Homosexuals Anonymous and Courage International

1. Introduction

Version followed: the psychotherapist's own work with clients and families touched by two religious programmes for people with same-sex attraction: Homosexuals Anonymous (HA), as documented in 1980s religious news and by sociologist Ronald Lawson, and Courage International with its family arm EnCourage, presented as Courage describes itself and as an investigative outlet and a 2026 Vatican synod document describe criticism of it. The professional framework is the APA 2021 resolutions, the UK Memorandum of Understanding on Conversion Therapy (version 2, Revision A), the UN Independent Expert's 2020 report (A/HRC/44/53) and the 2020 Independent Forensic Expert Group statement published with the IRCT's 2020 report.

This topic is covered for history and safety. Sexual orientation change efforts (SOGCE) are not recommended: the APA's 2021 resolution states that "there is no evidence of sexual orientation change" and that former participants look back on these experiences as harmful; signatories to the UK Memorandum agree conversion therapy is "unethical and potentially harmful"; the UN Independent Expert reports that "there is no sound scientific evidence that innate sexual orientation can be changed" (para. 20). [source: APA 2021 press release; UK MoU2; A/HRC/44/53]

The two programmes are not the same, and the guide keeps them apart:

• Homosexuals Anonymous was a network of support groups tied to the Quest Learning Center in Reading, Pennsylvania, which its co-founder Colin Cook directed and which the Seventh-day Adventist Church heavily financed. Cook's "14 steps" were adapted from Alcoholics Anonymous's twelve steps, but, unlike AA, they asserted that homosexual people are in fact heterosexual; the stated aim was "freedom from homosexuality". Twelve-step mutual-help programmes themselves are covered in Domain V. HA had about 60 chapters in the US and Canada by 1986. Its founding year (often given as 1980) is [uncertain: not verified]. [source: Christianity Today 1987; Lawson 1998/2007]
• Courage was founded in 1980 by Father John Harvey at the request of Cardinal Terence Cooke of New York as an outreach to Catholics with same-sex attraction who wish to live chastely; it reports Holy See endorsement in 1994, canonical status in 2016, about 175 chapters in nine countries, and more than 75 EnCourage chapters for relatives and friends. Courage describes its goal as chastity and holiness, not a change of orientation (a priest at its 2024 conference: "the goal is not the cessation of a particular feeling or orientation"), and states that it does not provide, refer for or require therapy. Critics, including campaigners cited by The Ferret (2020), say it has ties to conversion therapy; Courage denies this. [source: National Catholic Register/CNA 2024; The Ferret 2020]

Core idea for the psychotherapist: change in this work comes from an affirming, non-directive relationship in which a client can explore sexual orientation, faith and belonging without a predetermined outcome, and from accurate information, safety and repair where a change programme has caused harm. [source: UK MoU2; APA 2021] [synthesis for the framing]

2. Framework

The framework below describes the phases of the psychotherapist's work. Session number and length follow the client's needs and the setting; pacing follows the client [synthesis].

Historical outline of the programmes (for literacy only).

• HA (1980s): support groups using a twelve-step-derived format and a change goal, linked to a residential and counselling centre (Quest). In 1986 sociologist Ronald Lawson's interviews with 14 former counselees, reported by the Adventist LGBT group Kinship, led to Cook admitting sexual misconduct with several male counselees; Quest's board accepted his resignation and closed the centre, and HA continued under new management. In November 1986 Exodus International urged its affiliates to close or cut ties with HA chapters. [source: Christianity Today 1987; Lawson 1998/2007]
• Courage (1980 to the present): parish- and diocese-based support groups led by priests, with a chastity aim and a family group (EnCourage). Contested points: chapter materials found in 2018 that described same-sex attraction as a disorder and gave advice on reparative therapy (The Ferret, 2020), and testimony annexed to a May 2026 Vatican synodal study-group report describing meetings as "secretive and hidden", which Courage called a "false and unjust depiction". [source: The Ferret 2020; EWTN News 2026]

Phases of the psychotherapist's work.

