Mom of Six needing Career Advice

[R. Matey]

Science and the Catholic Church - Wikipedia

en.wikipedia.org

Thanks for the bedtime reading, but I'm referring to cases of miracles since that was being discussed. If I offended (again ugh), it wasn't intentional.

Edit: the earlier post isn't meant as an entire treatise on the relationship between the church and its relationship with science. That's little above my paygrade.

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[PsyDr]

Thanks for the bedtime reading, but I'm referring to cases of miracles since that was being discussed. If I offended (again ugh), it wasn't intentional.

I'm not offended at all. I don't know what the Catholics believe about that, but they are usually a good point of reference. The big bang theory was partially developed by a catholic priest, which is maybe analogous to miracles.

 

[borne_before]

My goodness, is this some pervasive psychology thing? It's not right, please don't perpetuate it. 'Iatrogenic' describes the result, not the intervention.

Definition of IATROGENIC

induced unintentionally by a physician or surgeon or by medical treatment or diagnostic procedures… See the full definition

www.merriam-webster.com

Medical Definition of Iatrogenic

Read medical definition of Iatrogenic

www.medicinenet.com

Wrong for two reasons:
1) Iatro (healer) + genic (generating/producing) = adverse results because we dont say iatrogenic benefits.
2) the context of its use already implies harm of a treatment, so it would be redundant to specify harm. Did this treatment come out of thin air?

 

[R. Matey]

I'm not offended at all. I don't know what the Catholics believe about that, but they are usually a good point of reference. The big bang theory was partially developed by a catholic priest, which is maybe analogous to miracles.

I googled it and it looks like a miracle to the Catholic Church is an event that can't be explained by natural causes. If there is a natural cause, I suppose they would say that it was God directing nature, at least that's what I gather. Endemic to the thread though is that a faith based clinician should probably rely on EBPs, but be open to miracles, which again, is what I remember faith based clinicians telling me.

 

[tr]

Wrong for two reasons:
1) Iatro (healer) + genic (generating/producing) = adverse results because we dont say iatrogenic benefits.
2) the context of its use already implies harm, so it would be redundant to specify harm.

Look, this isn't a debate, I already linked you the definition and appropriate examples. If you want to use it incorrectly be my guest.
But do consider the potential effects you have on readers. Personally I find this type of error like nails on a chalkboard. I can't even concentrate on the other content because the usage error is so distracting.

 

[borne_before]

Look, this isn't a debate, I already linked you the definition and appropriate examples. If you want to use it incorrectly be my guest.
But do consider the potential effects you have on readers. Personally I find this type of error like nails on a chalkboard. I can't even concentrate on the other content because the usage error is so distracting.

Would you say that the misuse of iatrogenic is iatrogenic?

Maybe pull your head out of your prescriptivist orientation a little. Language has a descriptive and pragmatic component in context.

 

[WisNeuro]

Would you say that the misuse of iatrogenic is iatrogenic?

Maybe pull your head out of your prescriptivist orientation a little. Language has a descriptive and pragmatic component in context.

Take this to a new grammar thread if we're going to keep this up, but @tr is correct in this instance.

 

[Rain Sova]

Science is not an opinion; it wasn’t opinion that provided my mother with lifesaving medication when she developed a work related bloodborne viral infection. It was methodological research, virology, and facts.

Fair enough and I knew I would catch some trouble for saying that but I think you know what I mean. There's so much controversy even within science. Isn't it called the replication crisis? I don't pretend to be an expert, I'm just saying bias infiltrates everything.

 

[Rain Sova]

I think you are intentionally choosing an extreme, extreme minority type of case to justify not answering the question. People advocating for minors to undergo transitional surgery are very few and exceptionally far between. Let's entertain a much more likely hypothetical situation. If someone came to you experiencing gender dysphoria related to feelings of outside prejudice and stigma resulting from their non-cisgender identity, would you, given that the evidence is in favor of supporting that identity to improve mental health outcomes, call them by their preferred pronouns, work with them to bring their family on board to supporting this identity, and, if they are not a minor, be willing and open to the idea of recommending transitional surgery? If you would not take these steps, would you at least recognize your own bias and refer them to another professional whom you know would take these evidence-based steps? Or would you attempt to counsel them away from their identity, fall short of being affirming of their reality, and fail to advocate for meaningful changes in their social network? If you cannot honestly say you would choose to be affirming or to refer them to someone who is, then that is an ethical, humanitarian, and epistemological problem. It simply is. We know that affirmative support saves the lives of transgender individuals and non-affirmative forces exacerbate suicidality on one end of the mental health spectrum and simple poor QOL on the other end. Therefore, we have a duty to do what is known to work (until such time as further evidence demonstrates that something else, or some other iteration of the same thing, works better).

I would refer out.

 

[Rain Sova]

Yes, the empirical evidence demonstrates efficacy (and we'll assume an objective, reliable/valid measure of efficacy). However, people can (and do) choose a different course of action based on what some authority figure says, anecdotal evidence, representative heuristic, etc. There's a large fancy building (Church of Christ, Scientist - Wikipedia) in my state capital that supports this position. It's their opinion- and one that empirical evidence would contradict- but it's supported by what they think is evidence.

Even in your mother's case, the specific example is post hoc ergo propter hoc reasoning. There is likely a large n, placebo controlled study somewhere that supports the medication as the mechanism of action, but in individual instances it's not possible to say that it wasn't the "thoughts and prayers" that really the virus go away. That's why it's so tough to argue with/change opinions of those who subscribe to a different doninant epistemology-they just don't follow the same rules.

