We are often asked how sexual identity therapy is different than reorientation therapy and gay affirmative therapy. Here are some things you might hear in either one of those two approaches, but should not hear in SIT.

To heal homosexuality, one must relive past wounds.

Same-sex attracted people are touch deprived, so you need to receive healthy touch in therapy in order to change.

Homosexuality is a gender identity disorder.

You were born gay and you should accept that as who you are.

Experts agree that people are gay because ______.

Anyone can completely be free of homosexual attractions if they are motivated.

If you are attracted to the same sex, you are not trusting God enough.

Coming out of the closet is the only way to be really well-adjusted.

Your religion is homophobic and heterosexist, you should consider changing your church.

Feel free to post other sayings you should not hear in sexual identity therapy.

It has come to our attention that some websites have hosted the SIT framework without our permission.

The most current version of the SIT framework is here and supportive bloggers, and professionals should link to this site. We require that others who might like to host the pdf file get our first.

Please direct questions to Warren Throckmorton at warrenthrockmorton@gmail.com.

Part 1

Part 2

Please leave comments here via the comment feature. Extensive comments on the SIT Framework can be directed to Warren Throckmorton at ewthrockmorton@gcc.edu and/or Mark Yarhouse at markyar@regent.edu.

Sexual Identity Therapy Framework to Be Reviewed

The Sexual Identity Therapy Framework, authored by Warren Throckmorton and Mark Yarhouse, will be reviewed in 2008 for possible revision. Proposed as a means to help counselors work with clients who experience value conflict surrounding homosexual attractions, the Framework is endorsed by Nicholas Cummings, the father of managed behavioral healthcare and Robert Spitzer, the architect of modern psychiatric diagnosis. The framework respects diversity of sexual orientation and religious practice. The authors are asking for public and professional comment on the Framework though January and February, 2008.

Interested persons can review the Framework at http://www.sexualidentity.blogspot.com. One may leave comment there. Therapists interested in a registry of therapists who adhere to the Framework should visit, www.sexualidentityinstitute.org.

Selected endorsements:

I have reviewed the sexual identity framework written by Warren Throckmorton and Mark Yarhouse. This framework provides a very necessary outline to help therapists address the important concerns of clients who are in conflict over their homosexual attractions. The work of Drs. Throckmorton and Yarhouse transcend polarized debates about whether gays can change their sexual orientation. Rather, this framework helps therapists work with clients to craft solutions tailored to their individual situations and personal beliefs and values. I support this framework and hope it is widely implemented.

Robert L. Spitzer, M.D., Professor of Psychiatry, Columbia University, New York State Psychiatric Institute, New York City, NY. Dr. Spitzer was Chairman of the committee that developed the Diagnostic and Statistical Manual of Mental and Emotional Disorders, 3rd Edition and 3rd Edition (Revised).

Drs. Throckmorton and Yarhouse have brilliantly resolved contention in psychotherapy by providing the field with unbiased guidelines that are responsive to scientific evidence, are sensitive to professional practice, and which restore patient determination in choosing his/her goals in psychotherapy.

Dr. Nicholas Cummings, PhD, ScD is Distinguished Chair in Psychology, University of Nevada, Reno. Dr. Cummings is the President of the Foundation for Behavioral Health and Chairman of the Nicholas & Dorothy Cummings Foundation, Inc. He was the founding CEO of American Biodyne (now Magellan Behavioral Care). He is also the former President of the American Psychological Association. Dr. Cummings was the founder of the four campuses of the California School of Professional Psychology, the National Academies of Practice, and the American Managed Behavioral Healthcare Association. He was the former Executive Director of the Mental Research Institute. Dr. Cummings is the co-editor with Rogers Wright of Destructive Trends in Mental Health.

A recent LA Times article by Stephanie Simon references the sexual identity therapy framework as providing guidelines for the new paradigm of helping people with conflicts over sexual orientation.

Dr. Spitzer recently wrote in an email:

I have reviewed the sexual identity framework written by Warren Throckmorton and Mark Yarhouse. This framework provides a very necessary outline to help therapists address the important concerns of clients who are in conflict over their homosexual attractions. The work of Drs. Throckmorton and Yarhouse transcend polarized debates about whether gays can change their sexual orientation. Rather, this framework helps therapists work with clients to craft solutions tailored to their individual situations and personal beliefs and values. I support this framework and hope it is widely implemented.

