Evolution, Adaptations, Social Pressure, and Pruning

As we have witnessed changes at Exodus International in their approach to ministry, their view of reparative therapy, and other developments, I want to reflect a little not on Exodus as such but on how Christians and various institutions and ministries evolve in response to a rapidly changing sociocultural climate. It is important that an organization is clear about what it believes and why, so that its primary motivation is to provide clarity about its brand.

One unintended consequence of organizations revisiting their brand is related to the positive feedback they receive from others. If that becomes the focus, they can get themselves into a dilemma. They do well to keep in mind that not everyone will support changes that fall short of a ministry reflecting a completely different conclusion than the one they hold doctrinally.

To return to the example of Exodus, consider the post over at ThinkProgress titled: “Ex-Gay Group’s Rebranding Makes it No Less Dangerous or Wrong.” There has been so much pressure on Exodus and other ministries to move away from a focus on change of sexual orientation that you would think that if they made that shift it would be seen as a welcomed development. The reality is, for some people and organizations, no shift will be sufficient if it falls short of a fundamental change in formed moral evaluation of all aspects of homosexuality, including same-sex behavior.

At its core, the organization clearly still believes that homosexuality is the cause of a person’s struggles, not the anti-gay society in which they live. Regardless of how these therapists attempt to treat homosexuality, they are still causing harm by trying to treat it at all — in complete violation of all social science research and ethics. As Truth Wins Out’s Wayne Besen notes in the AP article, “The underlying belief is still that homosexuals are sexually broken, that something underlying is broken and needs to be fixed. That’s incredibly harmful, it scars people.”

I haven’t really said much about the developments at Exodus. Generally speaking, however, I see a focus on identity, behavior, and spiritual maturity as a more constructive framework than a narrow focus on orientation, in part because that focus can become the measure of self-worth and spiritual maturity, which is a mistake in my view. That said, if a group makes changes in anticipation that others will cease to criticize them, they will be in for a rude awakening. (I’m not saying that is what happened with Exodus; I am saying that as a principle for Christians and ministries to consider.)

As Christians (and Christian institutions and ministries) take in new information, new data, respond to shifts in culture, and consider how they want to position themselves in relation to the topic and the people who are represented by that subject matter, they will benefit from making changes that truly reflect who they are, what their brand is. At the same time, keep in mind that the new brand–as accurate as it may be–will  still be utterly rejected  by some.

The question will arise: Can you hold convictions independent of the approval of others?

On the upside, these pressures help provide clarity about what people (and institutions/organizations/ministries) believe and why. It can be seen as a kind of pruning back the extra things that a person does not really see as critical, with the idea that what remains is essential.

Exodus International Further Distances Itself from Reparative Therapy

I’m unable to comment much on this due to my schedule this week, but several news outlets are reporting on the further distancing from reparative therapy by Exodus International. I don’t see this as a new story, but rather a further elaboration of what appears to have been developing at Exodus. It is likely getting more attention this week due to the Exodus International conference that is taking place.

Wheaton College & The CACTC

I will soon be teaching an intensive course at Wheaton College in Wheaton, Illinois. The course I teach is a graduate-level course titled Sexuality & Sex Therapy (I teach a similar course in my program.) It’s intensive because it is completed in just one week.

How is the course organized? We take the first couple of sessions to cover various perspectives on sexuality (i.e., theological, sociocultural, biological, and clinical). Then we discuss various presenting concerns, such as several of the sexual dysfunctions (e.g., dyspareunia, desire disorder), sexual addiction, the paraphilias, gender identity concerns, and so on.

While I am in the Chicago area, I will also provide a 2-hour training at the Chicago Area Christian Training Consortium (CACTC). The CACTC is an APA-approved pre-doctoral training program. That talk will be a 10-year review of the literature on various models of services for sexual minorities. I had completed a similar review that was published in Professional Psychology: Research and Practice in 2002. Hence the update on the past 10 years. In the context of that training, I will also provide a primer on Sexual Identity Therapy following the SIT Framework and develop more of how I provide SIT in my own practice.

AACC Statement on Michigan HB 5040

The American Association of Christian Counselors (AACC) issued a statement today on Michigan legislation HB 5040, also referred to by some as the “freedom of conscience” legislation. Here is the statement in its entirety:

“Freedom of Conscience Act” Protects Christian Counselors through Values-based Referrals

Last week, the Michigan House of Representatives passed HB 5040, named the “Julea Ward Freedom of Conscience Act.” This legislation affirms a counseling student’s “freedom of conscience” from providing mental health services that contradict and/or conflict with personal religious beliefs, including affirmative gay therapy. The law, in part, reads as follows:

A public degree or certificate granting college, university, junior college, or community college of this state shall not discipline or discriminate against a student in a counseling, social work, or psychology program because the student refuses to counsel or serve a client as to goals, outcomes, or behaviors that conflict with a sincerely held religious belief of the student, if the student refers the client to a counselor who will provide the counseling or services.

