Pray your gay away! /s

[MBellows]

Or it could mean you uphold the teachings of the Roman Catholic church? The term behaviors was used, not person. Think about it.

So what would otherwise be labeled as bigotry is morally neutral because groupthink makes it all ok?

---

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[G Costanza]

And I don't understand this "slippery slope" argument. That implies that we should be careful about this law because it could turn into something worse? So it's ok to refer a gay client becuase they are gay but it's not ok to refer a Hispanic client just because they are Hispanic? How about it's not ok to refer any oppressed client on the basis of their minority status? In this context, how is one not like the other?

 

[G Costanza]

It sounds like we pretty much agree -- that working with queer clients and working with substance-abusing clients are both important training topics, and that anyone who doesn't want to work with either of these populations out of personal animus has a huge competence problem. Does that sound about right?

So what would otherwise be labeled as bigotry is morally neutral because groupthink makes it all ok?

Ding ding ding.

 

[Qwerk]

I keep hearing how if someone isn't comfortable working with an LGBT client they would just refer them. What happens when you have been seeing this client for 9 sessions and you build enough trust where they come out for the first time to anyone and they pick you? I've had that happen. So all of sudden I say, "Sorry we can't work together anymore." How does an anti-gay handle that? Think of the implications for rejecting that person in that moment of their life.

This is a good point, and one to which I hadn't given much thought. It's quite possible to work with a client long-term -- maybe for years -- until the client comes out to you, or comes to terms with his/her sexuality. I've had that happen, too, albeit in a shorter timeframe. (I cringe to think of what my supervisor would say if I'd suddenly refused to work with this client.)

For those saying that a competent clinician can ethically refuse to work with gay clients, what should happen in this situation? Should the therapist refer the client? Work with the client, but refuse to discuss sexuality? Discuss sexuality, but tell the client that he/she believes that the client's sexual behavior is wrong? Flee to Brazil with a suitcase full of money?

 

[erg923]

So what would otherwise be labeled as bigotry is morally neutral because groupthink makes it all ok?

Am i bigot if i dont agree with the behavior of premartial sex, too? Give it a rest fellas...no one has to agree with anyone's behavior. Doesnt mean I am an incompetent therapist. Although I dont do much therapist these days anyway.

 

[Therapist4Chnge]

It could be both. I happen to be very passionate about this area and think there are a lot of incompetent psychologists when it comes to addiction that don't refer when they should.

...like the ones that require the person attend AA/NA or require 100% abstinence from all substances (as compared to a harm reduction model e.g. Suboxone for opioid addiction). I think any licensed psychologist should know how to handle substance abuse....and well. The reality is that many don't.

This is a personal pet peeve of mine, pardon the sidebar.

 

[Qwerk]

Am i bigot if i dont agree with the behavior of premartial sex, too? Give it a rest fellas...no one has to agree with anyone's behavior. Doesnt mean I am an incompetent therapist. Although I dont do much therapist these days anyway.

Beliefs vs. actions. You can believe whatever you want, and I've met clinicians with a wild and weird range of beliefs. I don't call it bigotry to be Catholic or to find gay sex disturbing or upsetting. I do call it bigotry to let this affect your gay-sex-having clients. Only you know whether you've ever let this happen.

 

[erg923]

For those saying that a competent clinician can ethically refuse to work with gay clients, what should happen in this situation? Should the therapist refer the client? Work with the client, but refuse to discuss sexuality? Discuss sexuality, but tell the client that he/she believes that the client's sexual behavior is wrong? Flee to Brazil with a suitcase full of money?

Depends, yes. no. no, but honesty about your inability (if it truly is) to provide competent care in good faith can be provided. It is not going to be easy. Clinical work generally isnt.

 

[erg923]

I don't call it bigotry to be Catholic or to find gay sex disturbing or upsetting. I do call it bigotry to let this affect your gay-sex-having clients. Only you know whether you've ever let this happen.

Well..exactly, which is why a support the right to refer in these situations. Isn't this what the thread is about, and what everybody around here seems to be against? Maybe you're not, I cant keep up with all the players here.

 

[Qwerk]

Depends, yes. no. no, but honesty about your inability (if it truly is) to provide competent care in good faith can be provided. It is not going to be easy. Clinical work generally isnt.

Sure, but why make it harder?

