This just in from APA’s Public Affairs office via email from Rhea Farberman:

APA Office of Public Affairs
(202) 336-5700
[email protected]

August 15, 2006

Statement by Dr. Gerald P. Koocher Concerning Therapeutic Interventions To Deal With Unwanted Same-Sex Attraction

During the Town Hall Meeting that took place at APA’s 2006 convention, I was asked about the role of patient choice in therapeutic interventions to diminish same-sex attractions.

This is an extremely complex issue. And discussion of it must balance patient choice with the therapist’s ethical obligation to obtain informed consent for any therapy process.

The issue centers on patient choice and the role of the therapist in supporting that choice with fully informed consent—be it sexual orientation or any other behavior or emotion.

In a full multifaceted therapeutic relationship, the therapist has every duty to respond to patient choice and to help patients achieve their goals. I affirmed during the Town Hall discussion, and I will always affirm, the crucial importance of providing our services with careful attention to patients’ wishes.

BUT—and this is absolutely essential, especially when dealing with sexual orientation—the therapeutic responsibility, in strict accordance with APA guidelines, MUST also include the following considerations:

One: The therapist has an obligation to carefully explore how patients arrive at the choices they want to make. Therapists must determine whether patients understand that their motives may arise purely from the social pressures of a homophobic environment. No type or amount of individual therapy will modify societal prejudices.

Two, informed consent: Patients must understand the potential consequences of any treatment, including those intended to modify sexual orientation. Patients must understand that such treatments lack a validated scientific foundation and may prove psychologically harmful.

Finally, I would add that our patients ought to know from the very start that we as their therapists do not consider homosexuality a mental disorder. In fact, the data show that gay and lesbian people do not differ from heterosexuals in their psychological health. By that I mean that they have no greater instance of mental disorders than do heterosexuals.

Dr. Koocher is the President of the American Psychological Association.

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Australian paper on the APA and the President Koocher’s comments regarding therapy for same-sex attraction conflicts.

Today’s Washington Times addresses the differences in interpreting APA President Gerald Koocher’s remarks at the APA convention last month. We covered that issue here at that time noting that President Koocher clarified his remarks following the APA Town Hall meeting.

The Washington Times site has been down most of the last two days. Here is the article from the Google cache.

APA denies any retreat on gay therapy

By Joyce Howard Price
THE WASHINGTON TIMES
September 3, 2006

Some pro-family groups say recent comments by the head of the American Psychological Association suggest the organization is softening its opposition to treating homosexuals who want to change their sexual orientation.

The APA denies any changes in its stance, and the president later clarified his statements.

The Rev. Lou Sheldon, founder and chairman of the Traditional Values Coalition, a group that believes some homosexuals can become heterosexuals through “deep reparative therapy,” said he is convinced “peer pressure came down on the APA president like a mountain cougar and forced him” to back away from public comments he made less than a month ago.

“The APA has no conflict with psychologists who help those distressed by unwanted homosexual attraction,” said Gerald P. Koocher, president of the 155,000-member APA, at the group’s annual convention in New Orleans last month.

In an e-mail message early last week, Sharon Slater, president of United Families International, a nonprofit that works to protect the family as the fundamental unit of society, called Mr. Koocher’s comments “an amazing turnabout,” given that for more than 30 years, the “APA has aggressively opposed treatment of unwanted same-sex attraction.”

Leaders of groups engaged in treating homosexuals who want to become heterosexuals, such as the National Association for Research and Treatment of Homosexuals and Exodus International, also described Mr. Koocher’s remarks as a positive development. They indicate the APA is “recognizing a person’s autonomy and right to self-determination,” Alan Chambers, president of Exodus International, told the Baptist Press. Mr. Chambers and other therapists who offer such treatment picketed outside the APA convention and believed their presence was a contributing factor in Mr. Koocher’s comments.

But the APA executive clarified his comments shortly after the convention. “In a full, multifaceted therapeutic relationship, the therapist has every duty to respond to patient choice and to help patients achieve their goals,” Mr. Koocher said. “I will always affirm the crucial importance of providing our services with careful attention to patients’ wishes.”

But Mr. Koocher said discussion of interventions in the “extremely complex issue” of sexual orientation “must balance patient choice with the therapist’s ethical obligation to obtain informed consent for any therapy process.” “When dealing with sexual orientation,” he said, a therapist “must” be sure that a person wishing to change is not “motivated purely from the social pressures of a homophobic environment” because therapy “will not modify societal prejudices.” Mr. Koocher further stressed that “patients must understand” that treatments intended to modify sexual orientation “lack a validated scientific foundation and may prove psychologically harmful.”

There is not much new here but the Times is the only paper that I know of that has covered the post-convention spin.

In a Q&A today at the American Psychological Association convention in New Orleans, APA president Gerald Koocher was asked about a client’s right to seek therapy to modify same-sex attraction. He reportedly said (and I am seeking confirmation from the APA) that clients may seek psychotherapy to affirm their religious values even if that meant that the therapy involved objectives to modify same-sex attractions. He reportedly said that it would not be outside the APA’s ethical guidelines to work with such a client toward the client’s chosen course, even if that course meant seeking to reduce or eliminate same-sex attractions.

Update: I spoke with David Blakeslee who was in the Q&A and asked Dr. Koocher a question about APA guidance regarding clients who have religious conflicts surrounding sexuality. Dave’s question went something like this: “Dr. Koocher, I appreciate you participation in constructing and presenting guidelines for ethical behavior and attended your conference in Portland 18 months ago which I found very helpful. As a social and religious conservative I have found myself in a difficult situation about which I think the APA has not provided sufficient ethical guidance. I have been sought out by clients with deeply held religious beliefs who also have unwanted same-sex attractions. For these persons their religious beliefs are even more important to their identity than their same-sex attractions. Because of APA’s lack of guidance in this matter, I am forced to seek advice outside APA. What is APA doing to give explicit guidance to psychologists like myself and thereby ensure that treatment of my clients honors their deeply held religious beliefs as they struggle with their same-sex attractions and is consistent with APA values of self-determination and client autonomy?”

In addition to what I reported above, Dr. Koocher reportedly emphasized that the therapeutic relationship is constructed by both the client and the therapist along the goals of the client and that the whole person must be taken into account when considering an intervention.

Dave tells me that Dr. Nicolosi followed up with a comment that his response seemed in conflict with official policy of the APA on homosexuality and that clients sometimes come to therapy wishing to explore their potential for heterosexual attraction; to which Dr. Koocher reemphasized his position of client self-determination and then cautioned about coercion.

I have heard back from Rhea Farberman, of the APA Publication Office this morning that she will soon give a complete response to my request for confirmation. She did add this:

In brief, this is a complex issue and one about which we seek to balance patient choice with the therapist’s obligation to gain informed consent. There are also questions about the efficacy of therapies intended to change sexual orientation and potential harm of such techniques. APA’s position is based on the standing Council of Representatives resolution on the topic.

Hit the link for the APA’s official statement. Anything that is said here or is said anywhere must be interpreted in light of that resolution.

My take on this is that the APA has stopped short of banning change therapies but guides psychologists to inform clients of the APA position on homosexuality, to forbid coercion, to oppose therapy that has as its premise homosexuality per se is a mental disorder and to avoid making public statements that cannot be supported.

Now where have I read guidance consistent with that…