Drug Program’s Tough Tactics Draw Fire
The teen-age girl’s lips tremble and her eyes brim with tears as she looks at her father across a large, windowless room in an Orange County warehouse.
She stands among several dozen adolescents who sit rigidly in rows of blue plastic chairs. Parents sit in similar rows of chairs facing the youngsters. The girl’s father is standing. He speaks to his daughter through a microphone.
“I get the feeling you’re hopeless,” he says in a flat, angry tone. “I love you.”
“I love you, Dad.”
This is family night at Straight Inc., a Florida-based national drug treatment program for adolescents that has come to California with the promise of putting parents back in control of their dope-using children.
Thousands of desperate parents across the country have turned to the organization, one of the largest live-in drug treatment programs for adolescents in the nation. Now, after setting up its first California treatment center, Straight is eager to expand throughout the state.
But in several other states, including Virginia, Florida, Ohio, Massachusetts and Texas, Straight has been accused of seriously abusing its clients, according to lawsuits, licensing documents, police reports and interviews with The Times. Some former clients complain of being held prisoner by Straight. Others say they were screamed at, spat upon, punched, kicked, tied up, held spread-eagled on the floor and even gagged with feminine hygiene pads as punishment.
Timothy J. Kelleher, assistant vice president of operations for Straight, maintains that complaints of abuse are relatively few considering, he says, that 35,000 children and parents have been involved in the program since it was founded 14 years ago. Moreover, Straight officials say many complaints come from disgruntled former clients and parents who lack credibility.
Licensing officials in several states have accused Straight of abusive practices, but with the intense nationwide concern over drugs and the need for treatment, none of the facilities has been shut down by authorities.
In Florida, for example, Straight was put on probation last year because of alleged mistreatment of clients, but subsequently a regular operating license was granted.
“I feel . . . that things will work out well between us and Straight,” said Martha Lenderman, head of Florida’s Drug Abuse and Mental Health Office. “We need all the treatment programs we can get with these awful drug problems we have.”
Straight’s Orange County program, which treats about 60 youngsters, opened last June in Yorba Linda and is under consideration for a license from the state Department of Social Services.
But some of the organization’s methods are against the law in California, according to state officials. For example, Straight’s practice of holding minor clients in the program against their will--which is legal in some states--is against the law in California, according to Francine Bremer, an attorney with the state Department of Social Services. And while Straight requires clients to earn private visits with their parents through good behavior, Bremer said juveniles in California have a right to such visits under the law. State officials are also concerned about reports of alleged abuses of clients in other parts of the country.
“We realize they have had problems in the past in other (states),” said Sergio Ramirez, head of the state social services licensing office in Santa Ana. "(But) they . . . have indicated they intend to comply with the (state) regulations.”
Straight was founded in St. Petersburg, Fla., in 1976. It has roots in a controversial rehabilitation program for adolescents called The Seed that flourished in Southern Florida in the early to mid-1970s. Some parents, whose children had been clients in The Seed, helped to found Straight and borrowed some of its techniques, including highly confrontational, all-day mass meetings of clients.
Straight officials say their tough program forces clients to “get honest” and come to terms with their addictions by involving the entire family in the treatment process and by applying “positive peer pressure.”
The program uses some conventional treatment techniques such as Alcoholics Anonymous’ famous 12 steps toward sobriety. But at the core of the program are the highly confrontational mass “rap” sessions attended by dozens to hundreds of youngsters.
The sessions are held daily for 10 hours or more in large, windowless warehouses where clients--boys on one side of the room and girls on the other--are required to sit straight up in plastic chairs. The proceedings are led by young graduates of the program who work as staff members.
Clients are required to confess in the meetings to drug abuse and related misbehavior. If the confessions are considered genuine, clients get support and encouragement. If not, they are verbally attacked, and if they are uncooperative, they are sometimes grabbed and held on the floor, according to former clients.
