Atlas›Domain XVI · Historical, discredited & harmful›Guide 076
Guide XVI-076

JONAH

Arthur Goldberg1998Jersey City, New Jersey
A 31 · L 59 · M 1019 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the organisation and its practices as described in the June 2015 New Jersey Superior Court jury verdict and the December 2015 permanent injunction (as reported by the Associated Press, the Philadelphia Inquirer and the Southern Poverty Law Center, counsel for the plaintiffs), read against the current statements of the American Psychological Association (2021), the UK Memorandum of Understanding on Conversion Therapy (Version 2), the UN Independent Expert on sexual orientation and gender identity (A/HRC/44/53, 2020) and the Independent Forensic Expert Group convened by the IRCT (2020).

This guide is listed for history and safety. JONAH was a conversion practice, not a therapy to be used: it is described here so that a psychotherapist can recognise it and its descendants, work with people who went through it or are drawn to it, and act on safeguarding and reporting duties. Nothing below teaches the practice.

JONAH (Jews Offering New Alternatives for Healing) was a Jersey City, New Jersey nonprofit that offered to change gay clients' sexual orientation to heterosexual, serving mainly Jewish clients from a faith-based perspective [source: New Jersey Jewish News, 5 June 2015; AP via CBS News Philadelphia, 26 June 2015]. The New Jersey Jewish News reported that it was founded in 1998 by two New Jersey Jewish couples [source: New Jersey Jewish News, 2015] [uncertain: some accounts give 1999]. Its premise was that same-sex attraction is a condition that can be healed; plaintiffs said it claimed success rates of 65 to 75 percent while keeping no statistics of its own [source: AP, 2015]. On 25 June 2015 a unanimous Hudson County jury found that JONAH, its co-founder Arthur Goldberg and counsellor Alan Downing had violated New Jersey's Consumer Fraud Act through misrepresentations and unconscionable commercial practices [source: AP, 2015; SPLC, 2015]. In December 2015 a permanent injunction required JONAH to cease operations and dissolve [source: Philadelphia Inquirer, 19 December 2015; SPLC, 18 December 2015]. The case is cited as Ferguson v. JONAH (N.J. Super. Ct., Hudson County) [uncertain: docket number not verified].

The current professional position is that such efforts do not change sexual orientation or gender identity and are associated with harm: the APA's 2021 resolution reports research since 2009 showing "no evidence of sexual orientation change" and that former participants describe the experience as harmful [source: APA press release, 2 March 2021]; the UK Memorandum calls conversion therapy "unethical and potentially harmful" [source: MoU Version 2]; the UN Independent Expert found that no approach can claim conversion as an outcome and that the practices may amount to torture or cruel, inhuman or degrading treatment [source: A/HRC/44/53, paras 20, 62, 70, 83]; and the IFEG states that offering it is a form of deception, false advertising and fraud [source: IFEG, Torture Journal 30(1), 2020].

How change happens in the psychotherapist's work (not in the practice): the client moves from shame, self-blame and a sense of being defective towards self-acceptance and an integrated life (sexual, religious, family, community) of the client's own choosing, through an affirming relationship that holds no preferred outcome for orientation or identity [source: MoU Version 2; APA 2021] [synthesis for the integration framing].

2. Framework

The framework below describes the phases of the psychotherapist's own work, built from the professional statements cited and marked [synthesis] where it goes beyond them. Session number and length follow the client's needs and the setting [synthesis].

Historical phases of the practice, in outline. Founding by two Jewish families in New Jersey (1998, per the New Jersey Jewish News); a programme the same paper describes as running for years, with individual and group sessions led by a non-licensed "life coach" [source: New Jersey Jewish News, 2015]; a civil suit filed in 2012 with the SPLC as plaintiffs' counsel [source: SPLC, 2015]; a February 2015 pre-trial ruling by Judge Peter F. Bariso Jr. excluding defence experts whose opinions, the court found, rested on the false premise that homosexuality is a disorder [source: SPLC, 2015]; the June 2015 verdict; the December 2015 injunction and dissolution [source: SPLC, 2015; Philadelphia Inquirer, 2015]. Because Goldberg and Downing were not licensed therapists, New Jersey's 2013 law barring licensed therapists from conversion therapy was not at issue in the trial [source: AP, 2015] — a reminder that much conversion activity happens outside licensed practice.

