"We are not to simply bandage the wounds of victims beneath the wheels of injustice,
we are to drive a spoke into the wheel itself." Dietrich Bonhoeffer, Letters and Papers from Prison (1943-1945)

Change Oriented Therapies (COTs) and SAFE-T

Core Issues Trust advocates Change Orientated Therapies (COTs), otherwise known as change-allowing therapies. Most commonly these are practised within the context of the SAFE-T (Sexual Attraction Fluidity Exploration in Therapy) model. We support the use of standard modalities (methods) to support those who want to move away from homosexual feelings, behaviours and attractions.  It's important to know that there is no special or "exotic" therapeutic or counselling approach promoted by the Trust by which to do this.

Many standard counselling approaches can be used to consider the issue of unwanted attractions and behaviours.  SAFE-T practitioners simply explore the recognised sexual fluidity that sexual attractions are known to reflect - for many persons. The value of doing so is to empower clients to make informed choices about the pathway they wish to follow in resolving conflicts around sexual identity, feelings, behaviours and patterns. SAFE-T work is a non-directive protocol. The pejorative, imposed term "Conversion Therapy" coined by APA activist Douglas Haldeman (1994)1 conveys the idea that special therapy is invoked and that any work problematising sexual fluidity or seeking to resolve conflict in respect to client primary values and personal goals is "Conversion Therapy". We reject this caricature. 

Core Issues Trust is committed to the values and gudelines articulated by the International Federation for Therapeutic and Counselling Choice (here).  We have offered our views on the UK Government's intention to ban therapeutic choice, and what it might do to regulate practioners (here).  We have examined and highlighted the fundamental flaws of the "National Faith and Sexuality Survery" (here). We have articulated the dangers of banning thereapeutic choice for society here. Finally we have provided an overview of the Trust's Safeguarding Policies and Practices, here.

Basic Overview of Change Oriented Therapies:

  1. Change-oriented therapies (COTs) encompass many therapy orientations and interventions.
  2. Reparative Therapy2 is the most articulated approach.
  3. But it is only one psychodynamic approach within a spectrum of COTs.
  4. Psychodynamic but also cognitive, interpersonal, narrative, and group modalities can be utilized in COTs.
  5. One focus is on “gender affirmation.”
  6. This can include the development of nonsexual intimacy and a sense of emotional comfort and belonging with same-sex heterosexual peers.
  7. COT stresses the importance of client autonomy and self-determination.
  8. Support client goals to prioritise conservative religious values over their same-sex attractions in identity development.

Possible Strengths:

  1. Affirms and allows the prioritization of religious values of clients above sexual orientation—a decisive matching factor for some conservative religious clients.
  2. Tends to be sensitive to and not discriminating against the traditions and values of religiously conservative clients.
  3. Shared values and goals can facilitate a strong therapeutic alliance.
  4. Takes the medical concerns associated with the same-sex behavior of clients seriously.

Possible Limitations & Risks:

  1. Overselling the likelihood and degree of change.
  2. Not sufficiently exploring the role of outside pressures on the client’s pursuit of change.
  3. Offering reductionistic explanations for homosexuality.
  4. Overstating the co-occurrence of psychopathology in homosexuality.
  5. Ignoring or minimizing the potential influence of stigma and discrimination on client symptoms.
  6. Difficulty referring to Gender Affirming Therapy or Sexual Identity Therapy counselors when such a referral may be ethically mandated.
  7. COT may be seen as ethically questionable, particularly in its evaluation of SSA and its conception of how SSA may develop.

Haldeman, D. (1994) "The Practice and Ethics of Sexual Oriention Conversion Therapy. Journal of Counselling and Clinical Psychology

2Accurately defined and registered by the US Trade Mark Office (registration number 5512452) as:

"Mental health therapy services, namely, voluntary psychotherapy for individuals seeking to explore underlying psychodynamic factors which may have led to the development of unwanted same-sex attractions, in which treatment interventions are directed toward resolution of underlying gender-related traumas reported by the client using evidence-based treatment interventions".