Have mental health associations banned the practice of change therapies?
No. To be sure, nearly all mental health associations have issued advisories concerning sexual orientation change in counseling. The one that has not, the American Mental Health Counseling Association, has taken no position on the subject. However, these organizations have not banned the practice of reorientation therapies. Consider the words of the former Executive Director of the American Psychological Association (APA), Raymond Fowler:
The APA’s position on reparative therapy is that those who wish to explore developing heterosexual feelings or behavior have a right to do so as part of every client’s right to self-determination. If an individual is comfortable with homosexuality, it is not the role of the therapist to convince the client otherwise. If one’s feelings are ego-dystonic and there is a desire to talk about changing, that is an acceptable choice and a psychologist may participate if he or she desires. – Ray Fowler, CEO, APA
This common sense statement makes clear that choosing an objective of reparative therapy is the decision of the client. Despite the fact that the mental health associations have politicized the issue of change, the APA chief makes it clear that participation does not violate ethical guidelines and may be an acceptable course. See also
Ethical Principles of Psychologists and the Code of Conduct, American Psychological Association , Principle D. p 1599, 1992 (“[T]hat psychologists…respect the rights of individuals to privacy, confidentiality,
self-determination and autonomy”). (Emphasis added.)
Dr. Spitzer was asked if the American Psychiatric Association should now revise the position statements revealing skepticism about sexual orientation change. He responded as follows:
I think they should; they will not be. It’s not going to happen in the near future, there’s no way it’s going to happen. I think the only issue is whether it goes beyond the position statement whether they go on to say its an ethical violation to do this kind of therapy but those position statements are not going to change. There’s, there’s a gay activist group that is strong and very vocal and recognized officially by the American Psychiatric Association. There’s nobody to give the other viewpoint. There may be a few people who believe it but they don’t talk. – Dr. Robert Spitzer, Columbia University
So despite Dr. Spitzer’s legitimate concerns that people not be forced into reorientation counseling, he clearly favors a revision in the official skepticism of mental health groups toward ex-gays. Dr. Spitzer has frequently commented that no one has any way to determine how many people can or will change, but he has stood by the view that sexual orientation is much more flexible than he thought before he conducted his study. So why would professional associations overlook the lives of ex-gays and claim reorientation to be ineffective? Dr. Spitzer related a hypothesis concerning that issue:
Now I do have to say that one of the concerns of people who have criticized the – the study has been criticized severely by many people particularly gay activists who apparently many feel quite threatened by it. I think they have the feeling that in order for them to get their civil rights its helpful to them if they can present the view that once you’re a homosexual it can never change. Which may actually, they may be right, politically it does help them but it may not be scientifically correct. – Dr. Robert Spitzer; 3/04
So why do critics keep beating the drum to eliminate reorientation counseling? According to Dr. Spitzer, it may have more to do with political objectives than clinical or professional ones.
The truth is Dr. Spitzer found that his participants benefited from their change experiences. Many were quite depressed prior to entering efforts to change sexuality and much improved afterwards. Dr. Spitzer notes: “
The majority of the subjects reported moderate to severe depression before they were into therapy and there was marked change. Very few were depressed when we saw them.” In terms of numbers, 42% of men and 47% of women were clinically depressed. After counseling for change, only 1% of the men and 4% of the women continued to experience depression.