and counselors and then being placed in a therapeutic residential campus 

where he has been able to learn the kinds of life skills that will allow him to be 

a productive and contributing member of society. This would not, under any circumstance, have happened had he not been spirited away from his destructive home 

environment and placed in the kind of supportive and substance free environment 

that allowed him to achieve his potential. One year ago, I would have guaranteed 

that he would be dead today. Sending him away, against his will (to the extent he 

had any independent judgment) was the hardest most wrenching moment of my life. 

He is now my best friend, has become the kind of man I dreamed he would become 

and is ready to take on society fully aware of his weaknesses, but with a determination to overcome them. 

I am concerned that the proposed legislation is seeking to address admittedly 

harmful ‘‘schools’’ by creating a one size fits all solution. My son’s school is fully accredited by both the state and the independent accrediting bodies. It has a staff of 

highly qualified psychologists and persons trained to deal with adolescents who are 

at extreme risk. It is also expensive and my greatest sadness is the inability of so 

many other parents with lesser means to find schools like it. Not only will the creation of additional regulatory bodies create additional regulatory compliance- and 

yet more expense for parents who are truly at the end of all other options (and often 

of their finances), but variations among the states will create a nightmare for 

schools simply seeking to care for their wards. As a former school board president, 

I know that California’s rules relating to residential facilities were created, much 

like the current proposed legislation, to prevent abuse by effectively banning residential care schools and non-voluntary programs. While this prevents abuse at one 

level, it does not save the children most in need. Applying those rules to schools 

in other states would effectively bar California children from participating in programs that are often a last resort. 

The wilderness programs of 8-10 weeks where most of the children are first taken 

before they can enter a therapeutic school are tremendous first steps and have a 

remarkable track record of awakening kids to the desperate state of their lives. 

These are regulated by the states and should remain as such. Without this first introduction to assuming responsibility for their actions, the children would never succeed in the longer programs at the therapeutic schools. 

I would hope that before this bill is reported out there will be some effort by members or staff to visit some of the very successful schools. If any of those members 

or staff have teenage children, there first response will probably be: ‘‘How I wish 

my child were in a school like this!’’ Stories of abuse are legion in our society. Preventing families from having the opportunity to take their children out of a poisonous environment (for the child) and placing him or her in a responsible and caring institution would be just as abusive as the supposed cure. 

Thank you for your consideration. 

Sincerely, 

DEWEY WATSON, 

Tierney Watson & Healy, Cornerstone Law Group, San Francisco, CA. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son/daughter and our family were the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program. My 

daughter had serious problems when she was a young teenager that led us to send 

her first to a wonderful wilderness program and then to an emotional growth boarding school. The daughter who came back to us after almost 2 years was a changed 

child and is now a productive young adult. Without these programs we do not think 

she could have become the person she is. 

15

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. 

Sincerely, 

ILENE FERBER. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son and our family were the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program. My 16 yr. old son 

was suffering from emotional issues ( poor identity, needy, phony face, mother 

issues, anger, violence, etc) which resulted in his joining a gang and dealing in 

drugs for acceptance while flunking out of a high quality high school. He has an 

IQ over 160. We had him abducted into a wilderness program in Utah for 6 weeks 

which was the best thing in the world for him at that time. I visited the nomadic 

troop of troubled teens in the winter for only two nights but it was long enough to 

see the care, concern and love the 2 or 3 ever present counselors had for the 10 or 

12 in their particular group. There is no abuse, physical touching, corporal punishment or cold or hunger issues. They were fully equipped for the elements and I was 

impressed with how these VERY troubled inner city gang members eventually 

began to pull together, to hold each other accountable, to accept responsibility, to 

join in and follow the rules and to work like men. No matches, (rub sticks together 

for fire). They cook their own food over the fire every meal and change camp sites 

every day packing everything they own on their backs. No knives except with counselors for food preparation, no flash lights, no watches * * * only the sun to keep 

time. Some kids stayed for 4 to 5 months until clean and emotionally ready to move 

on. These kids were happy and proud, even while reluctantly accepting the idea of 

rules and responsibility. 

After the wilderness program he attended an emotional growth school for 24 

months where he truly gain the life skills to put his life back on track. He accelerated his education (no TV, no phones, no ipods, no electronic games, etc.) and graduated from high school with a 3.1 GPA while also graduating from the schools emotional growth program. My son is now 19 and is a sophomore at Portland State University with a 3.2 GPA. He chose to live with me rather than his mother and has 

become a very squared away young man. I am very proud of the work he did for 

himself at both wilderness program and the emotional growth school. He and many 

others would be lost with out these services. I feel sorry for the many families who 

cannot afford or are not aware of these fine schools. Unfortunately, many of kids 

will end up in our court and penal systems instead of these much better programs. 

The government should help fund, but not regulate this work. Look what the government has done to most school systems. Free enterprise does a much more efficient, effective and economical job. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. 

MIKE DUYN, 

Macadam Forbes, Oncor Intl., Portland, OR. 

16

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I have heard about the bill you are sponsoring about 

child abuse at Residential treatment centers. I surely applaud any desire to end 

abuse, but wanted you to know the tremendous good the legit schools do. My son 

was going down a path of failure and drug abuse in high school. We had tried at 

the normal ways of helping him, drug counseling, tutors, special education plans, 

etc. but nothing worked. We were at wits end. Although we are middle class, I am 

a construction super and my wife was a gov’t secretary, we got a second mortgage 

on our house and got a educational consultant involved. She found a wilderness program for my son, and then a residential emotional growth school. We were reluctant 

at first of course, sending away our son for someone else to parent. And we had 

heard some of the horror stories about programs (in Costa Rica I think). But we 

visited some schools and found one that fit. Our son spend two years there. Two 

years he may not have had otherwise. the school was amazing, full of love and caring people who helped not only my son, but my wife and I as parents also. My son 

learned so much there, mainly to have the self esteem to value himself more than 

he did. He still struggles, as most young people do, but he is alive and happy and 

drug free. That was a gift to us beyond value. So I wanted you to know that there 

are many good programs out there. And they do tremendous good for so many families. We could barely afford the school, and I am worried that the passing of this 

bill as is will only escalate the costs so only the very rich can afford them. 

So please in your efforts to help, consider the effect this bill will have on the good, 

no LIFESAVING programs. The added paperwork and buracratic requirements will 

only make it harder for the schools to exist. 

I have read that many of the states that have abuse problems are handling it 

themselves with their own bills too. I am sure there are State’s right’s issues here 

also. A federal bill might make a school in one state have to meet the licensing requirements in the home state, further adding to the mess. 

Your bill is for a noble cause, but please be careful you don’t harm more families 

than you help. 

Please add my comments to the Official record regarding the Oct. 10 2007 House 

Committee on Education and Labor hearing on cases of child abuse and neglect at 

residential treatment centers. 

Thank you for you time, 

CHARLES H. BIRD JR., 

Waldorf MD. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son and our family are the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program. Our son was going 

down a dangerous path of self-destruction and oppositional behavior. Without access 

to the wonderful wilderness program and unbelievably effective therapeutic boarding school that he is at, he would never have been able to make the incredible 

changes that were necessary to turn his life around. If all children could attend 

school like this our jails would be empty. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. 

Please exclude emotional growth and therapeutic boarding schools from your proposed bill. It will only serve to place an undue burden on the children, parents, and 

administrators of such schools by making them devote more time to filling out government forms than teaching and helping. 

17

Thanks for your time. 

Sincerely, 

DENISE J. GRIGST. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that my comments be placed on the Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son has been through an excellent Wilderness Program and is currently in a 

wonderful Therapeutic Boarding School. He has never been more happy or productive in his life. I think the end result of this therapy will be to develop a productive 

member of society in a young man who had little chance of this a year ago. 

As in most things, there are good and bad. My wife and I personally put in a 

great effort and expense to find the right placements for our son and I urge other 

families to do the same. I hope that your Committee will not throw the baby out 

with the bath water regarding these treatment programs. Please find a way to preserve the good ones without making them more expensive. They are already a financial burden for most of us who have had to send our child there in the hope of saving their life. 

Respectfully, 

STEPHEN J. FOLZENLOGEN, 

Houston, Texas. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My daughter and our family were the grateful recipients of the highly professional 

services of a therapeutic boarding school and a wilderness program. Our school district had no viable options for my daughter, and she was on a risky and self-destructive path. At our wits’ end, our family life in disarray, we turned to an educational 

consultant who after meeting with us and interviewing my daughter recommended 

a wilderness program and therapeutic boarding school that I believe may have 

saved my daughter’s life. As a result of this intervention, today my daughter is 

doing very well as a healthy and productive student at a major college of art. 

I’m sure you would agree that the vast majority of therapeutic emotional growth 

boarding schools and wilderness programs are professional, experienced, ethical and 

extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until care and 

complete due diligence is accomplished on the complete impact the bill will have on 

the entire situation. 

Thank you. 

Respectfully, 

NEAL HIRSCH, 

Highland Park, IL. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son and our family were the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program. My son had issues 

growing through adolescence, which as a family we were not able to solve at home. 

We tried for nearly 15 months. He was and is an exceptionally bright child, who 

was heading on a path to jail or death. Until his issues surfaced, he was a perfect 

18

son, so to speak. Our need was to protect him, and provide a means for him to grow 

emotionally, in a safe and therapeutic environment. The program he attended was 

great for him and for our family. We re-connected and learned a lot about his inner 

issues and his poor coping mechanisms to deal with stress. He graduated high 

school at his emotional growth boarding school, came home for the summer and now 

is off at UC Berkeley. Had we not intervened with this therapeutic boarding school 

program, he would probably be in a juvenile hall, and if lucky rebuilding his life 

through community colleges. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. I appreciate the need to ensure ALL program are run safely, and as a parent 

it was a very scary process finding a good one. We found that educational consultants help identify schools, through their network and expertise. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. Placing a bureaucracy upon a system that in the most part 

is working, may increase costs and dis empower the schools to provide the structure 

they need. Unfortunately most of these kids have come from public schools, where 

for various reasons, all administration keep arms length with any issues with the 

kids, thus creating the legislated low-boundary type environment that kids with 

emotional issues just flounder in. 

Thank you for reading my comments, 

ELAINE WUERTZ. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: Please place the following comments on the Official 

Record regarding the October 10, 2007, House Committee on Education and Labor 

hearing on cases of child abuse and neglect at residential treatment centers. 

I understand that some recent, high-profile cases are propelling you to take action 

on wilderness programs and residential treatment centers. I would like to urge you 

to proceed with caution. 

My son recently spent several years attending wilderness programs and a therapeutic, emotional growth boarding school, following his explusion in rapid succession 

from several private and public schools in the Bay Area. 

He was making extremely bad choices and his behavior was out of control. 

Although he is extremely bright, my son also has ADHD, and his many teachers 

through the years had managed to instill in him the belief that he was stupid because he couldn’t sit still in class. His recourse was to try to position himself as a 

‘‘bad boy,’’ and he was able to indulge that fantasy to the extreme in the toxic social 

environment that children encounter in the Bay Area. I had to get him out of there 

and away from all the terrible peer pressure. 

My son spent 10 weeks in a Wilderness Program where he was able to detoxify 

his body, start to explore his behavior and motivations, and develop tremendous 

pride in his ability to ‘‘bust’’ a fire and move through the mountains without leaving 

a trace. He then spent a year at an emotional growth boarding school where he was 

enveloped in a loving culture far from the influences of TV, video games, gangsta 

rap, drugs, and negative peer pressure. He developed respect for his own intellect 

and started to do very well in his academic classes. He also learned to cook for the 

school, fell trees and remove tree stumps, care for the farm animals, sew clothes, 

cross-country and telemark ski, and numerous other skills that he never would have 

developed in the fast-paced, self-indulgent Bay Area. 

Our path was not a straight one. My son was not ready to give up his old image 

that easily, so he ended up back at Wilderness for another 10 weeks, and then attended a residential treatment center for about a year. He was finally able to leave 

the world of programs to attend his senior year at a more traditional boarding 

school, and he excelled. He is now enrolled as a freshman in the business school 

of a California university and is eager to get on with his life. He also believes that 

he has been fortunate to develop more emotional skills and maturity than any of 

his peers. 

The programs my son attended, along with the vast majority of wilderness programs, therapeutic emotional growth boarding schools, and residential treatment 

centers, are professional, experienced, ethical, and extremely valuable to children 

and families in crisis. As in our case and many others, they save lives and families. 

19

My son continues to tell me that he would be dead by now if I hadn’t sent him 

away. 

I am extremely concerned that the problems of a few programs might result in 

harm to the majority of them because of legislative over-reaction and heavy handedness. Harm to the programs will result in harm to the families that depend on 

them. Bad or unnecessary legislation will result in: 

• Higher costs and loss of resources to administrative functions. These programs 

are already extremely costly and present significant financial hardship to the families that rely on them. If they were to become more expensive due to unecessary 

bureaucracy, many families would find them completely unaffordable, and many 

children would be at risk. 

• The lumping of successful and ethical schools with abusive fringe programs. 

• Sensationalism that will further stigmatize the parents and children who have 

benefited so significantly from these programs. Most of us have had little support 

from our family and friends in this process because they just don’t get it—they 

haven’t had to live with our troubled children, and they don’t understand what 

these kids need to get better. 

I understand the current hearings are based, in part, on a report requested by 

you and issued by the Government Accountability Office, entitled ‘‘Residential 

Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs 

for Troubled Youth.’’ It should be noted that many of the cases cited in the report 

are over 10 years old. States have been and are currently adopting oversight and 

safety standards in response to these and other cases. This issue is a state’s rights 

(10th Amendment) issue: the states should retain the authority to regulate such 

programs as each state feels is appropriate. The concerns are already being dealt 

with responsibly at the state level so no federal government action should be needed 

at this time. 

In conclusion, I am asking that your Committee defer from drafting a bill until 

complete due diligence is done and the complete impact of the entire situation is 

known. Children’s lives are at risk if you make these programs less affordable and 

accessible. We need them. 

Sincerely, 

BARBARA B. KAMM, 

Los Altos, CA. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son and our family were the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. 

Sincerely yours, 

SETH FINKLESTEIN, M.D., 

Biotrofix, Inc., Needham, MA. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

There must be a distinction drawn between the types of programs that any new law 

would cover. The radical, 60 Minutes type of hysteria of the yelling and screaming 

drill instructor is far different than the type of program my daughter experienced 

20

during her seven weeks spent in wilderness and then eighteen months at her boarding school. 

My daughter and our family were the grateful recipients of the highly professional 

services of a therapeutic boarding school and a wilderness program. The program 

is a highly successful emotional growth, therapeutic boarding school that provided 

a miracle by allowing my child to become a happy, resilient, contributing member 

of society. Many methods were employed to achieve this result, the greatest of all 

was learning to trust in a very loving encouraging atmosphere. No ‘military’ tactics 

were ever allowed, it was not consistent with the founders vision. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. 

HOWARD L. PAGE, 

Residential & Commercial Broker. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

Our daughter and our family were the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program. Our 

daughter, outside her past environment, has matured. She is now able to articulate 

her feelings and addressed many issues that were preventing her from being the 

whole and beautiful young woman, and better citizen, that she is now. This has 

changed our lives. If there were more attention being paid to the local public schools 

in our country, many of these problems would be lessened for sure. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. The word ‘‘professional’’ is key here. The professional schools are not the problem. They do not need the burden of beuracracy and they need to be subsidized, if 

anything. 

I am extremely concerned if problems of a few, and scattered, results in harm to 

the majority, that is doing good. So, I am requesting that your Committee defer 

from drafting a bill until complete due diligence is done on the complete impact of 

the entire situation, which is your responsibility, is known. STOP THE DRAFTING 

OF THIS BILL. 

Don’t burden the parents and programs that are professional and well respected. 

I am a California resident, a citizen, a voter and a caring parent (who has to 

struggle with this issue, in large part, because of the abysmal public schools!). 

Very sincerely yours, 

BILL SMITROVICH. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

Our son’s life was saved by the Wilderness Program and following that, the emotional growth boarding school he attended. He went from being a child lost, on his 

way to certain death via drugs and alcohol (at the base of this behavior—low selfesteem) to a happy, productive, amazing young man who will contribute greatly to 

our society. 

We understand that there are programs that are unethical and can be abusive 

to children. This was our greatest fear in sending our son away. We did maniacal 

research on schools and while were fortunate to have found safe and beneficial environments, we certainly read about unethical facilities in business to profit from the 

21

tragedies and desperation of families in crisis. We are in complete agreement that 

these facilities should be closed. However, widespread legislation that forces the 

places that are helping our children, would be devastating. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. I can’t imagine where we would be if we hadn’t found 

such a place. 

It is vital that the schools that do help our youth are not negatively impacted by 

this bill. I am requesting that your Committee defer from drafting a bill until complete due diligence is done on the complete impact of the entire situation. 

I am happy to share our story and have attached a presentation that discusses 

the impact that low self-esteem can have on individuals and how powerful the 

change can be when they are in a safe, nurturing environment, with people who 

know how to deal with these issues. Please feel free to call us if you would like further information. 

Regards, 

SHELLY AND DAVID SEEGER, 

Symantec Corp. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

Our daughter and our family were the grateful recipients of the highly professional services of a wilderness program and a therapeutic emotional growth boarding school from September 2005 through June 2007. Our daughter, who had previously been an honor student and positively active teen, reacted to a boyfriend 

breaking up with her by slipping into depression and trying to ease those feelings 

with dangerous behaviors around alcohol, sexual promiscuity, and drugs. During a 

turbulent downward spiral the summer of ’05, she grew angry and defiant and in 

August ran away to California. We found her 9 days later and brought her home, 

but she believed her life was over and was intent on destroying herself. We understood that we needed to take action for our daughter and we sought out the help 

of an educational consultant who helped us to select the right wilderness program 

for our daughter (she was there for 91⁄2 weeks) and also the emotional growth boarding school where she enrolled in November 2005 and from which she graduated in 

June 2007. These programs saved her life and our entire family has benefited from 

the experiences The emotional growth school she attended is founded on the values 

of honesty and love. We/she wish that all students could grow and flourish in the 

positive environment that her emotional growth school provided and continues to 

provide. (Yes, she went back to visit over Labor Day and stays in contact with both 

staff and other students from the school.) Our daughter is now a freshman at University of Colorado—Colorado Springs and is pursuing a degree in psychology which 

will allow her to work with troubled teens and ‘‘give back’’. 

While there are some less than desirable programs/schools, the vast majority of 

therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. 

As in our case and many others, they save lives and families. The current expense 

structure was a significant hurdle for us but we found a way through a second home 

equity loan to pay for the help our daughter needed. These costs are already extremely high and it is wrong to put more bureaucratic cost onto the backs of parents 

when it is not needed. Please find a way to bring the poorly run programs into line 

without adding cost to programs that are well run and extremely effective in saving/

changing lives. 

I am concerned that your committee will let problems with a few programs/schools 

result in harm to the majority of well run and effective programs/schools. I am requesting that your committee defer from drafting a bill until complete due diligence 

is done on the overall impact of the entire situation. It is your responsibility to act 

with complete knowledge and not with a partial understanding of the ‘‘sensational’’ 

situations that are in the minority but get all the media attention and coverage. 

Please take into consideraton what federal legislation will do to the majority of proVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00025 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
22

grams, such as the ones our family experienced. Our daughter will tell you that they 

‘‘saved my life’’. 

Sincerely, 

DEBRA R. BRYANT, 

Monument, CO. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: We are requesting that the following comments be 

placed on the Official Record regarding the October 10, 2007 House Committee on 

Education and Labor hearing on ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities’’. 

Our daughter completed a 2 month wilderness program and is currently enrolled 

in a therapeutic boarding school. Prior to enrolling her in these programs we were 

keenly aware of, and were very concerned about of mistreatment in such programs. 

Of course, we wanted to ensure that our daughter was placed in an environment 

that was, first and foremost, safe and one where she would receive the type of care 

she and our family needed to get our lives back on track. We conducted extensive 

research and engaged with an educational consultant to assist us in our search. 

We learned that there is a broad range of programs which may be referred to as 

‘‘Residential Treatment Facilities’’. We were convinced that the vast majority of wilderness programs and therapeutic boarding schools which we investigated are professionally run, experienced, ethical and, most important extremely valuable to children and families such as ours. Such programs have saved lives and families. 

We are happy to report that our daughter has made remarkable progress as a direct result of the outstanding care and treatment she has received in both the wilderness program and the therapeutic boarding school. 

We agree that there is a need to put an end to all mistreatment but we believe 

this may only occur at only a small percentage of wilderness and residential treatment programs and it is not clear that mistreatment at residential treatment facilities is on the rise or decline. We are extremely concerned that increased regulation, 

aimed at addressing the problems of a few, could become intrusive and harmful to 

many reputable programs and affected families such as ours. 

We believe it is the committee’s responsibility, as it is ours as parents, to do what 

is in the best interest of our children and for our families. We hereby request that 

your Committee refrain from drafting legislation or taking any action until due diligence is done to more completely assess the situation. 

Respectfully yours, 

RICHARD AND DIANE SCHENO, 

Fremont, CA. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My daughter and our family were the grateful recipients of the highly professional 

services of a residential treatment center and a wilderness program in Utah. 

Our 15 year old daughter had become practically non-functional due to emotional 

issues. We had a team of therapists and doctors here at home working with her but 

it was only when she went to a wilderness program that we started to see real 

progress. After wilderness, she went to a residential treatment center where she got 

the care and support of an amazing therapeutic team. It is here that she learned 

the skills needed to cope with her emotional problems; it was here that real and 

lasting change was made. 

These two programs saved our daughter’s life. Many of the therapists and counselors who work at these programs are performing miracles every day, changing the 

lives of so many troubled teenagers. 

While reading the GAO’s report of abuse at some facilities is heartbreaking, I believe that the vast majority of residential treatment centers, therapeutic boarding 

schools and wilderness programs are professional, experienced, and ethically run. I 

also believe that continued regulations and oversight are critical for the safety of 

23

the residents in the programs. However, I hope that the problems caused by a few 

will not result in harm to the over all industry. 

These facilities provide a much needed level of service for so many families in crisis. Please don’t throw the baby out with the bath water. 

I am respectfully requesting that your Committee defer from drafting a bill until 

an assessment of the entire situation is done. 

Sincerely, 

ANN AND PHIL SHERIDAN, 

San Jose, CA. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: As a lifelong democrat and former constituent from the 

East Bay, I always supported your efforts and hope you will continue to reward my 

faith. I have some concerns regarding the October 10, 2007 House Committee on 

Education and Labor hearing on cases of child abuse and neglect at residential 

treatment centers. I am requesting that my comments be placed on the Official 

Record regarding this hearing. 

Our daughter and our family were the grateful recipients of the highly professional services of a therapeutic boarding school and a wilderness program beginning 

in 2005. Our daughter had previously fought severe depression and low self-esteem 

which lead her into self-destructive behavior. After years of therapy and even moving to a rural environment in a new state, my wife and I became desperate. We took 

what we believed to be a huge step and enrolled her in a wilderness program followed by a therapeutic boarding school. We found both programs to be highly professional and rewarding. Our daughter turned 18 while attending the boarding school, 

and stayed on another 9 months of her own choice as an adult in order to graduate. 

She is now living at home, attending college full time and working part time. Those 

programs saved our daughter and positioned her to thrive. 

The vast majority of therapeutic emotional growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned that problems with a few abusive programs may result 

in harm to the majority of programs. So, I am requesting that your Committee defer 

from drafting a bill until complete due diligence is done to thoroughly explore the 

residential treatment situation and how legislation might effect the good ethical programs as well as the bad. I agree that abusive programs must be ‘‘cleaned up’’ as 

quickly as possible, but I hope you can find a way to do that without encumbering 

the beneficial programs with unnecessary bureacrasy, while burdening the families 

with added costs. 

I wish you well in your efforts. 

Sincerely, 

PETE SMALL, 

Ridgefield, WA. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: We are requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

Our son and our family are the VERY grateful recipients of the highly professional services of a residential treatment center (RTC) and a therapeutic wilderness 

program. We are quite sure that without the assistance of the professionals at the 

RTC and the amazing therapist he worked with in wilderness, he would be part of 

the juvenile system and most likely, hopelessly addicted. 

We believe our story is typical for a child without underlying mental illness. The 

short version is that our son started to experiment with marijuana with his friends 

at about the age of 14. In his freshman year, his grades nose dived; he was using 

more and a greater variety of readily available street drugs. Out patient therapy 

was ineffective in getting the behavior under control. We dug into our retirement 

funds to send him to a non-therapeutic boarding school that offered ‘‘success 

through structure.’’ Unfortunately, that school enrolled a large group of adolescents 

24

that really needed a therapeutic environment because they had serious drug use 

and behavioral issues. Many of those children got worse, not better. The result for 

our child is that he used more drugs more frequently, despite the punishment of 

longer and longer detention and more severe campus restrictions, and he began to 

get in trouble with the authorities. He was arrested twice—once for assault and 

once for minor in possession. The frightening thing for us was that we could tell 

that he was scared and he was trying to change, but he couldn’t * * * he didn’t 

have the skills and by this time, he was not only scared, but angry and defiant. As 

parents, we knew that at the young age of 16, he was on the verge of making decisions that would have negative, life changing consequences. 

We decided to send him to a Wilderness Therapy program that came highly recommended by our educational consultant * * * we hired ed consultants because we 

realized that doing it on our own had led us to the first bad choice for placement. 

The wilderness program we used operates in the Blue Ridge Mountains and undoubtedly uses Federal lands. His initial reaction was to try to run and he resisted 

for about 2 weeks. But, then he finally ‘‘worked the program.’’ The program in this 

case was to help him reconnect with his old self, to become sober, to understand 

his anger and motivations and to become open to change. He was guided in this 

journey by a wonderful therapist with over 25 years of experience in working with 

adolescents. It was hard for him, but he was never in danger physically. We realize 

wilderness therapy isn’t for every kid, but his personnel growth during that period 

was phenomenal. In his own words, it was the ‘‘best worst thing I ever did’’ and 

he thanked us for sending him. 

We followed wilderness therapy with a private and well respected Residential 

Treatment Center in Utah (for this we have remortgaged our home). He is thriving. 

He has the guidance of a skilled therapist, is a leader among the other teen boys 

(strong positive peer culture environment); he is working a 12-step program to deal 

with addiction issues, his health has improved and his grades are up. Again he has 

thanked us. On the home front, we are participating in family therapy with him and 

with our other children to shore up our parenting skills and the extra skills we will 

need to support him when he is back. We are working toward bringing him home 

early next year. 

Prior to hearing about your inquiry at the Committee level, we had considered 

writing to our congressional representatives (Blumenauer, Smith and Wyden) to 

urge them to help families pay for this kind of life saving intervention. Our insurance (Federal Employee Program through Blue Cross Blue Shield) categorically excludes residential treatment and wilderness. The result is that we have sacrificed 

retirement and home equity. But we feel fortunate that we had those resources to 

tap into. Most families that we talk to who are also using these programs make 

these same sacrifices to afford the care their child needs. Many families cannot afford it and their children are at the very least jeopardizing their health and future, 

if not filling up juvenile detention facilities and jails. We ask that you avail yourselves to recent studies on the successful outcomes of children placed in well run 

private RTCs, therapeutic boarding schools and wilderness programs. Take input 

from juvenile probation officers and others in law enforcement, most of whom consider these interventions as positive alternatives to the juvenile court system. 

We realize there has been a virtual boom in the adolescent treatment industry 

and with that has come the establishment of some disreputable and unsafe places 

that prey on families in crisis. Our hearts ache for the parents that have lost children while trying to save them. Still, you must find a way to support the work of 

residential treatment centers, therapeutic emotional growth boarding schools and 

wilderness programs that are run by professionals, who are experienced, ethical and 

extremely valuable to the recovery of children and their families. As in our case and 

many others, they save lives and families. 

We are extremely concerned that the problems with a few bad programs will result in harm to the majority. So, we are requesting that your Committee defer from 

drafting a bill until complete due diligence is done and the entire situation is 

known. 

Thank you for considering and including our comments. 

Very respectfully yours, 

SHERYL CARRUBBA AND MARK MCCLURE, 

Portland, OR. 

25

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

My son and our family were the grateful recipients of the highly professional services of a residential treatment center and a wilderness program. We want you to 

know that at no time in either wilderness or RTC was there anything remotely close 

to physical abuse. 

This is our son’s story: 

By April, 2006 our 16 year old son was severely depressed, thought he was worthless and was failing in school—and had started self-medicating with a wide range 

of drugs. We were lucky in that our family has always gotten along with each other 

and had open communications. As parents, we did all we could and still his situation continued to worsen. We simply did not have the tools, knowledge or skills to 

help him. It was only a matter of time before he would be in jail or dead. And he 

didn’t care. 

We did an intervention and sent him to a wonderful wilderness program. Two 

months in the Utah desert helped a lot, but he was still not ready to come home. 

Although he was now clean, he still hadn’t done the hard work to look deep within 

himself to change his way of life and learn the tools that could help him do that. 

It took 10 months in a residential treatment center for him get his life in order. 

The RTC staff was demanding, but also loving and kind. 

Today our son is a mature young man who has been clean and sober for 18 

months. He is happy, confident and looking forward to going to college to become 

a therapist in order to give other at risk kids a reason to live. 

He went back to his wilderness program this past summer as a 12-step volunteer 

in order to help kids that were like him 18 months ago. He’s been invited to work 

there next summer because of the positive impact he had on the kids. 

The vast majority of residential treatment centers, therapeutic emotional growth 

boarding schools and wilderness programs are professional, experienced, ethical and 

extremely valuable to children and families in crisis. As in our case and many others, they save lives and families. 

I am extremely concerned if problems with a few result in harm to the majority. 

So, I am requesting that your Committee defer from drafting a bill until complete 

due diligence is done on the complete impact of the entire situation, which is your 

responsibility, is known. 

Sincerely, 

BARBARA DAMM AND JOHN MCKINNEY, 

6th California Congressional District. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: Our daughter and our family are recipients of the highly 

professional services of a therapeutic boarding school and a wilderness program. 

Lindsey was fourteen years old when we decided that she could no longer live at 

home with us without being a danger to herself. Lindsey did not want to abide by 

our rules and no matter the warnings, consequences, etc. she did not take us seriously. She was drinking, smoking marijuana and behaving in a manner that was 

totally out of control. We hired an educational consultant and by interviews determined that Lindsey needed to experience being at a Wilderness camp and then on 

to some type of boarding school. Lindsey stayed at the wilderness camp for ten 

weeks and in those weeks she began to slowly recognize her lack of self esteem and 

self confidence that led to her negative choices. The hard work both emotional and 

physical was facilitated by a highly competent and caring staff and therapist who 

believed in Lindsey. Although at the end of ten weeks strides of improvements were 

made we all knew that she was not ready to come back home. Lindsey is now enrolled at an emotional growth treatment school run by a team of administrators, 

teachers, staff and qualified therapists where she is being positively challenged to 

be accountable, honest, loving and vunerable in academics, emotional issues and 

physical abilities. It is good, hard work for her. As her parents, we are also challenged to do our part to improve our communication and relationship with each 

other. We are committed to this school for helping us navigate through a process 

of growth which ten months ago looked bleak. 

26

Families like ours are extremely grateful for these types of options such as wilderness camp and emotional growth/residential treatment facilities. This is why we are 

extremely concerned that problems with a few such facilities (such as neglect and 

abuse) result in harm to the majority. We are requesting that your Committee defer 

from drafting a bill until complete due diligence is done on the entire situation and 

results are known. 

We are requesting that our comments be placed on the Official Record regarding 

the October 10, 2007 House Committee on Education and Labor hearing on cases 

of child abuse and neglect at residential treatment centers. 

Sincerely, 

KURT AND ARLENE BOSSHARD, 

Kapaa, HI. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: I am requesting that these comments be placed on the 

Official Record regarding the October 10, 2007 House Committee on Education and 

Labor hearing on cases of child abuse and neglect at residential treatment centers. 

Our son and our family were the grateful recipients of the highly professional 

services of a therapeutic boarding school and a wilderness program. Our son had 

started on a downward spiral in his sophomore year of high school, smoking marijuana and not doing his school work. He ended that year using a multitude of different drugs and binge-drinking alcohol. After desperately exploring what options 

were available to us, we heard from a friend of the family about a wilderness program that had saved his daughter’s life. We worked with an educational consultant 

whom the friend recommended and chose the same wilderness program. This program was run in a caring and conscientous manner, and their counselors and staff 

are outstanding. Our son ended up liking the program and learned much about himself. He is even considering working there when he graduates from high school. He 

is now enrolled in an emotional growth/therapeutic boarding school. Whereas the 

wilderness program is the first step in taking a young person out of an unhealthy 

environment, the therapeutic boarding school provides a deep learning of healthy 

habits and cements them in an 18-month program. The program involves the whole 

family in this learning process. I can unequivocally say that this experience has 

saved our son’s life! 

I have met and spoken with numerous other parents whose children have attended similar programs. They all had excellent experiences and were extremely 

grateful that those options are available. The vast majority of therapeutic/emotional 

growth boarding schools and wilderness programs are professional, experienced, ethical and extremely valuable to children and families in crisis. As in our case and 

many others, they save lives and families. 

I am extremely concerned if problems with a few programs result in harm to the 

majority. So, I am requesting that your Committee defer from drafting a bill until 

complete due diligence is done and the complete impact of the entire situation is 

assessed. 

Sincerely, 

INGE JECHART, 

Pleasanton, CA. 

[Questions for the record submitted to Dr. Pinto follow:]

CONGRESS OF THE UNITED STATES, 

Washington, DC, October 15, 2007. 

Allison Pinto, Ph.D., Complexity Research & Development, 

Children’s Board of Hillsborough County, Tampa, FL. 

DEAR DR. PINTO: Thank you for testifying at the October 10, 2007 full Committee 

hearing, ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities.’’ Enclosed are the questions which Committee members have asked you to respond for the record. Please send an electronic version of your written response (in 

Word format) to the Committee staff by COB on Wednesday, October 24, 2007—the 

date on which the hearing record will close. If you have any questions, please contact us. Once again, we greatly appreciate your testimony at this hearing. 

Sincerely, 

GEORGE MILLER, Chairman.

27

Representative Robert Scott (D-VA), has asked that you respond in writing to the 

following questions: 

1) Do ‘‘tough love’’ strategies have an appropriate treatment role for major psychological disorders? If so, what is that role? 

2) Is there currently an obligation for mental health professionals who recommend 

these programs to clients to ascertain their safety and validity as a treatment option? 

3) Is there currently any requirement that other treatment options be utilized to 

address a child’s behavioral issues before sending them to such a center? 

[Questions for the record submitted to Mr. Kutz follow:]

CONGRESS OF THE UNITED STATES, 

Washington, DC, October 15, 2007. 

Gregory D. Kutz, Managing Director, 

Forensic Audits and Special Investigations, GAO, Washington, DC. 

DEAR MR. KUTZ: Thank you for testifying at the October 10, 2007 full Committee 

hearing, ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities.’’ Enclosed are the questions which Committee members have asked you to respond for the record. Please send an electronic version of your written response (in 

Word format) to the Committee staff by COB on Wednesday, October 24, 2007—the 

date on which the hearing record will close. If you have any questions, please contact us. Once again, we greatly appreciate your testimony at this hearing. 

Sincerely, 

GEORGE MILLER, Chairman.

Representative Robert Scott (D-VA), has asked that you respond in writing to the 

following questions: 

1) What percentage of youths attending these programs are minorities? 

2) Will or can the GAO report disaggregate the deaths/abuses being investigated 

by the reason the individual is in the program and whether the individual is taking 

psychotropic medication? 

3) Is there currently an obligation for mental health professionals who recommend 

these programs to clients to ascertain their safety and validity as a treatment option? 

4) Is there currently any requirement that other treatment options be utilized to 

address a child’s behavioral issues before sending them to such a center? 

[Questions for the record submitted to Ms. Moss follow:]

CONGRESS OF THE UNITED STATES, 

Washington, DC, October 15, 2007. 

Jan Moss, Executive Director, 

The National Association of Therapeutic Schools and ProgramsThe National Association of Therapeutic Schools and Programs, Prescott, AZ. 

DEAR MS. MOSS: Thank you for testifying at the October 10, 2007 full Committee 

hearing, ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities.’’ Enclosed are the questions which Committee members have asked you to respond for the record. Please send an electronic version of your written response (in 

Word format) to the Committee staff by COB on Friday, November 2, 2007. If you 

have any questions, please contact us. Once again, we greatly appreciate your testimony at this hearing. 

Sincerely, 

GEORGE MILLER, Chairman.

Representative Robert Scott (D-VA), has asked that you respond in writing to the 

following questions: 

1) What mechanism is in place to deal with circumstances where your members 

have self-certified that they are abiding by NATSAP’s ethics and good practices 

standards when they are in fact not in compliance with these standards? 

2) Dr. Pinto testified that she has collected 700 concerns on residential treatment 

centers over 6 months, while NATSAP has investigated less than 5 claims against 

its members. Can you please explain the discrepancy in these numbers? 

3) Is there currently any requirement that other treatment options be utilized to 

address a child’s behavioral issues before sending them to such a center? 

Chairman George Miller respectfully request that you respond to the following 

questions: 

28

1) What is NATSAP’s policy regarding the use of its logo by members. For example, are there any restrictions for using the NATSAP logo on marketing materials 

and websites? Are NATSAP members using the NATSAP logo required to disclose 

that use of the NATSAP logo does not represent endorsement by NATSAP of the 

safety, quality, or effectiveness of the members’ program. 

2) Ms. Moss indicated that NATSAP will research complaints or reports of alleged 

misconduct by members. What procedures are in place for reporting misconduct to 

NATSAP? Are reporting procedures documented? Does NATSAP make its reporting 

procedures widely available, for example on its website? Do members have a duty, 

arising from their membership, to report any misconduct to NATSAP that violates 

NATSAP’s Ethical Principles or Principles of Good Practice? How many complaints 

or reports of misconduct has NATSAP received since its formation, and what steps 

were taken to research such complaints or reports of misconduct. 

3) Ms. Moss indicated that NATSAP researched at least one instance where a 

complaint was made regarding a member’s website. Please describe the complaint, 

the actions taken by NATSAP, the corrective actions taken by the member; and provide the identity of the member. 

4) What actions does NATSAP intend to take in light of the testimony given by 

the U.S. Government Accountability Office regarding the Alldredge Academy’s delinquency in remitting permit fees to the federal government? Is operating on federal 

land without a valid permit a violation of NATSAP’s Ethical Principles or Principles 

of Good Practice? 

5) NATSAP hosts national and regional conferences to foster the professional development of its members. Have any of these conferences ever included lectures, 

workshops, presentations or discussions concerning cases of abuse, neglect, mistreatment, or death of children; what led to these horrific tragedies; what needs to 

change; and what NATSAP members need to do in response? 

6) NATSAP’s new membership requirements mandate that members be licensed 

by an appropriate state mental health agency, or accredit by a reputable mental 

health accreditation organization. On what basis is an accreditation organization 

deemed to be ‘‘reputable?’’

7) Please provide a chart showing the year in which each NATSAP member joined 

NATSAP, or lost its membership due to expiration or revocation. 

8) It is our understanding that the NATSAP board is primarily comprised of individuals associated with member programs. Given that NATSAP researches and acts 

upon complaints against members when they are reported to NATSAP, please describe NATSAP’s policy regarding conflicts-of-interest for its board members. For example, are board members required to recuse themselves on matters before the 

board when, by virtue of their affiliation with a particular member, their judgment 

may be prejudiced in fact or in appearance? 

9) Recent reports indicate that a NATSAP member, Youth Care, Inc., has been 

placed on probation by the Utah Department of Human Services and that criminal 

neglect charges have been filed against this member due to the death of a child. 

Youth Care, Inc. uses the NATSAP logo on its website to promote their program. 

Given these reports and the use of the NATSAP logo by this member, what steps 

does NATSAP intend to take to research reports of criminal neglect on the part of 

Youth Care, Inc.? 

10) Aspen Education Group, which owns Youth Care, Inc., also operates Aspen 

Achievement Academy, another NATSAP member. Aspen Achievement Center is 

currently being investigated for a teen’s attempted suicide. While local authorities 

conduct a thorough investigation, what does NATSAP do to ensure the safety of the 

students placed in its member facilities? 

Chairman MILLER. Before proceeding to introduce our witnesses, 

let me lay out the process we follow generally in investigative hearings specific to this hearing. 

An investigative hearing differs from a legislative or oversight 

hearing in that the investigations may involve allegations that public officials acting in their official capacity or private citizens or entities have engaged in certain conduct that may suggest the need 

for a legislative remedy. Because of the importance of getting complete, full and truthful testimony, witnesses at investigative hearings before the committees of Congress are sworn in, and our witnesses will be sworn today. 

29

I understand that some witnesses, as is their right, may be accompanied by counsel. While counsel are welcome to advise their 

clients, they may not coach them or answer questions on their behalf. House Rule 11 2(k)4 authorizes the chairman of the committee to ‘‘punish breaches of order and decorum and professional 

ethics on the part of counsel by censure or exclusion from hearings, 

and the committee may cite the offender to the House for contempt.’’

I will not tolerate any tactics designed to disrupt the purposes 

of this hearing, and I must say I do not expect any. 

To ensure that we have ample opportunity to flesh out the relevant facts for the record, I have exercised my prerogative as chair, 

pursuant to Committee Rule 2(b), to extend the 5-minute rule for 

myself and for Mr. McKeon. Following the witnesses’ testimony, we 

will each engage in one round of 15-minute questionings and then 

go to the other members of the committee under the 5-minute rule. 

I would like now to introduce our panel of witnesses. 

Mr. Greg Kutz is currently the managing director of GAO’s Forensic Audits and Special Investigations unit. Mr. Kutz has testified and written investigative reports about the federal governments’ handling of Hurricanes Katrina and Rita and military pay 

problems in Department of Defense and the smuggling of nuclear 

materials across our nation’s borders, among other important 

issues. 

He will be accompanied by Mr. Andy O’Connell, who is the assistant director for investigations at the GAO. 

Mr. Paul Lewis is the father of Ryan Lewis, who died in 2001. 

Ms. Cynthia Harvey is the mother of Erica Harvey, who died in 

2002. 

Mr. Bob Bacon is the father of Aaron Bacon, who died in 1994. 

Ms. Jan Moss is the executive director of the National Association of Therapeutic Schools and Programs created in January of 

1999. NATSAP is a 501(c)6 not-for-profit trade association that represents therapeutic schools, residential treatment programs, wilderness programs and other similar programs. 

