On a February afternoon in 2015, Josh Prinzo answered a pounding on his front door. Within minutes, the Georgia native found himself escorted onto a bus and taken to a wilderness camp with no prospect of returning home for about seven months.

Now a senior in the College of Arts and Sciences, then-teenaged Prinzo went through the perils of the troubled teen industry — a collective of for-profit boarding schools that advertise intensive behavioral discipline for rebellious teenagers.

“I was told that I was going to a co-ed college prep school,” he said. “But when I went … this [place] wasn’t sanitary. They don’t have anybody going in and monitoring these places.”

These residential programs are set up as anything from wilderness camps — like the one Prinzo attended — to behavioral modification institutions, according to the National Youth Rights Association.

Each school markets therapy programs that will give troubled teens the “tough love” their parents think they need. Prinzo said his behavioral camp was accredited by The National Association of Therapeutic Schools and Programs, a label he feels it was far from deserving.

The troubled teen industry’s foundational philosophy was born in 1958 out of a cult called Synanon, which promoted the sobering of heroin addicts through tactics such as physical labor and social isolation. Synanon’s teachings went so far as to deprive people of basic necessities, according to a 2007 Mother Jones report.

Robin Reber is the director of admissions for Star Guides Wilderness in Utah, which specifically treats teenagers with “sexual behavior problems,” according to its website. Reber said children are disconnected from their parents, which is one of the most important elements of the recovery process.

“Parents are the number one dependency of kids,” Reber said, “and if we can’t disrupt how the child is using those parents to continue the drama, that piece doesn’t get resolved. It’s not meant to alienate the children at all from their parents. It’s a tool that we use to help them learn other ways of discovering things.”

While Reber said parents are “involved” in their child’s three-to-five-month journey, Star Guides restricts communication to once-per-week phone calls with an on-site therapist and encourages residents to write letters instead.

“The idea behind residential treatment is, ‘Look, let’s give them an environment where they can’t fail while they’re trying to put these new skills actually into life,’” Reber said. “It’s not to keep my kid in treatment forever. It’s to recognize that kids are growing up and they don’t have brains that are fully developed, and it takes time to grow up.”

Residential programs gained public recognition recently in the YouTube Originals documentary, “This Is Paris,” which chronicled the life, fame and challenges of socialite Paris Hilton. As a teenager, Hilton was sent to a troubled teen residency in Utah, and she is now an advocate for Breaking Code Silence — a collective of abuse survivors who raise awareness against behavioral therapy programs.

Assistant psychology professor Catherine Caldwell-Harris, who has worked at Boston University for about three decades, recalled an encounter in a Facebook parenting group with a mother who sent her defiant child to a ranch for three months and expressed feeling “heartbroken” about the restricted contact.

“As a psychologist, that’s harmful. You want to be doing nightly phone calls if you can. So, something seemed kind of suspicious about that,” Caldwell-Harris said. “Suppose the experts say, ‘That’s what you have to do to make the kids change their ways, you’ve got to not let them have any contact with their parents.’ The truth is probably that they’ll complain too much, and so [the facilities will] miss out on their three months of tuition.”

However, Reber said wilderness programs’ approaches to limited communication simply enhance a troubled child’s development and, ultimately, their recovery.

“They live in a really point-and-click, instantaneous, ‘give it to me now’ world, and they’re not thinking through the ramifications of their very impulsive behaviors,” Reber said. “The letter-writing is a strategic, therapeutic element that we use to help them grow and use those parts of their brain, as well as to help the parents see in black and white what it is that my child is telling me, who is my child.”

Prinzo, who lived at the wilderness camp for 75 days followed by five months of boarding school, said therapists acted as middlemen between enrollees and their families, withholding letters home should a participant complain or defy any rules. Prinzo called this treatment isolating and “cruel.”

“They would always try to use things you said to keep you there longer,” Prinzo said. “I got diagnosed with so many different things, and they used it as an excuse to give you medication, and we were never tested. They tried to tell me for the longest time I had [attention deficit disorder].”

