Attack therapy is one of several pseudo-therapeutic methods described in the book Crazy Therapies . It involves highly confrontational interaction between the patient and a "therapist" or between the patient and fellow patients during group therapy, in which the patient may be verbally abused, denounced, or humiliated by the therapist or other members of the group. [1] [2]
The method has been used by groups such as Synanon, Odyssey House, Excel Academy (Conroe, Texas), Straight, Inc., the John Dewey Academy, Élan School, Phoenix House, DeSisto School, Amity Circle Tree Ranch, CEDU School, Hidden Lake Academy, Cascade School, Monarch School, and similar methods have been employed in Large Group Awareness Training. [3] [4] [5] [6]
A 1990 report by the Institute of Medicine on methods for treating alcohol problems suggested that the self-image of individuals should be assessed before they were assigned to undergo attack therapy; there was evidence that persons with a positive self-image may profit from the therapy, while people with a negative self-image would not profit, or might indeed be harmed. [2]
Attack therapy can be particularly problematic when the group members are captive, and not allowed to leave during the sessions. [7] In Group Psychotherapy with Addicted Populations, Flores notes that attack therapy can take place when individuals are psychologically intimidated in a confrontational atmosphere. [8] In her book Help at Any Cost: How the Troubled-teen Industry Cons Parents And Hurts Kids , Maia Szalavitz writes that attack therapy can include the tactics of isolation, and rigid imposition of rules, which later leads to a restoration of limited permissive freedom, and an acknowledgement of those that did comply with the strict rules. [9] Psychologist Donald Eisner writes in The Death of Psychotherapy that attack therapy "attempts to tear down the patient's defenses by extreme verbal or physical measures". [10] Tudor describes attack therapy in Group Counselling, writing that the individual is ridiculed in front of others, and cross-examined and questioned about their personal behavior patterns. [11] According to Maran's book Dirty, attack therapy can take place in "all-night encounter groups and daily interactions". [12] Monti, Colby, and O'Leary write in Adolescents, Alcohol, and Substance Abuse that in attack therapy, there was a movement to: "tear them down in order to build them up", referring to a methodology of tearing down the individual ego in order to then educate the individual in the inherent thought-patterns of the group and the group leader. [13]
In Concise Encyclopedia of Psychology, Corsini and Auerbach note that attack therapy puts an emphasis on the expression of anger by each individual. [14] One Nation Under Therapy by Satel and Sommers characterized attack therapy as among the "more bizarre expressive therapies", and put it in the same category as The Primal Scream, Nude Encounter, and Rolfing. [15] In Social Problems, Coleman and Cressey write that in attack therapy, one individual is criticized and "torn down" by the rest of the larger group. [16]
In their textbook Helping People Change, Kanfer and Goldstein note that the controversial group Synanon used a form of attack therapy. [17] A publication by the National Association for Mental Health wrote that the Synanon form of attack therapy was also called the "Synanon confrontation game". [18] The Concise Encyclopedia of Psychology also described the Synanon method of attack therapy, noting that it even differed from other models that could be seen as using a similar approach. [14] Balgooyen compared "Synanon game verbal attack therapy" to standard group therapy, in a study published in the Journal of Community Psychology. [19] In Dictionary of American Penology, Williams writes that attack therapy was actually first developed in the Synanon group. [20] In Therapeutic Communities for the Treatment of Drug Users, it is noted that in Synanon, attack therapy was referred to within the group by members simply as "The Game". [21] Similarly, the attack therapy techniques used in Synanon have been described in the Therapeutic Community by a former participant as "brutal and bordering upon sadism". [22] In addition to comparisons to Synanon, Miller and Rolnick also compare the methods of attack therapy to Scared Straight! , and "therapeutic" boot camps, in their book Motivational Interviewing: Preparing People for Change. They note that the supporters of attack therapy believe that: "...people don't change because they haven't suffered enough". [23] In her book Help at Any Cost: How the Troubled-teen Industry Cons Parents And Hurts Kids , [24] Maia Szalavitz describes the abusive attack therapy techniques by Straight, Inc. This method of therapy was also used at the now defunct Élan School. [25] Part of the reason for Élan being closed was due to pressure from activists who saw the usage of this form of therapy as wrong and humiliating. [26] Rumors of the use of attack therapy also surround the John Dewey Academy, as many ex-residents have written online about the brutal three-hour, thrice a week "confrontation groups" that make up the treatment program at the school. [27] [28]
The WWASP schools used a modified version of attack therapy, along with various other types of therapy, in the different seminars their students were required to attend in order to graduate. Some schools under the WWASP umbrella used it more often than others; for instance, attack therapy was pretty much part of the daily routine at Tranquillity Bay and Cross Creek.
