The APA report and the sexual identity therapy framework

The recent American Psychological Association task force report on sexual orientation and psychotherapy included several positive references to the SITF. I have archived those on the SITF website and am providing two here with brief commentary.

The abstract of the sexual identity therapy framework (SITF) says

Sexual identity conflicts are among the most difficult faced by individuals in our society and raise important clinical, ethical and conceptual problems for mental health professionals. We present a framework and recommendations for practice with clients who experience these conflicts and desire therapeutic support for resolution. These recommendations provide conceptual and empirical support for clinical interventions leading to sexual identity outcomes that respect client personal values, religious beliefs and sexual attractions. Four stages of sexual identity therapy are presented incorporating assessment, advanced informed consent, psychotherapy and sexual identity synthesis. The guidelines presented support the resolution of identity conflicts in ways that preserve client autonomy and professional commitments to diversity.


I think the APA report and the SITF are compatible in many important ways.  They both recognize the difference between attractions, behavior and identity. They both recognize that informed consent is critical and that client may seek congruence with other aspects of personality, other than sexual desire, a distinction made in this segment from page 18 of the APA report: Continue reading “The APA report and the sexual identity therapy framework”

New SIT Framework website and list

Late Friday afternoon might not be the best time to post this but…

I want to announce the new Sexual Identity Therapy Framework website and invite people to join the SIT Framework list serv.

Here is the listserv portal:

Click to join sexualidentitytherapy

The discussions will be geared primarily to mental health professionals but interested ministry leaders and others may find them to be of value. There may be some overlap with the blog but there will be unique material as well.

Misconceptions about the Sexual Identity Therapy framework

In the “reporting” by Gay City News regarding the now-cancelled APA symposium, a claim was made about the Sexual Identity Therapy framework. The symposium, approved by the APA program committee 7 months ago, was to include a presentation of this framework and related issues which would have allowed for questions and discussion.
The GCN said I am an advocate for sexual identity therapy and described it this way:
“Sexual Identity Therapy,” which he [Throckmorton] says he has successfully applied to help patients “alter homosexual feelings or behaviors” and live their lives “heterosexually” with “only very few weak instances of homosexual attraction.”
This is false. The article attributes to me claims about SIT I have never made. In fact, the SIT framework says this:

Prior to outlining the recommendations, let us define what they are not. They are not sexual reorientation therapy protocols in disguise.

The SIT framework, first contemplated formally in 2005, does not advance any means to do what the GCN article references (“alter homosexual feelings or behavior”), nor do they provide any reference for their assertion. Putting these phrases in quotes makes it appear that I have been quoted in reference to SIT when in fact that is not true. The SIT framework provides an ethical set of guidelines for therapists and clients pursuing a variety of goals but does not prescribe any specific goals. Some clients may wish to alter their sexual behavior but SIT does not prescribe this end unless it is the objective of an individual client.
The article said that there is no research support for the SIT framework and while it is true that we have no outcome studies as yet. It is misleading to portray it as being without research foundation. A review of the SIT framework will demonstrate that we have taken into account current research regarding sexual orientation, sexual identity and specify that clients should be informed about the positions of professional associations regarding homosexuality.
Those wishing to characterize the framework should read it first. Those with specific questions or criticisms, please alert either Mark Yarhouse or me.

Sexual Identity Therapy Framework to Be Reviewed

I posted this to the SIT Blog and I hope other bloggers post this on their blogs.  

News Release 

Sexual Identity Therapy Framework to Be Reviewed

The Sexual Identity Therapy Framework, authored by Warren Throckmorton and Mark Yarhouse, will be reviewed in 2008 for possible revision. Proposed as a means to help counselors work with clients who experience value conflict surrounding homosexual attractions, the Framework is endorsed by Nicholas Cummings, the father of managed behavioral healthcare and Robert Spitzer, the architect of modern psychiatric diagnosis. The framework respects diversity of sexual orientation and religious practice and anticipates a planned review of sexual orientation counseling which will be reported by the American Psychological Association in 2008.

“We believe this area of counseling practice is changing rapidly and we want to be sensitive to how therapists and consumers of sexual identity therapy feel the framework helps or hinder excellent outcomes. We want to hear from professionals and consumers alike,” said Dr. Throckmorton.

The authors are asking for public and professional comment on the Framework though the end of February, 2008.

Interested persons can download and review the Framework at One may leave comment there or send extended comments to Warren Throckmorton at and/or Mark Yarhouse at Therapists interested in a registry of therapists who adhere to the Framework should visit,

Selected endorsements:

I have reviewed the sexual identity framework written by Warren Throckmorton and Mark Yarhouse. This framework provides a very necessary outline to help therapists address the important concerns of clients who are in conflict over their homosexual attractions. The work of Drs. Throckmorton and Yarhouse transcend polarized debates about whether gays can change their sexual orientation. Rather, this framework helps therapists work with clients to craft solutions tailored to their individual situations and personal beliefs and values. I support this framework and hope it is widely implemented.

Robert L. Spitzer, M.D., is Professor of Psychiatry, Columbia University, New York State Psychiatric Institute, New York City, NY. Dr. Spitzer was Chairman of the committee that developed the Diagnostic and Statistical Manual of Mental and Emotional Disorders, 3rd Edition and 3rd Edition (Revised).

Drs. Throckmorton and Yarhouse have brilliantly resolved contention in psychotherapy by providing the field with unbiased guidelines that are responsive to scientific evidence, are sensitive to professional practice, and which restore patient determination in choosing his/her goals in psychotherapy.

Dr. Nicholas Cummings, PhD, ScD is Distinguished Chair in Psychology, University of Nevada, Reno. Dr. Cummings is the President of the Foundation for Behavioral Health and Chairman of the Nicholas & Dorothy Cummings Foundation, Inc. He was the founding CEO of American Biodyne (now Magellan Behavioral Care). He is also the former President of the American Psychological Association. Dr. Cummings was the founder of the four campuses of the California School of Professional Psychology, the National Academies of Practice, and the American Managed Behavioral Healthcare Association. He was the former Executive Director of the Mental Research Institute. Dr. Cummings is the co-editor with Rogers Wright of Destructive Trends in Mental Health.

One point I am considering is to discourage referral to NWTA and I-groups as a means of changing orientation. While no outcome studies have been done on this point, it seems clear that such referrals do nothing on average to change orientation. We welcome feedback and suggestions.