Instead of requiring counselors-in-training to continue providing therapy to a client whose value system is in direct conflict with their own, the bill offers another option called values-based referrals. This approach presents a refreshingly balanced, but also professionally consistent, ethical response to complex value conflicts within the therapeutic relationship.

In situations where a client’s presenting problem and requested treatment focus lies outside of a counselor’s deeply held personal beliefs, values, and convictions, counselors-in-training would be instructed to skillfully refer the client to another clinician who can offer the treatment and assistance the client desires. While many law proposals have focused primarily on the client’s right to treatment, the “Freedom of Conscience Act” considers both the client’s right to self-determination, as well as the counselor’s right to freedom of conscience.

Speaking to this important issue, AACC President, Dr. Tim Clinton, said, “Every responsible academic and clinician knows that there will always be the potential for value conflicts in counseling, and they are not all related to spirituality. Ethical counselors operate under informed consent, respect for client self-determination, and refer clients in a professional manner when a values conflict takes place in professional counseling and psychotherapy. This approach also makes sense, both professionally and ethically, because research shows that therapeutic alignment in counseling is significant to positive outcomes.”

The value-based referral approach supported by HB 5040 does just that—assuring that all clients can get the help they need from a therapist who offers treatment within the same worldview, while at the same time preserving each counselor’s freedom of personal and religious values.

The bill was introduced in response to Julea Ward’s religious discrimination case that led to her expulsion from the Eastern Michigan University counseling program. During her practicum, Ms. Ward faced this challenge while working with a client who asked her to affirm his gay lifestyle. As a committed Christian, Ms. Ward’s personal religious beliefs were in direct conflict with the client’s desired treatment goal, but she was told that a values-based referral was not an option.

Contrary to the views of some who criticize the bill, the “Freedom of Conscience Act” represents significant progress in responsibly addressing the ethical challenges that often arise in the counseling profession. It has always been the ethical duty of mental health providers to connect clients with another professional who can render quality care when the presenting issue lies outside of their area of expertise or core value system. The Michigan House of Representatives is to be applauded for taking on this ethical challenge, rather than avoiding it.

The bill passed the House 59-50 and will now go before the Senate for review.

Pending Letter to the Editor on Regnerus Study

Today I came across a letter to the editor that is being sent around in an attempt to add scholars as signatories before it is sent to the editor of Social Science Research, the journal that published the Regnerus study. Recall that the Regnerus study reported differences between children raised by a parent who had had a same-sex relationship and children whose parents were in intact, heterosexual marriages.

The letter has been drafted by Gary Gates of The Williams Institute at UCLA School of Law. The web site at The Williams Institute says it is a think tank that “advances sexual orientation and gender identity law and public policy through rigorous, independent research and scholarship, and disseminates it to judges, legislators, policymakers, media and the public.”

The letter acknowledges straight away that it (the letter) could be viewed as essentially a call to censor unwelcome research findings: “While the presence of a vibrant and controversial public debate should in no way censor scholarship, it should compel the academy to hold scholarship around that topic to our most rigorous standards.” Clearly the signatories do not want their letter to be viewed as a call to censor unwelcome research findings.

The letter questions three main points: (1) what appears to be an accelerated review process (i.e., 5-week submission to publication), (2) the selection of commentators (none of whom is believed by the signatories to have expertise in LGBT families), as well as (3) specific concerns with various aspects of the methods and analyses.

As I discussed here, I don’t have quite the same reaction to the study, although I appreciate some of the points raised in the letter. Some of the requested information could be provided or discussed further, and perhaps that would be helpful, but it might just not be enough to satisfy critics given the amount of attention and scrutiny the study is receiving.

My reaction may also reflect a different philosophy toward research findings in general. I tend to see published research as an ongoing dialogue within the scientific community. So various decisions that are made in terms of methods and analyses should be explained to the reader. If that happens, then there is more latitude around what is published (again, provided it goes through the peer-review process and is determined – by peers – to be warranted or justifiable and clearly explained to the reader).

The challenge that comes up with controversial topics is not so much that these limitations exist (as limitations exist in all research) but that they are not fully understood by others outside of the scientific community. I am thinking here of policy-makers and others who make decisions based on their understanding of a study or larger body of research.

Of course, this cuts both ways: existing research on this very topic is not very good either (in terms of sample size, use of convenience samples, non-representative samples, and so on). So it would be helpful if critics were also vocal about the limitations seen in other studies. It may be human nature to give a pass to these same standards when findings fit our own biases and interests. When a study’s findings do not, we may be more apt to identify its weaknesses/limitations and call for higher standards and greater scrutiny.

It will be interesting to see how the letter is received and whether anything will be done in response. There are already several prominent signatories, and I imagine more will be added in the next day or so.

