APA appoints task force on abortion and mental health

First mentioned in passing in a January 21 New York Times article, the APA has appointed a task force to conduct an updated review of research on abortion and mental health outcomes. In contrast to the more public process used by the APA to appoint the task force on sexual orientation responses, the APA did not consult the membership for nominations. The APA reached back to partially reconfigure the 1989 task force that found minimal mental health risk in abortion. The members of the Task Force are:

Mark Appelbaum, PhD, University of California, San Diego

Linda Beckman, PhD, California School of Professional Psychology

Mary Ann Dutton, PhD, Georgetown University School of Medicine

Brenda Major, PhD, University of California-Santa Barbara

Nancy Felipe Russo, PhD, Arizona State University

Carolyn West, PhD, University of Washington, Tacoma

According to Rhea Farberman, PR Officer at APA,

A slate of potential members for this task force was determined based on a database search of research on abortion and related issues. That initial list was reviewed by the APA Committee on Women in Psychology which sent recommendations to the APA Board for the Advancement of Psychology in the Public Interest which in turn sent recommendations to the APA Board of Directors. The Board of Directors made the final appointments to the task force.

The task force was constituted with the following goals:

Include leading researchers who were members of the group that did the review 15 years ago, while not completely reconstituting the original group;

Include research and practice expertise in the following areas: social attitudes, sexual behaviors, violence/trauma/sexual assault, women’s mental health, and minority populations; and,

Include a methodologist, because so many of the most visible/critical questions are methodological in nature.

Concerning the final composition of the task force, three of the task force members have prior expertise directly related to issue of abortion and mental health; the other three have expertise in the related issues noted above.

Rhea added that any information germane to the charge of the Task Force is welcome – it doesn’t necessarily have to be from members — and can be sent to: Women’s Program Office, American Psychological Association, 750 First Street, NE, Washington, DC 20002.

The manner and members of the task force have raised some questions. One psychologist I interviewed, Dr. Rachel MacNair, wonders about the objectivity of this committee. Dr. MacNair is the author of Perpetration-Induced Traumatic Stress: The psychological consequences of killing. Dr. MacNair says she is a “pro-life feminist” who “sees all violence as connected and wrong, with abortion being one kind of violence.” She observed that half of the task force have been openly critical of pro-life views and have public positions negating any relationship between abortion and negative mental health consequences. Dr. MacNair also believes qualified people were overlooked by the APA’s selection process.

Would the committee’s credibility have been strengthened by including members with opposing perspectives? Dr. MacNair thinks so and told me, “Only if the report comes out with conclusions opposite to what one would expect with the ideological commitment of half of its members will it have credibility. If it comes out as predicted, the absence of balance on the task force will be a problem for its scientific credibility.”

You can read more of Dr. MacNair’s thoughts in a column I just posted on my website call Abortion and American Psychology.

UPDATE: 5/18/07 – The Washington Times carried the Abortion and American Psychology column today.

Ex-wife of ex-ex-gay speaks about reorientation therapy experiences

Pam Ferguson, also known to many as Willful Grace, describes her experiences with her ex-husband’s reparative therapy in a post at ExGayWatch.

Her descriptions of some of the things done in the name of sexual reorientation make me cringe. I continue to believe those who support a patient’s right to pursue sexual reorientation should be more zealous to root out such practices. I appreciate Pam’s decision to share and encourage others to do so here in response.

I think the entire post is worth reading but here is one excerpt:

The therapist, who was always in stocking feet, would often rub his foot on Tdub’s [her nickname for her ex-husband] leg (This occurred in couples session; I witnessed this.) I found this a bit awkward and, assuming it went on in his individual sessions, I asked Tdub about it. He admitted that it made him feel awkward at first but that he’d gotten used to it and it was just a part of the therapist’s “way”. He later went on to mention that the therapist sort of played the role of a father figure and was teaching them lessons about safe and affirming male touch.

Note to the movement: The whole therapist-as-a-father-figure thing has got to go, and the sooner the better.

Sexual identity therapy: Is neutrality a bad thing?

Last year, I wrote an article for my website called I Am Not a Reparative Therapist. In that article, I indicated that one of my problems with reparative therapy, as I understood it, was that the therapist promoted reparative drive theory to clients as the singular source of same-sex attractions.

