Adopted kids confined in private programs marketed for “reactive attachment” claims
An Associated Press investigation examining the “troubled teen” industry found that some companies known for tough-love boarding schools for affluent, rebellious teenagers have increasingly targeted adopted children. AP reported that adoptees are overrepresented in the network of loosely regulated, for-profit residential treatment centers, wilderness programs and boarding schools, and that children in the programs described getting the opposite of what adoption promised.
AP said that adoptees it interviewed described being pulled into what they described as a “shadow orphanage system,” in which children who expected permanent homes were instead institutionalized for extended periods. Many adoptees told AP that confinement felt like prison even though, according to the account AP included, they had not been convicted of a crime, received no sentence from a judge and had no court-monitored oversight of the confinement.
The investigation’s reporting pointed to what it described as a pattern in how some programs diagnose children and what they promise parents they can do. AP reported that some facilities charge as much as $20,000 a month and market treatment aimed at reactive attachment disorder, often called RAD, as a way to explain behavioral challenges tied to adoption and to promise that children can learn to attach in faraway treatment.
Experts who spoke with AP said RAD is often misapplied to older children with behavioral problems. Brian Allen, a psychologist who runs a mental health program at Penn State’s Center for the Protection of Children, told AP that the diagnosis is intended for young children who were neglected early in life and that it reflects withdrawal in response to distress or fear, based on the Diagnostic and Statistical Manual of Mental Disorders criteria. Allen said RAD is extremely rare and applies to children under 5, not older children who struggle years later after earlier neglect, and he described his clinic’s work with adopted and foster children as showing that while many had been diagnosed with RAD, none fit the criteria.
Sloan Nova, a psychologist at the University of California in San Francisco, told AP about being adopted from South Korea in the 1980s and ending up in a treatment facility as a teenager. She said the RAD framing can function like an “overpromise” that is “seductive,” because it can sound “almost too good to be true.” Nova’s comments were part of AP’s focus on how marketing pitches can align with a desperate moment for adoptive families while not matching the diagnosis experts say the children actually have.
AP also said the diagnosis is part of a broader business model. The investigation reported that at least 80 private facilities advertise they treat adoption-related issues and that many of these companies have been acquired and commercialized over time by private equity and others. Raj Kumar, a health care industry analyst at Stephens who tracks healthcare, told AP that companies can make money by minimizing staffing costs and maximizing how long children remain in care, and he said those dynamics can be easier to sustain because there are fewer regulations than in other inpatient settings.
In AP’s reporting, that profit logic can intersect with alleged abuse and confinement conditions, particularly where families alone decide whether a child goes to a program and for how long. AP said adoptees described being required to comply under harsh rules and having little meaningful oversight, with one account describing physical episodes and restraints occurring in facilities where, AP reported, no sentence or judge monitored confinement.
One adoptee featured in AP’s reporting, who AP identified as Kate but used a first name only at the person’s request because AP said it does not typically identify sexual assault victims, described being sexually assaulted while at Asheville Academy and later being sent to Uinta Academy in Utah. AP said she was 13 when she arrived at Uinta and described her telling AP about panic she said began on her first night. In the account AP included, she described employees responding to her distress in ways she said involved physical restraint and force, and she also described rules and punishments for violating program expectations.
AP also cited a congressional investigation led by U.S. Sen. Ron Wyden of Oregon that, AP said, found chronic understaffing across facilities can result in improper physical restraints, a lack of mental health care and rampant physical, sexual and emotional abuse. The report described, according to AP, that these facilities often function more like confinement for children in trouble than places where vulnerable children receive healing.