 

[Qwerk]

Well..exactly, which is why a support the right to refer in these situations. Isn't this what the thread is about, and what everybody around here seems to be against? Maybe you're not, I cant keep up with all the players here.

Let me clarify -- I'm putting referral in the category of "letting this affect your clients." Sometimes it's not possible to refer. Sometimes it could be harmful to refer, as in the case of a client you've worked with for years, or with a client who has few other treatment options. This is why I don't think it's possible to categorically refuse to work with any gay clients and still act ethically.

 

[erg923]

Let me clarify -- I'm putting referral in the category of "letting this affect your clients." Sometimes it's not possible to refer. Sometimes it could be harmful to refer, as in the case of a client you've worked with for years, or with a client who has few other treatment options. This is why I don't think it's possible to categorically refuse to work with any gay clients and still act ethically.

Because the alternative is worse. Clinical work is not utopian and we are not super humans. People are complex and life happens.

In the case of no referral options, you would guide/treat through crisis to maintain saftey to self/others. But, there is no law saying I have to treat all who want my services. Its not the ideal scenario, but it happens. DO NOT confuse this to mean this is what I do/would do. I simply justify the right for it to happen without a bunch of outrage and cries of being an incompetent therapist. I would certainly not be this flexible with a trainee of mine.

 

[Therapist4Chnge]

Let me clarify -- I'm putting referral in the category of "letting this affect your clients." Sometimes it's not possible to refer. Sometimes it could be harmful to refer, as in the case of a client you've worked with for years, or with a client who has few other treatment options. This is why I don't think it's possible to categorically refuse to work with any gay clients and still act ethically.

I'd have a hard time finding a specific part of the Ethics Code that would be violated if a clinician decided to discontinue services with one of their long-term patients. If they are stable (not actively suicidal/homicidal), you provide them with a number of viable referrals, etc....is that really an instance where it isn't possible to refer? It may not be ideal for the patient, but it should still be well within your ethical (and legal) obligation as a psychologist.

The second part of your quote...that is a bit trickier. I'll leave that for others.

 

[MBellows]

Am i bigot if i dont agree with the behavior of premartial sex, too? Give it a rest fellas...no one has to agree with anyone's behavior. Doesnt mean I am an incompetent therapist. Although I dont do much therapist these days anyway.

Whoa whoa whoa, lets back up the fun bus. I'm incredibly sorry if that came off as me attacking anything to do with your skills as a therapist, though I suspect that last part may have been directed elsewhere. As I clearly expressed before, people with all sorts of biases can find themselves a perfectly competent and comfortable area of the market in which to work and still do great good and make money. My question, while admittedly pointed, was getting at how people in groups make choices and judgments based off of nothing more than ingroup edification and are typically resistant to evidence that may contradict with those beliefs or behaviors.

All of that said, and with my biases against religion as what I see as sort of a vestigial structure in society out in the open, I do (and have) admitted that people do some good in the name of religion or through the infrastructure set up by religious organizations. Your choice in religions, Catholicism, has a history in the United States and throughout the world of strongly promoting social justice in areas where the dogma allows for it.

 

[MBellows]

I'd have a hard time finding a specific part of the Ethics Code that would be violated if a clinician decided to discontinue services with one of their long-term patients. If they are stable (not actively suicidal/homicidal), you provide them with a number of viable referrals, etc....is that really an instance where it isn't possible to refer? It may not be ideal for the patient, but it should still be well within your ethical (and legal) obligation as a psychologist.

The second part of your quote...that is a bit trickier. I'll leave that for others.

Unless it's in the area of private pay personality issues, rich couples in "token" marital therapy, or in the provision of services for people with chronic disabilities (ABA for Developmental Disabilities for instance), I can't see any therapist working for years with a single individual for both monetary and ethical reasons without referring out.

 

[erg923]

As an aside, when people say they do not belive in "organized religion" what are are they really saying/really mean?

I have never understood what that means, nor why, when not "organized" all the sudden faith becomes much more plausible to them? A central feature of the christian faith, as I was raised, is in fellowship, and the power using that faith to serve others...as a group. If you are not "organized" do you not believe in formal worship? I don't even know how this word work if you claim to be believe in the christian faith?

 

[MBellows]

As an aside, when people say they do not belive in "organized religion" what are are they really saying/really mean?

I have never understood what that means, nor why, when not "organized" all the sudden faith becomes much more plausible to them? A central feature of the christian faith, as i was raised, is in fellowship, and power using that faith to serve others...as a group.

