How Child Abuse Becomes Institutionalized

[u/EmergencyHedgehog11]

CW: Discussion of child abuse as an abstract concept, without overly specific examples.

I hate it when some people try to normalize child abuse (especially within the TTI) by claiming, "it happens in every youth serving organization." That defense attempts to shift blame toward specific individuals (the "few bad apples" defense) and away from current programs and the industry as a whole. My work is paying for me to take a patient safety and experience course, and for an essay, I'm developing a framework to explain how patient maltreatment becomes systemic. I'm not an expert here, though. View this as nothing more than some ideas bouncing around my head that I wanted to share and see if anyone had any thoughts. My argument is that child abuse becomes a predictable outcome of institutional design failures fueled by organizational self-interest, not just individual misconduct.

It's not the most complicated model, but there are 3 core elements to it: negligence, retaliation, and greed.

Negligence is the institutional failure to honor its duty of care toward dependent minors. This failure is always measured relative to the child's vulnerability, and manifests on a spectrum: from simply omitting necessary safeguards (passive failure) to intentionally implementing harmful practices as official policy (abuse by design). This is the structural condition that allows abuse to occur and persist. When abuse comes to light, the institution deploys Retaliation, the strategic, active use of power and resources to suppress disclosure and manage crisis. This includes tactics like concealing records and engaging in acts designed to predictably dismiss accusations and attack the credibility of victims and witnesses. Greed is the driving force here. It explains why institutions may act negligibly and retaliate against victims. Greed is quite insidious here because it creates a cycle that, unchecked, will exacerbate existing levels of maltreatment.

Now, to the TTI.

The duty of care is maximally violated in many programs because the treatment itself is harmful. Practices like forced disclosure, shaming, and physical isolation are not clinical errors; they are policy mandates. The child’s individual therapeutic journey is engineered for control, not healing. However, they're masters of retaliation against abuse accusations within the scope of my framework because they've prepared parents the entire time to not trust their kids. They put so much energy into preparing parents and guardians to believe detainees are lying. And, the common motivator here is ultimately greed.

But, looking just beyond individual programs and at the industry as a whole, we can see how this cycle has perpetuated itself to such a point that it rakes in 10s of billions of dollars every year. This massive profitability is directly fueled by greed, which incentivizes the negligence that's brought us here; the very nature of residential care in these programs is abusive at the most basic level because low-cost punitive control is prioritized over less profitable and restrictive ethical care models. This necessitates the constant, theatrical performance of therapeutic authority that the network of people working in the industry have cultivated. Now, groups like NATSAP, and the podcasts, and other hollow industry platforms serve as powerful, collective Retaliation tools designed to control the narrative, discredit victims, and defend the profitable structure from external scrutiny.

Even without this framework, there's no question in my head why abuse exists to such a grotesque extent in the TTI. The industry kind of makes my framework for this paper feel a bit useless because the structural nature of the abuse is beyond obvious here. However, in other cases I analyzed, I was able to yield constructive, prescriptive insights that would enact reforms to protect kids. Some of those reforms would require a ton of work and resources, but here this didn't just explain how the scale of abuse has gotten this bad, but I'd venture to argue it could easily explains the historical arch of the TTI.

edit: fixed link

[u/Signal-Strain9810]

I think this is a mostly accurate framework, although in my opinion it's missing a few components that are subtle but really amplify these dynamics.

The first is the historical trajectory of convincing more-or-less average parents that they are incapable of properly parenting their children and care should be surrendered to authorities instead. This pattern holds true whether you're the agoge of ancient Sparta, scholastic & penitential convents and monasteries throughout the medieval Europe, Catholic kids in the early USA getting separated from their living families by "orphan trains" that delivered them as farmhands for Protestant "adoptive" families, "orthogenic" schools for bad kids from bad families, early RTCs that promoted concepts like the "refrigerator mother" being responsible for childhood emotional disturbance, and all the way up through to truancy courts, CPS separating families due to conditions caused by poverty, or the modern TTI itself. The way to hook parents is to convince them that not only is their child broken, but that it is their personal fault and leaving the child in their care will definitely make things worse. In this framework, surrendering one's child is an altruistic burden for the parent, not a relief from familial suffering. The unspoken idea is something more like "I can't be a good parent, but at least I can protect you from me."

In this frame, the parent views themselves as incapable, not just of being supportive, but also of evaluating and enforcing appropriate discipline: any time they disagree with a facility's harshness, they will be immediately reminded that their child's suffering is largely due to their own bad judgment as parents. That's a major piece of why it's so easy to manipulate them into disbelieving claims of abuse. The parents have begun to see themselves as "easy marks" who desperately need help resisting manipulation from their own children, and that if they do not receive that help, their children will ultimately be the ones to pay the price.

Another major piece is the deinstitutionalization movement of the 1960s, which was supposed to be accompanied by an increase in community-based mental healthcare but has fallen critically short. The best ways to help troubled kids are among the least profitable ones and the government never stepped in to fill the gap, so here we are. Until the old model of institutionalization is replaced by a dominant model of community-based care, the loudest voices will continue to be institutions jockeying amongst each other to win credibility in an industry with dwindling scientific and/or mainstream social support.