The APA and Psychology Need Reform: Full remarks of Nicholas Cummings

Nick Cummings has seldom been wrong about trends in psychology and I do not believe he is incorrect now. These remarks were presented at the APA convention in New Orleans, August 12, 2006.

Dr. Cummings is a past-president of APA and an innovator of the first order. He was a pioneer in managed behavioral healthcare and continues to lead the profession in providing state-of-the-art solutions to psychological service delivery. If you care about psychology as a profession, this is a must read: The APA and Psychology Need Reform.

APA President Koocher’s statement about therapy & same-sex attraction

This just in from APA’s Public Affairs office via email from Rhea Farberman:

APA Office of Public Affairs
(202) 336-5700
Public.Affairs@apa.org

August 15, 2006

Statement by Dr. Gerald P. Koocher Concerning Therapeutic Interventions To Deal With Unwanted Same-Sex Attraction

During the Town Hall Meeting that took place at APA’s 2006 convention, I was asked about the role of patient choice in therapeutic interventions to diminish same-sex attractions.

This is an extremely complex issue. And discussion of it must balance patient choice with the therapist’s ethical obligation to obtain informed consent for any therapy process.

The issue centers on patient choice and the role of the therapist in supporting that choice with fully informed consent—be it sexual orientation or any other behavior or emotion.

In a full multifaceted therapeutic relationship, the therapist has every duty to respond to patient choice and to help patients achieve their goals. I affirmed during the Town Hall discussion, and I will always affirm, the crucial importance of providing our services with careful attention to patients’ wishes.

BUT—and this is absolutely essential, especially when dealing with sexual orientation—the therapeutic responsibility, in strict accordance with APA guidelines, MUST also include the following considerations:

One: The therapist has an obligation to carefully explore how patients arrive at the choices they want to make. Therapists must determine whether patients understand that their motives may arise purely from the social pressures of a homophobic environment. No type or amount of individual therapy will modify societal prejudices.

Two, informed consent: Patients must understand the potential consequences of any treatment, including those intended to modify sexual orientation. Patients must understand that such treatments lack a validated scientific foundation and may prove psychologically harmful.

Finally, I would add that our patients ought to know from the very start that we as their therapists do not consider homosexuality a mental disorder. In fact, the data show that gay and lesbian people do not differ from heterosexuals in their psychological health. By that I mean that they have no greater instance of mental disorders than do heterosexuals.

Dr. Koocher is the President of the American Psychological Association.

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APA president speaks about a client’s right to self-determination

In a Q&A today at the American Psychological Association convention in New Orleans, APA president Gerald Koocher was asked about a client’s right to seek therapy to modify same-sex attraction. He reportedly said (and I am seeking confirmation from the APA) that clients may seek psychotherapy to affirm their religious values even if that meant that the therapy involved objectives to modify same-sex attractions. He reportedly said that it would not be outside the APA’s ethical guidelines to work with such a client toward the client’s chosen course, even if that course meant seeking to reduce or eliminate same-sex attractions.

Update: I spoke with David Blakeslee who was in the Q&A and asked Dr. Koocher a question about APA guidance regarding clients who have religious conflicts surrounding sexuality. Dave’s question went something like this: “Dr. Koocher, I appreciate you participation in constructing and presenting guidelines for ethical behavior and attended your conference in Portland 18 months ago which I found very helpful. As a social and religious conservative I have found myself in a difficult situation about which I think the APA has not provided sufficient ethical guidance. I have been sought out by clients with deeply held religious beliefs who also have unwanted same-sex attractions. For these persons their religious beliefs are even more important to their identity than their same-sex attractions. Because of APA’s lack of guidance in this matter, I am forced to seek advice outside APA. What is APA doing to give explicit guidance to psychologists like myself and thereby ensure that treatment of my clients honors their deeply held religious beliefs as they struggle with their same-sex attractions and is consistent with APA values of self-determination and client autonomy?”

In addition to what I reported above, Dr. Koocher reportedly emphasized that the therapeutic relationship is constructed by both the client and the therapist along the goals of the client and that the whole person must be taken into account when considering an intervention.

Dave tells me that Dr. Nicolosi followed up with a comment that his response seemed in conflict with official policy of the APA on homosexuality and that clients sometimes come to therapy wishing to explore their potential for heterosexual attraction; to which Dr. Koocher reemphasized his position of client self-determination and then cautioned about coercion.