In deference to the OP- sorry about the slight drift in topic. It's nice to see that you are still hanging around this thread, even when you may have heard some things that are uncomfortable or don't jell with your beliefs (and despite some obvious bullying from others!)

Thank you, the thread is fascinating and the bullying could be far worse.

 

[Rain Sova]

You cannot accurately predict both the location and momentum of a sub-atomic particle when given its initial position, therefore it follows that I had a free choice to eat leftover pizza for both breakfast and lunch today (as opposed to it being already determined at the point of the Big Bang that I would eat leftover pizza for breakfast and luch today, and if we just knew the conditions at the point of the Big Bang we would have been able to predict my meal choices today, yesterday, and tomorrow). Discuss

Interestingly, the original "experiement" by Heisenberg regarding this sub-atomic uncertainty took place soley in his mind (or in his private verbal behavior, as us ABA guys like to call it)!

Probably not the same but this reminds me of how we argue about Calvinism/free will/predetermination in the theology realm.

 

[Shiori]

I have received clients who were referred out by their previous provider for various reasons. Even under "good" circumstances, they often harbor hurt feelings and fear about opening up again. It might be the more ethical choice to refer out given the alternative, but it can have significant impacts on their perceptions of themselves and therapy as a whole. That is also another tricky part to keep in mind, especially if the client is already sensitized to rejection.

 

[Rain Sova]

Fr

I think you are intentionally choosing an extreme, extreme minority type of case to justify not answering the question. People advocating for minors to undergo transitional surgery are very few and exceptionally far between. Let's entertain a much more likely hypothetical situation. If someone came to you experiencing gender dysphoria related to feelings of outside prejudice and stigma resulting from their non-cisgender identity, would you, given that the evidence is in favor of supporting that identity to improve mental health outcomes, call them by their preferred pronouns, work with them to bring their family on board to supporting this identity, and, if they are not a minor, be willing and open to the idea of recommending transitional surgery? If you would not take these steps, would you at least recognize your own bias and refer them to another professional whom you know would take these evidence-based steps? Or would you attempt to counsel them away from their identity, fall short of being affirming of their reality, and fail to advocate for meaningful changes in their social network? If you cannot honestly say you would choose to be affirming or to refer them to someone who is, then that is an ethical, humanitarian, and epistemological problem. It simply is. We know that affirmative support saves the lives of transgender individuals and non-affirmative forces exacerbate suicidality on one end of the mental health spectrum and simple poor QOL on the other end. Therefore, we have a duty to do what is known to work (until such time as further evidence demonstrates that something else, or some other iteration of the same thing, works better).

For what its worth, minors transitioning seems to be a little more common where I live than one might think. 3 of my 6 kids have come across children that are in the process and considering that of the ones who have not, I have two very young children (infant and preschool) and a child at a Christian school, those odds seem rather high.

 

[WisNeuro]

Fr

For what its worth, minors transitioning seems to be a little more common where I live than one might think. 3 of my 6 kids have come across children that are in the process and considering that of the ones who have not, I have two very young children (infant and preschool) and a child at a Christian school, those odds seem rather high.

I wouldn't generalize too broadly based off a pretty small sample size.

 

[R. Matey]

Fair enough and I knew I would catch some trouble for saying that but I think you know what I mean. There's so much controversy even within science. Isn't it called the replication crisis? I don't pretend to be an expert, I'm just saying bias infiltrates everything.

The replication crisis is bigger than just bias, it more has to do with procedural transparency and much has been done to address it.

 

[WisNeuro]

The replication crisis is bigger than just bias, it more has to do with procedural transparency and much has been done to address it.

Also, I would like to add that bias and controversy within science is a very complex beast. Not every scientific hypothesis/theory is subject to the same amount of bias. Some things are fairly settled, with consistent, replicable results. Some are less settled, whether that be due to a very complex situation (e.g., human behavior) or the scientific exploration of something being relatively new. Citing the fact that bias and controversy exists, which is true in some instances, does not make the sides of every opinion equivocal. I guarantee that I can find a "scientist" who has a paper regarding the notion that the earth is flat. Doesn't mean we give him the same credence as legitimate scientists with NASA and other international space agencies.

 

[PsychSupreme]

Fr

For what its worth, minors transitioning seems to be a little more common where I live than one might think. 3 of my 6 kids have come across children that are in the process and considering that of the ones who have not, I have two very young children (infant and preschool) and a child at a Christian school, those odds seem rather high.

It's good to hear you saying you would refer out to someone who's affirming. I'm wondering what you mean by "transitioning." Minors transitioning insofar as changing pronouns/names and receiving hormone blockers, or getting actual surgery? I strongly suspect the former, in which case I would argue there's less controversy than there is regarding giving minors access to gender reassignment surgery.

 

[PsycIntern2021]

Fair enough and I knew I would catch some trouble for saying that but I think you know what I mean. There's so much controversy even within science. Isn't it called the replication crisis? I don't pretend to be an expert, I'm just saying bias infiltrates everything.

This troubles me a lot that you think that there being bias in science means that it's an opinion that has equal merit to other "opinions." As Wis Neuro said above, bias is something we as humans (or other things) introduce into scientific study. In some instances, bias can be measured. I think that this line of thinking has led to a lot of "I'll listen to the science when it's convenient for me but then do some hand-wringing and choose to 'challenge' the science when it's not convenient/doesn't line up with my belief." It's not a choice.

