Moving Back to Science and Self-Reflection in the Debate over Sexual Orientation Change Efforts

The April 2011 issue of Social Work featured a commentary by Adrienne Dessel regarding sexual reorientation therapies. At first we wondered why Dr. Dessel had chosen to comment on an article that appeared in a different journal from a different discipline (that is, marriage and family therapy; Serovich et al., 2008). However, it seems the most important feature of the article was that it could be used as a springboard for Dr. Dessel to question the very existence of such psychological care before an audience of social workers. In the interest of trying to provide a balanced perspective on the subject, we would like to briefly highlight some more recent contributions to the literature that can assist social workers in basing their advocacy claims in science and a self-reflective humility. In 2009 the American Psychological Association (APA) released the 130-page report of their task force on appropriate therapeutic responses to sexual orientation (APA, 2009). This report surveyed the literature on what the task force referred to as sexual orientation change efforts (SOCE) in far greater breadth and depth than did the Serovich et al. (2008) analysis. The report was widely lauded for its attempt to take the religious faith of clients seriously as a diversity dimension in addressing SOCE. Although the task force clearly discouraged the practice of SOCE in favor of an affirmative therapeutic model, the evidence (or lack thereof) did not support the banning of SOCE. The report "concluded that there is little in the way of credible evidence that could clarify whether SOCE does or does not work in changing same-sex attractions" [emphasis added] (APA, 2009, p. 28). The report has been questioned on the grounds that it had to set unrealistically high standards for methodological purity to summarily disregard this literature (Jones, Rosik, Williams, & Byrd, 2010), but the trade-off in doing so is having to acknowledge that the scientific jury is still very much out as pertains to SOCE. Here it is worth remembering that the absence of conclusive evidence of effectiveness is not logically equivalent to positive evidence of ineffectiveness. Moreover, banning SOCE on the basis of these methodological standards would likely bring into question the validity of other contemporary therapy approaches. Any failure to similarly ban them would give the impression of double standards and partisan rather than scientific motives. To its credit, the task force acknowledged that the affirmative therapeutic approach "has not been evaluated for safety and efficacy" (APA, 2009, p. 91) and that research meeting its methodological standards is still needed to establish this. We admire the compassion and concern for the betterment of gay, lesbian, and bisexual (GLB) clients that Dr. Dessel exudes in her commentary. We do, however, wish that her arguments could have shown a greater familiarity with and respect for the traditionally religious worldview that motivates many SOCE consumers. This omission may reflect a certain limitation in worldview brought about by what moral psychologist Jonathan Haidt refers to as the "tribal-moral community" of many mental health professionals who are united by "sacred values" that can hinder research and blind them to the unwelcoming climate that they may create for non-liberals (Tierney, 2011). In this regard, social workers and other mental health professionals from across the sociopolitical spectrum will benefit immensely from a knowledge of Haidt's moral foundations theory (MFT) (see http://www.MoralFoundations.org). MFT integrates anthropological and evolutionary accounts of morality to identify and explain the standards by which liberals and conservatives formulate their moral frameworks (Graham, Haidt, & Nosek, 2009; Haidt, 2012); to discover your own moral foundations profile visit http://www. YourMorals.org. Through the lens of MFT, these authors conclude that although conservative and liberal individuals share some similar moral concerns (relative to the rights and welfare of individuals), conservatives also are motivated by moral concerns that liberals may not recognize and that emphasize the virtues and institutions that bind people into roles, duties, and mutual obligations. …