I have spent the last five years interviewing homeless people, recovering addicts, former criminals, people who have spent years in prison and families desperately trying to save someone they love. After doing enough of these interviews, I started asking a pretty simple question:

What actually works?

Not what sounds compassionate or has the right credentials behind it, and not necessarily what government agencies have been funding for the last 20 years but what actually takes for a person to change? A person who has spent years using drugs, committing crimes, going to jail, getting out and doing the same thing again?

That question is what led me to The Other Side Academy.

TOSA is not a conventional treatment. It is a long-term residential program built around work, peer accountability, and behavioral change. Students live together, work together, and call each other out when they see behavior that needs to change. Sometimes that feedback is harsh. They call it getting a “haircut.”

Some people hate it and leave, and some former students say they felt humiliated or mistreated. Others have raised legitimate concerns about psychiatric medication and whether an intensely confrontational program is appropriate for people with certain mental illnesses.

Those concerns deserve scrutiny, but there is another question that keeps getting lost in the controversy: How should we judge a rehabilitation program? Do we judge it by its harshest moments, by the people who left, by the people who completed it, or by what happens to people five or ten years later?

I have interviewed a lot of TOSA graduates over the years, and their stories are hard to ignore.

Joel Haddock describes himself as a career criminal. He spent roughly 12 years incarcerated and eventually pleaded guilty to nine charges, most of them second-degree felonies. He was facing the possibility of spending decades behind bars when a judge gave him another option: The Other Side Academy.

Joel told me he initially went there for the obvious reason: he didn’t want to go to prison. But about 15 months into the program, he began to change. He noticed that he handled conflict differently. He looked at other people differently. Situations that once would have overwhelmed him didn’t anymore, and most importantly, he started liking the person he was becoming.

That took about 15 months, which is worth keeping in mind when we talk about 30-, 60- and 90-day treatment programs.

Joel told me that if someone has a decent career, a family and a home and then develops a substance-abuse problem, maybe 90 days of treatment is exactly what that person needs. But that wasn’t Joel. He had spent much of his adult life committing crimes and going to prison.

As he explained it, sitting with a therapist for 90 days and talking about his problems might have helped him understand how he got there, but then what? At TOSA, the “what now?” becomes the treatment. You don’t just talk about holding a job; you hold one. You don’t talk about honesty; people expect you to stop lying. You don’t talk about accountability; the people living and working beside you hold you accountable every day.

That is also where TOSA becomes uncomfortable.

Tyler Baker spent more than four years there, well beyond the minimum commitment, so I asked him the obvious question: Why stay?

Tyler said that when he reached two and a half years, he knew he wasn’t ready to leave. After three years, he still saw things about himself that needed work, so he stayed a fourth year. Eventually he admitted that part of the reason was that he was scared. He had never really lived a sober, responsible adult life and didn’t know what that transition was going to look like. Today, he helps other people make that transition.

I also asked Tyler about the infamous TOSA “haircuts.” He described them much less dramatically than critics do. To him, a haircut is direct and sometimes very blunt feedback—someone telling you that you’re treating people badly, shirking responsibility, or falling back into the same behaviors that brought you there in the first place. “It’s just very blatant, direct in-your-face feedback,” he told me.

Does everybody respond well to that? Obviously not, and that matters.

Investigative journalist Eric Peterson spent more than a year looking into TOSA after hearing concerns from people working in treatment, homeless services and social work. He interviewed former participants who described negative experiences, including people who said they felt pressure to stop taking psychiatric medications.

I don’t think that should be brushed aside. There are people who need psychiatric medication, and there are people whose primary problem is serious mental illness rather than criminal behavior or addiction. An intensely peer-driven behavioral program should not automatically be treated as the answer for every one of them.

Despite his criticism, Eric still called The Other Side Academy “obviously hugely successful.” He acknowledged that TOSA has received a lot of positive media coverage, and said it had “earned it because these are real success stories.”

Eric’s argument is that those success stories aren’t the entire story, and that’s fair. But the failures aren’t the entire story either, and that is where I think the debate over TOSA needs to go.

If two people leave TOSA and say the experience was terrible, their stories matter. If 20 graduates tell us it saved their lives, their stories matter too. Then we have to get beyond stories and ask what the evidence tells us.

That is what Jane Mitchell did.