[source for stance in every phase: UK MoU2; APA 2021] [synthesis for the phase structure and criteria]

3. Guiding principles

• No change attempt. Sexual orientation and gender identity are not targets of treatment; you never try to change or suppress them. Practical meaning: decline any goal framed as change, and say so openly. [source: UK MoU2; APA 2021]
• No predetermined outcome. Practice "without an agenda" favouring one orientation or identity (MoU paraphrase). Practical meaning: you also do not push a religious client to leave a faith or a group. [source: UK MoU2] [synthesis for the faith application]
• Exploration is legitimate. Helping a client explore, reduce distress and reach self-acceptance is not conversion therapy. Practical meaning: conflicted clients are welcome; exploration is the work. [source: UK MoU2]
• Accuracy over advocacy. State the professional bodies' positions plainly, and describe each programme as it describes itself and as reliable sources describe it. Practical meaning: do not tell a Courage member they are in conversion therapy; give the facts and let them weigh them. [synthesis]
• Self-determination of adults, protection of children. Adults choose their religious affiliations; the UN Independent Expert concludes that subjecting children to conversion practices is contrary to international human rights law regardless of parental consent (paras. 71 to 74). Practical meaning: with minors, safeguarding duties come first. [source: A/HRC/44/53]
• Risk is real. The APA cites a large online sample in which young LGBTQ people exposed to change efforts were significantly more likely to report suicide attempts; the UN report cites survey data on suicidal thoughts and attempts (para. 19). Practical meaning: assess suicide risk early and repeatedly. [source: APA 2021; A/HRC/44/53]
• Religion is a resource as well as a stressor. The UN report notes inclusive religious communities that have condemned the practices (para. 68). Practical meaning: work within the client's faith where they want to, with cultural humility. [source: A/HRC/44/53] [synthesis]
• Boundaries. Some harm in this field came from counsellor sexual misconduct. Practical meaning: no dual roles that compromise care (APA Ethics Code Standard 3.05, Multiple Relationships), touch never sexual, and any disclosed misconduct is taken seriously. [source: Christianity Today 1987; APA Ethics Code]
• Even-handed, non-moralising language. Practical meaning: describe what happened and its effects; avoid labels for groups or people. [synthesis]
• Competence. Develop cultural competence with sexually and gender diverse clients and with religious diversity (MoU; Vieten et al. 2013 spiritual competencies [uncertain: not verified]). Practical meaning: seek supervision when your own beliefs pull you towards an outcome. [source: UK MoU2] [synthesis]

4. Intervention inventory

The interventions below are the psychotherapist's own work; steps not drawn from a cited source are marked [synthesis].

4.1 Historical and organisational literacy

• Purpose: know what each programme is and is not, so you neither alarm nor reassure a client wrongly. Use before working with any client who names HA, Courage or EnCourage.
• Steps: (1) Learn the outline in sections 1 and 2: HA as a change-oriented twelve-step-derived network of the 1980s; Courage as a Catholic chastity apostolate that disclaims change and therapy. (2) Know the professional positions (APA 2021, UK MoU2, A/HRC/44/53). (3) Know the contested points about Courage and who makes each claim. (4) Ask the client what their own chapter or group actually did; local practice varies. [source: sections 1 to 2 sources] [synthesis for steps 1, 3, 4]
• Example language (illustrative): "Groups with the same name can run very differently. Tell me what your group was like, in your own words."
• Watch for: your assumptions filling gaps in the client's account. Working: the client's description, not your template, guides formulation.

