Therapy or abuse? Controversial treatments may sink Cascade

"I will still go where I need to go to help a kid. I'm not going to be Mr. Nice Guy. You have to be blunt with some of these kids or it's not going to work."

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On the floor, the therapy session is intensifying. Risenmay leans closer to her daughter and asks her how she feels about the man who abused her.

"Mad?" the girl whimpers.

"Well, you don't sound mad," Risenmay says sternly.

"I'm mad," the girl growls.

VanBloem holds his hand above her face.

"This is (the person who abused her) how do you feel?"

"I'm mad!" the girl screams. Risenmay screams with her, and soon the two are chanting in unison: "I'm mad! I'm mad!" at an increasing volume for 30 seconds or so, until the girl's voice begins to crack and tears bubble up from her eyes.

Once she has released her repressed rage, VanBloem and Risenmay speak to her in soothing tones about appropriate ways to deal with anger. When they are finished she hugs VanBloem. Risenmay sits on the couch, and her lanky daughter curls up in her arms like an infant.

"I'm sorry you have to carry so much inside you," Risenmay says, stroking the girl's forehead. "You're such a beautiful girl. I love you."

"I love you, too," the girl says. Then she gets up and runs downstairs to play.

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As part of the continuing fight to keep his license, VanBloem will present his therapy to a state regulatory board in January. He will argue that the physical prodding he does is an approved method of massage therapy and that holding therapy is supported by scientific research.

It will be a tough argument to make. According to both the American Psychiatric Association and the Utah Psychiatric Association, there is no scientific evidence to support holding therapy.

There is some debate within the mental health field over whether reactive attachment disorder even exists.

"I'm very skeptical of the way RAD is diagnosed. Therapists use a checklist that has no scientific basis, and every kid with a history of abuse gets diagnosed with it," says Jean Mercer, a psychology professor at Richard Stockton College in New Jersey and an outspoken critic of holding therapy. "It's very rare, but there are some cases of children who are psychotic from a very early age, but that's not RAD; that's early onset schizophrenia, and nothing but medication is going to help them. This idea that sitting on someone is the answer, it's just bizarre."