Sidney Shankman, a child psychiatrist who founded and directed the Second Genesis outpatient and residential drug and alcohol recovery programs for more than three decades, died Feb. 16 at a hospital in Bethesda, Md. He was 84.

The cause was liver failure, said a daughter, Dr. Mindy Shankman.

Dr. Shankman started the initial Second Genesis program in 1969 as an outpatient facility in Alexandria, Va. Second Genesis gradually expanded into 11 residential treatment centers in the Washington area and where, on any given day, 275 adults and 110 adolescents were in residential treatment; another 250 were in outpatient programs.

By 1989 the program was turning away more than 2,000 applicants a year, simply because there was no room for them, Dr. Shankman told The Washington Post. “It’s much easier to get drugs than it is to get treatment,” he said. “Addicts are used to instant gratification. ...When a person reaches out and you say no to him, that person is being condemned to a living hell.”

Most of its participants came from the criminal justice system, and few of them had any money. If they had families, they were dysfunctional. They lacked job skills. Most paid little or no fees.

“Anyone can leave at any time,” Washingtonian magazine quoted the Second Genesis staff as saying to newcomers by way of introduction to the program. “But if you do, you’re going to prison for the rest of your sentence.”

Residents in the Second Genesis remained for varying periods up to 24 months, and they faced a vigorous and painful program of self-examination directed by counselors and fellow residents.

“Some find recovery tougher than prison,” Washingtonian magazine said in a 2003 story in which it named Dr. Shankman a “Washingtonian of the Year.”

To substance abusers, the program was confrontational. Counselors and fellow patients were encouraged to challenge the validity of other patients’ excuses or explanations for drug or alcohol abuse. Claims of a difficult childhood, abusive parents or unfair treatment by employers were rejected as insufficient causes for addictive behavior.

One of the Second Genesis residential centers, Melwood House in Upper Marlboro, Md., drew national attention as a place where addicted mothers could receive treatment for themselves and their young children, offering vocational counseling, parenting classes, anger-management workshops and a variety of children’s services.

Prospective residential patients were admitted to Second Genesis after interviews with Dr. Shankman. At Christmas, he made a point of visiting each residential center in the role of a surrogate Santa Claus.

He retired from the management of Second Genesis in 2007. The program was on the decline, as financial support was weakening. In 2009 Second Genesis was still serving 1,200 clients a year, but there were now only five residential centers and one outpatient center.

The program closed in 2014, a casualty of reductions in government financial support, the Second Genesis Foundation said. Its board of directors set up a foundation to fund other drug treatment programs from the sale of real-estate assets still owned by Second Genesis. An estimated 30,000 had completed its recovery program, a graduation rate of 68 percent, which is considered a strong retention rate for substance abuse recovery programs.

Sidney Shankman, who lived in Rockville, Md., was born in Memphis on Oct. 7, 1934. His parents were Jewish immigrants from Russia, and his father was a shopkeeper and then a builder. He graduated in 1955 from Columbia University and in 1958 from the University of Tennessee medical school, where he also did his psychiatric training.

He was an Army psychiatrist, then, from 1966 to 1969, was chief of the community mental health clinic in Alexandria. His experience there became the germ of Second Genesis, which over the years was supported by government and foundation grants and individual contributions.

Dr. Shankman served on government-sponsored drug-abuse panels, advised federal agencies on drug-treatment policies and spoke about drug-treatment concerns with Presidents Ronald Reagan and George H.W. Bush.

After his retirement from Second Genesis, he continued a private practice of psychiatry for another nine years.

His wife of 51 years, Joyce Seidman Shankman, died in 2007. In addition to his daughter, of Silver Spring, Md., survivors include two other children, Ellen Shankman of Rehovot, Israel, and Jonathan Shankman of Teaneck, N.J.; 12 grandchildren; and 10 great-grandchildren.