I have heard back from Rhea Farberman, of the APA Publication Office this morning that she will soon give a complete response to my request for confirmation. She did add this:

In brief, this is a complex issue and one about which we seek to balance patient choice with the therapist’s obligation to gain informed consent. There are also questions about the efficacy of therapies intended to change sexual orientation and potential harm of such techniques. APA’s position is based on the standing Council of Representatives resolution on the topic.

Hit the link for the APA’s official statement. Anything that is said here or is said anywhere must be interpreted in light of that resolution.

My take on this is that the APA has stopped short of banning change therapies but guides psychologists to inform clients of the APA position on homosexuality, to forbid coercion, to oppose therapy that has as its premise homosexuality per se is a mental disorder and to avoid making public statements that cannot be supported.

Now where have I read guidance consistent with that…

APA responds to the Narth/Exodus protest

Gay365 is reporting a statement from the APA in response to the Exodus/NARTH protest this morning. I have a call in to the APA press office to verify it since I can’t find it online as yet.

Update: Pam Willenz from the APA confirmed the statement which will be released to the press today:

“For over three decades the consensus of the mental health community has been that homosexuality is not an illness and therefore not in need of a cure. The APA’s concern about the positions espoused by NARTH and so-called conversion therapy is that they are not supported by the science. There is simply no sufficiently scientifically sound evidence that sexual orientation can be changed. Our further concern is that the positions espoused by NARTH and Focus on the Family create an environment in which prejudice and discrimination can flourish.”

Here is the AP’s story about the protest.

Changing the tone

I like dialogue and I like spirited discussion but gradually the rhetoric has heated up here on the old blog. I have gotten a few emails from people who would like to comment but feel the heat is pretty hot here. They feel they would have to be snarky and nasty just to survive. I intend to change the tone.

So, if you comment here observe the following:

Posts may be rejected if they include defamation, threats, namecalling, profanity, ad hominem attacks, disruptive comments, or anything else that I think creates a hostile environment for people to engage in civil dialogue. Disagreement is fine as long as it is done in a respectful manner.

Some comments are mixed. I may contact a commenter with the remedy if I have time. If you don’t see your comment up within 24 hours, you can assume it was rejected. If that is the case, and you want to complain, send an email.

I have the comment moderation on and I know how to use it.

Ex-Ex-gay?

There may be a new meaning to the term ex-ex-gay soon. In the comments section of the post just prior to this one, Michael Bussee quoted Alan Chambers, Ex. Dir. of Exodus speaking about the term ex-gay as follows: “We need to do away with the term entirely and make sure it’s never used again.” Mr. Chambers confirmed this quote in an email.

And then later in the comments section, Mr. Bussee says: “I am pleased to announce that Alan Chambers has asked me to join him for a joint press conference to officially RETIRE the misleading term “Ex-gay.”‘ No word as yet if or when this might occur but from my vantage point, this would be a fine development. I have used the term “post-gay” before in discussing what change means, but I am not sure that it is an improvement. Probably some people who like the term ex-gay as a designation of identity might be bothered by this. I suspect Mr. Bussee and Mr. Chambers dislike the term ex-gay for different reasons. How ironic. My understanding is that Mr. Bussee originally favored the term ex-gay. Now 30 years later, he may be aided by the current Exodus leader in order to discourage its use.

I wonder if exgaywatch will also retire?

Michael Bussee speaks out about Exodus

Recently Michael Bussee and I have been getting acquainted over emails. He recently read my article regarding the founding of Exodus and took exception to my reporting. As I indicated to Mr. Bussee, I interviewed all of the other formerly gay members of the original board and reported what they told me. Mr. Bussee concedes that he was not one of two co-founders of Exodus but that there were others. However, as noted below, he does consider Mr. Cooper a co-founder as defined by the general word, found. The emails are pretty lengthy so I will only reproduce parts of them that Mr. Bussee permitted me to post. I feel it is fair to provide him with an opportunity to air his perspective.

On Gary Cooper as Founder of Exodus
Michael Bussee: “I just looked up “found” in the American Heritage College Thesaurus, since your wrote in you original posting that Gary “could not be considered a founder in any reasonable sense of the word.” The thesaurus offers these equivalents: establish, institute, ORGANIZE, SETUP, and start. A founder is “one who founds, creates or starts up.” I did NOT use the word incorrectly or deceptively as you assert when I described Gary’s role. He helped do ALL of these things. It says nothing of being an “official” or member of any “board.” If he was, I would have said that. I suppose I could have said “organizer” or”coordinator” — but even THAT would have been attacked by those who deceptively use the term “ex-gay” to lure in new clients.”

