Ethical Concerns with Referral to Privately-Owned Therapeutic Boarding Schools: The Case of Iowa's Midwest Academy

This study examines the ethical dilemmas that social workers confront when referring to privately owned therapeutic boarding schools, using Iowa’s Midwest Academy as a case study. It critically examines the conflict between parental preferences for residential treatment and the growing body of evidence advocating for less restrictive, community-based interventions as more effective for adolescents. The research uncovers diverse parental motivations for choosing residential programs, from seeking a fresh start to implementing behavioral control strategies. These motivations are set against a backdrop of mental health and educational systems prioritizing evidence-based, regulated care approaches. Profound ethical concerns arise with placements in unregulated Troubled Teen Industry (TTI) facilities, which lack licensing, accreditation, and qualified mental health professionals, thereby posing grave risks to youth’s welfare. The case of the Midwest Academy is utilized to illustrate the ethical breaches, including allegations of abuse, neglect, and substandard mental health care, highlighting the dangers of such placements. The discussion extends to the responsibilities of social workers in making ethical referrals, emphasizing adherence to national and international ethical codes. Advocating for a cautious, principle-driven referral process, the paper argues for prioritizing accredited, evidence-based services to protect young clients and uphold the integrity of the social work profession. It concludes with a call for a collaborative decision-making process in managing complex referral scenarios, contributing to the discourse on ethical practices in social work and emphasizing the need for continuous scrutiny of referral practices to privately owned therapeutic programs.