Article

Reflections from the Conversion Therapy Battlefield

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Abstract

Despite the efforts to resolve the decades-long controversy surrounding therapeutic attempts to change homosexual to heterosexual orientation ("conversion" or "reparative" therapy), it shows no signs of abating. A new trend is seen to emerge in this area, that of integrative solutions to conflicts between sexual orientation and religious belief. This article will briefly review how the controversy about therapeutic attempts to change sexual orientation arrived at this point of integrative solutions and will outline what I believe are assumptions underlying these nascent integrative solutions. The article will focus on how this controversy poses challenges and risks for psychology as a method of scientific inquiry and as a profession. Some efforts being done in this field, offer creative points of departure in the best traditions of psychology's respect for diversity and concern for professionalism in practice for the challenges of working with religiously conservative clients who are nonheterosexual. I strongly suspect, however, that these efforts will have little effect on conversion therapists' reckless disregard for client welfare and professional practice standards in their single-minded pursuit of enforcing religious orthodoxy and laying a claim to scientific respectability in the process. Avoiding polarization is a worthy goal but not at any price. The risks in the conversion therapy controversy are high, and psychology's integrity as an independent profession and as science is at stake. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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... For instance, individuals who have strong religious beliefs can experience tensions and conflicts between their ideal self and beliefs and their sexual and affectional needs and desires D. F. Morrow, 2003). The different worldviews would approach psychotherapy for these individuals from dissimilar perspectives: The telic strategy would prioritize values (Rosik, 2003;Yarhouse & Burkett, 2002), whereas the organismic approach would give priority to the development of self-awareness and identity Gonsiorek, 2004;. ...
... It is important to note that the organismic worldview can be congruent with and respectful of religion Gonsiorek, 2004;Mark, 2008;Ritter & O'Neil, 1995), and the telic worldview can be aware of sexual stigma and respectful of sexual orientation (Tan, 2008;Throckmorton & Yarhouse, 2006;Yarhouse, 2008). Understanding this philosophical difference may improve the dialogue between these two perspectives represented in the literature, as it refocuses the debate not on one group's perceived rejection of homosexuals or the other group's perceived minimization of religious viewpoints but on philosophical differences that extend beyond this particular subject matter. ...
... which sexual orientation or sexual orientation identity change were considered or attempted (e.g., Borowich, 2008;Drescher, 1998b;Gonsiorek, 2004;Horlacher, 2006;Karten, 2006;Mark, 2008;Tan, 2008Yarhouse, 2008); and (d) scholarly articles, case reports, dissertations, and reviews on the concerns of religious individuals who are conflicted by their same-sex sexual attractions, some of whom accept their same-sex sexual orientation (e.g., Coyle & Rafalin, 2000, Horlacher, 2006Kerr, 1997;Mahaffy, 1996;Mark, 2008, Moran, 2007O'Neill & Ritter, 1992;Shallenberger, 1998;Tan, 2008;Thumma, 1991;Yarhouse, 2008;Yip, 2000Yip, , 2002Yip, , 2003Yip, , 2005. We also reviewed a variety of additional scholarly articles on subtopics such as individuals in other-sex marriages and general literature on sexual orientation concerns. ...
... Some researchers and professionals have expressed reservations about pursuing any therapeutic course with same-sex attracted clients other than a gayintegrative one (Gonsiorek, 2004;Worthington, 2004;Tozer & McClannahan, 1999). Concerns about client harm have led some observers to call for prohibitions on conversion therapies designed to alter a client's sexuality, even if the client desires to pursue this outcome (Gonsiorek, 2004). ...
... Some researchers and professionals have expressed reservations about pursuing any therapeutic course with same-sex attracted clients other than a gayintegrative one (Gonsiorek, 2004;Worthington, 2004;Tozer & McClannahan, 1999). Concerns about client harm have led some observers to call for prohibitions on conversion therapies designed to alter a client's sexuality, even if the client desires to pursue this outcome (Gonsiorek, 2004). Some clients have reported negative results from a variety of activities done in the name of reorientation therapy (Shidlo & Schroeder, 2004). ...