4.2 Neutral recognition at intake

• Purpose: find out whether a client has met change programmes, faith-based support groups or pastoral counselling about sexuality. Use at intake and when religion or sexuality comes up.
• Steps: (1) Ask open questions about faith, community and any groups or counselling about sexuality. (2) Ask what the stated aim was (change, chastity, support), who led it, the client's age, whether attendance was voluntary, and what happened when they doubted. (3) Note one-to-one counselling separately from group meetings. (4) Record without labels. [synthesis] Minors and non-consent raise the UN report's concerns (paras. 62, 71 to 74). [source: A/HRC/44/53]
• Example language (illustrative): "Some people have been to church groups or counselling about their sexuality. Has anything like that been part of your life?"
• Watch for: shame or loyalty that keeps details back; return to it later. Working: the client volunteers more over time.

4.3 Assessing goals, distress and identity conflict

• Purpose: clarify what the client wants from therapy when sexuality and faith pull in different directions. Use early, and whenever goals shift.
• Steps: (1) Separate the client's distress (shame, fear of rejection, loss) from their orientation itself. (2) Map values: faith, family, relationships, integrity. (3) Agree goals that the MoU names as legitimate: reducing distress, living more comfortably, greater self-acceptance, clarifying sense of self. (4) Use the DSM-5-TR Cultural Formulation Interview and its supplementary module on spirituality, religion and moral traditions where faith is central; if a religious or spiritual problem is the focus, it may be coded Z65.8 [source: ICD-10-CM Z65.8 "Other specified problems related to psychosocial circumstances", Unbound Medicine]. [source: UK MoU2] [synthesis for steps 1, 2, 4]
• Example language (illustrative): "What would feel different in your life if therapy helped? Let's write that down before we decide how to get there."
• Watch for: goals stated in another person's words (a parent, a pastor). Working: goals become the client's own.

4.4 Responding to a request to change orientation

• Purpose: respond honestly when a client asks you to make them straight or to support an HA-style change goal. Use when the request arises.
• Steps: (1) Thank the client for saying it plainly. (2) Explain that you will not try to change orientation, and why: the professional bodies find no evidence of change and report harm. (3) Explore what change would give them (acceptance, marriage, belonging, salvation, relief from fear). (4) Offer to work on those underlying needs, without a predetermined outcome. (5) Keep the door open if they disagree. [source: APA 2021; UK MoU2] [synthesis for steps 1, 3 to 5]
• Example language (illustrative): "I won't try to change your orientation; the research doesn't support it and people report harm. I can help with what's driving the wish, at your pace."
• Watch for: the client hearing rejection; repair at once (see 5.4). Working: the client stays and talks about the needs beneath the request.

4.5 Psychoeducation on evidence and harm

• Purpose: give accurate information when the client asks, or when beliefs from a programme ("anyone can change") drive self-blame.
• Steps: (1) Ask what they were told. (2) Share, briefly and in plain words, the APA, MoU and UN positions. (3) Note that many participants report harm, and that in Lawson's 1986 interviews none of 14 former counselees changed orientation [source: Lawson 1998/2007]. (4) Invite reactions; do not argue. [source: APA 2021; UK MoU2; A/HRC/44/53] [synthesis for steps 1, 4]
• Example language (illustrative): "You were told change was a matter of trying harder. The evidence says otherwise, so not changing isn't a failure on your part."
• Watch for: information used to shame the group or the client's faith. Working: self-blame eases.

4.6 Suicide-risk assessment and safety planning

• Purpose: identify and manage suicide risk, which professional and UN sources link to change efforts. Use at intake, after disclosures, and at points of rejection or exit from a group.
• Steps: (1) Ask directly about suicidal thoughts, past attempts and current intent, using your service's standard risk assessment. (2) Build a collaborative safety plan: warning signs, coping, people and places, professional contacts, and lethal-means counselling limited to safe storage and removal. (3) Give crisis resources: 988 Suicide and Crisis Lifeline (US); Samaritans 116 123 (UK and Ireland). (4) Increase contact or escalate per local protocol when risk rises. [source: APA 2021; A/HRC/44/53 para. 19] [synthesis for steps 1 to 4]
• Example language (illustrative): "When people feel they've failed at something this important, thoughts of suicide can come up. Have they for you?"
• Watch for: risk peaks after family disclosure, leaving a faith group, or relapse into shame. Working: the client uses the plan and contacts help when needed.