“The staff tells the other kids what to do to the clients that don’t cooperate,” a former client of Straight’s Boston-area program in Stoughton told Massachusetts state police last year. “One time, they threw me down on the floor for no reason. They had other kids hold me down. . . . I had bruises on my hip bones and . . . back.”
Straight officials maintain that clients are restrained only by professional staff members and only to protect clients from hurting themselves or others or to prevent them from running away.
Until late last year, Straight clients commonly engaged in a practice called “motivating” in which they wildly waved their arms in the air at group meetings until one of them was chosen to speak. Often the first thing new clients saw was a room full of adolescents with their faces contorted in exertion as they frantically pumped their arms up and down.
“I thought I was in a funny farm,” recalled George LeCroy, 17, about the day in 1988 when he entered Straight’s center in Springfield, Va., and saw clients motivating.
If youngsters refused to motivate, according to former clients, others sometimes grabbed their arms and tried to wave them. If they resisted, maintain former clients, they were frequently thrown to the floor and held down.
LeCroy, who left the program last year, said that on numerous occasions he was held and spat upon when he failed to cooperate, and once his eye was blackened by his own hand when other clients tried to make him motivate.
Joy Margolis, Straight’s assistant vice president for resource development, said of such complaints: “It’s not the kind of behavior Straight condones, allows or encourages.”
Margaret P. Allen, administrator of Straight’s Orange County center, said the practice of motivating was stopped. “One of our goals,” she said, “is for people to view us as a health delivery system, not as a cult.”
Most of Straight’s clients are placed in the program by their parents rather than by courts, and youngsters are commonly tricked by parents into visiting Straight centers and not allowed to leave.
When clients are first admitted to the program, they are called “newcomers” and are accompanied wherever they go by “oldcomers” who hold them by the back of the pants in a grip called “belt-looping.”
“It’s a symbol of promoting support (and) responsibility,” said Page Peary, vice president of operations for Straight.
But state licensing officials in Florida said the practice has commonly caused “newcomers” to develop constipation to avoid the embarrassment of going to the bathroom in the company of “oldcomers.”
Straight officials insist that “newcomers” are allowed privacy in bathrooms.
Straight clients are required to move through “phases,” earning more and more freedom and outside activity--such as the right to go to school--until graduation, which usually takes about a year, program officials say.
In the first phase--which itself can take as long as year if a youngster doesn’t do well--clients are not allowed to go to school, visit privately with parents, read, watch television or listen to the radio. Phase-one clients spend their entire day at treatment centers where, except for daily indoor exercise periods--and in some cases, short periods for education--they sit on plastic chairs in group meetings.
Straight officials say that clients are excused from state compulsory education laws with medical leaves for treatment.
At night, the youngsters are transported to “host homes” where they write accounts of their behavior and goals before going to bed.
The program is also an all-consuming activity for parents who are required to attend group meetings twice a week and provide their own dwellings as “host homes” for clients. Parents must equip bedroom windows and doors in their homes with alarms to prevent escapes and are expected to provide food and transportation for clients staying with them.
Some advocates for minors contend that the national mood of fear over drugs has enabled programs such as Straight to violate the human rights and dignity of young people under the banner of keeping them off dope.
“If you create enough fear over an issue, it becomes an ends-and-means situation,” said Loren Warboys, senior staff attorney for the nonprofit Youth Law Center in San Francisco.
Straight’s Peary disagrees. “I think we are as committed to child rights as we are to any other process,” he said. "(But) I don’t think that children have the inalienable right to use drugs. . . . We say to a family, ‘Take charge of your child. Take charge and demand that they don’t use drugs.’ ”
As proof of the program’s effectiveness, Straight officials point to testimonials from parents and graduates of the program.
“I feel real grateful,” said Carolee Wright of Seattle, who was afraid her 16-year-old son would die of a cocaine overdose until she put him in the program’s Orange County center last summer. “I don’t think he would be alive (without Straight).”
Former client Jim Gilbert, 21, also praises the program, saying he has been sober for the last five years because of Straight.
