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Sexual Identity Therapy (SIT) is a framework to "aid mental health practitioners in helping people arrive at a healthy and personally acceptable resolution of sexual identity and value conflicts." [1] It was invented by Warren Throckmorton and Mark Yarhouse, professors at small conservative evangelical colleges. It has been endorsed by former American Psychological Association president Nick Cummings, psychiatrist Robert Spitzer, and the provost of Wheaton College, Stanton Jones. [2] Sexual identity therapy puts the emphasis on how the client wants to live, identifies the core beliefs and helps the client live according to those beliefs. [3] The creators state that their recommendations "are not sexual reorientation therapy protocols in disguise," [1] but that they "help clients pursue lives they value." They say clients "have high levels of satisfaction with this approach". [4] It is presented as an alternative to both sexual orientation change efforts and gay affirmative psychotherapy. [5]
Work for developing the framework began with the establishment of the Institute for the Study of Sexual Identity in 2004. [6] The announcement of the framework for Sexual Identity Therapy were first released on April 16, 2007. [7] [ better source needed ] In June 2007, the guidelines were presented at the American Psychological Association convention in San Francisco. [8] In 2008 the authors announced they were going to review the framework because of "continual changes that are occurring in the area of therapy for individuals experiencing same-sex attractions." [9] In 2009, the APA released a report stating that such an approach is ethical and may be beneficial for some clients. [10]
Gay psychologist Lee Beckstead spoke about his "middle-ground" approach to working with those in conflict with their sexual orientation and religion. He spoke about his approach along with others who spoke about Sexual Identity Therapy at an APA conference. [11] Robert L. Spitzer, who was instrumental in removing homosexuality from the DSM in 1973, endorsed the project, saying it was "a work that transcends polarized debates about whether gays can change their sexual orientation." [9] Michael Bussee, an outspoken critic of the ex-gay movement endorsed the project. [2] It has also been endorsed by several other professionals, including keynote speaker at the controversial organization National Association for Research & Therapy of Homosexuality (NARTH). [12] [13]
Its purpose is to help clients align their sexual identity with their beliefs and values, which in some cases means celibacy, if chosen by the client. [14] At any point during the therapy, a previous step may be revisited for further investigation or to explore a new direction in the therapy. [1]
The first step is to discover the reasoning of a client requesting therapy. Clinicians should determine whether the motivation is internal or external, followed by an open dialogue about motivations while respecting the client's world view. They should assist the client to clarify their values in order to determine their preferred course of action. This must be individualized. [1]
Clinicians should stay up to date on literature concerning the causes of homosexuality, but if the client asks about it, they should see how that would affect their course of action. [1]
Sexual Identity Therapy gives a framework for existing techniques rather than a specific method of psychotherapy. If a therapist's value position is in conflict with the client's preferred direction, a referral to a more suitable mental health professional may be indicated. The goal of therapy is to help the person explore and eventually live more comfortably within a sexual identity that is consistent with personal values and beliefs. This may not be quick or complete, and the client should feel free to pursue other directions. [1]
As clients synthesize a new identity, the therapist should make them aware of the consequences. Therapeutic interventions can be employed to assist clients pursue valued behavior while avoiding unvalued behavior. While the decision is the clients, clients are advised against sexual behavior until they are comfortable with their new identity. Many clients find it helpful to attend support groups and avoid social situations that do not support the new identity. [1]
Carl Ransom Rogers was an American psychologist who was one of the founders of humanistic psychology and was known especially for his person-centered psychotherapy. Rogers is widely considered one of the founding fathers of psychotherapy research and was honored for his pioneering research with the Award for Distinguished Scientific Contributions by the American Psychological Association (APA) in 1956.
Conversion therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation, gender identity, or gender expression to align with heterosexual and cisgender norms. Methods that have been used to this end include forms of brain surgery, surgical or hormonal castration, aversive treatments such as electric shocks, nausea-inducing drugs, hypnosis, counseling, spiritual interventions, visualization, psychoanalysis, and arousal reconditioning.
