Therapeutic Education Industry Booms As Parents Seek Help for Kids

CHICAGO - Ed Wundrum finally reached the end of the line with his teenage son.

Todd had struggled in school, had difficulty relating to his peers, and fought a depression that had dogged him since fifth grade. Increasingly, he sought to dull his pain with marijuana.

His parents tried therapists and medications. But then Todd was arrested after marijuana was found in his locker at Wheaton North High School. Worse, a drug dealer threatened his life. They knew they had to go a step further.

Joining what experts say is a growing number of families, the Wundrums sent him to a residential school, this one in Idaho, part of a thriving industry known as therapeutic education, which is designed to transform delinquent teenagers into happier, healthier young adults.

"We knew we couldn't fix it," said Ed Wundrum, who wears his weariness on his sleeve. "No matter how much we loved him, he needed help that we just couldn't give him."

He found it at Boulder Creek Academy, a therapeutic school in Bonner's Ferry, Idaho. The program helps troubled kids gain some emotional traction through relentless structure, accountability, peer support, intensive psychotherapy and vigorous outdoor activities. In exchange, the Wundrums paid $180,000 in tuition for 36 months - a crushing burden for a midlevel bank manager and a stay-at-home mother. The couple insist it was worth every penny.

"He's alive," said Ed Wundrum succinctly. "How do you put a price tag on that?"

Even in a lackluster economy, business for therapeutic schools is booming. While exact numbers are hard to come by, a trade association and other experts say the schools are a $1 billion to $1.2 billion industry that serves 10,000 to 14,000 school-age children.

Many schools pitch their programs to educational consultants whom parents hire to find an appropriate placement. Mark Sklarow, director of the Independent Educational Consultants Association, said that, a decade ago, 30 or 40 programs would call on members each year. Today, that figure is about 400.

"This whole thing has just exploded," said Jeanette Spires, a Lake Forest, Ill., educational consultant.

The programs vary greatly in style and execution, ranging from boarding schools with a strong discipline code and counseling component to strict wilderness programs where students bunk in sleeping bags and must cooperate with others to survive.

But all seem to share the common goal of fostering self-control and self-esteem by removing distractions - peers, TV, computers - and putting youth in environments that promote good choices.

Typically, the programs rely on a behavior modification system that rewards compliance and makes the students ultimately responsible for their own conduct. Ideally, as they progress through each level, they will gain new insight into how their actions affect others.

Critics say some programs are at best ineffective and at worst abusive. They cite 31 deaths in wilderness or "boot camps" over the last 11 years. Last year therapeutic schools again made headlines when allegations of cruel and inhumane treatment of children surfaced at a U.S.-owned facility in Costa Rica.

Still, few dispute the demand for such facilities - a last gasp effort before a child hits age 18 and can legally refuse treatment.

"No one starts here," Wundrum said.

Indeed, the path to a residential setting wends through the offices of psychiatrists, psychologists, pediatricians, allergists, neurologists, school administrators, tutors and a host of other professionals.

A constellation of factors has fueled the growth, say experts. The popularity of zero-tolerance policies, which allows schools to swiftly purge "bad apples." Less supportive institutions - from churches to families. Budget cuts to youth services. A Byzantine mental health system. An erosion of blue-collar jobs that, in a simpler time, would absorb dropouts.

"The demand has been amazing," said Spires, who typically charges $2,500 per client for her expertise. "This past summer is the first one where I had a lot of 13-year-olds in programs."

One North Shore, Ill., mother, who asked not to be identified, used Spires to help place her daughter at a California school for eighth grade at a cost of $70,000.

She first consulted a psychiatrist when their daughter was expelled from nursery school. Almost nine years of counseling and medication brought a variety of diagnoses (most recently, personality disorder) but little progress.

In the months leading up to her departure, the girl's mood became so volatile that her parents started hiding their kitchen knives and locking their bedroom door at night.

"I have no idea why this happened," said the mother. "All I know is that I thank God every day that she is in a good place."

In the past, most residential behavioral programs were funded by government agencies and usually required some court order for placement - often as an alternative to a correctional facility. But the majority of new programs depend on private tuition, and parents - not a judge - make admission decisions.

"The growth comes from parental empowerment," said Lon E. Woodbury of the trade newsletter The Woodbury Report. "Just as people are taking charge of their health with alternative medicine, the same is true with troubled teens."

Even so, such decisions are never easy. The Wundrums wondered, for one thing, if uprooting Todd might actually make the situation worse - especially since his new classmates would be equally troubled, if not more so.

Then there was the matter of selecting a school. Parents have few choices in the Midwest; many programs are located in Utah and Idaho, states that have a tradition of limited oversight into private enterprise.