Phase A: recognition and assessment. Goal: learn whether the client went through JONAH, a successor or a similar programme (religious, peer-led, coaching, residential, online), what was done in outline, and the current effects. Includes suicide-risk screening at first contact. Move on when risk is assessed and a shared, non-judgemental account of the experience exists [synthesis].

Phase B: safety and safeguarding. Goal: manage acute risk (suicidality, self-harm, crisis), identify any minor currently exposed, and identify any provider still operating. Move on when immediate risk is contained and any reporting duty has been discharged [source: IFEG 2020 on minors and reporting; A/HRC/44/53 para 71] [synthesis for sequence].

Phase C: processing and repair. Goal: work through shame, self-blame, blame of parents, fractured family and religious ties, and trauma responses; support an identity and religious life the client chooses. Move on when the client's distress is reduced and the client can speak of the experience without being overwhelmed [synthesis].

Phase D: integration, advocacy and follow-up. Goal: relationships, community and faith connections the client wants; information about legal and consumer recourse; optional advocacy; planned ending with an open door [synthesis].

Phases overlap; risk reassessment continues throughout. Format is individual therapy, with family or couple sessions where the client wants them [synthesis].

3. Guiding principles

  • No preferred outcome for orientation or identity. The therapist holds no agenda favouring one orientation or identity [source: MoU Version 2]. Practical meaning: never set heterosexuality, celibacy or coming out as a goal; the client's own aims lead.
  • Exploration is not conversion. The MoU says people with uncertain feelings or distress about their sexuality or gender must not be turned away and may be helped to explore, reduce distress and reach self-acceptance [source: MoU Version 2]. Practical meaning: explore the wish to change without trying to change orientation.
  • Orientation and identity are not disorders. Neither is in itself an indicator of mental disorder [source: MoU Version 2]; the JONAH court excluded expert evidence premised on the contrary [source: SPLC, 2015]. Practical meaning: never frame same-sex attraction as a symptom to be treated.
  • Change claims are unsupported. APA 2021 reports no evidence of orientation change; the UN Independent Expert says no approach can claim conversion as an outcome [source: APA 2021; A/HRC/44/53 para 70]. Practical meaning: give clients accurate information when they ask whether change is possible.
  • Validate and normalise. APA guidelines encourage psychologists to "validate, normalize, and assist" understanding of how orientation, identity and expression interact [source: APA press release, 2021]. Practical meaning: normalise attraction and identity as ordinary human variation.
  • Risk first. Conversion experiences are associated with suicidal ideation and attempts [source: APA 2021; A/HRC/44/53 paras 56, 61]. Practical meaning: screen for suicide risk early and repeatedly, using safe-messaging principles.
  • Consent must be informed. The IFEG holds that consent to conversion practices is invalid without accurate information on their ineffectiveness and harms, and especially suspect under family pressure [source: IFEG 2020]. Practical meaning: name pressure from family or community in the room and check what the client actually wants.
  • Minors are owed protection. Subjecting children to these practices constitutes ill-treatment and may constitute torture (UN) and may be child abuse and neglect (IFEG) [source: A/HRC/44/53 para 71; IFEG 2020]. Practical meaning: follow child-protection routes when a minor is exposed.
  • Respect for religion without collusion. The UN report notes that some religious communities have condemned these practices and that religion and exclusion are not inevitably linked [source: A/HRC/44/53 para 68]. Practical meaning: treat the client's faith as a resource to be explored, not an obstacle or a mandate.
  • The therapist never provides, supervises or refers to conversion practices. Health professionals should refuse to conduct them and report colleagues who offer them [source: IFEG 2020]. Practical meaning: no referrals to "ex-gay" coaches, ministries or programmes, including rebranded ones.
  • Covert forms count. Conversion therapy may be practised covertly under mainstream labels [source: MoU Version 2]. Practical meaning: judge a service by its aims, not its name.
  • Non-blame of the client. SPLC reported that JONAH's methods led some clients to blame themselves or relatives for their orientation [source: SPLC, 2015]. Practical meaning: actively undo self-blame and parent-blame narratives without assigning new blame.
  • Boundaries and touch. Because touch and undressing were part of what clients described [source: SPLC, 2015], the therapist offers no touch beyond ordinary courtesy, never sexual, with consent and a right to refuse [synthesis]. Practical meaning: ask before any physical gesture, and expect that some survivors will not want any.
  • Multiple relationships in close communities. In close religious communities the therapist may share social or communal ties with clients and families; manage these under APA Ethics Code Standard 3.05 (Multiple Relationships) [source: APA Ethics Code]. Practical meaning: consider whether a prior or concurrent relationship impairs objectivity or risks exploitation before taking on the client or family.
  • Cultural and religious humility. Use the DSM-5-TR Cultural Formulation Interview and its supplementary module on spirituality, religion and moral traditions, and spiritual and religious competencies (Vieten et al., 2013) [uncertain: DSM-5-TR wording not verified] [synthesis]. Practical meaning: learn the client's own tradition and community from the client.