... Some research finds both outcomes (e.g., Beckstead & Morrow, 2004 It is beyond the scope of this article to fully delineate all information or questions that might be discussed during this phase. In addition to what we have discussed above, clinicians should consult current resources providing a wide range of perspectives and research regarding biological factors and sexual orientation (Bailey, Dunne & Martin, 2000;Bem, 1996Bem, , 2000Byne et al, 2001;Jones & Kwee, 2005;Jones & Yarhouse, 2000;Mustanski, et al, 2005;Rice, Anderson, Risch & Ebers, 1999;Stein, 2001;Wilson & Rahman, 2005), environmental factors and sexual orientation (Bem, 2000;Balsam, Rothblum & Beauchaine, 2005;Dube, 2000;Frisch & Hviid, 2006;Kalichman, Gore-Felton, Benotsch, Cage & Rompa, 2004;Stanley, Bartholomew & Oram, 2005), outcomes of interventions designed to modify sexuality (Beckstead & Morrow, 2004;Nicolosi, Byrd & Potts, 2000;Schidlo & Schroeder, 2002;Spitzer, 2003;Throckmorton, 1998Throckmorton, , 2002Throckmorton & Welton, 2005), various approaches to sexual identity synthesis (Haldeman, 2004;Nicolosi, 1991;Yarhouse & Brooke, 2005;Yarhouse & Burkett, 2003;Yarhouse & Tan, 2004), ethical concerns relating to sexual identity interventions (Gonsiorek, 2004;Miville & Ferguson, 2004;Yarhouse & Throckmorton, 2002), the definition and measurement of sexual orientation (Broido, 2000;Diamond, 2003;Garnets, 2002;Kinnish, Strassberg & Turner, 2005;Klein, 1993;Laumann, Gagnon, Michael & Michaels, 1994;Stein, 2001) and religious and value issues in sexual identity synthesis (Lease, Horne, & Noffsinger-Frazier, 2005;Schaeffer, Hyde, Kroencke, McCormick & Nottebaum, 2000;Schaeffer, Nottebaum, Smith, Dech & Krawczyk, 1999;Schuck & Liddle, 2001;Yarhouse & Burkett, 2002;Yarhouse, Burkett, & Kreeft, 2001). ...
... For instance, individuals who have strong religious beliefs can experience tensions and conflicts between their ideal self and beliefs and their sexual and affectional needs and desires D. F. Morrow, 2003). The different worldviews would approach psychotherapy for these individuals from dissimilar perspectives: The telic strategy would prioritize values (Rosik, 2003;Yarhouse & Burkett, 2002), whereas the organismic approach would give priority to the development of self-awareness and identity Gonsiorek, 2004;. It is important to note that the organismic worldview can be congruent with and respectful of religion Gonsiorek, 2004;Mark, 2008), and the telic worldview can be aware of sexual stigma and respectful of sexual orientation (Throckmorton & Yarhouse, 2006;Tan, 2008;Yarhouse, 2008). ...
... The different worldviews would approach psychotherapy for these individuals from dissimilar perspectives: The telic strategy would prioritize values (Rosik, 2003;Yarhouse & Burkett, 2002), whereas the organismic approach would give priority to the development of self-awareness and identity Gonsiorek, 2004;. It is important to note that the organismic worldview can be congruent with and respectful of religion Gonsiorek, 2004;Mark, 2008), and the telic worldview can be aware of sexual stigma and respectful of sexual orientation (Throckmorton & Yarhouse, 2006;Tan, 2008;Yarhouse, 2008). Understanding this philosophical difference may improve the dialogue between these two perspectives represented in the literature, as it refocuses the debate not on one group's perceived rejection of homosexuals or the other group's perceived minimization of religious viewpoints but on philosophical differences that extend beyond this particular subject matter. ...
... We hope that an empathic and comprehensive review of the scholarly literature of the population that seeks and participates in SOCE can facilitate an increased understanding of the needs of this population so that an affirmative therapeutic approach may be developed. orientation or sexual orientation identity change were considered or attempted (e.g., Borowich, 2008;Drescher, 1998a;Gonsiorek, 2004;Karten, 2006;Mark, 2008;Tan, 2008;Yarhouse, 2008); and (d) scholarly articles on the concerns of religious individuals who are conflicted by their same-sex sexual attractions, many of whom accept their same-sex sexual orientation (e.g., Coyle & Rafalin, 2000;Horlacher, 2006;Kerr, 1997;Mahaffy, 1996;Moran, 2007;O'Neill & Ritter, 1992;Ritter & O'Neill, 1989Smith et al., 2004;Thumma, 1991;Yip, 2000Yip, , 2002Yip, , 2003Yip, , 2005. We also reviewed a variety of additional scholarly articles on subtopics such as individuals in other-sex marriages and general literature on sexual orientation concerns. ...
Article
Full-text available
Resilience among lesbian and gay (LG) Christians has received limited attention. We present results from a qualitative study of 27 LG Christians, for whom religion had high salience. The study explored the process of integrating sexual orientation with spirituality. Moving from recognition of incongruence between faith and sexual orientation to integration was found to be a resilience-building process. Through descriptive and process approaches, we identified three primary pathways individuals used to integrate their faith and sexual orientation: transforming theological meaning; finding a safe-enough congregation; and finding an affirming congregation. Some worked for social justice within congregations as part of the resilience-building process. We discuss important decision points for LG Christians that included critical evaluation of extant and potential support systems, redefining scripture and tradition, and transforming communities. A model for LG Christian Spiritual Resilience is presented.
