Tuesday, August 16, 2011

Sexual Orientation Change Efforts Do Not Lead to Increased Suicide Attempts



NARTH Bulletin - August 11, 2011 

A NARTH Research Report




Sexual Orientation Change Efforts Do Not Lead to Increased Suicide Attempts



Although accusations of harm are often made regarding Sexual Orientation Change Efforts (SOCE), the American Psychological Association admits that the research to date does not support such claims (APA, 2009). Despite the lack of research to support claims of harm, those claims continue to be made, including claims that SOCE actually contribute to a greater risk of suicide. What exactly does the research reveal? This summary of the research, taken from Whitehead (2010), reveals that providing psychological care to persons with unwanted homosexual thoughts and feelings does not increase a client's suicide risk.


Research has examined whether or not SOCE are harmful to clients (Nicolosi, Byrd, & Potts, 2000; Beckstead, 2004; Shidlo & Schroeder, 2002; Spitzer, 2003; Jones & Yarhouse, 2007; Karten & Wade, 2010.) Four of the six studies have empirically shown that there was no harm or increased rates of suicide for clients receiving psychological care, but rather many positive outcomes. However, Shidlo & Schroeder (2002) specifically report negative experiences for clients receiving psychological care for unwanted homosexual thoughts and feelings, including a worsening in self-image, and attempted suicides, sometimes ascribed to their therapy. A closer analysis of this study follows. However, it should first be noted that this study was designed with a very clear bias, as the researchers actually advertised for participants by stating, "Help Us Document the Damage of Homophobic Therapists". Their study was entitled, "Homophobic Therapies: Documenting the Damage" (Shidlo & Schroeder, 2002, p. 259).


Despite their clearly biased recruiting methods, Shidlo and Shchroeder (2002) did discover positive outcomes for some clients. To their credit, they honestly reported the positive results in their paper. Regarding their claims of harm, Shidlo and Schroeder report the number of persons involved in suicide attempts before, during, and after therapy respectively were: 25, 23, and 11. The number of suicide attempts decreases following therapy. In Figure 1 these are graphed allowing for the time periods involved, and comparing them with what would be expected if there were the same suicidality per unit time, i.e. no effect of therapy.


Figure 1. Observed and Expected Suicide Rates reported by Shidlo and Schroeder (2002). 





In addition, since Shidlo and Schroeder's (2002) sample contained 26 satisfied and 176 dissatisfied clients, it is unlikely that this represents the distribution of satisfaction among their previous clients for the average therapist, especially when compared to other satisfaction research (e.g. Karten, 2010). The reduction in suicidality would almost certainly be even larger and more statistically significant with a more representative sample. There is obviously a need for a fuller survey to establish this conclusion more precisely. This is a rather trivial conclusion-in some respects, anyone encouraged to adopt a less risky lifestyle will experience very good long term effects, and probably a reduction in suicidality.


It is very important to note that Shidlo and Schroeder's (2002) results reflect the universal pattern seen in all psychotherapy. As demonstrated numerous times (e.g. Erlangsen, Zarit, Tu, & Conwell, 2006; Qin & Nordentoft, 2005; Qin, et al. 2006), when psychiatric patients are admitted to a hospital, attempted suicide rates rise to a very high level in the first week after admission, and there is usually a secondary peak the first week after discharge, then a strong long-term decrease to well below pre-admission rates. In a kind of psychological reaction, once rescued ("under treatment"), they give up on their heroic endurance.


For therapists the conclusion of this statistical examination would be that overall the suicide attempts were not markedly higher in therapy than pre-therapy, but that there is a peak in attempts during therapy already familiar from other forms of psychological care. A continuance of conventional surveillance would be prudent.


(To read this article in its entirety, see Whitehead, N. (2010). Homosexuality and Co-Morbidities: Research and Therapeutic Implications. Journal of Human Sexuality, 2, 125-176.)




APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation. (2009). APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation, Washington, DC.


Beckstead, A. L., & Morrow, S. L. (2004). Mormon clients' experiences of conversion. therapy: The need for a new treatment approach. Consulting Psychologist, 32, 651-690.


Erlangsen, A., Zarit, S. H., Tu, X., & Conwell, Y. (2006). Suicide among older psychiatric inpatients: An evidence-based study of a high-risk group. American Journal of Geriatric Psychiatry, 14(9), 34-741.


Jones, S. L., & Yarhouse, M. A. (2007). Ex-gays? A longitudinal study of religiously mediated change in Sexual Orientation. Intervarsity Press, Downers Grove: Il.


Karten, E. Y, & Wade, J. C. (2010). Sexual orientation change efforts in men: A client perspective. Journal of Men's Studies. 18, 84-102.


Nicolosi, J., Byrd, A. D., & Potts, R. W. (2000). Retrospective self-reports of changes in homosexual orientation: A consumer survey of conversion therapy clients. Psychological Reports, 86, 1071-1088.


Qin, P., & Nordentoft, M. (2005). Suicide risk in relation to psychiatric hospitalization: Evidence based on longitudinal registers. Archives of General Psychiatry, 62(4), 427-432.


Qin, P., Nordentoft, M., Hoyer, E. H., Agerbo, E., Laursen, T. M., & Mortensen, P. B. (2006). Trends in suicide risk associated with hospitalized psychiatric illness: A case-control study based on Danish longitudinal registers. Journal of Clinical Psychiatry, 67(12), 1936-1941.


Shidlo A., & Schroeder, M. (2002). Changing sexual orientation: A consumers' report. Professional Psychology: Research and Practice, 33, 249-259.


Spitzer, R. L. (2003). Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation. Archives of Sexual Behavior. 32, 403-417.


Whitehead, N. (2010). Homosexuality and Co-Morbidities: Research and Therapeutic Implications. Journal of Human Sexuality, 2, 125-176.






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