FYI: Here is a contrasting letter from the Baylor University Institute for Studies of Religion in support of the publication of the Regnerus study.

Defining Exodus: A Letter from Alan Chambers

Update: Here is an interview with Alan Chambers that appeared in The Atlantic.

Here is a letter from Alan Chambers, President of Exodus International. It is his attempt to define Exodus as a ministry in light of the public relations challenges they face as an organization in light of a rapidly-changing cultural context around LGB issues. Let me encourage you to read the letter in its entirety, but here are a few nuggets that stood out to me:

Exodus International is repeatedly accused of seeking to make gay people straight through conversion therapy and prayer. As the media and culture rage around us, drawing battle lines in the sand and seeking to fuel the debate about homosexuality, my team and I have been working diligently to clearly state the calling of this great ministry and focus solely on that work. We want to reiterate that our mission is, first and foremost, to serve, support and equip the Church in providing refuge to individuals or families impacted by same-sex attractions (SSA).  Quite simply, our goal is to make the Church famous for loving and serving people as Jesus would and pointing them to Him.

People seeking this encouragement and guidance do so because they have decided to pursue an identity or life based on their relationship with Christ over their same-sex attractions.

We believe that in Christ we have been given completely new hearts and the ability to have power over the sin that remains confined to our earthly flesh.  While believers absolutely can fall to temptation, the mark of a maturing believer is finding increased victory in areas that have, at times, overwhelmed us. …

We respect everyone’s right to pursue their own course as it relates to seeking resolution for struggles. No one is ever coerced, forced into therapy, nor do we seek to ‘pray away the gay’ as many have suggested.  In fact we are no longer an organization that associates with or promotes therapeutic practices that focus on changing one’s attraction.  I found the greatest amount of freedom when I stopped focusing on my sin and struggles and started focusing on the grace and peace found only in Christ and the man He created me to be.  This life isn’t most about sin management but about living daily as the sons and daughters of God.  In part, it is the peace and rest found in that identity alone that transforms us daily.

Exodus does not believe SSA is sinful.  However, sexual expression resulting from SSA is. Making such clear distinctions has been a failure of the Church that is slowly being realized and changed. …

We must all recognize that behavior resulting from SSA is not easily overcome. Many may struggle for the rest of their lives with some form of temptation or unwanted feelings. That is the nature of human experience on earth. However, we do believe God’s grace can give us the ability to live beyond the power of our temptations as we acknowledge and yield our weakness to Him.  Change is possible for every human being who has a destiny-altering encounter with Jesus Christ.  But, change isn’t the absence of struggle but rather the freedom in the midst of struggle to choose differently.

Histrionic Personality Disorder?

With the recent request to introduce histrionic personality disorder in the Sandusky trial, it occurred to me that many people may not be familiar with personality disorders in general, let alone histrionic personality disorder. Here’s a quick summary adapted from our book, Modern Psychopathologies: A Comprehensive Christian Appraisal (Yarhouse, Butman & McRay, InterVarsity Press, 2005).

Mental health professionals have identified a group of disorders that reflect persons who have enduring patterns of maladaptive behaviors that are not a response to crisis, stress, or trauma. They are a more consistent way of relating. These maladaptive ways of relating impair social functioning and cause others distress typically. We call them personality disorders, and they are not without controversy throughout the history of making diagnostic categories.

Today they are organized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) into three major categories/clusters. There is the “odd or eccentric” cluster (Cluster A); the “dramatic, emotional or erratic” cluster (Cluster B); and the “anxious or fearful” cluster (Cluster C). The Cluster B group includes antisocial, borderline, narcissistic, and histrionic personality disorders.

It is the histrionic personality disorder that is becoming a point of controversy in the Sandusky trial. The public is likely more familiar with antisocial and borderline personality disorders from the portrayal of them in the media and entertainment. Histrionic personality disorder is typically characterized by a desire to be the center of social relationships. Often people diagnosed with histrionic personality disorder are described as self-centered and demanding, consistently looking for approval from others and focusing on their own accomplishments.

We seem to know a little more about the causes of antisocial and borderline personality disorders, and we have less clarity around histrionic personality disorder. Various psychosocial and interpersonal theories have been advanced.

The general themes for treating histrionic personality disorder include reducing demands, emotional ‘temper tantrums’ and seductiveness in relating to others. The person needs to learn to reduce their own need for attention for the wrong reasons. They learn how to develop more real and authentic relationships, which would be reciprocal and reflect a more consistent mood state and fewer dramatic displays of emotion.

It will be interesting to see where this development in the trial goes. Appealing to a personality disorder raises the question of what that means in the context of personal volition for behavior. It is apparently a novel and largely untested defense, as it is not the same as an insanity plea and it’s unclear exactly what will be claimed in light of a condition that is challenging to diagnose.