Katie R. (6:46)

Hi, my name is Katie R. I have a PhD in social work research and I went to Island View Residential treatment center in 2004 for eight months and then the Oakley School in 2005 for 12 months. I'm doing this podcast because this is a story that isn't told a lot. I don't think there's enough mainstream attention to it and there are a lot of people that are suffering as survivors of these institutions and often in silence because a lot of people can't understand these experiences. I'm also horrified that children continued to be treated this way in 2025. So it felt important to tell my story and to provide some context about why this type of treatment doesn't work for my research experience. I'm also doing this in hopes that it'll reach some parents who have kids with mental health issues. Unfortunately, the way our health insurance systems work is children are treated as the identified patient, but parents are often left out of the equation or minimally included in things like family therapy. Addressing youth mental health is more than fixing the child. It's addressing aspects of their environment. It doesn't mean that parents are bad parents, but parents aren't always well equipped to handle mental health and all its intended behaviors. And there are other ways to safely maintain your children at home to reserve residential care facilities for kids with the most extreme behaviors. My parents got divorced when I was three. So I would move away to a new city with my mom and then back with my dad and then back with my mom. Around age 6, we had moved to a city with my mom and her new husband, who had a lot of mental health issues of his own and struggled with explosive anger and was physically violent with my sister and I. He could also be really fun. I was very attached to him as a father figure. I didn't know that this was not normal. When I was 8, it hit a critical point where he had hurt my sister bad enough that my dad became aware of the abuse and he uprooted, rooted us and moved us back to the city he lived in. From there, I was raised in a household with a dad who worked all the time, nannies who worked regular business hours. I had very low supervision. I had trouble fitting in with my peers. I wasn't bullied or anything. I just never could quite figure out who I was and where I fit. At 12, I started to experience clinically severe depression and anxiety. I found self harm as a coping mechanism to deal with the overwhelming emotion. So I would cut in places that people couldn't see, like my shoulders and my ankles. And I would wear long sleeves and high socks because I didn't want anyone to know I was doing it. When my parents caught on, they immediately put me into individual therapy. In a practice that had a psychiatrist, I was getting medication. I remember the therapist sitting me down with the diagnostic statistics manual and looking through diagnoses and asking me, do you think you fit this one or do you think you fit that one? Mental health diagnoses just became a part of my identity. I'd always report I wasn't doing well and he would just continue to increase the milligrams of whatever medication I was on. I was on a mood stabilizer and an antidepressant. And as the medication increased, so did my suicidal ideation. I had faith at the time in some type of higher power that I called God. I would pray to God every night that I wouldn't wake up in the morning. And when I did, it felt like a failure of God. So I abandoned that idea. In the spring of my eighth grade year, I didn't have a ton of supervision. I was part of a crew of kids. You know, we'd get dropped off at the movie theater to see a movie, and we'd do anything but watch a movie. I was at a friend's house, and we had snuck out late at night to meet up with some boys in a park that I had not met before, but had communicated with on AOL Instant Messenger. One of the boys brought a big bottle of vodka, and it was the first time I ever drank. I have a memory of drinking straight out of that bottle. And the next thing I knew, I woke up in a hospital. I had at some point passed out, and one of the boys we were with had raped me while I was unconscious. They had dragged me through the mud trying to figure out what to do with me. And finally my friend called her mom, who picked us up to take me to the hospital. When I woke up in the hospital, my hair was full of leaves and mud. A nurse had asked me about whether or not I wore protection. I didn't know what she was talking