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 student chapter of Chi Sigma Iota in the School of Psychology and Counseling at Regent University has asked me to give a presentation, and I am going to speak on Sexual Identity Therapy (SIT). The presentation is Friday, October 30th, from noon to 1pm on the Regent University campus (CRB 227) for those in the area.
What I’ll be saying by way of introduction is that SIT is an approach to sexual identity in counseling that is a “third way” model that is an alternative to the often-polarized models of gay affirmative therapy and reorientation therapy. Also, the SIT Framework is itself an approach that fills a void identified by the American Psychological Association’s (APA’s) task force on appropriate therapeutic responses to sexual orientation. That is, in their recently released background document the task force encouraged alternative models that were affirmative but not gay affirmative. Affirmative models would be client-centered and identity-focused; they would also emphasize social support and coping skills. The SIT Framework was identified as one such appropriate approach, as was the narrative sexual identity therapy model that I previously published in American Journal of Family Therapy.
For this initial presentation, rather than go into narrative sexual identity therapy, I will just review the four main concepts in how I provide SIT: (1) the three-tier distinction (between same-sex attraction, homosexual orientation, and gay identity), (2) weighted aspects of identity, (3) ‘attributional search’ for identity, and (4) congruence.
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!