4.7 Supporting a religious client seeking congruence

• Purpose: help a client who wants to remain in their faith (including Catholics attending Courage) live with less conflict between faith and sexuality. Use when faith is a core value.
• Steps: (1) Ask how the client understands their tradition's teaching and their own conscience. (2) Explore without steering towards celibacy, a relationship or leaving the faith. (3) Distinguish chosen religious commitments from fear-driven ones. (4) With consent, help the client find faith resources (pastoral, theological, inclusive communities) that fit their own direction. (5) Use spiritual and religious competencies and cultural humility. [source: UK MoU2; A/HRC/44/53 para. 68] [synthesis]
• Example language (illustrative): "You've said your faith matters as much as anything. Let's look at what living in line with it would mean for you, not for me."
• Watch for: your own views on religion or sexuality leaking into the work; take it to supervision. Working: decisions feel chosen rather than forced.

4.8 Working with a client currently attending Courage or a similar group

• Purpose: support an adult who attends a chastity or change group by choice, while monitoring its effects. Use when attendance is current.
• Steps: (1) Respect the choice; do not demand they leave. (2) Ask what helps (company, prayer, being known) and what hurts (secrecy, hopelessness, being told they are disordered). (3) Check whether anyone in the group recommends therapy aimed at change; Courage states it does not, but critics found 2018 materials referring to reparative therapy [source: The Ferret 2020]. (4) Review effects on mood and risk regularly. [synthesis for steps 1, 2, 4]
• Example language (illustrative): "What do you get from the meetings, and is there anything there that leaves you feeling worse?"
• Watch for: loneliness, depression, hopelessness (the experiences described in the 2026 synod annex testimony and acknowledged by Courage as common among people it serves) [source: EWTN News 2026]. Working: the client can name both benefits and costs openly.

4.9 Survivor work: processing shame and spiritual harm

• Purpose: help adults who experienced change efforts (for example in HA or similar groups) recover from shame, self-hatred, trauma symptoms, and loss of faith or community. Use once safety is established.
• Steps: (1) Validate harm as reported by many former participants. (2) Use your evidence-based trauma or depression treatment for symptoms that meet criteria (the UN report lists loss of self-esteem, PTSD symptoms, social isolation, sexual dysfunction, para. 56). (3) Work with internalised messages ("broken", "really heterosexual") as beliefs that were taught, not facts about the client. (4) Grieve lost years, relationships and careers. (5) Address faith on the client's terms: rebuild, change or leave. [source: A/HRC/44/53; Lawson 1998/2007; APA 2021] [synthesis for steps]
• Example language (illustrative): "You were taught that a core part of you was a defect. We can look at where that message came from and what you want to keep or let go."
• Watch for: anger at faith or at you; relapse of shame. Working: less self-hatred, more connection.

4.10 Responding to disclosure of sexual misconduct by a ministry counsellor

• Purpose: respond when a client discloses sexual contact or sexualised behaviour by a counsellor, pastor or leader in a change or support ministry, as happened in the HA-linked Quest centre (admitted by its director in 1987). Use on disclosure.
• Steps: (1) Listen, believe, and avoid probing for detail beyond what safety and reporting require. (2) Name it as an abuse of a counselling relationship, not the client's fault. (3) Assess risk and current contact with the person. (4) Explain options without pressure: reporting to police (crime or minors), to the person's licensing board if licensed, to the religious body, or civil advice. (5) If a minor is or was involved and you are a mandated reporter, follow child-protection law. (6) Document carefully. [source: Christianity Today 1987] [synthesis for steps]
• Example language (illustrative): "What happened was not part of any real help. It was a misuse of trust, and none of it is your fault."
• Watch for: the client minimising, as the perpetrator may have framed it as therapy. Working: the client names what happened in their own terms and chooses next steps.