[source for section: as tagged; principles combining several sources are 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 legal literacy about JONAH

  • Purpose: to understand what JONAH was, what the court found and why, so that a client's account can be met with accurate knowledge rather than surprise or disbelief. Use before working with Jewish, Orthodox or other religious clients who mention "healing" of same-sex attraction.
  • Steps: (1) Know the outline: a Jersey City nonprofit serving mainly Jewish clients; a unanimous 2015 jury finding of consumer fraud and unconscionable practices against the organisation, its co-founder and a counsellor; a December 2015 injunction requiring closure and dissolution and barring the individual defendants from conversion activities in New Jersey [source: AP, 2015; SPLC, 2015]. (2) Know that the defendants were not licensed therapists, so licensing bans did not reach them [source: AP, 2015]. (3) Know the professional statements (APA 2021, MoU, UN, IFEG). (4) Do not lead with the history; offer it when the client wants context [synthesis].
  • Example language (illustrative): "If it helps, I can tell you what the court in New Jersey found about JONAH. Only if you want that."
  • Watch for: the client feeling their experience is reduced to a news story; a client who still values parts of the programme. Working: the client uses the facts to make sense of their experience on their own terms [synthesis].

4.2 Screening for a history of change efforts

  • Purpose: many clients do not volunteer a past of conversion efforts; asking routinely and neutrally lets it surface [synthesis, informed by MoU on covert forms].
  • Steps: (1) At intake, after asking about religion and family, ask whether anyone ever tried to change or suppress the client's sexual orientation or gender identity, including through counselling, coaching, a religious leader, a group, a retreat or online. (2) Ask who arranged it (self, parents, community) and at what age. (3) Record in outline only; do not press for detail at first contact. (4) Follow any yes with the risk screen (4.7) [synthesis].
  • Example language (illustrative): "Some people have been sent to, or sought out, programmes that tried to change who they're attracted to. Has anything like that been part of your life?"
  • Watch for: shame, minimising ("it was only coaching"), dissociation when describing it. Working: the client names the experience and its source without collapse [synthesis].

4.3 Recognising JONAH-type and rebranded practices

  • Purpose: to identify when a service a client is using, or is being urged towards, is a conversion practice under another name [source: MoU Version 2 on covert practice under mainstream labels].
  • Steps: (1) Listen for the marks courts and professional bodies describe: an assumption that one orientation or identity is preferable and an aim to change or suppress it [source: MoU Version 2]; claims of high success rates without data [source: AP, 2015]; framing same-sex attraction as a wound to be healed; terms such as "same-sex attraction" or "gender wholeness" in the sense the JONAH injunction listed [source: SPLC, 2015]. (2) Note practices the plaintiffs and SPLC described in the case: undressing in sessions, role-plays involving anti-gay slurs, striking an object representing a parent, and prolonged "healthy touch" contact sessions [source: SPLC, 2015; AP, 2015]. (3) Note non-licensed "life coach" leadership [source: New Jersey Jewish News, 2015]. (4) Share the concern with the client factually [synthesis].
  • Example language (illustrative): "From what you describe, this group is aiming to change your orientation. That's something professional bodies say doesn't work and can cause harm. Can we think about it together?"
  • Watch for: the therapist sounding as if they are attacking the client's community; a client loyal to a leader. Working: the client can evaluate the service against its claims [synthesis].

4.4 Establishing an affirming, non-directive stance

  • Purpose: to provide the relationship the professional bodies describe: no agenda about orientation or identity, normalising and validating [source: MoU Version 2; APA guidelines quoted in APA 2021 press release].
  • Steps: (1) State early that the therapist has no preferred outcome for the client's orientation, identity, religious practice or relationships. (2) Use the client's own words for their identity, and ask before using labels. (3) Normalise attraction and identity as ordinary variation. (4) Revisit the stance when the client tests it [synthesis].
  • Example language (illustrative): "I'm not here to steer you toward any particular way of living your sexuality or your faith. We'll work out what you want."
  • Watch for: a client who reads neutrality as disapproval, or affirmation as pressure to come out. Working: the client brings ambivalent or contradictory feelings without self-censoring [synthesis].

