Sunday, January 29, 2006

The Trouble with Tough Love

Important reading from the Washington Post:

The trouble with tough love is twofold. First, the underlying philosophy -- that pain produces growth -- lends itself to abuse of power. Second, and more important, toughness doesn't begin to address the real problem. Troubled teenagers aren't usually "spoiled brats" who "just need to be taught respect." Like me, they most often go wrong because they hurt, not because they don't want to do the right thing. That became all the more evident to me when I took a look at who goes to these schools.

A surprisingly large number are sent away in the midst of a parental divorce; others are enrolled for depression or other serious mental illnesses. Many have lengthy histories of trauma and abuse. The last thing such kids need is another experience of powerlessness, humiliation and pain...

The Justice Department has released reports comparing boot camps with traditional correctional facilities for juvenile offenders, concluding in 2001 that neither facility "is more effective in reducing recidivism." In late 2004, the National Institutes of Health released a "state of the science" consensus statement, concluding that "get tough" treatments "do not work and there is some evidence that they may make the problem worse." Indeed, some young people leave these programs with post-traumatic stress disorder and exacerbations of their original problems.

These strict institutional settings work at cross-purposes with the developmental stages adolescents go through. According to psychiatrists, teenagers need to gain responsibility, begin to test romantic relationships and learn to think critically. But in tough programs, teenagers' choices of activities are overwhelmingly made for them: They are not allowed to date (in many, even eye contact with the opposite sex is punished), and they are punished if they dissent from a program's therapeutic prescriptions. All this despite evidence that a totally controlled environment delays maturation.

Why is tough love still so prevalent? The acceptance of anecdote as evidence is one reason, as are the hurried decisions of desperate parents who can no longer find a way of communicating with their wayward kids. But most significant is the lack of the equivalent of a Food and Drug Administration for behavioral health care -- with the result that most people are unaware that these programs have never been proved safe or effective.

Indeed this situation permeates our whole "corrective" system. If we were, for example to find that some ways of parenting produce horribly harmful effects should we not attempt to intervene and prevent them? Of course, for gross abuse we do that.

But what about the above?

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