They eventually settled on Boulder Creek Academy, affiliated with CEDU (from See-Do) Education, a subsidiary of The Brown Schools - an established name in the business that, along with the Aspen Education Group, runs more than two dozen therapeutic programs nationwide.

The family made the grim 1,500-mile trip with their son, flying from O'Hare to Spokane, Wash., then driving another 100 miles to the remote mountain hamlet in Idaho. "We had 30 minutes before a staff member came in and said it would be better if we said goodbye," Wundrum said. "I was crying, my wife was crying. It was the hardest thing I've ever done."

Todd, a slight young man who is now back in Wheaton, shrugged at the memory. "I wasn't sure I cared. I was in so much pain I would have tried anything. My attitude was, `I've got nothing left. Do it."

At Boulder Creek he was held to a tightly scripted regimen that includes dress codes and "lights out" at 9:30. (Break a rule - on drugs, sex or violence - and a student can find himself hauling wood or shoveling snow.) Two weeks pass before students are permitted a 15-minute phone call to their parents. It is a year before they can return home for a visit.

"Even caffeinated soda is a privilege," Todd said.

The amount of money parents spend on therapeutic programs is staggering, with the average cost at about $5,000 a month. Even a summer wilderness program - designed to "get a child's attention" - can run $17,000 for six weeks. While some students in such programs are affluent, others come from middle-class families that are sacrificing heavily for their kids' sake.

"I've heard stories about people in their 80s taking out mortgages after their houses were paid off for 20 years," said Sklarow, of the consultants group.

Deborah Bernard of Seattle, whose 16-year-old daughter stole her credit cards to buy cocaine, is a nutritionist who could afford Boulder Creek only with the help of her parents. Wundrum took out a second mortgage and tapped into his retirement savings. Bob Kovitz, a public information officer in Oro Valley, Ariz., drained his son's college fund to pay Boulder Creek's tuition - plus $6,000 for escorts to make sure he got there.

"I thought, `What are we saving for?' There isn't going to be any college unless we got him out alive," Kovitz said. "When you're talking about life and death, money becomes a lot less important. For the first time in years, you know that your child is safe."

Operators defend their prices, citing the large number of highly educated employees - including clinical psychologists and physicians - plus residential and educational expenses. Sometimes financial aid is available and insurance will defray some medical expenses, but, more often, the tab is shouldered alone.

Almost as daunting is finding the right school - especially with more than 300 to 400 programs to choose from. Many use slick Web sites and videos that promise a quick fix, a seductive message for desperate parents scrambling for a placement in the midst of a crisis.

"There are just a lot of real bad places out there," said Andy Anderson, director of National Association of Therapeutic Schools and Programs, a trade group that started four years ago to establish standards and practices. "It's impossible to sort them all out on the Internet - especially when so many look and sound the same."

The Clearwater, Fla.-based group has grown from about a half-dozen members in 1997 to the current 113 members in 26 states. To earn NATSAP approval, schools must meet academic and therapeutic criteria - including a policy against corporal punishment.

"Poor programs are focused strictly on structure and discipline," said John Santa, head of Montana Academy and a NATSAP board member. "Sure, you can get a kid to drop down and do 100 push-ups and he'll learn not to be insubordinate again, but punishments have a very limited effect and it doesn't really change the underlying behavior. The goal is to get at the root of the behavior so kids can face the challenges of the world."

(Boulder Creek has had no serious incidents, according to the Utah attorney general's office, although The CEDU Schools have been the target of several personal injury lawsuits. Last year, a 17-year-old student died at OnTrack, a wilderness program in Texas, which is no longer owned by Brown and continues to be in litigation.)

Experts say a good program will have a high staff-to-student ratio, qualified staff with advance degrees, an emphasis on safety, and a family therapy component that will help the child transition back home. They will also permit visitors shopping for a school to talk with staff, students and other parents.

Research on the effectiveness of such programs is limited. In 2000, University of New Hampshire professor Keith Russell followed 900 kids in eight different outdoor behavioral programs and found that a majority of kids had a "significant reduction of symptoms" at discharge.

"A lot of the kids don't have anywhere to go, so they are forced to commit to the process," he explained.

But, he cautions, what happens to the teens afterward is crucial. "If parents drop the ball when their kids come home, they'll be right back with their old peer group, getting into trouble."

For Todd , resuming life in Wheaton has not been without its bumps, but he says the therapeutic milieu chipped away at his negative perception of himself. He got busy playing guitar and writing poetry, and his grades improved.

In short, he stopped thinking "that suicide was a ticket to a painless life," he said.

"I was in an environment where there were 100 people to talk to and you genuinely felt encouraged and cared for," he said. "There was no way an hour or so a week for therapy could do that for me. Nothing else could have pulled me out of my despair."

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(c) 2004, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.