4.5 Responding to a request to change orientation or gender identity

  • Purpose: to meet the request respectfully, explore it, and not attempt change [source: MoU Version 2; APA 2021].
  • Steps: (1) Thank the client for being direct. (2) Explain honestly that the evidence does not support orientation change and that change efforts are associated with harm [source: APA 2021; A/HRC/44/53 para 70]. (3) Say what therapy can offer: exploring the distress, its sources (family, community, faith, fear of loss), and ways to reduce it and live with more ease [source: MoU Version 2]. (4) Explore what the client imagines change would bring and what they fear losing. (5) Agree goals the therapist can ethically work towards. (6) If the client still wants change efforts, say plainly that the therapist will not provide or refer to them, and keep the door open [source: IFEG 2020 on refusal] [synthesis for sequence].
  • Example language (illustrative): "I can't help you change who you're attracted to; the research doesn't show that's possible, and attempts often hurt people. I can help with the pain that's making you want this."
  • Watch for: rising hopelessness or suicidality when change is said to be unavailable (go to 4.7); the client leaving for a provider who promises change. Working: goals shift from eliminating attraction to reducing distress and conflict [synthesis].

4.6 Informed-consent and pressure check

  • Purpose: the IFEG holds that consent is invalid without accurate information and suspect under family pressure [source: IFEG 2020]; this conversation protects the client's autonomy in therapy itself.
  • Steps: (1) Ask whose idea therapy was and who is paying. (2) Ask what the client has been told therapy will achieve. (3) Correct inaccurate expectations. (4) Clarify confidentiality, including from parents or community leaders, within legal limits. (5) For adults, confirm the client is choosing therapy for themselves [synthesis].
  • Example language (illustrative): "You mentioned your family arranged this. What do you want from our time, separate from what they want?"
  • Watch for: a parent or spouse seeking reports; a client unable to state any goal of their own. Working: the client states their own aims [synthesis].

4.7 Suicide-risk assessment and safety planning

  • Purpose: conversion experiences are associated with suicidal ideation and attempts [source: APA 2021, citing a large online sample of LGBTQ young people; A/HRC/44/53 paras 19, 56, 61]; peer-reviewed studies such as Blosnich et al. (2020, American Journal of Public Health) report elevated risk [uncertain: not verified; findings are disputed in a published reanalysis, also not verified].
  • Steps: (1) Ask directly about suicidal thoughts, past attempts and current intent, in line with current standard risk-assessment practice. (2) Ask specifically about periods during and after the programme, and after family rejection or religious exclusion. (3) Build a collaborative safety plan: warning signs, coping steps, people and places, professional contacts. (4) Lethal-means counselling limited to safe storage and removal. (5) Give crisis resources: 988 Suicide and Crisis Lifeline (US); Samaritans 116 123 (UK and Ireland). (6) Reassess at each phase [synthesis].
  • Example language (illustrative): "Many people who went through programmes like this have had times of wanting to die. Has that been true for you, then or now?"
  • Watch for: safe-messaging: no method detail, no framing of suicide as a response to injustice. Working: the client can name warning signs and use the plan [synthesis].

4.8 Trauma-informed assessment of effects

  • Purpose: to map the effects the professional bodies describe: self-hatred, depression, suicidality, PTSD, loss of relationships and low self-worth [source: A/HRC/44/53 para 56; IFEG 2020; APA 2021 on gender identity change efforts].
  • Steps: (1) Use standard validated measures for depression, anxiety and trauma symptoms (named, not reproduced) [synthesis]. (2) Ask about intrusive memories of sessions, avoidance of intimacy, and reactions to religious settings. (3) Ask about body-related experiences (undressing, touch) only in outline and only when the client is ready [synthesis, informed by SPLC 2015]. (4) Formulate the effects as consequences of the practice, not of the client's orientation [synthesis].
  • Example language (illustrative): "You don't need to give me details. I'd just like to know which parts still come back to you, and how."
  • Watch for: overwhelm and dissociation (slow down, ground). Working: a shared map of effects that the client recognises [synthesis].

