"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 Therapy (COT)

Core Issues Trust advocates Change Orientated Therapies (COTs).  We're not alone doing so.  The photograph above pictures some of the advocates of Change Oriented Therapy at the recent Alliance conference in Texas. (And no, not all COT dvocates are in the USA) More about them in the coming days. The important thing to say is there is no one therapeutic approach that is being promoted under the COT banner.  COT makes use of standard modalities (methods) to examine the one question: how best to support those who want to move away from homosexuality.  Its important to know that there is no 'one cap fits all' approach - which is why we object to the terms 'Gay Cure' or 'Conversion' therapists.  Its also important to know that there are groups all over Western Europe and North America who work to support the values and aspirations of those wanting to come out of homosexual practices and feelings.

Basic Overview of Change Oriented Therapies:

  1. Change-oriented therapy (COT) encompasses many therapy orientations and interventions.
  2. Reparative Therapy is the most articulated approach.
  3. But it is only one psychodynamic approach within a spectrum of COT.
  4. Psychodynamic but also cognitive, interpersonal, narrative, and group modalities can be utilized in COT.
  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 male heterosexual peers.
  7. COT stresses the importance of client autonomy and self-determination.
  8. Support client goals to prioritize 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 GAT or SIT 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.