I just returned from the Council for Christian Colleges and Universities (CCCU) International Conference in Atlanta. The theme of the conference was Critical Breakthroughs. I made a presentation titled “Navigating Sexual Identity Issues on Christian College Campuses.” It was a talk based on the past several years of visiting CCCU-affiliated institutions, speaking to faculty, staff, and students at these schools and providing consultations in the area of sexual identity. The talk also features some of the findings from the study of 104 Christian sexual minorities on three CCCU campuses.

The reason I am noting this talk on the SIT Framework site is that toward the end of the session I introduced Sexual Identity Therapy as an approach I prefer and discuss with campus counseling centers as the way I approach it is based on theoretical and research understandings of the four key concepts. First, I discussed the three-tier distinction between same-sex attraction, a homosexual orientation, and a gay identity. Such a distinction creates ‘intellectual space’ for using descriptive language while exploring identity considerations. Second, I discussed weighted aspects of identity, by which I mean that people consider many factors when they make decisions about public and private sexual identity labels. These ‘aspects of identity’ include biological sex, gender identity, attractions, intentions, behaviors, and beliefs/values. Third, I discussed joining people on an ‘attributional search’ for identity. This means exploring with students the meaning that they make out of the fact that they are attracted to the same sex. The fourth and final key concept for me is congruence. This means helping people line up their beliefs/values and behavior/identity. I have found this to be a natural result of the first three key concepts.

The audience was really interested in the various suggestions for navigating sexual identity issues on Christian college campuses. The introduction to SIT was more peripheral in the context of the larger discussion of these issues — I was emphasizing more of a community or systemic response; however, I wanted to discuss the direction I encourage on college campuses and the discussion of the four key concepts are also relevant to the community/systemic considerations as well.

Next week I will be travelling to Asbury College and Asbury Theological Seminary in Wilmore, Kentucky,  for a series of talks. At Asbury I’ll be giving chapel addresses, meeting with Student Development staff, and participating in various panel discussions and coffee shop discussions.

The time as Asbury Theological Seminary will focus on pastoral care and applications of the three-tier distinction between same-sex attractions, homosexual orientation, and gay identity and how that distinction can be a helpful reference point in Sexual Identity Therapy. I will also contrast an emphasis on orientation with an emphasis on sexual identity, look at the potential benefits and drawbacks, as well as the importance of achieving personal congruence  through pastoral care.

This past year I have had the opportunity to speak to several seminary students, and I have another similar talk coming up. For the most recent talk, I had been asked to provide two lectures. One was on the etiology of sexual orientation; the other lecture was on whether orientation can change. At the end of the second lecture, I introduced the Sexual Identity Therapy (SIT) approach to working with people in my clinical practice, and I was reflecting with them on how it might be adapted for pastoral care.

I assume that pastoral care is different than professional counseling in any number of ways, but one way would likely be that there is more direction, more of a sense of a normative endpoint or something toward which the person is to move. I don’t know if all pastoral care providers function in this way, but it is an assumption I have about the nature of pastoral care.

In any case, this reminded me of the difference between telic congruence and organismic congruence as defined in the APA Task Force background document on appropriate therapeutic responses to sexual orientation. Recall that telic congruence has to do with who the person wants to become and aligning one’s choices with that, while organismic congruence has to do with aligning one’s choices with who one experiences oneself to be.

It would seem to me that most pastoral care would rely more on telic congruence and have some say in what that congruence ought to look like. In contrast, much of mental health care has probably been based more on a sense of organismic congruence, but some clinicians may recognize the difference and may work with people who are interested in either type of congruence outcome.

An implication, then, might be that pastoral care ends up adapting SIT by not having as much of an open-ended quality to the various ways in which congruence might be experienced. Again, I don’t know that this is the case, but I would be interested in how pastoral care providers approach their work and consider these different ways of understanding congruence. It would seem to impact how sexual identity and religious identity conflicts are navigated.