I blame hipster kids for the first issue. I don't see any such thing as "disorganized" religion. Almost all religions that I've seen have some degree of structure to them, no matter how loose or tight that structure is... I don't see how it matters, and no religion should be singled out based on its structure.

As an aside, there are obviously some "religions" that have structures that are more telling of cult status than that of a religion. Scientology comes to mind.

 

[futureapppsy2]

So, what's the alternative to having people refer out when they can't competently treat clients for reasons of personal conflict/bias? Force them to treat the client, knowing they may do so in a potentially harmful way? Screen out all applicants based on the presence of any biases? Certain biases? Which ones? How?

I just don't see a better, more practical alternative than teaching people to competently and safely refer out, tbh, although I'd honestly love to hear any ideas.

 

[Qwerk]

I'd have a hard time finding a specific part of the Ethics Code that would be violated if a clinician decided to discontinue services with one of their long-term patients. If they are stable (not actively suicidal/homicidal), you provide them with a number of viable referrals, etc....is that really an instance where it isn't possible to refer? It may not be ideal for the patient, but it should still be well within your ethical (and legal) obligation as a psychologist.

The second part of your quote...that is a bit trickier. I'll leave that for others.

But we're talking specifically about a client referred because he/she is gay, not for other reasons. Picture that. You work for a few months with a client, say. Client tells you he's gay. You tell him you can't work with him anymore because he's gay. How is that ethical?

 

[futureapppsy2]

But we're talking specifically about a client referred because he/she is gay, not for other reasons. Picture that. You work for a few months with a client, say. Client tells you he's gay. You tell him you can't work with him anymore because he's gay. How is that ethical?

It's not, but if that means you're going to turn the sessions into conversion therapy or act in hostile ways towards the client based on this new information, referring out seems like the far lesser of the two evils, no?

I don't really think people should use clients as a way of "working through" heavyset biases--because some of that process could probably negatively affect the client, and that's not fair to them.

 

[MBellows]

I don't really think people should use clients as a way of "working through" heavyset biases--because some of that process could probably negatively affect the client, and that's not fair to them.

+1

Earlier when I a biased individual having organic exposure to those they are biased against in the therapeutic professions, I was referring to individuals that they work with, not their clients.

Any therapist working through their issues during a client's session is absolutely out of bounds.

 

[futureapppsy2]

+1

earlier when i a biased individual having organic exposure to those they are biased against in the therapeutic professions, i was referring to individuals that they work with, not their clients.

Any therapist working through their issues during a client's session is absolutely out of bounds.

ita.

 

[roubs]

As an aside, when people say they do not belive in "organized religion" what are are they really saying/really mean?

I have never understood what that means, nor why, when not "organized" all the sudden faith becomes much more plausible to them? A central feature of the christian faith, as I was raised, is in fellowship, and the power using that faith to serve others...as a group. If you are not "organized" do you not believe in formal worship? I don't even know how this word work if you claim to be believe in the christian faith?

I've heard people say they don't "follow" an organized religion, if one were to say one didn't "believe" in it, they probably still mean they don't follow the all of the rules and rituals laid down by a religious hierarchy. Or they could believe that some or all religious hierarchies are poor at implementing the core values of the religion. I could imagine many reasons for why people may come to this decision, yet they still may want to live by the teachings and morality of the religion and so still partially identify with it. Then it is left to people still within the organization to call them fakes and poseurs as the non-organized one continues on with their lives. My understanding of Christianity is that Christians disagree on which features are central or essential, such that some don't believe that serving others as an individual or family requires regular church attendance.

 

[G Costanza]

I hear the argument for not wanting people that are anti-LGBT to treat LGBT people. That makes sense to me.
I guess I'm still confused as to why being oppressive to a person of minority status is something some of you are defending. Tell me again why it's okay to allow someone to be denied your services if they are LGBT but not if they are a person of color? I just don't see how you can justify one but not the other.

And I still don't understand how Christian counselors that refuse to work with LGBT clients can work with clients who are having sex without being married? How can you justify one but not the other? If a "sin, is a sin, is a sin", then working with one and not the other seems like you are just playing into the oppressive system under the guise of Christianity.

I'm not looking to attack anyone here. Just curious about how you seperate those two examples. In my mind they seem the same.

