How to Turn Around Troubled Teens

Mike S. (not his real name) was 13 years old when one of us (Lilienfeld) met him on an inpatient psychiatric ward, where Lilienfeld was a clinical psychology intern. Mike was articulate and charming, and he radiated warmth. Yet this initial impression belied a disturbing truth. For several years Mike had been in serious trouble at school for lying, cheating and assaulting classmates. He was verbally abusive toward his biological mother, who lived alone with him. Mike tortured and even killed cats and bragged about experiencing no guilt over these actions. He was finally brought to the hospital in the mid-1980s, after he was caught trying to con railroad workers into giving him dynamite, which he intended to use to blow up his school. According to psychiatry's standard guidebook, the (now in its fifth edition), Mike's diagnosis was conduct disorder, a condition marked by a pattern of antisocial and perhaps criminal behavior emerging in childhood or adolescence.

Psychologists have long struggled with how to treat adolescents with conduct disorder, or juvenile delinquency, as the condition is sometimes called when it comes to the attention of the courts. Given that the annual number of juvenile court cases is about 1.2 million, these efforts are of great societal importance. One set of approaches involves “getting tough” with delinquents by exposing them to strict discipline and attempting to shock them out of future crime. These efforts are popular, in part because they quench the public's understandable thirst for law and order. Yet scientific studies indicate that these interventions are ineffective and can even backfire. Better ways to turn around troubled teens involve teaching them how to engage in positive behaviors rather than punishing them for negative ones.

Even so, research has yielded at best mixed support for boot camps. In a 2010 review of 69 controlled studies, criminologists Benjamin Meade and Benjamin Steiner, both then at the University of South Carolina, revealed that such programs produced little or no overall improvement in offender recidivism. For reasons that are unclear, some of them reduced rates of delinquency, but others led to higher rates. Boot camps that incorporated psychological treatments, such as substance abuse counseling or psychotherapy, seemed somewhat more effective than those that did not offer such therapies, although the number of studies was too small to draw firm conclusions.

Another method is “Scared Straight,” which became popular following an Academy Award–winning documentary (), which was filmed in a New Jersey state prison in 1978. Typically these programs bring delinquents and other high-risk teens into prisons to interact with adult inmates, who talk bluntly about the harsh realities of life behind bars. Making adolescents keenly aware of prison life is supposed to deter them from criminal careers. Yet the research on these interventions is not encouraging. In a 2003 meta-analysis (quantitative review) of nine controlled studies of Scared Straight programs, criminal justice researcher Anthony Petrosino, now at the research agency WestEd, and his colleagues showed that these treatments backfired, boosting the odds of offending by 60 to 70 percent.

The verdict for other get-tough interventions, such as juvenile transfer laws, which allow teens who commit especially heinous offenses to be tried as adults, is no more promising. In a 2010 summary, psychologist Richard Redding of Chapman University found higher recidivism rates among transferred adolescent offenders than among nontransferred ones.

Perils of Punishment

What is more, adolescents with conduct disorder often enter treatment angry and alienated, harboring feelings of resentment toward authority. Get-tough programs may fuel these emotions, boosting teens' propensity to rebel against parents and teachers. Finally, some programs may inadvertently provide adolescents with role models for bad behavior. For example, some of the at-risk teens exposed to prisoners in Scared Straight programs may perceive them as cool and worth emulating.

These results show that merely imposing harsh discipline on young offenders or frightening them is unlikely to help them refrain from problematic behavior. Instead teens must learn enduring tools—including better social skills, ways to communicate with parents and peers, and anger management techniques—that help them avoid future aggression. Several effective interventions do just that, including cognitive-behavior therapy, a method intended to change maladaptive thinking patterns and behaviors, and multisystemic therapy, in which parents, schools and communities develop programs to reinforce positive behaviors. Another well-supported method, aimed at improving behavior in at-risk children younger than eight years, is parent-child interaction therapy. Parents are coached by therapists in real time to respond to a child's behavior in ways that strengthen the parent-child bond and provide incentives for cooperation [see by Ingrid Wickelgren; , March/April 2014].

The negative data on get-tough programs remind us that we should be wary of our subjective impressions of strategies that simply seem right or that we feel ought to work. Although we lost track of Mike S., we now know that a concerted effort to teach him more adaptive behaviors would have been more likely to put him on a productive path than would any attempt to scare him straight.

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