On Friday, November 6th, I’ll be heading up to Chambersburg, Pennsylvania, for the Christian Association for Psychological Studies East Region Conference. The conference theme is actually on marriage and family, but I will be giving a presentation with two team members from the Institute for the Study of Sexual Identity (ISSI) on the topic of multicultural competence and clinical practice with sexual minorities. The multicultural movement has emerged as a significant reference point for working with diversity issues in clinical practice, and the services that are provided to sexual minorities are also included in that discussion.

The presentation we will be giving will offer Sexual Identity Therapy (SIT) as an alternative to the often-polarized therapy options under consideration with religious sexual minorities: gay affirmative therapy and reorientation therapy. We will note the inherent limitations in both of these models and offer a third option, SIT. The presentation will then explore (and briefly critique) the multicultural movement and its approach to sexual minorities, as well as the place of SIT as a client-centered, identity-focused approach that is consistent with what is best about the multicultural movement as applied to multiple aspects of diversity, as is often found when working with religious sexual minorities.

The presentation at AACC on working with mixed sexual orientation couples went well. Many in the audience had a stake in the topic.  We stayed for an hour to talk to people in such marriages – sexual minorities and their spouses – as well as parents and various clinicians. I had thought of this as a niche specialty, in a sense, so I was surprised by how many people had seen such couples.

Here is the link to the pdf of the PowerPoint slides. You’ll note that we went over some of the research on the experiences of mixed orientation couples. From the studies we’ve seen so far, not many attempt to stay together, and fewer report doing so over time. This may be due somewhat to sampling, but it is sobering. We highlight the characteristics of couples that do stay together – characteristics like flexibility, cohesion, social support, and so on.

We then offer the P.A.R.E. model as our suggested approach to working with mixed orientation couples (Provide sexual identity therapy; Address ‘interpersonal trauma’; Foster resilience through marriage counseling; Enhance sexual intimacy). It begins with SIT, which is in part psychoeducational for both the sexual minority and the spouse. I see this work as primarily individual counseling for the sexual minority and lasting a minimum of about one year. There is a lot involved here, but you can imagine that the sexual minority is sorting out identity considerations that impact self-perception and his or her understanding of the marriage. At the same time (or beginning later), the spouse can work through ‘interpersonal trauma’ often associated with instances in which the spouse feels that trust has been broken. This varies considerably and can be related to disclosure versus discovery, among other considerations. This work is done primarily with the spouse and can create a context for forgiveness (regardless of whether they choose to stay together). We mentioned a couple of different forgiveness protocols that may be relevant here, such as those by Worthington, Enright, and DiBlasio. My experience has been that this is about a year-long process.

Now the couple is in a position to make a decision about the future of their marriage (if they haven’t already). For those who want to work on their marriage, we offer suggestions based upon the current literature on characteristics of couples that appear to be more satisfied in their relationship (foster resilience through marriage counseling).

We included a fourth stage, enhancing sexual intimacy, as this was reported as an important issue for many couples in some of the studies we reviewed. We closed with a case study that illustrated these different principles for providing sex therapy.

BTW: I will close with this – we are actually still conducting a study of mixed orientation couples. Here is the invitation to participate if you know someone who would be appropriate:

A new study is being conducted on mixed orientation marriages, which are defined as a marriage where one individual experiences same sex attraction and the other does not. The purpose of the study is to understand the characteristics of these marriages and the experiences of individuals in them. Participants can be currently in a mixed orientation marriage or have been previously. If you or someone you know fits this description and would like to share your experience, participants are needed! The survey can be accessed online by going to www.mixedorientationstudy.com. The study is completely anonymous and confidential; however, participants are given the option of sharing limited contact information in order participate in future follow-up studies, if desired. Your participation would be greatly appreciated!

