A college psychology professor's observations about public policy, mental health, sexual identity, and religious issues
This evening the Fellowship of Christian Physician Assistants issued a press release regarding the American Academy of Physician Assistants House of Delegates action to oppose certain types of sexual reorientation therapy.
We have been discussing this matter on other threads. Bottom line, the professions discourage imposition of therapist views opposing homosexuality and they oppose therapies which begins with the premise that homosexuality is a mental disorder to be treated.
Yesterday, I reported the action taken by the House of Delegates of the American Academy of Physician Assistants regarding reparative therapy. I want to provide more detail in this post. As you can see from the association’s daily conference newsletter, the resolution was changed to reflect AMA policy and thus was a step back from the exclusive proposal submitted by the Committee on Diversity.
The policy described above (slightly different from what I reported yesterday) is:
The AAPA opposes psychiatric treatment specifically directed at sexual orientation, such as “conversion†or “reparative†therapy, which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.
The original resolution proposed by the Committee on Diversity discounted any evidence that demonstrated benefit for change therapies. I helped construct a substitute resolution that found support from some, but not enough of the delegates. The substitute resolution respected religious, and sexual orientation diversity.
Robert Spitzer supported the substitute resolution and provided a letter of support for it.
In the end, the delegates opted for a stance that opposes seeing homosexuality as an illness and coercing clients into counseling for their sexual orientation.
UPDATE: Apparently, the discussion regarding the various reparative therapy motions was intense. At one point, John Fields, president of the Vietnam Veterans Association of Physician Assistants read several paragraphs from the Spitzer letter on the floor. At that point, AAPA president Mary Ettari asked the Delegate Speaker to address the House of Delegates to question the source of the letter. According to Mr. Fields, sitting presidents rarely interrupt meetings to address the entire House. According to Ms. Ettari, she questioned the letter because she had not seen it before, it was not on letterhead and it was not signed in ink by Dr. Spitzer (there was a digital signature). Apparently by some miscommunication, the letter never did make it to the PA leadership. Ordinarily, colleagues would give each other some trust about such things, but the debate over this resolution seems to have eroded this usual stance.
UPDATE: The AAPA issued a news release today regarding a variety of actions taken at their convention. Thanks to David Roberts for pointing this out. The relevant point to this post is as follows:
The HOD voted to oppose attempts to “cure†homosexuality and adopted the following resolution about reparative therapy: “The American Academy of Physician Assistants opposes any psychiatric treatment directed specifically at changing sexual orientation, such as “conversion†or “reparative†therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her sexual orientation.â€
Today in Philadelphia, the American Academy of Physician Assistants debated and then decided a policy on reparative therapy. The AAPA’s Committee on Diversity originally proposed the following concise but inclusive statement:
The American Academy of Physician Assistants opposes the practice of treatments intended to alter sexual orientation.
This statement was an aspect of a resolution that I reported on over a month ago. The statement was so inclusive that it could have included even those who seek therapy to pursue behavioral change. A substitute resolution was offered that opposed coercive treatments but affirmed religious diversity.
After debate, the AAPA delegates voted 110 to 107 not to refer the matter to a study committee but instead affirmed the following policy:
The AAPA opposes, the use of “reparative” or “conversion” therapy that is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.
Those in the know will recognize this language as being the same as the American Medical Association’s policy. The Committee on Diversity was handed a setback in the sense that all treatments were not opposed but rather those which are coercive and/or based on homosexuality being a mental disorder.
I hope to have more on this tomorrow.
The San Francisco Chronicle has been criticized from all sides due to its recent article on adoptions. Today the paper ran a revised correction that puts some distance between Paul Cameron and Focus on the Family. It reads:
CLARIFICATION: In an article that ran on Page 1 on Monday about San Francisco’s campaign to get more gays and lesbians to adopt foster children — as well as an opposing evangelical campaign led by Focus on the Family to get more Christian families to adopt — the Chronicle quoted Paul Cameron, director of the Family Research Institute. The article should have noted that Cameron, who believes gays make unfit parents and self-published dozens of articles he said were based on his research, was expelled from the American Psychological Association in 1983 when he refused to subject his work to peer review. The article also should have reported that his Family Research Institute was named a hate group in 2006 by the Southern Poverty Law Center.
Writings by Cameron, who split with Focus on the Family many years ago, are still relied on by many conservative Christians.
APA Press Release
May 21, 2007
Contact: Public Affairs
(202) 336-5700
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APA APPOINTS TASK FORCE TO REVIEW RECENT SCIENCE ON THERAPEUTIC RESPONSES TO SEXUAL ORIENTATION
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WASHINGTON, DC—The American Psychological Association has appointed a Task Force of researchers and clinicians to review the current scientific research on therapeutic response to sexual orientation with an eye toward updating the Association’s 1997 policy statement on the topic.
