Over the past several years, a powerful wave of truth-telling has emerged from adults who once lived through the harsh realities of the so-called “troubled teen industry.” Survivors have courageously shared stories of coercion, neglect, and abuse—often beginning with midnight transports, followed by long periods in programs where they felt stripped of autonomy, safety, and voice.
High-profile advocacy from individuals like Paris Hilton, whose 2020 documentary This Is Paris exposed the trauma she endured at a Utah residential facility, has helped bring long-silenced voices into public discourse. In her testimony before Congress in 2021, Hilton declared:
“My name is Paris Hilton, and I am an institutional abuse survivor.”
She echoed what many others have bravely stated: that their experiences were not therapeutic, but traumatic.
This collective awakening is not only valid—it is vital. The field of adolescent treatment must face these truths with humility, accountability, and a willingness to transform. At Heather R. Hayes & Associates, we believe that real healing begins when we acknowledge harm, listen with respect, and commit to creating something better.
Listening to Survivors: Truth as the First Step Toward Change
Survivors are not “disgruntled clients”—they are truth-tellers. Their accounts align with documented patterns of abuse across parts of the teen treatment industry, including:
- Physical restraint and isolation as behavior control
- Involuntary transport under duress
- Shaming and humiliation as therapeutic “tools”
- Lack of trained, licensed clinical staff
- Severed family contact with little transparency
Academic research and investigative journalism support these reports. Maia Szalavitz’s Help at Any Cost (2006) was among the first to document the dangerous practices in many tough-love programs. More recently, organizations like Breaking Code Silence have amplified the voices of thousands of survivors calling for reform.
Not All Treatment is Harmful: The Nuance We Need
In the movement toward reform, it is critical to hold space for both accountability and nuance. While some programs have caused deep harm, others—rooted in clinical excellence, ethical leadership, and trauma-responsive care—have profoundly helped adolescents and families heal.
The danger lies in overgeneralization. Dismissing all residential or therapeutic programs based on the failures of some ignores the complexity of adolescent mental health, addiction, and trauma. There are young people today facing life-threatening issues—including substance use, suicidality, and eating disorders—who genuinely need structured, relational, and therapeutic environments.
The solution is not to throw out treatment, but to reimagine and re-regulate it in ways that prioritize:
- Respect for human dignity
- Clinical oversight by licensed professionals
- Family system inclusion and transparency
- Trauma-informed, developmentally appropriate care
- Voluntary engagement wherever possible
The Transport Issue: A Call for Reform, Not Abandonment
One of the most frequently cited harms is the method of adolescent transport, often involving children being woken up in the night by strangers, forcibly removed from their beds, and flown to treatment programs without prior consent. This practice has left deep emotional scars and fostered mistrust in the entire system.
It is possible—and essential—to do this differently.
Our team has developed the Respectful Adolescent Transport Protocol™ (RATP) and Trauma-Responsive Therapeutic Transport™ model, grounded in the work of trauma experts such as Bessel van der Kolk (2014), Bruce Perry (2021), and Stephen Porges (2011). These models focus on safety, transparency, emotional regulation, and relational connection, not fear or control.
Toward Ethical Adolescent Treatment: A Shared Vision
If we are to learn from the past, we must commit to the following principles:
Survivor-Centered Accountability
- Listen to and learn from those who have experienced harm
- Invite survivor voices into policy and program reform discussions
- Support transparency and third-party oversight
Trauma-Responsive Systems
- Embed trauma theory into every level of care
- Eliminate coercive practices, including forced silence, restraint-as-discipline, and shaming
Clinical Integrity and Ethical Oversight
- Require licensed clinicians on staff
- Monitor program quality through rigorous, independent evaluation
- Ban untrained or unregulated “wilderness” or “boot camp” models
Family Inclusion and Education
- Involve families in treatment planning
- Teach relational repair, healthy boundaries, and emotional attunement
- Offer aftercare that supports reintegration and long-term growth
Cultural Humility and Equity
- Recognize and address racial, cultural, and LGBTQ+ disparities in adolescent mental health treatment
- Avoid one-size-fits-all approaches that ignore identity, trauma history, or neurodiversity
From Industry to Integrity
The “troubled teen industry” is not simply broken—it is in need of moral repair. But it can be done. Ethical treatment providers, survivor advocates, clinicians, families, and young people themselves must come together, not in defensiveness, but in dialogue.
There is a way forward that acknowledges the pain of the past while building systems that protect, uplift, and heal. We are proud to be among those who lead with courage, compassion, and a commitment to ensuring that no young person is ever harmed in the name of help again.
Sources:
- Bowlby, J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human Development. Basic Books.
- van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin.
- Perry, B. D., & Winfrey, O. (2021). What Happened to You?: Conversations on Trauma, Resilience, and Healing. Flatiron Books.
- Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-regulation. Norton.
- Herman, J. L. (1992). Trauma and Recovery. Basic Books.
- Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.
- Szalavitz, M. (2006). Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids. Riverhead Books.
- Breaking Code Silence. (n.d.). Retrieved from https://www.breakingcodesilence.org
- Hilton, P. (2020). This Is Paris [Documentary]. YouTube Originals
