How Effective Are Tactics Used on TV Shows to Treat Troubled Teens?

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Terrifying teens by making them lie in coffins, forcing them to spend a night on a frigid street or a bare prison cell— these harsh measures are used in reality shows in an attempt to put delinquents back on the straight and narrow.  But the strategies may make for better TV than treatment.

On A&E’s Beyond Scared Straight and Lifetime’s Teen Trouble, producers document some extreme methods to address adolescents who act out. The shows intend to educate while entertaining, and some of the tough love strategies certainly make for riveting TV. But unfortunately, decades of research show that such extreme measures are at best ineffective and at worst, harmful.

Take Scared Straight, a strategy that is supposed to deter juvenile delinquents from a life of crime by briefly placing them in adult prisons, where hardened prisoners confront them with the brutal realities of incarceration. A documentary on the original initiative, founded at Rahway Prison in New Jersey, won an Oscar in 1978.  A&E’s Beyond Scared Straight, now in its third season, follows teens through such programs, zooming in as inmates literally get in the teens’ faces and attempt to break them emotionally.

(MORE: Why Juvenile Detention Makes Teens Worse)

It’s not like there’s a shortage of data or any scientific controversy over Scared Straight’s actual results.  In fact, a Cochrane review — the gold standard for evidence-based medicine — concluded that kids sent to Scared Straight were 68-71% more likely to commit crimes than those randomized to receive no intervention at all.

Teen Trouble’s approach is similarly problematic.  Most of the adolescents who appear on the show have drug problems and some have mental illnesses like depression, but are not given treatment proven to work for these conditions. Instead, Teen Trouble relies on inducing fear through confrontation, supposedly to show teens the potential consequences of their actions: disfigurement, disability, homelessness, death.

In one episode, for example, a girl is forced to lie down in a coffin and touch dead bodies; in another, a boy is put in casts and a wheelchair.  A third episode includes a “make over” where a teen girl’s face appears covered with scabs and sores; another sees a young woman spend a winter night on the streets with the homeless. Afterward, many of the teens are sent to tough wilderness or “emotional growth” boarding schools.

(MORE: Does Teen Drug Rehab Cure Addiction or Create It?)

“Time and time again, research finds these approaches to be innocuous at best and traumatizing at worst,” says John Norcross, professor of psychology at the University of Scranton who studies the effectiveness of psychological treatments.

A 2007 review [PDF] of the literature on tough-love or confrontational strategies to deal with drug problems concluded “Four decades of research have failed to yield a single clinical trial showing efficacy of confrontational counseling, whereas a number have documented harmful effects, particularly for more vulnerable populations.” Teens are one such susceptible group.

Studies on virtually all of the tactics seen on Beyond Scared Straight — from getting in people’s faces and screaming at them, to forcing them to view videos of themselves filmed when they were intoxicated— showed that these tactics have either no effects or negative ones on teens’ behavior.  One study revealed that the more a counselor confronts an alcoholic, the more he or she later drinks.

Nonetheless, Josh Shipp, the host of Teen Trouble— who has no credentials in psychology or addiction treatment and relies on an unnamed group of experts to approve his extreme interventions — continuously relies on such confrontational tactics.  The show also sends teens to programs with questionable oversight that use unproven techniques.

(MORE: An Oregon School for Troubled Teens Is Under Scrutiny)

In one episode, for instance, he ships off a 16-year-old girl with a drinking problem to a program called Axios Youth Community.  Several weeks after the show was taped, the program was shuttered following allegations that an employee had sexually molested a 13-year-old girl. In another episode, a 16-year-old girl who was injecting heroin was sent to a “therapeutic boarding school,” Copper Canyon Academy,  which claims to help troubled girls but is not a specialized center for treating teens with the most serious addictions.

The mother of a former student at Copper Canyon recently told the New York Post that while she’d expected a “top notch boarding school,” instead the program turned out to be a “Nazi concentration camp.”  Former students interviewed by the Post describe confrontational and humiliating tactics, such as being made to re-enact traumatic experiences, including rape, in front of their classmates.

The program at Copper Canyon, which costs $6,000 to $8000 a month, waives its tuition for Teen Trouble participants in order to be promoted by Shipp.  For licensed professionals, such an arrangement might be barred by ethical guidelines, which warn against “dual relationships” that could lead to a referral that is not in the best interest of the patient (in this case the teen), but in the interests of the contracting parties (the show and the treatment program).

Copper Canyon has denied the abuse allegations in a statement to the Post, saying “The reality is that our students come to us dealing with a variety of behavioral health and addiction issues, at varying levels of severity… We offer them a structured and nurturing treatment environment with professional staff who specialize in working with adolescent girls.”

(MORE: Treating Addiction: A Top Doc Explains Why Kind Love Beats Tough Love)

Copper Canyon is part of a network of teen programs run by Aspen Education, which also operated a school known as Mount Bachelor Academy in Oregon.  TIME reported on Mount Bachelor’s use of similar tactics in 2009:  they included forcing girls who had survived rape or sexual abuse to do lap dances and participate in other sexualized role play.  The exposé helped spur a state investigation ultimately resulting in the school’s closure.  Aspen maintains that there was no wrongdoing but Oregon’s investigators said that they had “reasonable cause to believe that abuse or neglect had occurred.”