And finally, Dr. Allison Pinto is a clinical child psychologist and 

research assistant professor at the Florida Mental Health Institute 

at the University of South Florida where she coordinates A START, 

which is Alliance for Safe Therapeutic and Appropriate Use of Residential Treatment. Dr. Pinto has coordinated public awareness and 

advocacy efforts relating to the mistreatment of children in private 

and unregulated residential treatment facilities. She also serves as 

a principal investigator of a qualitative study regarding experience 

of youth and families who have participated in the residential 

treatment programs. 

For those of you who have not testified, first, let me welcome you 

all to the committee and explain that we will have a lighting system. When you begin your testimony, there will be a green light, 

which is on the table, which will give you 5 minutes to testify. 

When you see the yellow light, it means you roughly have 1 minute 

in which to sum up your testimony. And with the red light, your 

time is expired, although we certainly want you to conclude your 

testimony in a fashion so you have properly conveyed those 

thoughts at that time. 

30

And let me remind you that you have to turn on the microphones 

in front of you. 

Before we move on to the testimony, if each of you would stand 

and raise your right hand for the purpose of being sworn in. 

Do you swear that the testimony that you are about to give, that 

you will tell the truth, the whole truth and nothing but the truth? 

Let the record show the witnesses have answered in the affirmative. 

Please be seated. 

We will now hear from our first witness, Mr. Kutz of the GAO. 

Welcome. 

STATEMENT OF GREG KUTZ, MANAGING DIRECTOR, FORENSIC AUDITS AND SPECIAL INVESTIGATIONS UNIT, GOVERNMENT ACCOUNTABILITY OFFICE 

Mr. KUTZ. Mr. Chairman and members of the committee, thank 

you for the opportunity to discuss residential treatment programs 

for youth. 

There are many who claim positive outcomes for troubled youth 

at these programs. At the same time, there are widespread allegations of death and abuse. My testimony today addresses these allegations. 

My testimony has two parts: first, some background on the scope 

of our work; and, second, the results of our work. 

First, since at least the early 1990s, hundreds of residential 

treatment programs have been established across the United 

States. There is no standard definition of these programs and no 

way to know how many exist. There are no federal laws that regulate private programs. However, some states have statutory regulations that require licensing. 

Common names for these programs include boot camps, boarding 

schools and wilderness programs. The first poster board shows examples of wilderness program settings which are typically in the 

mountains, the forest or the desert. The second poster board shows 

first the restrictive nature of some of these programs which you 

can see by the fencing and the cameras and, second, the military 

theme of other programs. 

All of these programs offer in some way to reform the lives of 

very troubled youth. 

The purpose of our work was to address allegations of death and 

abuse at these programs. Our focus was on private programs. However, our overall analysis of the extent of death and abuse included 

both public and private programs. It was beyond our scope to 

evaluate the benefits of residential treatment programs. 

Moving on to the results of our work, we identified thousands of 

reported cases of death and abuse at these programs. Sources of 

these allegations include HHS, state agencies, the Internet and 

pending and closed civil and criminal lawsuits. 

Allegations include physical, emotional and mental abuse. Examples of abuse include: youth being forced to eat their own vomit; denied adequate food; being forced to lie in urine or feces; being 

kicked, beaten and thrown to the ground; and being forced to use 

a toothbrush to clean a toilet and then forced to use that toothbrush on their teeth. 

31

We took an in-depth look at 10 cases that were closed of teenagers that died between 1990 and 2004. Ineffective program management played a key role in most of these deaths. 

The next poster board shows four key themes from our case studies, which include untrained staff, misleading marketing practices, 

abuse before death and negligent operating practices. I will now 

use these case studies to discuss these four themes. 

First, we found program staff with little or no relevant training. 

In many cases, program managers and staff misinterpreted signs 

of treatable conditions, such as dehydration. As a result, many of 

these kids died slowly while program management and staff continued to believe that they were faking it. It seems the only way staff 

could be convinced that these kids were not faking it was when 

they stopped breathing or had no pulse. 

For example, in one case, a 16-year-old male exhibited significant 

signs of distress for nearly 3 weeks, including the loss of bodily 

functions. In 30 days, this 5-foot 10-inch boy dropped from 131 

pounds to 108 pounds. Despite these warning signs, he was forced 

to continue hiking. There was no emergency response until he collapsed and stopped breathing. Unfortunately at this point, it was 

too late. 

In another case, a 14-year-old male was forced to sit in the 113-

degree sun for hours. He began eating dirt due to hunger, became 

dehydrated and appeared to have a seizure. He was hauled in the 

back of a pickup truck to a motel where he defecated and vomited 

on himself. Staff then pressed his stomach and mud oozed out from 

the boy’s mouth. They then cleaned him up, put him into the back 

of the pickup truck and took him back to the campsite. He died 

shortly after this in a hospital. 

Another 14-year-old male showed signs of excessive body temperature and heavy breathing, but staff assumed that he was faking it. Although the boy became unconscious, staff continued to believe that he was faking it. The final check was for staff to hide 

behind a tree for 10 minutes to see if this unconscious boy would 

actually revive himself. When the staff returned to the boy, there 

was no pulse, which finally triggered an emergency response. But, 

once again, it was too late. 

The second theme was misleading marketing practices. Many of 

these programs took advantage of desperate parents misrepresenting that their programs were a perfect fit for these kids’ unique 

issues. For example, as shown on the poster board, one program 

brochure touted their staff as highly trained survival experts with 

experience that was unparalleled. 

However, these experts believed that a 15-year-old female who 

was not eating, and vomiting water, was faking it. These experts 

allowed these symptoms to go on for 2 days until the girl finally 

collapsed on the road and stopped breathing. These experts became 

so lost that they wandered into another state. Lacking radios, these 

experts had to build a fire to signal for help. 

The next poster board shows the body of this girl who lay dead 

on the road for 18 hours until help arrived. 

Another program marketed its expertise in handling suicidal 

youth to the parents of a 14-year-old male who had twice attempted suicide. This boy committed suicide 6 days into the proVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00035 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
32

gram by hanging himself by his tent. The parents later found that 

there was no specific suicide expertise in this program. However, 

the staff were experts in whitewater rafting. 

Our third theme was abuse of these kids before they finally died. 

For example, a 14-year-old male was forced to wear black clothing 

and stand in direct sunlight for several hours during the day. Despite strenuous physical exertion, he was fed an apple for breakfast, a carrot for lunch and a bowl of beans for dinner. 

A 15-year-old male refused to return to a campsite after urinating. Although his refusal was not violent, two counselors forced 

him to the ground and held him face down in the dirt until he 

stopped struggling. One of the counselors was on top of this boy for 

45 minutes. This boy died from a severed artery in his neck. 

Another 15-year-old male was dragged around when he was unable to exercise. As his condition deteriorated and he lost bodily 

function, he was forced to wear a 20-pound sandbag around his 

neck as punishment. The autopsy report for this boy showed 30 

contusions and abrasions all over his body. 

As I am sure you will agree, there is no need for me to elaborate 

further on the fourth theme of these cases, the negligent and reckless operating practices of these programs. 

In conclusion, today’s testimony reveals disturbing facts about 

the world of residential treatment programs. If you had walked in 

partway through my presentation, you might have assumed that I 

was talking about human rights violations in a Third World country. Unfortunately, these human rights violations occurred right in 

the United States of America. 

Mr. Chairman, I want to commend you for holding today’s hearing and putting a spotlight on this important issue. I also want to 

thank the parents who represent three of our case studies for having the courage to testify about the tragic death of their child. 

Mr. Chairman, this ends my statement. 

[The prepared statement of Mr. Kutz and the GAO report, ‘‘Residential Treatment Programs: Concerns Regarding Abuse and 

Death in Certain Programs for Troubled Youth,’’ may be accessed 

at the following Internet address:]

http://www.gao.gov/new.items/d08146t.pdf 

[Responses to questions for the record from Mr. Kutz follow:]

October 24, 2007. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

Subject: Response to Post-hearing Questions on GAO-08-146T: Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for 

Troubled Youth 

DEAR CHAIRMAN MILLER: On October 10, 2007, I testified before the House Committee on Education and Labor on the results of our examination of residential 

treatment programs. This letter provides a response for the record to the four follow-up questions submitted by Representative Robert Scott. His questions and our 

responses follow. 

Question One 

What percentage of youths attending these programs are minorities? 

33

1Data are available from the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention (OJJDP) within the Office of Justice Programs. OJJDP’s Web site provides 

access to a variety of statistics related to the juvenile justice system—see http://ojjdp.ncjrs.gov/

ojstatbb. 

Response to Question One 

Based on our research, complete information is not available. As I testified, there 

is no reliable comprehensive data source on public and private programs, so we cannot determine what the total number of children in these programs is or their gender, race, or other characteristics. 

However, as part of GAO’s ongoing review of state oversight of public and private 

residential treatment programs for the Committee, GAO has found that information 

on juvenile offenders placed in various programs is available. Specifically, the Department of Justice through its Census of Juveniles in Residential Placement has 

race data on children held in various types of public and private residential placement facilities, including boot camps and ranch/wilderness camps.1 Those data show 

that, of almost 6,500 children under 21 held in boot camps and ranch/wilderness 

programs in 2003, the most recent year for which data are available, almost 35 percent (2,263) were black, almost 35 percent (2,257) were Hispanic, over 26 percent 

(1,714) were white, with American Indians, Asian/Pacific Islanders, and others accounting for the remaining 4 percent (252). 

Question Two 

Will or can the GAO report disaggregate the deaths/abuses being investigated by 

the reason the individual is in the program and whether the individual is taking psychotropic medication? 

Response to Question Two 

As part of GAO’s ongoing review of state oversight of juvenile residential treatment programs, we are attempting to provide a range of information about oversight, including information on deaths and abuse at such facilities. This effort has 

entailed an extensive effort to survey state agencies involved in the oversight of children in such programs, including state departments of education, mental health, 

and juvenile justice. GAO plans to include information on the cause of death and 

maltreatment (abuse) in its upcoming report. However, obtaining information as to 

why children are in these programs or the number of children in these programs 

who are taking medication was outside the scope of our recent review. Although the 

U.S. Department of Health and Human Services sponsors a national data collection 

effort called The National Child Abuse and Neglect Data System (NCANDS) for 

tracking the volume and nature of child abuse reporting each year within the 

United States, state reporting of information to NCANDS is voluntary. Moreover, 

NCANDS does not report on information about why children are in residential 

treatment programs or whether they take medication. 

Question Three 

Is there currently an obligation for mental health professionals who recommend 

these programs to clients to ascertain their safety and validity as a treatment option? 

Response to Question Three 

The issue as to whether mental health professionals are obliged or required to determine the safety and validity of juvenile residential treatment programs to clients 

was beyond the scope of our work for the testimony. The issue of program safety 

is primarily under state, not federal, oversight and is being addressed by GAO’s ongoing study regarding these programs. Our ongoing work focuses on treatment programs but does not cover individual mental health professionals. It also does not 

assess the validity of various treatment options, another complex topic that was beyond the scope of this work. 

Question Four 

Is there currently any requirement that other treatment options be utilized to address a child’s behavioral issues before sending them to such a center? 

Response to Question Four 

The subject of child behavioral treatment options and assessing which ones are 

appropriate for a child are complex issues and, as such, were beyond the scope of 

our work for the testimony. This is also outside the scope of GAO’s ongoing review 

of state oversight of juvenile residential treatment programs. 

34

If you have any further questions, or if you would like to discuss our response, 

please feel free to contact me. 

Sincerely yours, 

GREGORY KUTZ, Managing Director, 

Forensic Audits and Special Investigations. 

Chairman MILLER. Thank you very much. 

Mr. Lewis? 

STATEMENT OF PAUL LEWIS, FATHER OF RYAN LEWIS 

Mr. LEWIS. Chairman Miller and members of the committee, 

good morning. 

I am here today with my wife, Diana, and my daughter, Erin. 

The member of our family who is missing today is Ryan. 

Ryan lived his life to the fullest surrounded by his adoring 

friends and relatives. He was a Boy Scout, a Fire Explorer. He was 

an avid outdoor enthusiast. He enjoyed kayaking, hiking, camping 

and mountain biking. He read for hours and was a master at putting together complicated ship and airplane models. He was an allAmerican boy with sparkling blue eyes and a big smile that lit up 

his freckled face and our whole world. 

Ryan could weave an entertaining story and was oftentimes hilarious in his presentation. He had a remarkable way of relating 

to people of all ages and could draw anyone into a conversation on 

a variety of topics. He was sensitive to others and could articulate 

his views and feelings way beyond someone his age. 

He was a history buff and could match any adult conversation 

about World War II. In fact, one night, we met two World War II 

vets in a restaurant, and one remarked that Ryan knew more 

about the war than he did, but he had been there. 

With all of Ryan’s extraordinary qualities, he sadly suffered from 

clinical depression. He was a brave and courageous person who 

battled the darkness valiantly. But as a family, we knew that we 

needed help from professionals and sought out help from clinical 

psychologists and a child psychiatrist. In addition, Ryan needed an 

integrative program where he could continue his schooling and receive therapy while being among his peers. 

After exhausting all local resources to help Ryan, we reached out 

to Steve Bozak, an education consultant. We provided him with all 

of Ryan’s educational and medical records. Given Ryan’s background, he strongly recommended a therapeutic wilderness program named Aldredge Academy in Davis, West Virginia. He told us 

this would be the safest place for Ryan. Ryan’s psychiatrist, after 

speaking to the admissions department, also agreed that this might 

meet Ryan’s needs. 

Educational and medical records were then sent. His detailed 

psychiatric information required an extensive application. We were 

very hesitant to send Ryan so far away, but the program’s marketing was first class, appearing to be just what Ryan needed. 

Aldredge used Ryan’s love of the outdoors as a selling tool. The admissions personnel repeatedly touted their professionalism and expertise with children who had the same psychiatric diagnosis as 

Ryan. 

35

On February 7, 2001, we enrolled Ryan where, again, we were 

assured by the program personnel that Ryan would be safe. We 

called every day to inquire about how Ryan was doing. We were 

assured that he was just fine. 

On February 13, only 7 days into the program, we were startled 

by a call at 11:15 at night. The news ripped through us like an explosion tearing us into a million pieces. L. Jay Mitchell, the owner 

of Aldredge Academy, informed us that Ryan had hung himself. He 

told us that there was no indication that Ryan was in trouble. It 

caught them all completely by surprise, and there was nothing they 

could have done. 

The next day, we flew to West Virginia and met with L. Jay 

Mitchell, John Weston White and Lance Wells who repeated the 

same story as the night before. The story did not make sense to 

me. 

The following day, we met with the investigating West Virginia 

state trooper who told us we were being lied to about the circumstances of Ryan’s death. This news was like losing Ryan all 

over again. In his view, it was a death that could have been prevented. 

He told us that the night before Ryan died, he had slashed his 

arm four times with a pocketknife issued to him by the program. 

He told them, ‘‘Take this away from me before I hurt myself anymore. I cannot take it anymore, I want to call my mom, and I want 

to go home.’’ The counselors talked to Ryan for a few minutes, and 

he was told that the people that could help him were coming out 

the next day. Then they gave him the knife back. 

L. Jay Mitchell and John Weston White arrived the next day. 

Even though they called themselves therapists, neither one of them 

had any credentials that could remotely qualify them as mental 

health professionals. In fact, L. Jay Mitchell is a lawyer. 

These individuals decided Ryan’s desperate cry for help was manipulation so that he could get out of the program. Ryan was ignored and, consequently, at approximately 7:30 on a cold, rainy 

night, desperate, alone and abandoned, our son hung himself. 

One year later, Aldredge Academy, L. Jay Mitchell and John 

Weston White were indicted by the State of West Virginia for child 

neglect resulting in death. We were adamantly opposed to the plea 

agreement made that allowed Aldredge Academy, the corporation, 

to plea no contest in exchange for dropping charges against the individuals. Aldredge was fined $5,000 for the horrific death of my 

son. 

We filed a civil suit alleging wrongful death, fraud and a tort of 

outrage. Once again, L. Jay Mitchell was unable to defend himself 

and acknowledged fault. 

In spite of two court verdicts, L. Jay Mitchell continues in this 

business today. In my opinion, as we sit here today, children are 

at great risk. Incredibly, Aldredge continues to be a proud member 

of NATSAP, the National Association of Therapeutic Schools and 

Programs. 

Losing Ryan has been devastating to our family, our friends and 

the people in our community. We miss him terribly and live with 

this nightmare every day. All we have left are the fragile memories 

of Ryan and the wonderment of the prospects that could have been. 

36

We do not want other families to suffer the overwhelming loss 

of a child in this fraudulent industry. We ask you, Congressman 

Miller, to do everything in your power to put an end to this gross 

abuse of our children. 

Thank you for the opportunity to share Ryan’s story. 

[The statement of Mr. Lewis follows:]

Prepared Statement of Paul Lewis, Father of Ryan Lewis 

Our son, Ryan lived his life to the fullest, surrounded by adoring friends and relatives. He was a Boy Scout and a fire explorer. As an avid outdoor enthusiast, he 

enjoyed kayaking, camping, hiking, and mountain biking. He read for hours and 

was a master at putting together complicated ship and airplane models. He was an 

all American boy with sparkling blue eyes and a big smile that lit up his freckled 

face and our whole world. 

Ryan could weave an entertaining story and was often times hilarious in his presentation. He had a remarkable way of relating to people of all ages and could draw 

anyone into conversation on a variety of topics. He was sensitive to others and could 

articulate his views and feelings way beyond someone his age. He was a history buff 

and could match any adult conversation about WW11. In fact, one night we met two 

WW11 Vets in a restaurant and one remarked that Ryan knew more about the war 

than he did and he was there! 

With all of Ryan’s extraordinary qualities, he sadly suffered from clinical depression. He was a brave and courageous person who battled the darkness valiantly. But 

as a family, we knew that we needed help from professionals and sought help from 

a clinical psychologist and child psychiatrist. In addition, what Ryan needed was an 

integrated program where he could continue his schooling and receive therapy while 

being among peers. 

After exhausting all local resources to help Ryan, we reached out to Steve Bozak, 

an educational consultant. We provided him with all Ryan’s educational and medical 

records. Given Ryan’s background, he strongly recommended a Therapeutic Wilderness Program named Alldredge Academy in Davis, West Virginia. He told us this 

would be the safest, most appropriate place for Ryan. Ryan’s psychiatrist, after 

speaking to the Admissions department also agreed that this might meet Ryan’s 

needs. 

Educational and medical records were then sent as well as detailed psychiatric 

information required on an extensive application. We were very hesitant to send 

Ryan so far away but the program’s marketing was first rate, appearing to be just 

what Ryan needed. Alldredge used Ryan’s love of the outdoors as a selling tool. The 

admissions personnel repeatedly toted their professionalism and expertise with children who had the same psychiatric diagnosis as Ryan’s. On February 7, 2001 we 

enrolled Ryan and were again reassured by the program personnel that Ryan would 

be safe. We called every day to inquire about how Ryan was doing and we were assured that he was ‘‘just fine’’. 

On February 13, only seven days into the program we were startled by a call at 

11:15 at night. The news ripped through us like an explosion, tearing us into a million pieces. L. Jay Mitchell, the owner of Alldredge Academy, informed us that Ryan 

had hung himself. He told us that there was no indication that Ryan was in trouble, 

it caught them all completely by surprise and there was nothing they could have 

done. The next day, we flew to West Virginia and met with L. Jay Mitchell, John 

Weston White, and Lance Wells who repeated the same story as the night before. 

The story didn’t make sense to me. The following day we met with the investigating 

West Virginia State Trooper who told us we were being lied to about the circumstances of Ryan’s death. 

This news was like losing Ryan all over again since, in his view, it was a death 

that could have been prevented. He told us was the night before Ryan died; he had 

slashed his left forearm four times with a program issued pocket knife. He told 

them, ‘‘Take this away from me before I hurt myself anymore; I can’t take it anymore, I want to call my Mom and I want to go home.’’ The counselors talked to him 

for a few minutes and he was told that people who could help him were coming out 

the next day. Then they gave the knife back to him. L. Jay Mitchell and John Weston White arrived the next day. Even though they called themselves therapists, neither of them had any credentials that would remotely qualify them as mental health 

professionals. In fact, L. Jay Mitchell is a lawyer. These individuals decided Ryan’s 

desperate cry for help was manipulation so that he could get out of their program. 

Ryan was ignored and consequently at approximately 7:30 on a cold rainy night, 

desperate, alone, and abandoned, our young son hung himself. 

37

One year later, Alldredge Academy, Ayne Institute, L. Jay Mitchell and John 

Weston White were indicted by the state of West Virginia for ‘Child Neglect Resulting in Death’. We were adamantly opposed to the plea agreement made that allowed 

Alldredge Academy, the corporation, to plead no-contest in exchange for dropping 

charges against the individuals. Alldredge was fined $5000.00 for the horrific death 

of our son. 

We filed a civil suit alleging wrongful death, fraud, and a tort of outrage. Once 

again, L Jay Mitchell was unable to defend himself and acknowledged fault. In spite 

of two court verdicts, L. Jay Mitchell continues in this business. In my opinion, as 

we sit here today, children are at great risk. Astonishingly, Alldredge continues to 

be a proud member of (NATSAP) National Association of Therapeutic Schools and 

Programs. 

Losing Ryan has been devastating to our family, our friends and the people in 

our community. We miss him terribly and live with this nightmare every day. All 

we have left are our fragile memories of Ryan and wonderment of the prospects that 

could have been. We don’t want other families to suffer the overwhelming loss of 

a child in this fraudulent industry. We ask you, Congressman Miller to do everything in your power to put an end to this gross abuse of our children. Thank you 

for this opportunity to share Ryan’s story. 

Our family was duped into believing that caring people would help Ryan who was 

struggling with a learning disability and clinical depression. We thought these were 

professionals who knew what they were doing. We had no idea that their interest 

was profit, not healing. 

There are also additional details to our story that provide a deeper understanding 

of issues involved in this fraudulent residential facility claiming to help children by 

providing therapy and education. We would like to add these to the record. 

For example, consider these facts: While he was in the program, Ryan was 5’1 

and weighed 90 pounds. He was forced to carry a makeshift backpack with approximately 60 pounds of gear. At one point, he was restrained and had water forced 

down him. 

In addition, Ryan was forced to hike in silence. This was critical because Ryan 

was very articulate and was not allowed to express his feelings. There is no therapeutic justification for such a policy. 

Further, once he had cut his arm with the program-issued knife, there was no 

monitoring of his behavior. No buddy system was employed nor were counselors 

vigilant at staying with him at all times. Though he was clearly expressing suicidal 

thoughts and behaviors—and had been sent to the program with a diagnosis of depression—no mental health professional was consulted to determine whether he 

should continue in the program or be hospitalized. Nor were we even notified that 

he’d expressed such despair. 

The program was completely unprepared to deal with cases like Ryan’s. It operated under the assumption that all teenage misbehavior is ‘‘lies’’ and ‘‘manipulation’’ 

and that even depression is just ‘‘attention seeking,’’ not a mental illness that warrants compassion and support. We believed we were putting our child in the care 

of people who knew what they were doing—and yet the program didn’t even have 

a protocol in place to deal with suicides. We had no way of knowing that these people had no business dealing with sick children—there was no law in place that said 

they couldn’t sell their services as a treatment for depression. 

There were also additional signs of amateurism and complete insensitivity to the 

children they were supposed to be helping. For one, Ryan died at approximately 

7:30 P.M. and we were not notified until 11:15 P.M., a four hour delay. Phone 

records show that there were 30-40 calls made during that four hour delay. Clearly, 

they were scrambling to cover up what had gone on and figure out how to make 

it look better. 

Another example: in an early press release, Alldredge claimed that none of the 

other children saw Ryan. This was not true, in fact, another child found him. This 

child has been forever traumatized. 

In violation of confidentiality rules, another early press release provided enough 

information about Ryan’s funeral service to identify him. 

Finally, in yet another press release, personnel at Alldredge claimed that all the 

children successfully completed the program. This was not the case. In fact, two 

weeks after Ryan died, another child that had been in his group, slit his wrists. He 

was evacuated, hospitalized, and sent home. 

Four weeks into the program, a third child in his group threatened suicide in a 

note to his mother. He, too, went home. It was too late for Ryan. 

Alldredge Academy has changed its name to Alldredge Wilderness Journey. Although he is not listed as a staff member, L. Jay Mitchell is still actively involved 

38

in the operation of the program. For parents in crisis, it would be very difficult to 

get an accurate history on the program. 

We urge Congress to act to prevent people who do not know how to treat children 

with dignity—let alone treat mental illness—from selling their fraudulent treatment 

to other vulnerable parents and children. People with mental illness should have 

the right to safe, effective treatment that people with physical illness do—and these 

predators should not be allowed to prey on them and their parents. 

Chairman MILLER. Thank you very much, Mr. Lewis, and the 

rest of your testimony will be placed in the record in its form. 

Ms. Clark Harvey? 

STATEMENT OF CYNTHIA HARVEY, MOTHER OF ERICA 

HARVEY 

Ms. HARVEY. Good morning. My name is Cynthia Clark Harvey. 

Thank you, Chairman Miller and those committee members 

present today for the opportunity to share our family’s story. 

Our story is a personal tragedy, but please remember that for 

each family that has suffered the ultimate damage, the death of a 

beloved child, there are perhaps thousands of others who have suffered physical or psychological neglect and abuse. For those individual and family victims, there is no public acknowledgement of 

their sorrow and pain, as there has been of ours. 

This is Erica. Our first-born, Erica, was an amazing kid. Everyone says that about their own, but it is true. She was. 

So many times during Erica’s too short life, she would do or say 

or create something that just knocked our socks off. Erica was an 

incredible student, straight A’s, with gifted classes in math and 

language. She was a competitive springboard diver with dozens of 

medals. Erica was a musician who played clarinet and drums, a 

prizewinning visual artist, a weekly volunteer with a local animal 

shelter from the time she was 10 and dragged us along so they got 

two, three or four for the price of one determined little girl. 

But Erica’s bright light seemed to flicker when at 14 and in the 

eighth grade she began to experience mental health problems. 

Erica became depressed, then suicidal. She engaged in cutting behaviors. To medicate herself, she began abusing and using illegal 

drugs. Erica was hurting in many ways, and our whole family was 

suffering. 

Erica was in the care of a psychiatrist and a therapist who both 

recommended that we consider a residential treatment program. 

Michael and I were desperate to find help for Erica. Our daughter 

was 151⁄2 years old when we made the decision to send her to what 

we believed was a legitimate treatment program, a place staffed 

with people who could help our family move forward from some 

very dark times. 

We compared several programs over a period of many weeks. We 

eventually focused in on Catherine Freer Wilderness because they 

were and continue to be leaders in the industry, one of the founding members of NATSAP and of OBHIC. We chose Catherine Freer 

because they have claimed to be fully licensed, because they were 

JCAHO accredited, because they claimed experience with teens 

being treated with psychiatric medications. 

We as parents were interviewed by the program. We laid bare 

our hearts, our souls and our story to the program. They told us 

39

our daughter would be treated by experienced staff, experienced 

therapists and experienced wilderness guides and emergency medical technicians. They touted their backcountry planning and emergency procedures. They told us we could trust our most precious 

first-born daughter, Erica, to them. 

On May 26, 2002, we arrived at Catherine Freer’s Nevada office. 

We had been advised by Freer not to tell Erica we were placing her 

until our arrival for the family meeting that would begin the trek. 

Of all the many profound and tormenting regrets we have about 

our terrible decision, agreeing to deceive Erica is one of the worst. 

When we told her why we were there, she was shocked, angry and 

scared. We will be haunted as long as we live by Erica’s cry of 

‘‘Please, Daddy, don’t make me go.’’

On May 27, 2002, the first full day of Erica’s Nevada wilderness 

trek, Freer’s trusted team mistook a dire medical emergency for 

teenage belligerence, and Erica died that afternoon of heat stroke 

with dehydration. 

Over a period of hours, Erica’s condition had worsened as she 

was pushed to keep hiking. When Erica’s eyes rolled into the back 

of her head and she fell off the trail head first into rocks and scrub 

brush, she was left to lie where she fell for 45 minutes while two 

Freer staffers, still unwilling or unable to recognize what was happening, watched Erica died a slow, painful death. 

When the Freer team finally responded to Erica’s last few tortured breaths, they contacted their on-call medical doctor, but the 

doctor turned out not to be a doctor at all, rather a physician’s assistant located in Oregon. 

They called the local authorities to ask for help and a helicopter 

to get Erica to a hospital, but they did not know where they were, 

and they sent a search-and-rescue team to the wrong GPS coordinates. The helicopter took hours to arrive because, contrary to the 

advanced planning that we were told to expect, no arrangements 

with local authorities had been made, nor was any sort of trip plan 

filed. 

Later, we found out that none of the Freer team had experience 

with administering psychotropic drugs and no training in how to 

evaluate those drugs’ effects on an individual during a trek. We 

also found out that the EMT on the team was on his very first trek 

and had only recently completed coursework in EMT and had never 

experienced a real medical emergency before. 

Six days from today, October 16, is Erica’s 21st birthday. The 

day she was born, we held her and we saw the universe in her 

fierce, dark eyes. We filled ourselves with dreams for her. We imagined who she would be at 2, at 10, at 12, 21, 30. And today, we 

are only left with memories—some of them beautiful, some of them 

harsh—and no dreams for Erica’s tomorrows. 

[The statement of Ms. Harvey follows:]

Prepared Statement of Cynthia Clark Harvey, Mother of Erica Clark 

Harvey 

Thank you, Chairman Miller, and those Committee members present today for the 

opportunity to share our family’s story. Our story is a personal tragedy, but please 

remember that for each family that has suffered the ultimate damage, the death 

of a beloved child, there are perhaps thousands of others who have suffered physical 

40

or psychological neglect and abuse. For those individual and family victims, there 

is no public acknowledgement of their sorrow and pain, as there has been of ours. 

Our first-born, Erica, was an amazing kid—everyone says that about their own, 

but it’s true, she was. So many times during Erica’s too-short life, she’d do or say 

or create something that just knocked our socks off. Erica was an incredible student, 

straight A’s, with Gifted classes in Math and Language. She was a competitive 

springboard diver with dozens of medals. Erica was a musician who played clarinet 

and drums, a prize-winning visual artist, a weekly volunteer with a local animal 

shelter from the time she was 10 (and dragged us along, so they got two, three or 

four for the price of one determined little girl.) 

Erica’s bright light seemed to flicker, when at fourteen and in the 8th grade, she 

began to experience mental health problems. Erica became depressed, then suicidal. 

She engaged in cutting behaviors. To medicate herself, she began abusing illegal 

drugs. Erica was hurting in many ways and our whole family was suffering. 

Erica was in the care of a psychiatrist and a therapist, who both recommended 

that we consider a residential treatment program. Michael and I were desperate to 

find help for Erica. Our daughter was 15 and a half years old when we made the 

decision to send her to what we believed was a legitimate treatment program, a 

place staffed with people who could help our family move forward from some very 

dark times. 

We compared several programs over a period of many weeks. We eventually focused in on CF because they were, and continue to be, leaders in the industry, one 

of the founding members of NATSAP, and of OBHIC. We chose CF because they 

claimed to be fully licensed, because they were JCAHO accredited, because they 

claimed experience with teens being treated with psychiatric medications. We, as 

parents, were interviewed by the program. We laid bare our hearts, our souls and 

our story to the program. They told us our daughter would be treated by experienced staff: experienced therapists and experienced wilderness guides and emergency medical technicians (EMTs). They touted their back country planning and 

emergency procedures. 

They told us we could trust our most precious firstborn daughter, Erica, to them. 

On May 26th, 2002, we arrived at CF’s Nevada office. We had been advised by 

CF not to tell Erica we were placing her until our arrival for the family meeting 

that would begin the trek. Of all the many profound and tormenting regrets we 

have about our terrible decision, agreeing to deceive Erica is one of the worst. When 

we told her why we were there, she was shocked, angry and scared. We will be 

haunted as long as we live by Erica’s cry of Please, Daddy, don’t make me go. 

On May 27th, 2002, the first full day of Erica’s Nevada wilderness trek, CF’s 

trusted team mistook a dire medical emergency for teenage belligerence and Erica 

died that afternoon of heat stroke with dehydration. Over a period of hours, Erica’s 

condition had worsened as she was pushed to keep hiking. When Erica’s eyes rolled 

into the back of her head and she fell off the trail, head first, into rocks and scrub 

brush, she was left to lie where she fell for forty five minutes, while two CF staffers, 

still unwilling or unable to recognize what was happening, watched Erica die a slow, 

painful death. 

When the CF team finally responded to Erica’s last few tortured breaths, they 

contacted their on-call medical doctor, but the ‘‘doctor’’ turned out not to be a doctor 

at all, rather a physician’s assistant located in Oregon. They called the local authorities to ask for help and a helicopter to get Erica to a hospital but they didn’t know 

where they were and sent the search and rescue team the wrong GPS coordinates. 

The helicopter took hours to arrive because, contrary to the advance planning that 

we were told to expect, no arrangements with local authorities had been made, nor 

was any sort of trip plan filed. Later we found out that none of the CF team had 

experience with administering psychotropic drugs and no training in how to evaluate those drugs’ effect on an individual during a trek. We also found out that the 

EMT on the team was on his very first trek, had only recently completed 

coursework in WEMT and had never experienced a real medical emergency before. 

Six days from today, October 16, is Erica’s 21st birthday. The day she was born, 

we held her and we saw the universe in her fierce dark eyes. We filled ourselves 

with dreams for her. We imagined who she’d be at two, at ten, at twelve, twentyone, thirty. Today we’re left with only memories, some of them beautiful, some of 

them harsh, and no dreams of Erica’s tomorrows. 

Chairman MILLER. Thank you very much. 

Mr. Bacon? 

41

STATEMENT OF ROBERT BACON, FATHER OF AARON BACON 

Mr. BACON. Chairman Miller and committee members, my name 

is Bob Bacon, the father of Aaron Bacon. Speaking for my wife and 

Aaron’s mother, Sally, his brother, Jared, and his sister, Tia Sullivan, and speaking on behalf of the many families not at this table 

whose lives have been shattered by these fraudulent programs, we 

deeply appreciate your efforts to put a stop to this country’s growing industry of institutionalized child abuse. 

During our search for the best alternative, the remaining 3 

months of Aaron’s sophomore year of high school, my wife and I 

spoke with therapists, counselors, pastors and doctors until we 

were eventually referred by friends to North Star Expeditions, a 

now defunct but formerly licensed Utah-based program that billed 

itself as a wilderness therapy program for troubled teens. 

After reading their very compelling brochure, speaking to their 

office by phone, and finally meeting with the owners for a personal 

interview, we thought we had found the perfect situation—caring 

people who were experienced in counseling kids who were struggling with drugs and social pressure—and to top it off, writing in 

a daily journal we were told was an integral part of their so-called 

counseling program. As a writer, we felt journaling would help 

Aaron to sort things out, and we were certain that, as a poet, 

Aaron would find the awesome beauty of southern Utah to be inspirational and spiritually healing. 

Of course, being normal, trusting and honest people ourselves, 

we assumed we were being told the truth. We were dead wrong. 

His mother and I will never escape our decision to send our gifted 

16-year-old son to his death at North Star. The guilt of our apparent naivete was crippling. We were conned by their fraudulent 

claims and will go to our graves regretting our gullibility. 

Adding further to our regret, we were talked into using their escort service. Aaron was taken from his bed at 5:00 a.m. on Tuesday 

morning, March 1, 1994, by two burly strangers who announced to 

Aaron with a tone of authority that any resistance on his part 

would be countered with whatever physical force was necessary. He 

was not allowed to speak with us or to put on any shoes. His eyes 

expressed a strange mixture of anger, despair, fear and loving sadness. 

I was able to manage only the briefest of hugs which, being restrained, he could not return. In the trauma of this surreal instant, 

I offered words of comfort without thinking of their potentially ominous meeting when I said, ‘‘Aaron, I know you will find God in the 

wilderness.’’ Little did I know that these would be the last words 

I would ever speak to my youngest son. 

His mother managed only a fleeting moment to cradle his face 

in her hands and utter her spontaneous words of love and the assurance that he would later see that this was really for the best. 

I cried inconsolably from the depths of my soul as the escort van 

backed out of our driveway with our terrified son pleading silently 

with his sad eyes for us not to send him away. This excruciating 

scene would have to serve for the rest of our lives as the last living 

memory of our beautiful son. 

Aaron arrived in the Escalante wilderness area of southern Utah 

that same night and waited a few days for a brief intake exam, inVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00045 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
42

doctrination into the rules of the program and the issue of ill-fitting 

shoes and clothing. 

Aaron’s body and bloody and tattered journal, in fact, would contain no poetry, but would record in his own words an unbelievable 

account of torture, abuse and neglect, a horrific tale that is corroborated by the journals of the so-called counselors, along with the 

journals and sworn testimony of his troubled young cohorts. 

A calendar was assembled by criminal investigators that chronicles 21 days of ruthless and relentless physical and psychological 

abuse and neglect. Aaron spent 14 of his 20 days on the trail without any food whatsoever while being forced to hike eight to 10 

miles per day. On the days he did have food, it consisted of undercooked lentils, lizards, scorpions, trail mix and a celebrated canned 

peach on the 13th. 

On top of this, with temperatures below freezing, he endured 13 

of 20 nights with only a thin wool blanket, plus five nights without 

any warmth or any protection whatsoever. 

Aaron complained of stomach pain and asked to see a doctor as 

early as the third day of hiking, and by the 10th day, he had lost 

all control of his bodily functions. But unbelievably, as he got 

weaker and lost nearly 20 percent of his body weight, they repeatedly refused to send him to a doctor. 

Taken from what appears to be the industry’s handbook, their 

policy had predetermined that these kids are all liars and manipulators and, therefore, Aaron was faking. This grotesque skeleton is 

what Aaron looked like the evening before he died. 

He was seen by Georgette Costigan, the registered EMT who is 

still insisting that he was faking, did not even take his vital signs, 

but instead took the occasion to barter a meager piece of cheese in 

return for his promise to try harder and to hike the following day. 

This company-employed EMT and relative of owner Bill Henry dismissed his final desperate plea to see a doctor who could prove he 

was not faking and made a conscious decision to prove a point, 

rather than render aid, thus effectively killing our son rather than 

saving him. 

What you cannot see in these photos are the bruises, cuts, lesions, rashes, blisters and open sores that covered Aaron’s body 

from head to toe. These scars of abuse and the dried skin stretched 

taut over his bones is what his mother and I were left to discover 

without any warning when the sheet was pulled back in the mortuary. ‘‘This,’’ we screamed, ‘‘could not be our son,’’ as we grabbed 

each other and collapsed to our knees, but the scar above his now 

sunken right eye, told us that it was. It was in that one shocking 

moment of proof that our lives changed forever. 

The stories of Aaron’s death and the others who have died or survived the abuses of these programs are chilling reminders of the 

dangers of absolute power and point out the extremely high risk we 

take in allowing these programs to operate without strict regulation and oversight. 

This country, this Congress and this committee are faced as 

never before with several urgent and critically important choices. 

If we choose economic growth over human rights, if we choose no 

growth in government over the safety of our children, if we continue to place our faith in the self-regulation of private enterprise 

43

over the mandate of our government to protect our nation’s health, 

safety and welfare, we are choosing to fail in our sacred obligations 

to our children, our families and our future. 

I implore you, as I know Aaron would, to please stop paying lip 

service to family values and start placing value in families. We can 

do this in part by investing the resources of the American people 

in our children who will soon inherit our challenging legacy, and 

we can start now by putting a stop to these fraudulent and destructive programs of institutionalized child abuse. 

[The statement of Mr. Bacon follows:]

Prepared Statement of Bob Bacon, Father of Aaron Bacon 

Chairman Miller and Distinguished Committee Members: My name is Bob Bacon, 

the father of Aaron Bacon. 

Speaking for my wife, and Aaron’s mother Sally, his brother Jarid and his sister 

Kia Sullivan; and speaking on behalf of the many families not at this table whose 

lives have been shattered by these fraudulent programs, we deeply appreciate your 

efforts to put a stop to this country’s growing industry of institutionalized child 

abuse. 

During our search for the best alternative to the remaining three months of Aaron’s sophomore year in high school, my wife and I spoke with therapists, counselors, 

pastors and doctors until we were eventually referred by friends to North Star Expeditions, a now defunct, but formerly licensed Utah-based program that billed itself 

as a ‘‘wilderness therapy program for troubled teens.’’

After reading their very compelling brochure, speaking to their office by phone, 

and finally meeting the owners for a personal interview, we thought we had found 

the perfect situation: Caring people who were experienced in counseling kids who 

were struggling with drugs and social pressure—and to top it off—writing in a daily 

journal we were told was an integral part of their ‘‘counseling’’ program. As a writer, 

we felt journaling would help Aaron to sort things out; and we were certain that, 

as a poet Aaron would find the awesome beauty of southern Utah to be inspirational 

and spiritually healing. 

Of course, being normal, trusting and honest people ourselves—we assumed we 

were being told the truth. We were dead wrong. His mother and I will never escape 

our decision to send our gifted 16 year old son to his death at North Star. The guilt 

of our apparent naivete was crippling. We were conned by their fraudulent claims, 

and will go to our graves regretting our gullibility. 

Adding further to our regret, we were talked into using their escort service. Aaron 

was taken from his bed at 5:00 AM on Tuesday morning, March the 1st, 1994 by 

two burley strangers who announced to Aaron with a tone of authority that any resistance on his part would be countered with whatever physical force was necessary. 

He was not allowed to speak to us, or put on any shoes. 

His eyes expressed a strange mixture of anger, despair, fear and loving sadness. 

I was able to manage only the briefest of hugs which, being restrained, he could 

not return. In the trauma of this surreal instant I offered words of comfort without 

thinking of their potentially ominous meaning when I said, ‘‘Aaron, I know you will 

find God in the wilderness.’’ Little did I know that these would be the last words 

I would ever speak to my youngest son! 

His mother managed only a fleeting moment to cradle his face in her hands and 

utter her spontaneous words of love and the assurance that he would later see that 

this was really for the best. 

I cried inconsolably from the depths of my soul as the escort van backed out of 

our driveway with our terrified son silently pleading with his sad eyes for us not 

to send him away. This excruciating scene would have to serve for the rest of our 

lives as the last living memory of our beautiful son. 

