Several people have asked if I would offer more of a review of the APA Task Force Report on Appropriate Therapeutic Responses to Sexual Orientation. Many people and organizations appear to be supportive of the document, while others have been critical. What I’d like to do is walk through the background document and discuss some of the points that stand out to me from various chapters and just offer reflections. So let’s start with Chapter 1, which is the Introduction.
The Preface opens with the charge of the task force, which included offering guidance on appropriate ways to respond to requests by adult to change their sexual orientation or behavior, how to respond to children and adolescents who have similar requests (or whose parents or guardians do), relevant issues in education and training, and other related matters. The report mentions the nomination process and selection of task force members. They note that the task force felt it best to review the relevant research on sexual orientation change efforts (SOCE). The report mentions that it was open for public comment and lists the reviewers.
The Introduction gives context to the report by discussing what is meant by “affirmative” approaches to sexual minorities. There is also a discussion of sexual stigma and relevant psychology of religion research. Both of these sections are important, but let me highlight the definition of “affirmative,” as it could be confused with “gay affirmative therapy,” which is a general approach to therapy that is often contrasted with other approaches. Anyway, here is part of what they say:
We define an affirmative approach as supportive of clients’ identity development without a priori treatment goals for how clients identify or express their sexual orientations. Thus, a multiculturally competent affirmative approach aspires to understand the diverse personal and cultural influences on clients and enables clients to determine (a) the ultimate goals for their identity process; (b) the behavioral expression of their sexual orientation; (c) their public and private social roles; (d) their gender roles, identities, and expression; (e) the sex and gender of their partner; and (f) the forms of their relationships. (p. 14)
They acknowledge in this same section that a gay affirmative approach generally emphasizes (or presumes) the adoption of a gay identity as the preferred outcome for an individual; that has been the primary reference point. However, in keeping with the concerted effort to understand the experiences of those who do not identity as gay, the report begins with a more client-centered and identity-focused approach that leaves the outcome more open-ended. Undoubtedly, some people will struggle with how best to respond to the affirmative framework. I am thinking specifically of social conservatives (religious or not) who may not agree with all of what is asserted in other sections of the Introduction. However, this idea that a model can be affirmative in a broad sense of being client-centered and identity-focused holds appeal to many clinicians and provides something of a starting point for the document.