Warren Throckmorton

Continuing the discussion about sexual identity therapy, I want to contrast our framework with both gay affirming and reparative therapies on the dimension of value neutrality in two posts. As a springboard for my thoughts, I want to quote from an article by Joseph Nicolosi on the NARTH website called, “Why I Am Not A Neutral Therapist.” He led with this explanation:

A Christian psychologist contacted me to discuss reorientation therapy for SSA men. Hoping to find a politically “safe” compromise with the APA, he was anxious to avoid value judgments and remain noncommittal about homosexuality. The solution, he thought, would be a simple behavior modification program. Speaking from my 25 years of experience in this field, I told him I found his approach naïve and ultimately unworkable.

Then he adds:

“Furthermore, why should I refuse to discuss philosophical issues with clients,” I told him, “when gay-affirmative therapists are working very hard as boosters of their philosophy? They tell clients that same-sex feelings are ‘sacred.’ They push them to revolutionize society’s and the church’s attitudes. Any client’s conviction that heterosexuality is the norm will be redefined by the therapist as a ‘psychological illness — homophobia.'”

“The fact is, neutrality fails for clinicians on both sides of this issue,” I told the psychologist. “Clinicians like you and me, who believe that humanity was designed for heterosexuality, must speak up about our philosophy. These men with unwanted SSA want boosters, allies, advocates, as they claim their masculine identity — someone who believes in them and stands strongly at their side.”

Dr. Nicolosi parallels his disclosure of reparative drive theory as an ideology to what he believes gay affirming therapists do with clients but from an opposing perspective. After all, if it is ethical for gay affirming therapists to promote homosexuality as a moral good, then why shouldn’t reparative therapists promote heterosexuality as God’s design?

Before I discuss this further, one might question whether gay affirming therapists or therapists in general really have a worldview on the matter. I cannot go into this exhaustively but a statement from the APA’s Clinton Anderson from a recent AP article by David Crary suggests there are favored and disfavored religious views on matters gay. Speaking about religious views which are at odds with homosexual behavior, Dr. Anderson said:

“We cannot take into account what are fundamentally negative religious perceptions of homosexuality — they don’t fit into our worldview,” Anderson said.

So can therapists be neutral?

In my view, not all therapists can practice in a neutral manner. In our sexual identity therapy framework, we have clear guidance which allows for referrals when value conflicts impair what therapy has to offer a client. In other situations, the role of the therapist is to assist clients clarify their own perspectives and work toward congruence. For clients who do not know what they believe, it can be very valuable for the therapist to refrain from imposing a religious worldview or stigmatizing conservative religious views.

Some people want a non-neutral therapist on either side of the worldview spectrum. Perhaps they would not be happy with sexual identity therapy. My investigations into this arena suggest that retrospective assessments of therapist helpfulness are associated with therapists not attempting to impose a contrary value position on to the client. And so, I continue to believe that SIT occupies a niche that offers something not available in ideologically-driven approaches. For those who are still figuring things out or have not felt successful with other approaches, our framework could provide something different.

Part two will explore where the sexual identity therapist isn’t neutral.

Got your attention?

Nature reports on research with mice where a little genetic tinkering led to male-like sexual behavior in females.

You can even watch a video…

Ex Gay Watch posted a link to an interview with Episcopal Bishop Gene Robinson that covered many topics but included several of recent interest to readers here. He specifically says that he had twice weekly reorientation therapy in his younger years.

He says it worked but didn’t work at the same time.

Q. Did you feel it (the therapy) had worked, or did it just put you in denial?

‘It didn’t work, and it almost never works for people who attempt it. I guess I did think it had worked. I suspect it didn’t make the same sex feelings go away, but it certain worked in that I felt ready emotionally and spiritually and physically for a relationship with a woman, so it certainly made that part of myself possible. And so when I entered into a relationship with the woman who became my wife, it was full of integrity – I wasn’t pretending to be something that I was not. And yet within a month of meeting her, I shared that all of my primary relationships had been with men, that I had been in therapy to make a heterosexual relationship possible, and that I felt I was in a good place to do that.’

