HARPER, Texas — Deep in the Texas Hill Country, off a rutted road with a sign that says "Deer Processing,'' sits a three-bedroom mobile home.
This is the Rachel House, run by Pamela and Bob Hoch. Dozens of kids from all over the nation have been brought here for days, even weeks with the goal of making them like a parent they fear or despise.
"The children are expecting an institution, not this,'' says Pamela Hoch, gazing out over the 5-acre spread an hour-and-a-half from San Antonio and 22 miles from the nearest bus stop, pay phone or sheriff's office. It is a hard place to find — and a hard place to run away from.
At 2,400 square feet, the Rachel House is big enough that a child and estranged parent can have separate bedrooms, yet small enough that they have little choice but to spend time together watching TV, eating meals and, presumably, talking.
The idea is that the child will eventually realize the parent isn't so bad.
Though the Hochs say they have successfully reconciled many kids and parents, it is impossible to verify their claims because the Rachel House is not regulated by any state or federal agency. And its approach is rooted in the controversial notion that the kids they see have a mental disorder: parental alienation syndrome.
The term was coined in 1985 by New York psychiatrist Richard Gardner. He described it as a disorder that causes a child to vilify a parent without reason. It often arises, he said, in bitter custody cases in which one parent brainwashes a child against the other parent by making false accusations of sexual abuse.
Proponents of the theory are pushing to have PAS included in the 2012 edition of the Diagnostic and Statistical Manual of Mental Disorders, the "bible'' of the psychiatric field. So common is parental alienation, they say, that it could afflict 1 percent of American children. That means 750,000 children could potentially be deemed to have a mental disorder — more than are considered autistic.
"We don't want to label kids unnecessarily, but these kids are not reacting in a normal way,'' says William Bernet, a Vanderbilt University psychiatrist. "We're talking about kids who have a false belief, a little like a delusion, that the other parent is an evil, dangerous person. To me that looks and sounds like a mental disorder.''
But PAS is fiercely rejected by many child advocates. They call it "junk science'' and a tool used to help parents accused of sexual abuse — usually fathers — win custody of their kids.
PAS "is not geared toward helping the diagnosed individual, but assisting a third party — an estranged parent — with a legal or personal goal, and thus appears more to reflect a political agenda than a bona fide mental health disorder,'' says psychologist Joyanna Silberg, executive vice president of the Leadership Council on Child Abuse and Interpersonal Violence.
Classifying PAS as a mental disorder could lead to higher health costs as providers rush to cash in on therapies not now covered by insurance. Among those that could benefit are providers like the Hochs.
The couple say that 93 percent of the kids they have dealt with show an improved relationship with a previously reviled parent. But some children who have gone through the program say they were threatened and cut off from the parent they loved.
"You can't just open a facility with no accreditation, no oversight and say, 'This is what we do,' especially when you're dealing with vulnerable children,'' Silberg says.
Hero to fathers
The controversy over Rachel House and parental alienation syndrome is fanned by what many consider the outrageous ideas of the man who inspired both.
A onetime Columbia University professor, Richard Gardner thought society is too harsh on adults who have sex with kids.
"What I am against is the excessively moralistic and punitive reaction that many members of our society have toward pedophiles . . . far beyond what I consider the gravity of the crime," he wrote in 1991.
Though he called pedophilia "a bad thing,'' Gardner argued that it's common in many cultures and that children might be less harmed by sex abuse than by the "trauma'' of the legal process.
In the late '80s and early '90s, Gardner was widely quoted in counterpoint to what some felt were sensationalized allegations of sex abuse in day care centers. He was also a well-paid witness in custody cases, almost always appearing on behalf of the father.
Gardner contended that sex abuse allegations arising from divorce are usually false, made by a vindictive mother trying to cut off a child from the father. His typical advice: Kids should be forced to see the estranged parent, and judges should punish the "alienating'' parent.
Those views made Gardner a hero to the fathers' rights movement and an anathema to child advocacy groups.
"The premise that you can improve a relationship with a parent through force and coercion and isolation from the preferred parent is simply erroneous and unethical,'' Silberg says.
In 1998, a Pittsburgh high school student, Nathan Grieco, was found dead with a belt around his neck after complaining that his father had caused him and his brothers "endless torment'' in a custody fight. A judge, acting on Gardner's recommendation, had threatened to jail the mother if the boys refused to see their father.
"These children need coercion,'' Gardner had said.
