Accurate public statements: A Montel post-mortem
Since last Thursday’s Montel Williams Show, I have called show producers and emailed the show several times asking them for research to support a statement made by psychiatrist Alicia Salzer in reference first to Alan Chambers’ story and then to change therapies in general. She said:
This is marketing; this is not science: Science has shown us that 96% of people cannot change and along the way, absorb an enormous amount of self-loathing, a lot of confusion, a lot of family conflict, so I know the harm.”
I am completely aware that harmful things have been done and continue to be done in the name of reparative therapy, but Salzer’s statement about a rate of change cannot be supported. The closest thing to a study that might yield a 4% change rate is Shidlo and Schroeder’s qualitative study of those who said they were harmed by some type of effort to change. This was not a study that could test hypotheses about rate of change for any population. At present, science cannot say much about such change, and “it” surely cannot say what Dr. Salzer did. As noted, I have repeatedly contacted the Montel show about this statement with no response.
All mental health professionals are bound to make tentative statements about research findings and to take care to separate opinion from “science.” Consider this statement from the physician code of ethics:
Section 7
A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
1. Psychiatrists should foster the cooperation of those legitimately concerned with the medical, psychological, social, and legal aspects of mental health and illness. Psychiatrists are encouraged to serve society by advising and consulting with the executive, legislative, and judiciary branches of the government. A psychiatrist should clarify whether he/ she speaks as an individual or as a representative of an organization. Furthermore, psychiatrists should avoid cloaking their public statements with the authority of the profession (e.g., “Psychiatrists know that…”).
I feel pretty sure that Dr. Salzer believes she is acting to better community and public health. However, I do not believe exaggeration is the way to accomplish this end.
UPDATE: 3/20/07 - I received a call from Melissa Borusso, producer of the Montel Show. She left a voice mail saying that, as suspected, Dr. Salzer was relying on the study of Shidlo and Schroeder for her statistics.
So if I went on national television and said that science has shown us that 66% of gay males and 44% of lesbians can achieve good heterosexual functioning through reorientation therapy (from Spitzer’s study), what do you think the reaction would be? Would there be a You Tube video up denouncing my misuse of research? I would hope so…
Perhaps she’s also referencing Spitzer in a round about way and his comments that only a few percent experience change (or whatever the exact words were).
In any case, as an accountant, I hate it when people try to advance their position by use of degrees of accuracy that were never present to begin with. It annoys me when comments like “Only about a quater of the room applauded and a third of them were his relatives” turn into “8.33% were his relatives”.
While I think her number isn’t terribly far from correct (definitely less than 20% and probably in the low teens), “science” didn’t tell her anything (that I know of) about the efficacy of change therapy. And the limited work done (consisting of guess work from Spitzer and anecdotal estimates from Cummings) doesn’t provide anything close to the accuracy she reported.
It may be confusion on her part rather than deliberate deception, but it’s sloppy either way.
It also depends on how change is defined and whether satisfaction with therapy is the focus, etc.
I remember looking over the 1997 NARTH study some time back. An analysis of the data and one graph exist on the Courage Website. I remember that my thoughts on it went someting like this:
Start at the graph from the NARTH study which in the first half of the page. Read their Analysis of the Data and then go look at the graph and the numbers. NARTH claims that the number of people starting the study who were “exclusively or almost entirely heterosexual” was zero, and that number increased to 287 after two years of therapy. That’s an increase of 33%, which is supposedly the conventional success rate for all psychotherapy. They say that not everyone made this complete turnaround, but that number is enough to prove that many can make this change. Well, maybe 33% of those who are “highly motivated.”
If you really look at what they managed to accomplish, it doesn’t appear to look all that good. NARTH started with 584 gays (what they call “exclusively or almost entirely homosexual”) and 276 bisexuals (what they call “both homosexual and heterosexual attractions”). Even without knowing the actual individual cases it is quite easy to see what happened. They managed to move all (276) of their bisexuals into their straight category (what they call “exclusively or almost entirely heterosexual attractions”); and they also managed to get 8 gays into that straight category. The rest of the gays either stayed gay (112) or were now professing some degree of bisexuality (464). NARTH and also Courage want to claim those 464 ‘former gays’ as a form of success; but I see them rather as a failure. I liken them to having gone back to the insanity of confusion which society elicits in some gay men to walk. In truth NARTH may only claim a success rate among gays of about 1.4% (8 out of 584); compare that with their rate of complete failure 19.2% (112 our of 584) or factor in those they have confused and its 98.6% (576 out of 584). And this is with persons who said they wanted help in alleviating their homosexual feelings. I do not have any idea what percentage of the gay population wants help in alleviating their homosexual feelings; but if it is even 20% that do (probably way high a number?) then for the entire population of gays, NARTH can only claim a success rate of about 0.3%.
At least that is how I saw it about the year 2002 or so. As I understand it NARTH has reworked its numbers since then and the idea of thirds have crept in with their reports and that of some other studies. 33% of gays can gain heterosexual functioning, 33% (or less) can be turned bisexual (confused), and 33% (or more) remain homosexual.
But this is supposedly among “highly motivated individuals towards change.” Just what percentage of gays and lesbians are in that “highly motivated” category?
Glad you’ve kept ontop of the Montel (Dr. Salzar) claim.
There is a website which watches and comments on ex gays. I wonder what a website would look like commenting on those who critique and make claims about ex gays. I mean, really, is the ex-gay movement the only dishonest one?
[...] that she would make this dogmatic statement, I contacted the show to ask how she arrived at the 96% figure. The producer Melissa Borusso called to say Dr. Salzer [...]
For gay men of my generation, and previous ones, the trip through therapy was a requirement of life. Those who came out before 1980, at least, were often guilted into going into some sort of change therapy. When I was a student in the 60’s, at a liberal college by the way, anyone caught in gay activity was coerced into change therapy. At this time only the hard core fundamentalist shrinks thought it would work. A figure often heard was 98% failure from the various therapists.
I suspect she read the study, and applied the folk wisdom that almost all attempts fail to what it actually says.
During the 70’s I recall an event in which numerous people who were listed as ’successfully changed orientation’ in studies stood up and proclaimed that they had not. Larry Kramer of ACTUP was one such.
This looks to be a case of someone seeing what she expects to see.
Thank you for the positive action you take in assisting so many of us struggling with unwanted urges we never wanted.
I am aware of certain therapies professionals use in resolving these issues. What is your take on hypnotically induced ego-state therapy? How successful is this therapy, and what approaches need to be taken in order to ensure positive reorientation results?
Regards,
Jaco
[...] In all of this I am reminded of another study. The study of harm by Ariel Shidlo and Michael Schroeder is one that has been advanced by critics of change therapies as proof that such therapy doesn’t work and is uniformly harmful. I have documented this error in previous posts, most notably when psychiatrist Alicia Salzar said on the Montel Williams Show that: [...]
Ivan,
The problem with so many Ex-Gay ministries is that they are Christian - for the most part anyway - almost all are religious - so you would expect them to conduct themselves in ways that not only separated them from this world, but that would lead others to God. The sad thing is that you don’t see this. You see Ex-Gay groups and leaders acting just like anyone else - even going as far to twist and distort truth, usually for political and social ends. This may be the one thing that upsets me so much about the formal Ex-Gay movement.