What learning to be a scientist in a PhD program does is teach you how to be a critical consumer and producer of science. Good scientists hedge their language and don't make claims outside the scope of their data. Good scientists are willing to be "wrong" when new evidence emerges that changes a theory. Good scientists try to replicate their work to show it is a robust phenomenon. It's not a matter of "there is bias so can we truly trust science LOL", it's some science is really solid and some is still emerging. Yes, there is often controversy in the emerging science, which pushes researchers to do new, sound studies. As a very popular quote says "science didn't lie to you when it changed, it learned more."

I don't think your faith is the issue here - it's your willingness to be open to scientific discussion when it doesn't fit with your belief system. Again, that doesn't mean that you personally have to be a person who treats transgender children (as you rightly said that you would refer them out); it means that you wouldn't argue against the procedure from another medical professional who is recommending it as evidence-based care (and yes, I recognize your argument that the science IS not firm on this AND that is a strawman argument to avoid what everyone else on this thread is really asking.) It sounds like you are putting a lot of thought into this, which is great, but I would also recommend doing more listening and less justifying.

 

[albatross_at_crossroads]

Everything in life is a belief or opinion. Even science. You gave extreme and rare examples about abortion, but let's say a woman finds out her baby has DS. She wants an abortion. The doctor should absolutely be able to refuse the procedure. She should go elsewhere.

As the posters before me eloquently explained, not everything in life is a belief or opinion. I didn't give extreme or "rare" examples, those are real issues that impact many people in many places. Many have no place to go, but it's easy to bury your head in the sand and pretend it's the right thing. You might support a physician who shares your "Christian beliefs" but I sincerely doubt you would support physicians with other types of beliefs just as much (religious or not).

I don't think your faith is the issue here - it's your willingness to be open to scientific discussion when it doesn't fit with your belief system. Again, that doesn't mean that you personally have to be a person who treats transgender children (as you rightly said that you would refer them out); it means that you wouldn't argue against the procedure from another medical professional who is recommending it as evidence-based care (and yes, I recognize your argument that the science IS not firm on this AND that is a strawman argument to avoid what everyone else on this thread is really asking.) It sounds like you are putting a lot of thought into this, which is great, but I would also recommend doing more listening and less justifying.

This is exactly the point - while you seem on the surface to try to be open to scientific discussion, I doubt it can seriously change your long-held beliefs, especially now as a fully formed adult. The truth is it will impact your work and the field doesn't need any more of that. We need clinical psychologists and social workers who will put the well-being of their patients first, and who will advance the field in a scientific manner.

I also understand that you're between a rock and a hard place - even a PsyD from a for-profit place will be a serious time commitment, which severely limit the time you have for personal needs and responsibilities. The debt would be crushing even without a large family. To get into a funded PhD/ PsyD you will need some extra research experience and that will also take a year or possibly more. These past two application seasons have been insanely competitive and it doesn't sound like you have the credentials that would get you noticed. Then you will also have to move (at least twice probably). Unless you have the proverbial village behind you, I don't really see how you can make this work at this time. The LCSW path might be more doable, but still it won't be easy. A school psychology path might fulfill more of what you want in a future career, but it's still highly competitive.

For the record, I re-started on this path from scratch at an age older than you are right now, so I have an idea of how many sacrifices it takes and how difficult it can be. I also happen to have a more "mobile" and flexible family situation, but I still had to heavily prioritize this path and my personal side took a serious hit. I still have to keep this balance for at least several years just to make it successfully on the other side. Nobody on here can give you any other specific advice since it's all up to you - how much are you willing to sacrifice, for how long, and how willing will you be to listen?

 

[futureapppsy2]

Can you expand and unpack this a little more for me?

BTW - you are using iatrogenic correctly.

Sure thing. So, "masking" refers to hiding autistic traits--this would be things like making eye contact, not engaging in stimming, etc--basically, trying to appear non-autistic/typical. Traditionally, a lot of the outcomes we may use for autism treatment/intervention are things like "losing the diagnosis" (no longer meeting diagnostic criteria for ASD), not engaging in stimming, having typical social-communication behavior, etc.--of course, there's also function-based ways of examining outcomes (like employment, for example, or not engaging in self-injurious behavior), but for a long time--and to a considerable extent today--autism treatments are often sold with the promise or hope of having no one be able to tell that the person is autistic. Some of what this did/does is reinforce "masking" behavior--where the person deliberately and consciously engages in behavior that will make them look neurotypical/non-autistic. And there are benefits to this--the flipside, as we're seeing in an emerging body of research, is that masking behavior seems to increase risks of depression, anxiety, and suicidality, likely through a "burnout" mechanism--the person is basically putting on a show 24/7 and becomes exhausted and "burnt out" on life.

 

[Rain Sova]

I have received clients who were referred out by their previous provider for various reasons. Even under "good" circumstances, they often harbor hurt feelings and fear about opening up again. It might be the more ethical choice to refer out given the alternative, but it can have significant impacts on their perceptions of themselves and therapy as a whole. That is also another tricky part to keep in mind, especially if the client is already sensitized to rejection.

I understand that but is it not bound to happen even in other circumstances? Referring out? My sister has BPD and has been abruptly dropped by providers and it has really been hurtful for her.

 

[Rain Sova]

thank you for your response

The replication crisis is bigger than just bias, it more has to do with procedural transparency and much has been done to address it.