Aaron arrived in the Escalante Wilderness Area of southern Utah that same night 

and waited a few days for a brief intake exam, indoctrination into the rules of the 

program, and the issue of ill-fitting shoes and clothing. This picture of him was 

taken on March 8th, when he was noted as weighing 131 pounds on a lanky 5’-11’’ 

frame. 

Aaron’s bloody and tattered journal would contain no poetry, but would record in 

his own words an unbelievable account of torture, abuse and neglect; a horrific tale 

that is corroborated by the journals of the so-called ‘‘counselors’’, along with the 

journals and sworn testimony of his troubled young cohorts. 

44

This calendar was assembled by criminal investigators from program records and 

chronicles 21 days of ruthless and relentless physical and psychological abuse and 

neglect. Aaron spent 14 of his 20 days on the trail without any food whatsoever, 

while being forced to hike 8-10 miles per day. On the days he did have food it consisted of undercooked lentils, lizards, scorpions, trail mix, and a celebrated canned 

peach on the 13th. On top of this, with temperatures below freezing, he endured 

13 of 20 nights with only a thin wool blanket, plus 5 nights without warmth or protection of any kind. Aaron complained of severe stomach pain and asked to see a 

doctor as early as the third day of hiking, and by the tenth day had lost all control 

of his bodily functions; but unbelievably, as he got weaker and lost nearly 20% of 

his body weight they repeatedly refused to send him to a doctor. Taken from what 

appears to be the industry handbook, their policy had predetermined that these kids 

are all liars and manipulators and therefore ‘‘Aaron was faking.’’

[Slide #3] This grotesque skeleton is what Aaron looked like when he was seen 

the evening before he died by Georgette Costigan, the registered EMT who, still insisting that he was faking, didn’t even take his vital signs, but instead took the occasion to barter a meager piece of cheese in return for his promise to try harder 

and hike the following day. This company employed EMT, and relative of owner Bill 

Henry, dismissed his final desperate plea to see a doctor who could prove he wasn’t 

faking and made a conscious decision to prove a point rather than render aid, thus 

effectively killing our son rather than saving him. 

What you cannot see in these photos are the bruises, cuts, lesions, rashes, blisters 

and open sores that covered Aaron’s body from head to toe. These scars of abuse 

and the dried skin stretched taut over his bones are what his mother and I were 

left to discover without any warning when the sheet was pulled back at the mortuary. This, we screamed, could not be our son as we grabbed each other and collapsed to our knees, but the scar above his now sunken right eye told us that it 

was. It was in that one shocking moment of proof that our lives changed forever. 

The stories of Aaron’s death and the others who have died, or survived the abuses 

of these programs, are chilling reminders of the dangers of absolute power, and 

point out the extremely high risks we take in allowing these programs to operate 

without strict regulation and oversight. 

This country, this congress and this committee are faced as never before with several urgent and critically important choices. 

If we choose economic growth over human rights; if we choose no-growth-in-government over the safety of our children; and if we continue to place our faith in the 

self-regulation of private enterprise over the mandate of our government to protect 

our nation’s health, safety and welfare, we are choosing to fail in our sacred obligations to our children, our families, and our future. 

I implore you, as I know Aaron would, to PLEASE stop paying lip service to ‘‘family values’’ and start placing ‘‘value-in-families.’’ We can do this in part, by investing 

the resources of the American people in our children who will soon inherit our challenging legacy; and we can START NOW by putting a stop to these fraudulent and 

destructive programs of institutionalized child abuse. 

Chairman MILLER. Thank you. 

Ms. Moss? 

STATEMENT OF JAN MOSS, EXECUTIVE DIRECTOR, NATIONAL 

ASSOCIATION OF THERAPEUTIC SCHOOLS AND PROGRAMS 

Ms. MOSS. Mr. Chairman, Mr. McKeon, members of the committee, good morning. I am Jan Moss. I am a mother of two grown 

children and a grandmother of three. 

To those of you who have spoken today of your devastating 

losses, I express my condolences, respect and utmost deference. I 

have not suffered the loss of a child. I do, however, have a nephew 

who suffered abuse in an offshore program. 

I am here as the executive director of the National Association 

of Therapeutic Schools and Programs, generally known as 

NATSAP. We were established in 1999 in an effort to raise the bar 

of the private therapeutic programs serving children and families 

in crisis. Among our goals is the complete elimination of the abuVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00048 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
45

sive and neglectful practices we have heard about today. Clearly, 

we still have a very long way to go. 

Chairman Miller, you acknowledged in your December 2005 letter to the Government Accountability Office that there are, indeed, 

programs that provide high-quality services to help troubled adolescents get back on track. We are committed to ensuring that these 

programs remain available to families in dire need of help. We are 

working to ensure that the only programs on the market are those 

of the highest quality. 

NATSAP is the only entity in this country working with therapeutic schools and programs to improve them. We are a trade organization. We do not provide certifications nor do we conduct investigations. 

Our principles of good practice are based on our 12 ethical principles and were formulated using the standards set by the joint 

commission which accredits nearly 15,000 care programs in the 

United States. We will not accept or retain members that do not 

abide by our ethics or attest to following our principles of good 

practice. 

When we receive notification of a concern about one of our members, we review evidence from state licensing authorities, attorneys 

general, accrediting bodies and other third parties. If a member 

has acted in a manner inconsistent with the law or our principles, 

we proceed on a case-by-case basis, either requiring the program to 

implement change or canceling its membership. 

NATSAP will review the findings of the GAO’s investigation into 

NATSAP member programs and will take action as appropriate. 

Our professional development activities include a national conference which over 700 people attend annually. We hold six regional conferences with an estimated total attendance of over 800 

individuals. Each conference provides continuing education courses 

led by industry experts, university researchers and other clinical 

professionals. 

In 2006, NATSAP launched its first professional journal. Dr. Michael Gass of the University of New Hampshire is the managing 

editor. 

In 2007, NATSAP launched its research initiative which will provide members an affordable data collection tool to evaluate the effectiveness of their clinical work. The University of New Hampshire will house the database, making it available not only to internal but also external researchers. 

Dr. Keith Russell from the University of Minnesota has just released the results of his 4 years of research on outdoor behavioral 

treatment. 

In 2007, the NATSAP board of directors strengthened its membership requirements. We now require members to be licensed by 

the appropriate state mental health agency or accredited by a reputable mental health accreditation organization, such as the joint 

commission. 

Unfortunately, not all states have licensing requirements. We are 

working to address this inadequacy. We have worked successfully 

with the State of Utah to establish regulations for therapeutic 

boarding schools which had previously escaped licensure requirements by claiming plain boarding school status. In Montana, we 

46

worked diligently to have appropriate licensure requirements put 

into place, but the stringent bill that we favored lost to a less rigorous bill. 

We continue to push for strong state licensure and monitoring requirements. We are hopeful that Chairman Miller, Ranking Member McKeon and this committee will help us in these efforts. We 

need your assistance. 

The American Bar Association has submitted to this committee 

the ABA’s recommendations for legislation to assure the safety of 

children and youth placed in private residential treatment facilities. We are in fundamental agreement to the extent that the ABA 

recommends licensure and monitoring of these facilities. We expand on the ABA’s recommendations by supporting the licensure 

and monitoring of all adolescent treatment facilities, including 

those that are funded by public entities. 

Mr. Chairman and Mr. McKeon, NATSAP extends its sincere appreciation for your commitment to eliminating deceptive, abusive 

and neglectful programs by encouraging state licensure and enforcement. We are committed to working with this committee, other 

organizations and parents to draft and enact meaningful legislation 

to put an end to the horrific pain and suffering we have heard 

today. 

Thank you. 

[The statement of Ms. Moss follows:]

Prepared Statement of Jan Moss, Executive Director, National Association 

of Therapeutic Schools and Programs 

Mr. Chairman, Mr. McKeon, members of the Committee, thank you for the opportunity to participate in this hearing. I am Jan Moss. 

I am a mother of two grown children and a grandmother of three. To those of you 

who have spoken today of your devastating losses, I express my condolences, respect 

and utmost deference. I have not suffered the loss of a child. I do, however, have 

a nephew who suffered abuse in an offshore program. 

I am here as the Executive Director of the National Association of Therapeutic 

Schools and Programs, generally known as NATSAP. We were established in 1999 

in an effort to raise the bar of the private therapeutic programs serving children 

and families in crisis. Among our goals is the complete elimination of the abusive 

and neglectful practices we have heard about today. Clearly we still have a long way 

to go. 

Chairman Miller, you acknowledged in your December 2005 letter to the Government Accountability Office that there are, indeed, ‘‘programs that provide high-quality services to help troubled adolescents get back on track.’’ The three personal narratives I am attaching to my written testimony underscore the value of high-quality 

therapeutic schools and programs. We are committed to ensuring that these programs remain available to families in dire need of help. We are working to ensure 

that the only programs on the market are those of the highest quality. 

NATSAP is the only entity in this country working with therapeutic schools and 

programs to improve them. We are a trade organization. We do not provide certifications or conduct investigations. 

I am attaching the Ethical Principles of the National Association of Therapeutic 

Schools and Programs to my written testimony. Our Principles of Best Practice are 

based on our 12 Ethical Principles and were formulated using the standards set by 

the Joint Commission, which accredits nearly 15,000 health care programs in the 

United States. We will not accept or retain members that do not abide by our ethics 

or attest to following our Principles of Good Practice. 

When we receive notification of a concern about one of our members, we review 

evidence from state licensing authorities, attorneys general, accrediting bodies, and 

other third parties. If a member has acted in a manner inconsistent with the law 

or our Principles, we proceed on a case-by-case basis, either requiring the program 

to implement change, or cancelling its membership. NATSAP will review the findVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00050 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
47

ings of the GAO’s investigation into NATSAP member programs and will take action 

as appropriate. 

Our professional development activities include a national conference, which over 

700 people attend annually. We hold six regional conferences, with an estimated 

total attendance of over 800 individuals. Each conference provides continuing education courses led by industry experts, university researchers, and other clinical professionals. 

In 2006, NATSAP launched its first professional Journal. Dr. Michael Gass of the 

University of New Hampshire is the managing editor. In 2007, NATSAP launched 

its Research Initiative, which will provide members an affordable data-collection tool 

to evaluate the effectiveness of their clinical work. The University of New Hampshire will house the database, making it available not only to internal, but also external researchers. Dr. Keith Russell, University of Minnesota, has just released the 

results of his four years of research on outdoor behavioral treatment. 

In 2007, the NATSAP Board of Directors strengthened NATSAP’s membership requirements. We now require members to be licensed by the appropriate state mental 

health agency, or accredited by a reputable mental health accreditation organization, such as the Joint Commission. 

Unfortunately, not all states have licensing requirements. We are working to address this inadequacy. We have worked successfully with the State of Utah to establish regulations for therapeutic boarding schools, which had previously escaped licensure requirements by claiming plain ‘‘boarding school’’ status. In Montana, we 

worked diligently to have appropriate licensure requirements put into place, but the 

stringent bill we favored lost to a less rigorous bill. 

We continue to push for strong state licensure and monitoring requirements. We 

are hopeful that Chairman Miller, Ranking Member McKeon, and this Committee 

will help us in these efforts. We need your assistance. 

The American Bar Association has submitted to this Committee the ABA’s recommendations for legislation to assure the safety of children and youth placed in 

private residential treatment facilities. We are in fundamental agreement to the extent that the ABA recommends licensure and monitoring of these facilities. We expand on the ABA’s recommendations by supporting licensure and monitoring of all 

adolescent treatment facilities, including those that are funded by public entities. 

Mr. Chairman and Mr. McKeon, NATSAP extends its sincere appreciation for 

your commitment to eliminating deceptive, abusive, and neglectful programs by encouraging state licensure and enforcement. We are committed to working with this 

Committee, other organizations, and parents to draft and enact meaningful legislation to put an end to the horrific pain and suffering we have heard about today. 

ATTACHMENT 1.—TESTIMONY OF TREVOR MILES HEATON

Chairman Miller and Honorable Committee Members, I would like to thank you 

for the opportunity to share my testimony of hope and success with you. 

To understand my viewpoint regarding the issue at hand, a brief history of my 

past is necessary. My name is Trevor Heaton. I am a 19 year old recovering heroin 

addict living in Salt Lake City. I began smoking pot at age 13. From there I rapidly 

progressed to pain medications and eventually became confined to a vicious heroin 

addiction. I have been to four different treatment facilities, both in and out of Utah. 

I have been admitted to the psychiatric ward several instances for drug related 

problems. I have also been part of the juvenile court system. I stole, lied, cheated, 

abused, neglected, and rationalized my way through my addiction. My story is no 

different than any other addict out there in such that I have the disease of addiction 

and must do everything in my power to keep this demon in remission. 

It took years of using and several treatment programs for me to finally make the 

decision to change my life around. Obviously, the choice to stay sober is made by 

myself, and only for myself, but the treatment programs I attended were influential 

in helping me make this choice. The reason I did not remain sober after my first 

programs was do to a conscious decision on my part. The treatment centers provided 

me with all the necessary life skills, coping mechanisms, and tools to remain sober, 

but I simply chose not to apply the knowledge and skills I had been presented with. 

Two of the programs I went to were very impressive, and two were not. I can’t 

blame a program for my relapses because although a program may not have been 

as quality as another, I was still made aware of my addiction, yet chose to ignore 

all the instruction I had been given. 

I feel very fortunate to be alive today. I live a wonderful life and could not be 

happier. I am about to graduate from Salt Lake Community College with my Associates of Science Degree in Social Work. I have a 4.0 college GPA and plan to go for 

my Masters degree. I have a stable job. Relationships with family and friends have 

48

been restored to the fullest. I attend A.A. meetings regularly. I am on the Alumni 

Council of the National Association of Therapeutic Schools and Programs. I am also 

on the Salt Lake Mayors Coalition for Alcohol, Tobacco, and Other Drugs. As I said, 

life is beautiful at the moment. I have been given a second chance at life. This second chance was made possible by the many professionals and staff I encountered 

at various treatment centers throughout my journey. As we are all aware, the price 

of drug rehabilitation is quite expensive, but the lessons learned and the tools that 

are provided through such programs are priceless. 

I am very grateful to my family for providing me with such resources as drug rehabilitation. I am also grateful for those individuals who have helped shape my life 

into something truly amazing. I respectfully ask that do all you can to eliminate 

abusive and neglectful programs while also doing whatever is necessary to preserve 

options for children and families in need of specialized treatment and educational 

services. Treatment is the greatest tool we have in the fight against addiction. I am 

proof that there is hope and that recovery is able to breed success and triumph. If 

you would like more information on my experience, you may contact me at any time. 

Once again, thank you for the opportunity to participate in this extraordinarily important hearing. 

Respectfully submitted, 

TREVOR MILES HEATON, 

Riverton, UT. 

ATTACHMENT 2.—WRITTEN TESTIMONY OF THOMAS AND EMILY VITALE

Chairman Miller and Honorable Committee Members, thank you for the opportunity to share our testimony with you. Chairman Miller, we share your urgent desire to ensure that abusive and neglectful ‘‘boot camps’’ and ‘‘tough love’’ programs 

do not harm adolescents in need of special care and nurturing. 

However, most therapeutic schools and programs do provide healthy, positive environments in which children may learn while healing. Our daughter Caroline is 

one child who benefited greatly from a therapeutic boarding school. She had been 

in and out of many ‘‘regular’’ high schools, never able to get her homework done 

(she is extraordinarily bright so teachers assumed she was lazy). As she spiraled 

into depression and self-injury, we realized she needed a school where she would 

be both safe and able to work on the issues that caused her to de-rail. 

Caroline spent 18 months at the King George School, an emotional growth boarding school in Northern Vermont. During that time she attended academic classes, 

excelled in therapeutic art classes, participated in group and individual therapy sessions. At no time was she or any student there forced to participate in programs 

like those which you aim to eliminate. Her experience there has changed her life 

and ours. She is currently back at a ‘‘regular’’ high school and is applying to college 

for next year. She would never have been able to do this without the support and 

nurturing of the King George School. 

Certainly, you must eliminate abusive and neglectful programs. You must also 

preserve options for children and families in need of specialized treatment and educational services. 

If you would like more information on our family’s experience, or better yet, if you 

would like to hear from our daughter, Caroline, please contact us. 

ATTACHMENT 3.—TESTIMONY OF ALEXANDRINE LYONS-BOYLE

Chairman Miller and Honorable Committee Members, I sincerely applaud your 

desire to ensure that abusive and neglectful ‘‘boot camps’’ and ‘‘tough love’’ programs 

are not able to harm children who need therapy and care, and need to get on the 

right track. I’ve seen news programs that horrified me regarding these programs. 

However, I sent my daughter to a wilderness therapy program that was not a boot 

camp, not a tough love program, but was an outstanding therapeutic program that 

saved her life. 

My daughter had always been a happy child, a good student, and a sweet daughter until she reached high school. At that time, for many reasons, including depression, ADD, and the innate meanness of many teenage girls (the way ‘‘her friends’’ 

treated her would make you cry), she began to abuse drugs. She was so depressed 

that she would lie on our kitchen floor and just cry. She went from being an A-B 

student in high level classes (honors and advanced grades), to receiving straight F’s, 

and being told by the high school principal that they were processing her to have 

her removed from the school. She was arrested repeatedly. 

When I learned of Catherine Freer Wilderness Therapy from her psychiatrist, I 

immediately sent her to this program. She spent 3 weeks hiking in the wilderness 

with 5 other teenagers, and 3 adults—two of the adults were trained counselors, and 

49

one a licensed therapist. All operated in close contact with a licensed therapist back 

in the home office who was in constant contact with the parents. These were wonderful, caring people, who, through their program, changed my daughter’s life. 

They taught her self-reliance and self confidence (she had to cook for herself, set 

up her own tent at night, and carry her own supplies during the day). She is proud 

of what she did. They structured all conversation so the kids couldn’t just trade war 

stories, but had to really think about why they had made the decisions they had 

made, what they wanted from life, what their values were, and were they living by 

those values? How had they affected the people in their lives? What was their future 

going to be like? For 24 hours a day, every day for 3 weeks, my daughter was in 

therapy—caring, educational, and successful therapy. She was also in the healing 

environment of nature, which is awesome and cannot be duplicated indoors. 

After only 3 weeks, she was a changed person. The last day, when she walked 

into the room where her family was waiting, she had a huge smile on her face, she 

looked tanned, a bit heavier, much healthier; she looked confident and proud of herself, and happy! I was amazed! She was proud of all she’d accomplished, of how 

she’d changed, and she was looking so forward to sharing her experiences with her 

family. 

Much, much more amazing is how now, six months later, she is again an ‘‘A’’ student, a smiling, happy person, who has excellent values. In fact, she has an appreciation for life that she never had before. 

She has thanked me many times for sending her to Catherine Freer Wilderness 

Therapy. She changes her mind frequently now about what she will major in at college, but neither of us have any doubt that she will be a college graduate, a responsible member of society, and a good person. 

I could give you much more detail, but in the interest of being brief, I will simply 

say that you are welcome to contact either my daughter or myself to learn more of 

the outstanding wilderness program she attended. 

The people at Catherine Freer are very, very caring. They are NOTHING like I’ve 

seen on the news programs about the boot camps and tough love programs. Please, 

please do not lump them in with those other extremely scary, dangerous, and ineffective programs that harm children rather than helping them. 

Thank you for protecting our youth from those harmful programs, and thank you 

for finding a way to differentiate the good from the bad in your legislation, and 

making sure programs like Catherine Freer continue to help children like my 

daughter. 

Sincerely, 

ALEXANDRINE LYONS-BOYLE, 

Mother of Leilagh Boyle, Schaumburg, IL. 

ATTACHMENT 4.—NATSAP ETHICAL PRINCIPLES

Members of the National Association of Therapeutic Schools and Programs 

(NATSAP) provide residential, therapeutic, and/or education services to children, 

adolescents, and young adults entrusted to them by parents and guardians. The 

common mission of NATSAP members is to promote the healthy growth, learning, 

motivation, and personal well-being of our program participants. The objective of all 

our therapeutic and educational programs is to provide excellent treatment for our 

program participants; treatment that is rooted in good-hearted concern for their 

well-being and growth; respect for them as human beings; and sensitivity to their 

individual needs and integrity. 

In applying to become or continue as a member of The National Association of 

Therapeutic Schools and Programs, we agree to: 

1. Be conscious of, and responsive to, the dignity, welfare, and worth of our program participants. 

2. Honestly and accurately represent ownership, competence, experience, and 

scope of activities related to our program, and to not exploit potential clients’ fears 

and vulnerabilities. 

3. Respect the privacy, confidentiality, and autonomy of program participants 

within the context of our facilities and programs. 

4. Be aware and respectful of cultural, familial, and societal backgrounds of our 

program participants. 

5. Avoid dual or multiple relationships that may impair professional judgment, increase the risk of harm to program participants, or lead to exploitation. 

6. Take reasonable steps to ensure a safe environment that addresses the emotional, spiritual, educational, and physical needs of our program participants. 

7. Strive to maintain high standards of competence in our areas of expertise and 

to be mindful of our limitations. 

50

8. Value continuous professional development, research, and scholarship. 

9. Place primary emphasis on the welfare of our program participants in the development and implementation of our business practices. 

10. Manage our finances to ensure that there are adequate resources to accomplish our mission. 

11. Fully disclose to prospective candidates the nature of services, benefits, risks, 

and costs. 

12. Provide informed, professional referrals when appropriate or if we are unable 

to continue service. 

[Additional materials submitted by Ms. Moss follow:]

October 23, 2007. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: The National Association of Therapeutic Schools and 

Programs (NATSAP) respectfully requests the enclosed information be submitted for 

the record in regards to your hearing ‘‘Cases of Child Neglect and Abuse at Private 

Residential Treatment Facilities’’. 

1. Summary of Research from 1999—2006 and Update to 2000 Survey of Outdoor 

Behavioral Healthcare Programs in North America—Dr. Keith C. Russell, Ph.D., 

College of Education and Human Development, University of Minnesota 

2. Incident Monitoring in Outdoor Behavioral Healthcare Programs: A Four-Year 

Summary of Restraint, Runaway, Injury, and Illness Rates—Dr. Keith C. Russell, 

Ph.D., University of Minnesota, and Nevin Harper, M.A., University of Minnesota 

3. A Multi-Center, Longitudinal Study of Youth Outcomes in Private Residential 

Treatment Programs—Ellen Behrens, Ph.D. and Kristin Satterfield, Ph.D. of Canyon Research and Consulting 

4. Copies of agenda for the NATSAP Annual and Regional Conferences, which 

demonstrates the high quality of education, presented by credentialed individuals, 

that is provided at these conferences. 

5. Volume I, Numbers I and II of the Journal of Therapeutic Schools and Programs (JTSP); Managing Editor Dr. Michael Gass, University of New Hampshire. 

Thank you. 

Sincerely, 

NATSAP BOARD OF DIRECTORS. 

[The technical report, ‘‘Summary of Research From 1999-2006, 

and Update To 2000 Survey Of Outdoor Behavioral Healthcare 

Programs in North America,’’ by Keith C. Russell, Ph.D., Director, 

Outdoor Behavioral Healthcare Research Cooperative (OBHRC), 

College of Education and Human Development, University of Minnesota, dated May 2007, may be requested at the following Internet 

address:]

http://www.obhrc.org/

[The risk incident paper, ‘‘Incident Monitoring in Outdoor Behavioral Healthcare Programs: A Four-Year Summary of Restraint, 

Runaway, Injury, and Illness Rates,’’ by Keith C. Russell, Ph.D., 

Director, Outdoor Behavioral Healthcare Research Cooperative 

(OBHRC), College of Education and Human Development, University of Minnesota, may be accessed at the following Internet address:]

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http://cehd.umn.edu/kin/research/obhrc/publications/incidentnatsap001.pdf 


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Bylaws of the National Association of Therapeutic Schools and Programs

(A Tax-Exempt/Non-Profit Corporation)

Article 1.—Offices 

SECTION 1. REGISTERED AND PRINCIPAL OFFICES

The registered office of The National Association of Therapeutic Schools and Programs, Inc. (the ‘‘Corporation’’, a tax-exempt, non-profit Corporation, shall be 126 

North Marina, Prescott, Arizona 86301; and the name of the registered Agent at 

this address is Janice K. Moss. The mailing address of the initial principle office 

of the Corporation shall be 126 North Marina, Prescott, Arizona 86301. The registered office need not be identical with the principle office of the Corporation and 

may be changed at any time by the Board of Directors. 

SECTION 2. OTHER OFFICES

The Corporation may also have offices at such other places, within or without the 

State of Arizona, where it is qualified to do business, as its business may require 

and as the board of Directors may, from time to time, designate. 


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Article 2.—Directors 

SECTION 1. POWERS

All corporate powers shall be exercised by or under the authority of, and the business and affairs of the Corporation managed under the direction of its Board of Directors, subject to any limitation set forth in the Articles of Incorporation, other provisions of these Bylaws relating to action required or permitted to be taken or approved by the Members, if any, of this Corporation, the activities and affairs of this 

Corporation. 

SECTION 2. NUMBER AND ELECTION

The Corporation shall have no more than sixteen Directors excluding ex-officio 

Members, unless changed by amendment to these Bylaws. Collectively, they shall 

be known as the Board of Directors. Elections for available board positions shall be 

held by ballot. The exact number of Directors shall be fixed within the limit by a 

resolution adopted by the Board of Directors. 

SECTION 3. TERMS OF OFFICE

All Directors elected to the board shall serve for two-year terms and may be appointed at the pleasure of the board to serve one additional two-year term. The term 

of Directors begins and expires at the Annual Member meeting following the annual 

election. 

SECTION 4. QUALIFICATIONS

Directors of the Corporation shall be a Member of the Executive Committee with 

decision-making authority, or be owner, president, chief executive, or Director of 

Member programs in good standing 

SECTION 5. DUTIES

It shall be the duty of the Directors to: 

(a) Perform any and all duties imposed on them collectively or individually by law, 

by the Articles of Incorporation of this Corporation, or by these Bylaws; 

(b) Appoint and remove, employ and discharge, and, except as otherwise provided 

in these Bylaws, prescribe the duties and fix the compensation, if any, of all Officers, Agents and Employees of the Corporation; 

(c) Supervise all Officers, Agents and Employees of the Corporation to assure that 

their duties are performed properly; 

(d) Meet at such times and places as required by these Bylaws; 

(e) Register their addresses with the Secretary of the Corporation and notices of 

meetings mailed or telegraphed to them at such addresses shall be valid notices 

thereof. 

SECTION 6. VACANCIES

Vacancies on the Board of Directors shall exist (1) on the death, resignation, removal, or expiration of term of any Director, and (2) whenever the number of authorized Directors is increased. 

Vacancies on the board may be filled by the (1) the Members, (2) the Board of 

Directors, or (3) if the Directors remaining in office constitute fewer than a quorum 

of the Board, they may fill the vacancy by the affirmative vote of a majority of all 

the Directors remaining in office. 

SECTION 7. RESIGNATIONS

A Director may resign effective upon giving written notice to the President, the 

Secretary, or the Board of Directors. A resignation is effective when the notice is 

delivered unless the notice specifies a later effective date. 

SECTION 8. REMOVAL OF DIRECTORS

A Director may be removed, with or without cause, upon the affirmative vote of 

not less than a majority of the Directors. 

SECTION 9. COMPENSATION

Directors shall serve without compensation except that they shall be allowed reasonable advancement or reimbursement of expenses incurred in the performance of 

their regular duties as specified in Section 5 of this Article. Reasonable expense limVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00060 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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its shall be determined by resolution of the Board of Directors. Directors may not 

be compensated for rendering services to the Corporation in any capacity other than 

Director unless such other compensation is reasonable and is allowable under the 

provisions of Section 10 of this Article. 

SECTION 10. RESTRICTION REGARDING INTERESTED DIRECTORS

Notwithstanding any other provision of these Bylaws, no persons serving on the 

board may be interested persons. For purposes of this Section, ‘‘interested persons,’’ 

means either: 

(a) Any person currently being compensated by the Corporation for services rendered it within the previous twelve (12) months, whether as a full- or part-time Officer or other Employee, Independent contractor, or otherwise, excluding any reasonable compensation paid to a Director as Director; or 

(b) Any brother, sister, ancestor, descendant, spouse, brother-in-law, sister-in-law, 

son-in-law, daughter-in-law, mother-in-law, or father-in-law of any such person. 

(c) Any person so deemed by vote of the existing board of Directors. 

Article 3.—Meetings and actions of the board of directors 

SECTION 1. PLACE OF MEETINGS

Meetings shall be held at such place within or without the State of Arizona, which 

has been designated by resolution of the Board of Directors. Any meeting, regular 

or special, may be held by conference telephone, electronic video screen communication, or other communications equipment. Participation in a meeting through use 

of conference telephone constitutes presence in person at that meeting so long as 

all Directors participating in the meeting are able to hear one another. 

SECTION 2. NOTICE OF MEETINGS

Notice of the date, time, place, or purpose of annual and other regular meetings 

of the Board of Directors need not be given. Notice of any special meeting, setting 

forth the date, time and place of the meeting, shall be given to each Director by 

oral or written notice not less that two (2) days before the meeting. The notice need 

not describe the purpose of the special meeting unless otherwise required by the Articles of Incorporation or other provisions in these Bylaws. 

SECTION 3. QUORUM FOR MEETINGS

At all meetings of the Board of Directors, a majority of the Directors then in office 

shall constitute a quorum. If a quorum is present when a vote is taken, the affirmative vote of a majority of Directors present is the act of the Board of Directors unless 

the articles of Incorporation, other provisions of these Bylaws or the Code otherwise 

require the vote of a greater number of Directors. If a quorum shall not be present 

at any meeting of the Board, the Members present at such meeting may adjourn 

the meeting from time to time, without notice other than announcement at the 

meeting, until a quorum shall be present. 

SECTION 4. PRESUMPTION OF ASSENT

A Director who is present at a meeting of the Board of Directors when corporate 

action is taken is deemed to have assented to the action taken unless 1) his dissent 

or abstention from the action taken is entered in the minutes of the meeting, or 2) 

he delivers written notice of his dissent or abstention to the presiding offer of the 

meeting before its adjournment or to the Corporation immediately after adjournment of the meeting. The right of dissent or abstention in not available to a Director 

who votes in favor of the action taken. 

SECTION 5. CONDUCT OF MEETINGS

Meetings of the Board of Directors shall be presided over by the President of the 

Corporation or, in his or her absence, by the Vice President of the Corporation or, 

in the absence of each of these persons, by a Chairperson chosen by a majority of 

the Directors present at the meeting. The Secretary of the Corporation shall act as 

secretary of all meetings of the board, provided that, in his or her absence, the presiding Officer shall appoint another person to act as Secretary of the Meeting. 

SECTION 6. ACTION BY WRITTEN CONSENT WITHOUT MEETING

Any action required or permitted by the Board of Directors under any provision 

of law may be taken without a meeting. Such action by written consent shall have 

the same force and effect as the majority vote of the Directors. Any certificate or 

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other document filed under any provision of law which relates to action so taken 

shall state that the action was taken by unanimous written consent of the Board 

of Directors without a meeting and that the Bylaws of this Corporation authorize 

the Directors to so act, and such statement shall be prima facie evidence of such 

authority. 

SECTION 7. NON-LIABILITY OF DIRECTORS

The Directors shall not be personally liable for the debts, liabilities, or other obligations of the Corporation. 

Article 4.—Officers 

SECTION 1. NUMBER OF OFFICERS

The officers of the Corporation shall be a President, a Vice President, a Secretary, 

and a Chief Financial Officer who shall be designated the Treasurer. The President 

shall serve as Chair. 

SECTION 2. QUALIFICATION, ELECTION, AND TERM OF OFFICE

Officers of the Corporation must either be an owner, a member of the Executive 

Committee with decision-making authority, or be president, chief executive, or Director of member programs in good standing. Officers shall be elected by and from 

the Board of Directors. When a board member is elected to serve as an officer his/

her term on the board is extended to coincide with the term of the office Each officer 

shall hold office for two years and may serve an additional two-year term pending 

an affirmative vote of the majority of the Board of Directors at the regular meeting 

immediately preceding the end of the Officer’s first term. No President may serve 

more than two terms. Each officer shall hold office until his or her term expires or 

until he or she resigns, is removed, or otherwise is disqualified to serve, or until 

his or her successor shall be elected and qualified, whichever occurs first. 

SECTION 3. REMOVAL AND RESIGNATION

Any officer may be removed, either with or without cause, by a majority vote of 

the Board of Directors, at any time. Any officer may resign at any time by giving 

written notice to the Board of Directors or to the President or Secretary of the Corporation. Any such resignation shall take effect at the date of receipt of such notice 

or at any later date specified therein, and, unless otherwise specified therein, the 

acceptance of such resignation shall not be necessary to make it effective. 

SECTION 4. VACANCIES

Any vacancy caused by the death, resignation, removal, disqualification, or otherwise, of any officer shall be filled by the Board of Directors. In the event of a vacancy in any office other than that of President, such vacancy may be filled temporarily by appointment by the President until such time as the Board shall fill the 

vacancy. Vacancies occurring in offices of officers appointed at the discretion of the 

board may or may not be filled, as the board shall determine. 

SECTION 6. DUTIES OF PRESIDENT

The President shall be the chief executive officer of the Corporation. The president 

shall have general executive charge, management and control of the properties, 

business and operations of the Corporation with all such powers assay be reasonably 

incident to such responsibilities. The President shall have the authority to agree 

upon and execute all leases, contracts, evidences of indebtedness and other obligations in the name of the Corporation; and, shall have such other powers and duties 

as designated in accordance with these Bylaws and as from time to time may be 

assigned by the Board of Directors. 

SECTION 7. DUTIES OF VICE PRESIDENT

In the absence of the President, or in the event of his or her inability or refusal 

to act, the Vice President shall perform all the duties of the President, and when 

so acting shall have all the powers of, and be subject to all the restrictions on, the 

President. The Vice President shall have other powers and perform such other duties as may be prescribed by law, by the Articles of Incorporation, or by these Bylaws, or as may be prescribed by the Board of Directors. 

59

SECTION 8. DUTIES OF SECRETARY

The Secretary shall keep the minutes of all meetings of the Board of Directors 

and the minutes of all meetings of the Members, in books provided for that purpose; 

the Secretary shall attend to the giving and serving of all notices; may, in the name 

of the Corporation, affix the seal of the Corporation to all contracts of the Corporation and attest the seal of the Corporation thereto; shall have charge of such books 

and papers as the Board of Directors may direct, all which shall at all reasonable 

times be open to inspection of any Director upon request at the office of the Corporation during business hours; and shall in general perform all duties incident to the 

office of Secretary, subject to the control of the President and the Board of Directors. 

SECTION 9. DUTIES OF TREASURER

The Treasurer shall have responsibility for the custody and control of all the 

funds and securities of the Corporation. The Treasurer shall perform all acts incident to the position of Treasurer subject to the control of the President and the 

Board of Directors; and shall, if required by the Board of Directors, give such bond 

for the faithful discharge of duties in such form as the Board of Directors may require. 

Article 5.—Committees 

SECTION 1. EXECUTIVE COMMITTEE

The Officers of the Corporation will constitute the Executive Committee. The 

Board of Directors may delegate to such Committee any of the powers and authority 

of the board in the management of the business and affairs of the Corporation, except with respect to: 

a) The approval of any action which, under law or the provisions of these Bylaws, 

requires the approval of the Members or of a majority of all of the Members. 

b) The filling of vacancies on the board or on any committee, which has the authority of the board. 

c) The fixing of compensation of the Directors for serving on the board or on any 

committee. 

d) The amendment or repeal of Bylaws or the adoption of new Bylaws. 

e) The amendment or repeal or any resolution of the board, which by its express 

terms is not so amendable or repealable. 

f) The appointment of committees of the board or the Members thereof. 

g) The expenditure of corporate funds to support a nominee for Director after 

there are more people nominated for Director than can be elected. 

h) The approval of any transaction to which this Corporation is a party and in 

which one or more of the Directors has a material financial interest, except as expressly provided in Arizona Nonprofit Corporation Law. 

SECTION 2. OTHER COMMITTEES

The Corporation shall have such other committees as may from time to time be 

designated by resolution of the Board of Directors. Such other committees may consist of persons who are not also members of the board. These additional committees 

shall act in an advisory capacity only to the board. 

SECTION 3. MEETINGS AND ACTION OF COMMITTEES

Meetings and action of committees shall be governed by, noticed, held and taken 

in accordance with the provisions of these Bylaws concerning meetings of the Board 

of Directors, with such changes in the context of such Bylaw provisions as are necessary to substitute the committee and its members for the Board of Directors and 

its members, except that the time for regular meetings of committees may be fixed 

by the committee. The time for special meetings of committees may also be fixed 

by the Board of Directors. The Board of Directors may also adopt rules and regulations pertaining to the conduct of meetings of committees to the extent that such 

rules and regulations are not inconsistent with the provisions of these Bylaws. 

Article 6.—Members 

SECTION 1. IDENTITY OF MEMBERS

The Members of the Corporation shall be composed of those Members who have 

been elected as such by a majority of the Board of Directors; and shall retain their 

status as Members so long as they continue to meet the standards of membership 

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as determined by the Board of Directors and pay any and all annual dues imposed 

by the Corporation upon its Members in a timely fashion. 

SECTION 2. MEMBERSHIP STANDARDS

The Board of Directors shall establish by resolution standards for each category 

of membership, if any. The standards for membership may be changed from time 

to time at the discretion of the Board of Directors. Some categories of Members may 

not have voting rights. 

SECTION 3. MEMBERSHIP DUES

Membership dues shall be set by the Board of Directors from time to time in such 

amounts, as the Board of Directors deems appropriate. The dues amounts may differ 

among categories of membership. Membership dues shall be paid annually and the 

Treasurer shall be responsible for mailing an annual dues statement to each Member. 

SECTION 4. ANNUAL MEETING

The annual meeting of the Members shall be held at the national conference of 

the association of each year or such other date as designated by the Board of Directors. The date, time and place of the annual meeting shall be designated by the 

Board of Directors and stated in the notice of the meeting. The business to be transacted at the annual meeting shall include the transaction of business as may properly come before the meeting. 

SECTION 5. SPECIAL MEETINGS

Special meetings of the Members may be called at any time for any purpose by 

the President or a majority of the Board of Directors and shall be called by an Officer or Director of the Corporation upon the request in writing of a majority of the 

Members. Such request shall state the purpose or purposes of the meeting. Business 

transacted at all special meetings shall be confined to the purpose or purposes stated in the notice of the meeting. 

SECTION 6. NOTICE OF MEETINGS

The Corporation shall notify Members of the date, time, and place of each Annual 

and Special Members’ Meeting no fewer that ten (10), nor more than sixty (60) days, 

before the meeting date. Unless the Arizona NonProfit Corporation Code (the 

‘‘Code’’) or the Articles of Incorporation require otherwise, the Corporation is required to give notice only to Members entitled to vote at the Meet. Unless the Code 

or the Articles of Incorporation require otherwise, notice of an Annual Meeting need 

not include a description of the purpose or purposes for which the meeting is called. 

Notice of a Special Meeting must include a description of the purpose or purposes 

for which the meeting is call. If not otherwise fixed pursuant to the Code, the record 

date for determining Members entitled to notice of an Annual or Special Members’ 

Meeting is the close of business on the day before the first notice is delivered to 

Members. Unless other provisions of these Bylaws require otherwise, if an Annual 

or Special Members’ meeting is adjourned to a different date, time, or place, notice 

need not be given of the new date, time or place if the new date, time or place is 

announced at the meeting before adjournment. If a new record date for the adjourned meeting is or must be fixed pursuant to these Bylaws, however, notice of 

the adjourned meeting must be given under this Section to persons who are Members as of the new record date. Any Member may waive notice of any meeting by 

written waiver filed with the records of the meeting either before or after the holding of such meeting. If mailed, such notice shall be deemed to be delivered when 

deposited in the United State s mail with first class postage thereon prepaid, addressed to the Member at his address, as it appears in the Corporation’s record of 

Members. If telexed, such notice shall be deemed to be delivered the day such notice 

is telexed to the Member 

SECTION 7. WAIVER OF NOTICE

A Member may waive any notice required by the Code, the articles of Incorporation, or these Bylaws before or after the date and time stated in the notice. The 

waiver must be in writing, be signed by the Member entitled to the notice, and be 

delivered to the Corporation for inclusion in the minutes or filing with the corporate 

records. A Member’s attendance at a meeting (1) waives objection to lack of notice 

or defective notice of the meeting; and (2) waives objection to consideration of a parVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00064 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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ticular matter at the meeting that is not within the purpose or purposes described 

in the meeting notice, unless the Member objects to considering the matter when 

presented. Unless otherwise required by these Bylaws, neither the business transacted nor the purpose of the meeting need be specified in the waiver; provided, however, that any waiver of notice of meeting required with respect to an amendment 

of the articles of Incorporation pursuant to Code, as amended, a plan of merger pursuant to Code, amended, or a sale of assets pursuant to Code, as amended, shall 

only be effective upon compliance with Code, as amended. 

SECTION 8. QUORUM

Members entitled to vote may take action on a matter at a meeting only if a 

quorum of those Members, present in person or represented by proxy, exists with 

respect to that matter. Unless the Articles of Incorporation, other provisions of these 

Bylaws or the Code provides otherwise, ten percent (10%) of the votes entitled to 

be cast on the matter by the Members constitutes a quorum for action on that matter; however, unless twenty percent (20%) or more of the voting power is present 

in person or by proxy, the only matters that may voted upon at an annual or regular 

meeting of Members are those matters that are described in the meeting notice. 

When a quorum is once present at a meeting, it is not broken by subsequent withdrawal of any of those present. 

SECTION 9. VOTING

If a quorum exists, action on a matter by the Members is approved if the votes 

cast favoring the action exceed the votes opposing the action, unless the Articles of 

Incorporation, a Bylaw adopted by the Members pursuant to the Code, as amended, 

or the Code requires a greater number of affirmative votes. Unless otherwise provided in the Articles of Incorporation, Directors are elected by a plurality of the 

votes cast by the Members entitled to vote in the lection. Unless the Articles of Incorporation or these Bylaws provide otherwise, each Member is entitled to one vote 

in person, by proxy on each matter voted on at Member meeting or called for via 

mail or electronic mail. A Member may appoint a proxy by an instrument in writing 

not more than one month prior to the meeting, unless such instrument provides for 

a longer period. Such proxy shall be dated, but need not be sealed, witnessed or acknowledged. 

