Totalistic Programs for Youth

A Thematic Analysis of Retrospective Accounts

Abstract

Recent annual estimates suggest that in the United States, approximately 57,000 young people are placed by their parents into some type of residential treatment program. Parent – pay programs are exempt from federal safety standards and some states provide little or no regulatory oversight. Federal investigations revealed a nationwide pattern of institutional abuse across multiple facilities, and some professionals have noted ‘cruel and dangerous uses of thought reform techniques’ within such programs (U.S. House of Representatives 2007, 76). This article summarizes qualitative research based on interviews with 30 adults who lived for an average of 20 months within a ‘highly totalistic’ youth program. The concept of totalistic treatment was operationalized and measured with seven key identifiers found in the literature. Twenty – five different programs of four general types were represented: therapeutic boarding schools, residential treatment centers, wilderness/outdoor programs, and intensive outpatient programs. To organize qualitative findings, three themes explaining the experiences, immediate effects, and long – term impacts of treatment help to reveal implicit meanings woven throughout the interviews. By understanding a wider range of experiences associated with totalistic programs, efforts to improve quality of care and strategies to prevent harm may be improved. Harm prevention efforts would benefit from the analytical perspectives found in theories of coercive persuasion and thought reform.