We also urge that, both diagnostically and therapeutically, homosexual orientation and behavior not be regarded as separate nosologic entities but as partial manifestations of more basic adaptational disorders.
Four procedures were involved in the study: selecting the cases, reviewing the charts, conducting follow-up interviews, and conducting follow-up Rorschach testing.
Selection of cases was performed by reviewing charts of all H.M.P.C. patients who had been recorded on the McBee Clinic Keysort Card (Lief, Lief, Warren, & Heath, 1961) as having "homosexual personality disturbance" as part of their diagnoses.
From a review of the charts, a profile of each patient was compiled and recorded in a protocol form, which is reproduced in Appendix B ( see p. 336) . Section 2-B on pattern of sexual behavior was based on Rado's classification (1956). The diagnosis of true homosexual versus pseudohomosexual conflict in Section 2-C was applied in accordance with Ovesey's concepts (1954; 1955a; 1955b) . Sections 2-D and 2-E on family constellation and sexual history were adapted from Bieber ( Bieber et al., 1962). Sections 2-F, 2-G, 3-A, and 4-B were modified from an evaluation system proposed by Malan (1959). The patients' statuses at the beginning and at the end of treatment were rated according to the scales in sections 5-B, 5-C, and 5-D. These five-point rating scales were adapted and modified from those of Miles et al. (1951). In several charts no mention was made of change in structured symptoms. The symptomatic evaluation was therefore supplemented by having each patient complete a Cornell Medical Index (Broadman, Deutschberger, Erdmann, Lorge, & Wolff, 1954; Broadman, Erdmann, Lorge, Gershenson, & Wolff, 1952a; Broadman et al., 1952; Broadman, Erdmann, Lorge, & Wolff, 1954), hereafter referred to as CMI, which was modified to include a self-evaluation of the presence and the degree of severity of the patients' somatic and psychological symptoms at the beginning of therapy, at the end of therapy, and at follow-up. The parts of the CMI analyzed included areas M through