ASTART provides education on signs of abuse in residential treatment

March 21, 2013


Dear Colleague,

We wish to offer important information to mental health and medical professionals providing services to youth who have lived in a residential treatment facility or boarding school for “troubled teens.”

Teens and young adults sent to residential treatment and/or wilderness survival programs may have faced abuse, maltreatment or neglect in the hands of unqualified staff. Many have had challenges in recovering from their experiences due to the trauma they have experienced. Many professionals have inaccurate or incomplete information about the nature of some of these facilities. This may lead to disbelief when teenagers or adults recount their stories to professionals. As we know you will understand, it is crucial to take such stories seriously as doubts or disbelief can intensify an  individual’s sense of hopelessness and estrangement.

As health professionals ourselves, we are affiliated with the Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment, or ASTART (, so we may protect youth from harm in these programs and be constructive in helping individuals find a healing context to recover from such maltreatment. At the same time, we work to support families in need of resources and guidance. We are concerned about the difficulty many families face in finding the help they need  in their communities. We support families before they seek help from the “teen help” industry, or after their son or daughter returns from these programs with new traumas.

Your client/patient may present with issues and symptoms including:

  • Post Traumatic Stress Disorder
  • Depression Secondary to Trauma
  • Other Trauma Reactions
  • Suicidal Ideation
  • Anxiety Disorders
  • School Failure or Disinterest
  • Dissociative Disorders
  • Peer Relationship Problems
  • Learned Helplessness
  • Drug Abuse or Dependency
  • Estrangement from Parents, Family
  • Rejection by Parents, Family

Your clients/patients may have suffered further from the failure of well meaning professionals to recognize or believe that signs of current emotional disturbance are related to the abuse and/or neglect that they experienced in residential treatment.

We invite you to learn more about this issue by visiting our website at . Please take a moment to read the warning signs of an abusive program, and other guidance for professionals.

If you would like be in touch with any questions or concerns, please contact us.


Charles Huffine, M.D.
Private Practice of Adolescent and Young Adult Psychiatry
Medical Director; Child and Adolescent Programs, King County Mental Health, Chemical Abuse and Dependency Services

Nicole Bush, PhD
Child Clinical Psychologist
Assistant Professor of Psychiatry at University of California, San Francisco

Lenore Behar, PhD
Child Psychologist and Mental Health Administrator Child & Family Program Strategies, Durham, NC
Former State Director of N.C. Child & Family Mental Health Services
Former Clinical Associate Professor, Department of Psychiatry, Duke University

Robert Friedman, PhD
Psychologist and Professor Emeritus
Department of Child and Family Studies, University of South Florida, Tampa

  • Download the ASTART letter here.
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