Gilbert, who now lives in Newport Beach and is attending college, graduated from Straight’s Boston-area center in 1986. He said he began sneaking drinks when he was 7 years old and, by the time he entered Straight at the age of 16, he was using drugs daily.
“When I went in, I didn’t have any self-esteem,” he said. “When I came out of that program, I was able to take care of myself. . . . I was able to act instead of react.”
But even Gilbert acknowledged that misbehaving youngsters in Straight were sometimes held down by other clients in “four-point restraints.” He also said uncooperative youngsters were sometimes confronted by “bomb squads” of clients who, he said, spit in their faces while screaming at them. He said the spitting was inadvertent but acknowledges that clients were told not to wipe off the saliva.
“I would not want to go through it again,” he said of the program. “But I’m glad I did go through it.”
Besides such testimonials, Straight boasts of an endorsement by President Bush and a visit to one of its facilities by Nancy Reagan and Diana, Princess of Wales.
Furthermore, Straight points to its accreditation by the Joint Commission on Accreditation of Healthcare Organizations, a private agency. But the joint commission itself has been criticized by patients’ advocates for endorsing health facilities that were allegedly substandard.
The Times has received nearly 200 letters from Straight clients, parents and employees extolling the organization. Straight officials acknowledge that the letters were solicited because of concern that The Times might print a “negative” story about the program. The mail also included two anonymous letters accusing the program of controlling and manipulating parents.
Straight is not alone in its use of peer pressure and confrontational tactics. Phoenix House and Daytop treatment centers, for example, are two well-known national drug rehabilitation programs that use such techniques. But both of these organizations use smaller, shorter and more conventional group therapy sessions. Phoenix House and Daytop also provide formal education as a large part of their daily programs.
Phoenix House and Daytop belong to the Therapeutic Communities of America, which subscribes to a code of clients’ rights and disavows the use of force. Straight does not belong to the organization.
A client must have the choice of leaving treatment, even if the youngster is on probation and the alternative is jail, said David Deitch, executive director of Daytop’s drug treatment program for adolescents in Redwood City. Using force to keep a client in treatment will not work therapeutically, he said.
Straight insists that its methods not only work but are less expensive than other programs.
The organization says about 55% of the youngsters who enter Straight graduate and, of those, 70% remain drug-free after two years. The success rate is similar to that claimed by Phoenix House, although there is no third-party confirmation of those figures.
Operations assistant Kelleher maintains that Straight is “the most cost-effective program in the country.”
Straight’s Orange County facility charges about $14,000 per client per year. Phoenix House, which is largely publicly funded, charges about twice Straight’s rates in California but does not require parents to provide housing, food and transportation.
Straight currently treats about 1,000 clients--mostly middle-class youngsters--in nine centers located in seven states. The private, nonprofit organization, which reported an annual income of $12 million in 1987, is supported for the most part by fees paid by parents and insurance companies, and by donations.
Straight’s growth from a local treatment facility in St. Petersburg to a multimillion-dollar national program over the last decade has been accompanied by repeated complaints of client abuse.
In 1983, a federal court jury in Virginia found that the organization illegally held an 18-year-old client against his will. Straight was ordered to pay the teen-ager, Fred Collins, $220,000.
Jeffrey James McQuillen testified in the Collins case that in 1983, when he was 19, a rope was tied around his waist when he asked to leave Straight’s St. Petersburg program.
“They put a rope (through) my belt loops,” he testified, “and started tying me up and leading me around like a little monkey.”
Straight’s Peary said the Collins decision persuaded the organization to allow clients over 18 to leave the program upon request.
But recent clients of Straight told The Times that some people over 18 have been held in the program against their will within the last two years.
Alex Zak was 19 when he spent about five months in Straight’s Springfield, Va., center in 1988. Zak said that when he submitted a written request to leave the program, it was torn up by a staff member and thrown in his face. He said when he tried to escape by climbing out a “host home” window, he was tackled and held by another client.
Zak said of his treatment in the program: “I’ve had the inside of my nose cracked by being slammed to the floor. A staff member dragged me across the floor by my hair.”
