How reliable are the claims of Joseph Nicolosi, Jr.?

Nicolosi's own study is valuable as an illustration of why one should be skeptical of him.

Joseph Nicolosi Jr., is the inheritor of the forms of conversion therapy developed by his father, Joseph Nicolosi, Sr. The younger Nicolosi, like his father, has exercised considerable influence on the Catholic community, and on the Christian community generally. He has been promoted by people and organizations such as Lila Rose, the Ruth Institute, the Fresh Catholic Podcast, the Line of Fire podcast, the International Foundation for Therapeutic and Counselling Choice, and others. His work has been promoted in the National Catholic Register and by EWTN. And, most recently, he submitted a legal brief in the U.S. Supreme Court case Chiles v. Salazar, seeking to overturn Colorado’s ban on conversion therapy for minors.

The elder Nicolosi, who has been referred to as the “father of conversion therapy,” developed “reparative therapy,” an approach to “healing” same-sex attractions through addressing traumas and wounds related to one’s sexed identity. In more recent years, conversion therapy efforts such as “reparative therapy” have been found to be ineffective and harmful for many. They compound shame and strain parental relationships, and nearly double the risk of suicide.

Perhaps because of the negative views towards “reparative therapy”, Nicolosi, Jr. has rebranded his efforts, calling them “Reintegrative Therapy” or “sexual attraction fluidity in therapy” (ironically, SAFE-T). Nicolosi, Jr. argues that his treatments are safe, effective, and backed by research.

But are they? To validate them, I examined Nicolosi’s legal brief in Chiles. Given the significance of the case, one might expect Nicolosi to present his best arguments and strongest evidence in the brief. In the interest statement of his brief, Nicolosi writes:

“Although sexual-attraction change is not a goal of Reintegrative Therapy, sexual-attraction change is a known byproduct. See Carolyn Pela & Philip Sutton. Sexual Attraction Fluidity and Well-Being in Men: A Therapeutic Outcome Study, 12 J. Hum. Sex. 61 (2021); Joseph Nicolosi Jr. & Jacek Szandula, Memory Reconsolidation for Unwanted Sexually Arousing Memories: A Randomized, Placebo-Controlled Study, 2 Integratus 287 (2024).”

The two studies cited in this section are seminal for Nicolosi. They are later cited to back up his claim:

“Dr. Nicolosi’s non-profit exists solely to train professional therapists and educate the public about a treatment approach that has been shown to safely and effectively change sexual attractions for many people, including but not limited to those with same-sex attractions, as a spontaneous byproduct of trauma treatment.”

Indeed, Nicolosi consistently cites these two studies to defend his particular brand of conversion therapy. The homepage of the Journal of Human Sexuality—a journal associated with Nicolosi and run by conversion therapists Christopher Rosik and Philip Sutton—refers to the 2024 study as a “landmark prospective, longitudinal study of 75 men receiving trauma treatment through Reintegrative Therapy, providing statistically and clinically significant evidence that contradicts the mainstream narrative.” But do these studies really provide what Nicolosi, Rosik, and Sutton claim? I’ll examine each study in turn, looking at what they provide and what they don’t…

The Sutton and Pela study

Sexual Attraction Fluidity and Well-Being in Men is a 2021 study by Carolyn Pela and Philip Sutton. Pela is a Licensed Marriage and Family Therapist and the Dean of the School of Graduate Studies at Arizona Christian University. Philip Sutton is a clinical psychologist who has served as a leader in NARTH and its predecessor organization, the Alliance for Therapeutic Choice and Scientific Integrity (ATCSI). Both of these organizations exist specifically to defend and promote conversion therapy practices. Both Nicolosi and Pela are former presidents of ATCSI. The study was published in the Journal of Human Sexuality, a publication of ATCSI. Already, we can see red flags, in that Pela and Sutton are publishing their work in organizations where they have held leadership positions and which is presumably run by close peers and colleagues.

The study’s abstract lends itself to misrepresentation. It states:

“Participants were 75 adult male psychotherapy clients reporting both same-sex attraction experiences (SSAE) and the desire to participate in SAFE-T to achieve SAF. Well-being was measured with the OQ-45.2, SSAE, and opposite-sex attraction experiences (OSAE) with a Likert scale, and sexual attraction identity (SAI) with a Likert-type item. Results of t-tests of the means of baseline and final well-being measures revealed a clinically and statistically significant improvement in well-being. A linear mixed model was used to analyze the SSAE, OSAE, and SAI data obtained at baseline, 6 months, 12 months, 18 months, and 24 months, with results showing statistically significant fluidity of all three factors.”

The abstract suggests that it arrived at its conclusions after evaluating 75 participants over the course of two years. But this is not true, something only realized by discerning readers. If one carefully examines Table 3, one will notice that the 75 participants only took part in the first six months of the study, and only 22 participants remained in the study for the full two years. This is not made clear in the text of the study, raising concerns about whether it was written in a way so as to mislead readers.

