ICSA TODAY 26
occurred between 1972 and 2004. Although Chatfield admits
that this study was an exercise and does not prove anything,
the very small differences between responses to very specific
questions from former clients who were treated in programs
from around North America over a period of 32 years is
astonishing enough to be a call for further research.
In Chapter Nine and Chapter Ten, the author explores the
constitutionality of using thought reform for behavior change
in adolescents who cannot give consent. He cites senators
and psychologists who have said that the use of thought-
reform techniques for reforming “drug addicted” children
was appropriate if it was for their own good or the good of
society. He points out that treatments used in programs such
as Straight are defined in international law as mental torture
(my italics, but not my words). In the United States, mental
health professionals are prohibited from participating in
torture of any kind, with the exception of psychologists, who,
since 2003 when the APA changed its policy, can do so. If the
involvement is overseen by government agencies, such as
human-services agencies or the military, some participation is
permitted. This information was ironic to me in that the same
year the APA voted this way, I was in China, where I was told
that at that time all psychologists worked for the army. The
overall stance of the intelligence community at the time left
the issue of torture in a gray area in the United States, open
to interpretation when it was used for the good of the subject
or for humanity in general. Chatfield says the American teen
facilities did not employ licensed addictions professionals,
who had no such leeway. Instead, staff consisted only of
former clients.
His thesis widens when he shows us that the legal status
of children in this country needs to match the rest of the
developed world. He documents that thought-reform
techniques are against the law in countries that have signed
the United Nations Declaration on the Rights of the Child.
The only two countries remaining in the world that have not
signed the Declaration are Somalia and the United States.
In the final chapter, Chatfield lists specifics that could
negatively impact the ability of adolescent treatment centers
to use these methods. He admits to the complexities around
actually making a difference in today’s political climate. He is
nonetheless confident that change can come.
The author points out that the Joint Commission on
Accreditation of Healthcare Organizations, or JCHAO, the same
organization that accredits my employer and most hospitals
and treatment facilities in this country, accredited Straight.
This national accreditation and the heavily criticized research
the author documented in Chapter 4 give the impression that
the program was both safe and effective.
The author shows how JCHAO focuses on process and
avoiding mistakes in the delivery of care. Strict guidelines for
documenting “sentinel events” such as injuries and deaths that
occur when patients are placed in restraints are an example.
I have been through many JCHAO evaluations and heard
directly from their evaluators that their focus was on process,
not program of care. Chatfield states that JCHAO’s failure
to critically address the content or practices of the Straight
program opened the door to the mental and emotional abuse
of adolescents in long-term, locked facilities.
This work was originally an undergraduate thesis, primarily
an academic exercise that required formal organization and
writing styles it can be hard to make derivative publications
work for the reader without extensive editing. Although
many times this too-long book clearly needed a skilled
editor, Marcus Chatfield has made a thorough, if sometimes
exhaustive, case for his thesis. It is a sordid tale of emotional
violence that is still being perpetrated on 30,000 adolescents
in North America every day. It deserves a read and a second
edition. n
About the Reviewer
Ron Burks, PhD, holds an MDiv and
an MA in counseling from Asbury
Theological Seminary and a PhD
in Counselor Education from Ohio
University. He worked for many years
at Wellspring Retreat and Resource
Center in Albany, Ohio. He and his
wife Vicki wrote Damaged Disciples:
Casualties of Authoritarian Churches and the Shepherding
Movement, published by Zondervan. He and Vicki now live
near Tallahassee, Florida where both are licensed mental
health counselors. Ron is a former president of the board of
Wellspring and serves on the clinical advisory boards of both
Wellspring and MeadowHaven. n
References
Salter, F. (1998). Indoctrination as institutionalized
persuasion, its limited variability and cross-cultural evolution.
In I. Eibl-Eibesfeldt &F. Salter (Eds.), Ethnic conflict and
indoctrination (pp. 421–452). New York, NY &Oxford, UK:
Berghahn Books.
Schein, E. (1962). Management development, human
relations training, and the process of influence. In I. Weschler
&E. Schein (Eds.) Issues in training, 5 (47–60). Washington,
DC: National Training Laboratories, National Education
Association.
Singer, M. T., &Ofshe, R. (1990). Thought reform programs
and the production of psychiatric casualties. Psychiatric
Annals: The Journal of Continuing Education, 20, 188–193.
Wilson, Bill (1952). Twelve steps and twelve traditions.
Alcoholics Anonymous. New York, NY: AA World Services.
occurred between 1972 and 2004. Although Chatfield admits
that this study was an exercise and does not prove anything,
the very small differences between responses to very specific
questions from former clients who were treated in programs
from around North America over a period of 32 years is
astonishing enough to be a call for further research.
In Chapter Nine and Chapter Ten, the author explores the
constitutionality of using thought reform for behavior change
in adolescents who cannot give consent. He cites senators
and psychologists who have said that the use of thought-
reform techniques for reforming “drug addicted” children
was appropriate if it was for their own good or the good of
society. He points out that treatments used in programs such
as Straight are defined in international law as mental torture
(my italics, but not my words). In the United States, mental
health professionals are prohibited from participating in
torture of any kind, with the exception of psychologists, who,
since 2003 when the APA changed its policy, can do so. If the
involvement is overseen by government agencies, such as
human-services agencies or the military, some participation is
permitted. This information was ironic to me in that the same
year the APA voted this way, I was in China, where I was told
that at that time all psychologists worked for the army. The
overall stance of the intelligence community at the time left
the issue of torture in a gray area in the United States, open
to interpretation when it was used for the good of the subject
or for humanity in general. Chatfield says the American teen
facilities did not employ licensed addictions professionals,
who had no such leeway. Instead, staff consisted only of
former clients.
His thesis widens when he shows us that the legal status
of children in this country needs to match the rest of the
developed world. He documents that thought-reform
techniques are against the law in countries that have signed
the United Nations Declaration on the Rights of the Child.
The only two countries remaining in the world that have not
signed the Declaration are Somalia and the United States.
In the final chapter, Chatfield lists specifics that could
negatively impact the ability of adolescent treatment centers
to use these methods. He admits to the complexities around
actually making a difference in today’s political climate. He is
nonetheless confident that change can come.
The author points out that the Joint Commission on
Accreditation of Healthcare Organizations, or JCHAO, the same
organization that accredits my employer and most hospitals
and treatment facilities in this country, accredited Straight.
This national accreditation and the heavily criticized research
the author documented in Chapter 4 give the impression that
the program was both safe and effective.
The author shows how JCHAO focuses on process and
avoiding mistakes in the delivery of care. Strict guidelines for
documenting “sentinel events” such as injuries and deaths that
occur when patients are placed in restraints are an example.
I have been through many JCHAO evaluations and heard
directly from their evaluators that their focus was on process,
not program of care. Chatfield states that JCHAO’s failure
to critically address the content or practices of the Straight
program opened the door to the mental and emotional abuse
of adolescents in long-term, locked facilities.
This work was originally an undergraduate thesis, primarily
an academic exercise that required formal organization and
writing styles it can be hard to make derivative publications
work for the reader without extensive editing. Although
many times this too-long book clearly needed a skilled
editor, Marcus Chatfield has made a thorough, if sometimes
exhaustive, case for his thesis. It is a sordid tale of emotional
violence that is still being perpetrated on 30,000 adolescents
in North America every day. It deserves a read and a second
edition. n
About the Reviewer
Ron Burks, PhD, holds an MDiv and
an MA in counseling from Asbury
Theological Seminary and a PhD
in Counselor Education from Ohio
University. He worked for many years
at Wellspring Retreat and Resource
Center in Albany, Ohio. He and his
wife Vicki wrote Damaged Disciples:
Casualties of Authoritarian Churches and the Shepherding
Movement, published by Zondervan. He and Vicki now live
near Tallahassee, Florida where both are licensed mental
health counselors. Ron is a former president of the board of
Wellspring and serves on the clinical advisory boards of both
Wellspring and MeadowHaven. n
References
Salter, F. (1998). Indoctrination as institutionalized
persuasion, its limited variability and cross-cultural evolution.
In I. Eibl-Eibesfeldt &F. Salter (Eds.), Ethnic conflict and
indoctrination (pp. 421–452). New York, NY &Oxford, UK:
Berghahn Books.
Schein, E. (1962). Management development, human
relations training, and the process of influence. In I. Weschler
&E. Schein (Eds.) Issues in training, 5 (47–60). Washington,
DC: National Training Laboratories, National Education
Association.
Singer, M. T., &Ofshe, R. (1990). Thought reform programs
and the production of psychiatric casualties. Psychiatric
Annals: The Journal of Continuing Education, 20, 188–193.
Wilson, Bill (1952). Twelve steps and twelve traditions.
Alcoholics Anonymous. New York, NY: AA World Services.
