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An Inclusive Response to LGB and Conservative Religious
Persons:
The Case of Same-Sex Attraction and Behavior
Mark A. Yarhouse and Lori A. Burkett
Regent University
How should psychologists demonstrate respect for religion as an
aspect of diversity when that aspect of
diversity seems inconsistent with another form of diversity?
This is a striking challenge when considering
conservative expressions of religion in relation to a person’s
experience of same-sex attraction and
behavior. This article (a) asserts that conservative religion is a
legitimate, though often overlooked,
expression of diversity; (b) identifies ways in which gay-
integrative theorists and conservative religious
persons fail to appreciate each other’s perspective; and (c)
presents a continuum of service delivery
options to expand clinical services to persons who experience
same-sex attraction.
How should psychologists respond to persons who enter therapy
distressed by their experiences of same-sex attraction? Does it
matter if a person experiences distress about his or her same-sex
attractions and behavior due to a religious valuative framework?
In
other words, how do psychologists balance respect for both
sexual
orientation and religion as legitimate aspects of diversity?
Thoughtful, scientifically informed responses to these questions
are often lost in the debates surrounding reorientation therapies
and ex-gay1 religion-based ministries.
Respecting Religion as an Aspect of Diversity
There has been a rather dramatic interest in religion and spiri-
tuality in the last few years, both in the public interest and in
psychological circles. The American Psychological Association
(APA) has published valuable resources on religion and
spiritual-
ity, including books by Shafranske (1996) and Richards and
Ber-
gin (1997, 2000). Other publishers have done the same (e.g.,
Emmons, 1999). What is implied by the availability of these
resources, we believe, is that religion is an important expression
of
diversity. Just as race, ethnicity, socioeconomic status, age,
gen-
der, and sexual orientation are legitimate expressions of
diversity,
so too is religion.
The Ethical Principles of Psychologists and Code of Conduct of
the APA (1992; henceforth referred to as the Ethics Code)
clearly
includes religion among many areas of diversity that
psychologists
are to respect. For example, General Principle D: Respect for
Rights and Dignity calls for psychologists to aspire to “accord
respect to the fundamental rights, dignity, and worth of all peo-
ple . . . . Psychologists are aware of cultural, individual, and
role
differences, including those due to . . . religion . . .” (APA,
1992,
p. 3). The Ethics Code also includes respect for others: “In their
work-related activities, psychologists respect the rights of
others to
hold values, attitudes, and opinions that differ from their own”
(Standard 1.09; APA, 1992, p. 5).
But what does “respecting” religion as an area of diversity
entail? At a basic level, it would seem that it means not
discrim-
inating against clients because of their religion or religious
prac-
tices or the values that derive from their religion (Stan-
dard 1.08, 1.10). This does not mean that psychologists agree
with
every belief or value associated with a religion. This is
impossible
because major religions disagree with one another on
fundamental
claims and worldview assumptions. In a similar way, when psy-
chologists respect cultural differences, they do not necessarily
endorse specific cultural values, but they do not discriminate
against a client because of his or her cultural beliefs.
Complications arise when psychologists respect two competing
expressions of diversity: sexual orientation and conservative ex-
pressions of religion. The recent Resolution on Appropriate
Ther-
apeutic Response to Sexual Orientation (APA, 1998;
http://www.
apa.org/pi/sexual.html) and Guidelines for Psychotherapy with
Lesbian, Gay, and Bisexual Clients (Division 44/Committee on
Lesbian, Gay, and Bisexual Concerns Joint Task Force, 2000)
clearly expand on what it means to demonstrate respect for
sexual
orientation. These documents address psychologists’ awareness
of
negative social messages and prejudices against lesbian, gay
male,
and bisexual (LGB) persons, reports of emotional distress, and
1 Throughout this article we use the terms gay, ex-gay, and ex-
ex-gay; in
this context, the term gay is used broadly to mean a person who
has
integrated his or her same-sex attraction into a lesbian, gay
male, or
bisexual identity.
MARK A. YARHOUSE received his PsyD in clinical
psychology from
Wheaton College in 1998. He is an assistant professor of
psychology at
Regent University and is in independent practice in Virginia
Beach, VA.
His research interests include human sexuality, ethics, and
integration of
psychology and theology.
LORI A. BURKETT is a student in the doctoral program in
clinical psychol-
ogy at Regent University.
PORTIONS OF THIS ARTICLE were presented as part of a
symposium chaired
by M. A. Yarhouse, Gays, Ex-Gays, and Ex-Ex-Gays:
Examining Key
Religious, Ethical, and Diversity Issues, which was conducted
at the 108th
Annual Convention of the American Psychological Association,
August
2000, Washington, DC.
CORRESPONDENCE CONCERNING THIS ARTICLE should
be addressed to Mark
A. Yarhouse, School of Psychology and Counseling, Regent
University,
CRB 215, 1000 Regent University Drive, Virginia Beach,
Virginia 23464.
E-mail: [email protected]
Professional Psychology: Research and Practice Copyright 2002
by the American Psychological Association, Inc.
2002, Vol. 33, No. 3, 235–241 0735-7028/02/$5.00 DOI:
10.1037//0735-7028.33.3.235
235
how some persons may feel pressured into treatment to change
their sexual orientation.
In these resources and in the broader discussions of LGB issues,
however, conservative expressions of religion often appear to be
overlooked as an aspect of diversity. It appears that most
psychol-
ogists are comfortable with more liberal expressions of a
religion
(e.g., some Christian groups, such as Dignity/USA, are gay-
affirmative). However, inherent in “respecting” religion as an
aspect of diversity is also demonstrating respect for those who
hold
to the conservative, orthodox teachings of that religion. This
concept becomes clearer if we return to what it means to
“respect”
cultural diversity. Psychologists would not, for example,
demon-
strate respect for cultural diversity if they worked only with
members of a minority group who were sufficiently acculturated
and divorced from the customs and values of their country of
origin. Rather, psychologists respect cultural diversity by trying
to
help clients balance their traditional, cultural values and beliefs
with some of their experiences in their new society. The same
approach is needed regarding conservative religious beliefs.
A recent Chronicle of Higher Education article reported on data
suggesting antipathy and prejudice against conservative
Christians
(Miller, 2000). In fact, it was reported that about 20% of Ameri-
cans, and nearly 40% of highly educated Americans, are
“intensely
antagonistic” toward conservative Christians (p. A18). It was
also
reported that as many as 20% of Americans who are not
Christian
fundamentalists hold Christian fundamentalists in lower regard
than they do illegal aliens. Are conservative religious persons at
risk of becoming marginalized in society?
Psychologists can play a role in protecting those at risk of
becoming marginalized by hearing the voices of those who live
by
traditional, conservative expressions of their religion or who are
religiously orthodox. Religious orthodoxy refers to “the degree
to
which a person believes in and adheres to the traditional
doctrines
and moral teachings of his or her religion” (Richards & Bergin,
1997, p. 177). Richards and Bergin distinguished between belief
orthodoxy, or “acceptance of the doctrinal beliefs of one’s reli-
gion,” and behavior orthodoxy (more commonly referred to by
theologians as orthopraxy), or “adherence to the moral
teachings
and practices of one’s religion” (p. 177).
Respecting belief orthodoxy and behavior orthodoxy is at the
heart of what it means to respect religion as a legitimate
expression
of diversity. Respect for diversity implies that it would be intol-
erant to disregard a religious person’s conservative theological
view that same-sex behavior is immoral; it means understanding
why a conservative religious person chooses not to engage in
same-sex behavior.