SECTION 10. REPRESENTATION OF MEMBERS

Each Member school shall be represented at any meeting of Members by an individual designated in writing to the Corporation by the chief administrator of the 

Member program. Any action by such representative shall be deemed to be the action of the Member so represented. 

SECTION 11. CHANGE OF MEMBER’S REPRESENTATIVE

If any person serving as a representative of a Member program ceases to be an 

Employee of or associated with the Member school, such person shall cease to be 

a representative of such Member school or an Officer or Director of the Corporation, 

as the case may be. 

SECTION 12. TERMINATION OR SUSPENSION OF MEMBERSHIP

(a) Grounds for Termination or Suspension. The membership of a Member shall 

terminate or be suspended upon the occurrence of any of the following events: 

• Resignation of the Member; 

• Expiration of the period of membership, unless the membership is renewed on 

the renewal terms fixed by the board; 

• The Member’s failure to pay dues, fees, or assessments as set by the board 

within sixty days after they are due; 

• Upon his or her notice of such termination or suspension delivered to the office 

of the Executive Director of the Corporation personally or by mail, such membership 

to terminate or suspend upon the date of de1ivery of the notice or date of deposit 

in the mail. 

• Upon a determination by the Board of Directors that the Member has engaged 

in conduct materially and seriously prejudicial to the interests or purposes of the 

Corporation. 

(b) Procedure for Termination or Suspension. Following the determination that a 

Member should be terminated or suspended under subparagraph (a) of this section, 

the following procedure shall be implemented: 

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• A notice shall be sent by first-class or registered mail to the last address of the 

Member as shown on the Corporation’s records, setting forth the termination or suspension and the reasons therefor. Such notice shall be sent at least fifteen (15) days 

before the proposed effective date of the termination or suspension. • The Member being terminated or suspended shall be given an opportunity to 

be heard, either orally or in writing, at a hearing to be held not less than five (5) 

days before the effective date of the proposed termination or suspension. The hearing will be held by the Board of Directors in accordance with the quorum and voting 

rules set forth in these Bylaws applicable to the meetings of the Board. The notice 

to the Member of the termination or suspension shall state the date, time, and place 

of the hearing. • Following the hearing, the Board of Directors shall decide whether or not the 

Member should in fact be terminated, suspended, or sanctioned in some other way. 

The decision of the Board shall be final. • Any action challenging a suspension or termination of membership, including 

a claim against alleging defective notice, must commence within one year after the 

date of termination or Suspension. • If this Corporation has provided for the payment of dues by Members, any 

Member terminated from the Corporation shall receive a refund of the current years 

dues already paid. The refund shall be based on the effective date of the termination. 

SECTION 13. RIGHTS ON TERMINATION OF MEMBERSHIP

All rights of a Member in the Corporation shall cease on termination or suspension of membership as herein provided. 

SECTION 14. AMENDMENTS RESULTING IN THE TERMINATION OF MEMBERSHIPS

Notwithstanding any other provision of these Bylaws, if any amendment of the 

Articles of Incorporation or of the Bylaws of this Corporation would result in the 

termination of all memberships or any class of memberships, then such amendment 

or amendments shall be effected only in accordance with the provisions of Arizona 

Nonprofit Corporation Law. 

Article 7.—Indemnification 

SECTION 1. INDEMNIFICATION BY CORPORATION OF DIRECTORS, OFFICERS, EMPLOYEES

AND OTHER AGENTS

To the extent that a person who is, or was, a Director, Officer, Employee or other 

Agent of this Corporation has been successful on the merits in defense of any civil, 

criminal, administrative or investigative proceeding brought to procure a judgment 

against such person by reason of the fact that he or she is, or was, an Agent of the 

Corporation, or has been successful in defense of any claim, issue or matter, therein, 

such person shall be indemnified against expenses actually and reasonably incurred 

by the person in connection with such proceeding. 

If such person either settles any such claim or sustains a judgment against him 

or her, then indemnification against expenses, judgments, fines, settlements and 

other amounts reasonably incurred in connection with such proceedings shall be 

provided by this Corporation but only to the extent allowed by, and in accordance 

with the requirements of, Arizona Nonprofit Corporation Law. 

SECTION 2. INSURANCE FOR CORPORATE AGENTS

The Board of Directors may adopt a resolution authorizing the purchase and 

maintenance of insurance on behalf of any Agent of the Corporation (including a Director, Officer, Employee or other Agent of the Corporation) against any liability 

other than for violating provisions of law relating to self-dealing (Arizona Nonprofit 

Corporation Law) asserted against or incurred by the Agent in such capacity or arising out of the Agent’s status as such, whether or not the Corporation would have 

the power to indemnify the Agent against such liability under the provisions of Arizona Nonprofit Corporation Law. 

Article 8.—Execution of instruments, deposits and funds 

SECTION 1. EXECUTION OF INSTRUMENTS

The Board of Directors, except as otherwise provided in these Bylaws, may by resolution authorize any Officer or Agent of the Corporation to enter into any contract 

or execute and deliver any instrument in the name of and on behalf of the Corporation, and such authority may be general or confined to specific instances. Unless so 

63

authorized, no Officer, Agent, or Employee shall have any power or authority to 

bind the Corporation by any contract or engagement or to pledge its credit or to 

render it liable monetarily for any purpose or in any amount. 

SECTION 2. CHECKS AND NOTES

Except as otherwise specifically determined by resolution of the Board of Directors, or as otherwise required by law, checks, drafts, promissory notes, orders for 

the payment of money, and other evidence of indebtedness of the Corporation shall 

be signed by the Treasurer and countersigned by the President of the Corporation. 

SECTION 3. DEPOSITS

All funds of the Corporation shall be deposited from time to time to the credit 

of the Corporation in such banks, trust companies, or other depositories as the 

Board of Directors may select. 

SECTION 4. GIFTS

The Board of Directors may accept on behalf of the Corporation any contribution, 

gift, bequest, or devise for the charitable or public purposes of this Corporation. 

Article 9.—General provisions 

SECTION 1. MAINTENANCE OF CORPORATE RECORDS

The Corporation shall keep at its principal office in the State of Arizona: 

(a) Minutes of all meetings of Directors, committees of the board and, if this Corporation has Members, of all meetings of Members, indicating the time and place 

of holding such meetings, whether regular or special, how called, the notice given, 

and the names of those present and the proceedings thereof; 

(b) Adequate and correct books and records of account, including accounts of its 

properties and business transactions and accounts of its assets, liabilities, receipts, 

disbursements, gains and losses; 

(c) A record of its Members, if any, indicating their names and addresses and, if 

applicable, the class of membership held by each Member and the termination date 

of any membership; 

(d) A copy of the Corporation’s Articles of Incorporation and Bylaws as amended 

to date, which shall be open to inspection by the Members, if any, of the Corporation 

at all reasonable times during office hours. 

SECTION 2. FISCAL YEAR OF THE CORPORATION

The fiscal year of the Corporation shall begin on the first day of January and end 

on the last day of December in each year. 

SECTION 3. CORPORATE SEAL

The Board of Directors may adopt, use, and at will alter, a corporate seal. Such 

seal shall be kept at the principal office of the Corporation. Failure to affix the seal 

to corporate instruments, however, shall not affect the validity of any such instrument. 

SECTION 4. ANNUAL STATEMENTS

No later than three (3) months after the end of the fiscal year, the Corporation 

shall prepare: 

(a) A balance sheet showing in reasonable detail the financial condition of the 

Corporation as of the close of its immediately preceding fiscal year, and 

(b) A profit and loss statement showing the results of its operations during the 

preceding fiscal year. 

(c) Form 990EZ will be filed for each fiscal year. 

Upon written request, the Corporation shall promptly mail to any Member of 

record a copy of the most recent such balance sheet and profit and loss statement. 

Article 10.—Amendment of bylaws 

SECTION 1. AMENDMENT

These Bylaws may be amended by a two-thirds vote of the Board of Directors of 

the Corporation. The Members will be notified of the change to the Bylaws. Upon 

notification a simple majority of the Members may overturn the Board’s decision to 

amend the Bylaws. The membership at large is also empowered to amend the bylaws by proposing a change to the membership at an annual meeting or in writing. 

64

Such proposed change in the Bylaws must pass with a simple majority vote of all 

eligible Members. The membership may also provide by resolution that any Bylaw 

provision repealed, amended, adopted or altered by them may not be repealed, 

amended adopted or altered by the Board of Directors. 

Article 11.—Amendment of articles 

SECTION 2. AMENDMENT OF ARTICLES

After Members, if any, have been admitted to the Corporation, amendment of the 

Articles of Incorporation may be adopted by the approval of the Board of Directors 

and by the approval of the Members of this Corporation. 

SECTION 3. CERTAIN AMENDMENTS

Notwithstanding the above sections of this Article, this Corporation shall not 

amend its Articles of Incorporation to alter any statement which appears in the 

original Articles of Incorporation of the names and addresses of the first Directors 

of this Corporation, nor the name and address of its initial Agent, except to correct 

an error in such statement or to delete such statement after the Corporation has 

filed a ‘‘Statement by a Domestic Non-Profit Corporation’’ pursuant to Arizona Nonprofit Corporation Law. 

Article 12.—Prohibition against sharing corporate profits and assets 

SECTION 1. PROHIBITION AGAINST SHARING CORPORATE PROFITS AND ASSETS

No Member, Director, Officer, Employee, or other person connected with this Corporation, or any private individual, shall receive at any time any of the net earnings 

or pecuniary profit from the operations of the Corporation, provided, however, that 

this provision shall not prevent payment to any such person of reasonable compensation for services performed for the Corporation in effecting any of its public 

or charitable purposes, provided that such compensation is otherwise permitted by 

these Bylaws and is fixed by resolution of the Board of Directors; and no such person or persons shall be entitled to share in the distribution of, and shall not receive, 

any of the corporate assets on dissolution of the Corporation. All Members, if any, 

of the Corporation shall be deemed to have expressly consented and agreed that on 

such dissolution or winding up of the affairs of the Corporation, whether voluntarily 

or involuntarily, the assets of the Corporation, after all debts have been satisfied, 

shall be distributed as required by the Articles of incorporation of this Corporation 

and not otherwise. 

Certificate 

This is to certify that the foregoing is a true and correct copy of the Bylaws of 

the Corporation named in the title thereto and that such Bylaws were duly adopted 

by the Board of Directors of said Corporation on the date set forth below. 

Responses to Questions for the Record From the National Association of 

Therapeutic Schools and Programs 

Chairman Miller and Members of the Committee on Education and Labor: We appreciate the opportunity to appear before your committee and address the important 

issues relating to abuses in private residential treatment of children and adolescents. The National Association of Therapeutic Schools and Programs is fully in support of stopping abusive, irresponsible practices in residential treatment of children 

in both public and private settings. 

We appreciate your leadership and focus in pushing for responsible, informed legislation aimed at improving safety and quality of care for troubled children and adolescents who must be placed in out of home residential settings. We too feel that 

strong, well-informed licensure and regulation is called for, and is in fact available 

in many states. It should be encouraged and available in all states. 

We are enclosing answers to your specific queries as well as a brief statement of 

background information that provides a context to better understand both the evolution of private residential care and the evolution of NATSAP as a professional and 

trade organization committed to improving the quality of care for children and their 

families. 

A Brief History of Private Therapeutic Schools and Programs 

There has been a rapid growth of private residential treatment programs in the 

past 20 years. Figure 1 demonstrates the acceleration of growth by simply plotting 

65

the number of NATSAP programs founded by decade revealing a rapid acceleration 

of programs in the past two decades.

FIGURE 1

*2000-2010 is estimated based on the number of programs founded from 2000-2005. 

Prior to 1980 there were in fact few options for treating troubled adolescents. For 

the first half of the century one could summarize the approaches as follows: reformatories (prisons), military academies, the military, boarding schools, the unskilled 

labor market in factories, mines, and farms, or for the most seriously disturbed and 

wealthiest families—long term, psychoanalytically inspired, psychiatric facilities. 

In the 1960s and 70s a number of alternative approaches for treating adolescents 

emerged. They stood in stark contrast to treatments offered by the penal system or 

by mainstream medicine and psychiatry. Many of the early programs opposed the 

‘‘medical model’’ by explicitly rejecting the use of professional therapists and psychotropic medication. 

What principles guided these programs? Mel Wasserman, the founder of the 

CEDU programs, stated that the path of a troubled adolescent is built on a foundation that is not ‘‘plumb and square.’’ To correct this problem, children needed the 

elements of strong parenting such as adult, attention, supervision, clear structure, 

and accountability. In brief, the early models suggested that adolescents should not 

be pathologized or diagnosed; they didn’t need therapy. Instead they needed a 

chance to grow up and develop character in a new environment, free from the obstacles that interfered with normal emotional development. 

In the 1980s, program growth began to accelerate and led to spin-offs from the 

original alternative programs such as the CEDU programs. Wilderness programs 

also began to emerge and provided a natural way to address psychological defenses 

by placing adolescents in challenging natural situations that took away their ingrained but maladaptive strategies of dealing with society. Wilderness programs 

also provided meaningful accountability. In addition, they added a spiritual element 

by forcing self-centered adolescents to confront and be inspired by natural forces 

much larger than themselves. Wilderness programs also provided the format for a 

rite of passage and a chance for adolescents to see themselves in a new perspective. 

These approaches were quite diverse in style and inspiration, but shared a common belief that in order to correct the dangerous trajectory of troubled youth they 

must be removed from toxic environments in their communities and placed in situations that provided increased adult supervision and structure. These programs provided alternative environments aimed at teaching skills, reducing maladaptive behaviors, and providing time for adolescents to return to the path of developing a 


nat3.eps
66

healthy character structure. With few exceptions these programs remained outside 

the mainstream practice of psychiatry. 

Rise and Fall of Inpatient Psychiatry 

Mainstream psychiatry underwent many changes that profoundly influenced the 

rise in alternative programs. In the late 1970s and into the mid 1980s, psychiatry 

underwent a rapid growth in residential programming. Hundreds of adolescent psychiatric hospitals, both public and private, opened throughout the country. These facilities offered treatment with medium length of stays up to a month or more, and 

served thousands of troubled adolescents. The initial growth of psychiatric hospitals 

was in response to a clear need to address the increasing struggles of youth in a 

modern American culture that had lost the presence of adult supervision, and structure for youth. 

These hospitals provided a bio-psychosocial form of treatment, but the environment and management style were heavily influenced by the general medical-hospital model. Psychiatric hospitals were staffed with attending psychiatrists and 

skilled nursing staff. Treatment included medication management, individual and 

family therapy, as well as milieu management generally provided in locked and secure facilities with the ability to physically restrain patients when necessary. 

However, the rapid expansion of conventional residential psychiatric facilities 

ground to a halt in the latter half of the 1980s, due in large part to managed care 

and Prozac (or more accurately stated, to the powerful organizations behind these 

concepts: insurance and pharmaceutical companies). Insurance and pharmaceutical 

companies were the agents that dramatically changed the direction of mainstream 

psychiatry. Reacting to rising costs, marketing corruption and greed, insurance companies began to manage and restrict length of stay to the point that psychiatric hospitals became strictly emergent, short-term, palliative treatments for the acutely suicidal. At the same time, psychiatry became enamored with the power of 

neurotransmitters and in 1985 we entered the age of Prozac, a new antidepressant 

with fewer side effects that could change an individual’s mood quickly by altering 

the level of serotonin available at the synapse. 

For a variety of reasons, beyond the scope of this introduction, short term palliative and medication based treatments in unstructured community settings fail to address the needs of thousands of struggling adolescents. And so, these changes in 

mainstream psychiatry in the latter half of the 80s and first half of the 90s created 

the environment that led to the rapid growth of private residential programs, many 

of which are members of NATSAP. 

In the past decade we have seen the emergence of creative alternative residential 

programs that combine the best of the earlier alternative and wilderness programs 

with the sophistication and professional training of psychiatry, psychology, social 

work, and family therapy. The NATSAP member programs represent unique blends 

of these various influences, in environments that provide a much needed and less 

expensive level of care than offered by in-patient psychiatric hospitals. 

The National Association of Therapeutic Schools and Programs (NATSAP) 

The National Association of Therapeutic Schools and Programs (NATSAP) was 

itself formed in 1999 in an effort to raise awareness of these relatively new levels 

of care. The founding members sought to create a professional organization that 

would support the work of treating adolescents in non-traditional residential settings. The first priority of this fledgling organization, unanimously endorsed by the 

early members, was to develop a common set of ethical principles and best practice 

standards. Our goal was to educate and increase awareness among all programs of 

practices that would create safe environments for working with adolescents and 

their families. 

For the past eight years NATSAP has maintained an ongoing process of evaluating and improving our practice standards. We have annual conferences attended 

by over 700 individuals as well as 6 regional conferences attended by over 800 this 

year. The conferences focus on continuing education for professionals in our programs as well as educating all member employees as to best practice standards. In 

addition, we have launched a professional journal, publish a quarterly newsletter, 

and have begun a long term outcome research project in cooperation with the University of New Hampshire that will examine program effectiveness and create a long 

term data base to facilitate further research by independent investigators. A number of our member programs have also supported major research efforts by independent investigators in the past eight years*. In particular, Dr. Keith Russell (associate professor at the University of Minnesota) has published a number of articles 

on the short and long term effectiveness of wilderness programs. Dr. Ellen Behrens 

67

has published several articles documenting the effectiveness of longer term therapeutic programs. 

It is important to understand that NATSAP is a professional and trade organization. We strive to educate, exchange information, and raise practice standards. We 

are not an accrediting or licensing agency although we have asked that all members 

provide evidence that they are licensed by a state agency charged with monitoring 

the well being of participants in behavioral health settings, or if state licensure is 

not available, programs must be accredited by a national entity that accredits behavioral health programs. We also require that a member’s clinical program be directly supervised by an independently licensed clinician. 

We do not speak for programs that are not members of our organization, but as 

a group of programs we have taken a clear public stand against all abusive practices 

with children. We have continuously educated programs and staff in models and 

methods of handling adolescents with the aim of eliminating the use of potentially 

abusive methods. Our practice standards specifically preclude: • procedures that deny a nutritionally adequate diet; • physically abusive punishment; • any behavior support management intervention that is contrary to local, state 

and/or national licensing or accrediting standards; and, • the application of consequences that are not in accordance with the program 

participant’s basic and fundamental rights and protections. 

We are as opposed to the abuse of children as much or more than anyone who 

has testified at your hearings. At the same time we recognize the importance and 

value of residential treatment offered by NATSAP member programs, and we ask 

that the House Committee on Education and Labor take time to study and understand this important level of care. Our member programs now serve nearly eighteen 

thousand children annually. Families who seek private alternatives do not do so 

lightly or capriciously, but generally out of desperation. They look for alternatives 

because they see their children failing and unable to get back on a trajectory that 

will make it possible to become independent, productive young adults. Children end 

up in residential treatment only after they have failed in numerous attempts in outpatient and community based settings. Parents make the difficult decision to send 

their child to a residential program only when they realize that, despite their best 

efforts, their home environment is failing support their child’s growth and development in healthy ways. Parents see that their children are lost, anxious, depressed, 

failing in school, or engaging in behavior that is risky and dangerous. Many of these 

children drift into a world filled with alcohol, drugs, and a dangerous lack of respect 

and empathy that compromises society’s collective values. Parents have no choice 

but to separate these lost adolescents from their toxic community environments. 

It is the failure of community based service that has given rise to the growth of 

private residential programs. It is vitally important that legislators understand the 

importance of this level of care, and understand how many lives would be at greater 

risk if private residential programs were not available. Of course such programs 

should be licensed and regulated in a manner that adequately assures the safety 

and well being of participants, but it is also essential that regulation be well designed and informed so as to support the important, life saving environments and 

levels of care that such private programs offer. 

We further ask that any legislative effort take into consideration the major distinctions in types of programs that are available and not proceed as if all private 

residential programs are the same. They are not. NATSAP member programs include the following basic types of programs: 

• Therapeutic Boarding Schools 

• Small Residential Programs 

• Residential Treatment Centers 

• Outdoor Therapeutic and Wilderness Programs 

• Specialty Psychiatric and Behavioral Health Programs 

• Transitional or Young Adult Living Programs 

Each of these program types requires basic practice standards, coupled with 

standards that reflect the differences in setting and level of structure required in 

each setting. 

Outside of NATSAP, there remain a number of ‘‘boot camps’’ or punishment based 

programs that employ degrading, abusive behavioral management techniques that 

are in direct violation of NATSAP practice standards. Many of these programs are 

public or state contracted corrective facilities, not private programs. If such a program is a member of NATSAP, and we become aware of an inappropriate practice, 

we will ask the program to stop and correct such practices immediately or be removed from membership. If such a program is not a member of NATSAP we, of 

course, have no influence over it. Therefore, we educate the public of the differences 

68

between programs that ascribe to our published practice standards and those that 

do not. 

Finally, our hearts go out to those brave individuals who testified about the circumstances of their adolescent’s deaths in programs. Due in large part to their 

heartfelt testimony, we have recently enacted a ‘‘sentinel event’’ policy (attached) 

that will require reporting, review and data sharing in an effort to learn from past 

mistakes and prevent future serious injury or loss of life in our member programs. 

We are working with an extraordinarily troubled population of adolescents who 

have failed to respond to numerous medications, outpatient care, and other community-based treatments. Working with such a population is inherently risky. Nonetheless, we must not ignore or give up on these adolescents at a time when they need 

our help most. 

NATSAP is committed to ensuring that families in desperate need of specialized 

treatment services for their adolescents may choose confidently from an array of 

nurturing, safe, and effective programs. We continue our mission to improve adolescent residential care with renewed vision, vigor, and optimism. , 

RESEARCH REFERENCES

Behrens, E. (2006). An evidence-based practice model for residential treatment programs. Journal of Therapeutic Schools and Programs, 1 (2), 33-65. 

Behrens, E. & Satterfield, K. (2007). Longitudinal family and academic outcomes in 

residential programs: How students function in important areas of their lives. 

Journal of Therapeutic Schools and Programs, 2 (1), 81-94. 

Russell, K.C. (2003). Assessing treatment outcomes in outdoor behavioral healthcare 

using the Youth Outcome Questionnaire. Child and Youth Care Forum. 32(6), 

355-381. 

Russell, K.C. (2002). Assessing outcomes in outdoor behavioral healthcare. Behavior 

Management, March/April, 22(2), 12-18. 

Russell, K. C. (2002). Does outdoor behavioral healthcare work? A review of studies 

on the effectiveness of OBH as an intervention and treatment. Journal of Therapeutic Camping, Summer/Fall, 2(2), 5-12. 

Russell, K. C. and Hendee, J.C. (1999). Wilderness therapy An emerging treatment 

for adolescents with behavioral problems. Proceedings of the 6th World Wilderness Congress, Bangalore, India. Watson, A. ed., Rocky Mountain Research Station, US Forest Service, USDA, Ogden, UT. 

In Response to Representative Robert Scott 

1. What mechanism is in place to deal with circumstances where your members 

have self-certified that they are abiding by NATSAP’s ethics and good practices 

standards when they are in fact not in compliance with these standards? 

If a member program is not complying with the signed ethics and good practice 

standards we encourage employees, other programs, or families to submit a specific 

written complaint. The complaint process is as follows: 

a) Any complaint against a member program must be submitted to NATSAP in 

the form of a signed letter to the Executive Director of NATSAP. 

b) If the complaint involves a specific program participant the Executive Director 

must obtain an appropriate release of information permitting NATSAP to access and 

review personal and confidential information. 

c) After receiving a written, signed complaint, the Executive Director will contact 

and inform the President of NATSAP. 

d) The Executive Director and President will review and determine whether the 

complaint involves a potential violation of ethics or practice standards. If so the 

complaint is referred to the Ethics Committee Chairperson. 

e) The Ethics Committee Chairperson will establish a 3-5 member subcommittee 

to review the complaint. 

f) Oftentimes, problems are resolved by directly addressing issues with the member program. If it agrees to change its practices to correct any deviation from our 

standards the issue is typically closed. Depending on the severity of the infraction 

and its consequences, the subcommittee might recommend the program’s membership status be made conditional or be terminated. 

g) The subcommittee reports its findings and recommendations back to the President and Executive Director. 

h) If membership sanctions are recommended, the matter will be brought to the 

Board of Directors, and the Board will follow Section 11 (Termination or Suspension 

of Membership) of the organization’s by-laws (attached). 

2. Dr. Pinto testified that she has collected 700 concerns on residential treatment 

centers over 6 months, while NATSAP has investigated less than 5 claims against 

its members. Can you please explain the discrepancy in these numbers? 

69

Dr. Pinto and her colleagues have been engaged for several years in efforts to 

draw attention to private ‘‘institutional abuse’’ of children. They have collaborated 

with advocacy groups and have contributed as ‘‘experts’’ to several web sites and 

blogs that are intended to expose the horrors of abusive private adolescent treatment programs. Dr. Pinto’s recent testimony before the House Committee on Education and Labor suggested that she actively solicited narratives from victims of adolescent maltreatment as part of her efforts to collect and draw attention to reports 

of abuse and neglect in private residential treatment settings. Dr. Pinto’s high visibility among, and active outreach to, communities of victims of abuse and neglect 

were likely the greatest factors contributing to the large quantity of narratives she 

managed to gather. 

NATSAP does not solicit reports of abuse and neglect; however, anyone who affirmatively contacts NATSAP via email, telephone, or our website receives information as to how an ethical or practice complaint about a NATSAP member may be 

filed with NATSAP. NATSAP has prepared for the Committee on Education and 

Labor a summary of some 17 complaints it has received regarding member programs. NATSAP does not accept complaints about non-members, yet it does refer 

to governmental and credentialing entities those individuals who contact NATSAP 

seeking to file a complaint against a non-member. 

3. Is there currently any requirement that other treatment options be utilized to 

address a child’s behavioral issues before sending them to such a center? 

We are aware of no legal or industry requirement that other treatment attempts 

be made prior to an adolescent’s placement in a private residential program. As a 

matter of practice, however, families typically make numerous unsuccessful attempts at treatment and exhaust all other options prior to placing their son or 

daughter in a private residential setting. 

The NATSAP principles require programs to establish specific admission criteria 

used to distinguish between those candidates for treatment who will, and those candidates who will not, be best served by their program. 

Principle 4.0—Admission/Discharge Policy The program/school will have a written 

Admission Policy, which defines the enrollment criteria and delineates inclusion and 

exclusion criteria. Such criteria will be consistent with the mission of the program/

school. Admission forms will provide pertinent history including family, medical, 

psychiatric, developmental, and educational background information. 

Principle 4.1—The Admissions screening process will examine the physical, emotional, behavioral, and academic history, in order to determine whether the program 

is appropriate in light of the respective participant’s needs and limitations. 

In Response to Chairman George Miller 

1. What is NATSAP’s policy regarding the use of its logo by members? For example, are there any restrictions for using the NATSAP logo on marketing materials 

and websites? Are NATSAP members using the NATSAP logo required to disclose 

that use of the NATSAP logo does not represent endorsement by NATSAP of the 

safety, quality, or effectiveness of the members’ program? 

All members of NATSAP are encouraged to use the logo to indicate they are a 

member of an association that promotes ethical practices and standards that are 

openly available to the public. To be a member of NATSAP, programs have to submit annually an affidavit affirming that they are in compliance with our ethical 

principles. On our website and in our directory we clearly indicate that our members endorse our principles of good practice and ethics, but we are not and make 

no claim to be an accrediting or licensing agency. We operate much like most other 

professional organizations such as the American Psychological Association, or the 

American Psychiatric Association, or the Association of Licensed Social Workers. All 

of these associations ask members to attest by signature that they are in compliance 

with membership standards. Sanctions are applied to a member only upon discovery 

that the member has failed to comply with standards or made a false representation 

in this regard. We operate in the same fashion. 

2. Ms. Moss indicated that NATSAP will research complaints or reports of alleged 

misconduct by members. What procedures are in place for reporting misconduct to 

NATSAP? Are reporting procedures documented? Does NATSAP make its reporting 

procedures widely available, for example on its website? Do members have a duty, 

arising from their membership, to report any misconduct to NATSAP that violates 

NATSAP’s Ethical Principles or Principles of Good Practice? How many complaints 

of misconduct has NATSAP received since its formation? And what steps were taken 

to research such complaints or reports of misconduct? 

The procedures for handling complaints regarding ethical or best practice standards are outlined in the first answer to Representative Scott above. In addition, 

NATSAP members are encouraged and expected to report to NATSAP any misVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00073 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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conduct that violates NATSAP’s Ethical Principles or Principles of Good Practice. 

The 2008 NATSAP membership agreement will state this obligation as a duty of 

membership. 

NATSAP has no record of complaints concerning its members submitted or reviewed prior to 2002. Since 2002, 17 complaints have been filed with NATSAP. 

Twelve of these complaints were submitted after the current complaint procedure 

was published. Please see our summary of complaints for greater detail on 

NATSAP’s responses to reports of misconduct. 

3. Ms. Moss indicated that NATSAP researched at least one instance where a 

complaint was made regarding a member’s website. Please describe the complaint, 

the actions taken by NATSAP, the corrective actions taken by the member, and provide the identity of the member. 

NATSAP[MB1] received this particular complaint in June 2006 and forwarded it 

to Gil Hallows, Ethics Chair. The complaint and NATSAP’s internal reporting on 

the matter (printed in italics) read as follows: 

a) Program listing on their website and on the NATSAP website stated ‘‘individual therapy twice per week, flexible lengths of stay, daily group sessions’’. 

Rick Meeves, Executive Director of Outback Therapeutic Expeditions, acknowledged the statement was in error in the NATSAP Directory (and website) and on 

the program’s website and stated it was an unintentional oversight on their part. 

He committed to reviewing all of their marketing literature and correcting this 

misstatement. He authorized NATSAP to change the statement to ‘‘weekly individual therapy sessions’’ on our website and would make sure that next year’s directory is accurate. Mr. Meeves also committed to clarifying the statement ‘‘daily group 

sessions’’ to more accurately reflect that two groups are conducted by therapists and 

the balance are educational or process groups conducted by other staff. 

b) Generally not delivering what they said they would: 

• Parent weekend was minimized compared to what they were told • Couldn’t see the camp or other kids because of ‘‘3 hours of HIPAA paperwork’’. 

Verbally and on website ‘‘supposedly take part in desert rituals and rites of passage. 

There was no exposure to camp rituals, understanding the process, etc.; no rites of 

passage that are talked about and that staff [previously informed me] would be part 

of the parent visit when I checked [my son] in.’’ • [Cancellation] of a family therapeutic experience on the parent visit should not 

have been blamed on ‘‘the wilderness is both advantageous and difficult, and today 

we got the bad, sorry. There were things we had to deal with and we didn’t get to 

you. Bye.’’

Mr. Meeves further committed to reviewing all of the written material Outback 

uses pertaining to their parent visits in the context of what they are actually doing 

to insure they are accurately representing this part of their program. He believes 

that they occasionally have a therapist who may not deliver the full extent of services to parents during the parent visits, and committed to monitoring this more 

closely, but believes overall they deliver what they say they will to parents. 

I feel confident that Rick [Meeves] will follow through with his commitments. I 

will check in with Rick [Meeves] in the near future to hold him accountable for making the stated corrections and completing the internal reviews. 

4. What actions does NATSAP intend to take in light of the testimony given by 

the U.S. Government Accountability office regarding Alldredge Academy’s delinquency in remitting permit fees to the federal government? Is operating on federal 

land without a valid permit a violation of NATSAP’s Ethical Principles or Principles 

of Good Practice? 

NATSAP reviewed Alldredge Academy’s application carefully when it applied for 

membership in late 2003. We interviewed the ownership and management, as well 

as talking directly to the licensing agency in their state. After careful consideration 

and deliberation we admitted them to membership status in late 2004. There are 

a few facts that we were unaware of that emerged from your hearings and in your 

question that we will consider to be a written ethical complaint. These issues, and 

the delinquency in remitting permit fees to the federal government, have been referred to our ethics committee for review and investigation. We are willing to provide you with a copy of our findings. We respectfully request copies of the GAO and 

Committee on Education and Labor’s investigations and sources of information that 

indicate a failure on Alldredge Academy’s part to comply with specific ethical and 

practice principles. 

5. NATSAP hosts national and regional conferences to foster the professional development of its members. Have any of these conferences ever included lectures, 

workshops, presentations or discussions concerning cases of abuse, neglect, mistreatment, or death of children; what led to these horrific tragedies; what needs to 

change; and what NATSAP members need to do in response? 

71

Agendas for NATSAP’s past five national conferences are attached. Examination 

of the agendas makes it clear that most of the topics are related to improving the 

clinical treatment of children in our members’ programs. The aim of the conference 

is to exchange information, generate enthusiasm for best practices, and support 

those who work directly with children. Inherent in the presentations are many ways 

to approach children that obviate the need for confrontational interactions that have 

the potential of leading to abuse. We also have had many direct presentations at 

both national and regional conferences that address specifically prevention of abuse 

and deaths in programs. Below is a listing of such presentations: 

NATSAP 2003 Conference 

• Abuse Risk Management • Risk Management 

NATSAP 2005 Conference 

• Critical Incident Response (4 hour workshop) • Effective Programs and Risk Reduction: It Is All About Relationships 

NATSAP 2006 Conference 

• A Look At Suicide in Out-of Home Placements 

NATSAP 2007 Conference 

• Behavior Support Management from a NATSAP Perspective (3 hour workshop) • Critical Incident Response • Joint commission—pre-conference workshop (note) 

NATSAP 2008 Conference 

• Risk Management (8 hour workshop—scheduled as of August 15) 

Regional Conferences 

2006: 

• Self Harm, Cutting; Dealing With a Growing Epidemic 

2007: 

• Crisis Management • Emergency Preparedness 

6. NATSAP’s new membership requirements mandate that members be licensed 

by an appropriate state mental health agency, or accredited by a reputable mental 

health accreditation organization. On what basis is an accreditation organization 

deemed to be credible? 

The accreditation organization must have standards on Clinical service, and safety of program participants that clearly define requirements regarding the treatment 

being offered and the credentials of the staff providing the clinical services. Currently NATSAP will accept the Commission on Accreditation of Rehabilitation Facilities (CARF), Commission on Accreditation (COA) and Joint Commission 

(JCAHO). These three agencies are the most respected independent behavioral 

health accrediting agencies in the country. All of these accrediting agencies require 

annual reports of compliance and have regular on-site inspections to assure that 

programs operate in accordance with their own, and the accrediting organization’s, 

policies. 

7. Please provide a chart showing the year in which each NATSAP member joined 

NATSAP, or lost its membership due to expiration or revocation. [See Addendum 

A] 

8. It is our understanding that the NATSAP board is primarily comprised of individuals associated with member programs. Given that NATSAP researches and acts 

upon complaints against members when they are reported to NATSAP, please describe NATSAP’s policy regarding conflicts-of-interest for its board members. For example, are board members required to recuse themselves on matters before the 

board when, by virtue of their affiliation with a particular member, their judgment 

may be prejudiced in fact or in appearance? 

To be considered for election to the board of directors of NATSAP, an individual 

must be an owner or an executive of a member program in good standing. It has 

always been our practice to have board members recuse themselves during discussions where conflicts of interest exist or have the potential to exist. The specific procedure reads as follows: Conflicts of interest that affect NATSAP at times exist with 

individual Board members, the executive director, ad hoc board members, committee 

chairs or committee members. During all business meetings it is necessary and appropriate for the leader of such meeting to ask members who have a potential conflict of interest to recuse themselves during discussion and or voting whenever such 

conflicts arise. 

9. Recent reports indicate that a NATSAP member, Youth Care, Inc., has been 

placed on probation by the Utah Department of Human Services and that criminal 

neglect charges have been filed against this member due to the death of a child. 

Youth Care, Inc. uses the NATSAP logo on its website to promote their program. 

Given these reports and the use of the NATSAP logo by this member, what steps 

72

does NATSAP intend to take to research reports of criminal neglect on the part of 

Youth Care, Inc.? 

10. Aspen Education Group, which owns Youth Care, Inc., also operates Aspen 

Achievement Academy, another NATSAP member. Aspen Achievement Center is 

currently being investigated for a teen’s attempted suicide. While authorities conduct a thorough investigation, what does NATSAP do to ensure the safety of students placed in its member facilities? 

Response to Questions 9 and 10: 

Both Youth Care and Aspen Achievement Academy are current members and we 

will ask both to respond to our current ‘‘sentinel event review policy’’. Since both 

are also accredited by the Joint Commission and licensed by the state of Utah they 

are required to provide detailed information regarding all sentinel events. They are 

also required to conduct a ‘‘root cause analysis’’ to examine the causes of the death 

and to determine whether procedures or policies need to be revised to increase safety in the future. On review we will require a corrective action plan and, if the 

deaths resulted from violations of practice standards or ethical principles, sanctions 

will be issued. 

Add a summary of the complaint and identify the parties. 

October 23, 2007. 

Hon. DALE K. KILDEE, 

U.S. House of Representatives, Rayburn HOB, Washington, DC. 

DEAR REPRESENTATIVE KILDEE: We are enclosing a full accounting of the ethical 

complaints received by NATSAP since 2002. We do not have records of complaints 

filed prior to 2002 as we changed executive directors, moved central office location, 

and did not have adequate reporting procedures in place. As we compiled existing 

records since 2002 we realize that while our procedures have improved, they remain 

inadequate to ensure accurate registration, recording of deliberation, and documentation of outcomes. This hearing has made it clear that NATSAP must move 

quickly to establish a more transparent and accurate record of complaints. To this 

end the Board has already adopted a new Sentinel Event Policy (enclosed in the report to Chairman Miller) that creates a mandatory reporting of any events that lead 

to death or serious injury. We are now in the process of creating a more comprehensive system to encourage reporting of all ethical and practice complaints as well as 

a process that will ensure accurate and timely response and record of such complaints. 

The following pages provide summaries of all ethical and practice complaints we 

have records for from 2002- 2007. We are also enclosing copies of all of our records 

of complaints in Appendix A with specific names removed in order to protect confidentiality of individuals. 

Sincerely, 

NATSAP BOARD OF DIRECTORS. 

Ethical and Practice Standard Complaints 

1. (February, 2002) Program A—The complaint, filed by the parents on February 

3, 2002 included a) not being responsive to the young man’s need for medical attention; b) violation of privacy by contacting the parent’s school district regarding the 

young man’s crisis prior to contacting the parents; c) moving the young man to a 

‘‘safe house’’ and not disclosing the costs. There is a document marked confidential 

that appears to have been faxed to a machine that was out of ink. The document, 

however, is included with the other information. • The review information on this complaint is limited except for a copy of an 

email sent by Dr. John Santa, then Ethics Chair, that indicated the complaint needed to be reviewed but first needed to obtain appropriate releases of information, 

which were not forthcoming. The program closed January 2004. 

2. (June, 2004) Program B—A former teacher sent email expressing concern regarding the ownership of the program and requesting confidentiality. This request 

for confidentiality and use of his statement prevented further review. 

3. (September, 2004) Program C—A complaint was received from an educational 

consultant. Written complaints and releases of information were received from two 

parents. The complaints focused primarily on quality of care and that the executive 

director was not licensed in Montana as a therapist. • Gil Hallows, Ethics Chair, reviewed the complaint and, according to his report, 

found facts that supported a disgruntled employee assisted by an educational consultant. Mr. Hallows There is a document marked confidential that appears to have 

been faxed to a machine that was out of ink. The document, however, is included 

with the other information, that the Executive Director’s role was that of an adminVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00076 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
73

istrator with therapy provided by two licensed therapists. The complaint of a ‘‘misrepresentation of the nature of services’’ was not substantiated but did suggest 

shortcomings in the areas of quality assurance and customer service more than a 

clear-cut breach of ethics. 

4. (September, 2004) Program D—The complaint was filed by a NATSAP member 

program regarding the recruiting of their employees by another member program. • Dr. John Santa and Gil Hallows spoke with the individual filing the complaint 

and the member program named in the complaint. Dr. Santa and Mr. Hallows did 

not find a violation of ethical standards. They did recognize the potential impact if 

our members failed to recruit in open ways. Several articles have been written for 

the NATSAP newsletters as well as open discussions held at Regional and National 

Conferences regarding ethical practices in recruitment. 

5. (March, 2005) Program E—Father wrote letter stating his daughter was started 

on medication without his consent. He stated he shares custody with his ex-wife. 

He further requested ‘‘anonymity and the utmost delicacy in approaching the [program]’’. While he handwrote a release to investigate, a NATSAP Release of Information was mailed to him on March 22, 2005. He failed to sign it and return it. 

6. (February, 2006) Program F—Employee complaint. Sharon Laney, President, in 

review of the complaint with Jan Moss, Executive Director found it to be an employee grievance and that the employee had done the right thing by contacting the 

Montana Labor Board. The individual was advised that the incidents reported, 

which were labor related, were not addressable under NATSAP’s guidelines. 

7. (June, 2006) Program G—A parent filed a complaint addressing the information 

on the program’s website and their delivery of services. The complaint and the report provided by Gil Hallows (in italics) follow: 

a) Program listing on their website and on the NATSAP website stated ‘‘individual therapy twice per week, flexible lengths of stay, daily group sessions’’. 

The Executive Director acknowledged the statement was in error in the NATSAP 

Directory (and website) and on the program’s website and stated it was an unintentional oversight on their part. He committed to reviewing all of their marketing literature and correcting this misstatement. He authorized NATSAP to change the 

statement to ‘‘weekly individual therapy sessions’’ on our website and would make 

sure that next year’s directory is accurate. He also committed to clarifying the statement ‘‘daily group sessions’’ to more accurately reflect that two groups are conducted 

by therapists and the balance are educational or process groups conducted by other 

staff. 

b) Generally not delivering what they said they would: 

• Parent weekend was minimized compared to what they were told • Couldn’t see the camp or other kids because of ‘‘3 hours of HIPAA paperwork’’. 

Verbally and on website ‘‘supposedly take part in desert rituals and rites of passage. 

There was no exposure to camp rituals, understanding the process, etc.; no rites of 

passage that are talked about and that staff [previously informed me] would be part 

of the parent visit when I checked [my son] in.’’

• [Cancellation] of a family therapeutic experience on the parent visit should not 

have been blamed on ‘‘the wilderness is both advantageous and difficult, and today 

we got the bad, sorry. There were things we had to deal with and we didn’t get to 

you. Bye.’’

