APA Task Force Report – Chapter 3 (Methodological Issues)

460The task force indicated that they felt the best way to answer the charge to them was to provide a review of the literature on attempted change of sexual orientation. So the next chapter of the report reviews the methodological issues present in the existing research. The authors also set up the criteria upon which they based their review (such as inclusion/exclusion criteria).

Many people, myself included, have been quite clear that there are definitely methodological limitations in this older research. After all, much of the research was conducted in the 1950s-1970s. The studies were conducted in keeping with the standards of the day, so we want to be careful to keep that in mind when critiquing them from that standpoint. It has also been said that poor methodology does not disprove success.

It is interesting to note, too, that many current textbooks still cite older studies with similar methodologies as evidence for the effectiveness of other approaches to therapy. I remember looking into this several years ago, and one leading family therapy textbook cited studies from the 1970s and 1980s that had similar methodological concerns as evidence for the effectiveness of widely practiced models of family therapy. I think people who feel that the task force unfairly applied rigorous standards to this literature may feel that a similar standard would sink many other therapy models for a wide range of practices. On the other hand, I think those who provide such scrutiny point out the potential for misleading and harmful outcomes are greater given the topic.

On the question of standards being applied consistently, one other observation that has been made about the report is that the task force used different standards when reviewing the evidence about change of orientation than when they looked at the question of harm or how normal homosexuality is or other issues. On these other matters, they cited studies that had significant methodological limitations.

I do agree that it is important that better studies are developed and conducted, particularly if clinicians provide change of orientation therapy. As with so much of counseling and psychotherapy, there is a need to conduct more and better studies on various treatment models.

1 Comment

  1. As I look at this section, I wonder if they have considered other difficult to treat conditions, recognized by psychology as a disorder, such as Narcissistic personality disorder. It’s very interesting that Havelock Ellis was the first to publish on the subject of narcissism and a large portion of his work was in the realm of human sexuality… The prognosis for treatment is also quite poor. It has also been observed by Elan Golomb (1992) in his book “Trapped in the Mirror” that, “Subconscious fears of exposure or inadequacy often cause defensive disdain of therapeutic processes”.

    When assembling the litany of research, there was a decision made which bears witness to some bias. I’m referring to the decision to exclude “grey literature”. Due to the existing policy bias (APA 1997) against SOCE there may be some effect on researchers willing to publish certain results which would not support current policy. You could say that Lisa Diamond’s research is a good example. She showed that change is not only possible, but it occurs spontaneously outside of therapeutic interventions without reports of negative affect. She fumed for years after publishing because the data supports conclusions that were not in harmony with APA policy. They actually recognize this bias when observing, “we found that the peer-reviewed empirical literature after 1981 contains no rigorous intervention trials on changing same-sex sexual attractions” (p.27). I also observe that the statement “The studies in this area also include a highly select group of people who are unique…” has not been supported by any empirical data gathered to distinguish participants from any other individuals that experience same-sex attraction. It is generally observed that highly motivated individuals have made up some of the participants (to vehemently refute the preposterous notion that change does not occur and nobody wants to change) and it is widely understood that a self selection bias plagues almost every corner of research into sexual orientation. Concerns over internal validity of research are reasonable. I suspect that some of these same limitations are not the subject of similar scrutiny in other lines of research. I have recently identified problems with demand effects and social desirability bias which could be expected in ALL research touching on sexual behaviors. Additionally, construct validity is another area which I believe is a valid and reasonable source of problems. The Kinsey scale is simply not sufficient.

    What I took away from this section is that MORE research is needed which adheres to a more rigorous application of approved methods. Let’s get started then…

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