about. And that's how I found out that I had been raped. I did have a chance to connect with that friend that was there that night, and she said I was unconscious. She wondered if she should intervene, but was afraid it wouldn't be cool if she did. So we are 14 years old. It wasn't really her job to protect me. It was the adults that should have been keeping an eye on us. So I don't hold fault for her in that regard. Three months later, I was really depressed, and I was also feeling socially isolated. This boy that had raped me was also an ex boyfriend of a really good friend of mine. I felt responsible because I had flirted with this kid over AOL Instant messenger before it happened. So I had my dad drive me to my friend's house so I could sit her down and tell her what happened. And I thought she was going to be furious at me. And she just cried and held me and told me how sorry she was. It was a confusing time. I Was embarrassed, and I was afraid of any social backlash. I think my mom called this kid's parents. That mother was like, not my sons, never my sons. I just dove deeper into depression. I had started going out at night regularly. I was drinking in bars. I was waking up in people's lawns. I was engaging in a lot of high risk behavior because I'd pretty much given up. And nothing about the way my parents parented me changed. There was no change to communication, to supervision. They didn't know what to do, so they didn't do anything. I think about three months later, I swallowed a bottle of Excedrin pm, hopeful not to wake up. But then my phone started ringing. I picked it up and it was my grandmother on the phone calling for my dad. I've always been really close to my dad's mother, and I felt guilty. I started thinking like, I can't do this to her. So when my dad got off the phone, I said, I think I need to go to the hospital. And then I spent three days in the hospital while they did a mini psychiatric evaluation to decide whether or not to release me. My parents were at a loss, and someone connected them with an educational consultant. This is someone who helps parents figure out school stuff with their kids, which could include residential treatment centers. Some of them are accredited schools. She had told them at that point, if you don't send this kid away, she's not going to live. I ended up on a wait list for Island View because the year before, some family friends of ours had sent their daughter there and they were like, this place was really great for her. It was a couple years later that they realized how badly that place had traumatized her. But they didn't know then. The programs are really good at generating behavioral compliance. So when a kid comes out of treatment, they may seem like a reformed child, but sometimes there's a lag effect of when the mental health issues arise. It was 2003 that we got connected with that ED consultant. It was March 19, 2004, that I went to Island View. During that time, I just gave up in school. I stopped submitting assignments because I knew I was going away. The idea that I could escape where I was for any amount of a time appealed to me before I knew what I was getting into. So I went willingly. We had a layover on the way to Utah, and my dad looked at me and was like, are you really sure you want to do this? And I was like, yeah, absolutely. I look back at that moment and I'm like, I wish there was any doubt in my mind because I'm pretty sure my dad would have put me back on a plane and taken me home. I think sending me away was one of the most painful things my dad ever had to do. For them, this was a last resort. When I got there, they gave my dad and I like a 15 minute tour. I remember the doors kept locking behind me and I looked at the admissions person and said, when do I get keys to the doors? And she laughed and continued on. It turns out that the way that program was designed, the only time we were outside on the campus, unless we were like going hiking off site, was when we were doing physical education. And the rest of the time we were in a locked building. Whether it was where we went to school or where our team was housed. When the doors would close, there was like a three second delay before the door locked. I used to lie in bed and just listen to people coming in and out of the building and thinking about that three seconds. If I got up right now, could I make it out the door and get away? Some people tried and did get away but for a time and then they were returned.

Tiffany Reiss (16:56)

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Katie R. (18:09)

The building I was in, there was one long hall with rooms on either side and then one group room. In this group room is where we had all our therapeutic groups. But it was also the place where we had, quote, free time, where we could sit and hang out. It was our only common space. And then there was a identical group room and residential hallway on the other side. So in our building, we had one female unit and one male unit. And then there was another building that had two female units and two male units. But. But there was no social interaction between the teams. And I think there were like around 15 to 20 people per team. When you were walking through the hallways, you had to avert your gaze to the ground because if you were caught making eye contact with someone on a different team, it was considered flirtatious communication and you could get big trouble for that. The only time we were allowed to talk to each other is if there was a classroom assignment and we'd been given permission to talk about the assignment at hand. I'm sure at some point a staff member sat me down and handed me the resident manual and explained some of the rules to me. But a compass was a student that had been there for a while and achieved a certain level status. And a compee was someone that was new. So my compass was my roommate. It was her job to kind of onboard me onto the rules. Our days were very, very structured. We would get up, we had 20 minutes to straighten up our rooms to a certain standard to shower and get ready for the day. I wouldn't say that any hygienic products were withheld from me. We couldn't have access all the time to like a razor to shave our legs. It was something we had to check out of a closet during our 20 minute hygiene window. So most people just opted not to shave their legs and armpits because there just wasn't time. The way our rooms were designed, there was two people per room and a bathroom between each pair of rooms. So it was four girls to a shower. I would say. In general, the facilities were relatively clean. We didn't have a cleaning crew. We were responsible for all the upkeep and maintenance of our units. I think that was part of their overall philosophy of discipline. Kind of like the military. We had like a morning group on weekdays. We would go to school. We would have these therapeutic groups where they had a box of complaints or observations peers made of others. And they would attend to the people who had the most complaints or observations to try to correct behavior. For instance, if someone was doing too well, if they weren't having any issues, they'd be confronted on what they called fronting, where you're pretending like everything's okay, but it's not. People might get confronted on being confrontational or engaging in underground talk. Let's say two girls were overheard talking about a boy on another team that they thought was cute. That would be a cause to be confronted. Any behavior that broke from the behavioral compliance mode could be confronted in these groups. But they had these special groups called problem solving groups. And these were groups where your team, I was on copper team, they would pull you out of class. You had no idea who was in trouble, but you knew someone was in the shit. And they would bring you into the conference room in. A couple therapists would walk in and some of the milieu staff, which were the house parents, they would call out one person. And once you were called out, you were not allowed to speak, you were not allowed to respond. You had to just listen. And they would go around the room and confront you. As residents, we also need to engage in confrontation. It's how we're able to gain privileges and work our way up the level system to eventually leave. When the group is over, they usually give you some time to reflect on your own and then you go back to class. And the assumption from staff was always that there was malicious intent. You couldn't make a mistake, you couldn't be impulsive. It was always an indication of your bad character that they needed to fix. The mentality was, we're going to break you down to build you up. And there was a lot of breaking down and not a lot of building up. Even as you climbed the level ladder, there was this omnipresent fear of I could make a mistake and I could lose everything and fall down the ladder. So it was a very fear driven program as well. There was a delay in getting to call my dad. The first time we got one or two calls home a week for 10 minutes, all calls were monitored. And if they thought you were trying to manipulate your parents, they would end the call and remove your call privileges. I didn't know this yet, but before I got to call home, they had been prepping my dad. When she calls, she's going to tell you, this is not a good place. She doesn't belong here. We're awful. She's going to say all of these things and if you believe her, you're enabling her behavior and her state of being and you are prohibiting her growth. And so that first call, which I'll never forget, I was like, dad, I don't belong here. The way they treat us isn't right. He was just conflicted. I could tell he wanted to believe me. But he had already been prepped that I would say all these things.

Tiffany Reiss (24:06)

What were the staff like that were monitoring the communication?

Katie R. (24:11)

So it was just the milieu staff that we regularly engaged with. These were like the house parents. They were the ones that were lining us up. I would say for the most part they were young. A couple of them were college students, some for them, this was their full time job. It was a spectrum of people. I don't know what qualifications they needed to have those positions, but I can't imagine they needed any type of mental health qualification to serve in those roles.

Tiffany Reiss (24:41)

But you did see a therapist?

Katie R. (24:43)

Yes, he was a provisionally licensed master's of social work and I had a licensed chemical dependency counselor because, you know, I had this nine month substance use career. So I had a chemical dependency counselor too that I think I met with weekly. When I first got there, it was a rough landing place for me. I was pretty outspoken. I didn't have a strong will to live, but I was confident and I had a strong personality, which resulted in a lot of confrontation. I was never subject to physical restraint. Had I showed any type of physical aggression, they would have what they called pi4me. When a resident would show any physical aggression, they would send out an intercom like we need a pi4. And they would call in the biggest dudes on staff that day and they would tackle students to the ground, restrain them and haul them off to a timeout room that they were left in until staff had decided that they had sufficiently calmed down. I think about two or three weeks in I had started to submit. I stopped fighting because one, I hated being confronted in a group of people. It was very uncomfortable and I realized that if I didn't figure this out, I was going to be here forever. I had a pair of nail clippers that I had brought inside a teddy bear because I was so attached to my coping mechanism of self harm. And I decided that I was going to give those up because I wanted to figure out how to do well to get out. When I surrendered those, they pulled my mattress out into the hallway. You had to sleep under the fluorescent light so that the sole night staff person could watch you in the night and make sure you didn't hurt yourself. And I was pissed. I remember getting in a fight with one of the staff. She was telling me to put on my pajamas and I was telling her she could go fuck herself. I wasn't putting on my pajamas and sleeping in a hall under fluorescent lights. From what I recall. I was just sitting on the mattress Screaming at her and she was screaming at me. And I think eventually she just gave up. And I slept in my clothes in the hallway. I think that was kind of my rock bottom. I thought I was doing the right thing by holding myself accountable. Everything they do is punishment based. And so you try to figure out the rules and how to navigate them because you want to be on good behavior, you want to be compliant because you don't want to be the kid that's been there for two years. But even as you get rewarded with these level systems, there's always this increasing fear of at any time I could lose this. It was an intense environment. After that first few weeks, I started to figure it out. You're on this initiation phase and then we have all these levels you're on explore where you get some minimal privileges. At the time, we had walkmen and we could listen to music. You couldn't sing it out loud if it was inappropriate words. But it was one little bit of freedom you could have. And then you move on to apply where you might be able to go on an off site like a field trip, and then impact where you were given some more responsibility and a little bit more freedom. Then at the test level, you had the ultimate privileges. They there could be times where you could talk to people on other units and go on special camping trips and serve on accountability or leadership boards where you were part of a panel that would dole out punishments to other peers when they got in trouble. Other than just dropping people down a level so taking away their privileges, they use social isolation. If you broke a rule, they could put you on what's called yellow zone. Yellow zone is where you're socially isolated for at least 24 hours. And up to 72 hours you're confined to your room. So all schoolwork comes to your room. All meals come to your room. None of your peers can acknowledge you. Staff have minimal contact with you. You're expected to reflect on the bad thing you did. If you were sick, it was the same treatment. You were socially isolated. You could not leave your room. People could not engage with you or look at you until your therapist had signed off that you could once again be engaged and rejoin your community. I had so many attachment issues. Connection for me was what I always yearned for. If I had to wager a guess, that's probably true for a lot of kids that end up in these facilities. Being completely cut off socially was an awful experience. I may have taken confrontation over complete lack of social interaction. A couple of boys, units in a Different building had been caught looking at a yearbook and objectifying girls in their high school class. They thought the boys needed a reality check. So my therapist thought it would be helpful to have me sit in a group room with about 40 boys my age and talk about what it was like to be raped. It was still somewhat of a recent unprocessed event for me and I don't remember a ton about that experience. And I remember thinking something doesn't seem right about this. But also, I didn't have a choice. You know, if I didn't take my therapist's suggestions, I wasn't being behaviorally compliant. I was really averse to boys at this point. My therapist had also scheduled play dates between me and boys for like 10 minute card games in the evening to get me more comfortable with boys my age, which I didn't want to do. He would jokingly threat that if I didn't do these things then he was going to move me into a room on the boys unit. Of course I didn't want that, so I would do these things. But that was wildly inappropriate. You get in this place where you have to internalize the way of the program, it becomes a way of survival. I think there are some kids that are really good at faking it, doing what they need to do and getting out. I have never been a good liar. My face says everything I think and feel. So I really had to internalize this philosophy. I had to believe that they knew better than I did, that I was an inherently bad person. But if I could follow their rules, I could redeem myself. I was paralyzed by those rules. I was on sick bed in social isolation. We had very strict rules that we couldn't go into each other's rooms. It must have been during a school day or something because no one else was on the unit except for a residential staff who was in the epicenter of the building down the hall. And I heard one of the other residents across the hall from me crying and screaming. She was on Yellow Zone. She had somehow gotten a hold of some sharp instrument and was self mutilating. I was on social isolation and I was afraid of breaking the rules. I couldn't flag down a staff because I wasn't allowed to speak directly to staff. And I certainly couldn't go in her room and all I could do was sit outside her door and cry. And it was probably the most helpless I felt. Eventually a staff member caught wind and I think they took her for medical care. There was nothing trauma informed or mental health oriented about was like that the whole way through. When I was there, a kid figured out a way to die by suicide. We were in our units. There were like all these frantic calls over the intercom. We heard ambulances, but we didn't know what was going on. The next day, we found out that he had hung himself in the bathroom. An hour and a half before he had hung himself. I was sitting across from him in history class. I knew what he was wearing. I could see his face. Every time I closed my eyes, I could see him. The executive leadership walked around to all the classrooms. They wanted us to. To know that his family knew he was going to do this, and they were just happy he did it. Here at that age, at 14 years old, I remember thinking, like, something's not right about this. Why are you saying this? Why are you telling us this? And who knows what the purpose was. I don't know if it's because they were afraid we were all going to call home and tell our families and our families were going to pull us out of there, but that was the messaging. After he died, they did some immediate crisis processing with us. But I don't know that I ever really was able to process that death, especially in that situation. I still think about that kid today. It just left a mark. This place was not designed or equipped to handle mental health issues. It was designed and equipped as if it was a juvenile detention facility, which kids in juvenile detention facilities also need. Compassionate mental health care.

Tiffany Reiss (34:10)

Did your parents come and visit you at all while you were there?

Katie R. (34:14)

Yes. Maybe, like in month three or four, my parents could come out and visit around a parent's weekend. We do in person family therapy. And then if we were on the appropriate level, we could go off site with them for a couple hours. And so my dad, he could only take me to lunch and then return me. And then as soon as I got back, they did all the drug tests and the strip searches to make sure I wasn't using and had brought back contraband. We're sitting in the restaurant and I had to go to the bathroom, and I looked at my dad and I was like, can you come stand outside the bathroom? And he was like, why? I hadn't gone to the bathroom unsupervised, and I was just so afraid to be in a public bathroom by myself that somehow I was going to do something wrong and I was going to get in trouble that my dad had to get up and stand outside the women's bathroom. Six or seven months in, I got to go home for three days. And I was so afraid to make a mistake that I didn't want to leave the house. My mom was like, do you want to go to the mall? I'm like, absolutely not because I'm going to run into people I know and then there's a chance I'm going to do something wrong. So I just stayed at home for three days and then flew back. And I don't know if I got norovirus or something, but the first night back things were coming out all orifices all night long in the bathroom. It was a mess. And the way they handled it is when morning shift came on, they dropped a bunch of cleaning supplies outside my bathroom and said clean it up. As soon as I cleaned myself up and came out, they put me in a confrontational group to ask me what I was so nervous about. Clearly I had done something while I was home that I'm feeling bad about and nervous about and that's why I was so sick. And they never let it go, at least for the next few days, to the point where I started asking myself, did I do something wrong?

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Katie R. (37:24)

I read back on my journals and as I was approaching eight months my therapist had decided that I needed to go to a step down program called the Oakley School. I in my journal wrote about like but he won't tell me why I thought I was doing good. I don't understand why I have to go somewhere else. I wasn't allowed to have any input. The director of Island View had chosen a place for me and my dad had consented to send me there. Although my dad was also confused about why I Couldn't come home. What they didn't explain to my dad is that the same parent company owned both treatment centers. So it was also an opportunity for them to self refer to continue to take money from my parents. When a resident leaves, they make something to put on the wall. And since we were the copper team, it was always a giant penny. You go around the circle and all the therapists you've worked with, you can invite some staff members you like, come and congratulate you and wish you well and tell you what they hope you'll continue to work on and then you leave. I was only at Island View for eight months. I quote graduated from Island View, I think on November 16th of 2004. My birthday was on the 18th and I started Oakley on the 19th. That transition to Oakley was a wildly unhealthy experience. Experience for me as well. They wouldn't let me go home in between programs because they warned my dad that if he brought me home I'd run so I wouldn't have to go to the next program. I didn't know what a long term program was. I thought it was going to be like summer camp. I was going to go for two months and hang out with other kids and talk to therapists and then I was going to come home. I had no idea how long I was going to be gone.

Tiffany Reiss (39:16)

And this was a quote, step down program. For those of us who have no idea what that means, would you mind explaining?

Katie R. (39:23)

It's like a boarding school with therapists and really strict punishment. Kids were doing teenage things. For someone like me and others who had come out of lockdown facilities, this was really unnerving because the fear of breaking a rule was omnipresent. But like everyone around you was breaking rules. So there was objectively more, quote, freedom. But the threat of severe punishment was still always there. You get caught violating a rule, you're put on social isolation. Or if you're someone who breaks a big rule or has broken rules frequently they send you on trails where they'll wake you up at 5am and you put together some camping gear and they take you on these three to seven day hikes in silence. They're like grueling physically. There's no conversation. So it's like social isolation on the mountain and sweating your balls off. People were terrified of trails. When you saw people going on trails, it was like watching them walking on death row.

Tiffany Reiss (40:31)

Most of these kids had already gone through a program like you would you say?

Katie R. (40:35)

Some had gone straight there and been there for like three Years they were going to do their whole high school career there. Some had come out of lockdown facilities, some had come straight from wilderness.

Tiffany Reiss (40:46)

Now, at Oakley, did you still have to do group therapy and did you still see a therapist?

Katie R. (40:52)

We would go to, like, topic specific groups. Like there was an adoption group. I did see a therapist. I really liked my therapist a lot. But the environment was very hostile. So no matter how great the therapist, the environment that we were living in, the rules and the structure we were living under was really antagonistic to mental health care. When I first got to Oakley, for the first couple months, I didn't eat. Being in a cafeteria and being around other kids that were talking about things they weren't supposed to talk about, it was so overwhelming that I just completely stopped eating. I lost 30 or 40 pounds in the first two months just out of fear. I did end up getting in trouble in that environment. Going on social isolation. That was one of the more painful experiences I had. I had been put on social isolation because I had admitted to my therapist that I had been secretly holding hands with my boyfriend under a couch pillow. They would have these come clean periods where they knew stuff was going on, but they didn't know what it was. So they would, like, separate us into small groups in different rooms. And they'd be like, we know what's happening. If you don't tell us and we find out from someone else, the punishment's gonna be more severe. And they would last for days where they would keep us all separate so that we couldn't collude and we didn't know who was saying what. There wasn't a lot of protection. I found out I was going home about nine months in. They had scheduled a graduation date for me at month 12. I was 16 when I entered Oakley. And then when I left, I think it was the. The day after my 17th birthday. That was almost exactly a full calendar year. I had attachments there to other residents, and I think that aspect of it was hard. But I was so ready to be with my family. I wanted to be home. I wanted to not have to live and breathe in the same place with other kids that were engaging in behavior that made me uncomfortable too. I wanted a chance to be normal. When they announced my graduation dates, there were only two options of a high school. I could return to the Catholic high school I had gone to or the rival Catholic high school where my rapist went to school. So I chose to go back to my original high school. Their condition was that I could come back, but to Ensure I was accountable. They had me come home for a home visit and get up and find front of each of the classes and tell my story. Telling my story in treatment meant something different than telling your story outside of treatment. I disclosed all this information to all these high school kids and then returned to high school. And nobody wanted to touch me with a 10 foot pole. I think people were scared of my experience. My friends had been writing me letters and they withheld the letters, then threw them away when I graduated. When I got home after 20 months, I didn't understand why my friends weren't talking to me. And they were like, we were writing you the whole time. I kind of had a lonely existence in high school. I reconnected with some old friends that didn't go to my high school, but there went the opportunity to be a normal kid. I would actually say some of the best teachers I had in my high school career. Right at Oakley. There are people that lived in this small town of Oakley, Utah, and they were incredibly passionate. And that's also the complexity of this. The institutions themselves were very harmful. The people within those institutions were not always awful people. They, like us, were asked to act in such a way that conformed with the institution, even if it went against their own values and beliefs.

Tiffany Reiss (44:43)

There also seems to be a lot of religious elements or undertones in a lot of them. Was that the case with either of the institutions you were in?

Katie R. (44:51)

Not overtly, but there are a lot of treatment centers in Utah. And I think all the staff at both centers I went to were Mormon. And there may be some religious element to the shaping of that approach. Spare the Rod, not the child. There was no forcing of religion on us in our programs. But certainly religious beliefs could shape their approach to how they treat children. For sure, they want to sufficiently shame you. They want to put you in that position, because then they can control you. It was so hard to see it that way until I was in my early 20s and I become friends with some kids in the film school at Florida State. They were making a documentary about Scared Straight where they were interviewing survivors and family members of those that didn't survive. They were reenacting scenes from these people's memories. And I was watching these scenes unfold and hearing these interviews and thinking, holy shit, this is exactly what I went through. And it was the first time that I was able to see it for what it was. It was hard to come to that realization because then I also had to confront who I was in those environments that I was ashamed of too I was kind of embarrassed about the way I felt about that experience for a long time until I started telling like bits and pieces of it to friends. And their reactions were always so huge, like holy shit, that's fucked up. That's when I started to realize how bad it was and it was okay to see it that way. I knew I wanted to be a social worker from the time I was in third grade. I had a friend whose dad was a pastor and he used to go preach at this residential community for low income families where they could live there if they went to church on Wednesday nights and we provided childcare for them. It was a really impactful experience to see how other people lived, but also to feel like I could be of service. When I went to college, I pursued social work. I got my undergraduate and master's degree. That was a pretty self destructive time in my life in terms of drinking and drugs. Then I packed up and moved to Austin, Texas and continued that self destruction and sold tacos and then stopped using and got clean and started working as a clinician. That was when I decided I wanted to go back and get a PhD. Not because I wanted to be an academic or teach college courses, but because I wanted to have a seat at the table. All the research I did when I was in my doctoral program was in adult male and female prisons. But my studies were always focused on kids and detention in residential settings. That's ultimately what I did my dissertation on. Now I work for a research institute where our focus is on improving the child welfare system and minimizing the trauma to system in parent impacted families or best case scenario, keeping children and their families out of the system by figuring out how to help them. I think that's always where my passion will be in supporting families and children so that parents aren't forced into these situations where they have to surrender their children out of desperation to programs that worsen them. It also feels important too to honor the memories of all the kids that I went to treatment with who died by suicide or overdosed. I think I always would have been a social worker, but whether or not I would have focused on institutional settings for kids was probably decided by my own experience. When I interview kids for research, when I interview foster parents and parents, I think that's when it really hits. It's heavy stuff like I can only handle a couple hour interviews a week and then I gotta do some self care and separate a little bit because it's too overwhelming. My third year of my doctoral program, I was doing a whole conceptual Thing about girls in detention. And my chair said to me, I know this is really personal to you. You. And I looked at him like, what are you talking about? I've never been in detention. He's like, you were in residential treatment. I can do research. I can describe institutional trauma for other kids. I can look at conditions, I can look at mental health issues. But when it comes to applying that knowledge to my own experience, there's this weird disconnect. It's like my experience is written in a different language that I can't read. When I read about these lost saints, the people who sued Island View, the people who are suing elevations, and I read other survivors stories and they match my own, that's when I can like take a breath and I'm like, okay, this really did happen. Any phase of development along the way is so fundamental to the wiring of the brain. Think about what you're going through. As an adolescent and for 20 months of my adolescence, my identity was developing around this idea that I was afraid of fundamentally bad person who was capable of destroying the lives of all the people around me. All the issues I had with mental health and behavior were entirely attributable to a fault in my character. And I want to say that 20 years of therapy later, I've undone that wiring. But there are just some things you can't completely undo. I can catch myself when I'm engaged and negative or shame based self talk, I can turn that around. But it's a fundamental part of who I'll be for the rest of my life. I have a high attention to threat in my environment, so I overattend to people's nonverbal cues. I'm very shame avoidant. I work in an academic setting. I do love teaching. But the anxiety I feel standing up in front of a room full of undergraduates, even on a zoom meeting is panic inducing because I'm afraid at some point I'm going to say something wrong and the whole group is going to jump on me and they're going to know I'm a bad person. I have a deep fear of conflict. I anticipate conflict in situations where there typically isn't. Every conflict feels like it's on full volume for me. I feel a lot of shame about every role that I hold. I'll probably be in therapy for the rest of my life, which I'm okay with.

Tiffany Reiss (51:35)

The shame for you, it sounds like has been the hardest thing to overcome. Would you say that's true?

Katie R. (51:41)

Yeah, I think it's the shame and I Think it's also the acting in a way that I was expected to that didn't feel right. It was having to confront people. I remember sitting on a review committee. I had made it to the highest level and I'd been appointed to a leadership board and we would review other residents infractions. We had decided collectively the kid wasn't remorseful enough. So we doled out an additional several weeks of no privileges. These were the things that we were expected to do, but they were behaviors that fundamentally misaligned or offended my internal values. That aspect of it sticks with me too. Behavioral modification, social isolation, shame, confrontation are nowhere in any research indicated as effective modes of treating mental health in children. You would think that was obvious, but clearly it's not because these treatment centers abound to this day.

Tiffany Reiss (52:46)

If you don't mind me asking, what is your relationship like with your parents and family today?

Katie R. (52:51)

I have a pretty good relationship with my family. My mom's a little tough to manage, but my kids are nuts about her. They love spending time with my mom. My dad learned a lot in family therapy. He learned not to lecture. I think because he was brought to his knees by sending me away, he became willing to change. I just wasn't a great kid dad. But as an adult, my dad is like my rock. I love my dad so much. He gives me the best advice. He listens really well. He never passes judgments on decisions I make, even the ones he doesn't agree with. And I'm really lucky to have a parent like that. And then I have a sister. I love her. We're the historians of each other's lives and we drive each other crazy. I definitely didn't have one of those stories where I was estranged from my family after treatment. And I'm lucky for that too.

