ACC “Bans” Reparative Therapy

In an extraordinary move the Association of Christian Counsellors in the UK has asked its members not to conduct reparative therapy.

In December 2012, ACC made a statement to its members supporting and clarifying our ethical framework. The Board has continued to discuss and reflect on the area specifically relating to work with clients who present with same sex attraction issues and is now updating our guidance to counsellors, supervisors and members.

For the purpose of clarity below is the first part of the original statement mentioned above:

“All counsellors are required with due diligence to provide safe practice on behalf of their clients. This requires the counsellor to practice fully within the Ethics and Practice framework they are using with each client. The client is to be aware of the Framework being used as essential information during contracting and guidance given as to which complaints procedure is in operation.

The particular ethical considerations taken from the ACC Ethics and Practice are:
(From’ Ethics for Members of the Association of Christian Counsellors’ section)

5.1 “Members should be trustworthy…maintain confidentiality…”
5.2 “Members should respect their clients’ right to take decisions for and to act for themselves.”
5.3 “Members should be committed to securing the client’s best interests.”.
5.5. “Members should avoid any action which might cause harm to a client.
One of the most important aspects in counselling is client autonomy.”

In addition ACC has now reflected on the following (from ‘ACC Good Practice in Christian Counselling and related fields’ section 5) and its application including how it relates to the Equality Act 2010: Good Practice in Christian Counselling and related fields states5.1.1.12. Members should not allow any personal views they may hold about lifestyle, gender, age, disability, race, sexual orientation, beliefs or culture to prejudice their professional relationships with clients. The Equality Act 2010 requires that discrimination does not occur on the following protected grounds: age, disability, gender, gender reassignment, pregnancy and maternity, race, religion and belief and sexual orientation.

As counsellors working in the UK, ACC members are expected to adhere to both ACC Code of Ethics and Good Practice and to UK Law, which means adhering to both of the statements made above.

It is clear that in some instances the ‘protected grounds’’, as defined by the Equality Act 2010, of one individual may appear to be contrary to that of another (or indeed may be in conflict within an individual) i.e. the religious beliefs of a counsellor and the sexual orientation of a counsellee. In such instances ACC would expect our members to act without discrimination towards all and uphold the rights of the protected characteristics enshrined in the Equality Act 2010.

In addition the essential characteristics of a therapeutic relationship are genuineness, congruence, unconditional positive regard, empathy and understanding (being non-judgmental, warm and empathic) thus providing a safe environment for the client to explore their feelings and concerns. It is clear that in protecting client autonomy it is important for counsellors not to impose themselves or their beliefs on anyone who comes for therapy, either by implying that a particular outcome is possible or expecting the client to come into alignment with their own belief system or understanding on certain approaches to life. Such actions would be unethical and so ACC would expect any member to consider the therapeutic model that they are using to be in-line with these principles and characteristics. ACC has therefore expanded on the original statement that reflects more clearly its view on therapy in relation to same sex attraction.

There are certain guiding principles arising from ACC Ethics and Practice framework. These guiding principles apply when deciding what is appropriate in practice or for any therapeutic model. Namely that …

a) Counsellors / therapists do not make assumptions that the client is looking for a particular outcome
b) Do not allow counsellors/ therapists to suggest, impose, advertise that therapy would achieve a particular outcome / change etc.
c) Counsellors / therapists do not make the achievement of a particular outcome (determined by the counsellor/therapist), be the measure by which success / failure of the therapy is determined
d) Counsellors / therapists do not impose a particular moral standpoint or belief system on the client.

We have considered Reparative (or Conversion) Therapy by these principles and have decided that it does not fit the above criteria for the following reasons:

i. Its language implies that sexuality can be ‘repaired’ and so introduces the idea of treatment or cure.
ii. Where it is proposed, advertised, or practiced as a therapy, it suggests that a specific outcome is possible and appears to make an a-priori assumption that it should happen. This would not fit any of the above guiding principles.
iii. It is incompatible with the Equality Act 2010.

For this reason, we do not endorse Reparative or Conversion Therapy or any model that implies a predetermined direction of outcome of counselling at the outset. We recognize that such models have the potential to impose situational demands on the client at a time of vulnerability with the potential to create harm and therefore view them as incompatible within the ethos of counselling.