The American Psychological Association (APA) is the main professional organization of psychologists in the United States, and the largest psychological association in the world. It has over 157,000 members, including scientists, educators, clinicians, consultants, and students. It has 54 divisions—interest groups for different subspecialties of psychology or topical areas. The APA has an annual budget of around $125 million.
The Alliance for Therapeutic Choice and Scientific Integrity (ATCSI), which until 2014 was known as the National Association for Research & Therapy of Homosexuality (NARTH), also known as the NARTH Institute, is a US organization that promotes conversion therapy, a pseudoscientific practice used in attempts to change the sexual orientation of people with same-sex attraction. NARTH was founded in 1992 by Joseph Nicolosi, Benjamin Kaufman, and Charles Socarides. Its headquarters were in Encino, California, at its Thomas Aquinas Psychological Clinic. NARTH has not been recognized by any major United States-based professional association.
Albert Ellis was an American psychologist and psychotherapist who founded rational emotive behavior therapy (REBT). He held MA and PhD degrees in clinical psychology from Columbia University, and was certified by the American Board of Professional Psychology (ABPP). He also founded, and was the President of, the New York City-based Albert Ellis Institute. He is generally considered to be one of the originators of the cognitive revolutionary paradigm shift in psychotherapy and an early proponent and developer of cognitive-behavioral therapies.
The field of psychology has extensively studied homosexuality as a human sexual orientation. The American Psychiatric Association listed homosexuality in the DSM-I in 1952, but that classification came under scrutiny in research funded by the National Institute of Mental Health. That research and subsequent studies consistently failed to produce any empirical or scientific basis for regarding homosexuality as anything other than a natural and normal sexual orientation that is a healthy and positive expression of human sexuality. As a result of this scientific research, the American Psychiatric Association removed homosexuality from the DSM-II in 1973. Upon a thorough review of the scientific data, the American Psychological Association followed in 1975 and also called on all mental health professionals to take the lead in "removing the stigma of mental illness that has long been associated" with homosexuality. In 1993, the National Association of Social Workers adopted the same position as the American Psychiatric Association and the American Psychological Association, in recognition of scientific evidence. The World Health Organization, which listed homosexuality in the ICD-9 in 1977, removed homosexuality from the ICD-10 which was endorsed by the 43rd World Health Assembly on 17 May 1990.
The ex-gay movement consists of people and organizations that encourage people to refrain from entering or pursuing same-sex relationships, to eliminate homosexual desires and to develop heterosexual desires, or to enter into a heterosexual relationship. Beginning with the founding of Love In Action and Exodus International in the mid-1970s, the movement saw rapid growth in the 1980s and 1990s before declining in the 2000s.
Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.
Joseph Nicolosi was an American clinical psychologist who advocated and practised "reparative therapy", a form of the pseudoscientific treatment of conversion therapy that he claimed could help people overcome or mitigate their homosexual desires and replace them with heterosexual ones. Nicolosi was a founder and president of the National Association for Research and Therapy of Homosexuality (NARTH). Medical institutions warn that conversion therapy is ineffective and may be harmful, and that there is no evidence that sexual orientation can be changed by such treatments.
Ex-ex-gay people are those who formerly participated in the ex-gay movement in an attempt to change their sexual orientation to heterosexual, but who then later went on to publicly state they had a non-heterosexual sexual orientation.
Ego-dystonic sexual orientation is a highly controversial mental health diagnosis that was included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) from 1980 to 1987 and in the World Health Organization's (WHO) International Classification of Diseases (ICD) from 1990 to 2019. Individuals could be diagnosed with ego-dystonic sexual orientation if their sexual orientation or attractions were at odds with their idealized self-image, causing anxiety and a desire to change their orientation or become more comfortable with it. It describes not innate sexual orientation itself, but a conflict between the sexual orientation a person wishes to have and their actual sexual orientation.
