A behavior modification facility (or youth residential program) is a residential educational and treatment institution enrolling adolescents who are perceived as displaying antisocial behavior, in an attempt to alter their conduct. Due to irregular licensing rules across countries and states, as well as ambiguity regarding the labels that facilities use themselves, it is hard to gauge how widespread the facilities are. The facilities are part of what has been called the Troubled Teen Industry. Programs in the United States have been controversial due to widespread allegations of abuse and trauma imposed on the adolescents who are enrolled, as well as deceptive marketing practices aimed at parents. Critics say the facilities do not use evidence-based treatments. Methodologies used in such programs Practices and service quality in such program vary greatly. The behavior modification methodologies used vary, but a combination of positive and negative reinforcement is typically used. Often these methods are delivered in a contingency management format such as a point system or level system. Such methodology has been found to be highly effective in the treatment of disruptive disorders (see meta-analysis of Chen & Ma (2007). Positive reinforcement mechanisms include points, rewards and signs of status, while punishment procedures may include time-outs, point deductions, reversal of status, prolonged stays at a facility, physical restraint, or even corporal punishment. Research showed that time out length was not a factor and suggestions were made to limit time out to five minute durations. A newer approach uses graduated sanctions. Staff appear easily trained in behavioral intervention, such training is maintained and does lead to improved consumer outcomes, as well as reduce turn over. More restrictive punishment procedures in general are less appealing to staff and administrators. Behavioral programs were found to lessen the need for medication. Several studies have found that gains made in residential treatment programs are maintained from 1–5 years post discharge. Therapeutic boarding schools are boarding schools based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with emotional and behavioral problems, substance abuse problems, or learning difficulties. Some schools are accredited as Residential treatment centers. Behavioral residential treatment became so popular in the 1970s and 1980s that a journal was formed called Behavioral Residential Treatment, which later changed its name to Behavioral Interventions. The journal continues to be published today. History In the late 1960s, behavior modification or practice referred