When faced with a clinical situation in which a conservative
religious individual is struggling with same-sex attraction or be-
havior, it is critical that the psychotherapist consider what it
means
to an orthodox religious person to have such thoughts or to have
engaged in such sexual behavior. It is important to think about
what it means to conservative religious individuals to live by
the
normative teachings of their church and faith.
Respecting a conservative religious person’s view of same-sex
behavior is not tantamount to supporting inappropriate
heterosex-
ism (discrimination and prejudice against LGB persons that is
the
equivalent of racism or sexism). There is a difference between
moral evaluation of same-sex behavior as volitional conduct and
prejudice against another for his or her race or sex. Some gay-
affirmative theorists acknowledge this distinction. For example,
Stein (1999) acknowledged that sexual attractions and behavior
are
two different things and that behaviors are volitional and may
be
evaluated with respect to their moral status:
Even if one’s sexual orientation is primarily biological and not
a
choice, much of what is ethically relevant about being a lesbian
or a
gay man is not biologically based and is not determined, [such
as]
engaging in sexual acts with a person of the same sex-gender.
(pp.
288 –289)
Key Issues That Are Viewed Differently
Five key issues seem to be viewed differently by gay-
affirmative theorists and conservative religious persons: (a) ap-
praisal of same-sex behavior; (b) the existence of “ex-gays”; (c)
the existence of “ex-ex-gays”; (d) the existence of reorientation
therapies, alternative therapies, and religious ministries; and (e)
research on change of sexual behavior and orientation.
Appraisal of Same-Sex Behavior
One of the primary differences between gay-affirmative theo-
rists and conservative religious persons is how they view or
evaluate same-sex behavior. Gay-affirmative theorists view
same-
sex behavior as integral to full expression of oneself as a
person.
Thus, gay-integrative therapy has the goal of helping people
who
experience same-sex attraction to integrate their experiences
into a
gay male or lesbian identity synthesis (Dworkin, 2000).
In contrast, conservative religious persons do not assume that
same-sex identity is at the core of how a conservative religious
person wants to experience himself or herself, with religious
identity at the periphery. Rather, some conservative religious
per-
sons view sexual attraction and behavior in the context of a
broader religious valuative framework (cf. Harvey, 1987; Satin-
over, 1996). Conservative Christians teach that God created
people
as men and women and that marriage is the context for genital
sexual contact (Prichard, 1991). Also, a conservative religious
person would not necessarily assume that full sexual intimacy is
integral to one’s core identity or self-expression.
Both views are probably not equally true—that is, same-sex
behavior is not simultaneously moral and immoral. However,
psychology as a science cannot determine the moral status of
same-sex behavior. The behavioral sciences can only inform
moral
reasoning by measuring the results of specific behaviors; they
cannot determine which moral system to use (e.g., egoism, the
view that what is right is what produces the most happiness for
a
person; divine command, the claim that what is right is what
God
says is right; or another ethical system). Such empirical criteria
may be relatively short-term (as contrasted with a conservative
religious person’s concern for eternal significance), but they
can
inform moral reasoning and be treated as “informed consent”
for
the choices made by clients whom psychologists are expected to
treat as autonomous, self-determining agents (APA, 1992, pp.
3–5).
Ex-Gays
How do the two groups view “ex-gays”? At one level (and a
simplistic level at that), ex-gays are often viewed as those who
236 YARHOUSE AND BURKETT
succeed in changing their sexual orientation from gay to hetero-
sexual. At another level, ex-gays may be understood to be those
who experience same-sex attraction but choose not to integrate
same-sex impulses into an LGB identity. Rather, they seek to tie
their identity to other aspects of who they take themselves “to
be
as a person,” and they see their sexual impulses as one of many
aspects of their experience that they choose not to identify with
(Bergner, 1995; Comiskey, 1989). This is often the experience
of
many active in religion-based ministries, such as Exodus
Interna-
tional, Homosexuals Anonymous, and Courage.
Gay-affirmative theorists, in contrast, tend to view people who
identify themselves as being ex-gay as casualties of a larger
social
conflict characterized by prejudice and discrimination. Change
attempts are the result of repressive and condemnatory
socioreli-
gious prejudices. In one presentation, it was suggested that ex-
gays
exist because the gay community failed to support them in their
efforts toward identity synthesis (Shidlo & Schroeder, 1999). In
other contexts, ex-gays are sometimes characterized as really
being
bisexuals rather than as being true gay males or lesbians.
Is it possible that both accounts are partially true? It is
important
to clarify the motivations for change in relation to the existence
of
ex-gays. Some people pursue change because they do not feel
supported in their desire to come out and identify as LGB. It is
not
uncommon to work with individuals who say they would like to
come out but fear doing so because of the response they would
receive from their family, coworkers, or others. This requires
conservative religious persons to admit that not everyone who
experiences same-sex attraction and seeks change does so
because
of a moral valuative framework; rather, some pursue change be-
cause of how hard it would be to integrate their impulses into an
LGB identity and live openly in society with such an identity.
Of
course, an alternative motivation for change is that some people
pursue change because they hold convictions about the
immorality
of same-sex behavior that they derive from a theology of human
sexuality. They are religious persons, and they want to live ac-
cording to the prescriptive dimension of their religion, which,
in
this case, prohibits same-sex behavior. It may be that most
people
who pursue change do so for a combination of reasons.
Ex-Ex-Gays
A similar tension exists when we consider “ex-ex-gays.” They
are individuals who once lived an LGB lifestyle, later attempted
to
change their behavior or attractions, and still later returned to
living an LGB lifestyle. From a conservative religious
perspective,
ex-ex-gays may be the result of poor therapeutic technique,
insuf-
ficient client commitment or motivation, moral or spiritual
failure,
or failure of ministries to offer realistic expectations of change.
This last consideration is particularly important. It might be that
conservative religious persons hold out expectations for change
that are too high (i.e., that a person would be free from every
vestige of same-sex desire and would be happy and fulfilled in
marriage). From this perspective, ex-ex-gays are discouraged,
sometimes angry, about their experiences within religion-based
ministries.
Gay-affirmative theorists tend to see ex-ex-gays as casualties of
professional interventions and religious ministries (Haldeman,
1994). Gay-affirmative theorists propose that ex-ex-gays are the
result of the predictable failure of sexual reorientation therapy
and
religion-based ministries to accomplish what they purport to ac-
complish. According to Haldeman, some question whether these
proponents of reorientation and reparative therapies are not dis-
turbed themselves, preying on vulnerable persons who are
hoping
against hope to experience change.
Again, is there merit to both accounts? Is it possible that some
people are misled about what reorientation and reparative
therapy
can offer? It is possible that some people do hold expectations
for
change that are too high. Whether the individual is freely
seeking
changes for personally felt reasons or is being taken to a
program
for change by a third party is also a factor in relation to this
topic.
All of this depends on several factors, including what sexual
orientation is, whether it is immutable, and what evidence exists
for the effectiveness of reorientation and reparative therapies. It
is
important for professionals and ministry leaders to recognize,
too,
that there have been attempts to cover up sexual indiscretions
by
past ministry leaders (Blair, 1982). Presumably, a small
percentage
of ministry personnel are involved in ministry for the wrong
reasons or are at least vulnerable to acting-out behavior and do
not
have a sufficient support system and accountability structure to
facilitate their ministry.
