You know, you're right. They probably are true believers, thinking they are actually fighting the good fight. This, to me, illustrates the insane depth of their delusions and ignorance.
If you look through history, you will see that the True Believers are much more harmful than the merely corrupt.
I doubt very much that Miller and Ruthie sit back at home and drink toasts "To Evil!" while reminiscing about the years of abuse, but this in no way makes them any less responsible for the suffering they have caused. If anything, claims that they are providing treatment and therapy, rather than merely giving advice, or even (trying not to laugh) dispensing wisdom, raise the standard to which they are held.
This said, I believe that Miller probably took an "ends justifies the means" philosophy and if it meant committing fraud against insurance companies, the government, and parents of "clients" in order for him to "carry the message", then by God, he was going to do it.
I kind of look at the fraud and such as a separate issue from the abuse, though they do intertwine. Straight was fucked up on so many different levels, it's hard to know where to begin.