I (Mark) will be presenting the SIT Framework at the American Association of Christian Counselor’s (AACC) World Conference in Nashville on Friday, September 18th. The title of the talk is “Working with Mixed Sexual Orientation Couples.” Mixed orientation couples are couples in which one partner experiences same-sex attraction and the other does not. This presentation is a conceptual paper based on our review of the literature (I am co-presenting with Jill Kays, a doctoral student in clinical psychology whose dissertation deals with this subject) and a previous five-year longitudinal study of ‘resilient couples,’ or couples in mixed orientation marriages who stayed together and reported marital satisfaction.

Sexual Identity Therapy (SIT) represents one stage in our four-stage approach to working with mixed orientation couples. In this context, SIT is provided to the sexual minority who is making decisions about his or her identity and behavior, as well as the unique considerations in that type of relationship. Other stages address the important relational considerations, such as dealing with disclosure or discovery and, for those couples who are interested in the relationship, clinicians can follow recommendations for improving the marriage.

The conference location is the Opryland Hotel and Convention Center in Nashville. The session is scheduled for 8:45-10:00am on Friday morning. I will post some of the PowerPoint slides on the site after the workshop.SIS

During the first week of August, the American Psychological Association’s Task Force on Appropriate Therapeutic Responses to Sexual Orientation released a report outlining findings of a two year investigation. The sexual identity therapy framework was referenced prominently and favorably in the report. An upcoming post will provide more information on the APA report.

This post notes an article in the Wall Street Journal by Stephanie Simon which describes the new APA report and the similarity between the APA suggestions and the SIT framework. Here are excerpts:

The men who seek help from evangelical counselor Warren Throckmorton often are deeply distressed. They have prayed, read Scripture, even married, but they haven’t been able to shake sexual attractions to other men — impulses they believe to be immoral.

Dr. Throckmorton is a psychology professor at a Christian college in Pennsylvania and past president of the American Mental Health Counselors Association. He specializes in working with clients conflicted about their sexual identity.

The first thing he tells them is this: Your attractions aren’t a sign of mental illness or a punishment for insufficient faith. He tells them that he cannot turn them straight.

But he also tells them they don’t have to be gay.

For many years, Dr. Throckmorton felt he was breaking a professional taboo by telling his clients they could construct satisfying lives by, in effect, shunting their sexuality to the side, even if that meant living celibately. That ran against the trend in counseling toward “gay affirming” therapy — encouraging clients to embrace their sexuality.

But in a striking departure, the American Psychological Association said Wednesday that it is ethical — and can be beneficial — for counselors to help some clients reject gay or lesbian attractions.

The approach described in the article is not step-by-step the methodology of the SIT framework. This is because we designate an individualized approach which may involve some of the steps noted in the WSJ article but not all and certainly not in any set order.

The SIT framework is not about the pursuit of sexual reorientation but rather the pursuit of chosen values. The APA report describes the SIT framework as one of several approaches in the professional literature which meet the APA model.

The APA report mentions as one possible framework the approach taken by Dr. Throckmorton, who teaches at Grove City College and has a Ph.D. in community counseling. He starts by helping clients prioritize their values. Then he shows them stock video of a brain responding to sexual stimuli. When the clients see how quickly the brain lights up, they often feel relieved, he said, because they realize that their attractions are deeply rooted.

Dr. Throckmorton says at that point, some clients choose to accept a gay identity. Others, however, say they prefer to live in accordance with their faith.

In therapy that can last years, Dr. Throckmorton says he tries to help these clients accept that their attractions will not go away — but need not define them. Many clients, he said, learn to override sexual impulses, reminding themselves that what looks like an oasis will only “take me farther away from what I really want to be,” as he puts it.

Stay tuned for more about the APA report and the SIT framework.

During September 12-14, 2007, I hosted a sexual identity therapy research summit in Nashville, TN. SIT framework co-author, Mark Yarhouse and I presented the four papers. The participants were invited to attend at no cost to them. As a part of the summit, there was an extensive sourcebook provided. I want to now make that available for those interested in knowing more about sexual identity therapy.

The sourcebook consists of papers on correlates and change of sexual identity and clinical strategies with people in conflict involving sexual identity.

You see the contents and order the sourcebook here.

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.