On April 27, 2016, the governor of Tennessee signed into law House Bill 1840, which “declares that no person providing counseling or therapy services will be required to counsel or serve a client as to goals, outcomes, or behaviors that conflict with the sincerely held principles of the counselor or therapist; requires such counselor or therapist to refer the client to another counselor or therapist; creates immunity for such action; maintains liability for counselors who will not counsel a client based on the counselor’s religious beliefs when the individual seeking or undergoing the counseling is in imminent danger of harming themselves or others.”
In short, counselors can refer a client anytime something the client is, says, or does conflicts in some way with what the therapist sincerely and principally believes. It is no secret that the bill is a deliberate attempt to give so-called “religious freedom” to therapists hoping to find a way to legally deny mental health services to LGBTQ clients based. As The Atlantic’s Emma Green remarked as a host of other similar legislation has been proposed throughout the country:
This legislation is part of a wave of religious-freedom bills that have been introduced and passed in the past year or so, almost all inspired by objections to homosexuality and same-sex marriage. Some of these measures are just for show—pastors could never be legally compelled to perform a gay-marriage ceremony in the way some bills have suggested, for example. But some represent a relatively novel approach to religious-freedom legislation: They offer legal cover to people of faith who don’t want to provide certain goods or services to LGBT people, especially when doing so might seem like a tacit endorsement of their relationships and sex lives.
The problem here (well, one of many) is that this directly contradicts the American Counseling Association’s 2014 Code of Ethics, section A.11.b., Values Within Termination and Referral, which reads as follows, “Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.”
According to that same code of ethics, section A.4.b., Personal Values, the call instead would be for counselors to “be aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors…respect the diversity of clients…and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.”
It is here worth noting that the ethical code doesn’t absolutely, positively, once and for all prevent counselors from doing things — people who treat codes of ethics like they are laws use them incorrectly and misunderstand their purpose:
- Laws are ideally black and white, whereas ethics are gray.
- Laws are linear, whereas ethics are experienced on a continuum.
- Laws restrict and prohibit, whereas ethics encourage us to refrain and restrain.
- Laws close down particular street paths, ethics encourage practitioners to give a wide berth.
In this case, the ethical code is saying,
[button type=”big” color=”teal”] “It is better if you don’t touch referring clients away solely because of your personal beliefs with a 10-foot pole. A better alternative is to get educated on why your personal beliefs and your clients can’t exist in the same room. Because guess what? If you talk to another human being long enough, you’re going to find out you don’t have 100% the same beliefs with anyone, so you’d have to refer everyone away. And you wouldn’t do that. You’d just pick the humans that really bug you. And that’s called discrimination.”[/button]
I routinely provide counseling to individuals who are doing and saying things that I find personally offensive, or that are by their very being simply an affront to the points of view I hold very deeply. For example:
- I help number of individuals who believe there is no God and actively campaign to proselytize others to that point of view.
- I help folks who think that faith is a crutch for the weak and who are openly hostile to Christians of all kinds (even us non-conservative ones).
- I help others who think that marriage is an outdated convention for the boring or sexually-repressed.
- I help people who think that some of the methods I employ in parenting my children are inappropriate and ineffective.
In all of these cases, I do not refer them out, but instead try to be aware of the ways in which my values inform how I approach my clients in these areas, to mitigate the impact of those values if they run the risk of me railroading them and presuming to know what is best for their lives or what they ought to do. When this is a significant struggle, I seek help and further education from literature and therapist mentors and colleagues. And <GASP>, I bring these things up with my clients and talk about how this might impact us and what it means for the two of us to continue working.
Even for people who can concede that this is probably a more appropriate approach, they often remark: “Yes, but is it really appropriate for someone who is anti-gay to work with someone who is gay?”
But this question obscures a much larger, encompassing question: “Is it appropriate for a person who is licensed by the state to provide counseling services to be anti-gay to the extent that they cannot help a gay person without bias interfering?”
I mean, let’s hash out what we’re typically talking about here**:
- I worked with a lesbian who was going through a devastating divorce and whose spouse didn’t want the credit card loans that her now depleted savings had paid off to factor into their divorce settlement.
- I worked with a gay man who felt disconnected from his work life, and another who was having regular anxiety attacks.
- I worked with a transgender man who needed help determining forward momentum in life since he’d decided to transition.
(**client scenarios are typical, but details are changed and do not reflect exact experiences to protect client confidentiality)
In any of these cases…
Do counselors need to have some sort of specialized code of agreement about the phenomenological nature of sexual orientation or sexual identity or gender identity to support someone through grief and mistreatment?
Is it really providing a “tacit endorsement of their relationships and sex lives” to weep with those who weep, to mourn with those who mourn?
Do therapists have to don leather chaps or march in the next pride parade to pick another human up off the ground or to help them think through the best way to respond to a tough situation?
From a counseling perspective (and imho, a Christian one), the answer is an overwhelming, resounding, “NO, MY GOD, NO. YOU JUST BE WITH PEOPLE AND HELP THEM FIGURE OUT THEIR STUFF.” We don’t have to “agree” with anything, because it isn’t our role to do so — nobody’s asked us our danged opinions and counseling isn’t advice-giving. This is something we’re supposed to have learned in our first semester of counselor training. There are hundreds and thousands of other decisions my clients make which I probably wouldn’t “agree” with, but which nonetheless don’t prevent me from helping them.
And to think that this is motivated by so-called “Christian” folks. <SIGH> I’ve said this before, but I’ll do it again:
Late Dutch-Catholic priest and Harvard Professor, Henri Nouwen, believed the way of Jesus is ‘…to enter into solidarity with those who suffer. Those who can sit in silence with their fellowman, not knowing what to say but knowing that they should be there, can bring new life in a dying heart. Those who are not afraid to hold a hand in gratitude, to shed tears in grief and to let a sigh of distress arise straight from the heart can break through paralyzing boundaries…’
In other words, Christians who want to use their Christianity as a reason to not help people, for real:
Long story short:
HB1840 misses that the very core of counseling as a vocation and the mandate of our professional licensure is that we are to be ethical counselors, and that it is not enough to just make some cursory and perfunctory effort to act that way, to simply throw up our hands when our belief-o-meter ticks red and beeps frantically. We can’t just say, “But dontcha see, MY BELIEFS are sincerely held. I don’t feel like working on this one. Hey Tom — you take em!”
As counselors, when it comes into our field of conscious awareness that there is within us such a rigidly held value that it would prevent us from helping others, we must investigate, self-reflect, think deeply, ask for help — not just move on and hope it doesn’t happen again. This is the distinction that the ACA ethical code makes, and it is improper to embrace a statute that fails to make this same distinction, as it is making lawful what is unethical. And that’s just what Tennessee’s HB1840 has done. It says, “Well, the ACA may say it’s unethical, but in Tennessee, it’s legal.” For shame. For shame.