... For instance, individuals who have strong religious beliefs can experience tensions and conflicts between their ideal self and beliefs and their sexual and affectional needs and desires D. F. Morrow, 2003). The different worldviews would approach psychotherapy for these individuals from dissimilar perspectives: The telic strategy would prioritize values (Rosik, 2003;Yarhouse & Burkett, 2002), whereas the organismic approach would give priority to the development of self-awareness and identity Gonsiorek, 2004;. It is important to note that the organismic worldview can be congruent with and respectful of religion Gonsiorek, 2004;Mark, 2008), and the telic worldview can be aware of sexual stigma and respectful of sexual orientation (Throckmorton & Yarhouse, 2006;Tan, 2008;Yarhouse, 2008). ...
... The different worldviews would approach psychotherapy for these individuals from dissimilar perspectives: The telic strategy would prioritize values (Rosik, 2003;Yarhouse & Burkett, 2002), whereas the organismic approach would give priority to the development of self-awareness and identity Gonsiorek, 2004;. It is important to note that the organismic worldview can be congruent with and respectful of religion Gonsiorek, 2004;Mark, 2008), and the telic worldview can be aware of sexual stigma and respectful of sexual orientation (Throckmorton & Yarhouse, 2006;Tan, 2008;Yarhouse, 2008). Understanding this philosophical difference may improve the dialogue between these two perspectives represented in the literature, as it refocuses the debate not on one group's perceived rejection of homosexuals or the other group's perceived minimization of religious viewpoints but on philosophical differences that extend beyond this particular subject matter. ...
... We hope that an empathic and comprehensive review of the scholarly literature of the population that seeks and participates in SOCE can facilitate an increased understanding of the needs of this population so that an affirmative therapeutic approach may be developed. orientation or sexual orientation identity change were considered or attempted (e.g., Borowich, 2008;Drescher, 1998a;Gonsiorek, 2004;Karten, 2006;Mark, 2008;Tan, 2008;Yarhouse, 2008); and (d) scholarly articles on the concerns of religious individuals who are conflicted by their same-sex sexual attractions, many of whom accept their same-sex sexual orientation (e.g., Coyle & Rafalin, 2000;Horlacher, 2006;Kerr, 1997;Mahaffy, 1996;Moran, 2007;O'Neill & Ritter, 1992;Ritter & O'Neill, 1989Smith et al., 2004;Thumma, 1991;Yip, 2000Yip, , 2002Yip, , 2003Yip, , 2005. We also reviewed a variety of additional scholarly articles on subtopics such as individuals in other-sex marriages and general literature on sexual orientation concerns. ...
... Some researchers and professionals have expressed reservations about pursuing any therapeutic course with same-sex attracted clients other than a gayintegrative one (Gonsiorek, 2004;Worthington, 2004;Tozer & McClannahan, 1999). Concerns about client harm have led some observers to call for prohibitions on conversion therapies designed to alter a client's sexuality, even if the client desires to pursue this outcome (Gonsiorek, 2004). ...
... Some researchers and professionals have expressed reservations about pursuing any therapeutic course with same-sex attracted clients other than a gayintegrative one (Gonsiorek, 2004;Worthington, 2004;Tozer & McClannahan, 1999). Concerns about client harm have led some observers to call for prohibitions on conversion therapies designed to alter a client's sexuality, even if the client desires to pursue this outcome (Gonsiorek, 2004). Some clients have reported negative results from a variety of activities done in the name of reorientation therapy (Shidlo & Schroeder, 2004). ...
... Some research finds both outcomes (e.g., Beckstead & Morrow, 2004 It is beyond the scope of this article to fully delineate all information or questions that might be discussed during this phase. In addition to what we have discussed above, clinicians should consult current resources providing a wide range of perspectives and research regarding biological factors and sexual orientation (Bailey, Dunne & Martin, 2000;Bem, 1996Bem, , 2000Byne et al, 2001;Jones & Kwee, 2005;Jones & Yarhouse, 2000;Mustanski, et al, 2005;Rice, Anderson, Risch & Ebers, 1999;Stein, 2001;Wilson & Rahman, 2005), environmental factors and sexual orientation (Bem, 2000;Balsam, Rothblum & Beauchaine, 2005;Dube, 2000;Frisch & Hviid, 2006;Kalichman, Gore-Felton, Benotsch, Cage & Rompa, 2004;Stanley, Bartholomew & Oram, 2005), outcomes of interventions designed to modify sexuality (Beckstead & Morrow, 2004;Nicolosi, Byrd & Potts, 2000;Schidlo & Schroeder, 2002;Spitzer, 2003;Throckmorton, 1998Throckmorton, , 2002Throckmorton & Welton, 2005), various approaches to sexual identity synthesis (Haldeman, 2004;Nicolosi, 1991;Yarhouse & Brooke, 2005;Yarhouse & Burkett, 2003;Yarhouse & Tan, 2004), ethical concerns relating to sexual identity interventions (Gonsiorek, 2004;Miville & Ferguson, 2004;Yarhouse & Throckmorton, 2002), the definition and measurement of sexual orientation (Broido, 2000;Diamond, 2003;Garnets, 2002;Kinnish, Strassberg & Turner, 2005;Klein, 1993;Laumann, Gagnon, Michael & Michaels, 1994;Stein, 2001) and religious and value issues in sexual identity synthesis (Lease, Horne, & Noffsinger-Frazier, 2005;Schaeffer, Hyde, Kroencke, McCormick & Nottebaum, 2000;Schaeffer, Nottebaum, Smith, Dech & Krawczyk, 1999;Schuck & Liddle, 2001;Yarhouse & Burkett, 2002;Yarhouse, Burkett, & Kreeft, 2001). ...