Robert L. Spitzer, M.D., Professor of Psychiatry, Columbia University, New York State Psychiatric Institute, New York City, NY. Co-editor of the Diagnostic and Statistical Manual of Mental and Emotional Disorders, 3rd Edition and 3rd Edition (Revised).

Feel free to offer comments…

News Release

New Paradigm to Help People with Sexual Orientation Conflicts

“Drs. Throckmorton and Yarhouse have brilliantly resolved contention in psychotherapy by providing the field with unbiased guidelines that are responsive to scientific evidence, are sensitive to professional practice, and which restore patient determination in choosing his/her goals in psychotherapy.” — Dr. Nicholas Cummings, past president, American Psychological Association

MEDIA ADVISORY, April 16 — When Rev. Ted Haggard’s ongoing struggle with homosexuality became public last November, the nation’s attention turned to how people resolve conflicts between strongly held personal beliefs and homosexuality. Now, two prominent clinicians have crafted a framework, endorsed by an American Psychological Association past-president, that will help counselors and clients address such conflicts in order to achieve a valued sexual identity. This new paradigm is authored by Warren Throckmorton, Fellow for Psychology and Public Policy with the Center for Vision and Values at Grove City College and Mark Yarhouse, Professor of Psychology at Regent University and Director of the Institute for the Study of Sexual Identity.

The framework, titled “Sexual Identity Therapy: Practice Framework for Managing Sexual Identity Conflicts” have been endorsed by American Psychological Association past-president Dr. Nicholas Cummings and other prominent clinicians. A partial list is available on the website or by request.

Why the Sexual Identity Therapy Framework is Needed

Dr. Throckmorton says, “We believe the mental health professions could provide more specific guidance about situations where clients experience religious and value conflicts over sexual attractions to the same sex. We don’t know what causes homosexual behavior for any given individual nor do we know how much, if any, change in attractions might be possible but what we can do is help clients to pursue lives they value. In our application of this paradigm with clients, we have found clients to have high levels of satisfaction with this approach.”

“People who struggle with sexual identity concerns ought to be able to meet with mental health professionals who can assist them to reach a place of congruence in their lives. We believe this framework provides clinicians with a general map, so that they can work collaboratively with their clients to navigate their concerns and ultimately arrive at a place of congruence, so that clients’ behavior and identity lines up with their beliefs and values,” explains Dr. Yarhouse.

The sexual identity paradigm of Throckmorton and Yarhouse is crafted with the recognition that we do not know precisely what causes the individual direction of sexual orientation nor can we say to what degree sexual orientation can change. Thus, therapists should not assume why clients have the attractions they do but rather conduct individualized assessments. Furthermore, instead of focusing on change or uncritical acceptance of undesired attractions, therapists strategically work with people to develop a life consistent with personal values and beliefs.

Dr. Cummings says, “Drs. Throckmorton and Yarhouse have brilliantly resolved contention in psychotherapy by providing the field with unbiased guidelines that are responsive to scientific evidence, are sensitive to professional practice, and which restore patient determination in choosing his/her goals in psychotherapy.”

Sexual Identity Therapy Discussion Group

Mental health professionals who affirm the sexual identity therapy framework are invited to join the Sexual Identity Therapy Discussion Group. This group is an online forum devoted to ongoing development and implementation of the sexual identity therapy framework and related issues. Mental health professions desiring to join may do so at www.sexualidentity.blogspot.com or by writing Warren Throckmorton, PhD, co-moderator, at ewthrockmorton@gcc.edu.

Warren Throckmorton, Ph.D. is Associate Professor of Psychology at Grove City College, and Fellow for Psychology and Public Policy in Grove City College’s Center for Vision and Values. He produced, I Do Exist, a documentary about sexual identity.

Mark A. Yarhouse, Psy.D., is a licensed clinical psychologist and Professor of Psychology at Regent University, where he also directs the Institute for the Study of Sexual Identity (www.sexualidentityinstitute.org).

Several new people have endorsed the Sexual Identity Therapy Framework. To read the comments, click here.

The following individuals have provided supportive comments.

Nicholas Cummings, PhD, ScD

Stanton L. Jones, PhD

Lee Beckstead, PhD

Merton Strommen, PhD

David Blakeslee, PsyD

Kenyon Knapp, PhD, LPC, NCC

Michael Bussee, MA, MFT

Michael A. Rosebush, PhD, LPC

Steven Donaldson, MA, LPC

David C. Pruden, MS

This is not a statement specifically regarding the SIT guidelines but rather in response to a Q&A meeting at the APA 2006 convention. Let me clear, Dr. Koocher is not endorsing the SIT guidelines. However, this statement is so consistent with them, that I wanted to post it here. This was received 8/15/06 via email from Rhea Farberman, APA Public Affairs Office.

