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!

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.