Article
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ABSTRACT 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
... The titles of the reactions to this major contribution alone set the stage for further exploration of the issues regarding the hopes and dreams of same-sex attracted (SSA) clients in religious conflict and their therapists, issues of choice, and whether or not it is possible-or even appropriate-to depolarize the current debate (Gonsiorek, 2004;Miville & Ferguson, 2004;Phillips, 2004;Worthington, 2004). It will be impossible in this brief rejoinder to adequately respond to all of the reactants' superb thoughts and critiques, so we have selected a few core topics to which to respond. ...
... Thus, it is critical that the possible outcomes of therapy be clarified with clients. A central issue is that conversion therapies, as Gonsiorek (2004) and Worthington (2004) noted, are based on assumptions that are untenable and unsupported empirically. At heart, conversion therapies depend on maintaining the belief that heterosexuality is "biologically and morally superior to same-sex orientations" (Worthington, 2004, p. 745), and the experiences of Beckstead and Morrow's (2004) participants highlighted the ways that anti-lesbian/gay/bisexual (LGB) stereotypes (such as the belief that gay relationships are all furtive and unsatisfying) were actually used to reinforce avoidance of a "gay lifestyle." ...
... In light of the fact that we all identify as LGB-affirmative and almost all as either lesbian or gay-as well as "out and proud" about our identities-it became clear to us that it is not possible to choose between objectivist "science" and politics in the interest of fairness or neutrality. Gonsiorek (2004), in his unflinching critique, further challenged our thinking as he wrote about the assumptions underlying the idea of "unlimited client choice" (p. 754). ...
... (NCLGB, 2000, p. 12) With this statement in mind, this paper explores evidencebased ap proaches that affirm and support both the sexual and spiritual identity of the LGBTidentified client seeking mental health services after conversion ther apy. Such approaches are referred to as "integrative solutions" (Gonsiorek, 2004). The following case example highlights many of the traumatic experi ences unique to LGBT populations involved in conversion therapy. ...
... Integrative solution therapies propose that mental health clinicians respect all the components of a client's identity and assist the client in making room for a variety of aspects of identity in their overall selfschema (Gonsiorek, 2004). The therapist does not seek to indoctrinate the client into the LGBTaffirmative community, but rather intends to illuminate the ways in which social forces coalesce to devalue, invalidate, and sometimes oppress gender and sexually nonconforming individuals. ...
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Evidence based practice (EBP) has enjoyed increasing popularity in the field of social work. However, not everyone is enthusiastic about this movement. This paper defines EBP, attempts to clarify common misconceptions about EBP, and organizes and analyzes some of the criticisms of EBP so that the field of social work can move onto a more productive debate about its legiti­mate strengths and limitations
... In light of the ethically questionable nature of CT, we turn to ethical reviews and the ethical framework of APA to understand better whether CT holds any ground for continued practice. A number of scholars and practitioners have written about the ethical considerations and ramifications of CT (e.g., Gonsiorek, 2004;Haldeman, 1994Haldeman, , 1999Halpert, 2000;Steigerwald & Janson, 2003;Tozer & McClanahan, 1999). For example, Gonsiorek highlighted the clash between implementing psychological services while respecting and incorporating religious beliefs. ...
... The increasing rift between psychology and theology must be addressed. Gonsiorek (2004) and others have written much on the innate conflict of these disciplines, particularly as related to CT. He also noted that multifaceted models incorporating both perspectives exist, but another step beyond mere scholarly publication is necessary. ...
Article
Full-text available
The American Psychological Association's (APA's) as well as other professional organizations' (e.g., American Psychiatric Association) removal of homosexuality as a mental disorder represented a paradigmatic shift in thinking about exual orientation. Since then, APA (2000)2. American Psychiatric Association. 2000 . Position statement on attempts to change sexual orientation (conversion and reparative therapies). . American Journal of Psychiatry , 157 : 1719 – 1721 . [PubMed], [Web of Science ®], [CSA]View all references disseminated guidelines for working with lesbian, gay, and bisexual (LGB) clients, and a variety of scholars and researchers alike have advocated affirmative therapeutic interventions with LGB individuals. Despite these efforts, the controversy over treating individuals with LGB orientations using nonaffirmative techniques continues. In this discussion, the limited evidence regarding the efficacy and effects of conversion therapy is surveyed, particularly in the context of empirically supported treatment criteria summarized by Division 12 (clinical psychology) of the APA. Authors then consider the resulting ethical considerations in performing conversion therapy and propose alternative uses of affirmative therapy on the basis of ethical standards defined by APA. Finally, options for treating LGB individuals who are coming to terms with their sexual orientations are discussed.