Reorientation/Alternative Therapies and Religious
Ministries
Gay-affirmative and conservative religious persons also dis-
agree about the existence of reorientation therapy, alternative
therapies (e.g., sexual identity management, behavior manage-
ment), and religious ministries. Some gay-affirmative theorists
believe that the very existence of religious ministries and
reorien-
tation therapies suggests that LGB persons are “sick” (and
should
be “cured”). They fear other negative repercussions for the LGB
community overall. For example, Stein (1999) argued that
the availability of conversion programs, hormonal therapy,
dietary
supplements, or other techniques for changing sexual
orientations
would encourage the view that lesbians, gay men, and bisexuals
are
diseased; increase pressure to keep one’s homosexuality secret;
en-
gender and perpetuate attitudes that lesbians and gay men are
worth-
less; encourage policies that discriminate against lesbians and
gay
men; and increase violence towards them. (p. 323)
Some may say that the existence of the alternative therapies is
detrimental to the LGB community if the therapies do not work.
Others, including Stein (1999), have argued that these therapies
are
detrimental even if the therapies are found to be successful:
“The
availability of psychological conversion programs have [serious
negative] effects whether or not they are ‘successful’” (p. 325).
Haldeman (1994) pointed out that some reorientation ap-
proaches and religious ministries promote the view that
homosex-
uality is a pathology. Some organizations may also share misin-
formation about sexual orientation, a concern raised by the
APA’s
Resolution on Appropriate Therapeutic Responses to Sexual
Ori-
entation (APA, 1998; http://www.apa.org/pi/sexual.html). The
public is often unaware that although some religious ministries
and
alternative therapies promote accurate information, others do
not.
The concern for the conservative religious person is the impli-
cation for what it means to “respect” the autonomy and self-
determination of persons who have different beliefs and values
about same-sex behavior. From a conservative religious
perspec-
237SPECIAL SECTION: RELIGION AS AN ASPECT OF
DIVERSITY
tive, reorientation therapies, alternative therapies, and religious
ministries exist as a response to a person’s decision that acting
on
same-sex attraction is wrong. Change may mean attempting to
change sexual orientation, although it may also mean attempting
to
decrease same-sex fantasies and behavior, increase heterosexual
fantasies and behavior, or achieve celibacy.
The middle ground here may be to recognize that in a diverse
and pluralistic society, gay-affirmative therapy, reorientation
ther-
apy, and alternative approaches may be viable options, and psy-
chologists should be mindful of ways in which harm can result
from misinformation. The challenge may lie in whether the
poten-
tial impact of the existence of such programs outweighs the po-
tential impact of not providing such services to those who
request
them. In the meantime, the key concern is whether such
programs
are effective.
Research on Change of Sexual Behavior and Orientation
Perhaps the greatest point of disagreement is whether change in
sexual orientation is possible. Many gay-affirmative theorists
ar-
gue that therapy cannot change sexual orientation or that, at
least,
there is no evidence to date that therapy can change sexual
orien-
tation. In his review of the change literature, Haldeman (1994),
for
example, discussed several individual and group treatments
from
the 1960s and 1970s, as well as more recent efforts by Nicolosi
(1991). Haldeman was particularly concerned that researchers
and
clinicians may sometimes mislabel gay men and lesbians as bi-
sexual. He also criticized the research as too often emphasizing
changed behavior rather than a more fundamental change of
orientation.
Conservative religious persons who have looked at the change
research have argued that sexual orientation does not appear to
be
immutable (Satinover, 1996). Recent survey research by MacIn-
tosh (1994; see also National Association for Research and
Treat-
ment of Homosexuality, 1997; Nicolosi, Byrd, & Potts, 2000)
has
challenged the claim of the absolute immutability of sexual
orien-
tation; 274 psychoanalysts reported working with 1,215 gay
male
and lesbian patients, with reported change of sexual orientation
for 22.7% of patients (23.9% of men; 20.2% of women). Studies
of
therapist recall are susceptible to overreporting of treatment
suc-
cess and underreporting of treatment failure; however, from the
conservative religious person’s perspective, the MacIntosh
study
and those like it cannot be dismissed as irrelevant to the debate
about whether such therapy can be beneficial.
More recent research, also of a convenience sample, suggests
that religious motivation is an important factor for some people
who report behavioral change and change of “feeling-based
sexual
orientation” (Schaeffer, Hyde, Kroencke, McCormick, & Notte-
baum, 2000, p. 64). Moreover, at the one-year follow-up, those
who were highly successful in attempting change of behavior
and
maintaining celibacy reported positive mental health on a
variety
of measures of happiness, loneliness, self-acceptance, and
depres-
sion (Schaeffer, Nottebaum, Smith, Dech, & Krawczyk, 1999).
These studies are mentioned simply because some conservative
religious persons dispute the claim that sexual orientation is im-
mutable. It should be noted, however, that these studies are with
convenience samples and are not meant to be representative of
all
LGB persons.
What complicates this area of research is that gay-affirmative
theorists disagree on what sexual orientation actually is.
Essential-
ists argue that sexual orientation is a universal reality, a stable
aspect of who an individual is as a person. Social
constructionists,
in contrast, view sexual orientation as a linguistic category con-
structed by society to explain a person’s sexual preference. This
is
not a debate between conservative religious and gay-affirmative
persons; rather, this is a discussion among theorists on both
“sides,” and the research does not yet clearly support one
perspec-
tive over the other. But if theorists are uncertain as to what
sexual
orientation is, then it is understandable that there is
disagreement
on whether it can be changed.
Respect for Diversity: Clinical Applications
What are the practical applications for psychologists who wish
to demonstrate respect for religion and sexual orientation when
they work with clients who enter therapy distressed by their
experiences of same-sex attraction? Psychologists can expand
what they see as viable resources for clients by thinking of a
continuum of professional and paraprofessional services for a
variety of presenting concerns. On either end of the continuum
are
gay-integrative approaches and reorientation therapies, and in
be-
tween are programs to help people achieve celibacy/chastity or
work toward sexual identity management (see Table 1).
Gay-Integrative Therapy
The goal of gay-integrative therapy is to integrate same-sex
impulses into an LGB identity. The assumption often expressed
is
that sexual orientation cannot (or, in some cases, should not) be
changed, and those who experience same-sex attraction are
better
off, all things considered, integrating their impulses into an
LGB
identity.
Dworkin (2000) is a professional exemplar of this approach. She
has discussed several themes in therapy with LGB clients,
includ-
ing sexual identity and self-identification, coming out,
internalized
homophobia, and victimization. She has viewed the coming-out
process as particularly important to LGB identity development
and
synthesis.
Dignity/USA is a paraprofessional exemplar of the gay-integra-
tive approach. Dignity/USA is an organization of LGB and
trans-
gender religious persons. Although not an official group sanc-
tioned by the Roman Catholic Church, Dignity is made up of
Catholics who seek to integrate their experiences of same-sex
attraction into an LGB identity. Dignity has five primary areas
of
concern and commitment: spiritual development, education,
social
justice, equality, and social support
(http://www.dignityusa.org).