“I am pleased to announce the initiation of this Task Force. Its work will be of significant value as it will help inform all mental health practitioners about appropriate and effective therapeutic responses to sexual orientation. I look forward to the group’s report,†said APA President Dr. Sharon Stephens Brehm.
Task Force members were selected after an open nominations process. All nominations were reviewed by the APA Committee on Lesbian, Gay, Bisexual and Transgender Concerns (CLGBTC) which forwarded the complete list of nominations and a suggested slate of nominees to the APA Board for the Advancement of Psychology in the Public Interest (BAPPI) for review. The CLGBTC and BAPPI recommendations as well as the full list of nominations were then sent to the APA President who made the final appointments to the task force in consultation with the APA Board of Directors.
The members of the Task Force, as announced today, are:
Judith M. Glassgold, PsyD – Dr. Glassgold is a clinician, researcher and visiting faculty at the Graduate School of Applied and Professional Psychology, Rutgers University. She sits on the editorial boards of Pragmatic Case Studies in Psychotherapy, Journal of Gay and Lesbian Psychotherapy and PsycCritiques. Much of her work focuses on ethical issues in psychotherapy including the interplay of psychology and religion. Dr. Glassgold will serve as the Task Force Chairperson.
Lee Beckstead, PhD – Dr. Beckstead is a counseling psychologist who has focused his research and clinical work on helping gay, lesbian, bisexual, and transgender people with strong religious affiliations. He works full-time in private practice and is a staff associate in the University of Utah’s Counseling Center.
Jack Drescher, MD – Dr. Drescher is a psychiatrist in clinical practice. His academic appointments include that of Adjunct Clinical Assistant Professor in the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis and Clinical Assistant Professor of Psychiatry at New York Medical College. He also serves as the editor of the Journal of Gay and Lesbian Psychotherapy.
Beverly Greene, PhD – Dr. Greene is a Professor of Psychology at St. John’s University and a practicing clinical psychologist. She has published extensively in the psychological literature on multi-minority identities and the interplay between multiple identity status, coping with social marginalization and psychotherapy. She was a founding co-editor of the APA Division 44 series Psychological Perspectives on Lesbian, Gay and Bisexual Issues.
Robin Lin Miller, PhD – Dr. Miller is a community psychologist and an associate professor at Michigan State University. She is currently the editor-in-chief of the American Journal of Evaluation. She was appointed to the Task Force to provide specific expertise in research and evaluation methods.
Roger L. Worthington, PhD – Dr. Worthington is the interim Chief Diversity Officer at the University of Missouri-Columbia and an Associate Professor in the university’s Department of Educational, School and Counseling Psychology. Dr. Worthington is on the Board of Directors of the National Association of Diversity Officers in Higher Education and on the editorial board of the Journal of Diversity in Higher Education. His research interests include multicultural counseling, heterosexual identity, sexual prejudice, and lesbian, gay and bisexual issues.
The task force will review the scientific literature on therapeutic responses to sexual orientation, particularly any research published since the Association’s resolution on Appropriate Therapeutic Responses to Sexual Orientation was passed (1997). The Task Force will furthermore make recommendations on any revisions or updates to the resolution. Since the 1997 resolution was written, new research on sexual orientation conversion therapy has been published. This new science enables the Association to review its policy position and offer additional guidance to mental health professionals who treat persons with concerns about their sexual orientation.
The task force is expected to generate a report that will address the following:
The appropriate application of affirmative therapeutic interventions for children and adolescents who present a desire to change either their sexual orientation or their behavioral expression of their sexual orientation, or both, or whose guardian expresses a desire for the minor to change;
The appropriate application of affirmative therapeutic interventions for adults who present a desire to change their sexual orientation or their behavioral expression of their sexual orientation, or both;
The presence of adolescent inpatient facilities that offer coercive treatment designed to change sexual orientation or the behavioral expression of sexual orientation;
Education, training, and research issues as they pertain to such therapeutic interventions; and
Recommendations regarding treatment protocols that promote stereotyped gender-normative behavior to mitigate behaviors that are perceived to be indicators that a child will develop a homosexual orientation in adolescence and adulthood.
Once completed, the report and any recommendations of the Task Force will be reviewed by APA governance including the APA Board of Directors and Council of Representatives. Any actions concerning possible adoption of the Task Force report and any included recommendations will be the purview of the APA Council.
The Task Force is expected to meet twice in 2007. A schedule for completion of the Task Force’s work is not yet determined.
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