The Pittsburgh Post-Gazette detailed the case in 2001 — the year Gardner testified in Tampa in a custody battle.
John M. Kilgore, a Brandon doctor, had accused his ex-wife of poisoning their two daughters against him to the point they refused to see him. The oldest had even changed her name.
Hillsborough Circuit Judge Ralph Stoddard allowed Gardner to interview all four family members, ruling that PAS had gained enough acceptance in the scientific community to be admissible as evidence.
But once Gardner got on the stand, his testimony was so biased in favor of the father against the daughters that the judge rejected it.
While interviewing the girls, Gardner "was really trying to get them to admit the facts were as their father saw them,'' Stoddard said.
The Tampa case underscored what critics say is a major problem with classifying parental alienation as a mental disorder: It is hard to determine the cause of the alienation, who is to blame or even who has the alleged disorder.
In his ruling, Stoddard said both parents "were pretty much equally scoring out in their bad behavior.''
Few knew of the judge's rebuke, and Gardner continued testifying in cases until 2003. At age 72, shortly after failing to appear in another Florida courtroom, he repeatedly stabbed himself with a steak knife.
"Let's pray that his ridiculous, dangerous PAS foolishness died with him,'' Richard Ducote, a New Orleans lawyer and child advocate, said at the time.
But the idea that a parent could brainwash a child to hate the other parent had its believers, including Pamela Hoch.
A former music teacher, Hoch, 58, says she herself was an alienated parent whose first husband turned their four children against her by falsely claiming she belonged to a religious cult. A judge agreed that the father had "deliberately poisoned'' the children's minds, and in 1991 gave Hoch custody of the two youngest kids. (The others were deemed too old to be successfully reunited with her.)
The case drew heavy media attention and led to Hoch and Gardner meeting as guests on a TV program. Partly on his recommendation, she became executive director of a foundation that spread information on parental alienation syndrome.
But Hoch says she didn't want to talk about alienation; she wanted to find a "solution.''
In 2000, she and her new husband, Robert Hoch, started their own nonprofit organization with $50,000 from the U.S. Justice Department. The Rachel Foundation gets its name from a Bible verse in which Rachel weeps for her descendants' exile.
"Your children will return,'' the Lord tells her.
Parents who go through the program must have legal custody of their kids, though Pamela Hoch acknowledges that most parents they deal with "have been accused of something.'' The Hochs don't do any checking but rely on the courts to ensure that sex abuse allegations "have been clearly investigated and negated,'' she says. Referrals come from various sources, including court orders and websites.
At first, the Hochs operated out of a church parsonage in Maryland. One of their early "reunifications'' involved a 14-year-old boy who had been on the run with his mother for nearly a decade after she accused her ex-husband of molesting him. (He was not charged.)
In 2000, the FBI arrested the mother for child abduction. Father and son spent weeks in a hotel suite. Each had his own room, separated by a room with a couch where Pamela Hoch slept.
"In the daytime, we would play games designed to help us learn about each other,'' the son, now 23, said in a statement to the St. Petersburg Times. "For example: Write 10 things you like about your father so far . . . Things you don't like . . . Finding positive memories we had of each other.''
A 2002 Readers' Digest story suggested the reunification had been a success: Rather than run errands with Hoch one day, the son went shopping with his dad.
But the son says his experience with the Rachel Foundation was traumatic.
"I was well aware of parental alienation syndrome already, but I had to hear about it probably every day I was with the Rachel Foundation. Pam would tell me how my mother was disturbed, manipulative and selfish, had deprived me of a life with my father, who would tell me of the life I might have had with him.
"The Rachel Foundation is a scary organization. It's taken every day of my life since to put myself back together in a way I see fit.''
The Hochs say they decided to leave Maryland in 2004 because the church didn't renew their lease. Records show the couple owed $2,546 in Maryland state income taxes.
They weren't in Texas long before a controversy erupted.
A New Jersey man who claimed his ex-wife was a "parental alienator'' won custody of his two daughters in a 2004 court order and took them to the Rachel House.
At first, "they were very withdrawn and alienated toward their father,'' Pamela Hoch says.
A month later, they were doing "very well,'' she says, and even baked him a birthday cake. But the girls gave a different view when they testified last year on behalf of a Georgia woman fighting to keep her own daughter from being sent to Texas.