Sometimes clients request a gay-integrative approach following
unsuccessful attempts to change their sexual orientation or
behav-
ior. With an increasingly visible LGB community, more clients
will presumably request this approach without having seriously
considered change. Psychologists who consider a referral to a
gay-integrative therapist should consider whether their client (a)
states this as a goal for treatment; (b) is in his or her normal
state
of mental health (e.g., has worked through feelings of anger,
frustration, or depression following unsuccessful approaches to
change orientation or behavior); (c) has had same-sex
experiences
(as opposed to fantasy); (d) is motivated by internal factors
(e.g.,
238 YARHOUSE AND BURKETT
personal values or sense of congruence) or external factors
(e.g.,
peer or subculture pressure); (e) has considered whether he or
she
has adequate social support and access to friends, family, places
of
worship, and community services that support such a decision;
and
(f) is aware of some of the possible benefits of and risks in
pursuing gay-integrative therapy at this time. Psychologists
should
remember that gay-integrative therapy can result in strained
friend-
ships and family relationships, as well as threats to employment
and housing. Benefits of gay-integrative therapy can include
pos-
itive self-esteem and a sense of congruence.
Reorientation/Reparative Therapy
On the other end of the continuum are reorientation/reparative
approaches, the goal of which is to assist individuals in
changing
their sexual orientation. A reparative approach is probably best
suited to those who come to view their inclinations as reflective
of
normal developmental needs that were unmet. These clients may
feel more compelled to find some kind of resolution, and they
may
feel that integrating their experience into an LGB sexual
identity is
irreconcilable with their beliefs and values.
The professional exemplar of the reparative approach is the
work of Nicolosi (1991, 1993), who responded to these clients
by
exploring their gender identity development. According to Nico-
losi, this involves exploring how some people can become at-
tracted to the attributes of their gender and later eroticize same-
sex
attraction through genital sexual activity and self-identification.
The paraprofessional exemplars of this approach are many
religion-based ministries, such as some Exodus International af-
filiates and Homosexuals Anonymous. Exodus is an umbrella
organization of many religion-based ministries, and some
(though
not all) of the specific affiliates place emphasis on change of
sexual orientation (http://www.exodusnorthamerica.org). Homo-
sexuals Anonymous also holds to a view that is consistent
with conservative religious clients who would view same-sex
be-
havior as inconsistent with their religious values about human
sexuality and sexual behavior
(http://members.aol.com/Hawebpage/
AboutHA/AboutHA.html).
When considering a referral to a reorientation therapist, the
psychologist should ask or assess if the client (a) states this as a
goal for treatment, (b) is not also suffering from a mental
illness
that is having an impact on decision making (e.g., the client has
worked through feelings of depression following unsuccessful
attempts to integrate his or her impulses into an LGB identity),
(c)
is motivated internally (e.g., personal values) versus externally
(e.g., societal disapproval), (d) has had experience with same-
sex
or opposite-sex behavior, (e) has adequate social support, (f)
has
sufficient emotional and financial resources to pursue an
extended
course of therapy, (g) has not already found reorientation
therapy
to be unsuccessful, and (h) is aware of the possible benefits and
risks of pursuing reorientation at this time. Psychologists may
also
discuss success rates and definitions of success in professional
therapy and paraprofessional ministries. Alternative approaches,
such as sexual identity management or celibacy/chastity ap-
proaches, may be appropriate for those who do not see a
reorien-
tation therapist but whose values do not support gay-integrative
therapy.
Sexual Identity Management
The …
AVIA 300
Final Paper Grading Rubric
Criteria
Levels of Achievement
Advanced
Proficient
Developing
Not present
Introduction
23 to 25 points
- A clear introduction statement introduces the topic the paper
is going to address;
-The introduction provides a clear overview of the paper's
contents.
18 to 22 points
One of the following is met:
- A clear introduction statement introduces the topic the paper
is going to address;
-The introduction provides a clear overview of the paper's
contents.
1 to 17 points
An introduction paragraph has been included but does not
contain either of the following:
- A clear introduction statement introduces the topic the paper
is going to address; -The introduction provides a clear overview
of the paper's contents.
0 points
There is no introduction paragraph present.
Content
72 to 80 points
All of the following conditions are met: -Content is substantive
with good development of ideas and concepts; -Assertions are
clearly supported and/or illustrated; -Understanding of the
subject is evident; -Focus of the paper is clear and coherent.
56 to 71 points
3 of the following conditions are met: -Content is substantive
with good development of ideas and concepts; -Assertions are
clearly supported and/or illustrated; -Understanding of the
subject is evident; -Focus of the paper is clear and coherent.
1 to 55 points
1-2 of the following conditions is met: -Content is substantive
with good development of ideas and concepts; -Assertions are
clearly supported and/or illustrated; -Understanding of the
subject is evident; -Focus of the paper is clear and coherent.
0 points
None of the following conditions are met: -Content is
substantive with good development of ideas and concepts; -
Assertions are clearly supported and/or illustrated; -
Understanding of the subject is evident; -Focus of the paper is
clear and coherent.
Conclusion
23 to 25 points
All of the following conditions are met: -The conclusion offers
a good summary of issues covered in the paper: -The conclusion
appropriately ties the main points of the paper together; -
Biblical/Personal viewpoint is presented.
18 to 22 points
Two of the following conditions are met: -The conclusion offers
a good summary of issues covered in the paper: -The conclusion
appropriately ties the main points of the paper together; -
Biblical/Personal viewpoint is presented.
1 to 17 points
One of the following conditions are met: -The conclusion offers
a good summary of issues covered in the paper: -The conclusion
appropriately ties the main points of the paper together; -
Biblical/Personal viewpoint is presented.
0 points
A conclusion is not included in the paper.
Materials/ Sources
41 to 45 points
All of the following conditions are met: -At least 3 academic
resources (books, journals, articles, etc.) are used; -Sources are
legitimate and traceable; -Effective research supports the
findings.
32 to 40 points
Two of the following conditions are met: -At least 3 academic
resources (books, journals, articles, etc.) are used; -Sources are
legitimate and traceable; -Effective research supports the
findings.
1 to 31 points
One of the following conditions is met: -At least 3 academic
resources (books, journals, articles, etc.) are used; -Sources are
legitimate and traceable; -Effective research supports the
findings.
0 points
None of the following conditions are met: -At least 3 academic
resources (books, journals, articles, etc.) are used; -Sources are
legitimate and traceable; -Effective research supports the
findings.
Format
36 to 40 points
All of the following conditions are met: -General appearance is
readable and neat; -Current APA style is used (margins,
font/type style, pagination, etc.); -Reference page is
alphabetized and correctly formatted; -Sources are cited in-text
28 to 35 points
3 of the following conditions are met: -General appearance is
readable and neat; -Current APA style is used (margins,
font/type style, pagination, etc.); -Reference page is
alphabetized and correctly formatted; -Sources are cited in-text
1 to 27 points
1-2 of the following conditions are met: -General appearance is
readable and neat; -Current APA style is used (margins,
font/type style, pagination, etc.); -Reference page is
alphabetized and correctly formatted; -Sources are cited in-text
0 points
None of the following conditions are met: -General appearance
is readable and neat; -Current APA style is used (margins,
font/type style, pagination, etc.); -Reference page is
alphabetized and correctly formatted; -Sources are cited in-text
Spelling/ Grammar
32 to 35 points
All of the following conditions are met: -Sentence fluency is
coherent, unified, and varied; -Sentence structure is complete,
clear, and concise; -Punctuation is correct; -Spelling is correct;
-Diction is precise, unambiguous, and appropriate.
