An awful story has been unfolding in Arkansas. On March 5, Benjamin Hardy of the Arkansas Times published an explosive investigation about how State Representative Justin Harris “rehomed” his young adoptive children, leaving them in the care of a former employee, who was later convicted of raping one, a six-year-old girl.

In March 2013, Rep. Harris and his wife Marsha adopted two sisters from foster care. They had previously fostered a third sister. Just six months later, the Arkansas Times revealed, all three children had been sent away from the home: the oldest girl, who reportedly had severe behavioral issues, was removed by the Arkansas Department of Human Services. But, without any DHS supervision or vetting, the Harrises placed the two youngest with the family of 38-year-old Eric Cameron Francis, who had worked for the Harrises at their Christian preschool business in northwest Arkansas. In April 2014, Francis was arrested on charges of raping one of the sisters, and was eventually sentenced to 40 years in prison.

The story got worse this week, as the Arkansas Times reported that, in the Harris home, the sisters had allegedly been isolated from one another in bedrooms equipped with alarms and video monitors because the Harrises believed that they were “possessed by demons and could communicate telepathically.” At one point, a former babysitter told the paper, the Harrises hired a team of exorcists to treat the girls.

While all of this is shocking, some elements of the case are not as anomalous as one would wish. When adoptions fail, things can go terribly wrong for adopted children. Sometimes they’re passed from home to home, without any outside oversight, as Reuters reported in an extensive series on online “rehoming” forums in 2013. Some adoptees have been neglected and abused or, as I reported for Mother Jones earlier in 2013, even forcibly repatriated to their countries of origin. Sometimes, as I wrote in Slate, adoptees end up homeless or—in very rare cases—dead.

Often when adoptions fail—particularly when the cases become public knowledge—adopted children’s behavioral issues are blamed, and the children are said to have been too traumatized or damaged to function in their new homes. When Rep. Harris gave a press conference last week to respond to the controversy around the Arkansas Times’ report, he presented his family as victims of the foster care system. He argued that the girls had greater emotional problems than were disclosed, and, once the adoptions were finalized, they began acting out in frightening ways. One, he said, screamed for hours at a time, and threatened to kill the family. Another harmed a family pet. Harris said he and his wife kept their biological sons with them at night out of fear that their new sisters might hurt them.

That the sisters adopted by the Harrises had significant emotional challenges seems undisputed. Two of the sisters had previously been sexually abused, and a foster family who had cared for two of the girls say they strongly discouraged the Harrises from adopting, warning them that they were not prepared to meet the girls’ needs.

After the oldest adoptee was removed by DHS, the Harrises still had problems with the younger two sisters. They believed that the middle child—the one who was later abused by Francis—had reactive attachment disorder, or RAD, and said that keeping her confined in her room for extended periods of time and taking away her books and toys was a form of treatment.

The Harisses’ attorney denied that the couple’s strong evangelical faith supported exorcism or demon possession and instead said the family had relied on the teachings of a woman named Nancy Thomas, a self-styled expert on RAD attachment therapies and author of the book When Love Is Not Enough: a Parent’s Guide to Reactive Attachment Disorder.

As medical professionals define it, RAD is an uncommon condition that results from children experiencing early abuse or neglect, and is expressed through a pattern of behavior wherein children are either unusually withdrawn or unusually friendly. But while adopted children sometimes contend with psychological conditions that can make normal family life very challenging, or sometimes impossible, critics say that that RAD is misunderstood and greatly over-diagnosed, particularly among adoptees who may be undergoing predictable difficulty adjusting to a new family.

Linda Rosa, a nurse and Executive Director of Advocates for Children in Therapy, also charges that proponents of the sort of attachment therapy Nancy Thomas practices have conflated the medical condition of RAD with a pseudoscientific diagnosis of “Attachment Disorder” that sounds like a nightmare scenario, conjuring images of permanently broken and violent children who set fire to the family home or mutilate the pets.

Rosa says the symptoms of this unrecognized but widely discussed version of Attachment Disorder appear broad enough to include the behavior of nearly all children on a bad day, such as refusing to look parents in the eyes, being disobedient or demanding, resisting being held or failing to smile. Some of these attachment therapists have claimed that all or most adoptees and foster children have attachment disorders.

