A vote for prejudice and discrimination

A new law in Tennessee allows therapists to refuse to see LGBTQ+ clients. Karen Pollock explores how this is not only discriminatory, but will protect incompetent and unethical practitioners.


Amidst bathroom bills and claims of political correctness gone mad, there is another piece of news from Tennessee which may have slipped under the radar. The House of Representatives has passed a bill allowing therapists to refuse to see clients whose “goals, outcomes, or behaviors that conflict with the sincerely held principles of the counselors or therapist”. In case there is any doubt about who this is aimed at, the wording was originally “religious beliefs” not sincerely held principles. This bill has been prompted by the American Counselling Association’s 2014 code of ethics, and the outcome of a case which therapists across the world watched with interest. In order to understand why this is happening now, we need to look at both the history, and how therapy is regulated in the US.

The regulation of counselling/therapy (the difference between the two is largely one of taste and price bracket) is far stricter in the US than it is in the UK. You need a license to practice, and in order to get a license (and indemnity insurance, which protects you if you are sued) you need to be a member of a recognised professional body. In the UK, there is no such requirement. However, to work with the NHS or any similar organisations, you are expected to be a member of a regulatory body such as the BACP, anyone can however call themselves a counsellor, life coach, angel wing therapist, or whatever the title de jour is. Back to the US, in order to call yourself a counsellor, you must have a recognised qualification, and membership of a recognised organisation. This protects clients from the kind of abuses that Phil Dore covers on his blog, as unethical therapists can be struck off, just as doctors, nurses and others can in this country. When you join an organisation, be it the American Association of Counselling, or the local leek club, you agree to abide by their rules (although I do not think the ACA has a turkey raffle at Christmas). Part of the ACA code of ethics states that “counselors may not discriminate against clients on the basis of age, culture, disability, ethnicity, race, religion/spirituality, gender, gender identity, sexual orientation, marital status/partnership, language preference, socioeconomic status or any basis proscribed by law.

Amidst bathroom bills and claims of political correctness gone mad, there is another piece of news from Tennessee which may have slipped under the radar. The House of Representatives has passed a bill allowing therapists to refuse to see clients whose “goals, outcomes, or behaviors that conflict with the sincerely held principles of the counselors or therapist”.

In 2009 a counselling student at the Eastern University of Michigan (EMU)  was assigned a client, its how we all learn, and how many volunteer organisations keep going, using students who need to meet a required number of placement hours. However this student was a conservative Christian, and when they saw that the client was LGBTQ+, refused to work with them.

The refusal to take a LGBTQ+ client became a minor cause celebre for those who rally outside every butchers, bakers, and candlestick makers waving placards declaring that their right to be prejudiced freedom of religion was being curtailed. In order to be an accredited course the university  had to abide by the ACA code of ethics, and the student, despite high-profile (and a lot of financial support) lost their case.

Which brings us to Tennessee today, and lawmakers stating that the ACA have somehow overstepped themselves by having rules their members should abide by, which I shall remember when I enter a spring onion in the Leek Club competition. The policy of being non discriminatory is not just about some “liberal agenda” either, but goes to the heart of how counselling works.

The refusal to work with a LGBTQ+ client became a minor cause celebre for those who rally outside every butchers, bakers, and candlestick makers waving placards declaring that their right to be prejudiced freedom of religion, was being curtailed.

Being non judgemental is not an optional extra for therapists, nor is leaving your own opinions and beliefs outside of the room, it lies at the very heart of what we do. I cannot, of course, give examples from my client work, but fortunately, my own training has an example which shows how difficult, but important these are. One of our last assignments was a series of filmed role play session, where we had to counsel someone who in the words of my tutor “pushed every single one of our buttons”. Beforehand we had to consider which type of client we would find the most difficult to work with. Since the process of training to be a counsellor involves pulling yourself apart in front of your classmates, there was no getting away with,”well I might struggle with a Daily Express reader.” I realised that I struggled to understand those women who stuck by their partners when they had been convicted of child abuse, rejecting the victim, their own child. I could honestly say I would have struggled with empathy, unconditional regard or a non judgemental attitude towards someone who had done this.

The point of the training, and of my objection to this proposed legislation beyond its discriminatory nature, is that to be a competent therapist you need to be able to leave those personal feelings outside the room. This is wider than arguments about whether a guest house can refuse gay couples, even if on first sight it appears very similar. Tennessee is not only saying it can overturn the rules an organisation has around membership, but that counsellors do not have to demonstrate basic competency.

Being non judgemental is not an optional extra for therapists, nor is leaving your own opinions and beliefs outside of the room, it lies at the very heart of what we do.

Being unable to offer non judgemental therapy makes someone unable to offer counselling. Indeed I would go as far as to say that a therapist who refuses to work with LGBTQ+ clients on religious grounds is not safe for anyone to work with. If as a therapist you bring so much of yourself, your views, your opinions, into the therapy room, no client will be able to benefit, you are taking up the space which belongs to them. Tennessee is not only passing an anti LGBTQ+ bill; it is passing a bill that protects inadequate, unethical, and dangerous therapists. It says so much about the vehemence of anti LGBTQ+ feeling that protecting vulnerable people matters less than making a political point. If you never cared before about the various laws being passed to make the lives of LGBTQ+ people worse, consider that legislators now see everyone, cis or trans, straight or queer as expendable in this fight they have created out of hate, prejudice and bigotry.

Follow Karen on Twitter (@CounsellingKaz)

 

4 thoughts on “A vote for prejudice and discrimination

  1. I agree with you that every therapist should strive to be objective, non-judgemental, and capable of leaving their politics and world views outside of the therapy room. The reality however, is that therapists are human and they may encounter people they find too difficult to develop a therapeutic relationship with.

    You may be thinking “If you can’t work with client group X, then you have no business being a therapist”. But let’s consider another scenario: suppose during the course of therapy, a client revealed extremely strong Conservative political views, and as a result the therapist really struggled to empathise and engage with this client emotionally. Suppose this therapist had a very good track record, and was highly qualified, but this particular issue was beyond their capacity for empathy. Undoubtedly it would be an issue to take to supervision, and it should be worked on, but should the therapist lose their job?

    I would argue that it’s within the best interests of the client to be referred onto another therapist if the original therapist has serious doubts about their ability to build a therapeutic relationship with that client. To compel a therapist to work with a client when they have these doubts out of fear they could lose their license would be potentially damaging for both parities. Referral, followed by serious personal reflection and supervision regarding the referral, are what’s needed, I believe.

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    1. Of course a therapist should refer on if they cant work with a group, then they should take it to supervision in order to do better next time. I am unsure where the idea of compelling people comes from?

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      1. You’re arguing that a law, which allows a therapist to refuse to treat clients where the client’s values are in direct conflict with the therapist’s, is wrong. The only alternative is to legally compel all therapists to work with any and all client groups. If a therapist were legally compelled in such a manner, it puts congruence and the therapeutic relationship in jeopardy, which is damaging to both client and therapist.

        I think a therapist lacking the capacity to treat any sort of person, whoever they are, is a failing on the therapist’s part and a great shame. But I think forcing a therapist to work with everyone is much worse, for both client and therapist.

        This isn’t the same thing as refusing to bake a cake for a gay couple. Psychotherapy and counselling is a relationship! It needs warmth, congruence and empathy. If a therapist can’t provide that, it’s best for all parties that they find other options.

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