The program Executive Director further committed to reviewing all of the written 

material the program uses pertaining to their parent visits in the context of what 

they are actually doing to insure they are accurately representing this part of their 

program. He believes that they occasionally have a therapist who may not deliver 

the full extent of services to parents during the parent visits, and committed to 

monitoring this more closely, but believes overall they deliver what they say they 

will to parents. 

I feel confident that [Executive Director] will follow through with his commitments. I will check in with him in the near future to hold him accountable for making the stated corrections and completing the internal reviews. 

8. (July, 2006) Program H—The father notified NATSAP of a complaint filed with 

the State of North Carolina, Department of Health and Human Services, Division 

of Facilities. The email was sent to Gil Hallows, Ethics Chair, on August 15, 2006. 

A Release of Information was not required at the time as this review could be conducted without the need to question the program about the specific young woman 

involved. The complaint covered unauthorized medical treatment. No formal report 

was submitted after Gil Hallows’ inquiry. 

9. (September, 2006) Program I—The complaint focused on disputing a) a penalty 

for early withdrawal from the program; b) a delay in the discussion of a Treatment 

Plan the parents had received; c) loss of contact lens; d) requirements for letter writing (program requires student to write 1 per week; parents received 3 letters in the 

74

10 weeks their daughter was in the program; e) the consulting psychiatrist prescribed naltrexone and zonisamide; and f) because of all of the above they requested 

a refund of the early withdrawal penalty cost as applied to their American Express 

card. • Gil Hallows, Ethics Chair, advised Jan Moss, Executive Director that the review 

included requesting a copy of the contract with the parents and found that the contract advises the parents of the early withdrawal. Mr. Hallows also advised Ms. 

Moss the other concerns raised were ‘‘customer service’’ issues as opposed to ethical 

or practice violations and that he had counseled the program, encouraging them to 

review their practices. 

10. (September, 2006) Program J—The parent provided NATSAP with the complete medical history of the child, police reports and was advised that the state was 

conducting an investigation. Sharon Laney reviewed the situation with an attorney 

due to the ongoing state investigation. October 2007, Ms. Laney has followed up 

with the mother, who has not responded. We are sending an official request to the 

State of Florida Investigation agency for the results of their investigation. 

11. (December, 2006) Program K—A mother wrote a letter outlining her concerns 

regarding her adult daughter’s admission to a young adult program under the guidance of her father. Due to the age of the young woman, which would require a Release of Information from her, and her father’s participation in the admission process, NATSAP did not conduct any review. 

12. (December, 2006) Program L—The parents’ written complaint addressed the 

program’s philosophy including 

a) Dedicated to the concept of using the least restrictive means necessary to induce change. 

Actual experience: For the first 2 weeks of enrollment, the young woman was 

made to sleep on the floor in the common room; was made to wear shower shoes, 

inside and out, weather conditions notwithstanding; all students are given ‘‘time 

outs for crying. Timeouts consisted of sitting cross-legged away from the group’’. 

b) The therapist will contact the parents within the first 2 weeks of placement 

to establish a regular schedule of therapeutic phone calls and begin the therapeutic 

alliance with the parents. Actual experience: Received only one phone call and it 

was a message left on the home message machine 

c) Karate is inherently therapeutic and promotes character development and 

physical well-being. Quotes follow from the philosophy including ‘‘multiple benefits 

for the students, including * * * a greater respect for others’’; ‘‘increased understanding of self and increased tolerance for others’’; ‘‘students * * * develop personalities founded on humility and gentleness’’. Actual experience: Daughter was openly chastised in class for not paying attention (daughter has ADHD). 

d) Initial and ongoing assessment of academic needs and academic programs are 

individualized. Actual Experience: Two weeks after enrollment the educational advisor contacted the parents and advised them that an academic assessment had not 

been done (normally within two weeks of enrollment). The assigned educational advisor was ignorant of the Psychological Evaluation of their daughter, had no knowledge of her expressive language disorder, nor her diagnosed ADHD. 

• Executive Director, Jan Moss, directed the parents to the Utah state licensing 

agency, Department of Human Services as this agency has comprehensive behavior 

management and program management standards. Note: Copy of the Release of Information has been misplaced. 

13. (January, 2007) Program M—The parent submitted a complaint in writing 

and release of information. The complaint addressed the school was dispensing 

medication without a license to do so. An email request was placed on April 13, 

2007 requesting details that would assist NATSAP in its review of the complaint 

with no response. Over the next several weeks, Jan Moss called several times to 

confirm academic licensure status as requested in the complaint, but did not receive 

a return call. Ms. Moss was advised months later that no return call was made due 

to an ongoing investigation and was advised at that time of the program closure on 

August 31, 2007. 

14. (February, 2007) Program N—The complaint filed by the parent outlined that 

medical treatment was denied to her son initially and that they waited until he was 

dehydrated to the point he had to be hospitalized for 4 days. Jan Moss responded 

to the email requesting a signed letter outlining the complaint and attached 2 Release of Information forms. One form was to be signed by the parent and the 2nd 

form by her son, as he was over 18. Due to not receiving the signed releases, we 

were unable to conduct a review. 

15. (May, 2007) Program O—NATSAP was among 60 organizations and individuals copied on a complaint filed with the State of Utah Department of Human Services. The complaint addressed in detail the parent’s view of the program’s violation 

75

of Utah regulations. Within the week after receipt, James Meyer, Ethics Chair, inquired with Ken Stettler of the Utah licensing agency and was advised the complaint was being reviewed. We will inquire further with the program and with the 

state authorities. 

16. (June, 2007) Program P—The parent provided email notification of complaint. 

Jan Moss sent response to request complaint with signature plus completion of Release of Information on June 28, 2007. Due to not receiving the signed releases, we 

were unable to conduct a review. 

17. (July, 2007) Program Q—The parent complaint addressed treatment of a sinus 

infection and misrepresentation of the program’s population. Per procedure, Jan 

Moss reviewed the complaint with President, Sharon Laney. Ms. Laney advised Ms. 

Moss to direct the parents to the Utah licensing authorities, Department of Human 

Services, regarding the treatment of the medical condition and the misrepresentation to the Ethics Chair, James Meyer. Mr. Meyer reported that his review found 

no evidence of misrepresentation. Ms. Moss is in receipt of a 2nd letter from the 

parents questioning the review and she has requested Mr. Meyer to follow-up with 

the parents. We have not completed the review of this complaint. 

Chairman MILLER. Dr. Pinto? 

STATEMENT OF ALLISON PINTO, PH.D., RESEARCH PSYCHOLOGIST AND ASSISTANT RESEARCH PROFESSOR, LOUIS DE LA 

PARTE FLORIDA MEDICAL HEALTH INSTITUTE, UNIVERSITY 

OF SOUTH FLORIDA 

Dr. PINTO. Good morning, Chairman Miller, Ranking Member 

McKeon and distinguished members of the committee. 

Thank you for this opportunity to testify before you today, and 

I am grateful for your leadership and your efforts to help protect 

youth from maltreatment by convening this hearing. 

I am Dr. Allison Pinto, and I am a child and adolescent psychologist licensed in the states of California and Florida. I am a member 

of the American Psychological Association and assistant professor 

at the University of South Florida and a researcher at the Children’s Board of Hillsborough County, a children’s services council 

in Florida. 

For the past 3 years I have served as the coordinator of A 

START: Alliance for the Safe, Therapeutic and Appropriate use of 

Residential Treatment. 

Each week, I receive phone calls and emails from concerned 

youth, family members and professionals who are trying to navigate the increasingly complex world of residential services for 

youth, or to cope with the aftermath of their experiences. I have 

also spoken with a variety of individuals associated with the growing number of programs that are being framed as alternatives to 

traditional residential mental health care. 

Many parents and professionals are shocked by the descriptions 

of institutional abuse that continue to emerge regarding the care 

that American adolescents are receiving in alternative residential 

programs. In disbelief, they often ask, ‘‘Well, how do you know that 

these are not just a few isolated incidents that have been sensationalized in the media?’’ or ‘‘How do you know that these are not 

just the complaints of manipulative, troubled teens or disgruntled 

families?’’

People are also in shock to learn that in many states these programs are not required to be licensed or regulated with regard to 

the education, mental health care and residential services that 

they provide. 

76

In order to address this disbelief and to gain a clearer understanding of the variety of residential services that are now available for youth, we posted an online survey to systematically gather 

reports from individuals who participated in residential programs 

when they were adolescents. Within 6 months, over 700 people responded to the survey. 

The detailed descriptions that young adults have been willing to 

share through this survey provide data that reveal a highly disturbing phenomenon. While there are youth and families who are 

satisfied with the services that they have received, a significant 

number of adolescents report maltreatment in programs across the 

country. Survey findings reveal the following: 

Reports of mistreatment, abuse and neglect are widespread. 

There were concerns expressed regarding 85 programs located in 

23 states and in several foreign countries. 

Facilities are not maintaining health and safety standards, and 

youth are experiencing medical neglect and educational deprivation. 

Incidents of physical and sexual abuse have occurred that were 

never reported by youth due to threatening program environments 

or the absence of universal access to protection and advocacy hotlines. 

Treatment is violating human rights. In the guise of behavior 

modification, youth are required to earn their basic human rights 

to privacy, dignity and contact with family members. Youth are 

being deprived of food, sleep and shelter. They are forced to endure 

stress positions, humiliation and intentionally fear-inducing encounters. Programs are also using cruel and dangerous thought reform techniques. 

The use of seclusion and restraint is highly, highly, grossly inappropriate. These practices are being used as punishments for rule 

violations rather than only when a person is a serious danger to 

themselves or others. Youth are enduring painful restraint practices, and isolation for periods of weeks, even months has been reported. 

Youth have expressed profound distress about their residential 

experiences. For some respondents, the memories of their experience remain deeply disturbing and have led to a pattern of anxiety 

consistent with post-traumatic stress disorder. 

So are these reports credible? Based on the level of detail and the 

overall coherence of the accounts provided and using my clinical 

judgment as a child psychologist, I conclude that they are very 

credible. If those of us who are mandated reporters of suspected 

child abuse were to learn of this type of treatment occurring in a 

family’s home, we would be required to file a suspected child abuse 

report so that the concerns could be investigated. We must consider 

the reports of maltreatment and abuse occurring in residential facilities just as seriously. 

Recognizing that the online reports provided are retrospective 

and are not necessarily from a representative sample of all individuals who attended residential programs, the survey findings, nonetheless, indicate that a serious problem has emerged. 

Because there are now hundreds of reports of abuse and neglect 

related to a diversity of programs across many states, these reports 

77

reveal a coherent pattern of institutional maltreatment. Once a 

pattern becomes apparent, it is not appropriate scientifically or 

ethically to dismiss reports of maltreatment as a few bad apples or 

a few noisy complaints. 

We must now acknowledge the problem in order to resolve it. 

Thank you again for the opportunity to present this testimony 

and for your efforts to safeguard and restore the wellbeing of American youth and families. I would be pleased to answer any questions. 

[The statement of Dr. Pinto follows:]

Prepared Statement of Allison Pinto, Ph.D., Research Psychologist and Assistant Research Professor, Louis de la Parte Florida Medical Health Institute, University of South Florida 

Thank you, Mr. Chairman and committee members, for this opportunity to testify 

before you today regarding the very serious problems of mistreatment, abuse and 

neglect of youth in residential facilities. 

I am a child psychologist licensed in the states of California and Florida, an assistant professor at the University of South Florida, and a researcher at the Children’s Board of Hillsborough County, a children’s services council in Florida. 

For the past three years I have served as the coordinator of A START: Alliance 

for the Safe, Therapeutic and Appropriate use of Residential Treatment. A START 

is a national, cross-sector alliance of mental healthcare and other child-serving professionals, as well as parents and youth, who have come together in response to 

growing concerns regarding the mistreatment and abuse of youth in residential facilities. 

Each week, I receive phone calls and emails from concerned youth, family members and professionals who are trying to navigate the increasingly complex world 

of residential services for youth, or to cope with the aftermath of their experience 

in residential programs. I have also spoken with a variety of individuals associated 

with the growing number of residential programs that are being framed as alternatives to traditional residential mental healthcare. 

Many parents and professionals are shocked by the descriptions of institutional 

abuse that continue to emerge regarding the care that American adolescents are receiving in alternative residential programs. In disbelief, they often ask, ‘‘How do you 

know that these aren’t just a few isolated incidents that have been sensationalized 

in the media?’’ or ‘‘How do you know that these aren’t just the complaints of manipulative, ‘‘troubled teens’’ or disgruntled families? 

In order to address these questions, and to gain a clearer understanding of the 

variety of residential programs now available for youth, my colleagues and I posted 

an online survey to systematically gather reports from individuals who participated 

in residential programs when they were adolescents. Within six months over 700 

people responded to the survey. 

The detailed descriptions that young adults have been willing to share through 

this survey provide data that reveal a highly disturbing phenomenon. While there 

are youth and families who are satisfied with the care and services they have received in residential programs, a significant number of adolescents report being mistreated and maltreated in programs across the country. To give you a sense of the 

nature and scope of problems that have emerged, I will be submitting for the record 

a preliminary summary of our survey findings, which reveal the following: 

1. Reports of mistreatment, abuse and neglect are widespread. There were concerns relating to 85 programs located in 23 states, and in U.S.-owned programs 

based in foreign countries as well. More than half of the identified programs are 

self-described ‘‘therapeutic boarding schools,’’ and more than one third of the identified programs are members of NATSAP. 

2. Youth are being transported to residential facilities by escort services under 

threat or use of force, without their consent. Youth were transported in handcuffs 

and leg-irons, and experienced these practice as highly distressing—they frequently 

felt like they were being kidnapped with their parents’ permission. 

3. Facilities are not maintaining health and safety standards. Youth were not provided with the basics of a sanitary environment, leading to illnesses such as scabies, 

and staff supervision was not consistently provided to ensure the safety of program 

participants. 

4. Amateur psychological interventions are being conducted. In the guise of ‘‘behavior modification,’’ youth were required to earn their human rights to privacy, 

78

dignity, contact with family members, and peer relations—rights that are now safeguarded for all participants in licensed and regulated mental healthcare facilities. 

Youth were recruited and admitted on the basis of identified psychiatric disorders, 

but then received services that ignored established standards of care specific to their 

presenting problems. 

5. Educational deprivation is occurring. In a variety of programs, youth were not 

receiving instruction from trained and qualified teachers, textbooks and educational 

materials did not meet state curriculum standards, and vacuous education is being 

provided in the guise of ‘‘independent study.’’ Some students returned home to their 

original school settings to find themselves significantly behind and some who ‘‘graduated’’ from the alternative residential programs discovered afterward that the diplomas they received were not recognized by their home states or college admissions 

departments. 

6. Medical neglect is occurring. Medications were administered without appropriate supervision by trained medical personnel, as well as the discontinuation of 

medications without physician monitoring. The absence of trained medical providers 

in residential programs has caused health problems to go unrecognized and untreated, in some cases leading to death. 

7. The use of seclusion and restraint is grossly inappropriate. Seclusion or physical restraint were used as a punishment for rule violations and negative attitudes. 

Isolation for periods of weeks was reported, and youth described enduring painful, 

dangerous and humiliating restraint practices. In licensed mental healthcare facilities this would be prohibited, as seclusion and physical restraint can only be used 

when a person is determined to be a serious danger to self or others. 

8. Treatment is violating human rights. Youth were deprived of food, sleep and 

shelter as a consequence for breaking rules or not evidencing sufficient progress in 

the program. Youth have been forced to endure stress positions, physical pain and 

fear-inducing encounters such as being taken into the woods or onto the highway 

blindfolded. 

9. Treatment is explicitly abusive. There were incidents of physical and sexual 

abuse that youth never reported due to distrust of staff, threatening program environments, or the absence of universal access to child protection and advocacy hotlines. 

10. Youth are in distress and suffering. Respondents expressed profound distress 

about their residential experiences. Comments included: • ‘‘It was a terrible place. Mentally scarring. I would hope NO ONE would ever 

have to go to a place like that. It’s worse than jail.’’ • ‘‘I don’t ever want another child to be so abjectly hopeless or so horribly abused. 

I don’t ever want another family to be torn up when there is the possibility of being 

reunited and healed.’’ • ‘‘I still have bad dreams about it. I wake up shaking and nervous that I am 

there again. It has scarred me emotionally and I don’t know if I will ever get over 

it.’’

Some youth were informed by staff that their parents were aware of the maltreatment that they were enduring, and then felt betrayed and abandoned by their families, causing damage to their relationships that has been difficult to heal even after 

families have been reunited. For some respondents, the memories of their experience in alternative residential programs remain deeply disturbing and have led to 

a pattern of anxiety consistent with post traumatic stress disorder. 

Are these reports credible? Based on the level of detail and the overall coherence 

of the accounts provided, and using my clinical judgment as a child psychologist, 

I conclude that they are very credible. If those of us who are mandated reporters 

of suspected child abuse were to learn of such treatment occurring in a family’s 

home, we would be required to file suspected child abuse reports so that the concerns could be investigated. We must consider the reports of mistreatment and 

abuse occurring in residential facilities just as carefully. 

Recognizing that the online reports provided are retrospective and are not necessarily from a representative sample of all individuals who attended residential 

programs as youth, the survey findings nonetheless provide compelling information 

indicating that there are far more than a few isolated cases of youth who are being 

mistreated and are suffering in residential programs. Because there are now hundreds of reports, related to such a diversity of programs, in such a broad range of 

states and countries, these reports reveal a coherent pattern of institutional maltreatment. Once a pattern becomes apparent in this manner, it is not appropriate, 

scientifically or ethically, to dismiss reports of maltreatment as exceptions to the 

norm. Rather, it becomes necessary to understand each report in the context of an 

evolving, societal phenomenon of institutional mistreatment and abuse, which must 

be acknowledged if it is to be eliminated. 

79

Thank you for bringing attention and responding to this disturbing phenomenon, 

in order to safeguard and restore the well-being of American youth and families. 

[Responses to questions for the record from Dr. Pinto follow:]

October 24, 2007. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

DEAR CHAIRMAN MILLER: Thank you for the opportunity to testify at the October 

10, 2007 hearing, ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities.’’ I appreciate the opportunity to contribute what I have learned 

from youth, family members, service providers and other child-serving professionals 

regarding patterns of mistreatment and maltreatment in residential programs. I am 

grateful for your attention and expressed concern about these problems, and I am 

hopeful that the Committee will respond both to protect youth and families from 

further harm and to restore the well-being of those who have already been injured 

in residential care. To augment my testimony, I am submitting a response to the 

questions posed by Representative Robert Scott (D-VA) as well as the following materials for the hearing record: • ‘‘Protecting Youth in Unlicensed, Unregulated Residential ‘Treatment’ Facilities,’’ an article co-authored with Lenore Behar, Robert Friedman, Judith KatzLeavy and William G. Jones, which was published in Family Court Review in July, 

2007. • This peer-reviewed article includes preliminary findings of the online survey of 

young adults who attended specialty residential programs when they were adolescents, which I referred to in my testimony. Analyses of the full set of personal accounts are currently underway, and will be made available when completed. • ‘‘Unlicensed Residential Programs: The Next Challenge in Protecting Youth,’’ an 

article co-authored with Robert M. Friedman and other members of the Alliance for 

Safe, Therapeutic and Appropriate use of Residential Treatment (A START), which 

was published in the American Journal of Orthopsychiatry in 2006. • This peer-reviewed article reviews the phenomenon of ‘‘specialty’’ residential 

programs for youth, describes the efforts A START, and provides recommendations 

regarding responses across fields and sectors. • ‘‘The Exploitation of Youth and Families in the Name of ‘‘Specialty Schooling:’’ 

What Counts as Sufficient Data? What are Psychologists to Do?’’ an article co-authored with Robert Friedman and Monica Epstein, which was published in Summer, 

2005 in the APA Public Interest Directorate: Children, Youth and Families Division 

News. • This peer-reviewed article provides a summary of identified problems relating 

to the phenomenon of private residential services for youth, based upon an initial 

review of reports published in the media prior to the availability of any more systematically collected information on the issues. 

• ‘‘A START Fact Sheet’’ posted on the A START website at http://

astart.fmhi.usf.edu 

• This fact sheet describes the phenomenon of mistreatment in private residential 

facilities for youth, summarizes initial efforts of A START, and provides a list of 

warnings for parents considering residential treatment. 

• Postings to http://endinstitutionalabuse.wikispaces.com, an online wiki created 

less than one week prior to the October 10, 2007 hearing to provide a virtual space 

where individuals can post letters, accounts and concerns that they want to share directly with Congress regarding the abuse of youth in residential facilities. Many people who submitted letters to this wiki described their personal experiences of mistreatment and abuse in private residential facilities. The wiki is also an opportunity for 

individuals to provide input regarding proposed legislation to address this issue as 

a means of participatory policymaking. 

Thank you again for the opportunity to contribute to the Committee’s efforts to 

clarify and respond to the patterns of mistreatment and abuse in private residential 

treatment. If you need any further information from me, I would be pleased to provide it. A powerful response is urgently needed in order to protect and restore the 

well-being of American youth and families, so your leadership in these efforts is 

deeply appreciated. 

Sincerely, 

ALLISON PINTO, PH.D., 

Department of Child and Family Studies, Louis de la Parte Florida Mental Health 

Institute. 

80

Response to Questions Posed by Representative Robert Scott (D-VA) 

• Do ‘‘tough love’’ strategies have an appropriate treatment role for major psychological disorders? If so, what is that role? 

‘‘Tough love’’ strategies are not appropriate treatment strategies for major psychological disorders or for other milder social, emotional or behavioral difficulties experienced by youth. In 2004, the National Institutes of Health (NIH) issued a Stateof-the-Science Conference Statement regarding the prevention of violence and related health-risking social behaviors in adolescents. NIH concluded, ‘‘the evidence 

indicates that ‘scare tactics’ don’t work and there is some evidence that they may 

make the problem worse rather than simply not working.’’ This report noted that 

ineffective, inappropriate treatment for adolescents included programs limited to 

scare tactics or toughness strategies. (For further details, go to: http://consensus.nih.gov/2004/2004YouthViolencePreventionSOS023html.htm) 

Often these ‘‘tough love’’ strategies are actually referred to as ‘‘behavior modification’’ in private residential facilities for youth. It should be noted that these practices were addressed decades ago in a 1974 study prepared by the staff of the Subcommittee on Constitutional Rights of the Committee on the Judiciary, U.S. Senate, 

which was titled, ‘‘Individual Rights and the Federal Role in Behavior Modification.’’ 

Even at that time, there was opposition to ‘‘behavior modification therapies’’ on the 

basis of rights to privacy and mandates against cruel and unusual punishment, especially with regard to thought reform techniques. Similar techniques are now being 

used in numerous private residential programs for youth, per the reports of former 

program participants and staff members (For examples, see the article I am submitting for the record titled, ‘‘Protecting Youth in Unlicensed, Unregulated Residential 

‘Treatment’ Facilities,’’ as well as letters submitted on the ‘‘End Institutional Abuse’’ 

wiki). These strategies place all program participants at risk, but especially those 

youth with major psychological disorders who are already particularly vulnerable. • Is there currently an obligation for mental health professionals who recommend 

these programs to clients to ascertain their safety and validity as a treatment option? 

Psychologists, psychiatrists, clinical social workers and psychiatric nurses abide 

by the principles and standards established by their respective professional ethical 

codes. For example, the APA Ethical Principles of Psychologists and Code of Conduct defines principles of beneficence and nonmaleficence, fidelity and responsibility, 

integrity and justice. With regard to justice, the Code states, ‘‘Psychologists exercise 

reasonable judgment and take precautions to ensure that their potential biases, the 

boundaries of their competence, and the limitations of their expertise do not lead 

to or condone unjust practices.’’ With regard to standards of competence, the Code 

states, ‘‘Psychologists have or obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals.’’ Furthermore, psychologists do not accept fees for referrals as this 

is deemed unethical. (For further details, go to: http://www.apa.org/ethics/

code2002.html) 

Each mental health profession has a code that is similar in many ways to this 

APA Code for psychologists, and in many states the licensing of mental health professionals through the Department of Health and Human Services or Board of Behavioral Sciences is linked to these various professional codes. As such, there is an 

accountability for providing safe, therapeutic and appropriate referrals among licensed mental healthcare professionals. 

There are two dilemmas worth noting, however. First, very little information is 

available and accessible at this time with regard to particular residential treatment 

programs for youth, especially programs that advertise themselves as alternatives 

to traditional residential mental healthcare. In many states these alternative residential programs are still not required to be licensed or regulated with regard to 

the mental healthcare they provide (e.g. programs that self-identify as ‘‘therapeutic 

wilderness programs,’’ ‘‘therapeutic boarding schools’’ or ‘‘emotional growth academies.’’) This makes it difficult for mental health professionals, as well as families, 

to discern whether a particular program is safe and appropriate. 

The other dilemma worth noting is that many families are being referred to private residential treatment facilities by individuals other than mental health professionals. Families receive recommendations from teachers, pastors, legal professionals and friends and often these recommendations are more compelling to them 

than those they receive from mental health professionals (if they seek a referral), 

especially if the family has already tried to get their child’s needs met through the 

formal mental healthcare system without success. Furthermore, there is an emerging referral ‘‘industry’’ of self-identified ‘‘educational consultants,’’ and these individuals are not required to be licensed. As such, they are not accountable for the recommendations they provide to families. It should also be noted that numerous priVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00084 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
81

vate residential programs pay these referral sources, a practice that is prohibited 

in the ethical codes of mental health professionals. • Is there currently any requirement that other treatment options be utilized to 

address a child’s behavioral issues before sending them to such a center? 

Through the Individuals with Disabilities Education Act (IDEA), youth are entitled to receive services in the ‘‘least restrictive environment.’’ The federal law indicates that states must have procedures in place to assure that, ‘‘to the maximum 

extent appropriate, children with disabilities, including children in public or private 

institutions or other care facilities, are educated with children who are not disabled, 

and that special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only when the nature or 

severity of the disability is such that education in regular classes with the use of 

supplementary aids and services cannot be achieved satisfactorily.’’ Through the Individualized Education Program (IEP) planning process, students are safeguarded 

from inappropriate placement in residential facilities. (For further details, go to: 

http://www.wrightslaw.com/info/lre.osers.memo.idea.htm) 

The dilemma is that many families are by-passing the IEP process because they 

are paying out-of-pocket to place their children in private residential facilities. Families who choose this route are often never made aware of the full continuum of educational and mental healthcare options that might benefit their children. Families 

who contact me after having placed their children in private residential facilities 

often indicate that they were never made aware of community-based treatment that 

could have provided more intensive interventions than regular education and outpatient psychotherapy, without requiring them to use out-of-home residential care. 

This realization is often quite distressing to parents who say they never wanted to 

send their children away but were led to believe that residential treatment was 

their only option. 

Thank you for the careful attention you are paying to these issues, and for your 

leadership in safeguarding and restoring the healthy development and well-being of 

youth and families. 

Respectfully submitted, 

ALLISON PINTO, PH.D. 

[Additional submissions from Dr. Pinto follow:]

Exploitation in the Name of ‘‘Specialty Schooling’’

The Exploitation of Youth and Families in the Name of ‘‘Specialty Schooling:’’ What Counts as Sufficient Data? 

What are Psychologists to Do?

ALLISON PINTO, PH.D., ROBERT M. FRIEDMAN, PH.D. AND MONICA EPSTEIN, PH.D.,

Louis de la Parte Florida Mental Health Institute, University of South Florida 

Correspondence concerning this article should be addressed to Allison Pinto, Department of Child and Family Studies, Louis de la Parte Florida Mental Health Institute, MHC 2222, University of South Florida , 13301 N. Bruce B. Downs Boulevard , Tampa , Florida 33612 or apinto@fmhi.usf.edu. 

A multi-disciplinary taskforce has formed at the Louis de la Parte Florida Mental 

Health Institute to study the issues raised in this article, and the authors wish to 

thank and acknowledge the other members of this taskforce: Lenore Behar, Amy 

Green, Barbara Huff, Charles Huffine, Christina Kloker-Young, Wanda B. Mohr and 

Christine Vaughn. 

The Exploitation of Youth and Families in the Name of ‘‘Specialty Schooling:’’ 

What Counts as Sufficient Data? What are Psychologists to Do? 

Despite an expanding evidence base regarding promising and effective practices 

in children’s mental health, and the implementation of these practices in a growing 

number of communities, an alarming treatment phenomenon is now occurring. Since 

the early 1990’s, hundreds of private residential treatment facilities have been established across the country and abroad, and thousands of American youth are now 

receiving services in these institutions. Many of these programs identify themselves 

as private ‘‘therapeutic boarding schools,’’ ‘‘emotional growth schools,’’ or ‘‘specialty 

boarding schools.’’ Unlike accredited and licensed residential treatment centers that 

are required to meet clear and comprehensive standards with regard to the treatment they provide, many of these new programs are not currently subject to any 

licensing or monitoring as mental health facilities in a number of states. It is the 

unlicensed and unregulated programs that are the focus of this article. 

Highly disturbing reports have been published in the public media describing financial opportunism by program operators, poor quality treatment and education, 

rights violations and abuse of youth in these facilities (Dibble, 2005; Rowe, 2004; 

Aitkenhead, 2003; Weiner, 2003d; Kilzer, 1999). Outrage has been expressed by 

82

youth, family members and program employees (Rock, 2005; Rowe, 2004; Rubin, 

2004; Aitkenhead, 2003; Rimer, 2001). The former director of one program expressed 

her dismay by sending a letter to the regional Department of Child Welfare calling 

for the program to be closed immediately because it ‘‘takes financial advantage of 

parents in crisis, and puts teens in physical and emotional risk’’ (Weiner, 2003a, 

par. 39). Multiple state investigations have been conducted and lawsuits have been 

filed in response to reports of abuse, neglect and mistreatment of youth in ‘‘therapeutic boarding schools.’’ In numerous cases the lawsuits have led to convictions or 

high cost settlements (Hechinger & Chaker, 2005; Dukes, 2005; Rock, 2005). 

Several states already have good laws on licensing and regulation of these facilities and other states have responded to these growing concerns by proposing (and 

in a few states passing) legislation to monitor and regulate the full range of residential programs for youth, including ‘‘therapeutic boarding schools.’’ An example of 

such legislation is Utah Senate Bill 107, which was signed into law in March, 2005; 

this bill defines ‘‘therapeutic schools’’ and clearly specifies that these programs must 

be licensed and regulated like all other residential treatment facilities for youth (S. 

107, 2005). Beyond the state level, Federal Bill HR 1738, the End Institutionalized 

Child Abuse Bill, was introduced in Congress in April, 2005; this bill proposes to 

provide funding to states to support the licensing and monitoring of the full range 

of child residential treatment programs. 

Although policymakers have begun to take action, there has been little response 

from the field of children’s mental health. In particular, there has been no acknowledgement of the reports of abuse in ‘‘therapeutic boarding schools’’ and similar programs by the American Psychological Association. In one sense, the lack of response 

from psychologists is consistent with our epistemological framework and commitment to the scientific method; we typically gather data first, and then analyze and 

interpret it, prior to developing a response or course of action. Currently, there are 

no comprehensive, systematically collected data available about private, unregulated 

residential treatment, so the lack of response at this time might seem appropriate. 

In addition to valuing the science of psychology, however, we also aspire to safeguard the welfare and rights of those whom we seek to serve, and we say that we 

are aware that special safeguards may be necessary to protect the rights and welfare of vulnerable persons or communities (Ethical Principles of Psychologists and 

Code of Conduct, 2002). It is therefore important that we educate ourselves about 

the current residential treatment phenomenon and then respond, as psychologists, 

in a manner consistent with our principles and our mission. Although the increased 

and unregulated institutionalization of youth is far from what we may have hoped 

for or predicted, it is occurring nonetheless, and we cannot ignore it any longer. 

The following review is a summary of the issues that have been identified in the 

accounts that have been published to date regarding residential treatment programs 

that are not licensed or accredited as such, but continue to operate. These accounts 

have been featured in publications including the New York Times, the Washington 

Post, and Time Magazine, and have been aired on BBC News and National Public 

Radio. The series of articles published in 2003 by Tim Weiner at the New York 

Times is particularly comprehensive, and is based on interviews and correspondence 

with more than 200 parents, youth, staff members and program officials. Lou Kilzer 

has also reported extensively on the topic in the Denver-Rocky Mountain News 

(Kilzer, 1999). It should be noted that these series do not address all residential 

treatment and neither does this article. They specifically raise concerns about unlicensed and unregulated private programs that serve youth with emotional and behavioral challenges. 

A ‘‘Booming Industry’’

It is difficult to determine exactly how many private residential treatment programs billed as ‘‘specialty schools’’ currently exist. In a white paper titled, ‘‘Unregulated Youth Residential Care Programs in Montana’’ the author noted that, ‘‘Because private behavioral healthcare programs are not required to be licensed or registered with any state agency, it is a bit like knowing about an ‘undiscovered lake’ 

in the mountains (Montana Department of Public Health and Human Services 

[DPHHS], 2003).’’ Regardless, an Internet search using the term ‘‘troubled teen 

therapeutic boarding school’’ easily identifies a few hundred facilities, many of 

which are listed on websites such as strugglingteens.com, familyfirstaid.org and 

natsap.org. In January, 2004, the Chicago Tribune reported, ‘‘Even in a lackluster 

economy, business for therapeutic schools is booming. While exact numbers are hard 

to come by, a trade association and other experts say the schools are a $1 billion 

to $1.2 billion industry that serves 10,000 to 14,000 school-age children (Rubin, 

2004, par. 8).’’ Some of these residential programs house over 500 youth in a single 

facility (Cole, 2004; Weiner, 2003a; Weiner, 2003d). According to reports in the Wall 

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Street Journal and the New York Times, the cost of each program generally ranges 

from $30,000 to $80,000 per year (Hechinger & Chaker, 2005; Rimer, 2001). Medicaid and most health insurance plans will not pay for youth to attend these programs, so families are typically paying out of pocket, sometimes mortgaging their 

homes or borrowing money from relatives to pay for ‘‘tuition’’ (Cole, 2004; Rubin, 

2004; Rimer, 2001). It is the very fact that this involves a private transaction between a family and a program that makes it possible for the programs to operate 

outside of public monitoring. 

How the Programs Describe and Market Themselves 

Residential facilities that self-identify using the labels of ‘‘therapeutic boarding 

school,’’ ‘‘emotional growth school’’ or ‘‘specialty boarding school’’ seem to emphasize 

non-pathologizing approaches in their marketing materials. One program conveys 

this by stating, ‘‘Labels and diagnoses are left at the door and students are identified and accepted as being intrinsically valuable and good.’’ Phrases like, ‘‘respecting 

dignity and integrity,’’ ‘‘uncovering true potential’’ and ‘‘accepting personal responsibility’’ are frequently incorporated into the program mission statements. At the 

same time, these programs are often quite explicit in marketing to families of youth 

with psychiatric diagnoses, claiming expertise in treating a variety of serious conditions including PTSD, Bipolar Disorder and Eating Disorders (NATSAP Directory, 

2005). 

In terms of the services marketed within these programs, various mental health 

interventions are described, including individual, group and family therapy, substance abuse counseling, cognitive-behavioral therapy, behavior management (sometimes described in terms of ‘‘point systems’’ and ‘‘level systems’’), and the maintenance of a therapeutic milieu. Other less traditional interventions are described in 

some of the institutions, including equine therapy, canine therapy, and wilderness 

therapy. The educational opportunities in these institutions are often highlighted in 

marketing materials with phrases such as ‘‘extensive college-preparatory curriculum,’’ a ‘‘boutique educational package customized for each participant,’’ and 

education ‘‘custom-tailored to each student’s unique needs (NATSAP Directory, 

2005).’’

There appear to be three major ways in which these programs are currently marketed: through the Internet, through ‘‘educational consultants,’’ and through participating family referrals. Many programs host their own websites and are listed as 

well on ‘‘referral sites,’’ which offer web-based surveys for parents to complete to determine whether their children are exhibiting problems that would benefit from residential placement. ‘‘Educational consultants’’ are also available to connect families 

with programs. The qualifications and credentials of these consultants vary (Rubin, 

2004) and there is no evidence of educational requirements or state regulations for 

this profession. It is reported that some referral sources receive a commission by 

certain residential facilities for each family they recruit, although this arrangement 

is not regularly made explicit to families (Rock, 2005a; Hayes, 2003). Some programs also encourage families whose youth are attending the program to recruit 

other families they know; for each new admission, the referring family receives a 

month of ‘‘tuition-free’’ services (Aitkenhead, 2003). Families have reported sending 

their children to programs on the recommendation of other parents without ever 

further investigating the program or services described (Cole, 2004). 

Actual Services Delivered 

Although the services and educational resources described in marketing materials 

may be highly appealing to families seeking support, many of these programs seem 

to provide far less than they advertise. With regard to mental health intervention, 

therapy is often provided by staff members who have no formal clinical training, 

and therapeutic interventions suggestive of gross incompetence are commonly reported (Cole, 2004; Aitkenhead, 2003; Kilzer, 1999; Weiner, 2003a; Weiner, 2003d). 

Harsh and punitive behavioral modification practices have been repeatedly documented (Romboy, 2005; Weiner, 2003c; Kilzer, 1999). 

Some youth have reported that they were required to discipline other youth in the 

facility in order to progress within the behavioral modification level system (Lukes, 

2005; Weiner, 2003a). Psychiatrists are not regularly part of the treatment team, 

and incorrect dosing (Romboy, 2005) as well as frequent over-medication of program 

participants has been reported (Weiner, 2003d). Education has been described as a 

series of monitored study halls without trained, licensed teachers (Rowe, 2004; 

Aitkenhead, 2003) and some programs issue ‘‘diplomas’’ that would not be officially 

recognized by state Departments of Education (Garifo, 2005). 

Some facilities are explicit about their refusal to accept accountability for delivering the services they advertise (Kilzer, 1999; Weiner, 2003a). For example, in one 

84

program, parents are required to sign a contract that ‘‘states plainly that the program ‘does not accept responsibility for services written in sales materials or brochures’ or promises made by ‘staff or public relations personnel (Weiner, 2003a, par. 

25).’ ’’

Abuse of Youth by Program Staff 

Highly disturbing incidents of physical, emotional and sexual abuse as well as 

rights violations have been documented in a number of reports (Hechinger & 

Chaker, 2005; Rock, 2005; Garifo, 2005; Harrie & Gehrke, 2004; Bryson, 2004b; 

Weiner, 2003b; Montana DPHHS, 2003). In some programs, parents are instructed 

by staff to immediately dismiss their children’s reports of abuse as attempts at manipulation (Aitkenhead, 2003; Weiner, 2003c). Emotional abuse has been reported 

in terms of verbal abuse, humiliation, forced personal self-disclosure followed by 

mockery and extreme fear inducement (Hechinger & Chaker, 2005; Rock, 2004; 

Aitkenhead, 2003; Weiner, 2003b; Weiner, 2003d; Kilzer, 1999). Criminal probes relating to allegations of sexual assault by staff members have occurred in multiple 

programs as well (Hechinger & Chaker, 2005; Bryson, 2004b; Hayes, 2003; Weiner, 

2003d; Montana DPHHS, 2003; Kilzer, 1999). 

Excessive and Abusive Seclusion and Restraint Practices 

In a number of programs, the seclusion and restraint procedures are significantly 

more restrictive than the standards generally accepted by mental health licensing 

and accrediting bodies. In one program, youth described lying on their stomachs in 

an isolation room for 13 hours a day, for weeks or months at a time, with their arms 

repeatedly twisted to the breaking point (Rowe, 2004; Weiner, 2003c; Aitkenhead, 

2003). A youth from one Montana facility reported that he spent six months in isolation (Weiner, 2003d). Signed affidavits from former employees of a therapeutic 

boarding school in northern Utah indicate that youth in that program were restrained face down in manure (Romboy, 2005; Stewart, 2005). 

In some programs, parents sign contracts authorizing program staff to use mechanical restraints on the youth for unlimited periods of time (Kilzer, 1999). The 

restraint practices in one institution were described by a former resident as, ‘‘a completely degrading, painful experience * * * they pin you down in a five-point formation and that’s when they start twisting and pulling your limbs, grinding your ankles (Aitkenhead, 2003, par. 9).’’ Records allegedly documenting the use of handcuffs, belts, pepper spray and duct tape to restrain youth have been cited as well 

(Bryson, 2005b; Dibble, 2005). 

Rights violations 

Some programs restrict youth rights without clear clinical justification. Restricted 

rights include prohibitions against: written and phone contact with family members 

for the initial two to six months (Kilzer, 1999; Aitkenhead, 2003); privacy, even in 

bathrooms and showers (Aitkenhead, 2003; Kilzer, 1999); and wearing shoes, which 

could facilitate running away (Kilzer, 1999). There is no indication that families or 

youth are provided with information about how to contact advocacy groups if they 

have concerns about the treatment and care the youth receives. This is quite unlike 

accredited psychiatric hospitals and residential treatment centers, which are required to post hotline numbers that youth and family members can call if they believe their rights are being violated. 

‘‘Escort’’ Services 

Families frequently hire ‘‘professional escort services’’ to transport youth to the 

residential facilities (Bryson, 2005; Rowe, 2004; Cole, 2004; Labi, 2004; Rimer, 

2001). It is estimated that more than twenty escort companies are currently in operation, and to date they are not state-regulated (Labi, 2004). Parents pay escorts as 

much as $1800 to enter their sleeping children’s bedrooms in the middle of the 

night, awaken them, handcuff and/or leg iron them if they protest or resist, and 

travel with them to the residential programs where they will be admitted (Labi, 

2004; Weiner, 2003a). Parents sign a notarized power-of-attorney authorizing the escort(s) to ‘‘ take ‘any act or action’ on the parents’ behalf during the transport (Labi, 

2004, par. 16,’’ and promising that the family will not sue the escort(s) ‘‘for any injuries caused by ‘reasonable restraint’ ’’ (Labi, 2004, par. 16). 

Neglectful Conditions 

Some of these programs are neglectful, in terms of environmental safety and 

cleanliness, nutrition and medical care. Unsanitary living conditions have been described repeatedly (Bryson, 2005; Romboy, 2005; Stewart, 2005; Harrie & Gehrke, 

2004; Labi, 2004; Weiner, 2003d; Aitkenhead, 2003; Kilzer, 1999). Youth have contracted scabies while living at some residential facilities (Romboy, 2005; Weiner, 

85

2003d; Kilzer, 1999). Unhealthy diets are maintained for youth in a number of programs (Romboy, 2005; Labi, 2004; Weiner, 2003d; Weiner, 2003a; Aitkenhead, 2003; 

Kilzer, 1999). Authorities have reported that they found expired medications in a 

program investigated in December, 2004 (Dibble, 2005), and other programs were 

recently investigated for medical neglect as well (Rock, 2005; Romboy, 2005). 