 

[Rain Sova]

Also, I would like to add that bias and controversy within science is a very complex beast. Not every scientific hypothesis/theory is subject to the same amount of bias. Some things are fairly settled, with consistent, replicable results. Some are less settled, whether that be due to a very complex situation (e.g., human behavior) or the scientific exploration of something being relatively new. Citing the fact that bias and controversy exists, which is true in some instances, does not make the sides of every opinion equivocal. I guarantee that I can find a "scientist" who has a paper regarding the notion that the earth is flat. Doesn't mean we give him the same credence as legitimate scientists with NASA and other international space agencies.

I just had this exact conversation with my son who wants to study biomedicine. These are very fair points.

 

[Rain Sova]

It's good to hear you saying you would refer out to someone who's affirming. I'm wondering what you mean by "transitioning." Minors transitioning insofar as changing pronouns/names and receiving hormone blockers, or getting actual surgery? I strongly suspect the former, in which case I would argue there's less controversy than there is regarding giving minors access to gender reassignment surgery.

Pronoun changes and hormones with plans on surgery.

 

[Rain Sova]

This troubles me a lot that you think that there being bias in science means that it's an opinion that has equal merit to other "opinions." As Wis Neuro said above, bias is something we as humans (or other things) introduce into scientific study. In some instances, bias can be measured. I think that this line of thinking has led to a lot of "I'll listen to the science when it's convenient for me but then do some hand-wringing and choose to 'challenge' the science when it's not convenient/doesn't line up with my belief." It's not a choice.

What learning to be a scientist in a PhD program does is teach you how to be a critical consumer and producer of science. Good scientists hedge their language and don't make claims outside the scope of their data. Good scientists are willing to be "wrong" when new evidence emerges that changes a theory. Good scientists try to replicate their work to show it is a robust phenomenon. It's not a matter of "there is bias so can we truly trust science LOL", it's some science is really solid and some is still emerging. Yes, there is often controversy in the emerging science, which pushes researchers to do new, sound studies. As a very popular quote says "science didn't lie to you when it changed, it learned more."

I don't think your faith is the issue here - it's your willingness to be open to scientific discussion when it doesn't fit with your belief system. Again, that doesn't mean that you personally have to be a person who treats transgender children (as you rightly said that you would refer them out); it means that you wouldn't argue against the procedure from another medical professional who is recommending it as evidence-based care (and yes, I recognize your argument that the science IS not firm on this AND that is a strawman argument to avoid what everyone else on this thread is really asking.) It sounds like you are putting a lot of thought into this, which is great, but I would also recommend doing more listening and less justifying.

I recognize some may not be a fan of my opinions and see it as justifying religion as a means to avoid science but my life is pretty intertwined in my faith. My husband stopped a serious alcohol dependence via our faith, and the list goes on and on and on. However, I also have ample personal experience with family members suffering mental illness, grew up in DV, etc etc etc. So my "dream job" I suppose would integrate the two. I have seen it done just not sure of all the ins and outs. I gratefully and humbly accept any and all advice given on here regardless of the motivation. But that's where I am coming from.

 

[Rain Sova]

As the posters before me eloquently explained, not everything in life is a belief or opinion. I didn't give extreme or "rare" examples, those are real issues that impact many people in many places. Many have no place to go, but it's easy to bury your head in the sand and pretend it's the right thing. You might support a physician who shares your "Christian beliefs" but I sincerely doubt you would support physicians with other types of beliefs just as much (religious or not).



This is exactly the point - while you seem on the surface to try to be open to scientific discussion, I doubt it can seriously change your long-held beliefs, especially now as a fully formed adult. The truth is it will impact your work and the field doesn't need any more of that. We need clinical psychologists and social workers who will put the well-being of their patients first, and who will advance the field in a scientific manner.

I also understand that you're between a rock and a hard place - even a PsyD from a for-profit place will be a serious time commitment, which severely limit the time you have for personal needs and responsibilities. The debt would be crushing even without a large family. To get into a funded PhD/ PsyD you will need some extra research experience and that will also take a year or possibly more. These past two application seasons have been insanely competitive and it doesn't sound like you have the credentials that would get you noticed. Then you will also have to move (at least twice probably). Unless you have the proverbial village behind you, I don't really see how you can make this work at this time. The LCSW path might be more doable, but still it won't be easy. A school psychology path might fulfill more of what you want in a future career, but it's still highly competitive.

For the record, I re-started on this path from scratch at an age older than you are right now, so I have an idea of how many sacrifices it takes and how difficult it can be. I also happen to have a more "mobile" and flexible family situation, but I still had to heavily prioritize this path and my personal side took a serious hit. I still have to keep this balance for at least several years just to make it successfully on the other side. Nobody on here can give you any other specific advice since it's all up to you - how much are you willing to sacrifice, for how long, and how willing will you be to listen?

Your post led me to believe the opposite of what you wanted to convey. Maybe there is a monopoly in the field and maybe there is a need for faith based clinicians. Terms like "bury your head in the sand" towards a stranger on the internet don't seem really appropriate.

