Interview with Mark Yarhouse on SAMHSA Report Calling for an End to Sexual Orientation Change Efforts for Minors

On October 15, I linked to a report published by SAMHSA which called for an end to sexual orientation change efforts for LGBT minors. At the time, I wrote:

Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth was released today by the Substance Abuse and Mental Health Services Administration. The report recommends the end of change therapies for minors via professional advocacy and legal strategies.

Mark Yarhouse, co-author with me of the Sexual Identity Therapy framework and professor at Regent University, was an evangelical presence on the panel of experts who produced the consensus statements.

I also said I hoped to have commentary from Mark. Today, I have an interview with him on his committee experience and his views of the consensus. Mark is professor of psychology at Regent University and Director of the Institute for the Study of Sexual Identity. He is co-author with me of the Sexual Identity Therapy Framework, which is a model for ethically and effectively helping clients with distress surrounding their sexual orientation and religious beliefs. For more on SITF, see the website which supports the framework. This will be cross–posted there.
This interview comes amid a bit of a controversy involving Mark and a speaking engagement in Canada. I hope those who assume they know Mark’s views will also read this and the SITF.

Warren Throckmorton: In general, what was your experience like being on the consensus committee? Did you feel the rest of the committee members took religious concerns seriously?
Mark Yarhouse: Overall, it was a good experience. I am always grateful for the opportunity to engage with others around complex issues, to learn from other experts, and to share from my own lines of research. We reviewed existing research and past policy statements, as well as shared from our professional experience working with children, adolescents, and families. In answer to your question about religious concerns, I think committee members wanted to take religious concerns seriously, although the primary focus was the well-being of minors who are navigating sexual identity and gender identity. As you know all too well, the beliefs and values of religious families are important considerations when working with families whose teen may be navigating gender identity or sexual identity concerns. In any case, my experience was that other committee members were interested in the experiences I’ve had – and others had – working with conventionally religious families.
WT: Even though the sexual identity therapy framework (SITF) wasn’t mentioned or cited, do you feel the report is supportive of the approach we take in the framework?
MY: Yes, I think so. We had the opportunity to review many documents, including the SITF and the 2009 APA task force report on appropriate therapeutic responses to sexual orientation, which, as you know, cited the SITF favorably. The kind of practice we saw as helpful would emphasize identity exploration without an a priori fixed outcome. I think the framework does that in the area of sexual identity. However, the framework does not address in much detail working with minors, and that may be something we consider if we offer a revision in the future.
WT: Do you have any comments, reservations about the consensus reported in the paper?
MY: As the SAMHSA report notes, we decided at the outset that we would define consensus as a reasonably high percentage of agreement rather than unanimous consensus. We all agreed to that, but that meant that what counted as consensus in at least a few occasions was not reflecting unanimity. We worked hard for unanimity in all cases, but that did not always happen. I at times found myself in disagreement with some of the wording, for example, but the threshold for consensus was met in those instances, and I understood and respected that process.
WT:It seems to me that the consensus surrounding sexual orientation is more settled than gender identity. How do you see that?
MY: There are fewer professional debates about sexual orientation, which likely reflects the consensus you are referring to. There seem to be more professional discussions about a range of clinical options with gender dysphoria. However, I was impressed by how little research is published on minors – particularly efforts to achieve congruence between gender identity and biological sex.  I was under the impression that more studies of higher quality had been published in some areas, and as the committee looked at them together, we found them lacking. Also, while research was one consideration, we drew on other sources, too, such as committee members’ professional experience and prior reports. In any case, I would have preferred to frame and word various aspects of the consensus report differently, but again that in some cases goes back to what counted as consensus. Without going into too much detail, you could imagine someone favoring the language of  ‘insufficient evidence’ in discussions of effectiveness and harm, to reflect how little published research is available in a given area of inquiry. Other topics, such as how to conceptualize sexual and gender identities and expressions in a diverse and pluralistic culture raise important philosophical and theological questions that were beyond the scope of the discussion.
WT: In general, do you support the recommendations of the paper (or asked another way). Is there anything in the recommendations you have concerns about?
MY: It is important to distinguish the consensus statement from the SAMHSA report. I did provide feedback on portions of the SAMHSA report, especially around family, community, and religious considerations, but it was written by designated persons from that agency. I think it reflects a little more regard for conventionally religious persons and families and provides for more resources than otherwise may have been available. But many committee members provided input and suggestions, and I imagine the author of the report had to balance various considerations in putting together the final document.
As far as concerns, I indicated at the outset that I did not think the government should be involved in legislating around the complexities of clinical practice in these two areas. I prefer to see government support the regulatory bodies that provide oversight to mental health professions in a given jurisdiction. I shared more of my thoughts on that in an interview with First Things. My opinion has not changed on that matter.

