APA president speaks about a client’s right to self-determination

In a Q&A today at the American Psychological Association convention in New Orleans, APA president Gerald Koocher was asked about a client’s right to seek therapy to modify same-sex attraction. He reportedly said (and I am seeking confirmation from the APA) that clients may seek psychotherapy to affirm their religious values even if that meant that the therapy involved objectives to modify same-sex attractions. He reportedly said that it would not be outside the APA’s ethical guidelines to work with such a client toward the client’s chosen course, even if that course meant seeking to reduce or eliminate same-sex attractions.

Update: I spoke with David Blakeslee who was in the Q&A and asked Dr. Koocher a question about APA guidance regarding clients who have religious conflicts surrounding sexuality. Dave’s question went something like this: “Dr. Koocher, I appreciate you participation in constructing and presenting guidelines for ethical behavior and attended your conference in Portland 18 months ago which I found very helpful. As a social and religious conservative I have found myself in a difficult situation about which I think the APA has not provided sufficient ethical guidance. I have been sought out by clients with deeply held religious beliefs who also have unwanted same-sex attractions. For these persons their religious beliefs are even more important to their identity than their same-sex attractions. Because of APA’s lack of guidance in this matter, I am forced to seek advice outside APA. What is APA doing to give explicit guidance to psychologists like myself and thereby ensure that treatment of my clients honors their deeply held religious beliefs as they struggle with their same-sex attractions and is consistent with APA values of self-determination and client autonomy?”

In addition to what I reported above, Dr. Koocher reportedly emphasized that the therapeutic relationship is constructed by both the client and the therapist along the goals of the client and that the whole person must be taken into account when considering an intervention.

Dave tells me that Dr. Nicolosi followed up with a comment that his response seemed in conflict with official policy of the APA on homosexuality and that clients sometimes come to therapy wishing to explore their potential for heterosexual attraction; to which Dr. Koocher reemphasized his position of client self-determination and then cautioned about coercion.

I have heard back from Rhea Farberman, of the APA Publication Office this morning that she will soon give a complete response to my request for confirmation. She did add this:

In brief, this is a complex issue and one about which we seek to balance patient choice with the therapist’s obligation to gain informed consent. There are also questions about the efficacy of therapies intended to change sexual orientation and potential harm of such techniques. APA’s position is based on the standing Council of Representatives resolution on the topic.

Hit the link for the APA’s official statement. Anything that is said here or is said anywhere must be interpreted in light of that resolution.

My take on this is that the APA has stopped short of banning change therapies but guides psychologists to inform clients of the APA position on homosexuality, to forbid coercion, to oppose therapy that has as its premise homosexuality per se is a mental disorder and to avoid making public statements that cannot be supported.

Now where have I read guidance consistent with that…