 

[Qwerk]

It's not, but if that means you're going to turn the sessions into conversion therapy or act in hostile ways towards the client based on this new information, referring out seems like the far lesser of the two evils, no?

I don't really think people should use clients as a way of "working through" heavyset biases--because some of that process could probably negatively affect the client, and that's not fair to them.

Exactly. There's no way for the client to win. This is why I don't think people with biases so severe that they can't work with the LGBTQ population (or particular races, ethnicities, or other innate traits) should enter mainstream mental health graduate programs. Remember, the case that sparked this proposed law was about a counseling student, not a practicing professional. The student demonstrated that she was unwilling to abide by the rules of her internship site, and the college was unwilling to let her violate the counseling department's ethical requirements and the ethical code of the profession as a whole. Although this case was settled, a similar case in which a student wanted to recommend conversion therapy to a client was decided in favor of the university.

I can't say I disagree with the decision. Her school should not be forced to give her a degree or find her a less gay-friendly internship site. Let her find a biblical Christian counseling program -- look, they even have their own code of ethics -- and see how many employers are willing to hire her. Maybe she can find a church or religious university to work at, but she doesn't belong in a mainstream mental health setting.

 

[erg923]

I hear the argument for not wanting people that are anti-LGBT to treat LGBT people. That makes sense to me.
I guess I'm still confused as to why being oppressive to a person of minority status is something some of you are defending.

1. I am not sure how someone is being oppressive to them? They are stating that they cant work with them competently and thus will provide them a person who can. Where is the oppression?

2. And obviously, one comes from religious conviction/teachings, which is protected, whereas the other does not. You do not have to like it/agree with it, but that's the reason, and the government recognizes it.

 

[Qwerk]

I hear the argument for not wanting people that are anti-LGBT to treat LGBT people. That makes sense to me.
I guess I'm still confused as to why being oppressive to a person of minority status is something some of you are defending. Tell me again why it's okay to allow someone to be denied your services if they are LGBT but not if they are a person of color? I just don't see how you can justify one but not the other.

This was brought up earlier in the thread and still hasn't been addressed. If my religious or other beliefs preclude me from working with Asian clients, for example, should I be accommodated? As with being gay (and there is scientific consensus on the former), being Asian is innate, unchangeable, and not the client's decision. It's totally possible to have religious beliefs about race -- remember, the Mormon church discriminated against blacks for a long time.

(Now I'm picturing a pair of Asian parents: "It's okay, son. It's not your fault you're Asian. We'll love you no matter what.")

EDIT: Erg923 sort of addressed it, but sort of didn't. What if someone had racist religious beliefs? Or religious beliefs about other types of sexual behavior, such as pre-marital sex or interracial marriage? Again, this isn't just a hypothetical. These are beliefs that people really have.

 

[Pragma]

From a purely philosophical standpoint, I agree that someone who refuses to work with one group of people they consider morally repugnant but will work with another group that they also consider morally repugnant is being highly inconsistent and therefore discriminatory.

But it isn't that clean unfortunately. As for the comments about "defending" these beliefs - well yes, I defend someone's right to be an *****hole, so long as they are not actually causing harm, I could care less what their beliefs are.

I think our disagreement here stems from how we view a) suitability for training or continued practice and b) whether or not referring someone out is indeed a harmful act.

With regard to a, we can do everything we can from a training perspective to help practioners recognize and manage any biases they may have. However, I really view this as a slippery slope. Unless our profession comes out with an edict saying "all psychologists must be capable of working with all people" then you will undoubtedly have continued referral out. These things already happen with other subgroups than the queer population a lot. Unless you are willing to address all biases that result in all referals out due to the therapist's level of discomfort or bias, I don't think your argument is valid. The fact of the matter is that there are tons of biases out there - the ones involving the queer population are just particularly emphasized, publicized, and politicized.

With regard to b, I would suggest that referring a patient to someone better suited to treat them is always less harmful then trying to treat them yourself.

I just think making some blanket statement about who is and who is not cut out for mainstream training in clinical psychology based on personal beliefs is a very dangerous statement to make. Whomever makes such a statement would have a difficult time proving their complete personal bias management system to me. To bring it back to our lovely religious texts - I'd see them as having an eye full of plank. I think it is much more realistic to expect responsible management of biases without placing some value on which biases are worse than others and then excluding people based on their personal beliefs. If they in fact are willing to ethically manage those beliefs, I don't see why we can't allow them to practice.

