Attack therapy and how it’s literally hurting children

Attack therapy involves the therapist or peers in group counseling verbally abusing and humiliating the client.

In 1990, a study came out by the Institute of Medicine stating that if someone already had a positive self-image, they may benefit from attack therapy, but if they had a negative self-image, it could harm them further.

Anyone going to therapy who is already doing well, or has a positive self-image, in this instance, is going to do better coming out of therapy than someone not doing as well, or in this instance, having a negative self-image.

That’s not saying a lot for this type of therapy if people who are already doing well come out of it fine and people at a detriment are worse off.

One big problem I have with attack therapy is that sometimes the therapist or peers don’t allow the client to leave.

That’s physical abuse. Not “borderline” physical abuse. There’s no such thing. It’s physical abuse, plain and simple.

If a woman is in a relationship with a man and in a heated argument, she tries to leave the house and he blocks the door, she can call the police. But in attack therapy, you’re physically blocked from doing so.

There’s more.

Another tactic is isolating the individual, rigid imposition of rules, and if these rules are followed, allowing small amounts of freedom in return.

So why do they do it?

The idea behind attack therapy is to break down the ego and its defenses and then rebuild and rehabilitate the person.

What does a session of attack therapy look like?

A session could look like a group of peers standing in a circle with the subject standing in the middle. The group then tears the client apart by criticizing everything about them. This is sometimes called, “the confrontation game”.

So why do therapists use this method?

The philosophy is that clients don’t change until they haven’t suffered enough. Sort of how Alcoholics Anonymous believes you must hit “rock bottom” before you’re willing to change.

I do believe there must be a certain level of motivation to want to change into a better, healthier person. But I don’t believe you only change once you have been completely broken down. For some, such as myself, that was the case, but plenty of clients come into therapy without having hit their own personal rock bottom. I also think people experience several rock bottoms throughout their lifetime, rather than there being one single rock bottom that causes change to begin.

Typically this form of therapy is used to “scare straight” unruly, troubled teens. Much like what was seen on such shows as Maury in the 90’s. Unfortunately, media like this normalized the tactics as effective when they’re not.

Elan School was one such program that used this form of counseling. They were eventually shut down after activists pressured them enough to discontinue their abusive, humiliating practices.

What is the evidence for negative effects?

In 9.1% of clients in attack therapy, over the course of only half of the counseling, long lasting trauma resulted up to 6 months after treatment. Increased alcohol abuse was found in clients of especially authoritarian leaders.


Lieberman M., Yalom I., Miles M., Encounter Groups: First Facts, Basic Books, 1973, p. 170–174.

Miller et al., 1993 W.R. Miller, R.G. Benefield and J.S. Tonigan, Enhancing motivation for change in problem drinking: A controlled comparison of two therapist styles, Journal of Consulting and Clinical Psychology 61 (1993), pp. 455–46

Meyer, June. “Controversial Elan School closing due to low numbers, negative Web campaign”.

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