Members who are considering using this model of therapy should neither commence nor continue to use it and any advertising or promotional material should be replaced immediately, or at least removed from current use. This includes the ACC “Find a counsellor” facility on our website.

We recognize that this is not the view of some of our members but in the interests of public safety we have decided to make clear what is expected by those who choose to be part of ACC.

Let’s begin by examining what is good about this statement. It is absolutely correct that counsellors / therapists should not impose their beliefs on clients and neither should they be heavily steering counselling sessions. If we need reminding, when Lesley Pilkington was brought in front of the disciplinary panel of the BACP, the issue of her conducting reparative therapy was never actually ruled on – rather it was her poor practice (as the BACP saw it) that was criticised (despite what Patrick Strudwick may claim when he states this was a condemnation of “gay cure therapies”). Therapists should always hold the highest professional standards and not attempt to manipulate someone into taking a particular course of action.

I’ve also written here before about my concerns with some proponents of reparative therapy in that they seem to want to impose particular reparative frameworks on all clients, regardless of whether their personal historic narratives actually fit the assumptions of the therapy. This is bad practice and is less about the gift of prophetic insight into someone’s life and more to do with not listening to the person in front of you. My experience is that the insights of reparative therapy work for some people, but not for others.

That said, here’s the problem. Firstly, reparative therapy is very hard to define. Are we talking just about therapies based around the counselling principles espoused by the likes of Nicolosi and Aardweg? Can we specify what those are? What if a reparative therapist uses the same kind of prayer ministry toolkit as other therapists? Do we include therapies around exploring sexual identity? Does the ACC mean a wider understanding, for example the Living Waters course? If so, why would it be wrong for a homosexual to go on the Living Waters course but not a heterosexual? Many people going on such a course don’t struggle with homosexuality at all, but the same prayer ministry and therapeutic approaches are offered to all. Why is this bad for a celibate homosexual who wants to explore reducing his homosexual attractions but good for a heterosexual who wants to reduce her sex drive which is getting her into problems?

Secondly, what evidence is being presented that reparative therapy does not achieve it’s goal? None is offered in the statement and rather the approach is taken that “any model that implies a predetermined direction of outcome of counselling at the outset”. But surely therefore a reparative therapist simply needs to say that he/she does not guarantee any outcome? How is this different from someone who comes to a therapist and asks for help with obsessive compulsive behaviour and is told “well I can’t guarantee you will stop but we can explore issues in your life together”? And please note, I am not arguing here that reparative therapy is effective, rather that no evidence has been offered either way.

Third, on what possible grounds does reparative therapy violate the Equality Act (2010)? That the notion that some people with same-sex attraction want to reduce it offends other people with same-sex attraction is a given (just read some of my hate-mail when you have a moment), but surely saying to someone who is homosexual that you cannot engage in the same form of therapy that some who is heterosexual can is itself a violation of the Equality Act? Surely lesbians are as free to make self-determined therapeutic choices as straight women are? The ACC’s ethics and practices itself says,

5.2 “Members should respect their clients’ right to take decisions for and to act for themselves.”

How is saying to a client “you can’t choose to take that decision” in accordance with this principle? Would we take the same approach with someone transexual who turned up wanting to discuss transiting? Why is it unethical for a therapist to discuss changing sexuality with someone but not to discuss changing sex?

Fourth, surely almost all clients begin therapy wanting a particular outcome – that after all is why most people enter therapy, to “fix” something. The notion that those seeking to change their sexuality should be dissuaded but those seeking to change something else (eg OCD as before) are fine to enter therapy is nonsensical. Yes, at some point in the therapeutic journey many clients realise the aim of therapy is in and of itself to explore the self rather than to achieve a particular outcome, but the reality is that most going to see a counsellor for the first time do not have such an approach.

It strikes me that most of the ACC’s concerns can be handled by simply changing the wording of the therapy offered. Don’t offer to change sexuality, instead say you you will help explore sexual identity. Be clear you do not guarantee a particular outcome. If Christian therapists use this approach, what issues can the ACC have?

The ACC statement looks like a knee-jerk reaction to societal pressure and hasn’t been well thought through. The ACC needs to come back and define clearly (i) what it means by reparative therapy, (ii) why it in particular is not to be advocated, (iii) how the expectations of clients at the start of such therapy materially differ from those at the start of other therapies and (iv) what this nonsense about violating the Equality Act (2010) is all about.

Update

A good statement from Core Issues here.