 

[roubs]

The more that gay people are accepted in the wider society, the more some religious groups will fall back on a perceived first amendment right to discriminate against this select group of sinners. Obviously private organizations, especially religious ones, do have constitutionally protected rights to operate how they see fit. I fully support a religious organization's right to preach against gay behavior and sanction or throw out "practicing" gays.

However, when it comes to their interaction with the public or the public sphere, I don't see how judgement against certain sins should give individuals the right to apply their religious beliefs toward people who have no interest in living under a conservative Christian set of rules. For example, if a state allows and supports adoption by gay parents and a Christian organization refuses to permit this, they are not entitled to a contract with the state. They can surely carry on their own services and withhold them from gay parents (who will surely corrupt and damage children, from their point of view), but the institution should not be allowed to take on the victim role just because our mainstream culture is quickly moving beyond equating gay with wrong much as we moved beyond equating shellfish with wrong.

 

[Pragma]

The more that gay people are accepted in the wider society, the more some religious groups will fall back on a perceived first amendment right to discriminate against this select group of sinners. Obviously private organizations, especially religious ones, do have constitutionally protected rights to operate how they see fit. I fully support a religious organization's right to preach against gay behavior and sanction or throw out "practicing" gays.

However, when it comes to their interaction with the public or the public sphere, I don't see how judgement against certain sins should give individuals the right to apply their religious beliefs toward people who have no interest in living under a conservative Christian set of rules. For example, if a state allows and supports adoption by gay parents and a Christian organization refuses to permit this, they are not entitled to a contract with the state. They can surely carry on their own services and withhold them from gay parents (who will surely corrupt and damage children, from their point of view), but the institution should not be allowed to take on the victim role just because our mainstream culture is quickly moving beyond equating gay with wrong much as we moved beyond equating shellfish with wrong.

These issues are very different from whether an individual psychologist who holds certain beliefs should not be allowed to practice because they choose to refer out clients that they don't believe they can serve.

Personally, I am of the mind that religious organizations only make meaningful changes through grassroots, lead-by-example efforts without trying to force their ideology on others. When they start lobbying on political issues, I think the ideology becomes corrupted. But that is another topic entirely...

 

[roubs]

With regard to a, we can do everything we can from a training perspective to help practioners recognize and manage any biases they may have. However, I really view this as a slippery slope. Unless our profession comes out with an edict saying "all psychologists must be capable of working with all people" then you will undoubtedly have continued referral out. These things already happen with other subgroups than the queer population a lot. Unless you are willing to address all biases that result in all referals out due to the therapist's level of discomfort or bias, I don't think your argument is valid. The fact of the matter is that there are tons of biases out there - the ones involving the queer population are just particularly emphasized, publicized, and politicized.

With regard to b, I would suggest that referring a patient to someone better suited to treat them is always less harmful then trying to treat them yourself.

I just think making some blanket statement about who is and who is not cut out for mainstream training in clinical psychology based on personal beliefs is a very dangerous statement to make. Whomever makes such a statement would have a difficult time proving their complete personal bias management system to me. To bring it back to our lovely religious texts - I'd see them as having an eye full of plank. I think it is much more realistic to expect responsible management of biases without placing some value on which biases are worse than others and then excluding people based on their personal beliefs. If they in fact are willing to ethically manage those beliefs, I don't see why we can't allow them to practice.

I don't think the lack of universal principles in this area should preclude developing any standards whatsoever. And I don't see how you need to be free of bias in order to develop or enforce standards of practice. We shouldn't be evaluating people based on the outcome of having to refer out, but rather the process they used in order to reach that conclusion. Individuals whose process resembles the person described above who refused to work with "aids, SA, homeless" because they felt all that behavior was wrong, is really showing a refusal to function as a competent clinician in mainstream psych.

 

[roubs]

These issues are very different from whether an individual psychologist who holds certain beliefs should not be allowed to practice because they choose to refer out clients that they don't believe they can serve.

Personally, I am of the mind that religious organizations only make meaningful changes through grassroots, lead-by-example efforts without trying to force their ideology on others. When they start lobbying on political issues, I think the ideology becomes corrupted. But that is another topic entirely...

I think these issues are at the root of it. To what extent are sincerely held personal beliefs allowed to guide your interaction with individuals who may live by a very different set of principles?