4.9 Undoing self-blame and parent-blame narratives

  • Purpose: SPLC reported that JONAH's methods alienated some clients from their families and led them to blame themselves or relatives for their orientation [source: SPLC, 2015]; this work loosens those beliefs.
  • Steps: (1) Elicit the explanation the client was given for their orientation. (2) Contrast it, gently, with the professional view that orientation is not a disorder or a wound [source: MoU Version 2]. (3) Separate real family hurts (which may exist) from the programme's causal story. (4) Support the client in deciding what, if anything, they want to repair with parents [synthesis].
  • Example language (illustrative): "You were told your mother caused this. Your relationship with her may have its own hurts, but your attraction isn't something anyone caused."
  • Watch for: the client swinging to blaming themselves for having joined. Working: compassion for self and a more nuanced view of family [synthesis].

4.10 Processing body and boundary experiences

  • Purpose: clients described undressing and prolonged physical-contact sessions [source: SPLC, 2015]; these may leave shame and confusion about touch and consent.
  • Steps: (1) Offer no touch in therapy; tell the client so. (2) Name, in the client's words, any boundary that was crossed, at the level of detail the client chooses. (3) Validate that consent obtained under a false promise is not free consent [source: IFEG 2020 on invalid consent]. (4) Use standard trauma-focused methods the therapist is trained in, with pacing and consent at each step, and the client's right to stop [synthesis]. (5) Where sexual abuse is disclosed, follow reporting duties and offer specialist referral [synthesis].
  • Example language (illustrative): "What happened to your body in those sessions wasn't your fault, even if you agreed at the time. We can go as slowly as you need."
  • Watch for: re-traumatisation, freezing, sudden withdrawal. Working: the client can speak of it with less shame and set boundaries in current relationships [synthesis].

4.11 Religious and spiritual integration work with Jewish clients

  • Purpose: JONAH served mainly Jewish clients from a faith-based perspective [source: New Jersey Jewish News, 2015]; survivors often carry conflict between faith, family and sexuality. Where the difficulty centres on faith, DSM-5-TR "Religious or Spiritual Problem" may be recorded as Z65.8 [source: ICD-10-CM Z65.8 (Unbound Medicine)].
  • Steps: (1) Use the DSM-5-TR Cultural Formulation Interview and its supplementary module on spirituality, religion and moral traditions to learn the client's denomination, observance, community and what faith means to them [synthesis] [uncertain: DSM-5-TR wording not verified]. (2) Do not assume the client wants to leave or stay in their community. (3) Explore the client's own range of options, which may include remaining observant, changing community, or other paths; the therapist does not rule on religious law. (4) With consent, the client may consult religious leaders of their choosing; the therapist does not choose for them [synthesis]. (5) Remember that some religious communities have condemned conversion practices [source: A/HRC/44/53 para 68].
  • Example language (illustrative): "Your faith matters to you, and so does being honest about who you are. I won't ask you to give up either. Let's see what living with both could look like for you."
  • Watch for: the therapist's own views on religion leaking in; the client experiencing exploration as a test of loyalty. Working: less sense of having to choose between self and faith [synthesis].

4.12 Work with parents and families

  • Purpose: parents were among the JONAH plaintiffs [source: AP, 2015], and the organisation was founded by parents [source: New Jersey Jewish News, 2015]; parents may have enrolled or paid for a child and now feel guilt, or may still hope for change.
  • Steps: (1) Only with the client's consent, meet family members. (2) Give parents accurate information: orientation is not a disorder, change efforts do not work and are associated with harm [source: MoU Version 2; APA 2021]. (3) Acknowledge parents' fears (community standing, religious obligation, grandchildren) without endorsing rejection. (4) Support repair conversations at the client's pace. (5) Where parents still seek change for a minor, move to safeguarding (4.14) [synthesis].
  • Example language (illustrative), to a parent: "You sought help because you were frightened for your son. What we know now is that those programmes don't change orientation and can hurt. What he needs most from you is connection."
  • Watch for: parents recruiting the therapist to their goal; the client's safety at home. Working: less rejecting behaviour and more honest contact [synthesis].

4.13 Work with spouses and mixed-orientation marriages

  • Purpose: the defence at trial said many JONAH clients were men in heterosexual marriages [source: New Jersey Jewish News, 2015]; spouses and children may be affected.
  • Steps: (1) Clarify who the client is (individual or couple). (2) Help the client decide what to disclose and when, without a preferred outcome for the marriage. (3) Offer couple sessions, or referral for the spouse's own support. (4) Attend to children's needs and to religious divorce or community implications as the couple raises them [synthesis].
  • Example language (illustrative): "There's no right answer here that I'm holding. We can look at what honesty, staying and leaving would each mean for you and your family."
  • Watch for: pressure from the spouse or community to resume change efforts; risk at disclosure. Working: decisions the client owns [synthesis].