... 1. Safe community to question 2. Evidence that "it's not a choice," therefore "not a sin" 3. Deepening trust in God through spiritual practices regarding LGBT affirmation the possibility that same-sex-attracted individuals might refrain from identifying as LGB or might choose to avoid sexual relationships for a variety of reasons, participants still maintained the belief that sexual attraction is innate and immutable, and this was an important factor in their decision to affirm-rather than seek to change-same-sexattracted clients. This finding lends support for the inclusion of scientific research on the immutability of sexual attraction, and the ineffectiveness of reparative or conversion therapies (Gonsiorek, 2004), in counselor education curriculum, particularly when working with nonaffirming or conflicted Christian trainees. ...
... Similarly, Whitman and Bidell (2014) offered the following recommendations to educators and supervisors who work with Christian students: (a) assist them to recognize the difference between altering their behavior and losing their faith, (b) support them through the potential grief that might arise from faith deconstruction, (c) refer them to counselors who are skilled in working with religious-based value conflicts, and (d) connect them with religious leaders who can help them navigate the transformation of their beliefs. Previous scholars (Bartoli & Gillem, 2008;Gonsiorek, 2004) have also encouraged educators and supervisors to empathize with the vulnerability these trainees may be experiencing. These suggestions are supported by the finding in this study that the risk of rejection by participants' primary support network can be a major obstacle to reconciliation. ...
Article
The purpose of this qualitative grounded theory study was to learn how 15 Christian heterosexual counselors successfully reconciled a perceived conflict between lesbian, gay, bisexual, and transgender (LGBT) affirmation and their religious beliefs. Obstacles to reconciliation, helpful factors, states, and participant characteristics were integrated into a grounded theory (the Relational Equilibrium Model) of religious‐based value conflict reconciliation to guide counselor educators and supervisors working with nonaffirming or conflicted Christian trainees to develop LGBT‐affirming dispositions and practices.
... There is renewed interest in the relationship between homosexual identities and mental health (Cochran, Sullivan, & Mays, 2003;de Graaf, Sandfort & ten Have, 2006;Meyer, 2003;Omoto & Kurtzman, 2006;Sandfort, de Graaf, & Bijl, 2003;Sandfort, de Graaf, Bijl, & Schnabel, 2001) and continuing controversy regarding the use of reparative therapies with lesbian, gay, and bisexual populations (Jenkins & Johnston, 2004;Gonsiorek, 2004;Spitzer, 2003;Zucker, 2003). Heterosexually married men who have sex with men (MMSM) are a key research population in these ongoing debates. ...
Article
Full-text available
There have been few investigations of sexual identity and psychological adjustment among behaviorally-bisexual married men. A critical issue is whether such men experience increased psychological adjustment if they exit their primary heterosexual relationship and assume a gay identity. Two hundred and one ever-married men (n = 201) with same-sex sexual interests and behaviors were administered the Brady and Busse (19944. Brady , S. & Busse , W. ( 1994 ). The gay identity questionnaire: A brief measure of homosexual identity formation . Journal of Homosexuality , 26 ( 4 ), 1 – 22 . [Taylor & Francis Online], [PubMed], [Web of Science ®], [CSA]View all references) gay identity development questionnaire (GIQ) and the symptom check list–90 (SCL-90) as part of a larger investigation of sexual identity development. The measurement of homosexual identity formation (HIF) using the original nominal scoring criteria for the GIQ did not adequately detail processes of HIF among respondents, and an alternative scoring system that allowed continuous, rather than stage, measurement of HIF was utilized. Psychological adjustment was found to be significantly correlated with HIF among ever-married gay-identified men. Within bisexual-identified men, no relationships between HIF and psychological adjustment were found. Future studies of HIF should clearly differentiate between gay and bisexual men. The findings suggest significant psychological gains accompany public affirmation of gay identity among self-identified gay men who have been in a previous heterosexual relationship.
... Options may include change of orientation, integrating same-sex attractions into a gay identity, and options that focus more on identity and living in ways that reflect one's beliefs and values. We would do well to put as much information in the hands of the consumer so that they are able to make informed decisions and wise choices among treatment options (see Gonsiorek, 2004;Haldeman, 2004;Yarhouse, 1998). ...
... Currently, there is much debate regarding the rights of clients who seek Beyond Acceptance 8 out such services in an effort to reconcile their sexual orientation with their religious beliefs (see, e.g., Morrow, Beckstead, Hayes, & Haldeman, 2004). However, advocates for the mental health rights of sexual minorities warn other mental health professionals about the potential misuse and harm that can ensue from reparative therapies (see, e.g., Gonsiorek, 2004; Haldeman, 2002; Morrow, et al., 2004). Although the American Psychological Association has not explicitly banned conversion therapy outright, the organization currently condemns the use of such potentially harmful clinical practices, particularly in the absence of empirically supported research and absolutely if the clinician's motives for carrying out such procedures occur in a manner that violates the organization' (APA, 1992, as cited in APA, 1997). ...