Now, teens and parents who say they were harmed by these programs are protesting Teen Trouble, creating an online petition to have it taken off the air and a website devoted to detailing problems with the show and with the programs in which Shipp enrolls adolescents.

Says Norcross, “The real process of psychotherapy tends to be slow, laborious and uninteresting to the external observer. It would be such boring TV, I appreciate that. While [producers] may protest, ‘No, we care about the kids,’ their behavior belies those public statements.” If they really cared, he says, “they would only select treatments for which we have scientific evidence of safety and effectiveness. Instead they do the exact opposite and focus on highly dramatic and largely discredited practices.”

(MORE: Viewpoint: Why Tough-Love Rehab Won’t Die)

TIME tried to reach A&E for comment, but did not receive a response. Of the 19 teens who appeared on Beyond Scared Straight and are not still in restricted environments like military school, the show’s website reports that at least 9 continued in sustained misbehavior, which mainly involved frequent marijuana use but also includes a teen who is in prison for robbery, one who was arrested for gun possession and another who was hospitalized for an overdose.

While dramatic confrontation may be entertaining, it is not therapeutic. Experts say shows like these that rely on discredited or questionable therapies legitimizes those who sell outdated and harmful treatments and could ultimately undermine the progress of evidence-based care to help teens with substance abuse or behavior problems get better.


I’m impressed, I have to admit. Seldom do I come across a blog that’s both equally educative and entertaining, and let me tell you, you have hit the nail on the head. The issue is something too few people are speaking intelligently about. Now i'm very happy I stumbled across this in my hunt for something regarding this.

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As a former resident of Island View Residential Treatment Center and the Aspen Achievement Academy wilderness program I am also weary of the use of these extreme measures. What is most concerning is that these adolescents are at an age where it likely is difficult for them to understand the future consequences of having these issues broadcast on live TV. Not only that but these teens are agreeing to do so while in a dire state, suffering from drug addiction, depression, and dealing with other mental and emotional issues. More than a decade later, I still have nightmares about the terror I experienced at Island View. This program used similar tactics from using restraints on teens that refused to sit in a chair for days on end to having girls wear inappropriate clothing to school to "work on" issues with promiscuity. As a successful adult, I would be devastated if those recollections of a time when I myself was in a dire state were available for the world to see. It is time that regulations be put in place to stop this kind of child abuse. 


These shows are child abuse and the sick people who make them need to be screamed at and lets see how they like it. I watched one episode so I could see how bad it was. IT "S TERRIBLE. PLease lets all call and complain to A & E. 


I think that there is a destitution of images of female centric life, as men have relied on robots to start fulfilling their needs in a mad scheme for power while women are seen as child bearing from 12-25 and death is the best result thereafter, if they are not killed at birth, there are probably more males on the planet, and although this is never outright stated, you can see that humans primarily kill mammals. There is an idiocy in the belief of sure hypothesis outside of time tested basic knowledge of children. When people start to realize that they are never touched softly, that they cannot think--the rage has always started protests over christ figures, and most people are tired of messups and then movements, that is not democracy, democracy is a conversation, life is taken so seriously with no good intelligence of the superstructure, we are telepathic, this is not the only world.


These tactics are abuse just like our drug laws are abuse. 

You have to abuse people to make people accept abusive laws. 

The drug laws are a crime against humanity and shows like this are no less than that. 

End the drug war and stop abusing the community and drug abuse and criminal and domestic violence will significantly decrease along with a whole  host of other problems. 

Legalize drugs, get the police out of health care and stop these bullies from abusing people.


I would respectfully submit that the strategy employed in 'Scared Straight' would be exceedingly effective if the participants were from affluent-upper middle class-middle class families. In other words, most of the participants profiled in these shows are going to end up in prison regardless of treatment, education or such "shock value" programs. These are the bad apples from disproportionately crime-inclined families on account of their socio-economic strata that they were born into, e.g., the "cool" kids become enmeshed in the local gang. On the other hand, "at risk" children from the other side of train tracks could materially benefit from such experiences for self-evident reasons. This should be carefully considered. 

"Humankind...can not bear very much reality." - TS Eliot


Having gone through outdated treatment practices that harm far more than help, I get sick to my stomach every time I see one of these shows that portrays the same old simplistic mentality of fixing kids by inducing a dramatic or emotional response. 

Ratings and profits take precedence over the welfare of kids on these shows. Every time someone like Josh Shipp gives the impression to be some divine "teen help" guru, it reinforces the notion that these practices are effective and acceptable. These shows effectively misinform the viewership and purport the false paradigm that "tough love" and "confrontational therapy" are successful treatment models. 

As usual I love the investigation, the science, the data and references. I only wish we had proper regulations to protect unwitting viewers from this nonsense. 


I do find BSS entertaining but after last nights episode where the guards let those inmates into cells where they destroyed the kids belongs, attacked them, and threatened them-- I was just pissed off. More so at the little boys whose mother sent him there because he has anger issues and so he attacked a kid for picking on him. If he has an anger issue get him help not have a convicted felon yelling in his face about how they're going to get him good. 


You don't need a weatherman to tell you which way the wind is blowing - though as survivors of these horrible  RTC's we need people like Maia to help make sure no one goes thru what some of us did as children.

survivor of Elan Corporation, Poland Springs, Maine  '74 to '76.


Incredible article, as usual, Maia. Thanks for all you do in exposing the truth!