25 to 31 points
3-4 of the following conditions are met: -Sentence fluency is
coherent, unified, and varied; -Sentence structure is complete,
clear, and concise; -Punctuation is correct; -Spelling is correct;
-Diction is precise, unambiguous, and appropriate.
1 to 24 points
1-2 of the following conditions is met: -Sentence fluency is
coherent, unified, and varied; -Sentence structure is complete,
clear, and concise; -Punctuation is correct; -Spelling is correct;
-Diction is precise, unambiguous, and appropriate.
0 points
None of the following conditions have been met: -Sentence
fluency is coherent, unified, and varied; -Sentence structure is
complete, clear, and concise; -Punctuation is correct; -Spelling
is correct; -Diction is precise, unambiguous, and appropriate.
Page 1 of 2

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An Inclusive Response to LGB and Conservative Religious Person.docx

  • 1. An Inclusive Response to LGB and Conservative Religious Persons: The Case of Same-Sex Attraction and Behavior Mark A. Yarhouse and Lori A. Burkett Regent University How should psychologists demonstrate respect for religion as an aspect of diversity when that aspect of diversity seems inconsistent with another form of diversity? This is a striking challenge when considering conservative expressions of religion in relation to a person’s experience of same-sex attraction and behavior. This article (a) asserts that conservative religion is a legitimate, though often overlooked, expression of diversity; (b) identifies ways in which gay- integrative theorists and conservative religious persons fail to appreciate each other’s perspective; and (c) presents a continuum of service delivery options to expand clinical services to persons who experience same-sex attraction. How should psychologists respond to persons who enter therapy distressed by their experiences of same-sex attraction? Does it matter if a person experiences distress about his or her same-sex attractions and behavior due to a religious valuative framework? In other words, how do psychologists balance respect for both sexual orientation and religion as legitimate aspects of diversity? Thoughtful, scientifically informed responses to these questions are often lost in the debates surrounding reorientation therapies
  • 2. and ex-gay1 religion-based ministries. Respecting Religion as an Aspect of Diversity There has been a rather dramatic interest in religion and spiri- tuality in the last few years, both in the public interest and in psychological circles. The American Psychological Association (APA) has published valuable resources on religion and spiritual- ity, including books by Shafranske (1996) and Richards and Ber- gin (1997, 2000). Other publishers have done the same (e.g., Emmons, 1999). What is implied by the availability of these resources, we believe, is that religion is an important expression of diversity. Just as race, ethnicity, socioeconomic status, age, gen- der, and sexual orientation are legitimate expressions of diversity, so too is religion. The Ethical Principles of Psychologists and Code of Conduct of the APA (1992; henceforth referred to as the Ethics Code) clearly includes religion among many areas of diversity that psychologists are to respect. For example, General Principle D: Respect for Rights and Dignity calls for psychologists to aspire to “accord respect to the fundamental rights, dignity, and worth of all peo- ple . . . . Psychologists are aware of cultural, individual, and role differences, including those due to . . . religion . . .” (APA, 1992, p. 3). The Ethics Code also includes respect for others: “In their work-related activities, psychologists respect the rights of others to
  • 3. hold values, attitudes, and opinions that differ from their own” (Standard 1.09; APA, 1992, p. 5). But what does “respecting” religion as an area of diversity entail? At a basic level, it would seem that it means not discrim- inating against clients because of their religion or religious prac- tices or the values that derive from their religion (Stan- dard 1.08, 1.10). This does not mean that psychologists agree with every belief or value associated with a religion. This is impossible because major religions disagree with one another on fundamental claims and worldview assumptions. In a similar way, when psy- chologists respect cultural differences, they do not necessarily endorse specific cultural values, but they do not discriminate against a client because of his or her cultural beliefs. Complications arise when psychologists respect two competing expressions of diversity: sexual orientation and conservative ex- pressions of religion. The recent Resolution on Appropriate Ther- apeutic Response to Sexual Orientation (APA, 1998; http://www. apa.org/pi/sexual.html) and Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients (Division 44/Committee on Lesbian, Gay, and Bisexual Concerns Joint Task Force, 2000) clearly expand on what it means to demonstrate respect for sexual orientation. These documents address psychologists’ awareness of negative social messages and prejudices against lesbian, gay male, and bisexual (LGB) persons, reports of emotional distress, and
  • 4. 1 Throughout this article we use the terms gay, ex-gay, and ex- ex-gay; in this context, the term gay is used broadly to mean a person who has integrated his or her same-sex attraction into a lesbian, gay male, or bisexual identity. MARK A. YARHOUSE received his PsyD in clinical psychology from Wheaton College in 1998. He is an assistant professor of psychology at Regent University and is in independent practice in Virginia Beach, VA. His research interests include human sexuality, ethics, and integration of psychology and theology. LORI A. BURKETT is a student in the doctoral program in clinical psychol- ogy at Regent University. PORTIONS OF THIS ARTICLE were presented as part of a symposium chaired by M. A. Yarhouse, Gays, Ex-Gays, and Ex-Ex-Gays: Examining Key Religious, Ethical, and Diversity Issues, which was conducted at the 108th Annual Convention of the American Psychological Association, August 2000, Washington, DC. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Mark A. Yarhouse, School of Psychology and Counseling, Regent University, CRB 215, 1000 Regent University Drive, Virginia Beach, Virginia 23464.
  • 5. E-mail: [email protected] Professional Psychology: Research and Practice Copyright 2002 by the American Psychological Association, Inc. 2002, Vol. 33, No. 3, 235–241 0735-7028/02/$5.00 DOI: 10.1037//0735-7028.33.3.235 235 how some persons may feel pressured into treatment to change their sexual orientation. In these resources and in the broader discussions of LGB issues, however, conservative expressions of religion often appear to be overlooked as an aspect of diversity. It appears that most psychol- ogists are comfortable with more liberal expressions of a religion (e.g., some Christian groups, such as Dignity/USA, are gay- affirmative). However, inherent in “respecting” religion as an aspect of diversity is also demonstrating respect for those who hold to the conservative, orthodox teachings of that religion. This concept becomes clearer if we return to what it means to “respect” cultural diversity. Psychologists would not, for example, demon- strate respect for cultural diversity if they worked only with members of a minority group who were sufficiently acculturated and divorced from the customs and values of their country of origin. Rather, psychologists respect cultural diversity by trying to help clients balance their traditional, cultural values and beliefs with some of their experiences in their new society. The same approach is needed regarding conservative religious beliefs.