4.11 Family work, including families involved in EnCourage

• Purpose: help parents and relatives (some of whom attend EnCourage) respond to a family member's sexuality in ways that protect the relationship and the person's safety. Use with consent of the adult client, or in family therapy.
• Steps: (1) Hear the family's fears, grief and faith commitments without judgement. (2) Share the professional bodies' positions on change efforts and harm. (3) Distinguish holding religious beliefs from rejecting or pressuring the person. (4) Coach acceptance-protective behaviour: staying in contact, no ultimatums, no pressure into change programmes. (5) Refer family members for their own support. [source: APA 2021; UK MoU2] [synthesis for steps 1, 3 to 5]
• Example language (illustrative): "You can keep your faith and still keep your son close. What matters most for his safety is that he knows he hasn't lost you."
• Watch for: a parent seeking your help to change the child; decline clearly (4.4). Working: fewer ruptures; the young person reports feeling safer.

4.12 Safeguarding minors

• Purpose: protect children and adolescents from conversion practices. Use whenever a minor is, or may be, sent to a change programme or counselling.
• Steps: (1) Assess the young person's wishes, assent, risk and home safety. (2) Inform parents of the professional positions. (3) Where coercion, threats, isolation or harm amount to child abuse or neglect under your jurisdiction's law, follow mandatory reporting and child-protection routes. (4) Coordinate with school or child-protection services as required. [source: A/HRC/44/53 paras. 57, 71 to 74] [synthesis for steps]
• Example language (illustrative, to a young person): "Nobody should be trying to change who you are. My job is to make sure you're safe; here's what I have to share and with whom."
• Watch for: the UN report's finding that most survivors were young (four in five aged 24 or under, para. 36) and that exposure before age 10 carries higher odds of severe distress and suicide attempts (para. 57). Working: the young person has at least one safe adult and a safety plan.

4.13 Gender identity questions within religious change settings

• Purpose: support clients whose gender identity, not only orientation, was targeted. Use when it arises.
• Steps: (1) Apply the same non-directive stance: no agenda towards any gender identity. (2) Explore at the client's pace. (3) Refer for specialist assessment where the client seeks medical options; you do not advise on medicines. [source: APA 2021 Resolution on Gender Identity Change Efforts; UK MoU2] [synthesis for steps 2, 3]
• Example language (illustrative): "We can explore this together without me deciding the answer for you."
• Watch for: the APA's reported harms of coercion to conform: "emotional distress, loss of relationships, and low self-worth". Working: the client feels free to explore.

4.14 Collaboration with clergy and faith communities

• Purpose: coordinate care with a client's priest, pastor or chaplain where it helps. Use only with explicit consent.
• Steps: (1) Agree with the client what may be shared and the aim of contact. (2) Keep clinical decisions in therapy and spiritual guidance with clergy. (3) If a clergy member recommends change-oriented therapy, discuss it with the client and decline any role in it. [synthesis]
• Example language (illustrative): "Would it help if I spoke with your priest about how we're working? You decide what I share."
• Watch for: role confusion; never accept a dual role that impairs objectivity (APA Ethics Code Standard 3.05). Working: the client experiences support as joined up, not competing.

4.15 Duties when a colleague or institution offers change efforts

• Purpose: act responsibly if a colleague, service or institution offers or refers to conversion practices. Use when you learn of it.
• Steps: (1) Do not provide, supervise or refer to such practice. (2) Raise concerns with the colleague where safe. (3) In the UK, note that NHS bodies and major professional bodies signed the MoU committing not to commission or provide conversion therapy; report to the relevant professional body or regulator under its complaints route. (4) In the US, report to the licensing board or professional association as their procedures state; check current state law (see 4.17). (5) Document. [source: UK MoU2] [synthesis for steps 2, 4, 5]
• Example language (illustrative, to a colleague): "I'm concerned this work aims at changing orientation. Our professional bodies say that's harmful, and I can't be part of it."
• Watch for: practice under mainstream labels; the MoU notes it may be offered covertly. Working: concerns are logged and acted on.