New SAMHSA Report Calls for End to Change Therapy for LGBT Youth

I may have more to say about this report in the coming days, hopefully with some commentary from Mark Yarhouse, but for now, I am going to link to it.
Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth was released today by the Substance Abuse and Mental Health Services Administration. The report recommends the end of change therapies for minors via professional advocacy and legal strategies.
Mark Yarhouse, co-author with me of the Sexual Identity Therapy framework and professor at Regent University, was an evangelical presence on the panel of experts who produced the consensus statements.
The most controversial parts of the report, in my opinion, deal with gender identity. I think most therapists now understand that sexual orientation is durable and rarely, if ever, changes dramatically as the result of change therapy. However, the recommendations on gender identity are more controversial. Despite the use of the word consensus, I question whether there is a consensus among professionals of all ideologies about how to respond therapeutically to youth dealing with stress over gender expression.
As for the goal of ending change therapy for youth, I am a supporter. Despite years of research and effort, no safe, effective and ethical approach to sexual orientation change has emerged. The very few people who still claim effectiveness are small operations with no research of their own methods. The anecdotes of harm are convincing and the candid admissions of people like Alan Chambers that the change they claimed didn’t happen is enough to cause significant skepticism. My own professional experience researching change efforts in clients and research participants informs me that any claimed change is unlikely to be lasting or complete. The biological research, while not conclusive, supports a very early establishment of sexual desires (especially for males). The available options for attempting change are often bizarre and carry potential to create psychological problems. Thus, limiting these efforts in a free society to adults seems like a reasonable professional position.
 

Southern Baptist Seminary Leaders Reject Reparative Therapy

Let me just say that I opposed reparative therapy before it was cool to oppose it.
Yesterday, Al Mohler and others articulated their position against reparative therapy, also known as sexual orientation change efforts.
Atlantic has an article on Alan Chambers’ new book and chronicles the demise of the ex-gay movement from Alan’s point of view.
Essentially, Mohler and colleagues believe changing orientation is not the Christian goal. Rather, avoidance of same-sex sexual relations is the objective in the narrow sense, and more broadly, pursuit of a spiritual life is what Christians should seek. Some same-sex attracted people are bisexual and others sometimes fall in love cross-orientation to form a mixed orientation marriage.
Although it is dated, I have a page on reparative therapy which demonstrates my approach to the issues in the professional sense.

JONAH Guilty of Consumer Fraud According to NJ Jury

That didn’t take long.
Today, the jury in the sexual orientation change case in NJ said Jews Offering New Alternatives to Healing (JONAH) was guilty of consumer fraud by claiming sexual orientation can be changed.
According the report, the jury found that JONAH founders Arthur Goldberg and Elaine Berk and life coach Alan Downing:

…engaged in unconscionable commercial practices” and misrepresented their services.

This is a big deal and should have a chilling effect on such services elsewhere. Hopefully, fewer therapists will engage in such practices and instead work with clients in conflict over sexual attractions to explore realistic options.
JONAH will have to refund fees collected.
 

Desire, Faith & Therapy: Sexual Orientation and Orthodox Jews; Rabbinical Council Rejects JONAH

Desire Conf ColumbiaOn Sunday, I participated in a conference titled Desire, Faith and Therapy at the Kraft Jewish Student Center at Columbia University on appropriate therapeutic responses to sexual orientation. The conference was designed for therapists, rabbis and other interested members of the Orthodox Jewish community.
From the brochure:
 

“Desire, Faith and Psychotherapy” presents a Psychoanalytic perspective on sexual orientation and gender identity in the Orthodox Jewish community. We will explore the intersection of psychological, religious and communal issues that present with LGBT people from Orthodox & Hasidic communities. The program features experts in the field and professionals with experience working with this population. They will review the latest research and develop a conceptual framework in which therapists and Orthodox rabbis can work together to offer the best care.