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Beyond acceptance: An evaluation of the Safe Zone Project in a clinical psychology doctoral program
... Evidence of data do exist to inform the psychology of LGB individuals, but such information came only after a paradigm shift occurred socially and institutionally (APA, 2009;2012;Gonsiorek, 1991). Regarding client selfdetermination, Gonsiorek (2004) warned clinicians about ''the assumption of unlimited client choice''and asserted,''Client choice properly functions as an aspect of informed consent and not as a substitute for ethical decision making and practice standards''(pp. 754-755). ...
Article
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The self-reports of individuals who claim that they have changed their sexual orientation are either dismissed as false or relied upon to promote sexual orientation change efforts. However, these reactions do not capture the complexity of the sexual reorientation phenomenon. This article provides an overview regarding the promise and effort of sexual reorientation and how this knowledge may inform our current understanding of human sexuality. Specifically, a brief history is given of the interventions used to change attractions to same-sex adults and the assumptions underlying these efforts. Information will be given regarding which conclusions can be derived from sexual reorientation studies. The limitations of these studies will be explained to strengthen future research. Hypotheses will be presented regarding the motivations and needs of those distressed by a same-sex erotic orientation and the impact that the hope of sexual reorientation may have for family members, religious leaders, and policy makers. A multivariate model of sexuality and sexual orientation, including scales of attraction and aversion, will be proposed based upon current understanding of sexuality and the distinctions found in sexual reorientation research. In the end, a therapeutic framework will be highlighted that may be used (and researched) to help those distressed by their sexual orientation.
... One of the dilemmas some religiously committed individuals and practitioners often address is changing sexual orientation through psychological treatments (Gonsiorek, 2004;Haldeman, 2004). As Chaya realized that she was a lesbian, she had to confront the reality that her marriage and her lesbian identity did not appear compatible. ...
Article
Full-text available
Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Currently, there is significant debate regarding the rights of clients who seek out such services in an effort to reconcile their sexual orientation with their religious beliefs . Advocates for the mental health rights of sexual minorities warn other mental health professionals about the potential misuse and harm that can result from reparative therapies (Gonsiorek, 2004;Haldeman, 2002;Morrow, et aI., 2004). Although the American Psychological Association has not explicitly banned conversion therapy, the organization currently condemns the use of such potentially harmful clinical practices, particularly in the absence of empirically supported research and the evident potential to violate the organization's Ethical Principles ofPsychologists and Code ofConduct (AP A, 2002). ...
... In particular, the psychologist developed trust and assurance that shared histories would not confound the therapy. Grounding the therapy in evidence from psychological research on LGBT issues, the relationship between stigma and substance abuse, gay male sexual behavior, and attachment styles further helped to manage risks associated with counterproductive countertransference. Gonsiorek (2004) has noted that "for clients who are both same-sex attracted and conservatively religious, effective therapy cannot focus on one of those aspects but must work to integrate both if it is to be effective and beneficial" (p. 752). ...
Article
Full-text available
Conservative religions that condemn homosexual sexual orientation and acts as unnatural and sinful pose significant challenges for gay persons whose faith is a core part of their identity. The condemnation presents a serious barrier to the acceptance and integration of their sexuality, a primary task of psychosexual development. As a result, they can manifest depression, anxiety, suicidal ideation, and even suicide attempts. The ecclesiastical censure also imposes an untenable dilemma for homosexuals in that they feel pressed to reject their sexual identity or renounce their spiritual identity and heritage. Psychotherapists who treat gay persons caught in this quandary can find themselves facing a similar problem: how to help their homosexual client reconcile their proscribed sexuality with their spiritual commitments. The case presented here recounts the treatment over many years of a gay man suffering from such a conflict and his eventual accommodation of both his homosexuality and his faith. Recommendations are offered for constructive treatment with those torn between two conflicting core identities.
... One of the dilemmas some religiously committed individuals and practitioners often address is changing sexual orientation through psychological treatments (Gonsiorek, 2004;Haldeman, 2004). As Chaya realized that she was a lesbian, she had to confront the reality that her marriage and her lesbian identity did not appear compatible. ...
Article
Full-text available
Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.
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This article addresses the treatment of individuals who experience conflict between their religious convictions and their same-sex attraction. Recently, attention has been drawn to the ethical issues involved in the practice of sexual reorientation therapy (SRT) with such conflicted individuals. This article reviews the ethical arguments for and against SRT through the lens of the general ethical principles of the American Psychological Association's (2002) ethics code. Practitioners are then challenged to think about how they might respond virtuously (Meara, Schmidt, & Day, 1996) when presented with such a client. Thought questions are presented to assist therapists to develop in virtue while working with religious clients who are conflicted about same-sex desire.
