The following is an interview with Frederic Reamer and Deborah Siegel, authors of Teens in Crisis: How the Industry Serving Struggling Teens Helps and Hurts Our Kids:

Question: What do you mean by “struggling teens,” and on what programs and schools do you focus?

Frederic Reamer and Deborah Siegel: As all of us know, the adolescent years can be challenging. Although adolescence can be an emotionally stormy phase for virtually all teenagers, sometimes a youth’s struggles are especially intense and require very skilled intervention. The struggling teens we discuss in Teens in Crisis include those who are having an extraordinarily difficult time with mental health issues, substance abuse, high-risk sexual activity, and other self-harming behaviors. Common warning signs include: extreme isolation and withdrawal; school failure and truancy; defiance toward authority; running away from home; choosing high-risk friends; impulsive behavior; getting in trouble with the police; depression; abusing alcohol or drugs; eating disorders; and self-injury (such as cutting, burning, and branding).

Ideally, struggling teens can be helped in their home communities. Local therapists, social workers, crisis intervention programs, partial hospitalization programs, drug and truancy court programs, group homes, alternative (nontraditional) high schools, and mentoring programs can be very helpful and effective. However, some teens do not benefit from these local programs and continue to pose major health and behavioral risks. In these extreme circumstances, parents and professionals may need to consider specialty schools and programs that are located some distance from the home community, often hundreds of miles away. The most common options include: wilderness therapy programs; residential treatment centers; therapeutic boarding schools; and emotional growth boarding schools.

Q: Parents who are desperate to get help for their kids often have to find programs and schools in a hurry, sometimes in the middle of a hot crisis. What are some of the most common mistakes they make?

FR and DS: There are many impressive, professionally run programs and schools for struggling teens. However, as we discuss in Teens in Crisis, there are also programs and schools that have significant records of abusive and unethical practices. Parents who are desperate to find help quickly sometimes enroll their children in programs and schools that cause much more harm than good. Finding the right program or school takes considerable time, effort, and patience, all of which may be in short supply when a teen is spinning out of control and parents feel as if they’ve reached the end of their rope.

Some of the most common mistakes include: picking a program or school quickly and impulsively, without thorough assessment; selecting a program or school that is not designed to meet the teen’s unique needs; selecting a program or school whose methods are not grounded in sound research; sending a teen to a residential program or school for the wrong reasons (for example, to get the teen out of the house rather than to help them); avoiding out-of-home placement when it is the right option; and selecting a residential program or school primarily because it is close to home.

Q: What can parents do to avoid making these mistakes?

FR and DS: Parents who are not familiar with the full range of available options should find competent, knowledgeable professionals who specialize in matching struggling teens with programs and schools. Skillful social workers and counselors may be familiar with local resources. However, to find appropriate residential programs and schools (such as wilderness therapy programs, residential treatment centers, and therapeutic boarding schools), parents would be wise to retain a skillful and knowledgeable educational consultant. These professionals are often the best and most effective resource; competent educational consultants spend a great deal of time learning about and visiting programs and schools around the nation, assessing teens’ special needs, recommending appropriate schools and programs, and monitoring placements. A skilled educational consultant is invaluable in these stressful situations.

By all means, parents should not use popular Internet search engines as their primary information source. Internet Web sites about schools and programs can provide useful information, but they can also be very misleading and seductive. Some sites are sponsored by unscrupulous recruitment agencies and programs that are more concerned about enrollments than professional standards.

Q: What can parents do to avoid enrolling their child in an abusive, incompetent, or unethical program or school?

FR and DS: Parents need to be constructively critical consumers and should ask lots of questions before enrolling their children. It’s always a red flag when program and school staffers are reluctant to answer the questions forthrightly. Key questions include: Is the program or school accredited or licensed? Is it too large or small for my child? Do the staffers have appropriate credentials and professional experience? Are the staffers supervised skillfully? To what extent does the program or school tailor services to meet each teen’s unique needs? How much structure does the program or school provide? Are the rules and disciplinary procedures constructive, compassionate, nonpunitive, reasonable, and clear? In what ways does the program or school involve parents, or are parents “shut out” much of the time? How sensitive is the program or school to the teen’s ethnicity, culture, religion, and sexual orientation? How does the program or school handle the teen’s mental health and psychotropic medication needs? What is the program’s or school’s attrition rate? How often do teens run away from the program or school?

Q: What has to happen to prevent abusive, unethical practices in schools and programs for struggling teens? What reform does the industry need?

FR and DS: One of the principal reasons some schools and programs engage in abusive and harmful practices is that they have managed to avoid reasonable oversight and regulation. Too many programs and schools operate with little or no scrutiny, flying under the radar. That’s why we’ve witnessed some scandals. The most reputable and professionally administered programs and schools welcome visits and queries—they have nothing to hide.

To reform the struggling-teens industry, we advocate a series of measures: strengthening licensing and accreditation; emphasizing teens’ strengths rather than being preoccupied with their “deficits”; using disciplinary methods that include logical, natural, safe, and fair consequences; paying professional attention to teens’ mental health needs rather than viewing all of their behavioral challenges as evidence of character and attitude flaws; employing only staffers who have appropriate education and training to help struggling teens; evaluating programs’ and schools’ effectiveness and reporting the results accurately; and preventing unscrupulous marketing by unethical programs, schools, and recruitment agencies.

The bottom line is that the struggling-teens industry has burgeoned in recent years and now includes a remarkable mix of impressive, acceptable, and harmful programs and schools. As we discuss in the book, it is essential to take a good, hard look at this diverse mix and establish reasonable, constructive protocols to ensure that struggling teens’ needs are met and that programs and schools follow well-established “best practices.”

Read more about Teens in Crisis.