A study of group therapy in over 200 normal college students conducted by Yalom and Lieberman found that 9.1% of the students who completed over half of a series of "encounter groups" using attack therapy had psychological damage lasting at least six months. The most dangerous groups were the Synanon-style groups with a harsh, authoritarian leader. [29]
William Miller and colleagues found that the more confrontational a counselor was, the more his or her clients with alcohol problems drank. [30]
A 1979 study cited in Broadening the base of treatment for alcohol problems: report of a study by a committee of the Institute of Medicine, Division of Mental Health and Behavioral Medicine (1990) found that attack therapy applied to a "heterogeneous correctional population" did not result in a net benefit to the treatment group. The study noted that approximately half the individuals had benefited, while the other half had not been helped, or seemed in fact to have been harmed. The people who had been helped by the therapy were those who—according to the psychometric assessment carried out at the beginning of the study—had a positive self-image. The participants who had a negative self-image did not benefit from attack therapy. The report suggested that there should be a pre-treatment assessment of potential participants' self-image, and that treatment assignment should be guided by the results of such assessment. [2]
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD and anxiety disorders. Cognitive behavioral therapy focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.
Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group. The term can legitimately refer to any form of psychotherapy when delivered in a group format, including art therapy, cognitive behavioral therapy or interpersonal therapy, but it is usually applied to psychodynamic group therapy where the group context and group process is explicitly utilized as a mechanism of change by developing, exploring and examining interpersonal relationships within the group.
Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.
Synanon, originally known as Tender Loving Care, was a new religious movement founded in 1958 by Charles E. "Chuck" Dederich Sr. in Santa Monica, California, United States. Originally established as a drug rehabilitation program, Synanon developed into an alternative community centered on group truth-telling sessions that came to be known as the "Synanon Game", a form of attack therapy.
Cognitive analytic therapy (CAT) is a form of psychological therapy initially developed in the United Kingdom by Anthony Ryle. This time-limited therapy was developed in the context of the UK's National Health Service with the aim of providing effective and affordable psychological treatment which could be realistically provided in a resource constrained public health system. It is distinctive due to its intensive use of reformulation, its integration of cognitive and analytic practice and its collaborative nature, involving the patient very actively in their treatment.
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or other people's mental states, influences those behaviours, and consists of techniques based on behaviorism's theory of learning: respondent or operant conditioning. Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists. They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method, but it has a wide range of techniques that can be used to treat a person's psychological problems.
The John Dewey Academy is a private, coeducational college preparatory therapeutic boarding school in Great Barrington, Massachusetts, formerly housed in Searles Castle. It was founded in 1985 by Dr. Thomas E. Bratter, who died in 2012. In May 2020, the school was purchased by its current head of school, David Baum. As of July 2022, the school was on hiatus for a "complete reboot" at a new location.
Child psychotherapy, or mental health interventions for children refers to the psychological treatment of various mental disorders diagnosed in children and adolescents. The therapeutic techniques developed for younger age ranges specialize in prioritizing the relationship between the child and the therapist. The goal of maintaining positive therapist-client relationships is typically achieved using therapeutic conversations and can take place with the client alone, or through engagement with family members.
Élan School was an abusive behavior modification program and therapeutic boarding school located in Poland, Maine. It was a full member of the National Association of Therapeutic Schools and Programs (NATSAP) and was considered to be a part of the troubled teen industry. The facility was closed down on April 1, 2011, due to multiple reports of abuse, many from former students, dating back to its opening in 1970.
Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids is a non-fiction book by Maia Szalavitz analyzing the controversy surrounding the troubled teen industry. The book was published February 16, 2006, by Riverhead Books. Szalavitz focuses on four programs: Straight, Incorporated, a copy of the Straight Inc. program called KIDS, North Star wilderness boot camp, and the World Wide Association of Specialty Programs and Schools. She discusses the background, history and methodology of the troubled-teen industry, including techniques drawn from attack therapy and Synanon. She uses first-person accounts and court testimony in her research, and states that no evidence exists proving that these programs are effective. The book also includes advice for parents and an appendix with additional resources on how to get responsible help for teenagers.
Common factors theory, a theory guiding some research in clinical psychology and counseling psychology, proposes that different approaches and evidence-based practices in psychotherapy and counseling share common factors that account for much of the effectiveness of a psychological treatment. This is in contrast to the view that the effectiveness of psychotherapy and counseling is best explained by specific or unique factors that are suited to treatment of particular problems.
Daytop, or Daytop Village, or “Daytop Village New Jersey Inc.” is a drug addiction treatment organization with facilities in New York City and New Jersey. It was founded in 1963 in Tottenville, Staten Island by Daniel Harold Casriel along with Monsignor William B. O'Brien, a Roman Catholic priest and founder and president of the World Federation of Therapeutic Communities. Ron Brancato from the Pelham Bay area of Bronx New York, Program Director and former resident of Synanon, California. Synanon was the only other drug rehabilitation program until Daytop Village opened. Daytop also included a juvenile program based in Mendham, New Jersey. The Mendham, New Jersey facility also included a school for juveniles called Daytop School.
Daniel Harold Casriel was an American psychiatrist, psychoanalyst and writer from New York City. Casriel's method of group psychotherapy proposed a framework for the field of relationship education, the "PAIRS' relationship roadmap for couples". Dr. Casriel also founded the Daytop treatment centers, which were strongly inspired by the psychotherapy cult Synanon.
Addiction psychiatry is a medical subspecialty within psychiatry that focuses on the evaluation, diagnosis, and treatment of people who have one or more disorders related to addiction. This may include disorders involving legal and illegal drugs, gambling, sex, food, and other impulse control disorders. Addiction psychiatrists are substance use disorder experts. Growing amounts of scientific knowledge, such as the health effects and treatments for substance use disorders, have led to advancements in the field of addiction psychiatry. These advancements in understanding the neurobiology of rewarding behavior, along with federal funding, has allowed for ample opportunity for research in the discipline of addiction psychiatry. Addiction psychiatry is an expanding field, and currently there is a high demand for substance use disorder experts in both the private and public sector.
About 1 in 7 Americans reportedly suffered from active addiction to a particular substance. Addiction can cause physical, emotional and psychological harm to those affected by it. The American Society of Addiction Medicine defines addiction as "a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences."
Confrontation is an element of conflict wherein parties confront one another, directly engaging one another in the course of a dispute between them. A confrontation can be at any scale, between any number of people, between entire nations or cultures, or between living things other than humans. Metaphorically, a clash of forces of nature, or between one person and his own causes of internal turmoil, might be described as a confrontation.
Donald H. Meichenbaum is an American psychologist and Distinguished Professor Emeritus of Psychology at the University of Waterloo, Ontario. He is a research director of the Melissa Institute for Violence Prevention and Treatment at the University of Miami. Meichenbaum is known for his research and publications on psychotherapy, and contributed to the development of cognitive-behavioural therapy (CBT). In 1982, a survey of 800 members of the American Psychological Association voted Meichenbaum the tenth most influential psychotherapist of the 20th century. At the time of his retirement from the University of Waterloo in 1998, Meichenbaum was the most-cited psychology researcher at a Canadian university.
The troubled teen industry is a broad range of youth residential programs aimed at struggling teenagers. The term encompasses various facilities and programs, including youth residential treatment centers, wilderness programs, boot camps, and therapeutic boarding schools.
Jacques P. Barber is a French-born, American clinical psychologist and psychotherapy researcher. He is an Emeritus Professor and Dean at the Gordon F. Derner School of Psychology at Adelphi University. He served as Dean from August 2011 until his retirement in August 2023.
The widely reported stories of abuse and violent intimidation — all were bullied into sharing their innermost secrets via "The Game," a form of attack therapy; mass beatings were administered by a group called the Imperial Marines for perceived infractions — didn't really register with her.