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Despite the ethical and methodological concerns surrounding reparative therapy (RT) (also known as conversion therapy), a 2011 journal published a study claiming that lesbian, gay, and bisexual persons can “change” their sexual orientation. While much has been written about the deleterious effects of RT it continues to be researched and practiced, and, therefore, continues to cause harm. This article reviews methodological and ethical problems of RT and factors associated with it, and suggests steps to decrease and eventually end its practice as an aspect of social work's mission, which is to protect vulnerable populations, including lesbians and gay men.
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Potential identity conflicts arising at the intersection of sexual and religious orientations are examined. Using case examples, a therapeutic process that explores clients' intersecting identities, belief structures, and life experiences is described. This therapeutic approach is aimed at giving personal meaning to the conflict between sexual orientation and religion, allowing clients to seek identity resolutions that are flexible and do not compromise well-being. Multicultural counseling, psychology of religion, symbolic interactionism, and identity development theories provide frameworks for an analysis of the nature of the conflict and its potential resolutions. Countertransference issues arising from ethical and social justice considerations are also discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Incorporating spirituality and religion into psychotherapy has been controversial, but recent contributions have argued the importance and provided foundations for doing so. Discussions of ethical challenges in this process are emerging, and this contribution discusses several preliminary issues, relying on the Resolution on Religious, Religion-Based and/or Religion-Derived Prejudice adopted by the American Psychological Association in 2007, as guidance when used with the American Psychological Association’s (2002) Ethical Principles of Psychologists and Code of Conduct. Specifically, this discussion of preliminary challenges addresses competence, bias, maintaining traditions and standards of psychology, and integrity in labeling services for reimbursement. Commentators deepen the discussion, addressing what constitutes minimal competence in this area; effective and truly mutual collaboration with clergy; the high level of ethical complexity and “inherent messiness” of this domain of psychological practice; and the particular challenges of demarcating the boundaries of these domains for regulatory and billing purposes. This discussion offers decidedly preliminary ideas on managing the interface of these domains. Further development is needed before this nascent area approximates precise guidelines or standards. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Ethical dilemmas in the field of family therapy continue to evolve; this article addresses ethical issues family therapists are currently confronting or may confront in the future. We begin by examining a movement in the field towards relational ethics, which is inclusive of context, values, and power that permeate all relationships. Using this framework in relation to both our clients and our practice, we discuss defensive and risk-aversive practice of family therapy within our current socio-political context, family therapists working with child alienation in cases of non-normative divorce, the impact of digital technology on families and family therapy, and the polarisation of sexual value issues.
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This article examines the challenges that may be particular to African American counseling students who identify as Christian in learning to provide competent and affirming counseling to lesbian, gay, and bisexual (LGB) clients. The role and importance of the Black Church, race survival consciousness, and cultural constructions of sexuality and mental health may present unique barriers for these students in affirming LGB clients. Recommendations for counselor education programs are discussed. © 2016 by the American Counseling Association. All rights reserved.
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Religion-based LGBTQA + conversion practices frame all people as potential heterosexuals whose gender aligns with their birth sex (in a cisgender binary model of male and female sexes). Deviation from this heterosexual cisgender social identity model is cast as curable ‘sexual brokenness’. However, research shows conversion practices are harmful, and particularly associated with increased experiences of abuse, mental health diagnoses, and suicidality. This paper explores their contribution to the particular harms of moral injury and religious trauma, drawing firstly on the foundational moral injury literature to offer a unique conceptual framework of spiritual harm and moral injury, and secondly on a rare qualitative 2016–2021 study of the spiritual harms reported in semi-structured interviews of 42 survivors of LGBTQA + change and suppression practices in Australia. The paper examines the survivors' support needs around the nature and extent of religious trauma and moral injury, to inform services working towards supporting their recovery from such experiences and their resolution of conflicts deeply bound in their sense of self and belonging. It argues that impairment of conversion survivors' relationships with religious communities, and religious self-concepts, point to the need for additional improvements in pastoral practice.
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This study examined the potential influence of religiosity, sexual orientation identity development, and internalized homonegativity on the propensity to seek conversion therapy to change one’s sexual orientation. An Internet sample of 76 women and 130 men who were gay-identified, lesbian-identified, same-sex attracted, and “questioning” was studied. Results indicated that two types of religious orientations, intrinsic and quest, predicted a propensity to seek conversion therapy, although in different directions. Further more, internalized homonegativity fully mediated the relationships between religious orientation and propensity to seek conversion therapy. Additionally, there was a significant inverse relationship between sexual orientation identity development and propensity to seek conversion therapy. Implications for practice and research are discussed.
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Perspectives were gathered of 50 Mormon individuals who had undergone counseling to change their sexual orientation. The data were analyzed using the constant comparative method and participant verification, thereby developing a grounded theory. A model emerged that depicted participants’ intrapersonal and interpersonal motivations for seeking conversion or “reparative” therapy, their perceived benefits and harms of such interventions, and the factors that facilitated self-acceptance and consolidation of a positive self-identity. Based on these descriptions, this study provides the foundation for a broader-based treatment approach (besides one focused solely on changing sexual orientation or adopting a lesbian, gay, or bisexual identity), which is designed to produce individualized congruent solutions for religiously conflicted, same-sex-attracted clients.