Earl Warren Throckmorton is an American psychologist and retired professor of psychology at Grove City College in Grove City, Pennsylvania. He developed the Sexual Identity Therapy Framework and was a creator of the documentary I Do Exist, about people who say they have changed their sexual orientation. He is an example of an evangelical Christian who has changed his view about human sexuality, from traditional to more progressive.
Gay affirmative psychotherapy is a form of psychotherapy for non-heterosexual people, specifically gay and lesbian clients, which focuses on client comfort in working towards authenticity and self-acceptance regarding sexual orientation, and does not attempt to "change" them to heterosexual, or to "eliminate or diminish" same-sex "desires and behaviors". The American Psychological Association (APA) offers guidelines and materials for gay affirmative psychotherapy. Affirmative psychotherapy affirms that homosexuality or bisexuality is not a mental disorder, in accordance with global scientific consensus. In fact, embracing and affirming gay identity can be a key component to recovery from other mental illnesses or substance abuse. Clients whose religious beliefs are interpreted as teaching against homosexual behavior may require some other method of integration of their possibly conflicting religious and sexual selves.
Kenneth J. Zucker is an American-Canadian psychologist and sexologist. He was named editor-in-chief of Archives of Sexual Behavior in 2001. He was psychologist-in-chief at Toronto's Centre for Addiction and Mental Health (CAMH) and head of its Gender Identity Service until December 2015. Zucker is a professor in the departments of psychiatry and psychology at the University of Toronto.
Jack Drescher is an American psychiatrist and psychoanalyst known for his work on sexual orientation and gender identity.
Sexual fluidity is one or more changes in sexuality or sexual identity. Sexual orientation is stable and unchanging for the vast majority of people, but some research indicates that some people may experience change in their sexual orientation, and this is slightly more likely for women than for men. There is no scientific evidence that sexual orientation can be changed through psychotherapy. Sexual identity can change throughout an individual's life, and does not have to align with biological sex, sexual behavior, or actual sexual orientation.
Homosexuality was classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) beginning with the first edition, published in 1952 by the American Psychiatric Association (APA). This classification was challenged by gay rights activists during the gay liberation following the 1969 Stonewall riots, and in December 1973, the APA board of trustees voted to declassify homosexuality as a mental disorder. In 1974, the DSM was updated and homosexuality was replaced with a new diagnostic code for individuals distressed by their homosexuality, termed ego-dystonic sexual orientation. Distress over one's sexual orientation remained in the manual, under different names, until the DSM-5 in 2013.
Beverly Greene is a professor in the Department of Psychology at St. John's University. She is a clinical psychologist known for her work on sexism, racism, and analyzing the intersectionality of social identities. As a specialist in the psychology of women and of gender and racial issues in the practice of psychotherapy, Greene has also created many public health frameworks for understanding mental health in marginalized communities. She is the author of close to 100 psychological literature publications. Greene is involved with the Association for Women in Psychology and the Society for the Psychology of Women. She is one of sixteen women to have received the Distinguished Publication Award (DPA) from the Association for Women in Psychology in 2008.
Many health organizations around the world have denounced and criticized sexual orientation and gender identity change efforts. National health organizations in the United States have announced that there has been no scientific demonstration of conversion therapy's efficacy in the last forty years. They find that conversion therapy is ineffective, risky and can be harmful. Anecdotal claims of cures are counterbalanced by assertions of harm, and the American Psychiatric Association, for example, cautions ethical practitioners under the Hippocratic oath to do no harm and to refrain from attempts at conversion therapy.
The history of conversion therapy can be divided broadly into three periods: an early Freudian period; a period of mainstream approval of conversion therapy, when the mental health establishment became the "primary superintendent" of sexuality; and a post-Stonewall period where the mainstream medical profession disavowed conversion therapy.