4.16 Referral and survivor support

• Purpose: connect clients with affirming, faith-competent support. Use when needs exceed your scope or the client wants peer support.
• Steps: (1) Check that any clinician you refer to works within the MoU or APA positions. (2) Offer faith-competent options for religious clients. (3) Offer peer and community support the client chooses, checking each group's current stance. [synthesis]
• Example language (illustrative): "I can give you a few names of therapists and groups who respect both faith and sexuality; you choose."
• Watch for: referral to a renamed change programme. Working: the client connects with lasting support.

4.17 Legal and advocacy literacy

• Purpose: understand the changing legal setting when clients ask about complaints or rights. Use as needed; do not give legal advice.
• Steps: (1) US: on 31 March 2026 the US Supreme Court ruled 8–1 in Chiles v. Salazar that Colorado's conversion-therapy law, as applied to a counsellor's talk therapy, regulates speech based on viewpoint; it reversed the lower courts, which had not applied sufficiently rigorous First Amendment scrutiny, and sent the case back (SCOTUSblog; NPR). Its effect on other states' laws is [uncertain]. (2) UK: in June 2020 the UK government confirmed plans to ban conversion therapy; current status is [uncertain: may have changed]. (3) The UN Independent Expert recommends that states ban the practices (para. 87). (4) Refer to a lawyer or advocacy body for advice. [source: Dorsey 2026; The Ferret 2020; A/HRC/44/53]
• Example language (illustrative): "The law here has been changing; I can tell you what I know, but a lawyer can tell you your options."
• Watch for: stating law beyond your knowledge. Working: the client gets accurate referral.

4.18 Repair and documentation

• Purpose: keep records that support continuity, complaints and safeguarding, and repair your own missteps. Use throughout.
• Steps: (1) Record disclosures factually, with the client's words. (2) Note risk assessments and reports made. (3) When you misjudge (for example, sounding anti-religious), name it and repair. [synthesis]
• Example language (illustrative): "Last week I think I spoke about your church as if I'd already judged it. That wasn't fair to you."
• Watch for: records that label groups; describe instead. Working: trust holds after repair.

5. Handling problems

The problems below are the psychotherapist's own synthesis [synthesis]; a source is cited where one states the point.

• The client insists on change and threatens to leave. Restate that you will not attempt change and why (APA 2021; UK MoU2), then ask what leaving would mean and what they would look for elsewhere. Offer to keep working on distress, faith and relationships. If they leave, give crisis resources (988 US; Samaritans 116 123 UK and Ireland) and an open door. [synthesis]
• Stuck between faith and sexuality. Slow down; stop working towards resolution and work on tolerating ambivalence. Map values again (4.3). Long periods of not deciding are acceptable. [synthesis]
• Loyalty to the group and defensiveness. If a Courage member hears your questions as attack, acknowledge what the group gives them and return to their own experience. Remember that Courage disputes critics' accounts (The Ferret 2020; EWTN News 2026). [source cited] [synthesis for the response]
• Overwhelm during survivor work. Return to stabilisation; titrate exposure to memories; check sleep, substance use and risk. [synthesis]
• Rising suicide risk after disclosure, exit from a group or family rejection: reassess, update the safety plan, increase contact, involve crisis services per protocol. Follow safe-messaging principles in any discussion. [synthesis] [source for link: APA 2021; A/HRC/44/53]
• Rupture over religion. If a religious client senses contempt for their faith, name and repair it (4.18). If a client who has left their faith senses you defending it, do the same. [synthesis]
• Your own values interfere. Whether you are religious or secular, seek supervision when you feel pulled towards an outcome; the MoU asks for practice without an agenda. [source: UK MoU2] [synthesis]
• Parents demand change therapy for a minor. Decline, explain the professional and UN positions, offer family work (4.11), and follow safeguarding duties (4.12). [source: A/HRC/44/53] [synthesis]
• Disclosure of past counsellor misconduct but no wish to report. Respect an adult's decision unless law requires a report (minors, ongoing risk to others where your jurisdiction mandates); revisit later. [synthesis]
• Non-adherence (missed sessions after group meetings or retreats). Ask non-judgementally what happened; shame after such events is common in survivor accounts. [synthesis]
• A renamed or covert programme. If a client describes change-oriented work under a mainstream label, treat it as described in the MoU and apply 4.15. [source: UK MoU2]