4.14 Safeguarding minors and mandatory reporting

  • Purpose: the UN Independent Expert states that subjecting children to these practices constitutes ill-treatment and may constitute torture; the IFEG says it may be child abuse and neglect [source: A/HRC/44/53 para 71; IFEG 2020]. Children most often undergo them because parents or guardians want them to conform [source: A/HRC/44/53 para 26].
  • Steps: (1) Ask young clients, and parents of young clients, about any current change efforts. (2) Explain limits of confidentiality at the start, with age-appropriate assent and parental consent as the law requires. (3) Where a minor is being exposed, assess risk (emotional harm, suicidality, threats of expulsion from home). (4) Consult the local child-protection procedure and the professional body's guidance on whether the circumstances meet the reporting threshold; document the decision. (5) Work with the family to stop exposure where possible. (6) Never confront an unregulated provider directly without a plan for the child's safety [synthesis].
  • Example language (illustrative), to a teenager: "Some things I have to share to keep you safe, and I'll always tell you first. Nothing about who you like is something I'd report."
  • Watch for: reporting thresholds vary by jurisdiction [uncertain: not verified for each jurisdiction]; risk of the young person being sent away. Working: exposure stops and the young person stays connected to support [synthesis].

4.15 Consumer-fraud and legal-recourse information

  • Purpose: the JONAH case showed that conversion services could be challenged as consumer fraud; damages covered fees paid and remedial counselling [source: SPLC, 2015; AP, 2015].
  • Steps: (1) If a client asks, tell them, in outline, that a New Jersey jury found JONAH's promises fraudulent under consumer law. (2) Do not give legal advice; suggest an attorney, a state consumer-protection office or an LGBTQ legal advocacy organisation. (3) Help the client weigh the emotional costs of litigation (testimony, cross-examination, publicity) [synthesis]. (4) Keep clinical records accurate and factual, in case they are requested [synthesis].
  • Example language (illustrative): "In one New Jersey case, a jury decided that promising to change people's orientation was consumer fraud. If you want to explore a complaint, a lawyer is the right person; I can help you think about whether it's right for you."
  • Watch for: the therapist becoming an advocate in a way that blurs the clinical role; retraumatisation through legal process. Working: the client makes an informed choice either way [synthesis].

4.16 Duties when a colleague or institution offers conversion practices

  • Purpose: the IFEG says health professionals should refuse to conduct conversion therapy and report colleagues who offer it to the appropriate authorities [source: IFEG 2020]; MoU signatories have committed to ending it [source: MoU Version 2].
  • Steps: (1) Record what is known, factually. (2) Where safe and appropriate, raise the concern with the colleague. (3) Report to the relevant licensing board or registering body (in the UK, the registering body of an MoU signatory) [synthesis]. (4) If a minor is involved, follow 4.14. (5) For unlicensed providers, consider consumer-protection routes [synthesis]. (6) Do not refer any client to the provider [source: IFEG 2020].
  • Example language (illustrative), to a colleague: "I'm concerned that the programme you're running aims to change clients' orientation. That conflicts with our professional body's position, and I need to raise it."
  • Watch for: retaliation in small communities; confidentiality of the client who disclosed. Working: the concern reaches a body able to act [synthesis].

4.17 Connecting the client with affirming community

  • Purpose: isolation and loss of relationships are documented harms [source: APA 2021 press release on gender identity change efforts].
  • Steps: (1) Ask what kinds of community the client wants (religious, LGBTQ+, survivor peers, cultural). (2) Help them find groups that publish an affirming position; check that a group does not have a change agenda (4.3). (3) Plan for first contacts, which may be anxious [synthesis].
  • Example language (illustrative): "Would it help to meet others who've been through something similar, or people who share both your faith and your identity?"
  • Watch for: groups with hidden change agendas; overexposure before the client is ready. Working: at least one sustaining relationship outside therapy [synthesis].

4.18 Therapist self-scrutiny and supervision

  • Purpose: the MoU requires adequate knowledge of sexual and gender diversity and freedom from any agenda favouring one orientation or identity [source: MoU Version 2].
  • Steps: (1) Review own beliefs about religion, sexuality and gender in supervision. (2) Seek training in affirming practice and religious competence [synthesis]. (3) Bring cases with safeguarding or reporting questions to supervision promptly [synthesis].
  • Example language (illustrative), in supervision: "I notice I wanted my client to leave his community. I need to check that's not my agenda."
  • Watch for: subtle steering in either direction. Working: the client experiences the therapist as neutral on outcome and warm in stance [synthesis].