  • 6. A recent Chronicle of Higher Education article reported on data suggesting antipathy and prejudice against conservative Christians (Miller, 2000). In fact, it was reported that about 20% of Ameri- cans, and nearly 40% of highly educated Americans, are “intensely antagonistic” toward conservative Christians (p. A18). It was also reported that as many as 20% of Americans who are not Christian fundamentalists hold Christian fundamentalists in lower regard than they do illegal aliens. Are conservative religious persons at risk of becoming marginalized in society? Psychologists can play a role in protecting those at risk of becoming marginalized by hearing the voices of those who live by traditional, conservative expressions of their religion or who are religiously orthodox. Religious orthodoxy refers to “the degree to which a person believes in and adheres to the traditional doctrines and moral teachings of his or her religion” (Richards & Bergin, 1997, p. 177). Richards and Bergin distinguished between belief orthodoxy, or “acceptance of the doctrinal beliefs of one’s reli- gion,” and behavior orthodoxy (more commonly referred to by theologians as orthopraxy), or “adherence to the moral teachings and practices of one’s religion” (p. 177). Respecting belief orthodoxy and behavior orthodoxy is at the heart of what it means to respect religion as a legitimate expression of diversity. Respect for diversity implies that it would be intol- erant to disregard a religious person’s conservative theological
  • 7. view that same-sex behavior is immoral; it means understanding why a conservative religious person chooses not to engage in same-sex behavior. When faced with a clinical situation in which a conservative religious individual is struggling with same-sex attraction or be- havior, it is critical that the psychotherapist consider what it means to an orthodox religious person to have such thoughts or to have engaged in such sexual behavior. It is important to think about what it means to conservative religious individuals to live by the normative teachings of their church and faith. Respecting a conservative religious person’s view of same-sex behavior is not tantamount to supporting inappropriate heterosex- ism (discrimination and prejudice against LGB persons that is the equivalent of racism or sexism). There is a difference between moral evaluation of same-sex behavior as volitional conduct and prejudice against another for his or her race or sex. Some gay- affirmative theorists acknowledge this distinction. For example, Stein (1999) acknowledged that sexual attractions and behavior are two different things and that behaviors are volitional and may be evaluated with respect to their moral status: Even if one’s sexual orientation is primarily biological and not a choice, much of what is ethically relevant about being a lesbian or a gay man is not biologically based and is not determined, [such as]
  • 8. engaging in sexual acts with a person of the same sex-gender. (pp. 288 –289) Key Issues That Are Viewed Differently Five key issues seem to be viewed differently by gay- affirmative theorists and conservative religious persons: (a) ap- praisal of same-sex behavior; (b) the existence of “ex-gays”; (c) the existence of “ex-ex-gays”; (d) the existence of reorientation therapies, alternative therapies, and religious ministries; and (e) research on change of sexual behavior and orientation. Appraisal of Same-Sex Behavior One of the primary differences between gay-affirmative theo- rists and conservative religious persons is how they view or evaluate same-sex behavior. Gay-affirmative theorists view same- sex behavior as integral to full expression of oneself as a person. Thus, gay-integrative therapy has the goal of helping people who experience same-sex attraction to integrate their experiences into a gay male or lesbian identity synthesis (Dworkin, 2000). In contrast, conservative religious persons do not assume that same-sex identity is at the core of how a conservative religious person wants to experience himself or herself, with religious identity at the periphery. Rather, some conservative religious per- sons view sexual attraction and behavior in the context of a broader religious valuative framework (cf. Harvey, 1987; Satin- over, 1996). Conservative Christians teach that God created people
  • 9. as men and women and that marriage is the context for genital sexual contact (Prichard, 1991). Also, a conservative religious person would not necessarily assume that full sexual intimacy is integral to one’s core identity or self-expression. Both views are probably not equally true—that is, same-sex behavior is not simultaneously moral and immoral. However, psychology as a science cannot determine the moral status of same-sex behavior. The behavioral sciences can only inform moral reasoning by measuring the results of specific behaviors; they cannot determine which moral system to use (e.g., egoism, the view that what is right is what produces the most happiness for a person; divine command, the claim that what is right is what God says is right; or another ethical system). Such empirical criteria may be relatively short-term (as contrasted with a conservative religious person’s concern for eternal significance), but they can inform moral reasoning and be treated as “informed consent” for the choices made by clients whom psychologists are expected to treat as autonomous, self-determining agents (APA, 1992, pp. 3–5). Ex-Gays How do the two groups view “ex-gays”? At one level (and a simplistic level at that), ex-gays are often viewed as those who 236 YARHOUSE AND BURKETT succeed in changing their sexual orientation from gay to hetero-
  • 10. sexual. At another level, ex-gays may be understood to be those who experience same-sex attraction but choose not to integrate same-sex impulses into an LGB identity. Rather, they seek to tie their identity to other aspects of who they take themselves “to be as a person,” and they see their sexual impulses as one of many aspects of their experience that they choose not to identify with (Bergner, 1995; Comiskey, 1989). This is often the experience of many active in religion-based ministries, such as Exodus Interna- tional, Homosexuals Anonymous, and Courage. Gay-affirmative theorists, in contrast, tend to view people who identify themselves as being ex-gay as casualties of a larger social conflict characterized by prejudice and discrimination. Change attempts are the result of repressive and condemnatory socioreli- gious prejudices. In one presentation, it was suggested that ex- gays exist because the gay community failed to support them in their efforts toward identity synthesis (Shidlo & Schroeder, 1999). In other contexts, ex-gays are sometimes characterized as really being bisexuals rather than as being true gay males or lesbians. Is it possible that both accounts are partially true? It is important to clarify the motivations for change in relation to the existence of ex-gays. Some people pursue change because they do not feel supported in their desire to come out and identify as LGB. It is not uncommon to work with individuals who say they would like to come out but fear doing so because of the response they would
  • 11. receive from their family, coworkers, or others. This requires conservative religious persons to admit that not everyone who experiences same-sex attraction and seeks change does so because of a moral valuative framework; rather, some pursue change be- cause of how hard it would be to integrate their impulses into an LGB identity and live openly in society with such an identity. Of course, an alternative motivation for change is that some people pursue change because they hold convictions about the immorality of same-sex behavior that they derive from a theology of human sexuality. They are religious persons, and they want to live ac- cording to the prescriptive dimension of their religion, which, in this case, prohibits same-sex behavior. It may be that most people who pursue change do so for a combination of reasons. Ex-Ex-Gays A similar tension exists when we consider “ex-ex-gays.” They are individuals who once lived an LGB lifestyle, later attempted to change their behavior or attractions, and still later returned to living an LGB lifestyle. From a conservative religious perspective, ex-ex-gays may be the result of poor therapeutic technique, insuf- ficient client commitment or motivation, moral or spiritual failure, or failure of ministries to offer realistic expectations of change. This last consideration is particularly important. It might be that conservative religious persons hold out expectations for change that are too high (i.e., that a person would be free from every vestige of same-sex desire and would be happy and fulfilled in
  • 12. marriage). From this perspective, ex-ex-gays are discouraged, sometimes angry, about their experiences within religion-based ministries. Gay-affirmative theorists tend to see ex-ex-gays as casualties of professional interventions and religious ministries (Haldeman, 1994). Gay-affirmative theorists propose that ex-ex-gays are the result of the predictable failure of sexual reorientation therapy and religion-based ministries to accomplish what they purport to ac- complish. According to Haldeman, some question whether these proponents of reorientation and reparative therapies are not dis- turbed themselves, preying on vulnerable persons who are hoping against hope to experience change. Again, is there merit to both accounts? Is it possible that some people are misled about what reorientation and reparative therapy can offer? It is possible that some people do hold expectations for change that are too high. Whether the individual is freely seeking changes for personally felt reasons or is being taken to a program for change by a third party is also a factor in relation to this topic. All of this depends on several factors, including what sexual orientation is, whether it is immutable, and what evidence exists for the effectiveness of reorientation and reparative therapies. It is important for professionals and ministry leaders to recognize, too, that there have been attempts to cover up sexual indiscretions by