I didn’t let the organizers know in time to make the brochure but I spoke as a part of a panel with Jack Drescher and Rabbi Mark Dratch. Drescher covered research and history of sexual orientation change efforts, Rabbi Dratch covered the position of the Rabbinical Council of America and I described the sexual identity therapy framework.
Rabbinical Council of America Repudiates Reparative Therapy and JONAH
The framework seemed to fit the audience well in that affirming and non-affirming members of the Orthodox community were present and interested in working together for best practices. I was pleased to hear Rabbi Dratch describe the Rabbinical Council’s repudiation of JONAH, and reparative therapy in general. Dratch told the crowd that the Rabbinical Council asked JONAH numerous times to remove the 2004 letter recommending JONAH. In fact, even after the Council issued their repudiation of JONAH, the 2004 endorsement remains up on JONAH’s website. JONAH advertises falsely in more ways than one.
The lawsuit against JONAH will be a test of the consumer protection laws in New Jersey. JONAH continues to claim efficacy from the strange practices used to try to change sexual orientation. With a couple of exceptions, the crowd at the conference seemed to join the sentiment expressed by the Rabbinical Council concerning JONAH.
My powerpoint can be viewed here.

I Am Michael: The Retelling of Michael Glatze

Michael Glatze burst into the awareness of those in the ex-gay world in July 2007. He was a gay activist who in a panic turned to God. At that time, I had turned from my days supporting sexual reorientation change efforts and had established the sexual identity therapy framework as the better approach to traditionally evangelical believers who were also attracted to the same sex. I was very curious about his experience and he discussed some of it with me in an interview very shortly after the his coming out as straight with WorldnetDaily. At the time, I wrote, “I know nothing about Mr. Glatze beyond this article, although I suspect we may be hearing more about him in the coming days.”

Initially, Glatze was portrayed by the evangelical press as an orthodox Christian convert. However, he confirmed to me, albeit reluctantly, that he had converted to the Mormon church. He later left the LDS church and at one point joined a Buddhist retreat center. He gave two interviews to Joe Nicolosi (most recent in 2014) about change of orientation that somehow Nicolosi and Glatze spun into support for reparative therapy (recall that Glatze was not involved in any change therapy efforts).

Glatze resurfaced a couple years later with a series of blog posts sharply critical of President Obama. One, in particular, was featured by ExGayWatch and seemed to express racist overtones. Glatze later provided an explanation to me about the comments which seemed more like unfocused rage at Obama.
I was a little surprised when I heard that James Franco was going to do a movie about Glatze’s changes. The film, I Am Michael has been getting good reviews but may not be available widely. In any case, as a biopic, I am sure it is interesting but at some point I would like to explore what really happened to Glatze. There are clues that he might not have been exclusively gay or that he might be bisexual. Is his experience generalizable to others, or is there some infrequent alignment of circumstances that led to the dramatic change? The writing I have done previously gives me little that’s solid.
In his 2014 interview with Joe Nicolosi, Glatze denigrates the experience of LGB people in much the same way he did in 2007. However, in this video below, he seems to articulate what the American Psychological Association calls “organismic congruence” or being who you experience yourself to be. It is hard to tell what he believes now, at least from this interview, but he seems much more at ease.
[youtube]http://youtu.be/DERC4kpd5Ag[/youtube]
As I wrote before, I suspect we may be hearing more about him.
 
 

Was Michael Brown Right About Sexual Orientation and Secular Counseling?

David Barton on history. Ken Ham on science. Joseph Nicolosi on psychology and sexual orientation. Now Michael Brown on sexual orientation counseling.
In a Christian Post op-ed Michael Brown takes Al Mohler to task for his assessment of sexual orientation. Mohler now acknowledges that sexual orientation is a useful descriptive category, even as he appears to consider same-sex orientation to be inherently sinful. The former opinion seems to be self-evident, the latter position confusing. How can a set of givens be any more sinful than another set of givens? Isn’t what one does in response to our impulses the key?
Because of his shift in views, Mohler rejects reparative therapy, or any secular approach to curing sexual orientation. Minister and commentator Michael Brown enters the fray at this point. He says:

People find themselves attracted to the same sex for many different reasons, some of which can be unpacked through counseling, including secular counseling. In fact, as countless gays and lesbians have shared with counselors, their attractions can often be traced back to sexual abuse or serious family crises.
Cannot a secular counselor deal with these issues too? Must we put homosexuality into a special category of its own?

