Reorientation therapies in the UK: Survey results

A new survey from BMC Psychiatry found that 4-17% of therapists surveyed offer some form of therapy designed to reduce homosexual attractions.
From the article in the BBC News:

A significant minority of mental health professionals had agreed to help at least one patient “reduce” their gay or lesbian feelings when asked to do so.
The survey, published in the journal BMC Psychiatry and conducted by London researchers, involved 1,400 therapists.
Many were acting with the “best of intentions”, said the lead author.
Only 4% said they would attempt to change a client’s sexual orientation, but when asked if they would help curb homosexual feelings some 17% – or one in six – said they had done so.
The incidence appeared to be as prevalent in recent years as decades earlier.

Here is the abstract from the journal article:

Background
We know very little about mental health practitioners’ views on treatments to change sexual orientation. Our aim was to survey a representative sample of professional members of the main United Kingdom psychotherapy and psychiatric organisations about their views and practices concerning such treatments.
Methods
We sent postal questions to mental health professionals who were members of British Psychological Society, the British Association for Counselling and Psychotherapy, the United Kingdom Council for Psychotherapy and the Royal College of Psychiatrists. Participants were asked to give their views about treatments to change homosexual desires and describe up to six patients each, whom they have treated in this way.
Results
Of 1848 practitioners contacted, 1406 questionnaires were returned and 1328 could be analysed. Although only 55 (4%) of therapists reported that they would attempt to change a client’s sexual orientation if one consulted asking for such therapy, 222 (17%) reported having assisted at least one client/patient to reduce or change his or her homosexual or lesbian feelings. 413 patients were described by these 222 therapists: 213 (52%) were seen in private practice and 117 (28%) were not followed up beyond the period of treatment. Counselling was the commonest (66%) treatment offered and there was no sign of a decline in treatments in recent years. 159 (72%) of the 222 therapists who had provided such treatment considered that a service should be available for people who want to change their sexual orientation. Client/patient distress and client/patient autonomy were seen as reasons for intervention; therapists paid attention to religious, cultural and moral values causing internal conflict.
Conclusions
A significant minority of mental health professionals are attempting to help lesbian, gay and bisexual clients to become heterosexual. Given lack of evidence for the efficacy of such treatments, this is likely to be unwise or even harmful.

Going a little deeper into the study, it appears that some of the efforts designated as change might not be direct efforts to change after all. Consider some reasons given for what is labeled by the authors as support for change efforts:

“…where someone had a strong faith, then working to help the person accept their feelings but manage them appropriately may be the best approach if (the) person felt they would lose God and therefore their life was not worth living.”
“Some bisexual individuals may wish to choose an orientation that is
comfortable for them and their lifestyle choices for example. This is a
therapeutic issue to explore and support if that is their wish. It is different from behavioural attempts to reshape desire.”
“Yes, possibly those within marriages that wish to continue with that
relationship rather than break up”

Rather, these therapists give what sound like client-centered responses based on the individual circumstances of the clients. I wonder if the authors of this article may have pushed these responses into either change or gay affirming camps without considering a third more neutral position – what Mark Yarhouse and I call sexual identity therapy.
Most of the other comments relied on a belief that therapists should follow the wishes of the client. This seems reasonable if the client is informed that change is infrequent at best and we do not know going in who might shift and by how much. Also, it is necessary to provide prospective clients with accurate information regarding homosexuality without regard to the ideological loyaties of the therapist. Also, it seems clear that non-homosexually identified people experience same-sex attraction. Helping them sort out their particular situation and arrive and a value-congruent position is not the same thing as reparative or reorientation therapy.
The authors paint a picture of 1 in 6 therapists engaging in change therapy and I think that is misleading. The 4% figure seems like the right number of therapists who deliberately promote change among their same-sex attracted clients.