Critics like Rosa are concerned that the hazy diagnosis of Attachment Disorder can lead frightened parents to employ unproven treatment methods that border on abuse, noting that in 2006, the American Professional Society on the Abuse of Children published a report condemning these versions of Attachment Therapy, specifically referring to Thomas’ work.

Many of these treatments, popularized by attachment therapists in Evergreen, Colo., revolve around asserting parents’ absolute control over their children, through strict regulations on children’s movements and eating habits. Sometimes children are put on extremely limited diets of bland, unappetizing food; assigned hours of pointless, repetitive chores; forced to sit in one location, facing the wall, for hours at a time; and endure “holding therapy,” wherein children may be forcibly held down by parents or therapists to induce first a feeling of rage and powerlessness, then catharsis and acceptance when they finally submit. In 2000, 10-year-old Candace Newmaker famously died under the care of attachment therapists in Evergreen during a controversial “rebirthing” treatment.

In extreme cases that have gone to court in the last two decades, some adoptive and foster parents have justified locking children in caged-in bunk beds as a form of attachment therapy that they said they were inspired to try after reading books on attachment therapy, or employed terrifying punishments like forcing children to “dig their own graves.”

It’s important to note that Nancy Thomas has certainly not advocated putting children in cages nor digging their own graves. But there is enough in her methods to cause concern. Thomas came to attachment therapy not through medical or psychotherapeutic training, but through her longtime work with foster children. A former dog groomer and devout Christian, Thomas became a therapeutic foster parent at the Attachment Center at Evergreen in Colorado, complementing therapists’ work by maintaining a home environment of constant strict discipline. Thomas says that, of the many foster children she’s cared for over the years, 90 percent have been “kids who killed.” Today, Thomas has parlayed her experience working with Evergreen into a methodology she calls “Nancy Thomas Parenting,” which she promotes through her books, summer “attachment camps,” consultations and speaking engagements.

Thomas says that traditional therapy is “a total waste of time” with “Attachment Disordered kids.” She instead advises more radical methods, including her own reports of having sat on children who are acting out of control; feeding them “soup kitchen meals”; forbidding them from speaking; or, like the Harrises, putting alarms on their bedroom doors in case they try to leave without permission.

“In the beginning, your child should learn to ask for everything,” Thomas wrote in When Love Is Not Enough, the book the Harrises referenced. “They must ask to go to the bathroom, to get a drink of water, EVERYTHING. When it starts to feel like they must ask to breathe, you are on the right track.”

“The RAD therapies are really all about taking control of the children, under the auspices of keeping them safe and helping them trust adults,” says Rachael Stryker, an anthropologist and author of The Road to Evergreen: Adoption, Attachment and the Promise of Family.

Since writing her book Attachment Therapy on Trial: The Torture and Death of Candace Newmaker, psychology professor Jean Mercer has become a staunch critic of RAD therapies, which she says mistakenly equate obedience with attachment. Mercer also notes that there is a concerning synchronicity between attachment therapy principles and outdated religious child rearing philosophies that emphasize children’s submission above all else. That overlap makes it unsurprising that children said to have RAD are spoken of in almost supernatural terms: as demonic or possessed.

Some RAD therapy websites Mercer studies have claimed that one sign of the disorder is a darkness behind the children’s’ eyes. Nancy Thomas has often spoken about her attachment work in spiritual language. In a 1990 HBO documentary featuring Thomas and her adopted daughter, she said kids with RAD “believ[e] they’re evil, believ[e] they’re from the devil.” In one educational video, wrote Mercer, Thomas cautioned against allowing foster children to say grace at meals, “because you don’t know who they might be praying to.” And on her website’s definition of Attachment Disorder, Thomas includes a list of allegedly Attachment Disordered people “that did not get help in time,” including Saddam Hussein, Jeffrey Dahmer and Ted Bundy.

That sort of comparison raises the stakes with attachment disorders from pathologizing to demonization, says Mercer. “The phrase ‘these children,’ is something said again and again. They’re saying we’re talking about a special kind of person here, not an every-day child. … This is a person who will grow up to be a serial killer.”

And once frightened parents have that frame of reference—that they’re dealing with “killer kids” who cannot be fixed with love or traditional therapies—it can be a short step to believing that extraordinary measures are required, and that any means necessary are justified to intervene with a troubled child.