The trouble with troubled teen programs: how the "boot camp" industry tortures and kills kids.

• Author: Szalavitz, Maia

THE STATE OF FLORIDA tortured 14-year-old Martin Lee Anderson to death for trespassing. The teen had been sentenced to probation in 2005 for taking a joy ride in a Jeep Cherokee that his cousins stole from his grandmother. Later that year, he crossed the grounds of a school on his way to visit a friend, a violation of his probation. His parents were given a choice between sending him to boot camp and sending him to juvenile detention. They chose boot camp, believing, as many Americans do, that "tough love" was more likely to rehabilitate him than prison.

Less than three hours after his admission to Florida's Bay County Sheriff's Boot Camp on January 5, 2006, Anderson was no longer breathing. He was taken to a hospital, where he was declared dead early the next morning.

A video recorded by the camp shows up to 10 of the sheriff's "drill instructors" punching, kicking, slamming to the ground, and dragging the limp body of the unresisting adolescent. Anderson had reported difficulty breathing while running the last of 16 required laps on a track, a complaint that was interpreted as defiance. When he stopped breathing entirely, this too was seen as a ruse.

Ammonia was shoved in the boy's face; this tactic apparently had been used previously to shock other boys perceived as resistant into returning to exercises. The guards also applied what they called "pressure points" to Anderson's head with their hands, one of many "pain compliance" methods they had been instructed to impose on children who didn't immediately do as they were told.

All the while, a nurse in a white uniform stood by, looking bored. At one point she examined the boy with a stethoscope, then allowed the beating to continue until he was unconscious. An autopsy report issued in May--after an initial, disputed report erroneously attributed Anderson's death to a blood disorder--concluded that he had died of suffocation, due to the combined effects of ammonia and the guards' covering his mouth and nose.

Every time a child dies in a tough love program, politicians say--as Florida Gov. Jeb Bush initially did on hearing of Anderson's death--that it is "one tragic incident" that should not be used to justify shutting such programs down. But there have now been nearly three dozen such deaths and thousands of reports of severe abuse in programs that use corporal punishment, brutal emotional attacks, isolation, and physical restraint in an attempt to reform troubled teenagers.

Tough love has become a billion-dollar industry. Several hundred programs, both public and private, use the approach. Somewhere between 10,000 and 100,000 teenagers are currently held in treatment programs based on the belief that adolescents must be broken (mentally, and often physically as well) before they can be fixed. Exact numbers are impossible to determine, because no one keeps track of the kids in these programs, most of which are privately run. The typical way to end up in a government-run program, such as the camp where Martin Lee Anderson was killed, is for a court to give you the option of going there instead of prison. The typical way to end up in a private program is to be sent there by your parents, though judges and public schools have been known to send kids to private boot camps as well. Since they offer "treatment," some of the private centers are covered by health insurance.

In the nearly five decades since the first tough love residential treatment community, Synanon, introduced the idea of attack therapy as a cure for drug abuse, hundreds of thousands of young people have undergone such "therapy" These programs have both driven and been driven by the war on drugs. Synanon, for example, was aimed at fighting heroin addiction, its draconian methods justified by appeals to parents' fears that drugs could do far worse things to their children than a little rough treatment could. The idea was that only a painful experience of "hitting bottom" could end an attachment to the pleasures of drugs.

But like the drug war itself, tough love programs are ineffective, based on pseudoscience, and rooted in a brutal ideology that produces more harm than most of the problems they are supposedly aimed at addressing. The history of tough love shows how fear consistently trumps data, selling parents and politicians on a product that hurts kids.

Attack Therapy Utopia

Synanon was a supposedly utopian California community founded in 1958 by an ex-alcoholic named Chuck Dederich. Dederich believed he could improve on the voluntary 12-step program of Alcoholics Anonymous. Rather than rely on people choosing to change, Synanon would use extreme peer pressure and even physical coercion to impose the confession, surrender, and service to others that 12-step programs suggest as the road to recovery.

At the time, heroin addiction was seen as incurable. But when a heroin addict kicked drugs after participating in Dederich's brutally confrontational encounter groups, the founder and other members began living communally and promoting Synanon as an addiction cure.

The media took note, and soon state officials from across the country were visiting and setting up copycat programs back home to treat addicts. Only New Jersey bothered to do an outcome study before replicating Synanon. The investigation, released in 1969, found that only 10 to 15 percent of participants stayed in the program for more than a few months and actually ended their addictions, a rate no better than that achieved without treatment. A 1973 study of encounter groups by the Stanford psychiatrist Irvin Yalom and his colleague Morton Lieberman found that 9 percent of participants experienced lasting psychological damage and that Synanon groups were among those with the highest numbers of casualties.

But the research didn't matter. To both the media and the politicians, anecdote was evidence. The idea that toughness was the answer had a deep appeal to those who saw drug use as sin and punishment as the way to redemption. And Synanon produced testimonials worthy of...