Limited Rights of Youth 

Although numerous lawsuits have been filed to hold programs accountable for alleged misrepresentation, mistreatment and abuse, it is commonly understood that 

youth currently have little legal standing to challenge their placement in these programs (Kilzer, 1999). Barbara Bennett Woodhouse, the director of the Center on 

Children & the Law at the University of Florida, stated, ‘‘The constitution has been 

interpreted to allow teens effectively to be imprisoned by private companies like [escort services] and private schools like [unregulated ‘‘specialty boarding schools’’]—

as long as their parents sign off. If these were state schools or state police, the children would have constitutional protections, but because it is parents who are delegating their own authority, it has been very difficult to open the door to protection 

of the child (Labi, 2004, par. 79).’’

Minimal to Nonexistent Regulatory Oversight 

Limited to nonexistent regulatory oversight is evident in many states and there 

is a lack of federal legislation requiring oversight of private residential treatment 

programs (Hechinger & Chaker, 2005; Garifo, 2005; Gehrke, 2005; Rubin, 2004). 

Thus, institutions are able to market themselves and provide treatment without accountability, which in turn makes it possible for programs to take advantage of 

youth and families. Even when parents inquire about program licensure or accreditation, the response they receive may be misleading. Programs often cite accreditation by the regional Association of Schools and Colleges and Universities as ‘‘Special 

Purpose Schools;’’ however, this process only relates to the educational component 

of a program and does not address therapeutic or behavioral components or standards relating to overnight care (Montana DPHHS, 2003). 

Proposed Response 

A number of issues are raised by the current operation of hundreds of private residential treatment facilities marketed as ‘‘specialty boarding schools,’’ many of which 

are reportedly exploiting families and mistreating and abusing youth. The first issue 

relates to the need for responsible and effective oversight. As a society, one of our 

primary duties is to provide for the protection and safety of our citizens, particularly 

vulnerable populations such as minors. Within health care, concerns about safety 

contribute to the development of licensing, regulatory, monitoring, and accreditation 

procedures for organizations, as well as for professions. Laws and procedures regarding the reporting of child abuse and neglect, and the investigation of complaints, are primary mechanisms to help keep children safe. In response to the 

growing number of reports regarding mistreatment and abuse of youth in ‘‘therapeutic boarding schools’’ and other similar programs, responsible and effective oversight is crucial in all states. All facilities that serve minors with emotional and behavioral challenges need to be licensed and regularly monitored, with particular emphasis placed on those services provided to address the emotional and behavioral 

needs of youth. All such facilities also need procedures in place for the reporting of 

abuse. This is particularly important since accounts in the public media indicate 

that many of the private treatment facilities are not open to routine visits by family 

and/or professionals and operate outside public scrutiny. 

The issue we are raising here is not whether residential care is needed for some 

youth, or whether private residential treatment programs are effective. Clearly 

there is a need for residential care for some youth, and some programs are likely 

very high quality. Rather, the issue of central concern is whether appropriate standards exist such that all programs providing intervention to youth with identified 

emotional and behavioral challenges are licensed and monitored with regard to the 

residential treatment they provide, and are maintaining conditions that protect the 

safety of those who are served. 

A second issue reflected in the recent, dramatic growth of residential treatment 

facilities is the need to increase access to effective care for children and families in 

their own homes and communities so that residential care is used only when needed 

and not by default because other services are unavailable. Progress has been made 

through efforts such as the system of care grant program of the federal Center for 

Mental Health Services (2002) and through local and state initiatives, but there 

clearly is a need for great improvement, as described by the President’s New Freedom Commission (2003), and the Child and Family Subcommittee of the President’s 

New Freedom Commission (Huang et al., in press). Significant progress has been 

86

made in developing individualized, culturally competent, and intensive interventions 

to be provided in communities; now the ‘‘reach’’ of these efforts needs to be extended. 

A third issue related to the proliferation of unregulated residential treatment programs for youth is the use of the worldwide web as a powerful marketing tool. With 

the growth of access to the Internet by the general public, the mental health field 

must recognize that families will be the target of intensive, impressive, and effective 

marketing strategies, and that such marketing makes it difficult for both families 

and formal service providers to distinguish high quality programs from low quality 

programs. Such marketing creates a need for professional organizations such as the 

American Psychological Association to develop resources and provide information to 

help families make considered and sound choices among treatment options. 

There is also a need for professional organizations, including the American Psychological Association, to take a stand on issues such as the need for increased oversight of ‘‘therapeutic boarding schools’’ and similar programs, and the need for adequate protections for children in these programs. In the late 1980s, when there was 

concern about the marketing practices of private for-profit psychiatric hospitals, a 

Resolution on Advertising by Private Hospitals was issued by APA’s Division of 

Child, Youth, and Family Services (1986). Such action is needed again in the face 

of multiple, publicized reports that families are being exploited and children are 

being mistreated and abused in unregulated and unmonitored facilities, and youth 

have no mechanism to report abuse. 

It would certainly be easier to take a strong stand if there were an abundance 

of carefully and systematically collected data describing who is served in these programs, how they are served, how often abuse and mistreatment takes place, and 

what the overall outcomes are for the programs and youth. Given the fact that the 

programs of such great concern are not accountable to the public, these data are 

unavailable now and not likely to become available in the near future. In the face 

of multiple reports in the media, and multiple interviews with children, parents, 

and former staff of such programs, is there not now sufficient information to take 

action to protect children from abuse and families from exploitation? We strongly 

believe that the answer to that question is a resounding ‘‘Yes!’’ We cannot continue 

to look the other way or use the absence of data as an excuse for inaction. The time 

for action is now. 

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December 16, 2004 from http://observer.guardian.co.uk 

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code of conduct. Retrieved May 20, 2005 from http://www.apa.org 

Associated Press. (2004, September 20). Investigation shows troubled school may be 

buying interest with lawmakers. The Daily Herald. Retrieved April 15, 2005 

from http://harktheherald.com 

Bryson, A. J. (2005, April 21). Utah-based group under fire—legislation targets association of schools for troubled youths. Deseret Morning News. Retrieved April 

21, 2005 from http://deseretnews.com 

Bryson, A. J. (2005, February 8). Tighter control of youth programs sought in Utah. 

Deseret Morning News. Retrieved April 15, 2005 from http://deseretnews.com 

Bryson, A. J. (2004, April 17). Problems plaguing program for youths. Deseret Morning News. Retrieved April 15, 2005 from http://deseretnews.com 

Bryson, A. J. (2004, April 9). Youth programs in Utah targeted. Deseret Morning 

News. Retrieved April 15, 2005 from http://deseretnews.com 

Capitol Advantage LLC (n.d.) Legislation Details ‘To assure the safety of American 

children in foreign-based and domestic institutions, and for other purposes.’ Retrieved May 20, 2005 from http://www.congress.org/congressorg/

bill.xc?billnum=H.R.1738&congress=109

Cole, W. (2004, November 22). How to save a troubled kid? Time Magazine. Retrieved April 15, 2005 from http://www.time.com 

Dibble, S. (2005, January 10). Scrutiny increased on centers for teens. The San 

Diego Union Tribune. Retrieved April 15, 2005 from http://signonsandiego.com 

Dukes, L. (2005, March 26). Financial troubles shut down CEDU schools. Bonner 

County Daily Bee. Retrieved April 15, 2005 from http://

bonnercountydailybee.com 

Garifo, C. (2005, February 16). State agencies probe Ivy Ridge. Watertown Daily 

Times. Retrieved February 16, 2005 from http://www.wdtimes.com 

Gehrke, R. (2005, February 11). New push for camp regulation. The Salt Lake Tribune. Retrieved April 15, 2005 from http://www.sltrib.com 

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Harrie, D. & Gehrke, R. (2004, September 21). Teen-help operators have clout—

Family behind schools with checkered record 

calls in political favors, critics say. The Salt Lake Tribune. Retrieved February 17, 

2005 from http://www.sltrib.com 

Hayes, T. (2003, June 18). Boarding schools go unchecked in Utah. Deseret Morning 

News. Retrieved April 18, 2005 from http:// deseretnews.com 

Hechinger, J. & Chaker, A. M. (2005, March 31). Boarding-school options shift for 

troubled teens—shutdown of Brown schools shows challenge of selecting a 

‘therapeutic’ program. The Wall Street Journal. Retrieved April 7, 2005 from 

http://online.wsj.com 

Huang, L., Stroul, B., Friedman, R., Mrazek, P., Friesen, B., Pires, S., & Mayberg, 

S. (in press). Transforming mental healthcare for children and their families. 

American Psychologist. 

Kilzer, L. (1999, July 18). Desperate Measures. Denver Rocky Mountain News. Retrieved December 28, 2004 from http://www.denver-rmn.com 

Labi, N. (2004, July/August). Want your kid to disappear? Legal Affairs. Retrieved 

January 19, 2005 from http://www.legalaffairs. org 

Licensure and Regulation of Programs and Facilities, S.B. 107, General Session 

State of Utah, (2005). Retrieved May 20, 2005 from http://bb.utahsenate.org/

perl/bb/bb find.pl 

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youth residential care programs in Montana. Helena, MT: Author. 

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Rock, S. (2005, March 21). Boonville looks to sell old academy. The Kansas City 

Star. Retrieved April 15, 2005 from http://www.kansascity.com 

Rock, S. (2005, January 23). Referral agency’s connection to boot camp angers parents. The Kansas City Star. Retrieved April 15, 2005 from http://

kansascity.com 

Rock, S. (2004, December 19). Teen’s death raises concerns. The Kansas City Star. 

Retrieved May 20, 2005 from http://kansascity.com 

Romboy, D. (2005, March 6). Utah boarding school under fire. Deseret Morning 

News. Retrieved April 15, 2005 from http://deseretnews.com 

Rowe, R. (2004, December 7). Tranquility Bay: The last resort. BBC News—World 

Edition. Retrieved January 4, 2005 from http://news.bbc.co.uk 

Rubin, B. M. (2004, January 14). The last resort; Therapeutic education industry 

booms as parents seek programs for their troubled children. Chicago Tribune. 

Retrieved April 15, 2005 from http://www.chicagotribune.com 

Stewart, K. (2005, March 1). State’s oversight of school lambasted. The Salt Lake 

Tribune. Retrieved April 15, 2005 from http://www.sltrib.com 

Stewart, K. (2005, Febrary 5). Licensing for ‘‘therapeutic schools’’? The Salt Lake 

Tribune. Retrieved April 15, 2005 from http://www.sltrib.com 

The National Association of Therapeutic Schools and Programs, Inc. (2005). 

NATSAP 2005 Directory. Tampa, Florida: Author. 

Weiner, T. (2003, September 6). Program to help youths has troubles of its own. The 

New York Times. Retrieved January 27, 2005 from http://www.nytimes.com 

Weiner, T. (2003, June 17). Parents divided over Jamaica disciplinary academy. The 

New York Times. Retrieved January 19, 2005 from http://nytimes.com 

Weiner, T. (2003, May 24). Owner of private discipline academy in Costa Rica is arrested. The New York Times. Retrieved January 19, 2005 from http://

www.nytimes.com 

Weiner, T. (2003, May 9). Parents, shopping for discipline, turn to harsh programs 

abroad. The New York Times. Retrieved May 9, 2003 from http://

www.nytimes.com 

Protecting Youth Placed in Unlicensed, Unregulated Residential 

‘‘Treatment’’ Facilities

LENORE BEHAR, ROBERT FRIEDMAN, ALLISON PINTO, JUDITH KATZ-LEAVY, and HON. WILLIAM G. JONES

Throughout the country, there is considerable inconsistency in how states regulate 

residential treatment programs for youth. In states with little oversight, the health 

and safety of youth are unprotected and they may be subject to substandard treatment, rights violations, and/or abuse. Three initiatives to address this issue are reported: 

88

(1) an Internet survey of youth who are former residents, (2) a four-state pilot 

study of how states regulate and monitor residential programs, and (3) a bridgebuilding conference between residential treatment providers and mental health 

leaders. Recommendations address the next steps for lawmakers, lawyers, judges, 

mental health and education professionals, and parents. 

KEYWORDS

residential treatment for youth; licensure/regulation of residential treatment for 

youth; abuse in residential treatment; state responsibility for residential treatment of 

youth 

Introduction 

I did not know where I was going when two strangers came to my room at home 

at 3 in the morning, handcuffed me and dragged me down the stairs into a car. 

While I was at ‘‘name deleted,’’ the program used forced labor, excessive exercise, 

sleep deprivation, nutritional deprivation, physical aggression from staff, and 

threats. We had work sanctions like carrying rocks, digging holes, in both extreme 

heat and in cold and snow/rain. Staff punched kids when restraining them; restraints were done using duct tape and blankets. Now it is hard to have lasting relationships, and I don’t trust many people. I learned to ‘‘play their game’’ * * * make 

up things and admit anything to get them off your back. 

Quotation from a 20-year-old about treatment that occurred 3 years before I found 

this program on the Internet and it looked like it was perfect for our son, who argued all the time, skipped school and was disrespectful to me and my wife. We were 

afraid he would smoke pot and become a juvenile delinquent. They helped us to get 

a mortgage on our house to pay for the care. They told us to lie to him about where 

we were taking him, so we did. They told us he would lie to us about what was 

going on at the school to manipulate us; they told us to ignore his letters. We were 

not allowed to talk to him on the phone. We never knew what his treatment plan 

was, but didn’t realize that we had the right to know. 

When he ran away and was picked up by a shelter program, we were ready to 

send him back but the woman at the shelter told us she knew from other kids that 

the stories were true. We found out later that they used outhouses that they dug 

themselves. They were punished by being forced to eat with the hogs, down on their 

knees, like animals. There were many punishments that involved isolation or 

whippings by staff. They had forced marches and had to carry rocks in their 

backpacks. Medical problems, like infections, were untreated. We talked to other 

parents who had kids there and got the same stories. We were horrified about what 

we did to our son. It has taken years of family therapy to get past this.

Quotation from a parent.

A parent’s decision to place a child in a residential treatment center is a serious 

one, usually fraught with anxiety and based on serious concerns about the child’s 

difficulties, emotional stability, and/or behavioral problems. The decision is frequently guided by the recommendations of a mental health professional, school 

counselor, juvenile probation officer, or judge. In many cases, the decision comes 

after other, nonresidential treatments have failed. The choice of a residential treatment program is a complicated one, and in the best of circumstances, the decision 

is made by matching the child’s needs to the program’s strengths and based on the 

assumption that the program provides quality treatment, education, medical care, 

and honors the rights of children and parents. 

As seen in the opening quotations, substantial problems can arise when placements are made without verifying that these important elements of residential care 

are in place. A very basic source of verification of program quality is that the program is licensed by the state in which it is located; a higher source of verification 

is accreditation by a national organization. Neither is foolproof and questionable 

programs may exist with one or both of these seals of approval. Alternatively, good 

programs may exist with neither of these approvals. Thus, the issue of program 

quality is complex, but extremely important to the well-being and safety of children 

entering these programs and precedes any consideration of treatment effectiveness. 

This article addresses the most basic measure of quality—how states handle the 

issue of licensure; how they review or monitor the programs they license; and how 

they address problems that arise when the requirements for good child care, good 

treatment, and good education are deficient. 

Uncovering a problem 

One of the strongest reports in the media regarding exploitation, mistreatment, 

and abuse of minors in unregulated, private residential treatment facilities apVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00092 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
89

peared in July 1999 by Lou Kilzer in the Denver Rocky Mountain News. Over the 

past 4 years, there have been additional important and shocking media reports. 

Most notable are a series of articles by Tim Weiner, The New York Times (May 

through September 2003); Bonnie Miller Rubin, ‘‘The Last Resort: Therapeutic Education Industry Booms as Parents Seek Programs for Troubled Children,’’ Chicago 

Tribune (January 14, 2004); and Maia Szalavitz, ‘‘The Trouble with Tough Love,’’ 

Washington Post (January 29, 2006). Szalavitz has further captured the unsavory 

tactics of some programs in her recent book, Help at Any Cost (Szalavitz, 2006). 

Youth who attended such programs, parents, and former staff have also made powerful public statements about abusive experiences with some of these facilities. 

These issues have been discussed in publications of the American Psychological Association: Public Interest Directorate (Pinto, Friedman, & Epstein, 2005) and the 

American Journal of Orthopsychiatry (Friedman et al., 2006b) and in presentations 

at meetings of the American Bar Association (American Bar Association, 2006), 

American Psychological Association (Pinto, Epstein, Lewis, & Whitehead, 2006), and 

Research and Training Center for Children’s Mental Health (Friedman et al., 

2006a). 

Collectively, these reports describe: 

• basic human rights violations including (1) youth deaths; (2) inhumane, degrading discipline; (3) inappropriate, often dangerous, use of seclusion and restraint; (4) 

medical and nutritional neglect; (5) severe restrictions of communication with parents, lawyers, and advocates; 

• substandard psychotherapeutic interventions and education by unqualified staff; 

• failure to assess individual needs of residents; 

• denial of full access by parents to their children in residence; 

• financial opportunism and misrepresentations to parents by program operators; 

and 

• financial incentives to educational consultants who serve as case finders and recruiters of families. 

Investigations have been conducted of abuse and neglect at several private unregulated residential programs and lawsuits have been filed as a result; some lawsuits have led to criminal convictions of the programs’ officials or expensive civil 

case settlements (Hechinger & Chaker, 2005; Dukes, 2005; Rock, 2005; Rock, 2004). 

Some of the unregulated programs mislead parents to believe that creative programming that rises above regulation and above sound medical and psychological 

practices is necessary for their difficult children. Attractive advertisements, particularly on the Internet, are aimed at parents who are struggling to find help for their 

troubled children. Some parents make these placements at their own expense, without first seeking professional evaluations of the youth’s problems, and the programs 

do not require professional assessment prior to placement. Some programs offer to 

connect the family with an escort service to transport a child whom parents anticipate would not otherwise choose to go to the program, which essentially means that 

two or more strong adults physically control the youth and force him or her to go 

along, either by car or by plane, to the treatment facility. In some cases, the parents 

have not seen the programs, which may be hundreds if not thousands of miles away 

from home, and they have no independent data, other than promotional material, 

to attest to the effectiveness of the programs. Many programs severely limit parental contact, by phone and visits, sometimes for as long as a year (Szalavitz, 2006). 

Last year, the American Bar Association Center on Children and the Law, using 

data reported by Rubin and Szalavitz, reported an annual estimate of 10 to 15 thousand American youth being placed by their parents in these privately run, unregulated residential facilities, which may also include boot camps or wilderness programs (American Bar Association, 2006). 

Regulation of residential programs 

Policies regarding regulation of both public and private residential facilities are 

the responsibility of each state. These policies may be implemented by state legislation, regulation, or other administrative action. Although many states do oversee 

residential programs, in some states private residential treatment facilities for minors are not subject to regulation, or monitoring either as mental health facilities 

or educational facilities. Yet states regulate other private facilities, such as nursing 

homes, day care centers, hospitals, and restaurants. Depending on the state, failure 

to provide state oversight of residential programs for minors may occur because 

these programs (1) do not accept public funds; (2) are affiliated with religious organizations; or (3) describe themselves (inappropriately) as outdoor programs, boarding schools, or other types of nontreatment programs. In some cases, strong lobbying 

efforts by interested parties have contributed to creating and maintaining these exclusions. An additional problem in some states is that, although regulations exist, 

90

there is ineffective monitoring of programs for compliance; this may be an issue of 

insufficient resources being assigned to monitoring, which ultimately is an issue of 

insufficient priority. 

If a residential program advertises that it addresses behavior problems and calls 

itself a ‘‘therapeutic boarding school,’’ ‘‘emotional growth academy,’’ ‘‘behavior modification facility,’’ ‘‘wilderness program,’’ ‘‘boot camp,’’ or other similar terms, then it 

most likely should be considered a treatment program because it targets the social, 

emotional, and/or behavioral functioning of the children. Certainly some unregulated residential programs are reputable and likely could meet licensure requirements. However, other programs do not adequately provide for the safety and wellbeing of their residents and cannot meet such requirements, and it is these programs that are most concerning. 

Another aspect of the problem is which state agency is responsible for the licensing and monitoring of residential programs for youth. In most states these oversight 

responsibilities are placed in a health and/or human services or education agency, 

where there is considerable understanding of protection, treatment, and education 

issues and of the developmental issues of youth. However, in some states, the oversight responsibility rests with law enforcement, where tendencies to accept a more 

punitive view of corrective programs may prevail. 

Beginning to address the problem 

The Alliance for the Safe, Therapeutic and Appropriate Use of Residential Treatment (A START) was initiated by the Louis de la Parte Florida Mental Health Institute at the University of South Florida to call attention to this problem and seek 

solutions that will protect children in these programs. A START now includes advisors who are leaders in psychology, psychiatry, nursing, mental health law, policy, 

and family advocacy, as well as people with direct experience as director, evaluator, 

parent, or participant in such programs. A START worked with the office of Representative George Miller, now Chair of the House Committee on Education and the 

Workforce, to host a press conference regarding these programs at the U.S. Capitol 

Building on October 22, 2005. Major national organizations which endorsed A 

START’s concerns include the American Psychological Association, American Association of Community Psychiatrists, American Orthopsychiatric Association, Child 

Welfare League of America, Federation of Families for Children’s Mental Health, 

National Alliance for the Mentally Ill, and National Mental Health Association. The 

National Conference of State Legislatures (NCSL) shares the belief that state policy 

is central to addressing this problem and has distributed information, prepared by 

A START, to the chairs of relevant state legislative committees to inform them of 

the issues (Herman, 2005). 

In the past year, A START has highlighted the problems of private, unregulated 

residential treatment facilities through presentations at major conferences of professional and parent organizations (Friedman et al., 2006a; Pinto et al., 2006) and published papers in key professional journals (Pinto et al., 2005; Friedman et al., 

2006b). To clarify, the focus has been on facilities that are not licensed and not operated by public or governmental systems but operate private, residential facilities for 

troubled or difficult children or youth under the age of 18. The focus therefore has 

not included public or private boarding schools that provide only education, nor has 

A START addressed concerns related to publicly run psychiatric facilities or private 

facilities that are licensed and regulated. 

The American Bar Association, recognizing the failure of regulation in some states 

to cover all residential programs in the state, has passed a resolution (by the Association’s House of Delegates at their February 2007 meeting) concerning the use of 

unregulated residential treatment facilities. The resolution ‘‘urges state, territorial, 

and tribal legislatures to pass laws that require the licensing, regulation, and monitoring of residential treatment facilities that are not funded by public or government 

systems, but are otherwise privately operated overnight facilities for troubled and 

at-risk youth under the age of 18’’ (see text following this article). 

Bringing the problem into focus has been the first step. Efforts currently underway are described below. These include (1) an Internet-based survey of youth who 

have attended residential treatment programs and a similar survey for parents, (2) 

a pilot study of four states to gain understanding of the licensure issues and serve 

as a basis for a national, state-by-state study, and (3) a bridge-building task force 

of leaders in the child mental health field and directors of residential treatment centers to develop agreement about important elements in residential treatment programs. 

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Youth perspectives on residential programs for troubled teens 

In response to reports of institutionalized abuse, one question that parents, professionals, and residential program operators often ask is, ‘‘How do you know that 

these are not just a few isolated incidents that have been blown way out of proportion?’’ Sometimes the question asked is, ‘‘Yes, but how do you know that these are 

not just the complaints of disturbed youth who have already tried to manipulate 

their families and the residential programs and now are trying to manipulate the 

public?’’

As a means of getting better information, an online survey has been developed 

and posted to gather firsthand reports from young adults who attended residential 

specialty programs when they were adolescents. The survey is still active, so reports 

continue to be received. It has provided an opportunity for hundreds of former program participants to share their experiences and express their concerns. It is important that we listen to what they have to say. What follows is only a brief description 

of the preliminary findings. 

Survey methodology 

Participants were recruited to participate in the survey through e-mail correspondence; links to the survey were posted on various Web sites. E-mail and Web 

site addresses were identified based upon previous contacts to gain understanding 

about services provided to youth in unregulated residential facilities for youth (Pinto 

et al., 2006). Prospective participants were directed to a description of the study on 

surveymonkey.com, and if they then consented online to participate, they were directed to the survey itself. Participants were informed that their responses would 

be anonymous and they would not be linked to their e-mail addresses. The survey 

was programmed such that it would only accept one completed survey from a given 

e-mail address. It is recognized that this may not be a representative sample of 

former program participants; however, it was not possible to identify such a representative sample in this type of survey. This sampling procedure did permit A 

START to gather information directly from many former program participants. Participants who had attended more than one alternative residential program were instructed to choose one program they had attended and to focus their responses on 

their experiences in this particular program. At the end of the survey, participants 

were provided with contact information for the National Disability Rights Network 

as an available resource and were provided with the principal investigator’s contact 

information in case they wanted to follow up with questions or concerns. 

The survey comprised 194 questions regarding direct experience in residential 

mental health treatment programs. Questions were organized into sections focused 

on: (1) basic demographics and program identifying information, (2) the process 

leading up to program entry, (3) program participation, and (4) program effects. 

Questions were designed to gather information regarding the various aspects of residential care that have been highlighted as problematic in public media accounts, but 

efforts were made to ensure that questions were not framed in ways that would bias 

responses. The survey included a combination of forced choice and free-response 

questions. 

Survey findings 

The survey was posted online in July 2006. The findings reported are for the first 

3-month period and include responses of 500 individuals. For the purposes of the 

current analyses, individuals were included if they provided the name of the program they attended (N = 376), and the program named was an unregulated therapeutic boarding school, emotional growth academy, or residential treatment program 

(N = 298), rather than a licensed residential treatment center or a program of unidentifiable type. Of these individuals, only 5 reported that they had received the 

phone number of an advocacy organization to contact if they had any questions or 

concerns while participating in the program and 63 individuals provided no response to the question about access to an advocate. Responses from these individuals were removed as well, so that the sample for the current analyses included 230 

individuals who attended a residential specialty program and who reported no or 

unknown access to an advocate while attending the program. This group of participants represents a group of especially vulnerable youth, as they were attending the 

types of programs that are likely to have no state oversight, and the youth were 

not formally advised about seeking help if they perceived themselves to be in danger 

while attending the program. 

Who are these youth? 

The majority of the 230 respondents are White (87% Caucasian, 6% biracial/

bicultural, 3% Latino/Hispanic, 3% Asian or other cultural identities) and the majorVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00095 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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ity are female (68.6%). Half reported that their family income was $100,000 or 

greater. Half reported that they had received a psychiatric diagnosis prior to admission to the program (50.4%). Almost a third reported that they had also been prescribed psychotropic medications prior to attending the program (31.3%). Slightly 

over half (57.6%) reported that they had tried services and supports in their home 

community before attending the residential specialty program. At the time when 

they were sent away, youth were most commonly living in the states of California 

(26.9%), Florida (7.3%), New York (6.9%), Texas (5.2%), Michigan (4.3%), or Washington (4.3%). Almost half reported that they were transported to the program by 

an escort service (47.6%) that involved strong adults who forced the youth to leave 

home and then, using force or the threat of force, accompanied the youth to the residential program. 

What about the programs? 

Respondents identified 58 programs in 21 states. Survey participants most frequently reported that they had attended a program in Utah (15.7%), Montana 

(13%), New York (10.8%), California (7%), or Georgia (5.7%). There were also a number of individuals who reported that they attended a program outside the United 

States in Jamaica (12.2%) or Mexico (7%), and 4% reported attending programs in 

the Dominican Republic, Western Samoa, or Costa Rica. Lengths of stay in both the 

U.S.-based and foreign-based programs were extended; slightly over two-thirds 

(69.1%) reported that they attended the program for a year or longer. 

Concerns that emerged in the reports from young adults 

Violations of patient’s rights 

Many participants reported that they experienced patient rights violations. In addition to having no access to advocacy contact information, the majority reported 

that their mail was monitored (93%) and their calls were monitored (96%). Furthermore, the majority also reported that their letters or conversations were filtered, restricted, or interrupted (86%). As one participant explained, ‘‘They isolated you from 

your family back home. You had no way to freely contact anyone. They also enacted 

arbitrary bans to isolate you from friends/ peers.’’ Another reported, ‘‘I never spoke 

to my mom, or even touched a phone once during the 6 month stay in [program 

name deleted]. On Christmas you got to speak with your parents for 5 minutes and 

I did not get to talk to my mother because she was never informed of the call.’’ And 

another: ‘‘As for the e-mails and letters, they read them as they came in, and before 

you sent them out. I wrote 7 letters to my mom before they would send one. It 

ended up being one big lie, because I could not tell her I was upset or that I hated 

it there. At the time, that was all I was feeling.’’

Misuse of seclusion and restraint 

Many reported firsthand experience in seclusion (57%) or restraints (34%), and a 

number of participants witnessed their peers being placed in seclusion (45%) or restrained (60%). While the most commonly reported trigger for seclusion or restraint 

was aggressive behavior, especially aggression toward staff (87%), a number of behaviors that would never warrant seclusion or restraint in a licensed or accredited 

residential treatment center were endorsed as well, including breaking a program 

rule (67%), saying something disrespectful (52%), cursing (48%), or making a face 

(30%). 

Many responses were similar to these: 

They had a room with tile flooring where the kids went at 6:00 am until 10:00 

pm, where each hour you would rotate positions. One hour would be lying on your 

stomach with your chin on the ground, the next position was standing on your knees 

for an hour and the next one was standing for an hour with your nose to the wall. 

When participants were being ‘‘restrained’’, they were in fact being tortured. They 

would be forced face down on the hard tile floor by 3—6 staff members. One staff 

would ‘‘hold’’ your legs down, which usually meant they spent their time grinding 

your ankles into the floor. One or two other staff held your arms out at your sides, 

‘‘held’’ in the same way the ankles were. The last staff would keep his knee in your 

back as he pulled up one or both arms behind your back to the point where you 

could literally touch your ear with the opposite hand from behind your back. 

They would duct tape your hands behind your back then your legs together then 

wrap you up in a blanket like a burrito and duct tape that tighter so you couldn’t 

move or get out. Sometimes it would be so tight kids would be screaming that they 

couldn’t breathe and really start panicking. They made the students do this to other 

students. 

Isolation is where you didn’t see the sun or other people for weeks at a time, were 

given even more unrealistic exercise expectations, were more easily restrained, 

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given less time to shower, and you were forced to lay on your face all day unless 

exercising, for 16 hours each day. 

Note that none of these treatments or punishments are acceptable at any level 

in regulated programs. 

Reports of inhumane treatment 

Beyond seclusion and restraint, there were multiple reports of various forms of 

inhumane treatment and abuse. Many participants reported that they had been required to participate in forced labor (71%), restricted access to the bathroom (68%), 

scare tactics (63%), and exposure to harsh elements like extreme heat, snow, or rain 

(60%). In addition, participants described experiences of excessive exercise (58%), 

food/nutritional deprivation (43%), sleep deprivation (41%), and physical punishment (31%). When asked whether they were ever emotionally, physically, or sexually abused by staff, a number of individuals reported that was often or sometimes 

true (45%). It should be noted that, although each of these practices violates current 

U.S. standards regarding the treatment of adults who are prisoners of war and detainees, they are occurring in youth residential facilities across the country, without 

oversight or accountability. 

Here is one description that typifies the experiences reported by participants: 

We would be forced to do pushups until some boys got hernias. We would be put 

into an ‘iso’ box exposed to extreme heat. We would be deprived of meals as a punishment. They used stress positions. They beat people with sticks and their fists and 

feet. They made kids carry trash and building supplies up and down the hill above 

the program. They made kids move piles of rocks for no reason. They would keep 

you up as a way to ‘break’ you. 

The distress and suffering 

Youth were clearly distressed and suffering. When participants were asked to rate 

how much they experienced a variety of feelings while attending the program 

(where responses included ‘‘not at all,’’ ‘‘a little bit,’’ ‘‘some,’’ ‘‘a lot,’’ and ‘‘don’t 

know’’), the majority endorsed ‘‘a lot’’ of feeling sad, stressed, angry, confused, hopeless, and scared; most participants reported feeling happy, loved, hopeful, and proud 

only ‘‘a little bit’’ or ‘‘not at all.’’ In response to the question, ‘‘Would you recommend 

the program to others?,’’ participants’ responses included: ‘‘I still have bad dreams 

about it. I wake up shaking and nervous that I am there again. It has scarred me 

emotionally and I don’t know if I will ever get over it;’’ ‘‘The program helped me 

realize what a sick sad world we live in;’’ ‘‘It was terrible. I was and still am horrified by the whole experience;’’ ‘‘It was a terrible place. Mentally scarring. I would 

hope NO ONE would ever have to go to a place like that. It’s worse than jail;’’ ‘‘They 

abused me. That’s what they do. They abuse people;’’ ‘‘I don’t ever want another 

child to be so abjectly hopeless or so horribly abused. I don’t ever want another family to be torn up when there is the possibility of being reunited and healed;’’ ‘‘There 

are better ways to deal with a troubled teen than send them to a school that abuses 

kids.’’

What can we conclude? 

Recognizing that the reports provided are retrospective and fully acknowledging 

that these accounts are not necessarily a representative sample of all youth who 

have attended residential specialty programs, these findings nonetheless provide 

compelling evidence that widespread mistreatment is occurring and that youth are 

suffering in programs across the country. As for the question that parents, professionals, and program operators ask, here is a direct answer from one program participant: 

Okay * * * I have a good idea of what you may or may not be thinking at this 

point. ‘This guy’s just some defiant little bastard who hates the world, and sees everyone and everything negatively!’ Understandable, but whether you’ll believe it or 

not, I’m not making this stuff up. I’m not just some pissed off kid who wants to 

whine. I’m a highly intelligent, well-educated, and responsible citizen, and as such 

a person, I know very well that my rights were totally and completely denied. 

A study of four states 

A study of four states was undertaken as a pilot effort for a larger, national stateby-state study through a partnership of four organizations: A START, based at the 

Florida Mental Health Institute; the American Bar Association Center on Children 

and the Law; the National Disability Rights Network; and the Federation of Families for Children’s Mental Health. The 2-year study will involve (1) an in-depth review of state laws, policies, and practices regarding regulation and oversight of residential programs; (2) education of and technical assistance to state lawmakers and 

leaders to bring about needed policy reform; and (3) guidance for parents about placVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00097 Fmt 6633 Sfmt 6621 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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ing children in residential centers. The preliminary findings from the pilot study are 

presented because, even with such a small number, it is clear that there are problems of state policy that contribute to the problem of mistreatment of children and 

their families. 

Study methodology 

While we acknowledge that there are several approaches to remedying the problems that are described above, we believe the wisest course of action is to first systematically gather information about how states handle the issue of licensure and 

regulation of residential treatment programs for minors, as well as information on 

monitoring and quality assurance requirements. In order to begin this process, we 

developed a brief protocol designed to elicit the desired information from state administrators responsible for licensure of these programs and for ensuring quality of 

care, state child mental health administrators, and other key stakeholders such as 

the protection and advocacy administrators. The protocol was designed as a telephone interview and was expected to take between 45 minutes and 1 hour to complete. 

The study was conducted in Connecticut, Missouri, Utah, and California. These 

states were selected in order to achieve geographic diversity as well as diversity in 

size and history/experience in regulating residential programs for minors. Respondents were from the Protection and Advocacy agency, child welfare, education, juvenile justice, and mental health. We intended to assess: (1) the degree to which respondents were knowledgeable of the regulations and the monitoring process and 

the degree to which they agreed with each other and (2) the extent to which there 

were laws, regulations, and policies in place to address this issue. As the intent was 

to get an overview of what problems might exist regarding regulation, rather than 

to determine which states did this well or badly, the findings are not reported by 

specific state. 

Study findings 

Most respondents deferred to the individual who was in charge of licensing for 

the state. In some states, representatives from other agencies did not seem to have 

a working knowledge of how programs were regulated. The person with this responsibility was variously located in child welfare, social services, or human services. In 

general, the child mental health administrators were less familiar with the state 

regulations governing licensure and monitoring and did not see this as part of their 

domain. Representatives from the Protection and Advocacy agency saw this as an 

important issue, but had not become directly involved. 

All four states had legislation requiring the executive branch to issue rules/regulations regarding the operation of residential treatment facilities for minors. However, 

there was variance as to which kinds of programs the regulations applied. In one 

state, the rules applied only to facilities in which a governmental agency placed 

youngsters. In some states, there was an attempt to define levels of residential care, 

with more stringent treatment standards applying to the most restrictive group 

homes and community treatment facilities. 

All four states reported that there are several pathways to residential placements 

for minors. Placement could occur through social services/mental health (into therapeutic foster care, group homes, community treatment facilities, or hospitalization); 

juvenile justice (into boot camps); special education; and private placement. Respondents also stated that licensing and monitoring of juvenile justice, mental 

health, and special education residential programs were the purview of their respective agencies. None of the states were able to report how many children were placed 

privately by their parents or how many children were placed out of state by local 

agencies or by parents, nor was there any attempt to monitor the effectiveness of 

those placements. 

Programs were able to opt out of the licensing requirements established for the 

purpose of providing mental health treatment in facilities for minors in several 

ways. In some states, if the programs were considered to be religious institutions, 

they were exempt. Also, in some states, if a program accepted only private placements, it did not require licensure. In some states, if a program defined itself as 

a boarding school or educational facility, it could be exempt from regulation, even 

though the services provided were described as ‘‘emotionally corrective’’ or ‘‘therapeutic.’’

Despite the plan to describe the states with anonymity, it is important to mention 

Utah, a state that has had substantial problems with questionable programs existing and being exempt from regulation. In 2005, the state legislature amended the 

licensure law to ensure that all programs, except legitimate private residential 

schools, be subject to state regulation and monitoring (Utah Legislation, 2005). The 

95

rule-making process took over a year, which is not unusual given the importance 

of public review and comment. Commendably, Utah is now implementing its new, 

more stringent regulations that address how programs will be included in licensure 

requirements and will be monitored for compliance with those requirements. Although it is too early to understand the impact of new regulations in Utah, this 

state certainly bears watching. 

All four states reported that they have in place regulations establishing standards 

for treatment services, educational services, and child care/supervision; however, as 

noted above, these requirements do not apply to all programs in the state. The basic 

requirements included such elements as (1) each child must have an individualized 

treatment plan and 

(2) the provider must be able to meet the needs identified in the plan. Monitoring 

includes assessing (1) the individualized treatment plans, (2) the individualized educational plans, and (3) requirements to assess quality of services. In some of the 

states, there were requirements related to child care and supervision but these 

treatment aspects were not specified except for the higher end, more restrictive programs. 

For programs to which the rules and regulations apply, all four states reported 

that specific rules regarding children’s rights, parental rights, punishment, and use 

of seclusion and restraints are in place. All four also stated that there are procedures in place for reporting abuse. These included reporting abuse to a child welfare 

hotline and requiring that abuse laws be posted in every facility. Children must 

have access to a phone and employees of residential programs must be trained about 

the different kinds of employee behaviors that are not permitted. 

While all four states have established licensure requirements and standards for 

at least some types of residential treatment facilities providing services to minors, 

their ability to monitor compliance was of concern. Some states monitor compliance 

with requirements which govern such things as staff qualifications, staffing patterns, and number of hours of psychotherapeutic service per week per child. 

In some states, following application for licensure, there is an on-site review of 

requirements and interviews with staff and management. There may be unannounced licensing monitoring visits, as frequently as quarterly. There may also be 

a requirement for an annual inspection, which comes with the renewal process. Onsite visits may also be made if a complaint is made, either from staff, clients, family, 

or citizens. However, respondents reported that monitoring is compromised by the 

number of staff who do the job. In one state, the monitoring agency is staffed to 

visit a 10% random sample of licensed facilities, and this is not as frequent as once 

per year. States vary in whether they provide licensing and monitoring at no cost 

to the program or whether they charge to cover these services. 

Study conclusions 

While we recognize that four states are too small a number upon which to draw 

conclusions, it was apparent that there is an absence of data about how effective 

current laws are. Most agency respondents deferred to the person who was in 

charge of licensing and did not see licensing or in some cases even the monitoring 

of quality of care delivered as part of their responsibility. There appeared to be an 

assumption that providers will obey the laws, but there were no safeguards in place 

to protect children who are placed privately by their parents. Staff from the responsible state agencies is already stretched in its ability to monitor the safety and the 

effectiveness of the quality of care delivered for the children already in their custody. 

Building bridges with residential treatment centers 

The concerns about state policies regarding residential treatment have been supported by a related development. The Child, Adolescent, and Family Branch of the 

U.S. Center for Mental Health Services convened a meeting in Omaha, Nebraska 

in June 2006 to address the historic split between providers of residential care for 

children with mental health challenges and advocates for home and communitybased care within systems of care. The meeting brought together representatives 

from the federal, state, and local level, youth and family advocates, system of care 

council members, tribal representatives, providers of service, and representatives of 

national associations related to children’s mental health and to residential care. Although residential programs which lack oversight were not represented, the agreements that emerged should serve to inform parents, professionals who provide referrals to residential treatment programs, and the operators of residential programs—

good and otherwise—of the expectations that constitute good care and treatment. 

The purposes of the summit were to identify areas of agreement in values and 

philosophies between the different groups, to identify emerging best practices in 

96

linking and integrating residential services with home and community-based services, and to set the stage for strengthening relationships and services partly by developing a joint statement about the importance of creating a comprehensive and 

integrated service array and partly by creating action steps for the future. 

The sponsoring organizations involved with residential care were largely representative of well-established not-for-profit licensed residential programs rather 

than the unlicensed and unregulated, for-profit programs that have been the primary concern of A START (Friedman et al., 2006a; Friedman et al., 2006b). However, the summit was of direct relevance to the concern of A START about protecting children in residential settings and enhancing the availability of a wide 

range of supports and services for children and families. 

The summit did result in the beginnings of a ‘‘joint resolution to advance a statement of shared core principles’’ which was then distributed to participants and 

modified over a period of several months. This resulted in a final product, which 

was distributed by Dr. Gary Blau, Chief of the Child, Adolescent, and Family 

Branch of the Center for Mental Health Services, on September 14, 2006, with a 

request for individual, agency, and/or organizational endorsement. This process of 

securing endorsements is still ongoing. 