It seems to me that if a therapist begins with this theory or any one-size-fits-all theory, confirmation bias will operate to find it in the histories of clients. It also seems to me that any theory of origins, whether it be developmental or pre-natal or a combination thereof, is bound to contain much speculation due to the inadequacy of current research and the biases inherent in the therapeutic uncovering process. However, such speculation and uncovering may be quite useful in setting a context for the pursuit of valued action and may indeed lead to powerful emotional catharsis and the formation of a new way of looking at one’s self. A new perspective can be powerful, even if it is incorrect on certain objective points. E.g., some people say they have been freed of emotional bondage by resolving issues of trauma in past lives (past life regression). I do not believe they are correct but I suspect they really do feel better. This is an extreme example, of course, but it serves to illustrate that one may be objectively incorrect about the meaning of historical events but still feel relief because one has a meaningful perspective to make sense of it all. A single pathway theory can make clients and therapists feel better because it enhances a sense of certainty but I remain skeptical that single pathway theories are correct.

Having expressed skepticism about the meaning of historical events, I also believe that clients and therapists are sometimes correct in their inferences and finding the truth may or may not have real impact in the present. However, being correct in our inferences some of the time does not mean we are correct all of the time, nor does the events that ring so true for one client mean that the next client with similar issues has the same history or makes the same meaning of a similar history.

My reactions to reparative therapy as a means of addressing conflicted people are based in part on the belief that therapists should be prepared to flex from their theoretical and cognitive mindsets to address individual clients – the facts on the ground, so to speak. Perhaps, however, this is my bias showing about how therapy should be conducted. Perhaps, on the other hand, it is defensible to offer a form of therapy (e.g., cognitive-behavioral, client-centered, or gestalt) and say to the client, “Here is how I think about problems and how I work with them. If my way of working does not seem right for you then you are free to move on to another therapist.” Taking the analogy further, client-centered therapists refrain from giving advice, or making interpretations and view problems as arising due to discrepancies between a person’s real self and their idealized self. A client who wanted an active, directive therapist might be frustrated by a non-directive therapist. However, a non-directive therapist might be so wed to his viewpoint that he would need to refer clients who wanted a differing theoretical and technical perspective.

Germane to this discussion of therapy approaches, Dr. Nicolosi recently published an article on the NARTH website titled “Why I Am Not a Neutral Therapist.” This article lays out his rationale for advancing a specific theory of homosexuality and resultant therapy for those who do not feel congruent with their beliefs.

The developmental model we suggest must deeply resonate with the men we work with, or they will (rightfully) leave our office and pursue a different therapeutic approach. We explain that our position differs from the American Psychological Association, which sees homosexuality and heterosexuality as equivalent, and along the way, we encourage them to clarify and re-clarify the direction of their identity commitment. Gay-affirmative therapy should, of course, be available for any such client.

A few gay-identified clients do decide to stay with us. Out of respect for diversity and autonomy, I affirm them in their right to define themselves as they wish, and I accept them in their gay self-label.

This article addresses some of the concerns I cited in my article about reparative therapy. On one hand, it does appear that Dr. Nicolosi offers a singular explanation for homosexual attractions that clients encounter early in reparative therapy. On the other hand, Dr. Nicolosi tells clients the theory must ring true for them to proceed. And he apparently affirms some small group of gay clients. This is probably surprising news for many observers.

I continue to believe the reparative developmental model is probably not operative for all people who are same-sex attracted. And my bias is to hold all such theories loosely and indeed to think that there are many factors, both pre-natal and environmental, that lead to different outcomes for different people. I do wonder what people do if they do not believe reparative drive theory fits them. Does the insistence on the theory drive some people toward a more deterministic “born gay” view since they do not agree with the singular developmental theory of origins? Inasmuch as evangelical faith is often bound to an environmental explanation, can such determinism create more conflict with faith? These are of course open questions but I have written about this before.

From the article about therapist neutrality, it appears that Dr. Nicolosi envisions an environment where gay affirming therapists can assert their beliefs to clients and reparative therapists can likewise assert their beliefs and then let clients choose which approach they like. In contrast, the sexual identity therapy framework calls for therapists to refrain from offering preconceived ideas about causation and change but to focus instead on the realization of objectives which align with the individual values and beliefs of clients. In practice, I suspect there are times when therapists using any of three mindsets would look very similar.

I am hopeful that our framework provides therapists of all ideologies with a map to help clients determine their path. I believe our framework can be valuable in helping clients clarify which broad way may be most suitable for their individual situation.

Only the gay die young? Part 7 – Paul and Kirk Cameron reply

As expected, Drs Cameron have replied to my critique of their study of gay life expectancy. They have made it neat and tidy by separately replying so click each name below to read their letters.

Paul Cameron

Kirk Cameron

Paul Cameron’s letter came with my critique included so I have left this in the document (it is getting long) — Cameron’s thoughts begin on page 7.