Peary denied the allegations.
There are numerous similar accusations. For example, several lawsuits filed from 1983 to 1985 in Ohio by attorney David J. Scacchetti complained that youngsters in Straight’s treatment center in Milford, near Cincinnati, were beaten, painfully restrained, held for long periods in small isolation rooms and deprived of adequate sleep and food.
Two of the suits were settled out of court and two are pending.
Straight closed the Milford center in 1987 and denies the allegations in the suits.
In December, 1987, officials of Straight’s treatment center near Dallas admitted to the Texas Commission on Alcohol and Drug Abuse that “Kotex pads and towels had been placed over the mouths of clients who were acting out,” according to a commission report. Straight said the practice was stopped.
“We don’t condone gagging,” Straight’s Margolis told The Times. “One staff member I know of who was guilty of this was fired.”
One of the alleged victims of abuse at the Dallas area center was Erica Clifton, who was 14 when she was a client in 1987. Clifton said that because she was strong and rebellious, “They started putting me on the guys’ side (during group meetings) and calling me ‘butch’ and ‘bad ass.’ ” She said she was also held down while boys in the program painfully pulled her legs apart.
“One time I was resisting,” she recalled, “and they put a . . . Kotex pad down my throat to where I was gagging.”
“We regret things that have happened in the past,” Margolis said of Clifton’s allegations. “When it has been called to our attention, we have taken proper action.”
“It was complete hell,” said Gena Golden, 16, of her stay in Straight’s Dallas treatment center. Golden, who left the program early last year, said her nose was badly broken while she was being restrained, and that clients were sometimes held down and kicked.
Margolis acknowledged that Golden’s nose was broken while the girl while being held. She said it was an isolated incident. She also said that Straight does not condone kicking clients.
The Texas commission found in a report issued last December that abuse of clients continued into 1989 in Straight’s Dallas-area program.
The report said that clients were tied up with rope and with an automobile towing strap to prevent escape, that clients were physically restrained for minor infractions such as “failure to sit up properly,” and that bedrooms were overcrowded and furnished with “containers to be used for urination.”
Margolis said a staff trainee used a rope to tie up a client and was fired, as was an employee who instigated the practice of putting the containers for urine in bedrooms.
After making the allegations of abuse, the state Commission on Alcohol and Drug Abuse cited “an acute need for (drug) treatment services for adolescents in Texas” and allowed Straight to keep its license. An agreement between the commission and Straight calls for the state to monitor the program every 120 days for the rest of this year, requires Straight to use only trained staff members to restrain clients and forbids the use of isolation rooms.
Straight did not admit or deny violating state regulations in the agreement.
Straight also ran into trouble last year in Florida and Virginia where state licensing officials ordered the organization to stop using clients to physically restrain others.
Martha Lenderman, head of the state’s Alcohol, Drug Abuse and Mental Health Office, said officials were concerned about injuries to clients and about “humiliation” and lack of client privacy.
Straight denies that clients are humiliated in the program and maintains that youngsters restrain others only in self-defense. But Lenderman said the organization had been defining “self-defense” to include preventing escapes.
Last June, the Virginia State Department of Mental Health and Mental Retardation alleged that clients in Straight’s Springfield program were restrained by thumb-bending, were yelled at and spat upon, were deprived of food, sleep, family visits and access to toilets and were strip-searched by other clients.
“These are accusations that we well defended,” said Straight’s Peary.
Last Oct. 11, after several months of wrangling over the issue of clients restraining clients, Straight officials agreed in a letter to Virginia state licensing officials to stop the practice. But Straight counselor Traci Eng at the Springfield center told The Times about a month later that clients were still being restrained by other clients.
The Virginia State Department of Mental Health and Mental Retardation is investigating new allegations made this year of physical abuse of clients at the Springfield facility, The Times has learned.
In addition, in Massachusetts, state police and licensing authorities are investigating complaints of alleged abuse in Straight’s Boston-area program.