As indicated in the preamble to the resolution, the call is for ‘‘a comprehensive, 

flexible, family-driven and youth-guided array of culturally competent and community-based services and supports, organized in an integrated and coordinated system 

of care in which families, youth, providers, advocates, and policymakers share responsibility for decision making and accountability for the care, treatment outcomes 

and well-being of children and youth with mental health needs and their families’’ 

(Child, Adolescent, and Family Branch, 2006, p. 1). The joint resolution acknowledges the need for 24-hour out-of-home treatment settings but indicates that within 

such settings children and youth should have a developmentally appropriate role in 

their care and in creating rules and that family members should be viewed as partners and have open access to the setting. 

In the section on ‘‘Clinical Excellence and Quality Standards,’’ the joint resolution 

calls for ensuring ‘‘that all treatment services are licensed and regulated by appropriate agencies, and that monitoring is performed by well-trained individuals (including families and professionals) whose values are consistent with the principles 

articulated in this resolution’’ (Child, Adolescent, and Family Branch, 2006, p. 5). 

It also indicates in this section that programs should strive to eliminate coercive 

interventions such as seclusion, restraint, and aversive practices and that visits between families and children should not be restricted for punitive purposes. 

The document offers a set of values, principles, practices, and standards that, if 

implemented, would go a long way to addressing the concerns about the protection 

of children with mental health challenges and the pattern of sending children hundreds if not thousands of miles from home to unlicensed programs which reduce 

their contact with their families. The document provides important guidelines for 

policy makers and advocates who are seeking to develop a comprehensive, integrated system and also for policy makers who are seeking to develop or strengthen 

licensing and monitoring procedures to ensure that children are treated safely, that 

they and their families have an appropriate voice in their treatment, and that the 

use of coercive and aversive practices is eliminated. Over the next several years, if 

the values and principles of this joint resolution are not only endorsed but, more 

importantly, put into practice, they will go a long way toward ameliorating the risk 

that children and families are now encountering because of unlicensed and unregulated programs that are highly coercive and aversive in their practices. 

The importance of action: next steps 

The abusive and deceitful practices described in this article are unconscionable 

and cry out for remedial action. The following actions are recommended for questionable practices, to eliminate programs and protect against further harm to vulnerable children and families: 

• Identify programs that engage in the practices described above. Monitoring the 

Internet is one way of identifying them; this effort could be undertaken as a project 

of an organization involved in the protection of youth and advocacy for them. An 

additional way to identify programs is by locating children and families who have 

had negative experiences. Several Internet sites, used by youth, provide for information exchange with a focus on experiences in residential programs. The information 

collected should be organized to allow for systematic review. Similarly, the analysis 

of data from the current, ongoing Internet-based survey of youths’ experiences in 

residential programs (Pinto et al., 2006) should continue to include a focus on identifying programs that do not meet quality standards for care. 

97

• Identify states that do not license or regulate the operation of residential programs for youth or that otherwise tolerate the existence of programs with questionable practices. The proposed national, state-by-state study described above should 

provide good information to help states address needed policy changes. Individual 

state legislators, state legislative committees, and ultimately each affected state’s 

legislature must be aware of how their laws and policies govern the existence of 

these programs and take necessary actions regarding licensure, regulation, and 

monitoring to assure appropriate care and safety for the youth they purport to 

serve. 

• Advocate with the National Conference of State Legislatures to address these 

practices nationally and offer guidance to the states to strengthen oversight of residential programs. 

• Work with Congress to address the existence of these programs, including those 

that operate outside the country, and determine whether federal action is appropriate to assure that vulnerable children are not harmed and that parents are not 

paying exorbitant prices for programs that are ineffective at best. 

• Promote the 2006 ‘‘Recommendation from the ABA Youth at Risk Initiative 

Planning Conference’’ with all legislative bodies to ‘‘[p]rohibit operation of unlicensed, unregulated residential treatment facilities that operate programs whose efficacy has not been proven empirically, such as boot camps, tough love, and ‘scared 

straight’ programs, and require the closing of such facilities. The law should provide 

for such facilities to be replaced with: better access to preventative services, with 

a focus on family involvement and community-based resources, wherever possible; 

and carefully regulated ‘residential treatment facilities’ that are reserved for youth 

whose dangerous behavior cannot be controlled except in a secure setting.’’

• Urge vigilance by juvenile probation officers and other court officials, including 

lawyers and judges, as well as mental health, education, substance abuse, and other 

professionals who encounter troubled young people, in identifying youth who are at 

risk of being placed in one of these treatment facilities; encourage them to engage 

the youth and parents in a discussion regarding better options; impress upon them 

the necessity of parental involvement in the youth’s treatment; and identify to them 

the safety risks and the costs associated with programs that promise a quick fix or 

an unorthodox fix. 

• Create a coalition of national advocacy and legal organizations, mental health 

organizations, and professional organizations that promote the well-being of children to demand state and national action regarding the degrading and demeaning 

practices to which children in these unregulated programs are subjected. 

• Inform civil rights and tort attorneys of the practices in which these programs 

engage and encourage them to take legal action against them. 

• Also inform attorneys who represent youth in juvenile court proceedings of the 

risks these programs pose to their young clients and of more appropriate, evidencebased alternatives. Ensure that attorneys have ready access to the National Council 

of Juvenile and Family Court Judges’ ‘‘Delinquency Guidelines.’’

• Ensure that schools are cognizant of the risks that face youth who are placed 

in these programs and that they disseminate information to parents about child and 

adolescent behavior and the best available treatment programs for youth whose behaviors require intervention. School psychologists, social workers, and counselors 

must likewise be well informed about alternatives, ideally evidence-based programs. 

• Disseminate widely best practices that address diagnostic and treatment issues 

and placement issues with the collaboration of state mental health, child welfare, 

education, and juvenile justice agencies and by the U.S. Departments of Health and 

Human Services and Justice to those involved in the care, treatment, and education 

of youth. This information should also be disseminated by parent organizations and 

other sources of information for parents. 

REFERENCES

American Bar Association, Commission on Youth at Risk. (2007). Recommendations 

from the ABA youth at risk initiative planning conference. Family Court Review, 45, 366—380. 

Child, Adolescent, and Family Branch, U.S. Department of Health and Human 

Services, Substance Abuse and Mental Health Services Administration, Center 

for Mental Health Services. (2006, September). Building bridges between residential and community based service delivery providers, families and youth: 

Joint resolution to advance a statement of shared core principles. Building 

Bridges Summit, Omaha, NE. Retrieved February 13, 2007 from http://

www.aacrc-dc.org/public/pdfs/FinalBBResolution.pdf 

98

Dukes, L. (2005, March 26). Financial troubles shut down CEDU schools. Bonner 

County Daily Bee. Retrieved February 13, 2007 from http://

www.bonnercountydailybee.com/articles/2005/03/26/news/news01.txt 

Friedman, R. M., Pinto, A., Behar, L., Bush, N., Chirolla, A., Epstein, M., et al. 

(2006a, February). Unregulated residential treatment facilities: A present-day 

threat to youth, families and the field of children’s mental health. 19th Annual 

Conference of the Research and Training Center for Children’s Mental Health, 

Tampa, FL. 

Friedman, R. M., Pinto, A., Behar, L., Bush, N., Chirolla, A., Epstein, M., et al. 

(2006b). Unlicensed residential programs: The next challenge in protecting 

youth. American Journal of Orthopsychiatry, 76, 295—303. 

Hechinger, J., & Chaker, A. M. (2005, March 31). Boarding-school options shift for 

troubled teens—shutdown of Brown schools shows challenge of selecting a 

‘‘therapeutic’’ program. The Wall Street Journal, p. D1. 

Herman, M. (2005, September 19). Behavioral health news—When is ‘‘tough love’’ 

too tough? States scrutinize boarding schools. National Conference of State Legislatures State Health Notes: Forum for State Health Policy Leadership, 

26(452), 2—6. Retrieved February 13, 2007 from http://www.ncsl.org/print/

Health/shn/archive/shn452.pdf 

Kilzer, L. (1999, July 18). Desperate measures. Denver Rocky Mountain News. Retrieved February 13, 2007 from http://www.denver-rmn.com/desperate/site-desperate/mpg2-desperate.shtml 

Pinto, A., Epstein, M., Lewis, P., & Whitehead, K. (2006, August 12). Exploitation 

of youth & families: Perspectives on unregulated residential treatment. American Psychological Association Annual Meeting, New Orleans, LA. 

Pinto, A., Friedman, R. M., & Epstein, M. (2005). Exploitation in the name of ‘‘specialty schooling’’: What counts as sufficient data? What are psychologists to do? 

American Psychological Association: Public Interest Directorate, Children, 

Youth and Families Division News. Retrieved September 29, 2005 from http:/

/www.apa.org/pi/cyf/specialty—schooling.pdf 

Rock, S. (2005, January 23). Referral agency’s connection to boot camp angers parents. The Kansas City Star. Retrieved February 13, 2007 from http://

www.isaccorp.org/thayer/thayer-learning-center.01.23.05.html 

Rock, S. (2004, December 19). Teen’s death raises concerns about boot camp—Panel: 

it may have been prevented. The Kansas City Star. Retrieved February 13, 

2007 from http://www.isaccorp.org/thayer/thayer-learningcenter.12.19.04.html 

Rubin, B. M. (2004, January 14). The last resort: Therapeutic education industry 

booms as parents seek programs for their troubled children. Chicago Tribune. 

Szalavitz, M. (2006, January 29). The trouble with tough love. Washington Post, p. 

B01. Retrieved October 30, 2006 from http://www.washingtonpost.com/wpdyn/content/article/2006/01/28/AR2006012800062.html 

Szalavitz, M. (2006). Help at any cost: How the troubled-teen industry cons parents 

and hurts kids. New York: Riverhead. 

Utah Legislation ch. 2, § 62A. (2005). Licensure and Regulation of Programs and 

Facilities. Amendment S.B. 107. Retrieved September 30, 2005 from http://

www.le.state.ut.us/?2005/htmdoc/sbillhtm/sb0107.htm 

Weiner, T. (2003, September 6). Program to help youths has troubles of its own. The 

New York Times, p. 8. Weiner, T. (2003, June 17). Parents divided over Jamaica 

disciplinary academy. The New York Times, p. 10. Weiner, T. (2003, May 24). 

Owner of private discipline academy in Costa Rica is arrested. The New 

YorkTimes, p. 2. Weiner, T. (2003, May 9). Parents, shopping for discipline, turn 

to harsh programs abroad. The New YorkTimes, p. 1.

Lenore B. Behar, Ph.D. is the Director of Child & Family Program Strategies in Durham, 

North Carolina and she is a founding member of A START. For 32 years, Dr. Behar served as 

the director of children’s mental health for the State of North Carolina and brought about major 

policy changes which put the state in a national leadership position. She also served, from 1992 

to 2000, on a panel appointed by the federal court to oversee systems reform in Hawaii through 

a settlement agreement involving children’s rights to education and treatment.

Robert Friedman, Ph.D. is a Professor and Interim Dean of the Louis de la Parte Florida Mental Health Institute (FMHI) and he initiated A START in an effort to ensure that children with 

mental health challenges are adequately protected and served and that their parents are not 

misled and exploited. For the past 15 years, Dr. Friedman has been Chair of the Department 

of Child and Family Studies at FMHI, where he also has directed one of two federally funded 

Research and Training Centers for Children’s Mental Health. Dr. Friedman has been a consultant to over 40 states, has served on many national groups, such as the Planning Board for the 

Surgeon General’s Report on Mental Health, and has given testimony to congressional committees and, more recently, President Bush’s New Freedom Commission on Mental Health.

Allison Pinto, Ph.D. is a Research Assistant Professor at the Louis de la Parte Florida Mental 

Health Institute. She has served as Director of Clinical Training and Clinical Program Manager 

99

in a community mental health center and has worked directly with youth and families as a licensed clinical psychologist. She has been coordinating the efforts of A START since its inception.

Judith Katz-Leavy, M.Ed. is a consultant in the field of child and family mental health. She 

served for over 30 years in high-level positions related to children’s mental health services and 

systems of care in the National Institute of Mental Health and the Substance Abuse and Mental 

Health Administration. She served during 1992 and 1993 on the President’s Health Care Reform 

Task Force and in 1999 as Section Editor for Mental Health: A Report of the Surgeon General, 

Chapter 3: ‘‘Children and Mental Health.’’

William G. Jones, J.D. is a retired Chief District Court Judge from Charlotte, Mecklenburg 

County, North Carolina. He is a member of the advisory panel of the Katie A. vs. Banta lawsuit 

in Los Angeles County, which addresses the mental health treatment of children in the child 

welfare system. He is a consultant to the American Bar Association Center on Children and the 

Law’s National Resource Center on Legal and Judicial Issues, and the Family Violence Department of the National Council of Juvenile and Family Court Judges. 

End Institutional Abuse Wiki 

The following homepage and posts were downloaded by Allison Pinto from http:/

/endinstitutionalabuse.wikispaces.com on October 24, 2007 at 3:21 p.m. EST. This 

online wiki was created on October 4, 2007, less than one week prior to the October 

10, 2007 congressional hearing titled, ‘‘Cases of Child Neglect and Abuse at Private 

Residential Treatment Facilities.’’ It was created in order to provide a virtual space 

for individuals to post letters, accounts and concerns that they want to share directly with Congress regarding the abuse of youth in residential facilities. The wiki 

is also an opportunity for individuals to provide direct input regarding proposed legislation to address this issue. It is intended to serve as a means of participatory policymaking. 

All letters and accounts directed to Congress by the person posting on this ‘‘End 

Institutional Abuse’’ wiki are included in this document. Accounts that were submitted that focus on the experience of someone other than the person directly posting on the wiki are not included in this document. Newspaper articles posted on the 

wiki are also not included in this document. Finally, wiki participants’ responses to 

one another are not included in this document. 

Please note that the accounts included in this document represent the views and 

perspectives of the individuals who posted letters and accounts on the End Institutional Abuse wiki, and are not the views or opinions of Allison Pinto who created 

the wiki space. They are spell-checked but otherwise unedited. 

The wiki will remain active online so that members of Congress can continue to 

visit it in order to directly access accounts about abuse of youth in residential facilities as they are submitted. 

End Institutional Abuse Wiki Homepage

HELP END INSTITUTIONAL ABUSE 

We need to raise awareness in our society about the problems of institutional 

abuse and mistreatment. Please help. 

This wiki is a virtual grass roots effort to organize and speak out. We’ve got less 

than a week * * *

On October 10, 2007, the Committee on Education and Labor will be holding a 

hearing in Congress entitled, ‘‘Cases of Child Neglect and Abuse at Private Residential Treatment Facilities.’’

There will be an opportunity for the presentation of written personal accounts and 

position statements regarding issues of mistreatment, abuse and neglect in youth 

residential programs, to be submitted for the record. If you would like to submit a 

statement, letter or story to Congress, please click on the ‘‘discussion’’ tab above and 

post your letter or story. 

Please note that this wikispaces site is a public site, so it is visible to anyone and 

everyone. Be careful to include only that information that you are comfortable sharing in the public domain. 

Also, please recognize that wiki technology makes it possible for individuals to respond to one another’s contributions. If you choose to respond to someone else’s post, 

please maintain a respectful stance that honors the inherent dignity of that individual. 

If you would like to provide input, feedback or suggestions regarding the ‘‘End Institutional Abuse Against Children Act,’’ please click on ‘‘Federal Legislation’’ to the 

left, and submit your ideas on the corresponding discussion page. This legislation 

was proposed in 2005 and it is expected that it will be revised before it is reintroduced in Congress, so your ideas are needed. 

100

Thanks for any help you can provide in bringing attention to these issues, in order 

to restore the safety and well-being of youth and families in our society. 

[EDITOR’S NOTE.—To see all the entries in this wiki please access the following 

Internet address:] 

http://endinstitutionalabuse.wikispaces.com 


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Chairman MILLER. Thank you very much for your testimony. 

Thank you to all of you for your testimony. 

I cannot think of testimony that we have received in this committee that has caused a greater sense of anger or sorrow than 

what we just heard this morning. 

Mr. Kutz, I would direct again my fellow committee members to 

the first couple of paragraphs in your summary. They are absolutely astonishing in today’s world when you say that ‘‘We found 

thousands of allegations of abuse, some of which involve death, at 

residential treatment programs across the country in AmericanVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00112 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK

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owned and American-operated facilities abroad between 1990 and 

2000. 

‘‘Allegations include reports of abuse and death recorded by state 

agencies, by the Department of Health and Human Services, allegations detailed in pending civil and criminal cases with hundreds 

of plaintiffs, claims of abuse and death that were posted on the 

Internet. 

‘‘For example, according to the most recent NCANDS data, during 2005 alone, 33 states reported 1,619 staff members involved in 

incidents of abuse in residential programs. Because there are no 

specific reporting requirements or definitions of private programs 

in particular, we could not determine what percentage of the thousands of allegations we found related to such programs. 

‘‘We also examined in greater detail 10 closed cases where teenagers died while enrolled in the private program. We found significant evidence of the ineffective management in most of these 10 

cases with program leaders neglecting the needs of program participants and staff. This ineffective management compounded the 

negative consequences and sometimes directly resulted in the hiring of untrained staff, lack of adequate nourishment, reckless or 

negligent operating practices, including a lack of adequate equipment. These factors played a significant role in most of the deaths 

that we examined.’’

In the 10 facilities that you looked at, Mr. Kutz, where these 

children died, could you name those 10 facilities for the committee, 

please? 

Mr. KUTZ. Yes, if you would like me to go on the record with 

that, I would. 

Chairman MILLER. Yes. 

Mr. KUTZ. We did leave it off, but if you asked that, I will. 

Chairman MILLER. I will ask you to do that now. 

Mr. KUTZ. I will do them one by one. 

Number one was Summit Quest. Number two was Challenger. 

Number three is North Star. Number four is Obsidian Trails. Number five is the Aldredge Academy, which was already mentioned by 

one of the parents here. Number six was the American Buffalo Soldiers Reenactment Camp. Number seven was Red Rock Ranch 

Academy. Number eight was Catherine Freer Wilderness, which 

was also mentioned. Number nine was Skyline Journey. And number 10 was Thayer Learning Center. 

Chairman MILLER. Thank you. 

A number of these facilities, if I understand correctly, have remained open. Which facilities are those? Some have closed either 

related to these incidents or other reasons, but which of these remain open after these children have died? 

Mr. KUTZ. That is correct. Some have closed and there are five 

that remain open in some form, and I will go through those with 

you also. 

Again, Aldredge, which was our case number five. The Red Rock 

Canyon School, which was the parents of the Red Rock Ranch 

Academy, our case study number seven, is open. Catherine Freer, 

which was mentioned, is still open, but it is open now in Oregon. 

The Nevada location related to our case study is closed. The Skyline Journey from our case number nine is closed, but it now operVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00113 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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ates as something called Distant Drums. And then Thayer Learning Center, our case study number 10, is still operating. 

Chairman MILLER. From your investigation of these 10 deaths at 

these facilities, can you comment as to whether or not these deaths 

at these facilities appear to have been fully investigated? 

Mr. KUTZ. Not necessarily. I mean, from a criminal standpoint, 

we did not do an in-depth investigation of the quality. I would say 

that they were not done of equal quality necessarily, but we did not 

dig enough into that. 

From a criminal standpoint, there really was not a whole lot of 

result. There was one individual who was prosecuted and is serving 

concurrent 6-and 5-year sentences. The other prosecutions or pleas 

resulted in community service or probation, things like that. And 

in some cases, there were no charges at all made at the end of the 

day. 

So it was a wide variety, but very little criminal result for any 

one involved in these cases. 

Chairman MILLER. Thank you. 

Ms. Moss, it is my understanding that three of the facilities that 

Mr. Kutz just mentioned are NATSAP members—is that correct—

that remain open? 

Ms. MOSS. Yes. 

Chairman MILLER. And those are which? 

Ms. MOSS. Catherine Freer, Red Rock Canyon and Aldredge 

Academy. 

Chairman MILLER. Aldredge Academy. 

Mr. Kutz, are there additional members? Were there three, or 

was it five? 

Mr. KUTZ. There are three current. There were two that are now 

closed that were NATSAP members. The Obsidian and Skyline 

were NATSAP members based on our understanding. 

Chairman MILLER. Okay, but they are now closed, as I understand it. 

Mr. KUTZ. Correct. 

Chairman MILLER. Let me just ask Mr. Lewis, Ms. Clark Harvey 

or Mr. Bacon, in a sense, what would you say to parents who are 

considering this alternative for their child, and I think we all recognize that very often parents are considering these alternatives because they do not know quite what else to do. It is not that they 

have not tried a lot of things with their children, but they have not 

worked out the way they had hoped or had become more difficult 

or what-have-you. So it is a very difficult time for parents, but you 

have been there tragically. What would you recommend to parents? 

Mr. Lewis? 

Mr. LEWIS. In hindsight, I would not let my son out of my hand, 

out of my sight. Nobody loves your children like we do, and to turn 

your child over to somebody else and hope that they are going to 

love and protect your child, I think, was very naive on our part. 

I think what we need to do as a society and a community is provide much stronger home-based programs for children that are 

struggling so they stay with their families, and they stay with the 

community that they know and loves them. 

You know, hindsight is a wonderful thing. We thought Aldredge 

was an answer to our prayers, and it turned out to be a living 

111

nightmare for us, and I cannot imagine the nightmare it was for 

my son. 

Chairman MILLER. Ms. Clark? Ms. Clark, what do you think? 

Ms. HARVEY. I would have to agree. There is absolutely no way 

for any family to be certain of any of the claims that are made by 

these programs. There is just no way to do the amount of research 

and to determine whether it is appropriate or not, so I would make 

a blanket statement of do not send your child to a residential treatment program far away from your home because, as things stand 

right now, you have no absolutely no assurance that they will be 

taken care of. 

Chairman MILLER. Mr. Bacon? 

Mr. BACON. I would like all of the parents to understand that the 

risks involved in sending your child to one of these programs are 

far greater than what you can imagine. In our case, we were 

weighing the risks of what we thought was an unhealthy environment in the public high school that our son attended, whether it 

was drug use and peer pressure. The risks that we assumed, and 

the risk that I think every parent assumes when they send their 

child to a residential program, is much higher than probably any 

risk that they can face near home. 

Chairman MILLER. Thank you. 

Mr. Kutz, you mentioned one of your discussions was a question 

of misleading advertising or marketing or assurances to parents. 

Last night and early this morning, I was on the Internet and sort 

of scooting around some of these sites, and it is a very seductive 

introduction to parents who are distraught, who are stressed, who 

have been dealing with this maybe for multiple years. 

They generally list a series of problems that children have—bipolar, schizophrenia, depression, drug and substance abuse, ADD—

and the suggestion is that the staff can deal with all of these. Any 

one of those is a career for a professional, and all of my work in 

mental health and my wife’s work in mental health and involvement with kids, and the idea that you can just insert a problem 

and this counselor can take care of any number of these problems 

in an effective way is——

I have not seen a practice that way except in these representations, the suggestion that they are trained effective counselors for 

each one of these disorders, and, of course, most parents in that situation would identify with one or more on that list, and I just wondered if you might address that. 

Mr. KUTZ. Yes. And I can speak to the 10 cases in depth, but the 

parents were pretty much told what they wanted to hear. As you 

said, it almost did not matter what the circumstances were for the 

child. The programs were purported to be experts for those kids. 

And it went far beyond that. You had cases where you had no 

one that knew CPR in the entire program, you know, just something basic like that where you are having kids out in the wilderness or at a boot camp or whatever and no one knows CPR. 

And they market to the desperate parents. You heard these parents today. I mean, they were in a desperate situation. They were 

looking for something, and they were probably vulnerable at the 

time. I do not want to speak for them, but I think they probably 

were. I am a father. I could see how that could happen. 

112

And I just think what you mentioned earlier and what the parents mentioned here for parents looking today, it is buyer beware. 

Buyer beware. I mean, these are programs, especially where they 

are unregulated programs in certain states, you really do not know 

what you are getting. 

Could I go back to the criminal also? The fact is there were not 

a lot of criminal prosecutions and documented evidence that the 

people that are dealing with these programs have a background. 

When parents are doing due diligence on these programs, an interesting point here is how do they know that some of the people who 

were involved in the abuses and the cases that we talked about 

here are not dealing in the current programs today. The answer is 

they will not know, and so it is a very difficult environment out 

there for parents. 

Chairman MILLER. Could you elaborate on the Thayer case, number 10, the 10th case in your item? 

Mr. KUTZ. Yes. And that is the most recent case from Missouri. 

Yes, that was a case I mentioned. That was one where we believe 

that there was certainly abuse, and I read the autopsy report myself in depth twice, and I really could not believe it actually. 

I mean, this kid had bruises, abrasions and kind of signs of 

abuse from head to toe, from his head down to the bottom of his 

legs, and there were reports that he had been dragged around, and 

the other kids at the program had been forced to drag him around 

when he was unable to exercise. 

And I mentioned to you in the opening statement that when he 

was unable to exercise, then the penalty was not medical treatment, but to put a 20-pound sandbag around his neck and make 

him wear it around. So that is a case of absolutely clear abuse, in 

my judgment. 

Chairman MILLER. You know, Dr. Pinto made the point—and I 

think it probably strikes all of us here—had any parent engaged 

in any of this behavior against a child, they would be in jail. Almost any singular incident of numerous incidents and ongoing activities against these children—a parent, a schoolteacher, a coach—

they would all be gone. 

I will get into it later because I have a second round of questioning here, but, you know, my concern is that these people sort 

of reinvent themselves. They leave Nevada. They show up in Oregon. They leave this program. They rename themselves. 

I followed some of these programs now longer than it took to 

cross the West by walking. I mean, you know, these people constantly are morphing themselves, and your point is you do not 

know who is ‘‘counseling’’ your kid, whether there is criminal behavior, whether they have their own problems. 

But, you know, one of the things that stuns me is the marketing 

of the wilderness and the outdoors and nature and then to take 

people into the outdoors and the wilderness and nature and brutalize them in the name of the nature. I do not get it. 

I have backpacked for 30 years. I was on a trip this weekend in 

the high rims above Lake Tahoe in the aftermath of a snowstorm, 

and in that trip, we must have stopped six or seven times and 

checked everybody, saying, ‘‘Are we okay? Can you proceed? Do you 

think we should go back? We are this many hours into it. We have 

113

this many hours of daylight. Is everybody drinking water? Is everybody snacking, because we are burning a lot of energy because it 

is really cold?’’

For 30 years, I have hiked in that fashion with kids. I have had 

kids come into our camp in the middle of the night on different wilderness programs, but all of them were schooled in how to deal 

with the program. They were all given challenges, massive hikes, 

really quite stunning what they accomplished, with a guide, with 

full education with the dangers of how to take care of yourself, how 

to respond, how to handle the worst, and then the challenge is laid 

out, and I kind of understand that. I can see why that is used as 

a tool. 

But the idea that you take a person and you have her walk out 

in 100-degree weather and somehow this is good for you and nobody is paying attention to dehydration and nobody is paying—in 

the name of the wilderness that—this is therapeutic? No, this is 

abuse. 

And back to your point on mismarketing, it is a wonderful thing 

for parents to think, ‘‘Gee, maybe I can get my kid out of this 

neighborhood, and we can start over, and they can go out there 

and, you know, they will be fishing and they will be swimming and 

they will be doing all these things,’’ you know. It is just outrageous 

that they would suggest that somehow you can have a positive outcome with these children by using the outdoor experience as an 

abusive action against children. 

It is stunning to me, and it is contrary to any norm of anybody 

who has been out in those situations, especially when you have 

young people with you in terms of learning about the outdoors. 

I mean, as I went on these Web sites one after another—and 

then when you look at the cost—I do not know, Mr. Kutz. I have 

about 30 seconds. If you would just outline what you saw in terms 

of some of the costs——

Mr. KUTZ. Yes, the cost is fairly interesting. I mean, this is all in 2007 dollars, but the range was $131 to about $450, and the average was $300 per day, which is about $2,000 a week, and so the 

cost of this is very significant, and that is for the 10 cases that we 

looked at, certainly. We have looked at other ones that are in that 

kind of price range. So $300 a day was the average cost. 

Chairman MILLER. Thank you. 

Mr. McKeon? 

Mr. MCKEON. Thank you, Mr. Chairman. 

I would just ask the chairman kind of what he plans on doing 

about this. It is the first I have heard of these abuses going on. I 

have a couple of friends that have sent their children away to 

schools and did not have any of these kind of problems, but one 

death is more than should be tolerated. 

Question: Ms. Moss, in your report, you talk about a joint commission, 15,000 programs. Was that correct? 

Ms. MOSS. The joint commission accredits over 15,000 health 

care——

Mr. MCKEON. Programs such as these? 

Ms. MOSS. Yes. They are not all like these. There are psychiatric 

hospitals——

Mr. MCKEON. What is the point——

114

Ms. MOSS [continuing]. Medical hospitals. So it is over 15,000 

that they accredit. 

Mr. MCKEON. How many of these programs are in your association? 

Ms. MOSS. That are accredited by joint commission? 

Mr. MCKEON. Well, just how many are in your program? 

Ms. MOSS. We have 180 programs, sir, as members of our organization. 

Mr. MCKEON. And do you know how many children are enrolled 

in these programs, these 180? 

Ms. MOSS. The information that I received last year when we did 

our 2006 annual renewal is that there were approximately 16,000 

children served in our in our member programs during 2006. 

Mr. MCKEON. Sixteen thousand. Do you have any idea how many 

deaths have come from those 180 programs or out of those 16,000 

youth? 

Ms. MOSS. In 2006, sir, I do not recall immediately. Our organization has grown from a starting point of six programs to the 180 

this year. I am sorry I do not have that information at my hand 

right now. 

Mr. MCKEON. Mr. Kutz, do you have any idea from your investigation how many deaths have resulted from these programs? 

Mr. KUTZ. No, we do not. We just know that there are thousands 

of cases of reported death and abuse. There is no real central repository. 

Mr. MCKEON. Excuse me again. Thousands of——

Mr. KUTZ. Death and abuse. Mostly abuse, but there are other 

reports of death. There is just no way to quantify. There is no good 

centralized source in the federal or state governments to quantify 

this. 

Mr. MCKEON. It is amazing to me. As the chairman said, if a 

parent just were reported abusing a child, the children would be 

taken away from them, they would probably go to jail, and they 

would have to prove their innocence, and yet we have just from the 

witnesses here today three deaths, and it looks to me like there is 

no criminal action taken, except in the case where we had a $5,000 

penalty and some kind of probation or something. What are the police doing about this? I mean, deaths are pretty serious, and nobody is taking any action? 

Mr. KUTZ. Well, I can just answer this for the 10 cases. We did 

look at police reports. There were extensive investigations done in 

most of the cases, and, again, only one person is serving time 

today, from case study number six, for manslaughter and I believe 

another charge, concurrent 6-and 5-year sentences. Everyone else, 

as I mentioned, either was prosecuted or pled, either got community service or time served or some lesser charge. 

So there were really no teeth behind the investigation. It does 

not mean they were not good investigations. We did not really 

evaluate the quality of the investigations, but there was really no 

action on the criminal side here. 

Mr. MCKEON. This just boggles my mind. I cannot even imagine 

how this——

Mr. Bacon? 

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Mr. BACON. In the case of our son and North Star Expeditions, 

it was a program licensed in the State of Utah. It was owned by 

two gentlemen who were previously field counselors in the Challenger program where a young woman died. In the investigation on 

the former death, these two people turned state’s evidence against 

that owner in exchange for assisting the State of Utah in writing 

the regulations for the State of Utah and a license to operate their 

own program. 

So, when our son died, there was an immediate investigation 

that was brought about by the county attorney in Garfield County. 

We were very fortunate that in the sheriff’s office, there was an experienced homicide investigator who arrived at the scene first. 

From the evidence that she collected, it became clear very quickly 

to the county attorney that this was a very suspicious case, and he 

called in to the State of Utah, to the attorney general’s office, and 

asked them to assist in the investigation. 

As a result, both owners—I believe that there were seven people. 

I am not sure about the exact numbers—counselors and EMTs 

were charged with felony child abuse and neglect to report child 

abuse, among other misdemeanor charges. All of them pled guilty 

to lesser charges, were given probation and community service, and 

told that they could not work in child programs after this. 

There was one counselor who decided that a felony did not mean 

that much to him. So, despite the fact that the plea agreements 

were supposed to prevent us from the agony of going through the 

trial procedure, we had to do that anyway. He was found guilty of 

felony child abuse. 

The judge sentenced him to 1 year in jail and community service, 

he was out in 2 months, and we were informed that at that point 

it was no longer about Aaron Bacon, it was about what was good 

for Craig Fisher. The judge told us it was no longer about what 

was right for Aaron Bacon, it was what was right for Craig Fisher, 

and he got off with 2 months and community service. 

Mr. MCKEON. I would like to yield to Mr. Platts some of my time 

at this time. 

Mr. PLATTS. Thank you, Mr. Chairman and Ranking Member 

McKeon. 

First, I certainly add my words of sympathy on the loss of loved 

ones of our family members here today and thank all our witnesses, especially you, for your courage in sharing your family stories that we may do our best to see that they are not repeated and 

the tragedy that your families have suffered are not repeated in 

other families. 

Mr. Kutz, in your investigation, it seems that your focus was private programs, not public, but you do reference an ongoing investigation that is going to be more comprehensive. Is that correct? 

Mr. KUTZ. Yes, a more comprehensive look at the——

Mr. PLATTS. Would that include public and private to give us an 

understanding of maybe what is better? 

Mr. KUTZ. Yes, it will include both. 

Mr. PLATTS. What is the timeframe for us getting that information? 

Mr. KUTZ. I believe early next year. 

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Mr. PLATTS. Okay. In the 10 cases specific that you did investigate, how many, if any of those, were cases in states where there 

was state licensing in place? 

Mr. KUTZ. Several were, and several were not. It was mixed. 

Mr. PLATTS. And the ones where there was, was the response 

then more appropriate? 

I mean, I agree with the chairman and the ranking member. 

When you read these cases and Mr. Bacon just citing the example 

of his son’s, the repercussions, the consequences are unbelievable. 

There were not any. I mean, lives were taken in a horrific manner, 

and was it any better in any sense with those with state licensing? 

Mr. KUTZ. With respect to that, where there was state licensing, 

there were several cases where the licenses were revoked, and so 

there was some action on the license. Again, I mentioned not much 

on the criminal side, but on the licensing side, licenses were revoked or possibly permits on federal lands. Some of these did that 

on federal land also, and the permits were revoked there also. 

Mr. PLATTS. You reference in your written testimony that the 

states while they do not often regulate the private that they more 

often regulate publicly funded programs. Did you get in detail in 

what way they regulate the public funding in this report? 

Mr. KUTZ. No, I do not have any direct knowledge of the public. 

Mr. PLATTS. Okay. Of those that are privately regulated, private 

entities that are regulated by states, was there a state that you 

would point to us as the best model for us to look at to say this 

state seems to be doing it better than anyone else? 

Mr. KUTZ. I think that that will be probably in our report next 

year, but I know that talking to my staff, Utah has gone through 

several revisions because a lot of the cases here happened in Utah. 

There have been increases in the requirements in Utah, I think 

several iterations of that. Whether that is the model or not, I cannot speak to that, but there has been a lot of activity from a legislative standpoint in the State of Utah. 

Mr. PLATTS. I think that would be helpful. 

Chairman MILLER. If the gentleman would just yield for 1 second, I just want to inform the members of the committee that I 

think there is a little less than 5 minutes now on the roll call vote. 

We will recess for the votes, and we will come back immediately 

after. Hopefully, that is in 20 minutes or so. 

The gentleman is free to go ahead now. 

Mr. PLATTS. Thank you, Mr. Chairman. I will try to wrap up 

quickly or give the ranking member back——

Of that ongoing study, I think it would be very helpful if part of 

that investigation is kind of the best models out there that we can 

learn from to then try to look at how to replicate elsewhere. 

A final question, Ms. Moss. You mentioned 180 programs that 

are currently members, and in your testimony, you talked about 

they have to have a state license or an accreditation from the joint 

commission——

Ms. MOSS. Yes. Mental health accreditation. Yes, sir. 

Mr. PLATTS. So all 180 of your programs have that? 

Ms. MOSS. The board ruling went into effect the 1st of May, 

where all new members have to be licensed and-or accredited, and 

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they also have to have oversight by a licensed clinician, in other 

words, somebody that has a state licensure. 

The current members, for those that have been members of our 

organization, have until January of 2009 to obtain that licensure 

and-or that accreditation, and the organization is working with 

other states as well as with other accrediting agencies to make 

sure that those accreditations are available. 

In 2009, if we have a current member, whether it is a founding 

member or any other member that has not received that licensure 

or accreditation, they will not be a member of our organization. 

Mr. PLATTS. Okay. Thank you, Ms. Moss. 

And to our family members, I especially want to thank you 

again. As a parent of an 8-year-old and an 11-year-old, I cannot 

imagine the anguish that you have gone through, and your willingness to be here today is going to help save the lives of other children in the future, and I sincerely thank you. 

I yield back to the ranking member. 

Chairman MILLER. The gentleman has 2 minutes. 

Mr. MCKEON. Again, I would like to thank you for being here. 

I would like to thank you, Mr. Kutz, Mr. O’Connell, from the 

GAO for this study. 

I hope as we move forward on this issue that it does not become 

a partisan issue, that this is something that we can work together 

on to better the situation. I am sure that there are young people 

that have gone to some of these programs that have benefited, I 

would imagine out of that many people, but I think it is something 

we really need to look at. 

What concern I have is, apparently, law enforcement just does 

not get involved in these things, so if you can have a bad actor—

and it seems like whatever field you are in, you can find bad actors. We could find doctors that have had real problems in their 

lives. So I think it seems like people just gravitate to wherever 

they can do the bad things they want to do. 

My concern is that if there is an incident, such as these, where 

deaths occur and abuse and there is some attention brought to 

them and maybe there is some slight action taken, as we have seen 

here, it might shut them down. They might move to another state 

and start all over again, and nobody has any way of knowing the 

problems. So that is something that I think that we really need to 

look at. 

I am generally opposed—as Mr. Bacon maybe pointed out in his 

opening comments—I do not like to see federal legislation, but 

there are some times where it has to happen, and if you have a 

situation like this where people can go from one state to another 

to avoid prosecution, it might be that federal legislation is needed. 

I appreciate, Ms. Moss, what your organization is trying to do 

where you say if some way you can clean up some of the bad apples. I have seen it in other organizations that we deal with, where 

it has been effective, but sometimes it is not enough, and I think 

that is something that we need to address. 

And I appreciate the chairman holding this hearing. 

Chairman MILLER. Thank you very much. We will recess, and, 

hopefully, we will be back here in about 20 minutes. Thank you 

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very much, and thanks for sticking with us because we have a few 

more questions we would like to ask you. Thank you. 

[Recess.] 

Chairman MILLER. Thank you very much for bearing with us 

here and our busy congressional schedule. 

I would like now to recognize Congresswoman McCarthy from 

New York for questioning. 

Mrs. MCCARTHY. Thank you, Mr. Chairman, and thank you for 

bringing this to everybody’s attention. 

To the family members, I know it has been a very troubling journey for all of you, but with you being here today, you are bringing 

this to national attention, and with all the pain and suffering that 

your families have gone through, you can make a difference and, 

hopefully, prevent another family going through what you have all 

suffered these last several years, and my heart goes out to you. 

With that, Mr. Kutz and Ms. Moss, many parents put their children into these programs based on snazzy and, in some cases, according to your report, misleading marketing products. I imagine 

these marketing tools do not include any information on incidents 

of crime, violence, accidents or deaths. 

In 1990, Congress passed the Clery Act which requires colleges 

to notify parents about campus crime annually. I am shocked that 

there is no similar requirement for children in these residential 

programs who are arguably even more vulnerable than our college 

students. 

I am also shocked that owners and program leaders are not required to disclose if they have previously had to shut down a program and under what circumstances. It is totally unacceptable that 

parents are not informed, and families involved in these programs 

should have a parents’ bill of rights. 

Do you think these residential treatment facilities should have to 

disclose violent incidents, accidents and deaths in their marketing 

materials or to the parents of enrolled children on an annual basis? 

Mr. Kutz? 

Mr. KUTZ. Well, I would say that they did not do that, and with 

respect to disclosure to the parents of what was actually going on, 

not only did they not tell them what was going on, I believe in 

many cases we saw that they lied to the parents, and they misrepresented what was actually happening. 

Certainly, it would seem that that has merit, having some disclosure requirements here, and, again, you have to have teeth behind 

that somehow. I do not know how you get that, but some teeth behind disclosure of what is going on would have some merit. 

Mrs. MCCARTHY. In your report, did you find that even those 

that were hired into these particular programs—did anybody do 

any background checks on them? 

Mr. KUTZ. I think there were some that did and some that did 

not. We did have one case where there was an ex-con that was handling kids. So somehow that person got through, but I do not even 

know what the requirements were. There were no licensing requirements. There were not any real standards there, so I do not 

even know what the criteria was they were using to bring people 

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ments a background check is one of the thing that is required in 

some states. 

Mrs. MCCARTHY. Ms. Moss? 

Ms. MOSS. On the question of disclosure, one of the things that 

we always recommend when a parent calls is they need to check 

with the state licensing agency to see if there is anything in the 

background of that program. We also stress the fact that if there 

is no licensing agency, they need to contact the attorney general’s 

office to make sure that there is nothing in that background. 

Mrs. MCCARTHY. But how do we get this information to these 

parents? I mean, obviously, usually, the parents are so distressed 

by the time they even come to this situation where they are trying 

to find the best treatment for their child, and there are so many 

programs out there. Half of them are not even registered with the 

state. It is kind of hard to guide these parents. 

Ms. MOSS. It is very difficult. 

Mrs. MCCARTHY. They did due diligence. They asked the right 

questions, and yet they ended up with, unfortunately, their children dying. 

Ms. MOSS. I do not think any of our NATSAP programs would 

be opposed to disclosure on that. 

Mrs. MCCARTHY. What do you think about having some data 

where we can, you know, have data like where parents could go on 

to the Web site when they would be looking? 

I am sorry. Did you want to ask——

Mr. LEWIS. Yes. About 3 or 4 months after the criminal case was 

resolved in relation to our son, I had called the people at Aldredge 

Academy, and I talked to the woman that we had originally talked 

to when we placed Ryan, and I presented myself as a parent that 

was looking into the program. 

