APA Task Force Report, Preface & Introduction (Chapter 1)

460Several 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.

6 Comments

  1. The document took 2 years to write, it’s 138 pages long (about 90 not counting references) and is very dense reading. If you were not already invested in the debate within the professional community and you wanted perspective for your practice or for an individual client, how would you interpret this document? How would it affect your therapeutic approach with that individual?

    I had visceral reaction to the assignment of members to the task force two years ago. I know Drescher’s M.O. and this document moves away from a psychodynamic approach that utilizes well described therapeutic techniques in favor of newer approaches (non-reparative). In itself, it continues the dialogue in terms which attempt to remain positive and scientific

    In the big picture, it desensitizes the reader to the word “affirmative”. There are many things wrong with it from a purely spiritual point of view. I’m going to need more time to completely understand how this will impact the body of thought surrounding any kind of therapy with same-sex attracted clients. This is already going to complicate the responding in my research project… It’s a mixed bag if you ask me.

  2. The APA is to be much commended for its report. The very idea that homosexuality is an illness that needs to be cured by aversion/conversion or “reparative” therapy is absurd. The APA has taken a solid step in the right direction. Unfortunately, even in this day and age, a large segment of society still regards gay men and women as second-class citizens – or worse. That is the salient point of my recently released biographical novel, Broken Saint. It is based on my forty-year friendship with a gay man, and chronicles his internal and external struggles as he battles for acceptance (of himself and by others). More information on the book is available at http://www.eloquentbooks.com/BrokenSaint.html.

    Mark Zamen, author

  3. James, I think trying to sort out the difference between “gay affirmative” and “affirmative” will be important for the field, particularly if it hopes to take some forms of religious identity and experience seriously. I’d be interested in your take on the spiritual concerns associated with an “affirmatve” approach.

    • I need to start from a very basic place in order to drive a point when it comes to the word “affirm.

      http://www.merriam-webster.com/dictionary/affirm

      You can see it is a transitive verb. A transative verb is a verb that requires both a direct subject and one or more objects.

      Why start with the dictionary? It’s due to the fact that we are missing a key component when we talk about “affirmative” therapy in comparison to “Gay affirmative” therapy. Do you see the difference there? It’s the one word object of the affirmation!!

      Take a look at page 50 where they read a litany of Shidlo and Schroeder (2002). That list of percieved negatives is important. If you think about the prevelence of sexual acting out in the metro communities of gay men (e.g. barebacking, bugchasing) or the epidemic of methamphetamine abuse, then you can see that homopositive points of view have turned reality on it’s head when they say moving away from homosexual ideation causes x, x, and x! They are in essence saying that the efforts to move from homosexual to heterosexual are the sources of negative affect. It’s a fundamental breakdown in communication between the two differing points of view and a symptom of the overall problems with language in the exchange. It’s seems in this document we are missing (or is it?!) that all important object.

      Just what are we affirming? I want to make one more point on this and that is in the arena of couples counseling. If you affirm the homosexual ideation of one spouse that is experiencing same-sex attraction then you are essentially affirming (at a minimum) emotional infidelity and that translates into affirming the violation of one of the ten commandments (adultery). The therapist becomes the stumbling block and now everybody is deeper down a bad road. If we can take a moment to understand that if psychodynamic approaches got everything else wrong, they got the part about narcissism right.

  4. Mark, thanks for stopping by. I went to the site for your book, and your biography sounds interesting. I appreciate your willingness to write about the struggles your friend faced over the years.

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