In any event, the study was constructed in a way such that lends itself to various forms of bias. It leveraged Nicolosi’s “Reintegrative Therapy”, which uses EMDR and mindful self-compassion techniques to address trauma, advertising a “cooccurring reduction” in same-sex attraction experiences (SSAE) “in some men.” The claim is that Reintegrative Therapy’s approach to addressing various traumas can have a side effect of driving “sexual attraction fluidity” (SAF), i.e. reducing same-sex desires and increasing opposite-sex desires.

The Pela and Sutton study has a significant flaw, however, in that it exclusively invited men to the study who were “reporting SSAE and a desire to explore SAF.” In other words, it recruited exclusively men who were seeking the outcome that the study was advertising as a “side effect.” A better study would have recruited men who reported SSAE but may or may not have a desire to seek SAF, engaged in the trauma work of Reintegrative Therapy without advertising SAF as a potential outcome, and then evaluated their SSAE over the course of therapy.

Instead, the study asked men to rate how often they experienced things such as frequency of sexual thoughts, feelings, and behaviors. These men were actively seeking changes in their sexuality in the course of therapy, and over the two years only 22 men remained in the study for evaluation. And the shifts noted for those 22 men were hardly significant. On a 5-point scale, there was less than a 1-point change for both opposite sex attraction experiences (OSAE) and SSAE. And the changes were not linear. Between 18 and 24 months, participants saw a reduction in OSAE and an increase in SSAE. It’s quite possible that additional time in the study would follow that trend and find the participants at the same place that they started.

Finally, one should note that this study has exclusively men as participants, and thuse cannot be used to make claims about general human sexuality.

To summarize: the study had less than two dozen men who, over 2 years, self-reported slight decreases and then increases in same-sex attractions. It is remarkably irresponsible, unprofessional, and unethical to claim that this study can be used to argue that Reintegrative Therapy is effective generally. Such claims can only be made by professionals who are either incompetent or intellectually dishonest.

The Nicolosi and Szandula study

The 2024 study cited is one by Nicolosi himself, along with Jacek Szandula. The oddity of the study begins with that second author.

I searched the internet for Szandula and was able to find very limited information. The article states that Szandula is associated with WSB Merito University, a collection of private universities in Poland. I searched the university website and did not receive any results for “Szandula.” I was able to find a personal website for a Jacek Szandula who was likely an economics professor at Wroclaw University. But that university’s website also did not return any results. Most likely Szandula was an economics professor with no professional experience or credentials in mental health, which raises the question of what role he is playing in Nicolosi’s research.

Of course, leveraging unqualified professors is not new for these organizations. ATCSI’s predecessor organization NARTH often cited the work of Neil Whitehead in defense of conversion therapy. Whitehead was an earth scientist whose work lacked quality to such an extent that the journal of the Catholic Medical Association retracted one of his most-cited articles.

The 2024 Nicolosi and Szandula study was published in Integratus, the journal of the Catholic Psychotherapy Association. It examined potential benefits of memory reconsolidation, wherein one can change one’s relationship to past memories. Research increasingly shows that recalled memories and our relationships to them change over time, and mental health professionals are developing techniques to leverage these processes to support their clients.

Nicolosi and Szandula look at memory reconsolidation when it comes to clients suffering form “unwanted sexually arousing memories.” They divided the 144 students into four groups. Three of those groups of those groups would receive trauma treatments related to specific memories, while the fourth served as a control group. The first meeting for all participants consisted of a 15-20 minute Zoom call in which those treatments were administered. A week later, participants were given an assessment over a 3-minute call. And four weeks later, another assessment was given over a 3-minute call.

All groups reported a decrease in arousal, vividness, and emotionality related to those memories, with the participants who received the trauma treatments noting a significantly greater decrease. This shows promise for these treatments in decreasing unwanted effects of traumatic memories through various treatments.

There are a number of limitations to the study, however. First, the study was short-term and did not capture long-term effectiveness of these treatments. Second, the participants were not representative of the general population. The study itself states, “The generalizability of these effects for women is limited because nearly 90% of the participants were male and only 10% were female.” Given that Nicolosi uses this as one of two studies to support claims that Reintegrative Therapy is generally helpful, he is misrepresenting his own work. Indeed, the Reintegrative Therapy protocol uses some of the treatments tested in the 2024 study, but the study itself is not testing the effectiveness of Reintegrative Therapy. It is incorrect (and, I believe, ethically problematic) to present the study in the way that Nicolosi does in his brief.

The value of these studies

These studies are valuable, however, as illustrations of the reasons why one should be skeptical of Nicolosi, the Reintegrative Therapy Association, Reintegrative Therapy generally, the Alliance for Therapeutic Choice and Scientific Integrity, and the Journal of Human Sexuality. Given that Nicolosi is a key leader and referenced “expert” in these latter organizations, one is left suspecting that they are either comfortable with or ignorant of scientific misrepresentations.

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If you’d like to learn more about Reintegrative Therapy, I’d recommend this video by Julia Sadusky: