Thursday, July 11, 2013


"Part of what a doctor can give a patient is consolation and reassurance. This is not to be dismissed out of hand. My doctor doesn't literally practise faith-healing by laying on of hands. But many's the time I've been instantly 'cured' of some minor ailment by a reassuring voice from an intelligent face surmounting a stethoscope."
--Richard Dawkins ("The God Delusion")

I don't like talking about my job on this blog, although, today I feel compelled to do so. I have mentioned a few times in previous posts that I work with at-risk teenagers. The facilities in which I work are classified as Residential Treatment Centers. Basically, such facilities combine aspects of boarding schools, mental hospitals and juvenile detention centers.

More specifically, I work with teens with a variety of mental disorders, a history of physical, sexual, verbal and neglectful abuse, chemical dependency and substance abuse, and quite often a criminal history. Many of my patients are either orphans or children of the state (i.e. Child Protective Services takes the kid away from the parents). Many of my patients who still live with their biological families wish they didn't, and for damn good reasons.

These are children with the worst start in life. They have every reason to give up, and many of them do. For many, Residential Treatment Centers offer the first opportunity for a real education, real medical care, a real meal and some one to talk to. For some, this is their last stop before a life in prison.

Often times people will ask me what the success rate is for my line of work. Are we able to rehabilitate these kids? Can they get a job? Will they stop using drugs? Will they perpetuate or stop the cycle of abuse into which they were born?

I usually respond, "It depends on what you consider to be 'success'".

Most people I talk to seem to have the idea that we make these kids "normal" by conventional standards. But for me success is simply having them leave our facility better off than when they came in. For example, let's say we take in a 16 year old girl who has made several attempts to kill herself; if we can improve her self-image enough that she no longer makes serious suicide attempts, but instead starts cutting her forearms and wants to start drinking as soon as she gets home--that is success. It is not ideal. But at least she is alive, and hopefully will continue treatment of some kind when she leaves.

To a certain extent, success in this field is subjective. There is no way for me to be sure that kids really are better off going to Residential Treatment Centers rather than sticking it out at home, because there is no way for me to analyze the alternative for individual patients. Choosing one life-path necessarily means you will never go down another path. But studies are being conducted which follow-up with treatment patients.

As one might expect, the results are pretty scattered, but generally speaking, after about 5 years or so, most former patients tend to speak favorably of their experience in treatment. Some even confess that they would probably be dead if they had not been to a treatment center. Alas, this is still a bit subjective, though.

This leads me to the reason I started this post. A couple of days ago, a facility where I used to work posted the following on Facebook:

"Did you know that ‪#‎spirituality‬ can be therapeutic for teens. It's true"

They also included a link to the following "study": Helping Your Teenager Discover Spirituality.

First of all, the writers of this article differentiate between religion and spirituality, but only loosely:

"Spirituality can be defined as a sacred connection between oneself and a higher power... Religion focuses on beliefs and practices associated with a religious organization or creed; spirituality focuses on inspiration, self-reflection, and personal connection to the sacred."

The thing which bothers me the most by this opening statement is that they switch the definition of "spirituality" without acknowledging it to the reader. A connection between oneself and a higher power is not the same thing as focusing on inspiration, self-reflection and a personal connection to the sacred. I'm not really sure what is meant by the last line, a "personal connection to the sacred". What does "sacred" actually mean outside of a religious context?

The article continues by making claims that spiritual and religious teens have lower occurrences of "bad things" and higher occurrences of "good things" (as defined by the authors). But again, here we have a case of people generalizing and concluding things based on a correlation (which is not causation), rather than refining the research to determine what it is about religion and spirituality--if anything--that actually contributes to positive outcomes in the development of teenagers. There is an implication here that such success lends credence to the notion that god exists; but in reality, even if religion and spirituality do cause more positive outcomes in teens, it could just as easily be explained through the placebo effect. And considering the extensive research which has been done on the placebo effect and the utter lack of conclusive evidence for the existence of any sort of god, which seems more likely?

It always bothered me that this particular facility focused so much on religion while I worked there. One of the highest ranking (and highest paid) employees at this facility was a full-time Chaplin, who required every patient to meet with her upon admission in order to determine the belief system (or lack thereof) of the patient. At first it didn't really bother me since I was still a practicing Mormon. But over the few years that I worked there, I began my deconversion and began to see the problem of their model of ever-so-gently pushing religion on their patients.

These are young, volatile, impressionable teens, many of whom are either ambivalent towards religion due to having to deal with more pressing matters (i.e. abuse), or they hate the idea that a god would let all of these terrible things happen to them. They come to a facility for psychiatric help and for the first time feel safe among adults. In this state, some are susceptible to the views of the adults they are coming to know and trust. It is fantastically inappropriate and a conflict of interests to suggest to these young, damaged minds that they need religion or spirituality in order to be happy and normal (which is the implication). For this very reason, most Residential Treatment Centers train newly-hired employees to avoid talking about religion with the patients. They are here for treatment--not church. And for this reason, none of my patients know I'm an atheist.


Here is a great response from Hemant Mehta (the Friendly Atheist) concerning the idea that teens in treatment need religion: Does Believing in God Really Lead to Better Psychiatric Treatment Outcomes?

Here is Sean Mackey (Stanford Medical) on the placebo effect:

And the placebo effect of religion:

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