 

[Rain Sova]

Sure thing. So, "masking" refers to hiding autistic traits--this would be things like making eye contact, not engaging in stimming, etc--basically, trying to appear non-autistic/typical. Traditionally, a lot of the outcomes we may use for autism treatment/intervention are things like "losing the diagnosis" (no longer meeting diagnostic criteria for ASD), not engaging in stimming, having typical social-communication behavior, etc.--of course, there's also function-based ways of examining outcomes (like employment, for example, or not engaging in self-injurious behavior), but for a long time--and to a considerable extent today--autism treatments are often sold with the promise or hope of having no one be able to tell that the person is autistic. Some of what this did/does is reinforce "masking" behavior--where the person deliberately and consciously engages in behavior that will make them look neurotypical/non-autistic. And there are benefits to this--the flipside, as we're seeing in an emerging body of research, is that masking behavior seems to increase risks of depression, anxiety, and suicidality, likely through a "burnout" mechanism--the person is basically putting on a show 24/7 and becomes exhausted and "burnt out" on life.

Yes, absolutely, 100%. Very familiar with this. Thank you for posting

 

[albatross_at_crossroads]

Your post led me to believe the opposite of what you wanted to convey. Maybe there is a monopoly in the field and maybe there is a need for faith based clinicians. Terms like "bury your head in the sand" towards a stranger on the internet don't seem really appropriate.

After all of that, a response like this does not seem appropriate. Burying your head in the sand is not an insult, just an observation, and a fairly tame one at that. If you are this easily offended, it means all my efforts above to give you some food for thought were in vain. You also side-stepped all of the other things I mentioned on there as well.

If by "monopoly" in the field you mean that we are all trying to shed our biases and move towards evidence-based research and practice, than yes, hopefully that's where we are headed. There is no "need" for "faith-based" anything in psychology. Theology is the place you are looking for. And if you want to be insulted, maybe astrology.

 

[Rain Sova]

After all of that, a response like this does not seem appropriate. Burying your head in the sand is not an insult, just an observation, and a fairly tame one at that. If you are this easily offended, it means all my efforts above to give you some food for thought were in vain. You also side-stepped all of the other things I mentioned on there as well.

If by "monopoly" in the field you mean that we are all trying to shed our biases and move towards evidence-based research and practice, than yes, hopefully that's where we are headed. There is no "need" for "faith-based" anything in psychology. Theology is the place you are looking for. And if you want to be insulted, maybe astrology.

I am not even offended, I can just sense the hostility throughout your post, dripping with negativity and disapproval. The dislikes and quotes around "Christian faith" didn't help either. And that's okay! You're entitled to your opinion. Not sure where astrology fits in, since Christianity discourages it, unless that is your way of implying that both are equally fictitious.

 

[PsycIntern2021]

I recognize some may not be a fan of my opinions and see it as justifying religion as a means to avoid science but my life is pretty intertwined in my faith. My husband stopped a serious alcohol dependence via our faith, and the list goes on and on and on. However, I also have ample personal experience with family members suffering mental illness, grew up in DV, etc etc etc. So my "dream job" I suppose would integrate the two. I have seen it done just not sure of all the ins and outs. I gratefully and humbly accept any and all advice given on here regardless of the motivation. But that's where I am coming from.

I think you may have missed my point. I am not saying that your faith can't be a big part of your life or even that faith and science are mutually exclusive - there are many times, as you have pointed out, where they can live harmoniously together. I think that is totally possible. And I totally respect you wanting a career that aligns with your values. I think what we are all asking is whether you are willing to have scientific discussions based on the science and only the science. So in your example, have an open and honest discourse about the latest science of youth transition (which is quite a hot topic!) from a place of curiosity and critically reading the science on both sides; putting aside your personal beliefs for that moment.

At the end of the day, yes, you are entitled to your opinions and to live your life accordingly, it is whether you can temporarily put aside your opinion to have a discourse and then walk away from that with something new (even if it doesn't change your mind but maybe provides some new information or understanding!). I am encouraged by your responses to hear that it wouldn't affect the quality of care you would provide - I am also encouraged by you engaging with all of us folks on this thread. A lot of people are emphasizing this point because the ability to have these types of conversation is what makes psychology a science and separates our discipline from others. We ask hard questions because we have an enormous responsibility to our clients and want to provide the best possible care - not based on anecdotes, opinions, or beliefs - but what we know (to the best of our ability) will help them and relieve their suffering.

 

[Rain Sova]

I think you may have missed my point. I am not saying that your faith can't be a big part of your life or even that faith and science are mutually exclusive - there are many times, as you have pointed out, where they can live harmoniously together. I think that is totally possible. And I totally respect you wanting a career that aligns with your values. I think what we are all asking is whether you are willing to have scientific discussions based on the science and only the science. So in your example, have an open and honest discourse about the latest science of youth transition (which is quite a hot topic!) from a place of curiosity and critically reading the science on both sides; putting aside your personal beliefs for that moment.

At the end of the day, yes, you are entitled to your opinions and to live your life accordingly, it is whether you can temporarily put aside your opinion to have a discourse and then walk away from that with something new (even if it doesn't change your mind but maybe provides some new information or understanding!). I am encouraged by your responses to hear that it wouldn't affect the quality of care you would provide - I am also encouraged by you engaging with all of us folks on this thread. A lot of people are emphasizing this point because the ability to have these types of conversation is what makes psychology a science and separates our discipline from others. We ask hard questions because we have an enormous responsibility to our clients and want to provide the best possible care - not based on anecdotes, opinions, or beliefs - but what we know (to the best of our ability) will help them and relieve their suffering.

