A comprehensive investigation has uncovered how companies previously focused on boarding schools for wealthy troubled teens have shifted their attention to a vulnerable new market: adopted children.
Despite representing only 2% of children nationwide, adopted youth comprise an estimated 25-40% of those placed in the loosely regulated network of for-profit residential treatment facilities, wilderness programs, and boarding schools that experts call the “troubled teen industry.”
Former residents shared with investigators their belief that they became trapped in what amounts to a hidden orphanage system, where children face the exact outcome adoption was meant to prevent — instead of permanent loving homes, they found themselves warehoused for years in harsh and sometimes abusive institutions.
Former participants described these programs as prison-like environments, despite having committed no crimes and facing no formal sentences or judicial oversight. Parents typically make unilateral decisions about sending children away and determining the length of their stay.
Investigators spoke with numerous program participants, families, former staff members, government officials, lawyers and specialists, while reviewing hundreds of official documents and business records to understand how adopted children end up in these facilities despite their troubling histories.
These institutions command fees reaching $20,000 monthly by marketing themselves as specialists in treating adopted children for reactive attachment disorder, commonly known as RAD. They present themselves as solutions for overwhelmed adoptive parents, claiming children’s behavioral issues stem from an inability to form healthy relationships with caregivers that can be corrected through distant treatment.
However, mental health professionals assert that most teenagers in these facilities likely don’t suffer from RAD, and the treatments provided wouldn’t address the condition even if they did have it.
According to Brian Allen, a psychologist who directs the mental health program at Penn State’s Center for the Protection of Children, the diagnosis applies to young children who experienced such severe early neglect that forming bonds with caregivers becomes difficult.
Allen explained that the condition was originally identified in severely understaffed foreign orphanages where infants received minimal human contact or affection. The Diagnostic and Statistical Manual of Mental Disorders specifies it affects children under 5 who become so emotionally withdrawn they don’t seek comfort when frightened or upset. The condition is exceptionally uncommon and doesn’t apply to older children who experienced early neglect but exhibit behavioral problems years later.
Yet some practitioners broadly apply RAD diagnoses to virtually any adopted pre-teen or teenager displaying behavioral challenges, Allen noted. His clinic examined 100 adopted and foster children referred for treatment and found that while roughly 40% had received RAD diagnoses, none actually met the clinical criteria.
Allen advocates removing RAD from official diagnostic manuals, arguing the diagnosis has become too “corrupted.” Nevertheless, numerous facilities continue advertising RAD treatment services.
“Often what sweeps in is this overpromise, a very seductive promise from residential treatment centers,” explained Sloan Nova, a University of California San Francisco psychologist who was adopted from South Korea in the 1980s and later placed in a treatment facility as a teenager.
“So it just sounds almost too good to be true.”
The investigation identified significant financial incentives driving the targeting of distressed adopted children. Researchers found at least 80 private facilities marketing services for adoption-related issues.
Many operations began as small programs using behavioral modification methods historically based on Christian principles, according to experts. Today, public and private investment firms attracted by substantial profit potential and steady client flow have been purchasing centers and commercializing treatment approaches.
This dependable revenue stream enables investors to enter “into these markets risk free,” according to Raj Kumar, a healthcare analyst at financial services firm Stephens.
Kumar noted that residential treatment centers promise attractive 20% profit margins by minimizing staff expenses and maximizing treatment duration. This approach succeeds partly because these facilities face far fewer regulations than other residential healthcare settings like nursing homes.
Family Help & Wellness, a private equity-backed company operating more than a dozen facilities nationwide, currently faces multiple abuse-related lawsuits.
In a statement, the company said its programs operate independently and that it supports stronger industry regulations while working to enhance oversight and improve care quality aligned with current best practices.
“The safety, well-being, and long-term success of every young person and family are our priority,” the company stated. “We recognize this is an area of increasing public attention and scrutiny, understandably so, given the real impact on young lives.”
The consequences can be severe: Two of the company’s North Carolina facilities closed in the past two years following student deaths.
Kate, whose full name is being withheld due to her status as a sexual assault victim, spent most of her adolescence in institutions, including two later acquired by Family Help & Wellness. She reports being sexually assaulted by another student at Asheville Academy before transfer to Utah’s Uinta Academy.
Kate was 13 upon arriving at Uinta Academy. During her first night, she experienced a panic attack when her roommate extinguished her night light. She had feared darkness since the assault at her previous facility and ran to curl up while crying and hyperventilating.
Three staff members approached her, but instead of offering comfort, they forced her face-down onto the carpet while shouting that she was “OIC” — “out of instructional control.” For approximately an hour, they restrained her with one person on each arm and a third holding her legs.
Kate described screaming “I can’t breathe” as mucus ran from her nose. Eventually she fell silent from exhaustion and was released to sleep without her night light.
Students were required to follow all instructions without question while maintaining neutral facial expressions — no sighing, frowning, or crying permitted. Rule violations resulted in hours of scrubbing floors with toothbrushes while kneeling, or outdoor labor in 100-degree heat raking moldy hay and pulling weeds. The smell of freshly pulled weeds continues to nauseate her.
“We were afraid all of the time,” she recalled.
Her experience reflects broader patterns documented in a congressional investigation led by U.S. Senator Ron Wyden of Oregon, which found that facilities nationwide suffered from chronic understaffing leading to inappropriate physical restraints, inadequate mental healthcare, and widespread physical, sexual, and emotional abuse. The report, titled “Warehouses of Neglect,” detailed pervasive use of improper restraints, insufficient mental health services, and extensive abuse.
The investigation concluded that these facilities often operated more like detention centers for troubled youth rather than therapeutic environments where vulnerable children could heal.