Harm account

What was actually done

• Homosexuals Anonymous and Quest (1980s). HA groups and the Quest Learning Center in Reading, Pennsylvania offered a change goal to people with same-sex attraction, with steps derived from Alcoholics Anonymous that asserted homosexual people are in fact heterosexual. Quest's director, HA co-founder Colin Cook, admitted in 1987 to sexual misconduct with several male counselees, after the Adventist group Kinship reported interviews with former counselees. Quest closed and HA continued under new management. [source: Christianity Today 1987; Lawson 1998/2007]
• Later Colorado ministry (1990s). According to Lawson, the Denver Post reported fresh allegations of inappropriate sexual conduct with counselees in October 1995, which Cook denied; in 1996 a Colorado state grievance board found that he was practising psychotherapy and required him to register. [source: Lawson 1998/2007] [uncertain: secondary, unverified]
• Courage (contested). Courage describes its aim as chastity, not change, and says it does not provide, refer for or require therapy. The Ferret (2020) reported chapter materials, found in 2018, that described same-sex attraction as a disorder and gave advice on reparative therapy, and campaigners who say Courage fits definitions of conversion practices. Testimony annexed to a May 2026 Vatican synodal study-group report described meetings as "secretive and hidden" and attendees as "lonely, hopeless, and often depressed"; Courage called this "calumny and detraction". These are allegations and positions, not findings by a court or regulator. [source: The Ferret 2020; EWTN News 2026; National Catholic Register/CNA 2024]

What it looked like to members. Homosexuals Anonymous groups were peer-led meetings working through steps modelled on Alcoholics Anonymous, which framed same-sex attraction as something to be overcome and told members they were in fact heterosexual; the Quest Learning Center added one-to-one counselling by its director [source: Christianity Today 1987; Lawson 1998/2007]. The UN Independent Expert describes faith-based conversion programmes that adapt 12-step models and treat sexual diversity as an addiction (paras. 50-51) [source: A/HRC/44/53], and the UK study commissioned by the Government Equalities Office heard of mixed-faith men's groups it likens to Alcoholics Anonymous, and of confession and group accountability for thoughts and conduct in church settings [source: GEO 2021, sections 4.2-4.3]. These descriptions concern the practice class; they are not findings about Courage.

How it caused harm

• None of the 14 former Quest counselees Lawson interviewed changed orientation; most reported trauma, anger and stalled careers, and seven reported that their spirituality declined. [source: Lawson 1998/2007]
• Sexual contact by a counsellor exploited people who had come for help; this is the documented harm in the HA-linked centre. [source: Christianity Today 1987]
• Across conversion practices, the UN Independent Expert reports harms including loss of self-esteem, PTSD symptoms, social isolation and sexual dysfunction (para. 56), and survey data on suicidal thoughts and attempts (para. 19); some faith-based approaches treat orientation as an addiction using twelve-step models premised on "sexual brokenness" (para. 51). The Independent Forensic Expert Group (2020) concluded that forced or non-consensual conversion therapy is cruel, inhuman or degrading treatment and may amount to torture. [source: A/HRC/44/53; IFEG 2020]
• The APA reports that former participants look back on SOGCE as harmful and that young people exposed to change efforts were more likely to report suicide attempts. [source: APA 2021]