Thank you for this! Not a great example but I used to have to approve FMLA based on eligibility. Not what I thought of the situation. We had a man request it to undergo surgery to transition into a woman. My initial thought was, absolutely not. But then I knew my job was to apply the law and company policy to his leave request. I suspect it is like this but obviously in a far more complex and sensitive way of course.

 

[foreverbull]

Your post led me to believe the opposite of what you wanted to convey. Maybe there is a monopoly in the field and maybe there is a need for faith based clinicians. Terms like "bury your head in the sand" towards a stranger on the internet don't seem really appropriate.

More faith-based clinicians means, at BEST, clinicians who have to refer children out if they are gay and you don't agree, if they are trans/nonbinary and you don't agree, if a client wants an abortion and you don't agree (just for the sake of example, I do not assume you feel this way).....the list could just keep going on and on with "faith"-based practice. What that translates to is a lot of referring out, trying to managing countertransference reactions, or ignoring science and creating harm with clients with all kinds of intersecting identities. At WORST, the faith-based practitioners are STILL pushing conversion therapy for LGB folks despite science clearly showing the harm of such a backwards "treatment" (these folks ignore science when it doesn't fit perfectly into their spiritual belief systems--something that has been brought up here before).

I personally think our profession needs more folks who believe in science and human rights, regardless of one's spiritual foundation.

 

[R. Matey]

I personally think our profession needs more folks who believe in science and human rights, regardless of one's spiritual foundation.

 

[PsychJustice]

More faith-based clinicians means, at BEST, clinicians who have to refer children out if they are gay and you don't agree, if they are trans/nonbinary and you don't agree, if a client wants an abortion and you don't agree (just for the sake of example, I do not assume you feel this way).....the list could just keep going on and on with "faith"-based practice. What that translates to is a lot of referring out, trying to managing countertransference reactions, or ignoring science and creating harm with clients with all kinds of intersecting identities. At WORST, the faith-based practitioners are STILL pushing conversion therapy for LGB folks despite science clearly showing the harm of such a backwards "treatment" (these folks ignore science when it doesn't fit perfectly into their spiritual belief systems--something that has been brought up here before).

I personally think our profession needs more folks who believe in science and human rights, regardless of one's spiritual foundation.

I'd disagree with your "at best" notion. I think at BEST, there are faith-based clinicians who hold their more culturally-oriented views (e.g., LGBTQ+ rights, women's rights, etc.) to the side and offer services to individuals with strongly driven faith-based values who are seeking a therapist who can integrate their (the client's) faith more fully alongside psychotherapy services. Take a client who is struggling with depression which is also intertwining with their perspective on God and dealing with trials in life. They want to seek out a faith-based clinician who will used EBT along with incorporating their values of God (more than just your basic ACT-values conversation) with a clinician who has a similar understanding of their Christian beliefs. This would be my hope of the "best" type of faith-based clinician who uses EBP and balances their faith-influenced views on social topics with their ethical responsibility to do no harm to their clients (as discussed throughout this thread). Is it as simple as described? Probably not, there's much more nuance in it. And this is probably the exception rather than the rule for a good majority of "faith-based clinicians". But again, this is at "best."

 

[Rain Sova]

More faith-based clinicians means, at BEST, clinicians who have to refer children out if they are gay and you don't agree, if they are trans/nonbinary and you don't agree, if a client wants an abortion and you don't agree (just for the sake of example, I do not assume you feel this way).....the list could just keep going on and on with "faith"-based practice. What that translates to is a lot of referring out, trying to managing countertransference reactions, or ignoring science and creating harm with clients with all kinds of intersecting identities. At WORST, the faith-based practitioners are STILL pushing conversion therapy for LGB folks despite science clearly showing the harm of such a backwards "treatment" (these folks ignore science when it doesn't fit perfectly into their spiritual belief systems--something that has been brought up here before).

I personally think our profession needs more folks who believe in science and human rights, regardless of one's spiritual foundation.

I don't think you have a firm grasp on theology or experience with faith based clinicians. Also, there's an entire demographic who seek out faith based mental health services.

 

[borne_before]

I think people are setting up some faith based clinicians as a straw man . By in large, they exist for people who do not feel comfortable pursuing secular means. I think those people deserve relief from mental health conditions, too. It gets sticky when faithful people extend their dogma to their kids, but that’s a policy question.

 

[Rain Sova]

I'd disagree with your "at best" notion. I think at BEST, there are faith-based clinicians who hold their more culturally-oriented views (e.g., LGBTQ+ rights, women's rights, etc.) to the side and offer services to individuals with strongly driven faith-based values who are seeking a therapist who can integrate their (the client's) faith more fully alongside psychotherapy services. Take a client who is struggling with depression which is also intertwining with their perspective on God and dealing with trials in life. They want to seek out a faith-based clinician who will used EBT along with incorporating their values of God (more than just your basic ACT-values conversation) with a clinician who has a similar understanding of their Christian beliefs. This would be my hope of the "best" type of faith-based clinician who uses EBP and balances their faith-influenced views on social topics with their ethical responsibility to do no harm to their clients (as discussed throughout this thread). Is it as simple as described? Probably not, there's much more nuance in it. And this is probably the exception rather than the rule for a good majority of "faith-based clinicians". But again, this is at "best."

Yes, something more like this. Its not about the list of forbidden behaviors or sin or sending away undesirable clients from what I have seen, anyway. There's a lot of encouragement in the Bible, a lot of hope, prayer is a huge asset, and there's a theme of validating all creation (you have a purpose, God loves you, redemption, grace) that maybe a Pastor would use in a counseling session which could be expanded and intertwined with clinical psychology practices (or so I would hope). I know of a clinical psychologist who teaches on I believe "the intersectionality of faith and psychology" or something like that at Wheaton College.