 

[Pragma]

I don't think the lack of universal principles in this area should preclude developing any standards whatsoever. And I don't see how you need to be free of bias in order to develop or enforce standards of practice. We shouldn't be evaluating people based on the outcome of having to refer out, but rather the process they used in order to reach that conclusion. Individuals whose process resembles the person described above who refused to work with "aids, SA, homeless" because they felt all that behavior was wrong, is really showing a refusal to function as a competent clinician in mainstream psych.

Well then I would be very interested in seeing which standards for referral would be considered okay and which would not be, and which "process" variables are considered appropriate. Because as of now, the process is a personal ethical judgement.

As I said, I'd love to see what those standards would look like and how they categorize and prioritize bias. These types of standards would likely involve a lot of value judgments.

 

[Pragma]

I think these issues are at the root of it. To what extent are sincerely held personal beliefs allowed to guide your interaction with individuals who may live by a very different set of principles?

Well if you are talking about an individual's interaction with other individuals, then it seems relevant to this discussion, and I don't see how referring out is necessarily harmful. If you are talking about how an organization promotes a particular policy that may or may not discriminate against people, that is a different issue in my mind.

 

[MBellows]

As I said, I'd love to see what those standards would look like and how they categorize and prioritize bias. These types of standards would likely involve a lot of value judgments.

We could always resort to the utterly laughable...

But if that were the case, I wouldn't be able to work in rehab or with straight people...

 

[Pragma]

We could always resort to the utterly laughable...

But if that were the case, I wouldn't be able to work in rehab or with straight people...

Funny that you mentioned that because I was thinking about the IAT and how we all would not "pass" if we needed some metric.

I just find it laughable that someone would want to solve something that is questionable as a problem (referring cases out that you do not feel suitable to work with) by discriminating in the admissions process based on someone's religious beliefs. If our field wants to create some standards that exclude subgroups of people from training, I think adequate justification is going to be required...

 

[Therapist4Chnge]

Personally, I am of the mind that religious organizations only make meaningful changes through grassroots, lead-by-example efforts without trying to force their ideology on others. When they start lobbying on political issues, I think the ideology becomes corrupted. But that is another topic entirely...

You need to come play in the Socio-Political Forum here. I can't remember if I've seen your name before, but whenever I have popped in there it is entertaining if nothing else.

As for this topic...I still stick with the decision to refer out if there is any doubt that adequate and objective work cannot be offered by the clinician to the patient. It isn't perfect, and it may be more problematic if there are limited resources, but trying to put a square peg into a round hole only really works if you use a hammer....and that doesn't end well for anyone. I think the actual frequency is small enough that this approach will be sufficient for the vast majority of the time. I think in the 8ish years I have been involved in direct patient care, I've had this happen twice. I know it is only N=1, but it's been my experience.

 

[Pragma]

You need to come play in the Socio-Political Forum here. I can't remember if I've seen your name before, but whenever I have popped in there it is entertaining if nothing else.

As for this topic...I still stick with the decision to refer out if there is any doubt that adequate and objective work cannot be offered by the clinician to the patient. It isn't perfect, and it may be more problematic if there are limited resources, but trying to put a square peg into a round hole only really works if you use a hammer....and that doesn't end well for anyone.

I think I already distract myself enough in the psychology section

 

[bcliff]

Since homosexuality has been out of the DSM for nearly 30 years, shouldn't we be refraining from legislation that treats LGBT folk as a homogenous group? As was previously stated, there is much more variety within the LGBT community than there is within a group of people with a similar presenting problem. If I were to see a therapist today, the issues I would bring up have next to nothing to do with my sexuality.

What if someone 'comes out' to their therapist after seeing this clinician for weeks or months (or even during an I/C, shouldn't matter), does this legislation mean that their therapist is legally protected to say 'i'm sorry but from this point forward I am not allowed to offer treatment to you'. The entire relationship you've built with your client is now trashed because of their sexuality and their choice to disclose it with you. It's been brought up that this law will have 0 negative effects, but if someone chooses you as the first person they want to disclose their sexuality to and your response is to discharge them due to your own morality, how is that not harmful?