Surely there are many other areas of our lives that are deeply affected by our sinful nature, yet we do not say that counseling cannot help us make progress in those areas, do we?

It is amazing to me that evangelicals who reject so-called secular science on one hand, embrace Sigmund Freud and theories of sexual orientation derived from Freud’s fictions. Brown promote the discredited view that same-sex attraction arises because of sexual abuse and/or “serious family crises.” This was cutting edge a century ago, and even then Freud despaired that cure could come through analysis and didn’t think the effort was necessary. Freud, who believed that childhood trauma could lead to homosexual desires, wasn’t a strong advocate of therapy to change it. In 1935, a mother wrote Freud about help for her son. Freud interpreted the letter as a request to help the young man overcome homosexuality. Freud wrote back and said:

Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation; it cannot be classified as an illness; we consider it to be a variation of the sexual function, produced by a certain arrest of sexual development. Many highly respectable individuals of ancient and modern times have been homosexuals, several of the greatest men among them. (Plato, Michelangelo, Leonardo da Vinci, etc). It is a great injustice to persecute homosexuality as a crime – and a cruelty, too. If you do not believe me, read the books of Havelock Ellis.
By asking me if I can help, you mean, I suppose, if I can abolish homosexuality and make normal heterosexuality take its place. The answer is, in a general way we cannot promise to achieve it. In a certain number of cases we succeed in developing the blighted germs of heterosexual tendencies, which are present in every homosexual in the majority of cases it is no more possible. It is a question of the quality and the age of the individual. The result of treatment cannot be predicted.
What analysis can do for your son runs on a different line. If he is unhappy, neurotic, torn by conflicts, inhibited in his social life, analysis may bring him harmony, peace of mind, full efficiency, whether he remains a homosexual or gets changed.

Incredibly, Brown refers people to JONAH, a group being sued right now by former patients because their techniques did not produce change in orientation but rather shame and depression. In his article, I wish Brown would have explained what a client of JONAH might do to rid himself of his gayness. For instance, in court documents, former clients describe getting naked:

According to Plaintiffs, JONAH’s conversion therapy required them to engage in various individual and group activities. For instance, during a private session, defendant Alan Downing (“Downing”), a JONAH-affiliated counselor, instructed plaintiff Chaim Levin (“Levin”) “to say one negative thing about himself, remove an article of clothing, then repeat the process.” Levin submitted to Downing’s instructions until he was naked, when Downing directed Levin “to touch his penis and then his buttocks.” Plaintiff Benjamin Unger (“Unger”) and plaintiff Michael Ferguson (“Ferguson”) engaged in similar disrobing activities with Downing. Downing instructed Unger to remove his shirt in front of a mirror and requested that he “continue,” but Unger refused. Ibid. In addition, Unger participated in a group exercise in which Downing instructed him and other young men to remove their clothing and stand in a circle naked, with Downing also nude.  As with Unger, Downing instructed Ferguson to undress in front of a mirror and “repeatedly urged [him] to remove additional clothing,” but Ferguson refused.

JONAH clients are instructed to fight their way through group therapy clients to grab two oranges and take their “balls back.” Many of the techniques are taken from the decidedly pagan Mankind Project’s New Warriors Training Adventure. Those processes are based on a loose reading of and curious amalgamation of Gestalt therapy and psychoanalytic assumptions.
I hope Brown means well, but he isn’t doing well. Recommending JONAH to evangelicals is irresponsible.
Oh, and the “Alliance” Brown invokes? That is Freudian inspired National Association for the Research and Therapy of Homosexuality (NARTH) warmed over.  It sounds like a respectable scientific group. However, they are supporters of JONAH, and leaders within the group also recommend that techniques used by JONAH and the New Warriors Training Adventure.
We don’t know for sure what causes same-sex attractions, but we know that abuse and traumatic relationships aren’t general causes for homosexuality any more than they cause heterosexuality. Both gays and straights experience difficulties in childhood and both gays and straights experience loving, healthy childhoods. Thus, curing wounds, or finding non-existent woulds to cure, won’t dramatically alter sexual attractions for the vast majority of people. While a few people do show some change, for many of them the change was spontaneous and related to factors other than therapy or intentional efforts to change.
So to answer the question in the title: No, Michael Brown is about as wrong on sexual orientation and secular counseling as one can be.
 
