I don’t have a problem with any of those points.

Just me, but I’d be more clear and ask that if a client presents with issues (such as major depression, substance abuse, a distorted view of how they think people live as gay, whatever) that these are dealt with first. Without tackling those, the very idea of obtaining “informed consent” is problematic.

At the end of the day people are entitled to be as ridiculous as they see fit, but we should expect more from a professional therapist.

At least, at work I mean 🙂

A brief summary of the APA history around reorientation therapy is here (it’s the article by Haldeman).

I think they’re still struggling to ensure good practice without being overly prescriptive in an environment of seemingly willful nonsense from many (most?)reorienation therapists (eg Hallman in Warren’s post after this one) and false “advertising” from groups like Exodus, Focus etc.

I guess RT advocates can’t really complain. Nothing wrong with a caution. It’s not like anything is being banned. I believe a few years ago, the APA attempted to ban all RT’s, but the resolution failed at the last minute.

I wouldn’t have any problems with so called “conversion” therapies to help people change if:

a) the therapist first takes a realistic look at the patient to see if he indeed is capable of adapting to a heterosexual life. (check to see if he has latent heterosexuality?)

b) the therapist helps boost the patient’s overall self esteem, beyond merely trying to turn them on to the opposite sex.

c) work towards alleviating the patient’s sense of shame, and help him get over feelings of internalized homophobia–of not measuring up, of feeling defective.

d) do NOT precede from the premise that homosexuality NEEDS to be changed in order for the patient to be happy

I believe that it is possible to simultaneously respect the client’s will to change AND fulfill the above criteria.

Perhaps it just takes a really, really good therapist

Spitzer’s estimate is a guess. He has acknowledged as much. It doesn’t seem scientific to make policy based on a guess and anecdotes (Drescher).

The policy they have is cautionary. It does not ban reorientation therapy, as you’ve said many times, but it does alert both professionals and potential clients. I imagine that comes under resonable informed consent, no?

Yes, Spitzer is guessing. Yes, Drescher is working from anecdotes (his, and that of many others). I do wonder how you would describe the basis used by reorientation advocates, such as yourself?

Given RTs are only dealing with a minority of gay men and women — and failing to change them the majority of the time — I’d suggest that their grip on the science is even less secure.

The anecdotes of harm, and the APAs caution, do at least align with very well established information. Without even needing to see a client, attempts at reorientation have the potential to increase negative feelings that the client has about themself. These feelings are why they seek reorientation in the first place (in nearly all cases). The vast bulk of the literature and practice aligns with (I say, was designed to align with) a virulent social prejudice, as the APA has noted.

The potential for great harm therefore exists, a priori; particularly if the therapist deliberately uses that negativity to raise the stakes in the mind of their client. And particularly when the client fails to change, as most will even by the exgay promo materials.

(I don’t know where you sit on all this, but Nicolosi comes immediately to mind — let alone the “counselors” in the religiously-inspired exgay groups).

I don’t think the APA is under any obligation to establish the research. They aren’t the ones encouraging or promoting the attempts. Surely, that research is your obligation?

I felt no pressure from admin to get kids to enter reorientation.

And what pressure does the admin place on GCC kids? I’ve seen the current GCC handbook, and it makes it perfectly clear. While sexual orientation itself is not grounds for removal, an “uncooperative” attitude to that orientation is where the student and GCC part company. While at GCC they must adopt, at least in public, a negative attitude to that sexuality. Homosexuality activity — very broadly defined at GCC — is grounds for immediate expulsion. CK remembers the environment all too well, and this is unrelated to how you professionally conduct yourself while in session.

But we’re not talking at about little GCC. I’m more interested to know how the reorientation attempts that you advocate for are to be reconciled against the potential for harm (and the known behaviour of some therapists) when considering the 97-99% that you don’t see.

Until those are resolved, and given there is no medical reason per se to not be gay or lesbian, the APA is correct to caution anyone considering an attempt. They are being responsible.

Spitzer’s estimate is a guess. He has acknowledged as much. It doesn’t seem scientific to make policy based on a guess and anecdotes (Drescher).

I would not ask the APAs to endorse anything related to reorientation. On the other hand, I do not think it is appropriate to take the advocacy position they have taken. I think there should be more research, and a task force created with proponents and opponents to come to consensus about what we know, and what we don’t.

Ck – I am no longer in the Counseling office. I am in professoring and public policy full time. I do continue a small private practice.

The counseling service has no obligation to alert admin about anything except suicide or homocidal students. It would be unethical to do anything else. I know of no student removed for homosexual orientation however defined.

I have worked with gay couples in a variety of contexts, although as you might imagine, very few come to see me. I have also worked with clients who do not pursue reorientation and those who are deciding what to do. I felt no pressure from admin to get kids to enter reorientation. In fact, it has never come up about any student in the 11 years I have been here. Say what you want about GCC, this is a place that respected ethics (counseling ethics at least). When I came here I told them what the professional ethics were regarding the counseling services and admin has always respected it. I am glad for that environment.