Tiffany Reiss (53:44)

What do you feel is important for listeners to keep in mind when hearing survivors stories specifically of this form of institutionalized abuse?

Katie R. (53:55)

What I like people to think about is the mismatch between behavioral conditioning and shameful confrontation and youth mental health. These experiences are hard to describe. They're probably hard to absorb and understand if you haven't been through it. But fundamentally, if you could walk away with anything, it's just seeing how these programs are mismatched for what they're supposed to be treating. When we think about youth mental health crisis, shame and confrontation, how is that the solution to mental health? At its core? That's what I hope people walk away with being curious about. I've read a lot of survivor stories. Some of them are so much more Horrific in terms of physical and sexual violence and abuse in those settings. I think what feels important about telling my story is that it is certainly not the most horrific case, but it'll reflect someone else's story and give them permission to hopefully see it as being a trauma and something that they can have compassion towards themselves for.

Tiffany Reiss (55:08)

If you could address the people who continue to own and operate these programs, what would you want them to know?

Katie R. (55:17)

I think fundamentally these folks are worried about their margins. I think they're looking for ways to control behavior in a way that's easiest for staff. Staff. And I don't think they really care. But if they were to listen, they've caused decades of harm. When I walked into those programs, they told me that I had caused harm to my family. But they've caused irreparable harm to a number of families over several decades. The only way to stop that is to change their approach to care. It's not that residential treatment centers shouldn't exist, but we have to think about who belongs in those settings and what rehabilitation actually looks like. I think there also has to be opportunities for kids to file complaints and receive investigations, because that's the problem, too. A lot of what was going on in these facilities could meet criteria for child maltreatment by state definitions. But if kids phone calls are monitored and they have no way of reaching authorities, there's no way to file or purport an allegation that would then require investigation. Part of the problem is that perhaps they don't understand the definition of child maltreatment, but children do not have opportunities to advocate for themselves in that way. When people think about kids that get sent away to residential treatment, they think these are the worst of the worst, the unruly. It's just simply not the case. A lot of the kids that I went to treatment with just had severe mental health issues. I don't think a lot of people know about these programs, which is crazy. When I talk to people, at least my age, millennials, and I'm like, yeah, I went to this place when I was a kid. They're like, what is that? I've never heard of that before, except for, like, maybe the one person who's seen a documentary. I'm just so grateful you're doing this. When I was pregnant with my second daughter, I was painting her nursery, and I was binging the seasons you already had out. And I thought, oh, my God, if anyone can tell this story, it's Tiffany Reese. So when you put out the call for this I was like, oh, my gosh, yes. This is so incredible. You are doing your part. These voices are completely silenced. And you're giving people a platform to have a voice and tell their stories in a safe place, a safety that none of us are used to. You've given us something, something I've never needed for 20 years. You know, the first time I met with you, I went to my therapist's office and I cried. And it was the first time I was able to cry about this experience in at least 15 years. And it was because you listened, you reflected, you gave me language to describe what I had been through, and no one had ever been able to do that for me. I just really appreciate you as a person, and I also want to appreciate that you carry the weight of hearing and holding a lot of people's stories, and there's got to be a personal cost to that. I just respect the hell out of you for it.

Tiffany Reiss (58:15)

It's an honor, and I just think you're spectacular.

Katie R. (58:19)

Thank you.

Tiffany Reiss (58:26)

Next time on Something was wrong. He could sell it. He pretended and projected that he was this therapist. He was not. Everybody looked at him like he was God. I wanted his approval because if you were on his good side, you eventually got more privileges. You became what we called during my time there, Michael's kid. Something was Wrong is a broken cycle. Media production created and produced by executive producer Tiffany Reiss associate producers Amy B. Chesler and Lily Rowe with audio editing and music design by Becca High. Thank you to our extended team, Lauren Barkman, our social media marketing manager Sarah Stewart, our graphic artist and Marissa and Travis from wme. Thank you endlessly to every survivor who has ever to tried trusted us with their stories and thank you each and every listener for making our show possible with your support and listenership. In the episode notes, you'll always find episode specific content, warnings, sources and resources. Thank you so much for your support. Until next time, stay safe, friends.