This reminds me of the 'gay blood ban' that the Red Cross has in place. I can go donate blood and not tell them that I'm gay and successfully donate blood, but as soon as I answer their questions honestly and tell them that 'yes my boyfriend of two years and i have sex', i'll be politely asked to leave. The fact of the matter is that me being in a mongamous relationship for two years and tested for STD/STI every three months puts me at significantly lower risk to be carrying HIV/AIDS than someone that has never been tested and has dozens of sexual partners. So, what is that law actually doing? Nothing, other than promoting the idea that being gay is something that is dirty, and if you admit it then, your blood is suddenly unclean, or in this instance that your therapist is so opposed to the idea you of being gay that they can't treat you for any issue because your sexuality will be lingering in the back of their head. You can see a therapist for months and then as soon as you come out or announce your sexuality your therapist is no longer 'qualified' to treat you even if you are coming in for something as unrelated as substance abuse.

Shouldn't there be an emphasis on multiculturalism and promoting diversity in a clinician's education? What if I'm bisexual? pansexual? what if i identify as 'objectum sexual'? MSM?This law promotes gender binaries and sexual binaries, and a field as progressive as psychology shouldn't be caught blatantly supporting these institutions.

Could you open a law suit if your therapist refused to see you because you're gay, but you don't identify with that label? Will clinicians be able to document a client's sexuality based on their reported history even if the client doesn't subscribe to that label?

 

[Qwerk]

I just find it laughable that someone would want to solve something that is questionable as a problem (referring cases out that you do not feel suitable to work with) by discriminating in the admissions process based on someone's religious beliefs. If our field wants to create some standards that exclude subgroups of people from training, I think adequate justification is going to be required...

I agree that it would be problematic to have a "belief test" in the admissions process, but there's no need for that. The issue with the new law was whether a particular student (or students -- there has been more than one lawsuit) should be dismissed because she refused to comply with her internship site's, university's, and profession's ethical guidelines. This isn't so much a "what-do-you-believe" test as it is a "what-did-you-do-during-your-internship" test. Again, if she doesn't like her secular university's standards, she can go to a Christian counseling program.

 

[Qwerk]

what if i identify as 'objectum sexual'?

Funny, I actually wrote my undergrad thesis on objectum sexuality. One of the take-away points of this thread is that we'd better keep our knowledge current because new identities and cultures spring up every day. (Thank you, internet.)

 

[Pragma]

I agree that it would be problematic to have a "belief test" in the admissions process, but there's no need for that. The issue with the new law was whether a particular student (or students -- there has been more than one lawsuit) should be dismissed because she refused to comply with her internship site's, university's, and profession's ethical guidelines. This isn't so much a "what-do-you-believe" test as it is a "what-did-you-do-during-your-internship" test. Again, if she doesn't like her secular university's standards, she can go to a Christian counseling program.

I guess we can go back and forth between the specific case and the comments in this thread that suggest a psychologist unwilling to treat someone from a particular subgroup due to their personal beliefs/bias should not be able to practice, even if they make appropriate referrals.

I am speaking to the larger issue, and there appears to be some support for operationalizing standards that may exclude some psychologists from practicing if their personal beliefs would cause them to refer a client to someone else. Personally, I think that is a dangerous road to go down as a profession, and I think having the capability to make appropriate practice decisions as an individual (without governing what personal beliefs are and are not allowed) is generally a good thing.

I personally am not a fan of bigots, but I also hold a very broad view of what it means to be a bigot than I think most people engaged in this debate hold. I think our profession already has plenty of them, and that even though some of those personal biases are things I disagree with, I am not going to say those clinicians can't practice competently.

 

[bcliff]

Where I work, we are the only site that accepts medicaid in a hundred mile radius (at least). If this law pertained to us and we elected not to see gay clients then what would any gay clients in the area with medicaid do? Should clinicians preface that they don't accept gay clients to everyone they see in any capacity, so that they know if they elect to come out they won't be welcome there? How would this affect contracts with insurance providers (i.e. "we're in network with cigna, but we won't accept your policy because you're gay - sorry") - This all is starting to sound a lot like "separate but equal" mental health care with a little bit of "don't ask, don't tell" thrown in the mix.

 

[Pragma]

Where I work, we are the only site that accepts medicaid in a hundred mile radius (at least). If this law pertained to us and we elected not to see gay clients then what would any gay clients in the area with medicaid do? Should clinicians preface that they don't accept gay clients to everyone they see in any capacity, so that they know if they elect to come out they won't be welcome there? How would this affect contracts with insurance providers (i.e. "we're in network with cigna, but we won't accept your policy because you're gay - sorry") - This all is starting to sound a lot like "separate but equal" mental health care with a little bit of "don't ask, don't tell" thrown in the mix.