While at “wilderness,” as Prinzo calls it, he was told he also had oppositional defiant disorder, autism and manic depressive disorder at different points of his stay, each of which required an array of different treatments. But he said did not receive any professional evaluations that would qualify these as accurate diagnoses.

“They gave me all new medication when I went to the wilderness,” Prinzo said. “I was never shown any paperwork or anything. I was never even told what medication I was given.”

He said one therapist disputed two of those diagnoses, but did not adjust his medication. Prinzo also said that at boarding school, he was placed in isolation for hours by one of the facility’s staff members after entering a building without permission.

“The idea that sending a kid to a school to get extra emotional support and more therapists by them and someone to talk to is a great concept,” Prinzo said. “[But] I didn’t need to be treated like that.”

Wendy Nathan, a wellness coach and former director of counseling at Mercy College in Ohio, wrote in an email she knows parents who have enrolled their children in these programs and were disappointed with the outcome.

At one point, Nathan said, she had considered sending her own child to an “adventure therapy” camp, but decided not to due to its high pricing and the lack of information from its directors.

“My friend had issues with the structure of the program and how the organization was, well, organized,” Nathan wrote. “Communication at the beginning was sketchy, but their ratings were good online, and they ultimately pursued it. It was $36,000 for a six month experience, without much depth, in the end.”  

For Star Guides, which describes its therapeutic approach to the wilderness as “nomadic,” Reber attributed these costs to operational aspects such as fees to the Bureau of Land Management, equipment to avoid land damage, as well as training fees for hiking experts. Reber said there is “layer upon layer” of safety measures, including radios, GPS systems and satellites.

“We’re moving these youths around daily, and all of our gear has to move around with them daily, so it takes a lot of effort,” Reber said. “Wilderness is not the job you want to get into if you want to make a lot of money. It is costly, but you’re paying for a level of treatment that is very pinpointed and very specific to the needs of that child.”

NATSAP is an organization many residential centers hold membership with, according to its website, but participation is voluntary. Although NATSAP requires its members to be licensed with state agencies and offer clinician-approved therapy programs, it’s not an accreditation or licensing body.

NATSAP states it “values research and evaluation,” but in 2007, the organization came under fire when then-Executive Director Jan Moss testified in a U.S. congressional hearing that the organization does not conduct investigations to ensure residential centers comply with its standards.

But Reber, who has been in the wilderness industry for more than 30 years, said she believes NATSAP has contributed to improvements in overall operations since its conception in 1999.

“[The industry is] better organized now and they have a much more experienced communication style. And I think they’re more fair,” Reber said. “For a while, the presidents were also trying to run programs at the same time, and it wasn’t very effective. Now they have people that actually are full-time, so it’s a better organization.”

While Reber said there are standards treatment centers must meet in order to join NATSAP, she said the association does not enforce oversight or accountability measures. But she said states like Utah do have “very thorough” oversight regulations requested by professionals involved with treatment programs, as well as licensing organizations that conduct audits and spot checks.

“People that are nefarious and trying to rip people off aren’t going to establish programs to watch over them, to set a standard,” Reber said.

On the East Coast, however, Prinzo said he experienced some of the industry’s worst, including medical emotional abuse. For sake of privacy, he asked The Daily Free Press to omit the name of the residential center he attended.

The Daily Free Press reached out to two teen residential centers, neither of which responded to multiple requests for comment.

HuffPost reported in 2016 on a “time-out room” reminiscent of those in prisons, which Prinzo said mirrors his own experience. The article also reported that some facilities are known to sedate enrollees with high doses of antipsychotics, which have not been medically proven to effectively treat mental disorders in adolescents.

Aside from these incidents, Prinzo said therapists also commonly use acts of retaliation as evidence to convince parents their children need to stay longer.

“They keep roping your parents into it,” Prinzo said. “They make it seem like, ‘Oh, your kid’s still having a hard time.’ The parents are scared, they’re worried, they don’t really see what’s going on.”