 

Jonathan Merritt Discusses Sexuality and Vulnerability in New Book

On Sunday in a blog post at Religion News Service, Jonathan Merritt summarized some personal reflections on his sexuality which are detailed in his new book Jesus is Better Than You Imagined.
Merritt, also the author of A Faith of Our Own: Following Jesus Beyond the Culture Wars which I endorsed. In that book, Merritt raises good questions and frequently illustrates the damage done to the Gospel and to people by culture war battles over social issues. In this blog post and his new book, he makes the matter personal.

The church is at a critical juncture on sensitive matters such as these. Churches need to create safe spaces where their people can be honest about what they feel and what they’ve experienced. All of our stories belong at the table. We need to listen to each other and learn to love each other and then pick up the scriptures and ask, “What does it look like to follow Jesus with our hearts, minds, and bodies?” If I shared my story for any reason, it was this one.

Merritt describes unwanted sexual contact as a child and then struggles over his sexual identity as an adult. He doesn’t label himself with a sexual orientation label and describes a fluidity that is characteristic of some people. I appreciate that he does not peg his same-sex attraction on his childhood and in fact says that it is “dangerous” to assume a connection.
Merritt’s experience is similar to so many who are same-sex or bisexually attracted but maintain loyalty to beliefs which are incongruous with same-sex sexual behavior or relationships.  The American Psychological Association’s sexual orientation task force report calls this experience, telic congruence.
I look forward to reading his new book.

Association of Christian Counsellors (UK) Statement Prohibiting Reparative Therapy

Monday, the UK Guardian reported that the Association of Christian Counsellors* prohibited reparative therapy for their members.  The statement backing up this action sounds very much like the sexual identity therapy framework. Here is the AAC statement in full:

An ACC statement to its members January 2014
In December 2012, ACC made a statement to its members supporting and clarifying our ethical framework. The Board has continued to discuss and reflect on the area specifically relating to work with clients who present with same sex attraction issues and is now updating our guidance to counsellors, supervisors and members.
For the purpose of clarity below is the first part of the original statement mentioned above:
“All counsellors are required with due diligence to provide safe practice on behalf of their clients. This requires the counsellor to practice fully within the Ethics and Practice framework they are using with each client. The client is to be aware of the Framework being used as essential information during contracting and guidance given as to which complaints procedure is in
operation.
The particular ethical considerations taken from the ACC Ethics and Practice are:
(From’ Ethics for Members of the Association of Christian Counsellors’ section)
5.1 “Members should be trustworthy…maintain confidentiality…”
5.2 “Members should respect their clients’ right to take decisions for and to act for themselves.”
5.3 “Members should be committed to securing the client’s best interests.”.
5.5. “Members should avoid any action which might cause harm to a client. One of the most important aspects in counselling is client autonomy.”
In addition ACC has now reflected on the following (from ‘ACC Good Practice in Christian Counselling and related fields’ section 5) and its application including how it relates to the Equality Act 2010:
Good Practice in Christian Counselling and related fields states 5.1.1.12. Members should not allow any personal views they may hold about lifestyle, gender, age, disability, race, sexual orientation, beliefs or culture to prejudice their professional relationships with clients. The Equality Act 2010 requires that discrimination does not occur on the following protected grounds: age, disability, gender, gender reassignment, pregnancy and maternity, race, religion and belief and sexual orientation.
As counsellors working in the UK, ACC members are expected to adhere to both ACC Code of Ethics and Good Practice and to UK Law, which means adhering to both of the statements made above. It is clear that in some instances the ‘protected grounds’’, as defined by the Equality Act 2010, of one individual may appear to be contrary to that of another (or indeed may be in conflict within an individual) i.e. the religious beliefs of a counsellor and the sexual orientation of a counsellee. In such instances ACC would expect our members to act without discrimination towards all and uphold the rights of the protected characteristics enshrined in the Equality Act 2010. In addition the essential characteristics of a therapeutic relationship are genuineness, congruence, unconditional positive regard, empathy and understanding (being non-judgmental, warm and empathic) thus providing a safe environment for the client to explore their feelings and concerns. It is clear that in protecting client autonomy it is important for counsellors not to impose themselves or their beliefs on anyone who comes for therapy, either by implying that a particular outcome is possible or expecting the client to come into alignment with their own belief system or understanding on certain approaches to life. Such actions would be unethical and so ACC would expect any member to consider the therapeutic model that they are using to be in-line with these principles and characteristics. ACC has therefore expanded on the original statement that reflects more clearly its view on therapy in relation to same sex attraction.
There are certain guiding principles arising from ACC Ethics and Practice framework. These guiding principles apply when deciding what is appropriate in practice or for any therapeutic model. Namely that …
a) Counsellors / therapists do not make assumptions that the client is looking for a particular outcome
b) Do not allow counsellors/ therapists to suggest, impose, advertise that therapy would achieve a particular outcome / change etc.
c) Counsellors / therapists do not make the achievement of a particular outcome (determined by the counsellor/therapist), be the measure by which success / failure of the therapy is determined
d) Counsellors / therapists do not impose a particular moral standpoint or belief system on the client.
We have considered Reparative (or Conversion) Therapy by these principles and have decided that it does not fit the above criteria for the following reasons:
(i) Its language implies that sexuality can be ‘repaired’ and so introduces the idea of treatment or cure.
(ii) Where it is proposed, advertised, or practiced as a therapy, it suggests that a specific outcome is possible and appears to make an a-priori assumption that it should happen. This would not fit any of the above guiding principles.
(iii) It is incompatible with the Equality Act 2010.
For this reason, we do not endorse Reparative or Conversion Therapy or any model that implies a predetermined direction of outcome of counselling at the outset. We recognize that such models have the potential to impose situational demands on the client at a time of vulnerability with the potential to create harm and therefore view them as incompatible within the ethos of counselling.
Members who are considering using this model of therapy should neither commence nor continue to use it and any advertising or promotional material should be replaced immediately, or at least removed from current use. This includes the ACC “Find a counsellor” facility on our website.
We recognize that this is not the view of some of our members but in the interests of public safety we have decided to make clear what is expected by those who choose to be part of ACC.

*No relationship with American Association of Christian Counselors

PFOX Plays The Victim; Wants To Fix One Problem By Causing Another

Today, the Parents and Friends of Ex-Gays dropped a news release criticizing Virginia’s public universities for failing to distribute their literature to students. In the release, PFOX claims discrimination based on religion and ex-gayness is what motivates the lack of ex-gay literature.
While I don’t doubt that some of those counseling center staffers have problems with conservative religion, I submit that they are correct in their decision not to provide PFOX literature to students.  Much of what PFOX and related groups (e.g., International Healing Foundation, Voice of the Voiceless) promote is scientifically questionable and should be avoided for that reason alone.
The irony is that the group who conducted the undercover investigation accuse the university centers of suppressing accurate information when it is the ex-gay groups which (also?) do this. They know there is no peer reviewed research on therapeutic change that supports them. They also know that at least one of their therapeutic methods (i.e., cartharsis) has been evaluated via research and found to be harmful in some instances. They also know that their narrative regarding homosexuality (i.e., failures in the parent-child relationship) is scientifically dubious and yet they continue to promote this view as if it is supported by research and experience.
It may be that the counseling center directors favor gay affirming religion over non-affirming religion. If so, this would be problematic if the centers are publicly funded. However, any such finding of fact would not be reason to hand out erroneous literature to students. If there are non-affirming groups on campus or in the community (e.g., Andrew Marin’s groups or some other religious group which does not promote debunked theories and methods) then information about those groups should be made available to religious students. Therapeutically neutral approaches should be taught to center counselors to help them avoid establishing an approved religious stance on the subject in a public university. However, PFOX and Voice of the Voiceless should not be allowed to use religious discrimination as a basis to promote their problematic materials.