Mitchell, a BYU law professor who has spent years studying criminal justice and alternatives to incarceration, went into TOSA skeptical. She and a colleague conducted roughly 35 interviews with staff members, graduates and former participants. They also made an effort to find people who had left the program because they wanted to understand why. Interestingly, Mitchell said the former participants they were able to locate had positive things to say about the program despite leaving it.

What Mitchell found most interesting wasn’t simply the work program or peer support, because other programs use both. What surprised her was the culture.

When Mitchell asked people what had actually changed them, they kept talking about values: honesty, accountability, kindness, service, keeping promises, self-reliance, forgiveness and pride in work.

That may sound almost too simple until you consider the population TOSA is primarily trying to help. Many have spent years inside a culture where completely different rules apply. Lying might be useful. Manipulating somebody might get you what you want. Your friends might be the people you use drugs with, your status might come from committing crimes and your loyalty might be to a gang.

If we take someone out of that environment for 90 days, get him sober, talk about his trauma and then send him directly back into the same identity, relationships and value system, why are we surprised when he relapses?

Joel explained this better than I could. Short-term therapy might have helped him understand his past, but he needed something that taught him how to actually live. The Other Side Academy did that by giving him years of repetition: go to work, handle conflict, live with people, keep commitments, accept criticism, tell the truth and then get up tomorrow and do it again.

Then there is Jared Campbell, who came from almost the opposite background.

Jared grew up in a close, stable LDS family. His father was a bishop and his mother taught seminary, but he still ended up addicted to methamphetamine and severely psychotic. At one point, Jared was wandering through Caesars Palace in Las Vegas trying to convince security guards that he was Jesus Christ. He was hearing voices and making connections that made complete sense to him while he was high. Eventually his father called the police, and Jared says something about what happened next that isn’t fashionable to say: “Jail saved my life.”

Thirty days in jail forced him to become sober enough to begin thinking clearly, and from there he found The Other Side Academy. Even that didn’t instantly fix him. Jared said that after arriving at the Academy, he would still sometimes feel as though he were inside a movie and everybody around him was part of it. The process of coming back took time.

Today Jared talks about having something he didn’t have before: boundaries, along with people around him who will tell him when he starts slipping. 

The word—accountability—keeps coming up in nearly every conversation I have with TOSA graduates, and I believe that is where the debate over TOSA becomes much bigger than TOSA itself.

Our treatment system quite reasonably asks what happened to a person. Were they abused or traumatized? Do they have mental illness? Are they self-medicating? Those can be important questions, but TOSA asks another one:

What are you going to do now?

For people like Joel, Tyler and Jared, that question appears to have mattered enormously. It still doesn’t mean everyone needs TOSA, and Jane Mitchell told me exactly that.

She believes the program can be particularly effective for persistent offenders, people who have been through the criminal-justice system repeatedly, tried other programs and continued returning to drugs and crime. But she also said there are people who don’t need two and a half years. For someone with a functioning family and a less severe problem, removing that person from normal life for that long could actually be counterproductive.

That seems like common sense. Nothing works for everybody. One medication doesn’t work for every patient, one school doesn’t work for every kid, and one form of addiction treatment isn’t going to work for every person who develops a drug problem.

So the question isn’t whether TOSA is perfect. I doubt any organization dealing with people in extreme circumstances is perfect, and the fact that some people dislike the program doesn’t mean their experiences should be dismissed. Some of TOSA’s practices may also need to change as the organization grows and learns more.

The important question is whether it works, for whom it works and how its outcomes compare with the alternatives.

That is where the discussion should go next.

TOSA’s recidivism numbers need independent examination. Its graduate outcomes should be tracked over years, and researchers should look not only at graduates, but also at the people who leave and the people TOSA determines aren’t appropriate for the program. If the numbers don’t hold up under that scrutiny, we should know it. But if they do, we should know that too.

After interviewing person after person who spent years headed toward prison, overdose or death, I don’t think the most important question is whether somebody at TOSA made them uncomfortable. I want to know what happened afterward. Are they sober and staying out of trouble? Are they working and supporting themselves? Have they repaired relationships with their families, and have they become people others can depend on?

If the answer to those questions is yes, then maybe the uncomfortable parts of The Other Side Academy aren’t something we should automatically condemn but  try harder to understand.

*Featured photo by Dung Hoang