  • 13. past ministry leaders (Blair, 1982). Presumably, a small percentage of ministry personnel are involved in ministry for the wrong reasons or are at least vulnerable to acting-out behavior and do not have a sufficient support system and accountability structure to facilitate their ministry. Reorientation/Alternative Therapies and Religious Ministries Gay-affirmative and conservative religious persons also dis- agree about the existence of reorientation therapy, alternative therapies (e.g., sexual identity management, behavior manage- ment), and religious ministries. Some gay-affirmative theorists believe that the very existence of religious ministries and reorien- tation therapies suggests that LGB persons are “sick” (and should be “cured”). They fear other negative repercussions for the LGB community overall. For example, Stein (1999) argued that the availability of conversion programs, hormonal therapy, dietary supplements, or other techniques for changing sexual orientations would encourage the view that lesbians, gay men, and bisexuals are diseased; increase pressure to keep one’s homosexuality secret; en- gender and perpetuate attitudes that lesbians and gay men are worth- less; encourage policies that discriminate against lesbians and gay men; and increase violence towards them. (p. 323)
  • 14. Some may say that the existence of the alternative therapies is detrimental to the LGB community if the therapies do not work. Others, including Stein (1999), have argued that these therapies are detrimental even if the therapies are found to be successful: “The availability of psychological conversion programs have [serious negative] effects whether or not they are ‘successful’” (p. 325). Haldeman (1994) pointed out that some reorientation ap- proaches and religious ministries promote the view that homosex- uality is a pathology. Some organizations may also share misin- formation about sexual orientation, a concern raised by the APA’s Resolution on Appropriate Therapeutic Responses to Sexual Ori- entation (APA, 1998; http://www.apa.org/pi/sexual.html). The public is often unaware that although some religious ministries and alternative therapies promote accurate information, others do not. The concern for the conservative religious person is the impli- cation for what it means to “respect” the autonomy and self- determination of persons who have different beliefs and values about same-sex behavior. From a conservative religious perspec- 237SPECIAL SECTION: RELIGION AS AN ASPECT OF DIVERSITY tive, reorientation therapies, alternative therapies, and religious ministries exist as a response to a person’s decision that acting
  • 15. on same-sex attraction is wrong. Change may mean attempting to change sexual orientation, although it may also mean attempting to decrease same-sex fantasies and behavior, increase heterosexual fantasies and behavior, or achieve celibacy. The middle ground here may be to recognize that in a diverse and pluralistic society, gay-affirmative therapy, reorientation ther- apy, and alternative approaches may be viable options, and psy- chologists should be mindful of ways in which harm can result from misinformation. The challenge may lie in whether the poten- tial impact of the existence of such programs outweighs the po- tential impact of not providing such services to those who request them. In the meantime, the key concern is whether such programs are effective. Research on Change of Sexual Behavior and Orientation Perhaps the greatest point of disagreement is whether change in sexual orientation is possible. Many gay-affirmative theorists ar- gue that therapy cannot change sexual orientation or that, at least, there is no evidence to date that therapy can change sexual orien- tation. In his review of the change literature, Haldeman (1994), for example, discussed several individual and group treatments from the 1960s and 1970s, as well as more recent efforts by Nicolosi (1991). Haldeman was particularly concerned that researchers
  • 16. and clinicians may sometimes mislabel gay men and lesbians as bi- sexual. He also criticized the research as too often emphasizing changed behavior rather than a more fundamental change of orientation. Conservative religious persons who have looked at the change research have argued that sexual orientation does not appear to be immutable (Satinover, 1996). Recent survey research by MacIn- tosh (1994; see also National Association for Research and Treat- ment of Homosexuality, 1997; Nicolosi, Byrd, & Potts, 2000) has challenged the claim of the absolute immutability of sexual orien- tation; 274 psychoanalysts reported working with 1,215 gay male and lesbian patients, with reported change of sexual orientation for 22.7% of patients (23.9% of men; 20.2% of women). Studies of therapist recall are susceptible to overreporting of treatment suc- cess and underreporting of treatment failure; however, from the conservative religious person’s perspective, the MacIntosh study and those like it cannot be dismissed as irrelevant to the debate about whether such therapy can be beneficial. More recent research, also of a convenience sample, suggests that religious motivation is an important factor for some people who report behavioral change and change of “feeling-based sexual orientation” (Schaeffer, Hyde, Kroencke, McCormick, & Notte- baum, 2000, p. 64). Moreover, at the one-year follow-up, those who were highly successful in attempting change of behavior
  • 17. and maintaining celibacy reported positive mental health on a variety of measures of happiness, loneliness, self-acceptance, and depres- sion (Schaeffer, Nottebaum, Smith, Dech, & Krawczyk, 1999). These studies are mentioned simply because some conservative religious persons dispute the claim that sexual orientation is im- mutable. It should be noted, however, that these studies are with convenience samples and are not meant to be representative of all LGB persons. What complicates this area of research is that gay-affirmative theorists disagree on what sexual orientation actually is. Essential- ists argue that sexual orientation is a universal reality, a stable aspect of who an individual is as a person. Social constructionists, in contrast, view sexual orientation as a linguistic category con- structed by society to explain a person’s sexual preference. This is not a debate between conservative religious and gay-affirmative persons; rather, this is a discussion among theorists on both “sides,” and the research does not yet clearly support one perspec- tive over the other. But if theorists are uncertain as to what sexual orientation is, then it is understandable that there is disagreement on whether it can be changed. Respect for Diversity: Clinical Applications What are the practical applications for psychologists who wish
  • 18. to demonstrate respect for religion and sexual orientation when they work with clients who enter therapy distressed by their experiences of same-sex attraction? Psychologists can expand what they see as viable resources for clients by thinking of a continuum of professional and paraprofessional services for a variety of presenting concerns. On either end of the continuum are gay-integrative approaches and reorientation therapies, and in be- tween are programs to help people achieve celibacy/chastity or work toward sexual identity management (see Table 1). Gay-Integrative Therapy The goal of gay-integrative therapy is to integrate same-sex impulses into an LGB identity. The assumption often expressed is that sexual orientation cannot (or, in some cases, should not) be changed, and those who experience same-sex attraction are better off, all things considered, integrating their impulses into an LGB identity. Dworkin (2000) is a professional exemplar of this approach. She has discussed several themes in therapy with LGB clients, includ- ing sexual identity and self-identification, coming out, internalized homophobia, and victimization. She has viewed the coming-out process as particularly important to LGB identity development and synthesis. Dignity/USA is a paraprofessional exemplar of the gay-integra- tive approach. Dignity/USA is an organization of LGB and
  • 19. trans- gender religious persons. Although not an official group sanc- tioned by the Roman Catholic Church, Dignity is made up of Catholics who seek to integrate their experiences of same-sex attraction into an LGB identity. Dignity has five primary areas of concern and commitment: spiritual development, education, social justice, equality, and social support (http://www.dignityusa.org). Sometimes clients request a gay-integrative approach following unsuccessful attempts to change their sexual orientation or behav- ior. With an increasingly visible LGB community, more clients will presumably request this approach without having seriously considered change. Psychologists who consider a referral to a gay-integrative therapist should consider whether their client (a) states this as a goal for treatment; (b) is in his or her normal state of mental health (e.g., has worked through feelings of anger, frustration, or depression following unsuccessful approaches to change orientation or behavior); (c) has had same-sex experiences (as opposed to fantasy); (d) is motivated by internal factors (e.g., 238 YARHOUSE AND BURKETT personal values or sense of congruence) or external factors (e.g., peer or subculture pressure); (e) has considered whether he or she has adequate social support and access to friends, family, places
  • 20. of worship, and community services that support such a decision; and (f) is aware of some of the possible benefits of and risks in pursuing gay-integrative therapy at this time. Psychologists should remember that gay-integrative therapy can result in strained friend- ships and family relationships, as well as threats to employment and housing. Benefits of gay-integrative therapy can include pos- itive self-esteem and a sense of congruence. Reorientation/Reparative Therapy On the other end of the continuum are reorientation/reparative approaches, the goal of which is to assist individuals in changing their sexual orientation. A reparative approach is probably best suited to those who come to view their inclinations as reflective of normal developmental needs that were unmet. These clients may feel more compelled to find some kind of resolution, and they may feel that integrating their experience into an LGB sexual identity is irreconcilable with their beliefs and values. The professional exemplar of the reparative approach is the work of Nicolosi (1991, 1993), who responded to these clients by exploring their gender identity development. According to Nico- losi, this involves exploring how some people can become at- tracted to the attributes of their gender and later eroticize same- sex attraction through genital sexual activity and self-identification.