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Despite a long history of viewing homosexuality as pathological and in need of change, the majority of mental health professions have, during the past 30 years, adopted statements that have depathologized lesbian, gay, and bisexual individuals. However, concurrent with these advances has been a rise in religious and therapeutic approaches to sexual reorientation (conversion or “reparative”) therapies. Recent scholarship highlights these controversies and the benefits and harms experienced by clients who have sought such interventions. This major contribution extends extant scholarship to include predisposing environmental and personality variables that lead same-sex attracted individuals in religious conflict to conversion therapies, an understanding of the journey to and through such therapies, and clinical implications and recommendations for working with these clients in a manner that does not contribute to further conflict.
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Homosexuality and bisexuality have not been considered psychopathologies for many years, and recent research has suggested a wide variety of etiological considerations, many biologically based, to account for same-sex desire. Nevertheless, many patients still present with questions and distress regarding their sexual orientation. The authors address the question of how practitioners may manage these situations. To this end, the authors briefly review the background of the relevant issues, make various assumptions, consider therapists' values, and present 4 alternatives available to practitioners who may be confronted with this situation. Each alternative is discussed with regard to its relevant ethical issues and clinical implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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How should psychologists demonstrate respect for religion as an aspect of diversity when that aspect of diversity seems inconsistent with another form of diversity? This is a striking challenge when considering conservative expressions of religion in relation to a person's experience of same-sex attraction and behavior. This article (a) asserts that conservative religion is a legitimate, though often overlooked, expression of diversity; (b) identifies ways in which gay-integrative theorists and conservative religious persons fail to appreciate each other's perspective; and (c) presents a continuum of service delivery options to expand clinical services to persons who experience same-sex attraction. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This study uses interviews with 150 consumers of sexual orientation conversion therapies to identify critical incidents of poor practice and ethical violations. We found that some licensed conversion therapists may be practicing in a manner inconsistent with the APA Ethics Code, similar professional codes, and recent guidelines on treatment of lesbians and gay men. Areas of ethical violations identified include: informed consent, confidentiality, coercion, pre-termination counseling, and provision of referrals after treatment failure.
Article
The debate among scholars and gay activists and religious/political activists about the appropriateness and efficacy of conversion therapy has left out a number of individuals for whom neither gay-affirmative nor conversion therapy may be indicated. The present discussion, through the use of case material, offers considerations for the practitioner who seeks to assist same-sex attracted male clients in the integration of their conflicting religious and sexual selves. Issues of attachment, social and family considerations, religious and spiritual factors, and developing familiarity with the gay community are considered. Ethical considerations of treatment are discussed.
Article
This study uses interviews with 150 consumers of sexual orientation conversion therapies to identify critical incidents of poor practice and ethical violations. We found that some licensed conversion therapists may be practicing in a manner inconsistent with the APA Ethics Code, similar professional codes, and recent guidelines on treatment of lesbians and gay men. Areas of ethical violations identified include: informed consent, confidentiality, coercion, pre-termination counseling, and provision of referrals after treatment failure.
Article
What motivates individuals to pursue conversion therapy and ex-gay groups? How do they perceive its harmfulness and helpfulness? In this study, 202 consumers of sexual orientation conversion interventions were interviewed to answer these questions. The results indicated that a majority failed to change sexual orientation, and many reported that they associated harm with conversion interventions. A minority reported feeling helped, although not necessarily with their original goal of changing sexual orientation. A developmental model that describes the various pathways of individuals who attempt to change their sexual orientation is presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Despite the controversy surrounding sexual reorientation, there are only a few published empirical reports concerning the experiences of ex-gays. Summarizing these reports, this article describes the role of religious variables in the change process. Some kind of change appears to occur for many who identify themselves as ex-gay. Although sexual orientation is not an easily defined or measured phenomenon, change over time is not theoretically unfounded or empirically unprecedented. Many of the individuals who report efforts to become ex-gay feel that the efforts were helpful, and a small percentage feel the efforts were harmful. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The American Psychological Association's (APA, 1992) Ethical Principle D: Respect for Rights and Dignity is an important ethical principle for psychologists who work with clients who experience same-sex attraction and seek changes. Psychologists have an ethical responsibility to allow individuals to pursue treatment aimed at curbing experience of same-sex attraction or modifying same-sex behaviors, not only because it affirms the clients' rights to dignity, autonomy, and agency, as persons presumed capable of freely choosing among treatment modalities and behavior, but also because it demonstrates regard for diversity. Psychologists who work with clients distressed by their experience of same-sex attraction should only do so with advanced informed consent. (PsycINFO Database Record (c) 2012 APA, all rights reserved)