HALLSVILLE, Texas—No sign marks the entrance to Heartlight Ministries, set off a two-lane highway in East Texas. Its dozen or so log cabin buildings are nestled among tall pine trees, hidden in deep pools of shade. No gate blocks its entrance; no fence warns visitors to stay away. Drivers who turn onto its curved road by accident might mistake it for a bucolic resort.

But Heartlight is a therapeutic boarding school for troubled teens, a place parents send children struggling with depression and anxiety or experimenting with drugs, alcohol, promiscuity, or pornography. Thirty years ago, such “out-of-control” youth often ended up in behavior modification programs emphasizing military-style discipline and boot camp deprivation. Heartlight does aim to change behavior, but not by force—and definitely not through hardship.

At Heartlight, dorms feature rustic ski lodge styling, with open kitchen and dining spaces and tidy bedrooms. A state-of-the-art gym includes elliptical trainers, treadmills, and weight machines interspersed with flat-screen TVs. Next to the schoolroom, rows of plush leather recliners fill a small movie theater.

Recreational activities include horseback riding and water skiing. The setting inspires trust because it looks like Heartlight cares well for its charges. But looks can be deceiving—how can parents evaluate a program?

In Heartlight’s conference room, founder Mark Gregston points to a small, framed certificate hanging on the wall: the school’s state license. In Texas, all residential child care facilities must meet minimum health, safety, staffing, and training standards. Every year, and more often if they get a complaint, state inspectors visit the campus to check for compliance. Parents can review reports on the state’s website.

All of that is helpful regarding safety concerns—and some states don’t provide that help. Regulation varies state by state, especially for faith-based centers. In some states, like Texas, Christian programs must meet all the same health and safety requirements as their secular counterparts. But in Florida, which has some of the country’s most lax regulations, Christian centers have limited oversight.

The balancing act is important: Too much regulation can lead to governmental harassment; too little can open the door to draconian discipline and teens who leave more traumatized than when they arrived.

Government entities generally do a poor job of measuring effectiveness in changing lives. So how can parents find out whether a particular program will really help children get back on track? Ask lots and lots of questions.

THERAPEUTIC BOARDING SCHOOLS are part of a treatment industry that includes wilderness camps, ranching programs, and military-style boot camps. Their overall goal is to take struggling teens out of their familiar settings and help them work through the underlying issues leading to destructive behavior. Some are run by Christian organizations. Many are not.

Ben Mason began working as an education consultant in 1987, helping parents find the right program for their children. Explosive growth in the industry began several years later when health insurers stopped paying hospitals to treat children with emotional or behavioral problems. The sudden loss of funds led to some “colorful” bankruptcies, Mason recalled, and a treatment vacuum. Unemployed clinical care providers saw an opportunity to open private facilities. Few states had specific guidelines or rules for oversight.

The new programs often focused on discipline, structure, and punishment, either in a military-style setting or in remote wilderness camps. Many focused on the external behavior rather than the internal motivation and were run by some “real cowboys,” Mason said: “They thought if kids do enough pushups in the mud, they will come around. Well, guess what, they won’t.”

In 2007 the Government Accountability Office reviewed residential treatment programs for teens after several horrific deaths made national headlines. Investigators came to the same conclusion about dozens of cases: Lack of oversight made it hard to protect teens from abusive situations. Some states began cracking down on previously unregulated programs, and the unwanted attention forced the industry to make attempts at self-regulation.

Only 30 states had licensing requirements when Congress held its first hearing. Now, almost all do. That’s encouraging to Megan Stokes, executive director of the National Association of Therapeutic Schools and Programs (NATSAP), which promotes the development of best practices within the industry and requires all members to have either a state license or accreditation from one of three mental health agencies: “They need to have some oversight.”

The level of oversight varies widely.

FLORIDA is one of a handful of states that allow Christian programs to opt out of all government oversight. Since 1984, programs with a faith-based exemption fall under the oversight of the Florida Association of Christian Child Caring Agencies (FACCCA), a nonprofit organization run by the same people it’s tasked with evaluating. Member programs pay dues, vote on policies, and have the final say on new members.

Lawmakers created the exemptions to give Christian groups freedom to run their programs without secular interference. The state allows similar freedom for private schools, which are completely unregulated. When government regulators in Texas in 1995 overreached, Gov. George W. Bush in 1997 signed legislation that created a good balance. But in some other states a lack of basic safety and health regulation allows for abuse of vulnerable children cut off from any contact with the outside world.

Robert Friedman, a clinical psychologist and professor emeritus at the University of South Florida, opposes his state’s regulation vacuum. He says desperate parents who believe they’re sending a child to a program run by people who share their beliefs are easy to deceive: Some facilities use “practices in no way consistent with what a responsible Christian group would accept.”

FACCCA did not respond to repeated emails and phone calls requesting comment for this story. But a 2012 investigative report by the Tampa Bay Times documented dozens of abuse allegations against Florida facilities with faith-based exemptions. One girl said staff ordered other teens to pin her to the floor while the pastor’s wife whipped her with a thin rod. When she was done, the woman made all the girls sing “Amazing Grace.”

Other students recalled long stints in isolation rooms, forced sleep deprivation, and orders to exercise until they collapsed. After the Times published its report, FACCCA pledged to modify its guidelines for corporal punishment, isolation, and shackling.

Friedman believes safety has improved in the last 15 years, thanks in part to the industry’s own efforts to adopt professional standards. Programs also do a better job of hiring qualified staff, but he insists it’s still hard to know how safe programs really are. Although he opposes Florida’s faith-based exemption, Friedman doesn’t object to faith-based programs. He’s visited Christian centers in other states that impressed him.

Even the Tampa Bay Times report, clearly critical of faith-based programs, noted only a handful of Florida centers with exemptions had long lists of complaints filed with the state. One story featured a center that used a “gentler” treatment approach—no corporal punishment—while still requiring weekly chapel attendance, as if that were an offense.

TEEN CHALLENGE oversees 26 facilities for adolescents in 19 different states. Three are in Florida. The 60-year-old Christian organization uses a model for therapy and recovery that treats out-of-control behaviors as a sin problem, not primarily as a disease best treated with medication and other secular solutions.

Although Florida’s exemptions were designed for programs like Teen Challenge, President Joe Batluck said the organization hasn’t had any problems with government interference in states that have more stringent oversight: “We never or rarely ever have any question about the core values because they are so central to our mission.”

Teen Challenge leaves it up to individual centers to meet each state’s licensing requirements. One of its Florida programs belongs to FACCCA, while two others operate as unlicensed Christian boarding schools. Teen Challenge’s oversight of the programs that use its name focuses on more “macro” issues and on each program’s commitment to Christian values, Batluck said. When evaluating programs, he advises parents to get information about the treatment model, the length of the program, and its approach to community—and especially church—involvement.

The website for NATSAP, the national industry organization, includes a list of questions its leaders recommend parents ask before sending a child to any therapeutic program. They cover everything from licensing to discipline procedures and risk management. The Federal Trade Commission also offers its own list of recommended questions. But neither of those web pages comes up in the top results of Google searches for therapeutic boarding schools.

Instead, the search engine spits out a long list of websites for what appear to be model programs. Photos show happy teens sitting around campfires, hiking in the pristine wilderness, and talking earnestly with a deeply concerned adult. Mason, the education consultant, scoffs at such picture-perfect depictions: “People believe everything they see on the internet.” Many of the websites list a crisis hotline number parents can call—but those cries for help often get answered by a call center where the person on the other end of the line is paid to tell parents what they want to hear, Mason said.

Some programs, he added, might lie outright about their clinical staffing and experience, while others exaggerate their expertise and experience dealing with certain mental health problems: “Parents have no idea whether these places are going to do what they say they’re going to do.” Gregston of Heartlight Ministries echoed Mason’s warnings about unscrupulous programs, agreeing too many will say anything to get an enrollment: “Sometimes parents are so desperate that they’ll place a child anywhere. It reflects the intensity of what the parent is going through.”

Despite the emotional trauma, Gregston—who has a weekly radio program, Parenting Today’s Teens—encourages parents to ask questions, and notes it’s often not until something goes wrong that parents realize they never asked the right questions. Gregston demands parental involvement: Heartlight won’t take a teen unless parents commit to attend six family event weekends during the course of their teen’s yearlong stay.

Gregston advises parents evaluating other programs to look for similar requirements for family involvement, as well as detailed postgraduation transition plans. The walls of his group meeting room are covered with large photographs taken during weekend retreats—parents and teens, arm in arm, wide grins beamed at the camera.

He says parents should ask these eight questions, among others: What forms of punishment or discipline do you use? How often will I be able to talk to my child on the phone? Do you have licensed counselors on staff? If not, what other benchmark do you use to evaluate counselors for competency? What criteria do you use when hiring other staff at the program? How often will my child get counseling? Is it in a group or one-on-one setting? Can I tour the facility before enrolling my child?

Held against her will?

All programs dealing with troubled teens get complaints, so it’s important to get the details.

For example, Heartlight Ministries got some unwanted attention last year when one student’s relative took to social media to claim his cousin was being held against her will. Jeremy Jordan, an actor on the television show Supergirl, described Heartlight as a gay conversion camp where his cousin Sarah had been sent to “pray away the gay.”

Heartlight founder Mark Gregston strongly denied those claims, as did Sarah’s mother, who eventually withdrew her from the program. But Jordan’s social media campaign attracted the attention of 20/20 producers, who featured the story in a March 2017 episode of the program.

Gregston told me he doesn’t care about a teen’s perceived sexual orientation. Heartlight’s goal is to get to the root of destructive behavior. Legal documents filed in the family fight over Sarah indicated the teen suffered from “depression, self harm, and drug use.”

Sarah did reportedly try to flee Heartlight, not uncommon for teens sent away from their family and friends. Gregston said none of the teens who come to Heartlight want to be there, but they all need help: “We don’t treat them like they’re inmates. We tell them if they want help, we’ll help them. But we won’t fight them if they don’t want help.” —L.J.