Speaking descriptively here not prescriptively, many people in the ex-gay movement might characterize their results very similarly (same-sex attractions remain but opposite-sex attractions develop), but would consider this outcome a success. An unasked question in the interview was what changed in his thinking, beliefs, or values that led to the mutual decision to end the marriage.

Read the whole article; in my opinion, it is a candid and fascinating interview.

Next week (August 17) I will participate in a symposium on sexual identity conflicts at the American Psychological Association annual conference in San Francisco, CA.

Here is the brief description from the association website (scroll down to Division 36):

Div. 36 (Psychology of Religion)

Friday, 2-2:50 p.m.• Symposium: “Sexual Identity Therapy to Address Religious and Spiritual Conflicts.” Co-chairs: Mark A. Yarhouse, PsyD, and A. Lee Beckstead, PhD.Participants: Warren Throckmorton, PhD, Mark A. Yarhouse, PsyD, and Erica S.N. Tan, PsyD.

Click the links above to read the abstracts of the sessions.

This search page supports a search of sexual identity to find further description of the symposium (or just click the link).

Session Title: Sexual Identity Therapy to Address Religious and Spiritual Conflicts

Session Type: Symposium

Division(s): 36

Building–Room: Moscone Center–Room 2016

Location: Second Floor-West Building

Day/Time: Fri/2:00PM – 2:50PM

Event Type: Division Event

This is off the usual topic of this blog, but I want to note it anyway. The following news release just came via email from Beth Powell at AMHCA:

U.S. House Passes “Children’s Health and Medicare Protection Act,” Including Provision Establishing Medicare Coverage of Mental Health Counselors

August 1, 2007, was a historic day for the mental health counseling profession, as for the first time ever, the U.S. House of Representatives passed legislation to establish coverage of state-licensed mental health counselors under Medicare. The Medicare coverage provision was included in H.R. 3162, the “Children’s Health and Medicare Protection Act,” or CHAMP Act, a bill which seeks to increase access to health insurance for uninsured children and strengthen the Medicare program.

Passage of the provision has been a long standing goal of the American Mental Health Counselors Association (AMHCA), the American Counseling Association (ACA) and the National Board for Certified Counselors (NBCC). House passage of the counselor-coverage provision brings us a step closer to achieving this objective. The bill also eliminates the discriminatory 50% co-payment requirement for outpatient mental health services.

The primary focus of the legislation is to reauthorize and strengthen the State Children’s Health Insurance Program (SCHIP), which supports health insurance coverage for more than 6 million children whose families are low income but do not qualify for coverage under Medicaid. Unless legislation is enacted by September 30th to renew SCHIP, it will expire. H.R. 3162 would expand the program to cover 5 million children who would otherwise be uninsured, and allow states to keep pace with health care cost inflation and population growth. H.R. 3162 passed the House by a largely party-line vote of 225 to 204; all but 10 Democrats voted for the bill, and all but five Republicans voted against it.

The Senate is expected to pass their version of the SCHIP reauthorization bill-which does not include Medicare-related provisions-by the end of this week. Following Senate passage, a conference committee will be appointed to reconcile differences in the House and Senate legislation. Congress will then need to negotiate the legislation with President Bush, who has threatened to veto even the Senate’s more modest bill.

Even if the Medicare-related provisions are removed from the SCHIP legislation, Congress is expected to revisit Medicare soon in order to prevent cuts in physician payment rates scheduled to take effect by the end of the year.

I cut my teeth on advocacy for Medicare recognition in the early 90s when I discovered that my clinical counselor’s license in Ohio did not allow for Medicare reimbursement. Despite a similar scope of practice to social workers and clinical psychologists, mental health counselors (and consequently clients who wanted to see counselors) were at a disadvantage without payment recognition from the Medicare program. Through the 1990s, I helped negotiate recognition from private payers (managed care and insurance companies – e.g., Magellan Healthcare) for counselors but the Federal programs have remained difficult to enter. The Senate may yet add the provision or it may be added during conference. We have been close before but I do not think we have been this close.