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Sex Abuse in Rehab? How Predators Can Take Advantage of Addicts Seeking Help

Much of what is portrayed in the media as “professional treatment” isn’t based on evidence of what works and can lead to boundary violations and outright abuse.

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Take the notion that all people with drug problems are liars. While it is true that many addicted people do lie about their drug use to avoid being punished for it, most research finds that they are just as likely as anyone else to tell the truth when they feel safe doing so. For example, anonymous surveys of addicts about their drug use tend to line up closely with urine testing (this may not be the case for the significant minority of addicted people who also have personality disorders).

Why does this matter? If you label all your patients as liars, it is easy to dismiss their complaints and justify treating them in disrespectful, even humiliating ways. If teens tell their parents that they are uncomfortable with treatment, that’s just “druggie manipulation”; if they go to police or other authorities about the abuse, their stories are often dismissed for decades. In Angeli’s case, he kept his son in “treatment” for months after what he saw there had made him uncomfortable.

But Izentark made two mistakes rarely seen in abusive treatment: First, he got busted buying cocaine. Second, he hired a woman with actual psychology credentials who believed his victims’ accounts after she’d found he’d lied to her. That led to the court case that was his ultimate downfall.

Before that, though, many other red flags were clear. Angeli writes:

Bey had been at The House for about three months when I began to question Steve’s methods. Our health insurance had already declined to cover The House after Steve emphatically guaranteed the opposite. By then we’d learned that trying to get him on the phone was hopeless and that the messages my wife left rarely had an impact. 

Once, Steve and I walked out of his office after a meeting just as some kids had finished cleaning the living room. It looked immaculate. “Didn’t I tell you to clean this pigsty up?” Steve growled, and the kids kept cleaning what was already clean. Later, when I took exception to his autocratic gruffness, we argued. As part of Bey’s therapy, Steve had him build a wall in The House’s backyard. When Bey finished, Steve ordered him to tear it down and reconstruct it on the other side of the yard, which Bey did without saying a word.

The first warning sign was the insurance question: lying to parents about a program being covered when it is not is obviously not a good sign. And although insurers will often do anything to avoid paying, sometimes they actually have sound, evidence-based reasons to reject a type of treatment. Second, professional programs do not ignore phone messages or require intensive efforts for parents to get through to key staff. But the most disturbing aspect of that description is the arbitrary exercise of power and forced, meaningless labor. Although many addiction programs still see their role as “breaking people down,” in order to fix them, there’s no proof that this helps anyone get better.

Making people feel powerless, and fostering blind obedience are, in fact, generally viewed as antithetical to promoting mental health: research shows that the “learned helplessness” that comes from having no control over your life can lead to depression and even post-traumatic stress disorder, not recovery. Indeed, creating learned helpless in animals by placing them under uncontrollable stress until they stop trying to escape is a commonly used experimental model of depression. (If a drug restores an animal's struggle to get free, it typically helps human depression, too.)

These methods are also harmful to program staff. They basically create conditions that encourage the abuse of power, even situations that can lead ordinarily kind people to behave poorly.