Recognising it today

• Groups framing same-sex attraction as an addiction, a wound or "brokenness" to be recovered from through steps; claims that people are "really heterosexual". [source: A/HRC/44/53 para. 51; Lawson 1998/2007]
• One-to-one "counselling" by unlicensed ministry leaders, especially involving secrecy, touch or sexualised talk. [source: Christianity Today 1987] [synthesis]
• Materials describing orientation as a disorder or recommending reparative therapy; change work under mainstream labels (MoU). [source: The Ferret 2020; UK MoU2]
• Distinguish chastity-focused pastoral groups that disclaim change and therapy (as Courage describes itself) from change programmes, while listening for what a particular chapter actually did. [synthesis]

What to do instead and how to help those harmed

• Supported care: affirming, non-directive therapy that helps clients explore, reduce distress and reach self-acceptance, without an agenda for any orientation or identity (UK MoU2; APA 2021 guidelines encourage psychologists to "validate, normalize, and assist" understanding of identity). [source: UK MoU2; APA 2021]
• Survivors: trauma-informed work (4.9), suicide-risk assessment and crisis resources (988 US; Samaritans 116 123 UK and Ireland), faith-competent support. [synthesis]
• Families: family work focused on staying connected (4.11). [synthesis]
• Reporting and legal routes: police and child protection for crimes and minors; licensing boards and professional regulators for licensed practitioners (MoU signatory bodies in the UK); religious authorities for clergy; legal advice on the changing law (Chiles v. Salazar, March 2026). [source: UK MoU2; Dorsey 2026] [synthesis]

Sources

• Leading Ex-Gay Figure Resigns Counseling Post (Christianity Today, 1987)
• The Troubled Career of an "Ex-Gay" Healer: Colin Cook, Seventh-day Adventists, and the Christian Right (Ronald Lawson; ASA paper 1998, updated 2007)
• 'Courage' a Catholic Ministry For Those With Same-Sex Attraction, Offers Healing and Support (National Catholic Register/CNA, 2024)
• U.S. same-sex ministry group says criticism in Vatican report is false and unjust (EWTN News, 8 May 2026)
• Catholic church told to shut down gay conversion therapy groups (The Ferret, 28 June 2020)
• APA press release on resolutions on gender identity and sexual orientation change efforts (2 March 2021)
• Memorandum of Understanding on Conversion Therapy in the UK, version 2, Revision A (BACP-hosted copy, July 2024)
• Practices of so-called "conversion therapy": report of the Independent Expert, A/HRC/44/53 (UN Digital Library record)
• A/HRC/44/53 full text (UN documents)
• Statement of the Independent Forensic Expert Group on Conversion Therapy, Torture Journal 30(1), 2020
• Launch of IRCT report on conversion therapy ("It's Torture Not Therapy", 2020), Torture Journal 30(1)
• March 31 Supreme Court update: Chiles v. Salazar (Dorsey & Whitney, 2026)
• SCOTUSblog, Chiles v. Salazar case page, https://www.scotusblog.com/cases/case-files/chiles-v-salazar/
• NPR (via KUNC), Supreme Court strikes Colorado ban on conversion therapy, 31 March 2026, https://www.kunc.org/npr-news/2026-03-31/supreme-court-strikes-colorado-ban-on-conversion-therapy
• APA Ethics Code
• ICD-10-CM Z65.8, Other specified problems related to psychosocial circumstances (includes 'Religious or spiritual problem'), https://www.unboundmedicine.com/icd/view/ICD-10-CM/945432/all/Z65_8___Other_specified_problems_related_to_psychosocial_circumstances
• Vieten, C., et al. (2013). Spiritual and religious competencies for psychologists. [uncertain: not verified]
• Jowett, A. et al. (Coventry University) (2021). Conversion therapy: an evidence assessment and qualitative study. Government Equalities Office, published 29 October 2021