Sexual Orientation Change Efforts Fruitless

In 2007, the American Psychological Association commissioned their Task
Force on Appropriate Therapeutic Responses to Sexual Orientation. 
The background is this: early in the history of mental health treatment
efforts, homosexuality was considered to be an illness. 
Therefore, it was thought to be appropriate for therapists to try to
change the sexual orientation of persons who are homosexual. 



This attitude never was universal; it is said that even Sigmund Freud
was skeptical of it.  Even so, it was not until 1962 that efforts
began to remove homosexuality from the title="Diagnostic and Statistical Manual of Mental Disorders">DSM. 
It was decided, in 1973, to remove the diagnosis from the subsequent
edition.  The American Psychiatric Association issued a statement
at that time, in support of civil rights protection for homosexual
persons.  The American Psychological Association followed suit in
1974.  In 1991, the American Psychoanalytic Association finally
saw the light.  In 1992, homosexuality was removed from the World
Health Organization's International Classification of Diseases.



Even so, a small number of licensed mental health practitioners href="http://scienceblogs.com/corpuscallosum/2009/04/gaylesbian_reparative_therapy.php">continued
their efforts to pathologize and "treat" homosexuality. 



The American Psychological Association's Task Force on Appropriate
Therapeutic Responses to Sexual Orientation set out to research this
matter and issue a definitive proclamation.  This is described:

href="http://www.psychiatrictimes.com/display/article/10168/1472418">Sexual
"Conversion"? American Psychological Association Says Not Through
Psychotherapy

October 10, 2009

Psychiatric Times. Vol. 26 No. 10

Natalie Timoshin

In August, the American Psychological Association Task Force on
Appropriate Therapeutic Responses to Sexual Orientation target="_blank"
href="http://www.apa.org/pi/lgbc/publications/therapeutic-response.pdf">released
a report based on its systematic review of research on the
effectiveness of sexual orientation change efforts.

The
report stated that there is little evidence to suggest that efforts to
change a person's sexual orientation from gay or lesbian to
heterosexual are successful.

In fact, the report found that such efforts can cause harm. The
findings of the American
Psychological Association's
task force indicate that efforts to switch a person's sexual
orientation through psychological interventions not only don't work but
also can lead to loss of sexual feeling and to depression, anxiety, and
suicidality...

I find it interesting that the Task Force does not use the terms
"reparative therapy," or "conversion therapy."  These terms would
seem to imply that these activities are a form of therapy, which they
are not.  Instead, the Task Force uses the term sexual
orientation change efforts (SOCE).  This is -- suitably -- a
descriptive, nonjudgmental term. 



The Task Force issued a 138-page report, which appears to be a
reasonably comprehenive review of the work that has been published on
the subject.  They endeavored to be fair and balanced. 



Their "key findings" are as follows:

• Our systematic review of the research on SOCE found that enduring
  change to an individual's sexual orientation as a result of SOCE was
  unlikely.  Further, some participants were harmed by the
  interventions.
• What appears to shift and evolve in some individuals' lives is
  sexual orientation identity, not sexual orientation.
• Some participants in SOCE reported benefits, but the benefits
  were not specific to SOCE. Rather, clients perceived a benefit when
  offered interventions that emphasized acceptance, support. and
  recognition of important values and concerns.

In other words, SOCE is 90% dangerous bunk, and the 10% that isn't bunk
is due to the fact that the therapists doing it could not prevent
themselves from doing some real therapy mixed in with the bunk.



The Task Force considered proposing changes to the Amercian
Psychological Association's Ethical Principles for Psychologists
and Code of Conduct.  However, they decided that it is not
necessary to make any changes.  In their view, the existing
principles already lead to the appropriate conclusions.  The
prinicples they cited are:

• Bases for Scientific and Professional Judgments
• Beneficence and Nonmaleficence
• Justice
• Respect for People's Rights and Dignity

So if a practitioner sticks to the science, tries to do no harm, and
attends to principles of justice and respect, then that practitioner
will reject SOCE.  Instead, the practitioner will offer
appropriate assessment, affirmation, acceptance, support, and promote
active coping. 



They recommend that practioners adopt a therapuetic approach that
includes what they call identity exploration:

Licensed mental health providers address specific issues
for religious clients by integrating aspects of the psychology of
religion into their work, including by obtaining a thorough assessment
of clients' spiritual and religious beliefs, religious identity and
motivations, and spiritual functioning; improving positive religious
coping; and exploring the intersection of religious and sexual
orientation identities.

This sounds reasonable to me, although it can be difficult.  
In my experience, it tends to be particularly difficult with persons
for whom value judgments are so reflexive, that they are unable to
appreciate the distiction between observation and conclusion. 
They experience any attempt at description as necessarily implying
judgment.  As a result, whenever the practitioner tries simply to
describe what he or she sees and hears, the patient automatically
assumes that the therapist is making a value judgment. 



It takes a particular kind of mental discipline, in order to maintain a
strict separation between description and judgment.  It seems
obvious that it is entirely possible to form a judgment without
actually making any observations, so it is hard to understand why it is
so diffiucult to make an observation without making a judgment. 
But that seems to be the case, fairly often.