The Unethical Implications of Reparative Therapy

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God Save the Queen

• The Unethical Implications of Reparative Therapy

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The Controversy A Two-Sided Perspective

• Homosexuality has been a controversial issue in
  Western civilization varying degrees of debate
• Tolerant/accept
• Negativity/hate

What causes homosexuality?
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• According to Dr. Jeffery Satinover,
  homosexuality occurs not through genetic or
  biological evidence, but when boys experience the
  absence of a happy, warm, and intimate closeness
  with his father . . . leading to the boys
  pulling away in disappointment . . . in order to
  protect himself.

In other words, homosexuality according to Dr.
Satinover is due to a distant, or undeveloped,
relationship between a father and a son.
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• Homosexuality is a result of a persons
  suffering a broken gender identity and a stunted,
  stuck sexual development thats gone bad.2
• Moreover, conversion therapist believe the most
  therapeutic method of regaining ones
  heterosexuality is by becoming more of a man or
  more of a women.
• Organizations such as Exodus or Love in Action
  believe individuals need to become more in
  touch with their gender, not their sexuality

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In other words . . .

• These organizations believe a therapeutic cure
  for homosexuality is to engage is gender-specific
  activities, such as boys playing football

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• Dr. Elizabeth Moberly, published author, proposes
  the idea that homosexuality is the result of
  gender identity confusion
• For example, lesbians had an unhappy childhood in
  which the daughter and father were at odds with
  one another thus resulting in a dislike for him.
  This manifest itself into a dislike for all men
  in general and you feel sexually oriented to
  women
• Dr. Moberly suggests gay men and lesbians really
  do not want to be gay thus same-sex
  relationships are doomed not to last.
• As most reparative practitioners suggest, the
  reason behind homosexuality is something went
  horribly wrong during the individuals childhood
  molestation, physical abuse, incest, etc.

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Mental Health Professionals R.T.

• Since homosexuality was depathologized in 1973,
  both critics and advocates have weighed in on the
  debate of homosexuality.
• However, many professional organizations -
  including physicians, mental health professionals
  and agencies advocate and support affirming
  homosexuality
• American Counseling Association, American Academy
  of Pediatrics, American Psychological
  Association, National Education Association, and
  many others

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Exodus International
Conversion therapy
Reparative Therapy
Reorientation therapy
Ex-gay Movement
Love in Action
Sexual Reorientation
Gender Identity Disorder
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History of R.T.

• In 1998, the ACA Governing Council passed a
  resolution with respect to sexual orientation and
  mental health
• ACA opposes portrayals of lesbian, gay, and
  bisexual individuals as mentally ill due to their
  sexual orientation
• Supports dissemination of accurate information
  about sexual orientation, mental health,
  appropriate interventions and instructs
  counselors to report research accurately and in
  a manner that minimizes the possibility that
  results will be misleading.3

3ACA Code of Ethics, 1995, Section G.3.b
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• The following year, the Governing Council adopted
  a statement opposing the promotion of reparative
  therapy as a cure for individuals who are
  homosexual.
• ACA found through a variety of studies the
  following information
• No scientific evidence has been found that
  supports conversion therapy as an effective means
  of changing an individual's sexual orientation
• Conversion therapy may do more harm than benefit
  to clients

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Current Ethical Considerations

• The 2005 Code of Ethics stipulates several
  ethical standards in relation to R.T.
• Standard A.11.b states, If counselors determine
  an inability to be of professional assistance to
  clients, they avoid entering or continuing
  counseling relationships. Counselors are
  knowledgeable about culturally and clinically
  appropriate referral resources and suggest these
  alternatives.

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• Standard D.1.a reminds counselors that
  counselors are respectful of approaches to
  counseling services that differ from their own.
• Thus, since R.T. is or can be harmful to clients
• Standard A.1.a states, the primary
  responsibility of counselors is to respect the
  dignity and to promote the welfare of clients.
• Standard A.4.a continues with Counselors act to
  avoid harming their clients, trainees, and
  research participants and to minimize or to
  remedy unavoidable or unanticipated harm.

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Is treatment necessary?

• Since the removal of homosexuality as a mental
  disorder from the DSM in 1973, what does R.T.
  seek to cure?
• A therapist should only provide treatment that is
  scientifically indicated to be effective.
• Thus if homosexuality is not a mental disorder,
  what is there to be cured?

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• Reparative therapists try to invoke fear in the
  client by using the feelings of isolation,
  rejection, hate, disgust . . . the very feelings
  that society wants the homosexual to feel.
• Rather than teaching the client ways to cope with
  these outside influences, reparative therapists
  have the client thinking the problem is within
  the individual the reason the client feels the
  way they do is because he or she is gay
• R.T. prey upon the weak, instill fear and promote
  negative feelings about oneself.

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Our ethical duty?

• What does one do if a client insists on seeking
  conversation therapy?
• As ethical therapists, our duty is to inform the
  client on the potential harm, while respecting
  the client's decision to seek such treatment.

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The following information could be included as
part of a therapists informed consent
American Counseling Association (2006)
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• Conversion therapy presumes an individual is
  mentally disordered (against what ACA and other
  mental health and biomedical professionals
  believe).
• Any professional who engages in conversion
  therapy is not offering the professional standard
  of care, and is providing counseling within the
  scope of practice of some other profession (i.e.,
  Christian counselor).

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Current Leaders In Reparative Therapy
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• Conversion therapy as a practice is a religious,
  not psychologically-based practice.
• The treatment may include techniques based in
  Christian faith-based methods, such as the use of
  testimonials, mentoring, prayer, Bible readings,
  and Christian weekend workshops.
• However, there is no training or education
  condoned by ACA to educate and prepare a
  professional counselor wishing to engage in this
  type of treatment.

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• Research does not support conversion therapy as
  an effective treatment modality.
• The results of some research on the
  effectiveness of R.T. indicates that some clients
  do change their behavior approximately 30 of the
  time, but the same clients report changing only
  their behavior, not their sexual orientation
• It is easy to stop/change the behavior, not how
  one feels so it is good practice to show
  clients the distinctions between behaviors and
  sexual identity.

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• There is potential harm when clients participate
  in R.T. often reporting feeling worse than
  prior to entering treatment.
• The best treatment for GLBT clients is to seek a
  gay-affirming therapist a therapist that will
  help a client adjust or embrace their sexual
  identity/orientation.

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For further information, visit our website
www.counselingglbt.com
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Resources

• American Counseling Association (1995). Code of
  ethics. Alexandria, VA Author.
• American Counseling Association (2006). Ethical
  issues related to conversion or reparative
  therapy. Alexandria, VA Author.
• Kort, J. (2006). Extreme makeovers What
  reparative therapy is all about. Korts Korner,
  53.
• Satinover, J. (n.d.) How might homosexuality
  develop? Putting the pieces together. Retrieved
  June 26, 2007, from http//narth.com/docs/pieces.h
  tml