The Hochs "told us that if we didn't obey our dad and if we didn't agree to act happy with him that we would never see our mom again,'' testified Kelli Carr, now 17.
She said she and her sister weren't allowed to eat until they agreed to say positive things about their father.
"How many days did you go without being fed?" the judge asked.
"Just the first two days, because then my sister and I just started . . . making things up.''
Pamela Hoch calls the claims "ridiculous.'' The girls' mother, Stephanie Carr, sued the Hochs in 2005, but a judge recently dismissed the case for lack of prosecution. Carr's lawyers said she let it lapse because she had regained primary custody of her daughters and was short of money.
Soon after Carr sued, the Hochs declared bankruptcy. Their Chapter 7 petition made no reference to the Rachel Foundation. It showed Robert Hoch as "retired'' and Pamela as the $1,833-a-month music director of a local church.
The couple say they didn't list the foundation because they didn't draw a salary.
"We spend a lot of our own money,'' Robert Hoch says.
On its most recent 990 form, which nonprofits annually file with the IRS, the Rachel Foundation claims an impressive track record:
"Since 2000, reintegration services have been provided to over 1,000 families, 450 legal and mental health professionals and 241 organizations and agencies.''
The Hochs say that 44 parents and 59 children have attended "intense'' programs, either at the Rachel House or in other residential settings. The parent who accompanies the child is responsible for costs that include $75 per person a day in room and board and up to $1,500 a day for "professional reunification/reintegration services.''
Verifying the foundation's claims, like its 93 percent success rate, is stymied by the absence of any regulation. That is a huge problem, critics charge, especially as the Hochs consider expanding the Rachel House concept nationwide.
"I'm just blown away by the lack of information,'' says Andrew Vachss, a New York lawyer who represents only children, not parents. "I can't imagine a judge approving of a child going any place that isn't monitored.''
Others are concerned that the National Center for Missing and Exploited Children, largely funded by U.S. taxpayers, has referred cases to the unregulated foundation and its controversial programs.
''It's a very dubious association,'' say Eileen King, regional director of the advocacy group Justice for Children.
The Rachel Foundation's website says it gets referrals from the children's center. But the center says it has referred no families there since the Hochs started charging for their services in 2004.
The foundation falls through licensing cracks because it is not a hospital, group home or mental health facility — all of which are regulated by Texas. Professionals connected with the Rachel Foundation are licensed, but several have run afoul of regulators.
The former clinical director, California psychologist Randy Rand, is on five years' administrative probation for "unprofessional conduct'' in child custody cases in Orlando and California.
A former member of the foundation's advisory board, J. Michael Bone of Orlando, lost his Florida mental health counselor's license in 2007 for failing to act in the child's best interest in a custody case.
A Texas psychologist who has worked with the Rachel Foundation was put on probation for failing to disclose a DUI arrest and submitting a custody report with "numerous inaccuracies.''
And a California psychologist who has been to the Rachel House several times to help the Hochs does not have permission to practice in Texas, state regulators say.
Does it even exist?
Criticism of the Rachel Foundation reflects a broader concern — there is little solid research to determine if parental alienation syndrome really exists.
PAS is "highly controversial, and part of the reason for it being controversial is that there is no accepted definition or criteria for having the disorder,'' says Mitchell Kroungold, a Clearwater psychologist.
He notes that there can be valid reasons that a child refuses visitation with a parent — "separation anxiety,'' which often occurs with young children; or the preference a child feels for the parent who shares similar interests such as horseback riding or camping.
Kroungold, who has evaluated dozens of troubled families, says it would be unprecedented for the Diagnostic and Statistical Manual to include parental alienation as a mental disorder.
"All of the diagnoses in this manual are disorders that exist within an individual. My understanding is that when parental alienation is occurring, it's a family dynamic. It's describing the nature of communication and dysfunction in a family, and I think that's a major distinction as to why it's not in the manual.''
The Hochs say they consider PAS a symptom, not an illness itself, and no longer use the term because of the controversy. "We really don't care what they call it,'' Pamela Hoch says. "We focus on behavior.''
But critics say the Hochs' methods of altering behavior are highly questionable.
"There are scientific standards and practice standards for how to go about delivering therapy to children,'' Silberg of the Leadership Council says, "and nothing I've seen from the Rachel House follows any known standards about the delivery of mental health care.''
Times researcher Carolyn Edds contributed to this report. Susan Taylor Martin can be reached at firstname.lastname@example.org.