 

[Rain Sova]

I think people are setting up some faith based clinicians as a straw man . By in large, they exist for people who do not feel comfortable pursuing secular means. I think those people deserve relief from mental health conditions, too. It gets sticky when faithful people extend their dogma to their kids, but that’s a policy question.

This is true. I can't tell you how many times I have heard "psychology is demonic" "psychology is not for Christians " etc which I obviously disagree with.

 

[albatross_at_crossroads]

Thank you for this! Not a great example but I used to have to approve FMLA based on eligibility. Not what I thought of the situation. We had a man request it to undergo surgery to transition into a woman. My initial thought was, absolutely not. But then I knew my job was to apply the law and company policy to his leave request. I suspect it is like this but obviously in a far more complex and sensitive way of course.

People who need pastoral/ religious type of guidance should reach out to their church/temple/ other designated place of faith, and people with mental health disorders need the expertise of someone qualified in those specific matters.
There is a huge gap in values and beliefs even in different types of Christianity - for example, LDS beliefs are very different from Christian Orthodox. Your flavor of religion might not match what others have as religious foundation at all, so these "faith-based clinicians" would be "helpful" to only a narrow subset of the population, not hold the ultimate truth regarding spirituality.

The example above doesn't make me see you as "oh, this person is open minded and trying", it just reveals the truth. Your initial thought was biased, and if there was no "law" to compel you to decide differently, you would have seriously impacted the life of another human being in a negative way. What happens when there is no clear legal guideline to compel you?

And at last - after all these pages, what have you decided regarding you next steps?

 

[futureapppsy2]

I think there's definitely value in faith-based therapists, especially faith-based therapists who are trained in psychological science and use evidence-based practice alongside faith-based work. It's a form of cultural competence, and there are many people who would never see a non-Christian therapist, I think the issue that comes out here (no pun intended) is that *many* faith-based therapists have very recently engaged in practices that clearly cause iatrogenic harm to LGBTQ+ clients and done so seemingly happily. Even more "affirming" moves by some faith-based programs are basically "we kind of maybe tolerate LGBTQ+ folk, sorta" which... is better but far from great. Add in the fact that some LGBTQ+ people from non-affirming religious backgrounds may be more likely to see clinicians from similar faith-based points of view, and it seems dangerous to encourage it.

 

[foreverbull]

I'd disagree with your "at best" notion. I think at BEST, there are faith-based clinicians who hold their more culturally-oriented views (e.g., LGBTQ+ rights, women's rights, etc.) to the side and offer services to individuals with strongly driven faith-based values who are seeking a therapist who can integrate their (the client's) faith more fully alongside psychotherapy services. Take a client who is struggling with depression which is also intertwining with their perspective on God and dealing with trials in life. They want to seek out a faith-based clinician who will used EBT along with incorporating their values of God (more than just your basic ACT-values conversation) with a clinician who has a similar understanding of their Christian beliefs. This would be my hope of the "best" type of faith-based clinician who uses EBP and balances their faith-influenced views on social topics with their ethical responsibility to do no harm to their clients (as discussed throughout this thread). Is it as simple as described? Probably not, there's much more nuance in it. And this is probably the exception rather than the rule for a good majority of "faith-based clinicians". But again, this is at "best."

That is a fair point. Certainly a psychologist from X religion would be able to have a deeper understanding of a client from X religion and their experience and perhaps could blend clinical training/theory/research with spiritual ideology. I just think that gets really tricky to balance, and as I think someone else mentioned, that would be a very small subset of the population one would work with.

I also see utility in folks from x religion seeing a psychologist in the community who doesn’t necessarily have that background so that they have a greater sense of perspective than just the religious one. Especially when one’s experience is at odds with said religion in some way.

So yes, I can see the best case scenario being that client and therapist have congruent spiritual beliefs (client not in conflict with the beliefs) and they work through grief, meaning of life, etc. That is assuming that the client doesn’t present with anything in conflict with the therapist’s beliefs in that religion.

 

[Rain Sova]

People who need pastoral/ religious type of guidance should reach out to their church/temple/ other designated place of faith, and people with mental health disorders need the expertise of someone qualified in those specific matters.
There is a huge gap in values and beliefs even in different types of Christianity - for example, LDS beliefs are very different from Christian Orthodox. Your flavor of religion might not match what others have as religious foundation at all, so these "faith-based clinicians" would be "helpful" to only a narrow subset of the population, not hold the ultimate truth regarding spirituality.

The example above doesn't make me see you as "oh, this person is open minded and trying", it just reveals the truth. Your initial thought was biased, and if there was no "law" to compel you to decide differently, you would have seriously impacted the life of another human being in a negative way. What happens when there is no clear legal guideline to compel you?

And at last - after all these pages, what have you decided regarding you next steps?

well obviously I was HR at the time and I was looking at it as not qualifying, an elective surgery, Like a boob job. Please apply context.