My comment: I don’t see the term ex-gay as deceptive but not as descriptive as many would like it to be. The term gay is a socially constructed term that has no meaning about sexuality other than what the culture gives it. Given that gay is a socio-political label, then to say I once was gay and am not now, say more about your former identity than your inner life. Michael expands more on this below.

On the term ex-gay
“Ex-gay” was literally “voted in” at the first conference — and it caused dissention even then among the conference attendees. (Ask some of the other “founders” and they may remember the debate.) Some thought”ex-gay was misleading. I agree. They suggested “celibate homosexual Christians”. Some suggested “recovering Gay Christians). I forget some of the other more creative labels suggested.The majority of conference attendees SETTLED on “ex-gay” to represent the FAITH that one COULD (with God’s help) change over TIME. This was in keeping with the “name-it-and-claim-it” school of thought that was so prominent during the neo-Pentecostal movement of the time. It wasn’t what we WERE — it was what we WANTED to BECOME. Currently, I use the word gay as synonymous with “homosexual.” For others, it conjures up an image of a particular “lifestyle” (usually one of no personal restraint or moral value). Others use the term “gay” to denote belonging to a subculture. I suggest we do AWAY with the “ex-gay” term ENTIRELY since MOST in the general public would (rightly) assume that is means “no longer attracted to the same sex” — which even your side admits is NOT true for the vast majority who seek “help.”

My comment: Who knows if the vast majority lose their SSA or not? We really are talking about degrees here. Some do and some don’t. Until controlled follow-up research is published it is kind of an open question.

What Gary Cooper did for Exodus
He and I were TWO of the original co-founders. I have NEVER claimed that we were the ONLY ones. You are INCORRECT when you assert that Gary Cooper cannot be considered in any way to be a co-founder of EXODUS! Were you there? I WAS there — and I KNOW how hard Gary worked to create EXODUS. Did you come up with the idea of getting the various ministries together in the first place? Gary, another co-worker and I DID. Did YOU spend hours and HOURS (and many late nights) setting up the conference? Gary did. Did you help compile the extensive mailing list that resulted from that first conference? Gary did. Did you help devise the workshops and printed materials for that first conference? Gary did. Did you answer the phones, mail out articles and information packets during those first years of EXODUS when Melodyland was the EXODUS headquarters? Did you print and mail the newsletter? Gary did. Did you provide hours of phone and in-person counseling at EXODUS during those early years? Gary did. Did you go on many speaking engagements promoting EXODUS programs and services? Gary did.

My comment: By this account, Mr. Cooper did much to get Exodus going. I wanted to post this because I think some of the pain comes from the perception of a denial of Cooper’s investment in the early stages of ex-gay ministry. While I think it is misleading to call Mr. Cooper a co-founder in the formal, organizational sense, I apologize for creating any impression that he was not there or uninvolved. Apparently, Mr. Cooper preferred a more behind-the-scenes role which may be, according to Mr. Bussee, why few others knew his importance.

Who were the other founders?
Others served on the Board, ran their individual ministries and did their part in furthering EXODUS’s mission. The “original” group (we didn’t use the word “founders”) of 7 – 8 persons — including Frank Worthen, Robbi Kenney, Ed Hurst, Ron Dennis, Greg Reid, Jim Kaspar (I pray I have not forgotten someone) — all of us (I am sad to say) played important roles in EXODUS’s formation and growth.

My comment: Mr. Bussee has this to say about the movie and claims that they were the two co-founders of Exodus: “In spite of what any captions (which were added by the film-makers years AFTER Gary and I were interviewed) may seem to say, I NEVER said (and will NEVER claim) that we were the ONLY ones.” After reviewing the video, he is on target. He said that they were two of the original founders of Exodus. The captions made it appear that they were THE two founders.

Ok, so there were other founders. Everybody who was there now agrees. That may about all they would agree about but that much seems clear. Recently, Alan Chambers said in an Exodus newsletter that there were 62 founders in the sense that 62 people came together at the first conference which led to the current organization. What is clear is that this was more a movement in the beginning than an organization and as such it is misleading to say that any two people founded that movement.