I said, ‘‘I understand you have some legal issues that I have read 

about a little bit online, and I am concerned about it,’’ and her response was, ‘‘Well, that has all been taken of, and the family is 

very happy with the result,’’ and that could not have been further 

from the truth. 

So that is the information that they were telling people, if they 

were to call them and ask about my son’s death. They clearly misrepresented our position on the whole matter. 

Mrs. MCCARTHY. Thank you. 

Mr. Bacon, you mentioned earlier in your opening statement that 

you were talking about we here have a responsibility certainly for 

taking care of and looking to make sure our children are safe. One 

of the things that I was thinking of as you said it, you know, right 

now we have a mortgage crisis going on. One of the problems was 

that those that unfortunately were doing predatory lending might 

have been kicked out of the state, that did not stop them from 

going into another state and doing the same thing. 

I see that we seem to have the same case where one particular 

program was closed, reopened up into another program in another 

state. So, again, this is where data and the collection of data from 

state to state so the states would also have that information—do 

you have any comments on that? 

Mr. KUTZ. Yes. It is not just the programs moving from state to 

state. It is really the people. Because you can change the name of—

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we have seen that in a lot of the investigations we do in many different things. It is easy to start up a new entity and to shuffle the 

deck and reemerge somewhere. So that appears to be a real issue 

here. 

Mrs. MCCARTHY. I am looking forward to your second report in 

February. Appreciate it. 

I thank again everybody for their testimony. 

Mr. Chairman? 

Chairman MILLER. Mr. Kildee? 

Mr. KILDEE. Thank you, Mr. Chairman. 

Ms. Moss, you mentioned that when you get a complaint that you 

look into that complaint case by case. How many have you proceeded on case-by-case complaints? 

Ms. MOSS. Could you clarify proceeded on? 

Mr. KILDEE. Yes. You stated that when you get a complaint 

about an organization, an entity that belongs to your organization, 

that you examine that complaint and proceed on a case-by-case 

basis. That was your words. 

Ms. MOSS. Right. 

Mr. KILDEE. How many have you proceeded on? 

Ms. MOSS. As far as closing down, canceling their membership, 

sir, the two that we would have canceled their membership were 

closed prior to cancellation of the membership. 

Mr. KILDEE. So have you proceeded on any of these complaints 

case by case? 

Ms. MOSS. We did evaluate the Catherine Freer and the 

Aldredge Academy cases. There was no criminal negligence found 

and no wrongdoing found, sir. Therefore, they remained members. 

Mr. KILDEE. So there is one or two then that you have proceeded 

on a case-by-case basis about? 

Ms. MOSS. On the ones that had been reported to us, yes, sir. 

And in this case in the deaths, yes. 

Mr. KILDEE. There has only been one or two reported to you? 

Ms. MOSS. Right. On the deaths. The others that have occurred, 

sir, we have received the reports on those and also have found no 

negligence, no wrongdoing, no criminal action found. 

Mr. KILDEE. So, again, you have only received one or two complaints, and you have stated that you proceed on a case-by-case 

basis. It did not take you very long then if there is only one or two 

of those. 

Ms. MOSS. Sir, I misunderstood the question. I thought you were 

referring to the ones here in this hearing. There have been others. 

Mr. KILDEE. No. I am referring——

Ms. MOSS. Yes, sir. There have been others. I do not have the 

numbers that we have——

Mr. KILDEE. Do you have any idea about how many you have 

proceeded on a case——

Ms. MOSS. During my tenure, sir, there has probably been about 

five or six. 

Mr. KILDEE. Could you supply the records of those case-by-case 

interviews to this committee? 

Ms. MOSS. I can certainly try to do that, sir, yes. 

Mr. KILDEE. Well, I think more than try. 

Ms. MOSS. Okay. Yes, sir, I can do that. 

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Mr. KILDEE. All right. Because if we do not, Mr. Chairman, I 

would suggest that we subpoena the records then. But if you——

Ms. MOSS. I will provide them to you, sir. 

Mr. KILDEE. Thank you very much. 

Chairman MILLER. I thank the gentleman. 

Mr. Kutz, let me take you back to the Thayer Learning Center, 

if I might. Is it correct that the cause of death to date is a spider 

bite? 

Mr. KUTZ. Yes, Mr. Chairman. 

Chairman MILLER. And this is the incident which you talked 

about earlier where in reading the autopsy report and going over 

the autopsy, this was a child that was badly bruised? 

Mr. KUTZ. Thirty bruises and contusions from head to toe, yes. 

Chairman MILLER. So what is your thinking in reconciling the 

spider bite as the cause of death and what appears to be very substantial physical abuse? 

Mr. KUTZ. Well, I think there were two things going on. There 

was the abuse going on, and then there were the signs of other 

things related to the spider bite. So there was a medical issue and 

then at the same time they were misinterpreting the medical that 

he was faking it or for some other reason. So they were abusing 

him because he appeared to be lazy or appeared to not be actually 

exercising. So I think a lot of the abuse came because of the spider 

bite because he was exhibiting symptoms that, again, they misinterpreted as faking it. 

Chairman MILLER. And what is the status of that investigation? 

Mr. KUTZ. There is no ongoing investigation there that we are 

aware of. 

Chairman MILLER. What is the status of the—is it a closed case 

or——

Mr. KUTZ. There were no charges filed in that case. There was 

a civil settlement for $1 million in that case. 

Chairman MILLER. And Thayer remains open. Is that correct? 

Mr. KUTZ. Yes. 

Chairman MILLER. Well, I do not know. We will have to look at 

that. I think there is something glaring in this case, and, you 

know, I have previously asked the Justice Department to look at 

this business. They have refused, but maybe on a specific case, 

they can find new interest. When you have a child that appears, 

as you represent the autopsy, to be this badly and systematically 

abused, there has to be some other interest here. 

Mr. O’CONNELL. Mr. Chairman, if I could add something to the 

Thayer case? 

Chairman MILLER. Yes. 

Mr. O’CONNELL. We talked to the prosecutors who said there was 

not evidence to prosecute. However, the state’s family services division did find that there were patterns of neglect and abuse at 

Thayer. 

Chairman MILLER. Yes, I think, as you said, if you walked in in 

the middle of this testimony, you would think we were talking 

about human rights abuses in Third World countries. I have to believe that there is, in fact, a federal interest in this in the treatment of these children, and I think that at a minimum in a parVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00125 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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ticular case we might very well be on solid ground asking for oversight by the Justice Department of the death of that individual. 

You also mentioned, Mr. Kutz, Aldredge Academy is operating on 

federal lands. There with the Bureau of Land Management or 

what? Forest Service? Bureau of——

Mr. KUTZ. That one is Forest Service, Mr. Chairman. 

Chairman MILLER. That is Forest Service? 

Mr. KUTZ. Yes. 

Chairman MILLER. And they have been on that land how long? 

Mr. KUTZ. About 10 years, I understand. 

Chairman MILLER. My understanding is they are in arrears on 

their rent? 

Mr. KUTZ. Correct. They have not filed usage reports for, I believe, 8 years, and they will owe the federal government tens of 

thousands of dollars. So their permit is invalid basically. 

Chairman MILLER. Would that send you a signal as a trade association, Ms. Moss, that something might be amiss if people had not 

paid their rent for years? 

Ms. MOSS. Yes, sir. 

Chairman MILLER. So what have you done in that situation? 

Ms. MOSS. Haven’t paid their rent? 

Chairman MILLER. Yes. 

Ms. MOSS. For the federal land? 

Chairman MILLER. Yes. 

Ms. MOSS. We are not familiar with what programs operate on 

federal land or not, sir. So if they did not pay their membership 

dues, their membership is canceled. 

Chairman MILLER. So it is all about the membership dues? 

Ms. MOSS. No, sir, it is not. It is not. 

Chairman MILLER. Well, I am trying to figure out what else it 

is about because you cannot find any evidence of abuse, you do not 

know the financial situations. I am just trying to figure out what 

your association is about. 

Ms. MOSS. If there is findings of wrongdoing, sir, or criminal action taken or ethical violations——

Chairman MILLER. By outside organizations? 

Ms. MOSS. Yes, sir. We do not do the——

Chairman MILLER. So you do not do your own investigations? 

Ms. MOSS. We do not do our own investigations, sir. 

Chairman MILLER. You do not do your own looking at the quality 

of these organizations? 

Ms. MOSS. No, sir, we do not. 

Chairman MILLER. They essentially self-certify? 

Ms. MOSS. They are not certified by our organization. We are not 

an accrediting agency. We are not a licensing agency. 

Chairman MILLER. What the hell do you do? 

Ms. MOSS. We are a trade organization, sir, that is focused on 

improving the field of therapeutic schools and programs. 

Chairman MILLER. But, as I read your testimony, and correct me 

where I am wrong, you say that ‘‘we proceed on a case-by-case 

basis either requiring a program to implement change’’—where 

have you done that? 

Ms. MOSS. There have been ethical violations that have been 

filed with us, ethical complaints that have been filed with us. In 

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one case, there was a marketing issue that there was a 

misstatement on their Web site. We researched it, talked to them, 

and they removed that false advertising on their Web site. So they 

did make the corrective action. 

Chairman MILLER. Okay. Anything else on that Web site, on that 

marketing thing set off any bells and whistles for you? 

Ms. MOSS. I do not evaluate their marketing, sir. 

Chairman MILLER. And you have canceled memberships? 

Ms. MOSS. Counseled them, sir? 

Chairman MILLER. Canceled? 

Ms. MOSS. Yes, we have, sir. 

Chairman MILLER. For what purposes? 

Ms. MOSS. For an ethical violation. Primarily, most of the cancellations have come after they have lost their license. 

Chairman MILLER. Okay. So this would be a violation of your 

principles and best practices that you testified to in your statement? Is that what it is? 

Ms. MOSS. Yes. I am sorry, sir. I am not understanding the question. 

Chairman MILLER. Well, I am trying to figure out what the ethical violation is. Kids are dying and being abused in a rather 

wholesale fashion, and you say that there has been a cancellation 

or somebody had something wrong on their Web site and that violated the ethical standards. I just wonder where abuse of children 

falls in those ethical standards. 

Ms. MOSS. Sir, we look to the third-party investigators to advise 

us as to what actions were taken, what their findings were on 

these investigations. 

Chairman MILLER. So, essentially, you are an organization where 

these people self-certify that they will adhere to the principles of 

your best practices, which are based on 12 ethical principles which 

were formulated using the standards of the joint commission. So it 

is not like they are adhering to the joint commission. They are selfcertifying that they will adhere to 12 ethical principles that were 

formulated with those standards in mind. 

Ms. MOSS. Yes, sir, but we also require the licensure and accreditation. I have to have the license on file. We look to the states, sir, 

not to this association. 

Chairman MILLER. What kind of license do you have to have on 

file? 

Ms. MOSS. We have to have a mental health agency license on 

file or an accrediting agency which is a mental health accrediting 

agency. 

Chairman MILLER. But you——

Ms. MOSS. Those are our new membership requirements. 

Chairman MILLER. Are there schools in your program that are 

members of your trade association that do not have those requirements because they are not required by the state? 

Ms. MOSS. At this time, that is true, sir. That will not be true 

in 2009, as of January 1 of 2009. That is why we have been working so hard with——

Chairman MILLER. So, if they are not in a state that does not require this, they will no longer be eligible for membership. 

Ms. MOSS. They will no longer be eligible for membership. 

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Chairman MILLER. Do they have to have also a license from the 

Department of Education? 

Ms. MOSS. Could you state that again? 

Chairman MILLER. Some of these programs represent that they 

are also doing schooling at the same time. Do they have a license 

from the Department of Education? 

Ms. MOSS. Most of them do, sir, that do offer high school credits 

or high school diplomas, but that will on longer be accepted as an 

accreditation or a licensure within our organization. 

Chairman MILLER. Would they have to then have both? Would 

they have to have mental health and education? 

Ms. MOSS. If they offer high school credits and a high school diploma, they will have to be accredited by an academic accrediting 

body. The licensing will depend upon the state, sir. I am not familiar with all of the educational licensing, so I believe that would 

happen on a state-by-state basis. Some states require that the private schools are licensed. Others do not. 

Chairman MILLER. Mr. Kutz, what did you find in the universe 

of licensing here? Who was licensed, what were they licensed to do, 

and was it relevant to what they were doing? 

Mr. KUTZ. Some of our 10 case studies were licensed, and other 

ones—there was no licensing requirement. As I mentioned in one 

of the other earlier questions, in some cases, where there were entities who had deaths and there were violations of licensing requirements, their license was revoked in the state, but it was only after 

a death had occurred that that happened, which raises questions 

about what kind of due diligence is being done absent a death or 

significant abuse at these places. I think our broader study is probably going to look at that. 

Chairman MILLER. But let me ask you this. Are all of the licenses that they have related to their activities, or do they also 

have activities that are not licensed? 

Mr. KUTZ. There are some activities they were doing that they 

were not licensed for, yes. We did see that. I cannot remember specifics, but——

Chairman MILLER. And, again, I do not mean to hold NATSAP 

responsible for all of this activity or the industry responsible for all 

the activity, but when I look at these sites, it is very interesting. 

Sometimes they will tell you, you know, they are licensed with the 

State Department of Education, but they list a whole series of mental health treatment activities, and there is no mention of accreditation, licensing or anything, and that would not be true in 

NATSAP as of 2009. 

But what would a parent rely on? I mean, the words ‘‘accreditation’’ and ‘‘training’’ are thrown around in these marketing paragraphs. You know, you would think you were dealing with Johns 

Hopkins, okay, but you are not. But they constantly, you know, 

intersperse those words in the marketing, and so you do not know 

if ‘‘accreditation,’’ ‘‘licensing’’ pertains to the mental health services, 

to the educational services, to the medical services because it—I 

mean, they are pretty clever pieces of writing. 

Mr. KUTZ. It is very difficult. I could not have said it better than 

you just said it. I mean, it is very difficult for a parent to wade 

through this and figure out what exactly is going on, and someVerDate 0ct 09 2002 18:17 Apr 14, 2008 Jkt 000000 PO 00000 Frm 00128 Fmt 6633 Sfmt 6602 G:\DOCS\110TH\FC\110-68\38055.TXT HBUD1 PsN: DICK
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thing that might appear to be there that looks like you said, Johns 

Hopkins, or something like that, there might be nothing there. I 

mean, in some cases, the medical officer was also running the 

kitchen, and when you looked behind the medical officer, they had 

no medical training. They were not a licensed anything. So they 

were self-proclaimed, in many cases, experts in things with no credentials behind them. 

Chairman MILLER. Well, I mean, that is why I worry. Again, you 

know, I look, Ms. Moss, at your testimony that you are holding 

these people to ethical principles and so forth, and yet when you 

look at how a number of these children died—dehydration, heat exhaustion, dehydration, head trauma which was probably maybe 

caused to dehydration, loss of consciousness, dehydration, heat 

stroke, hyperthermia, another form of dehydration—you do not get 

very far in training before you tell people how dangerous and fatal 

dehydration can be, especially if you have a program that is designed to be in the desert. 

I mean, I do not get the ethical standards here or the professional standards of the training where people would not recognize 

and prevent—in fact, prevent—the dangers and the fatalities related to dehydration. I mean, this is like Care 101. 

Ms. MOSS. Sir, this is the first we have heard of the circumstances of these deaths. We will take these back to the board, 

and we will review them in depth. 

Chairman MILLER. Mr. McKeon said there is a lot of room here 

for something in terms of oversight. 

I also serve on the Resources Committee, so is the Forest Service 

looking at their arrears payment? 

Mr. KUTZ. That is something that we would refer to them, certainly. We do referrals of various things, and we will make sure 

there is an official——

Chairman MILLER. We will do a referral along with you. 

Mr. KUTZ [continuing]. Notice to them of what we identified, yes. 

Chairman MILLER. One of my concerns is, again, my experience 

with some of these organizations is, in some cases, you know, there 

is a substantial investment being made. In other cases, there is not 

much investment at all, and you are wandering around on federal 

land. We have had Conestoga wagons wandering around in the 

Southwest for a number of years, and there is really no investment, 

and when they had trouble in Arizona, they simply moved north 

into Nevada and continued their activities. So, if somebody is not 

paying their rent, bells and whistles might go off on whether they 

are paying properly trained people and skilled people to watch 

after these young people. 

Mr. KUTZ. Well, in the case here of the Forest Service, they were 

not aware that for 8 years they had not been receiving reports from 

Aldredge and that the fees had not been paid until we actually 

talked to them, and then they were like, ‘‘Oops. Looks like we have 

a problem.’’ So that raises questions—we did not look at that—on 

both sides. 

Chairman MILLER. If you knew how they treated holders on some 

federal, you would wonder what they are thinking. 

Let me stop there and see if Mr. McKeon or Mr. Kildee——

Mr. Kildee? 

126

Mr. KILDEE. Just another question to Ms. Moss. And I do look 

forward to some documentation that you will supply us as to how 

you responded on a case-by-case basis to the complaints or information you had received. But what do your members gain by joining 

NATSAP? 

Ms. MOSS. They gain continuing education with our conferences. 

They gain the journal. They gain access to others in this profession. 

They gain insight into the newest clinical studies. There are many 

clinicians in our organizations that present at our conferences. It 

is basically an education type of benefit. 

With the new research initiative, they will gain from that. They 

will be able to——

Mr. KILDEE. Not what they will, what have they. How many conferences do you have a year? 

Ms. MOSS. We have one national conference a year, and we have 

six regional conferences a year. 

Mr. KILDEE. It would seem that much of what they may gain—

and this is what I worry about—is that they may gain a certain 

credibility that to belong to, you know, this Good Housekeeping 

group. I do not think your group exactly is comparable to the Good 

Housekeeping seal of approval, but I think that can be used as an 

advertising thing, ‘‘We belong to NATSAP, and, obviously, we are 

good.’’

I think you have something to prove to this committee and to the 

American public that you are supplying more than just credibility 

to these groups that belong to you, and I worry about that. I think 

very often people see a national organization and feel it is something like the Good Housekeeping seal of approval. I think you 

have a long ways to go before you ever approach that. 

I think what I worry about is that you supply them just credibility. 

Ms. MOSS. Sir, that is why we are here asking for your help in 

state licensure and regulation. We do not want to be the Good 

Housekeeping seal of approval. We want to supply services to our 

members so that they can improve the care that they give to children and families. 

Mr. KUTZ. Congressman, could I add one thing? 

Mr. KILDEE. Yes. 

Mr. KUTZ. In the marketing materials—and, again, this is not 

NATSAP’s responsibility—these entities do market themselves as 

being members of NATSAP, and it does provide some credentials 

for them, even though they are a trade association so they are not 

really required to do due diligence necessarily. So that is something 

we saw in the marketing materials for many of our case studies 

that were NATSAP members or other members of other associations or whatever the case may be. 

Mr. KILDEE. But an organization could use that in their advertising, ‘‘We are a member of NATSAP,’’ right? 

Mr. KUTZ. They did. That is not could. They did. 

Mr. KILDEE. So it is used and it does give them a certain credibility perhaps to——

Mr. KUTZ. Someone who might not be aware of what it exactly 

means, yes. 

127

Mr. KILDEE. But it sounds good, right, that they belong to this 

national organization? 

Dr. PINTO. If I could comment because I do receive calls from 

families on a weekly basis at this point, and this point is absolutely 

what I am hearing from families, that they are having such difficulty because there is not a place that they can go on the Web 

or some kind of a clearinghouse where they can get information 

about programs, both good programs and programs of concern, and 

so they are desperately trying to make sense based on the information that is out there. 

And absolutely when you have a seal on a Web site that is the 

joint commission seal and right next to it you have a NATSAP logo 

seal, I have heard multiple parents saying, ‘‘Yes, but it is a 

NATSAP-affiliated program. It is a NATSAP-accredited program.’’ 

So, even though NATSAP says, ‘‘We are not about accreditation,’’ 

that is how parents are making sense of it. 

I am seriously concerned about the mixed messages that are 

going to families, because although NATSAP is saying that they 

are trying to help families, I do not understand why, when 

NATSAP attended a presentation that Paul Lewis, myself and several other individuals made last year at the American Psychological Association Conference, where we indicated that there were 

hundreds of reports of mistreatment and abuse in these kinds of 

facilities, after that presentation, NATSAP representatives came 

up and expressed such concern and said something very similar to 

what Ms. Moss just said when she just said, ‘‘Well, we will take 

these back to our board and review them in depth,’’ that was the 

same kind of language that we got last year. 

And what was the response? The response was the open letter 

to critics that now is on the NATSAP Web site that describes the 

concerns that we have reported in these presentations at the APA 

and elsewhere as ‘‘the noisy complaints of a few individuals.’’ So 

that is not sending a message to families that NATSAP takes these 

reports of abuse seriously, and I have not seen evidence that they 

have done anything in response to what we have made very clear 

in the presentations that we have done over the last 2 years that 

this is something that is a great concern to them. 

Mr. KILDEE. I really think we are all concerned up here. We are 

all parents up here, and I cannot imagine the pain that you parents have suffered. But really, you know, if you belong to an organization that deals with the most vulnerable in our society, the 

youth, you should be part of the solution and not part of the problem. 

Ms. MOSS. Sir, that is why we are here. 

Mr. KILDEE. After——

Ms. MOSS. We want to be a part of the solution. 

Mr. KILDEE. Go ahead. 

Ms. MOSS. We want to be a part of the solution. That is why we 

are here. 

Mr. KILDEE. I hope then if you supply us the information I requested. 

I yield back the balance of my time, Mr. Chairman. 

Chairman MILLER. Thank you. 

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Either Mr. Kutz or Ms. Clark Harvey, have there been additional 

deaths at the program since your daughter died? 

Ms. HARVEY. Yes, there were two deaths in Catherine Freer programs after Erica died, one occurred in Nevada close, I believe, in 

the same wilderness area that Erica died in, and that occurred in 

October of 2002, and then there was a death in Oregon in, I believe, March of 2003. 

Mr. KUTZ. That is correct. 

Chairman MILLER. That is correct with the information you 

have? 

Mr. KUTZ. Yes. 

Chairman MILLER. Again, I mean, this is not to make this 

NATSAP’s problem, but you have five out of 10 deaths here that 

are facilities that belong to your organization. Two of the five have 

been closed. One has had additional deaths since Erica Harvey. I 

mean, this is like Casa Blanca. You are shocked that gambling is 

going on here. 

Something is very wrong inside a trade organization—you know, 

one of the things trade organizations have to decide is you have to 

get rid of the frauds, and if you want to survive, and somehow 

something is wrong here in the review or the applications or the 

self-certification or something that people can bring this kind of 

history and just continue on. 

Now maybe that is fine. You are obviously making a determination or you are leading this committee to believe you are making 

changes, but I just say that there is, you know, a period of years 

here when somebody was asleep at the switch here. 

You know, I appreciate the three testimonies that were attached, 

Ms. Moss, to your testimony, three statements by people who had 

been through different programs, and their success, and that is 

what every parent would wish for. I find that terribly interesting, 

but not terribly relevant because that would be the expectation of 

people who signed up for these programs. 

That would be their hope, not that every kid is going to come 

back successful as they have cited—they have gone on with their 

lives, they have become productive, and they have done those 

things—but that your child would get treatment. At a minimum, 

you would expect them to be safely kept while they were in care, 

and that minimum was breached here time and time and time—

in fact, thousands of times that that has been breached by people 

taking care of these children. 

So I guess that, you know, we are here when things go terribly 

wrong, and I think Dr. Pinto has pointed out being subjected to 

this, people do not lightly disgorge others that they were abused or 

that they could not cut it or they could not do these things, and 

so I think to have people come back now in the numbers that they 

have and talk about it, this cannot be dismissed as noise. 

Ms. MOSS. No, sir, it cannot be dismissed as noise, and I agree 

with that. NATSAP would benefit from a clearinghouse of information as much as a parent and family would. We do not want to be 

the Good Housekeeping seal of approval. We do want to raise the 

bar in the industry. We are a young organization learning as we 

are going. We have made mistakes in the past. We recognize that. 

129

Chairman MILLER. There is some duty of care here, which I 

think you are missing. 

Ms. MOSS. Absolutely, sir. I agree with that. 

Chairman MILLER. I think you are missing it, with all due respect. You can decide for the moment, but I think you are missing 

it. There is some duty of care here, ‘‘as a trade organization,’’ about 

what happens in your name. 

Ms. MOSS. I will take that back to the board, sir, very definitely. 

Chairman MILLER. It is going to be a very busy board. You are 

taking things back that——

Ms. MOSS. Yes, sir. Very busy. 

Chairman MILLER. Thank you for doing that. 

Dr. Pinto, you raised the question. I am trying to figure out what 

it means, when these are individuals who have gone through the 

program, for them to come forward, and what weight we give that. 

Dr. PINTO. Again, I think it is easy for people to presume that 

there must be something wrong with these young adults, you know, 

‘‘Well, they were troubled teens to begin with, so they are probably 

just still messed up, and that is why they are describing this and 

they have it. They are trying to get the programs.’’

However, if you read the accounts—and I was really surprised 

when we created this online survey with over a hundred questions 

and many free response opportunities—it is over a thousand pages. 

Just trying to print out all of the responses that came back—this 

is definitely a group of folks who have not had an opportunity to 

speak to their experience, and when you read the accounts, when 

you hear what people have to say, there really is a level of detail 

and coherence to their accounts—any given account—but then also 

across accounts that makes it clear that there is a phenomenon occurring, a phenomenon of mistreatment and abuse. 

And it is not the case that everybody is experiencing this, but it 

is the case that there are far more than just a few cases, and, 

again, if we heard this from a teenager who was in their own home 

or in a public school or in a licensed mental health care facility, 

immediately, there would be a response and it would be an investigation to ensure that that just did not go overlooked, and that is 

not happening at this point. 

Chairman MILLER. In fact, there is an affirmative duty to report. 

Dr. PINTO. Absolutely. In fact, I am a licensed psychologist, and 

as such, I am a mandated reporter of suspected child abuse, and 

when I first started getting these reports, I thought, ‘‘My gosh, as 

a mandated reporter, I need to follow up with this.’’

So I called several states’ suspected child-abuse-hotlines, and I 

described the situation to them, and they said, ‘‘Well, can you give 

us the name of the particular staff member who was the one to 

conduct this suspected abuse?’’ And I said, ‘‘Well, no, but I can give 

you the name of the program.’’ And they said, ‘‘If you cannot give 

us the name of the individual, then it needs to go to the agency 

at the state level that monitors those kinds of programs. We cannot 

take a report unless you give us the name of the individual.’’

But then when I would call those agencies, Department of Education, Department of Health and Human Services, in the given 

state, they would say, ‘‘Well, we do not have any authority over 

130

those kinds of programs.’’ And so it is a complete black hole at this 

point. 

Chairman MILLER. Well, thank you very much. And I think that 

is a problem also that exists between public programs. I mean, that 

is one of the reason I fought very hard over the years to return 

children to their own states because once you have crossed the 

state line, one, whether you have any authority and, two, getting 

other people to respond, it just becomes a huge barrier, and our 

states now have changed the law so the kids are placed differently 

now than they were 20 years ago, 15 years ago with kids’ placement. 

Carolyn, do you have additional questions? 

Mrs. MCCARTHY. Actually, she just answered it because we are 

giving federal money to the states, and yet they do not seem to 

have any control over what that money is doing as far as these residential programs. So that might be an area we will look into. 

Chairman MILLER. Let me follow up on that, Mr. Kutz, if I 

might. You were not looking at the question of whether there is 

federal money for some of these programs. Do you have any sense 

of—you know, we have IV-B maintenance money for children, outof-home placements and foster care and whatever. We know in the 

past some out-of-state placements were made with IV-B money. We 

have juvenile justice money that goes to placement. I do not know 

whether some of these contract with school districts to receive 

funding within their state or not. Is there any reason to suspect 

that there is some federal involvement in the placement of—I 

mean, federal dollars? 

Mr. KUTZ. Not in the cases we looked at. 

Chairman MILLER. Not in the cases——

Mr. KUTZ. They were funded primarily by parents, and in one case, health insurance paid for maybe $10,000 of the fees. 

Chairman MILLER. So, as far as you can tell, they are operating 

essentially on a tuition——

Mr. KUTZ. Yes. 

Chairman MILLER [continuing]. Payment by parents. 

Dr. PINTO. If I could add to that just briefly, I do—if that is 

okay? 

Chairman MILLER. Yes. 

Dr. PINTO. It does seem like primarily the parents I have spoken 

to are paying out of pocket as well. However, there are times where 

a family makes a case, for instance through their IEP, that the 

publicly available programs or the nonpublic schools that are part 

of that district’s list of available services are not a good fit for their 

child and they advocate to have their child sent to one of these 

kinds of private programs, and there are districts, I do recall from 

my clinical work in California, where that does occur, and therapeutic boarding schools are paid for through the IEP process. 

Chairman MILLER. Thank you. 

Mrs. MCCARTHY. Mr. Chairman? 

Chairman MILLER. Yes? 

Mrs. MCCARTHY. May I follow up with a question? 

Chairman MILLER. Yes. 

Mrs. MCCARTHY. As we have heard all the testimonies, especially 

the data areas where I would like to see if we can concentrate that 

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in the future if we do legislation, right now, apparently, HHS does 

have money that is given to the National Child Abuse and Neglect 

Data System. With what we see, where do you think is—some 

states will call the child abuse centers. Some will call the state 

agencies. As we go forward, what would be the best area to collect 

the data and not have several agencies go through it, but one agency so it is a better clearinghouse and not a confusion to parents 

when they need to know that data? Do you have any idea, or does 

that come in the next study? 

Mr. KUTZ. No, but the data that was collected nationally was a 

self-reporting, so it is more than likely very incomplete. There were 

30-some states, I think, that reported, not that every state has 

these programs. I do not know whether they do or do not, but, certainly, some central reliable repository would be useful, whether it 

is at the federal level or not. I mean, maybe from a reporting 

standpoint, that would make the most sense. States could report to 

the federal government. But, again, that current database that was 

used—that is why we cannot say how many thousand or whatever—was self-reporting. 

Mrs. MCCARTHY. Okay. 

And, Ms. Moss, just to finish off with one thing. One thing I have 

learned since being here in Congress—I also sit on Financial Services—is when a trade organization puts their name out and gives 

the seal of approval of a corporation or an entity that they are supporting, the only thing they have is their reputation, and if you are 

supporting that reputation, those clients or family members usually will look at that and think that you have already done the investigation. So, whether it is your fault or not, I think you need 

to look at your organization and maybe possibly decide that you 

might be doing some of your own investigation if you want to keep 

your reputation. 

With that, I yield back. 

Chairman MILLER. Thank you. 

Any further questions? 

Well, let me thank all of you for your time and your testimony 

and your expertise in this area. I think it has been very helpful to 

us. 

Mr. McKeon and I will put our heads together and think where 

we go from here. We have a follow-on study from GAO, and, as you 

can see, there is considerable interest by the members of the committee that we somehow get a handle on what is taking place here 

and get about trying to keep it from happening. We will have to 

figure out what the right vehicle is, but we will figure that out, I 

want to tell you that, and with your help. I hope that you will continue to stay involved with us. 

To the family members, thank you for your testimony. I know 

this was not easy for you, and thank you, though, for sharing it 

with us. 

And, Ms. Moss, Dr. Pinto, thank you for your expertise. 

And, Mr. Kutz, and Mr. O’Connell, I know this was not an easy 

study for you to do, but we appreciate it and appreciate your frankness in dealing with the committee. 

Members will have the ability to submit statements for the next 

14 days. 

132

And with that, the committee will stand adjourned. 

Thank you again. 

[The statement of Mr. Altmire follows:]

Prepared Statement of Hon. Jason Altmire, a Representative in Congress 

From the State of Pennsylvania 

Thank you, Mr. Chairman, for holding this hearing on cases of child neglect and 

abuse at residential treatment facilities. 

Hundreds of residential treatment facilities operate throughout the United States. 

These facilities typically serve children with severe emotional and behavioral issues, 

however, vary greatly both in the needs addressed and in the interventions used. 

Currently, there is no federal law that specifically addresses residential treatment 

facilities. Most of the regulation for these facilities is at the state level, each with 

their own way of licensing and monitoring residential treatment facilities, and some 

with no regulation at all. 

Today, we will hear from three parents whose children were subject to abuse and 

neglect at residential treatment facilities. The outcome in each of these cases was 

the worst imaginable, the death of the child. I want to thank all of you for testifying 

today and extend my condolences for your loss. 

Thank you again, Mr. Chairman, for holding this important hearing. I yield back 

the balance of my time. 

[Statement for the record from the Alliance for the Safe, Therapeutic, and Appropriate Use of Residential Treatment (ASTART) 

follow:]

October 24, 2007. 

Hon. GEORGE MILLER, Chairman, 

Committee on Education and Labor, Rayburn House Office Building, Washington, 

DC. 

Dear Chairman Miller: I am writing to thank you, your staff, and the entire Committee on Education and Labor for conducting the investigative hearing on ‘‘Child 

Neglect and Abuse in Private Residential Facilities.’’ This is a very important and 

serious issue that deserves attention at a federal level, and I am delighted that you 

and your Committee are giving it the attention it deserves. 

I am a psychologist at the University of South Florida who specializes in children’s mental health. About three years ago, after hearing both from media people 

and parents about this problem, I began doing some research to try to understand 

its scope. I was struck then by how little is known about the problem, and how silent my mental health colleagues have been about it, despite fairly widespread coverage in the general media. 

In response both to the seriousness of the problem of abuse, neglect, and exploitation within private residential facilities, and the absence of voices within the mental health field that were speaking up about it, I invited several colleagues to join 

me in deciding how we can best help address it. We formed a small group called 

the ‘‘Alliance for the Safe, Therapeutic, and Appropriate Use of Residential Treatment’’ (A START—http://astart.fmhi.usf.edu) 

Our group held a press briefing, with the support of your office, in Washington 

about two years ago, has been involved in several research and public education efforts, and has prepared some of the first professional articles about this troubling 

problem. One of our members, Dr. Allison Pinto, provided testimony as part of your 

hearings. 

We have found that the abusive practices are most likely to occur in for-profit, 

unlicensed, and unregulated facilities. Although it certainly does occur as well in licensed and non-profit programs, the most serious problems of abuse and misleading 

marketing occur in the for-profit and unlicensed sector. 

We recognize that there is a role for high quality, responsible residential care 

within a children’s mental health system, but we believe strongly that there must 

be proper licensing, regulation, and accreditation in order to increase the likelihood 

that youth will be kept safe and will be provided with effective services. We believe 

that proper licensing, regulation, and accreditation will only serve to improve the 

quality of programs, and will be of benefit to all. We do worry, however, that if licensing is not accompanied by adequate monitoring and regulation, it can give the 

appearance of credibility to programs that do not deserve it, and so we would 

133

strongly support any proposal to provide resources to help ensure that there is 

strong monitoring and regulation to accompany licensing laws. 

We believe that it is unconscionable that within our country there is no systematic data collection to tell us how many children are served in residential programs 

each year, or even how many die or are seriously injured in such programs. We believe that such data collection is essential to allow us to understand the scope of 

the situation, track it over time, and develop sound policy to provide appropriate 

care for youth while at the same time protecting them from abuse and their families 

from exploitation. 

We recognize that there are many families who are desperate for help, and that 

this desperation is partly due to the absence of adequate services in their own communities, the stigma that is attached to mental health issues, and the lack of information for parents and professionals about just what is available. We would strongly encourage any effort to strengthen community systems of care for children with 

special mental health challenge and their families, and to provide families and professionals with access to complete and accurate information about alternatives that 

are available to them. 

We also have spoken to parents and youth who describe situations that are clearly 

not serious enough to merit residential placement. However, it has been reported 

to us that when parents make inquiry about services, the programs often create a 

sense of heightened desperation in order to generate an immediate referral. At this 

point it is not possible to know how many youth within these programs are genuinely experiencing a serious challenge, and how many have ended up there because 

programs have created a sense of unwarranted crisis in their parents. 

Our A START group is more than happy to assist you and the Committee in any 

way that we can. We include mental health professionals from a variety of disciplines, former staff of programs, young adults who were formerly in one or more 

of these programs, parents, and advocates. We have prepared a summary of the 

hearings and the accompanying GAO report and are circulating this widely through 

our own networks in order to better educate professionals and the general public 

about this problem. I am enclosing a copy of that summary for you. 

Thank you again for your outstanding leadership on this issue. It is clearly a reflection on our society that we allow our youth to be exposed to such cruel treatment 

rather than providing them and their families with more humane, supportive, and 

effective interventions. 

Respectfully, 

ROBERT M. FRIEDMAN, PH.D., 

Professor. 

Statement of Alliance for the Safe, Therapeutic, and Appropriate Use of 

Residential Treatment (ASTART) 

Now is the time to stop using violence, abuse, isolation, and fear tactics to adolescents whose family and friends want them to get better. Now is the time to prevent 

death and trauma in the name of a place to get better. Now is the time to provide 

systems of care that will help the youth with drug, alcohol, eating disorders, mental 

health issues and behavior problems with proven therapies that protect the youth’s 

human rights and work to repair family units. 

We are here today to ask your help to stop physical and emotional abuse, and 

even preventable deaths, in places that promise to ‘‘turn kids with behavioral difficulties around.’’ All over this country, there are young people being held against 

their wills and coerced to do and say self destructive things simply to survive. We 

are speaking of abuse and neglect in programs across the USA, and in programs 

around the world with US ownership. Even the families of those abused youth are 

often dragged into unbeneficial and coerced involvement, in efforts to salvage hope 

for their children’s future. The abuse and neglect must be stopped at these facilities! 

It is a great honor to be a citizen of a nation that provides for our elected leaders 

to call for independent investigations by the Government Accounting Office when a 

member of Congress believes those he or she represents are not being appropriately 

protected under the U.S. Constitution. This hearing by the U.S. House Education 

and Labor Committee is welcomed by those of us who have been working so hard 

to bring awareness and justice to the youth and families who struggle to find effective help. 

Thank you for your leadership and making this hearing happen. 

In the fall of 2004 a parent asked my aid in getting her son out of a facility in 

another state that she believed was hurting him. This boy was put in an orange 

jump suit, stripped of his shoes and the medication his psychiatrist had prescribed, 

134

locked in a dorm at night with no adult supervision. His mail was censored and he 

was not allowed contact with his parent until those who had done these things to 

him thought it was time. He was constantly shadowed within three feet by another 

youth, and denied access to a library, or the use of his musical instrument. All the 

while this boy and his family were being made promises that were rarely kept. The 

cost to the boy’s grandparents was $85,000 over 12 months. The professional counselor, who had been working with their grandson in his home city, suggested a place 

out of state that he said he, ‘‘didn’t think this one is as harmful as some’’ and it 

has a school attached to the drug and alcohol classes. But he had never been there 

and didn’t actually know about it personally. While he was in that place the boy 

was taught to blindly follow orders and was punished for speaking out. Now, he is 

finding it difficult to be independent and think for himself. The trained and experienced professionals I’ve talked with are genuinely amazed that places like this, pretending to do good for the young people under their care, could be so abusive. 

I too was amazed, but also enraged, because I had spent my adult life working 

to build systems of care in the United States that would help youth and their families cope with mental health challenges. As a Mental Health Assoc executive director, child advocate and educator, I have visited many of the psychiatric hospitals, 

group homes and day treatment programs in the US and Japan, and have seen effective care. For over 20 years I have served as a member and chair of the advisory 

board for the Research and Training Center for Children’s Mental Health at the 

University of S. FL and turned to my colleagues for help. Our action was to form 

the Alliance for the Safe, therapeutic, and Appropriate Use of Residential Treatment, (A START). We have spent the past two years studying, investigating and 

asking for help to educate families and authorities about this billion dollar industry. 

We wrote guidelines for families and set up a website (http://astart.fmhi.usf.edu). 

I worked with another non-custodial family member to help her daughter get out 

of a licensed facility that believed in five-point restraint, and isolation, where employees called the girl a whore when she wouldn’t admit to things that didn’t happen to her and prevented her from speaking to her mother when they learned of 

her mother’s efforts to get her out. She spent 7 months there and the cost was in 

excess of $100,000. The place now calls for a $17,000 deposit for new admissions. 

This place told the parents not to believe anything their child said as the child 

would be lying and manipulating their family. The family used all their savings for 

attorney fees to free her and has become bitter and untrusting of the judicial system. They asked me to spread this message: ‘‘Do not to take someone’s word that 

it is a good place or has a high rate of success.’’ The parents told me the place just 

trampled all over the child and families rights’’ They too ask, ‘‘where is the proof 

that violence, restraint, and seclusion works’’? 

Another mom is fighting for her son to get out of an abusive state run facility. 

When she asked for his medication for severe bi-polar disorder to be given back to 

him, she was given a choice in court to serve 3-8 hour days of community service 

or 10 days in jail, and a gag-ordered against talking about the program or questioning the juvenile justice system. The judge said to the mom ‘‘You are not the parent anymore, I am.’’ Please help us stop these injustices. 

As a child and family advocate I often speak out for those who can’t speak for 

themselves. The families and youth who face serious decisions about selecting services for helping the young persons to change their behaviors, need assurances that 

they will have options for safe, high quality and effective treatment NOT exploitation, abuse, mistreatment, and even death. They deserve child centered and family focused services that are based on the individual youth’s needs and provided by 

properly trained professionals. Many parents have reported feeling desperate and 

that the sense of urgency in their situation makes them settle for less. Many parents are also paying huge sums of money for escort services to transport the child 

from their home in handcuffs and for substandard solutions that further alienate 

them from their child. The marketing brochures for these facilities don’t match with 

reality. When our youth go to get their hair, nails done, or teeth cared for the technician is licensed and trained by law. Why isn’t all the staff in residential facilities 

also required to be licensed, regulated, and monitored, and overseen so they are prevented from abusing their customers, especially in those misguided times when they 

appear to believe abuse is appropriate treatment? 

For our youth and our families I and others like me will continue to advocate for 

safe and appropriate programs. We ask your help in our efforts. We need your help 

to prevent even one youth from being snatched out of their bed and transported to 

a place of harm. Please help us prevent more death and life long suffering for youth 

and families who need help not abuse. Our youth deserve just and appropriate care. 

Thank you. 

135


astart-1.eps
136


astart-2.eps
137


astart-3.eps
138

[Whereupon, at 1:27 p.m., the committee was adjourned.]

Æ


astart-4.eps