4.19 Advocacy, ending and follow-up

  • Purpose: to close the work while leaving routes back, and to support any advocacy the client chooses [synthesis].
  • Steps: (1) Review goals and risk; update the safety plan. (2) If the client wants to speak publicly or support bans, help them consider privacy, family and community consequences. (3) Agree how the client can return. (4) Re-give crisis resources: 988 (US), Samaritans 116 123 (UK and Ireland) [synthesis].
  • Example language (illustrative): "You've come a long way from feeling broken. If old feelings come back, or the pressure starts again, you can come back here."
  • Watch for: relapse of shame at religious holidays, family events or a marriage proposal. Working: the client can name supports and warning signs [synthesis].

5. Handling problems

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

  • Client still wants to change orientation after psychoeducation. Do not argue; return to the distress behind the wish (4.5). State the boundary once, clearly: the therapist will not attempt change or refer to anyone who does [source: IFEG 2020]. Keep risk under review, since loss of hope for change can raise suicidality.
  • Client defends JONAH or a similar programme and reports benefit. The defence at trial presented witnesses who said the therapy helped them [source: AP, 2015]. Acknowledge what felt helpful (community, being taken seriously, structure) without endorsing the change premise; separate those needs from the programme and look for other ways to meet them.
  • Client loyal to a leader or community that ran the programme. Avoid moralising. Explore the relationship, the client's fears about speaking against it, and the cost of loyalty. Never use the word "cult" about the client's community.
  • Overwhelm when recalling sessions. Stop detailed recall; ground; return to stabilisation. Remind the client that detail is never required. Resume only with consent.
  • Rupture: client hears affirmation as pressure to come out or leave faith. Name it, apologise for any steer, and restate no preferred outcome (4.4).
  • Rupture: client hears neutrality as hidden disapproval. Say clearly that the therapist sees nothing wrong with the client's orientation or identity [source: MoU Version 2 that orientation and identity are not disorders].
  • Non-attendance or dropping out. Often linked to family or community discovery. Make contact by agreed safe means only; never contact family without consent (except under safeguarding duties).
  • Family or community pressure to return to change efforts. Assess risk (housing, finances, safety); plan for disclosure conversations; involve safeguarding where a minor is involved (4.14).
  • Acute suicidality. Follow current standard risk management, use the safety plan, give 988 (US) or Samaritans 116 123 (UK and Ireland), and arrange urgent care where needed. Use safe-messaging principles.
  • Disclosure of sexual abuse in a programme. Follow mandatory reporting and adult safeguarding procedures as they apply; offer specialist referral; keep the client informed.
  • Therapist in the same religious community. Weigh the multiple relationship under APA Ethics Code Standard 3.05 [source: APA Ethics Code]; refer on to an affirming colleague where objectivity or confidentiality is at risk.
  • Legal uncertainty about bans. Laws are changing. 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]. One such law is New Jersey's 2013 law barring licensed therapists from conversion therapy [source: AP, 2015]. Status in other countries is [uncertain]; check official or major-news sources, dated, before telling a client. Whatever the law, professional bodies' positions stand (APA 2021; MoU Version 2).
  • Colleague or employer offering change efforts. Follow 4.16; seek supervision and the professional body's advice.
  • The therapist's own anger at the practice. Process in supervision so it does not take over the client's story.

Harm account

What was actually done

JONAH, a Jersey City nonprofit founded in 1998 according to the New Jersey Jewish News, offered mainly Jewish clients a programme claimed to change gay men's orientation to heterosexual, led in part by a non-licensed "life coach" [source: New Jersey Jewish News, 2015]. Plaintiffs said it claimed success rates of 65 to 75 percent without keeping statistics, and that its methods had no scientific basis [source: AP, 2015]. Practices described in the case included undressing in sessions, role-plays using anti-gay slurs, striking an object representing a parent, and prolonged physical-contact sessions called "healthy touch" [source: SPLC, 2015; AP, 2015]. In 2012 former clients and parents sued with the SPLC as counsel. On 25 June 2015 a unanimous seven-member jury found JONAH, co-founder Arthur Goldberg and counsellor Alan Downing liable under the New Jersey Consumer Fraud Act for misrepresentations and unconscionable commercial practices, awarding about $72,400 for fees paid and remedial counselling [source: SPLC, 2015; AP, 2015]. A permanent injunction of 18 December 2015, entered by agreement, required JONAH to stop all operations within 30 days, remove its websites, and dissolve; barred Goldberg and Downing from conversion activities in New Jersey; and barred referrals for, or promotion of, therapy aimed at changing sexual orientation or "same-sex attraction" [source: SPLC, 2015; Philadelphia Inquirer, 2015]. Cited as Ferguson v. JONAH (N.J. Super. Ct., Hudson County). The defence argued that JONAH made no guarantees and that it should be allowed to help people struggling with their sexuality [source: AP, 2015; Philadelphia Inquirer, 2015].