 

[Rain Sova]

I think there's definitely value in faith-based therapists, especially faith-based therapists who are trained in psychological science and use evidence-based practice alongside faith-based work. It's a form of cultural competence, and there are many people who would never see a non-Christian therapist, I think the issue that comes out here (no pun intended) is that *many* faith-based therapists have very recently engaged in practices that clearly cause iatrogenic harm to LGBTQ+ clients and done so seemingly happily. Even more "affirming" moves by some faith-based programs are basically "we kind of maybe tolerate LGBTQ+ folk, sorta" which... is better but far from great. Add in the fact that some LGBTQ+ people from non-affirming religious backgrounds may be more likely to see clinicians from similar faith-based points of view, and it seems dangerous to encourage it.

You bring up a great point. There may be someone looking for validation and support that is also religious. There are affirming churches and non-affirming as well - affirming have seen an uptick where I live. ETA and yes it is a form of cultural competence. I know when I needed to seek out play therapy for one of my kids, I searched for a Christian LCPC and it was a wonderful experience.

 

[Rain Sova]

That is a fair point. Certainly a psychologist from X religion would be able to have a deeper understanding of a client from X religion and their experience and perhaps could blend clinical training/theory/research with spiritual ideology. I just think that gets really tricky to balance, and as I think someone else mentioned, that would be a very small subset of the population one would work with.

I also see utility in folks from x religion seeing a psychologist in the community who doesn’t necessarily have that background so that they have a greater sense of perspective than just the religious one. Especially when one’s experience is at odds with said religion in some way.

So yes, I can see the best case scenario being that client and therapist have congruent spiritual beliefs (client not in conflict with the beliefs) and they work through grief, meaning of life, etc. That is assuming that the client doesn’t present with anything in conflict with the therapist’s beliefs in that religion.

It is kind of a known problem in the church that people seek out pastoral counseling when they need someone (depending on the situation) who is trained and licensed in mental health counseling and yet there is a huge stigma on the secularism/atheism perceived in that industry that people stick to just their pastors and sometimes (as much as I love and respect pastors) there are disastrous results.

 

[foreverbull]

It is kind of a known problem in the church that people seek out pastoral counseling when they need someone (depending on the situation) who is trained and licensed in mental health counseling and yet there is a huge stigma on the secularism/atheism perceived in that industry that people stick to just their pastors and sometimes (as much as I love and respect pastors) there are disastrous results.

Interesting. That is unfortunate to hear, but I understand what you’re saying about wanting the training to provide both perspectives (clinical plus faith-based). This is not inherently a problem until treatment more closely aligns with faith than ethics and scientifically-supported treatments in clinical practice. That’s when it becomes an issue for people needing mental health treatment.

The overarching message from several folks in this thread is that this field is bound by ethics and informed by science, and whether you are a faith-based therapist or not, ultimately the issue is whether you agree that you are ultimately willing to commit to ethics in our field, which sometimes can be challenging in some ways. In some cases, this may mean referring out to secular folks, and in some cases, you may need to put your faith aside and practice from your clinical training and knowledge of science.

Many folks have asked you whether you’d be willing to do this, and you seemed to believe you will always be able to refer out, but that will not always necessarily be the case. Is it possible for you to set aside your beliefs in those cases in which someone really needs your support but can’t go to anyone secular, and some aspect of their experience conflicts with your religious beliefs? Would you even feel comfortable allowing a client to explore their gender identity if it didn’t match what you thought was appropriate?

Again, I ask if there’s an openness to understanding and learning in these situations in a case by case basis and from further secular education because you’ve brought up another situation with trans folks that you didn’t agree with, so this seems to be a firmly-held belief that may affect how you practice and your approach.

 

[Rain Sova]

Interesting. That is unfortunate to hear, but I understand what you’re saying about wanting the training to provide both perspectives (clinical plus faith-based). This is not inherently a problem until treatment more closely aligns with faith than ethics and scientifically-supported treatments in clinical practice. That’s when it becomes an issue for people needing mental health treatment.

The overarching message from several folks in this thread is that this field is bound by ethics and informed by science, and whether you are a faith-based therapist or not, ultimately the issue is whether you agree that you are ultimately willing to commit to ethics in our field, which sometimes can be challenging in some ways. In some cases, this may mean referring out to secular folks, and in some cases, you may need to put your faith aside and practice from your clinical training and knowledge of science.

Many folks have asked you whether you’d be willing to do this, and you seemed to believe you will always be able to refer out, but that will not always necessarily be the case. Is it possible for you to set aside your beliefs in those cases in which someone really needs your support but can’t go to anyone secular, and some aspect of their experience conflicts with your religious beliefs? Would you even feel comfortable allowing a client to explore their gender identity if it didn’t match what you thought was appropriate?

Again, I ask if there’s an openness to understanding and learning in these situations in a case by case basis and from further secular education because you’ve brought up another situation with trans folks that you didn’t agree with, so this seems to be a firmly-held belief that may affect how you practice and your approach.

I greatly appreciate this response. I don't think I have answers to your questions, however, I have set up an appointment with a Christian psychologist..... a PhD with a long tenure where he is and I'm going to explore this further with him. I was going to see a woman that I knew had children, but I decided to go with someone who has been in the field longer. Thank you for all the advice. Psychology may be a passion of mine but becoming one may not happen for me... I'm hoping to talk through my concerns and either affirn my plans or find alternate plans. I definitely have the life experience and passion to be in the human services field but still have several mouths to feed. I know any commitment will bind me to certain ethics and vows and I don't take that lightly (hence the post).

 

[hamstergang]

Pronoun changes and hormones with plans on surgery.

So you don't actually know of any minors who have had gender surgery? And yet, that's your entire concern about entering this field?