I guess I am not viewing this as something widespread or specific to the queer population. I have witnessed therapists refer patients they don't want to see for a variety of reasons (the most common one being they don't want to work with substance users from what I've seen). I don't really agree with it, but if they can make an appropriate referral, I don't see what the major problem is. If there are no appropriate referrals, I think a different dilemma comes up.

If you haven't noticed, I prefer to view this issue about referring clients out due to personal bias and not a "gay" issue specifically, since as I noted earlier in the thread, I'm fairly certain it happens a lot more often in other subpopulations.

It is interesting to think about how we view our rights as professionals. Plenty of people decide that they only want to see XX types of cases and refer out all other ones. But if we view ourselves as mandated to serve anyone/everyone, then I suppose specialists would have to open their practices up, particularly if they were in a rural area. Then there is the whole financial discrimination piece - plenty of individual practitioners and institutions completely exclude people with Medicaid or other forms of third party payment. Is that discrimination or is that a practice decision?

 

[Qwerk]

I guess I am not viewing this as something widespread or specific to the queer population. I have witnessed therapists refer patients they don't want to see for a variety of reasons (the most common one being they don't want to work with substance users from what I've seen). I don't really agree with it, but if they can make an appropriate referral, I don't see what the major problem is. If there are no appropriate referrals, I think a different dilemma comes up.

If you haven't noticed, I prefer to view this issue about referring clients out due to personal bias and not a "gay" issue specifically, since as I noted earlier in the thread, I'm fairly certain it happens a lot more often in other subpopulations.

It seems disingenuous to claim that we don't apply the same standard to other (non-sexuality-related) beliefs and behavior. We do. That's why we have professional ethics: to draw a line and say, "If you can't do XYZ, find another occupation." Just to give an example, most grad programs wouldn't question dismissing a white supremacist student who wouldn't work with non-white clients. How is sexuality different? Where do you draw the line? And don't say it's not specifically a gay issue. If it weren't, this thread wouldn't exist.

 

[erg923]

It seems disingenuous to claim that we don't apply the same standard to other (non-sexuality-related) beliefs and behavior. We do. That's why we have professional ethics: to draw a line and say, "If you can't do XYZ, find another occupation." Just to give an example, most grad programs wouldn't question dismissing a white supremacist student who wouldn't work with non-white clients. How is sexuality different? Where do you draw the line? And don't say it's not specifically a gay issue. If it weren't, this thread wouldn't exist.

I have answered this question previously.

 

[Pragma]

It seems disingenuous to claim that we don't apply the same standard to other (non-sexuality-related) beliefs and behavior. We do. That's why we have professional ethics: to draw a line and say, "If you can't do XYZ, find another occupation." Just to give an example, most grad programs wouldn't question dismissing a white supremacist student who wouldn't work with non-white clients. How is sexuality different? Where do you draw the line? And don't say it's not specifically a gay issue. If it weren't, this thread wouldn't exist.

I don't think it is specifically a gay issue - I think people are trying to make it be. The fact of the matter is that psychologists avoid seeing clients they don't want to see due to personal bias, and I would be surprised if being gay was the top reason (even if it is the one that draws the most publicity).

 

[bcliff]

I'm still curious about insurance contracts and liability (refusing to see someone because they're gay/the client doesn't identify as gay) - Sorry if you already answered this.

Although I guess just with grad students the contracts bit wouldn't be an issue.. right..?

 

[Pragma]

I'm still curious about insurance contracts and liability (refusing to see someone because they're gay/the client doesn't identify as gay) - Sorry if you already answered this.

I'd have to look back at my own credentialing contracts, but I would imagine that most insurances would want you to treat people they refer to you unless there is some good reason to refer out, and I would assume that making a referral is not unheard of. It would definitely be an issue in areas with no other providers, and also in emergency situations per the ethics code.

 

[Qwerk]

I have answered this question previously.

Not really, no. You referred to federal law, which isn't the same thing as professional ethics. The point of having professional ethics is to cover the things that aren't illegal, but are still questionable in mental health practice. The government may categorize religion-based bias against gays and and personal bias against people of particular races differently, but that has little bearing on whether (and why) mental health professionals should. Plus, as I mentioned, it's perfectly possible to have religion-based racial bias.