What it looked like to clients. The Associated Press reported that the plaintiffs were gay men from strict religious backgrounds, three from Orthodox Jewish families and one raised Mormon, who were expected to marry women and have children; parents also took part in the suit, and two were among those awarded damages [source: AP via CBS Philadelphia, 2015]. According to the plaintiffs' lawyer, neither Goldberg nor Downing was a licensed therapist. The role-plays described at trial included a client striking a pillow that represented his mother with a tennis racket, and a staged locker-room scene in which anti-gay slurs were used [source: AP via CBS Philadelphia, 2015]. Goldberg acknowledged under cross-examination that the success rates JONAH advertised rested on counsellors' anecdotal reports rather than its own statistics [source: AP via CBS Philadelphia, 2015]. The defence said none of the plaintiffs had complained during or soon after the programme, and it called witnesses who said JONAH had helped them [source: AP via CBS Philadelphia, 2015]. The UK study commissioned by the Government Equalities Office heard similar accounts from people in the UK: psychodrama-style exercises to "release" repressed emotion, and touch-based "healthy touch" sessions presented as meeting unmet childhood needs [source: GEO 2021, sections 4.2-4.3].

Related: Exodus International, a Christian ministry founded in 1976, announced its closure in June 2013, and its president apologised for promoting "sexual orientation change efforts" [source: Religion News Service, 20 June 2013].

How it caused harm

SPLC, as plaintiffs' counsel, reported that JONAH's tactics alienated some clients from their families and led them to blame themselves or relatives for their orientation [source: SPLC, 2015]. More widely, professional and international bodies report self-hatred, depression, PTSD, loss of relationships, low self-worth, and suicidal ideation and attempts [source: A/HRC/44/53 paras 56, 61; IFEG 2020; APA 2021]. In a survey cited by the UN Independent Expert, 98 percent of 940 people who had undergone such practices reported damage [source: A/HRC/44/53 para 19]. The IFEG calls offering conversion therapy deception, false advertising and fraud, and says it is cruel, inhuman or degrading treatment when forced or non-consensual and may amount to torture depending on severity [source: IFEG 2020]. Clients also lost money: damages covered fees paid [source: SPLC, 2015].

Recognising it today

  • Any service, of whatever name, that assumes one orientation or identity is preferable and aims to change or suppress it [source: MoU Version 2].
  • Promises of change with success rates and no data [source: AP, 2015].
  • Explanations that blame parents or early wounds for orientation; terms such as "same-sex attraction" or "gender wholeness" used as targets of healing [source: SPLC, 2015].
  • Unlicensed coaches or mentors, faith-based or online, often outside the reach of licensing bans [source: AP, 2015; New Jersey Jewish News, 2015].
  • Covert practice under mainstream therapy labels [source: MoU Version 2].
  • Children brought by parents to make them conform [source: A/HRC/44/53 para 26].

What to do instead and how to help those harmed

  • Supported care: affirming, non-directive therapy with no preferred outcome; help with distress, conflict and self-acceptance [source: MoU Version 2; APA 2021].
  • Survivors: risk assessment and safety planning; trauma-informed work on shame, self-blame and boundary violations; religious integration on the client's terms (sections 4.7–4.11) [synthesis].
  • Families: accurate information and support for repair (4.12) [synthesis].
  • Reporting and legal routes: report licensed providers to their board or registering body and follow child-protection routes for minors [source: IFEG 2020] [synthesis for routes]; consumer-fraud claims are a documented route for unlicensed providers [source: SPLC, 2015].
  • Crisis resources: 988 Suicide and Crisis Lifeline (US); Samaritans 116 123 (UK and Ireland).
  • Survivor organisations: refer only to groups that publish an affirming position and no change agenda [synthesis].

Sources

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