There’s little evidence to support that behavior-modification tactics help regulate the actions of teens with behavioral issues. Mother Jones reported in 2007 on studies that found a 10- to 15-percent recovery rate in the Synanon groups on which these tactics were based.

Caldwell-Harris said the “old-fashioned” organization of these facilities is structured to make a profit off of those enrolled. However, she also said the industry’s conception as a get-rich-quick scheme is under the guise of a theoretically good cause.

“They don’t want to start out abusing kids. In fact, they might even think, ‘Hey, we’ll do a good thing and make a lot of money,’” Caldwell-Harris said. “‘We don’t even have to have housing, they’ll be camping. There won’t be electricity, we won’t have a lot of bills.’ … They’re cutting costs so furiously to try to get that win back on their money that, then, the abuses come in.”

At the wilderness camp Prinzo attended, he said, he did not shower for a month and sometimes was not allowed to know the time of day. While he and the other teenagers were allowed to brush their teeth, sometimes they were not given toothbrushes and had to use their fingers.

Counselors urged campers to “stay present,” Prinzo said, but the immediate impact of wilderness therapy left his social skills damaged.

Reber said the simplicity of the wilderness is necessary in fulfilling its mission — Star Guides’ method of wilderness therapy aims to “disrupt the efficacy of the dependencies” relied upon by troubled adolescents.

“We really are unplugging that child from everything that’s normal, and there’s no noise,” Reber said. “Most youth haven’t even had the opportunity to think through what their choices are actually doing in their life. They’re constantly plugged in or reacting or driving towards some type of stimulus, rather than engaging in any type of a reflective process.”

However, she said some programs miss the mark on manipulating these factors to assist in adolescents’ recovery, and believes that hiking alone isn’t a sufficient “reset” for adolescents dealing with the complex issues Star Guides typically treats.

Regardless, Prinzo said he found himself having trouble connecting with people after leaving the program, and that returning to normal life was challenging. Through an active pursuit of therapy, he said he’s been able to return to a relatively normal life.

Caldwell-Harris said she sees irony in the lack of safeguards overseeing the troubled teen industry, given extensive measures in U.S. policy to penalize child abuse.

She also said the accreditation committees that determine whether the boarding schools are qualified to operate are possibly part of the problem.

“If you’re trying to run a daycare or preschool, someone in the government has a lot of power to hold you to extremely high standards,” Caldwell-Harris said. “But where are those standards in regard to these teenagers? They’re absent.”

Like Caldwell-Harris, Nathan wrote she also had concerns surrounding the profit generated by the industry’s programs, and that these camps can hire staff unqualified for therapeutic services.

“Just because something costs a lot, doesn’t mean the program has integrity,” Nathan wrote. “We want trained and licensed professionals to be working with our teens, not someone who doesn’t have the background or skills.”

At Star Guides, Reber said, she has never discouraged a parent from sending their child to the program. She said some parents are desperate to take care of their troubled adolescents, some going so far as “selling their homes” in order to get their child the help they think is needed.

“You’ve got to find some place that can secure your child and also give them some help,” she said. “These aren’t parents that are bad parents. They’re trying to figure it out.”

Prinzo said he plans to pursue independent research next semester through Boston University’s Undergraduate Research Opportunities Program, which he hopes will allow him to dive into these ethical dilemmas.

Caldwell-Harris, who would be working with Prinzo through UROP, said she hopes he’s able to raise awareness about the troubled teen industry and investigate it through a scholarly lens, given the lack of research currently available.

Using a Facebook support group from others who have gone through the troubled teen industry, Prinzo said he plans to start small and compile data on their own experiences.

His main research objective is to analyze the interconnectedness of the different boarding schools, as well as the transportation companies who take the teens into custody. He said he also wants to evaluate the legitimacy of the accreditation bodies mentioned by Caldwell-Harris, and what their parameters are.

Prinzo said he hopes his project will help those affected by the industry and encourages parents to do more research before putting their children through these programs.

“I just remember when I was younger and wishing someone would have been doing what I was doing,” Prinzo said. “If I could help one kid not go through what I went through, it would help me sleep better at night.”