  • 21. The paraprofessional exemplars of this approach are many religion-based ministries, such as some Exodus International af- filiates and Homosexuals Anonymous. Exodus is an umbrella organization of many religion-based ministries, and some (though not all) of the specific affiliates place emphasis on change of sexual orientation (http://www.exodusnorthamerica.org). Homo- sexuals Anonymous also holds to a view that is consistent with conservative religious clients who would view same-sex be- havior as inconsistent with their religious values about human sexuality and sexual behavior (http://members.aol.com/Hawebpage/ AboutHA/AboutHA.html). When considering a referral to a reorientation therapist, the psychologist should ask or assess if the client (a) states this as a goal for treatment, (b) is not also suffering from a mental illness that is having an impact on decision making (e.g., the client has worked through feelings of depression following unsuccessful attempts to integrate his or her impulses into an LGB identity), (c) is motivated internally (e.g., personal values) versus externally (e.g., societal disapproval), (d) has had experience with same- sex or opposite-sex behavior, (e) has adequate social support, (f) has sufficient emotional and financial resources to pursue an extended course of therapy, (g) has not already found reorientation therapy to be unsuccessful, and (h) is aware of the possible benefits and risks of pursuing reorientation at this time. Psychologists may
  • 22. also discuss success rates and definitions of success in professional therapy and paraprofessional ministries. Alternative approaches, such as sexual identity management or celibacy/chastity ap- proaches, may be appropriate for those who do not see a reorien- tation therapist but whose values do not support gay-integrative therapy. Sexual Identity Management The … AVIA 300 Final Paper Grading Rubric Criteria Levels of Achievement Advanced Proficient Developing Not present Introduction 23 to 25 points - A clear introduction statement introduces the topic the paper is going to address; -The introduction provides a clear overview of the paper's contents. 18 to 22 points One of the following is met: - A clear introduction statement introduces the topic the paper is going to address; -The introduction provides a clear overview of the paper's contents. 1 to 17 points An introduction paragraph has been included but does not
  • 23. contain either of the following: - A clear introduction statement introduces the topic the paper is going to address; -The introduction provides a clear overview of the paper's contents. 0 points There is no introduction paragraph present. Content 72 to 80 points All of the following conditions are met: -Content is substantive with good development of ideas and concepts; -Assertions are clearly supported and/or illustrated; -Understanding of the subject is evident; -Focus of the paper is clear and coherent. 56 to 71 points 3 of the following conditions are met: -Content is substantive with good development of ideas and concepts; -Assertions are clearly supported and/or illustrated; -Understanding of the subject is evident; -Focus of the paper is clear and coherent. 1 to 55 points 1-2 of the following conditions is met: -Content is substantive with good development of ideas and concepts; -Assertions are clearly supported and/or illustrated; -Understanding of the subject is evident; -Focus of the paper is clear and coherent. 0 points None of the following conditions are met: -Content is substantive with good development of ideas and concepts; - Assertions are clearly supported and/or illustrated; - Understanding of the subject is evident; -Focus of the paper is clear and coherent. Conclusion 23 to 25 points All of the following conditions are met: -The conclusion offers a good summary of issues covered in the paper: -The conclusion appropriately ties the main points of the paper together; - Biblical/Personal viewpoint is presented. 18 to 22 points Two of the following conditions are met: -The conclusion offers
  • 24. a good summary of issues covered in the paper: -The conclusion appropriately ties the main points of the paper together; - Biblical/Personal viewpoint is presented. 1 to 17 points One of the following conditions are met: -The conclusion offers a good summary of issues covered in the paper: -The conclusion appropriately ties the main points of the paper together; - Biblical/Personal viewpoint is presented. 0 points A conclusion is not included in the paper. Materials/ Sources 41 to 45 points All of the following conditions are met: -At least 3 academic resources (books, journals, articles, etc.) are used; -Sources are legitimate and traceable; -Effective research supports the findings. 32 to 40 points Two of the following conditions are met: -At least 3 academic resources (books, journals, articles, etc.) are used; -Sources are legitimate and traceable; -Effective research supports the findings. 1 to 31 points One of the following conditions is met: -At least 3 academic resources (books, journals, articles, etc.) are used; -Sources are legitimate and traceable; -Effective research supports the findings. 0 points None of the following conditions are met: -At least 3 academic resources (books, journals, articles, etc.) are used; -Sources are legitimate and traceable; -Effective research supports the findings. Format 36 to 40 points All of the following conditions are met: -General appearance is readable and neat; -Current APA style is used (margins,
  • 25. font/type style, pagination, etc.); -Reference page is alphabetized and correctly formatted; -Sources are cited in-text 28 to 35 points 3 of the following conditions are met: -General appearance is readable and neat; -Current APA style is used (margins, font/type style, pagination, etc.); -Reference page is alphabetized and correctly formatted; -Sources are cited in-text 1 to 27 points 1-2 of the following conditions are met: -General appearance is readable and neat; -Current APA style is used (margins, font/type style, pagination, etc.); -Reference page is alphabetized and correctly formatted; -Sources are cited in-text 0 points None of the following conditions are met: -General appearance is readable and neat; -Current APA style is used (margins, font/type style, pagination, etc.); -Reference page is alphabetized and correctly formatted; -Sources are cited in-text Spelling/ Grammar 32 to 35 points All of the following conditions are met: -Sentence fluency is coherent, unified, and varied; -Sentence structure is complete, clear, and concise; -Punctuation is correct; -Spelling is correct; -Diction is precise, unambiguous, and appropriate. 25 to 31 points 3-4 of the following conditions are met: -Sentence fluency is coherent, unified, and varied; -Sentence structure is complete, clear, and concise; -Punctuation is correct; -Spelling is correct; -Diction is precise, unambiguous, and appropriate. 1 to 24 points 1-2 of the following conditions is met: -Sentence fluency is coherent, unified, and varied; -Sentence structure is complete, clear, and concise; -Punctuation is correct; -Spelling is correct; -Diction is precise, unambiguous, and appropriate. 0 points None of the following conditions have been met: -Sentence fluency is coherent, unified, and varied; -Sentence structure is
  • 26. complete, clear, and concise; -Punctuation is correct; -Spelling is correct; -Diction is precise, unambiguous, and appropriate. Page 1 of 2