APA Office of Public Affairs
(202) 336-5700
Public.Affairs@apa.org

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.

Earlier this year, I (Throckmorton) was a part of a lively discussion about sexual identity therapy on the Counselor Education and Supervision network list serv. Near the end of the discussion, a listserv participant asked Stephen Hayes about his views of sexual identity therapy.

Dr. Hayes gave me permission to post his reply to the participant:
——————————————————————-

To the CESNET list serv – 4/10/2006

Earlier Warren referenced Acceptance and Commitment Therapy as a model for his stance. This intrigued me since I’m currently reading Steve Hayes’ workbook “Get out of you mind and into your life” which is incredible! I struggled with Warren’s reference, because my understanding thus far is that ACT is grounded in the notion that we find relief from suffering through acceptance first and then value-consistent action. And that first step is crucial. It is NOT a kind of short-hand, I’ll accept it so I can get rid it. It is true acceptance. I was having trouble piecing that together with changing sexual orientation. So I wrote Steve Hayes and asked how his model would address clients who are seeking to align their identity with deeply held religious beliefs, when those beliefs clash with their sexual orientation. He has permitted me to forward his response, below, to the listserv. I hope you find it useful and I advocate strongly that if there is a panel to discuss this issue that Steve Hayes be invited to speak.

Name removed by request of the author

—–Original Message—–
From: Steven C. Hayes [mailto:]
Sent: Sun 4/9/2006 3:35 AM
To:

Subject: RE: ACT and changing sexual orientation??

ACT is about empowering people to live their values while making room for their history.

But suppose you have a religious value that is of higher importance? Could you also use these methods to live those values? It is a challenging question.

I struggled with the example you used when a student I helped train started a group at a Mormon university teaching gay Mormons to accept their feelings, defuse from the self critical thoughts, and then to make a choice about their religious values, and behave accordingly. What this group replaced was a very harsh group program that essentially attacked the idea of being gay. The former student got into trouble with the elders with his new approach and had to defend the group. He did, brilliantly (using as his defense the temptation of Christ and the idea that acknowledging a feeling or thought is not a sin).

The ACT model includes an active embrace of feelings without struggle. So if we are going to go in this direction, an ACT model will not support the “just don’t do it” model. We are not talking about suppression here. We are talking about self validation. I feel what I feel. I think what I think. I am a whole person. I choose my values. I choose to behave in accord with them.And we are not talking about imposed values … although all values are social in some sense.If you just try to “realign behavior” — that is not ACT.

I personally do not view this as an issue of identity. We are not our sexual feelings or our religious beliefs. We are whole human beings.

So, my answer is this:You have to decide as a therapist what your values are and what you are doing in therapy. Is it OK for you to support valued actions in others that conflict with your own? What is the limit? ACT can support the bisexual man become comfortable with having sex with men. Should you use it to help a gay Morman accept his sexual feelings and embrace his religious values? No doubt you could. Should you? It depends on how much of a values stretch it is for you.

I have dedicated much of my current work to the reduction of stigma and prejudice and gay people have suffered tremendously as a result of stigma and prejudice. And I do think some religious beliefs have fueled that process of stigmatizing.

Should we tell religious people what their values should be? If they wished to engage in human sacrifice, we would intervene. Is that situation the same as the one faced by a gay Mormon?

You have to decide as a therapist what your values are and what you are doing in therapy. An ACT model will frame the question but it will not provide the answer because values are a choice.

- S

Steven C. Hayes
Foundation ProfessorDepartment of Psychology
/298University of Nevada
Reno, NV 89557-0062

The listserv participant did not understand the role of the sexual identity therapy framework and ACT when she wrote Dr. Hayes. One reason the participant had “…trouble piecing that [ACT} together with changing sexual orientation” was because the participant did not understand that the SIT framework does not promote sexual orientation change. Indeed, ACT is quite compatible with the framework since the issue of relevance to clinical success is helping clients pursue chosen values, in contrast to fusion with private events {sexual thoughts and feelings inconsistent with values and beliefs). I felt Dr. Hayes gave a fine answer to the participant’s question.