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Tuesday, April 12, 2016

No Counseling for You!

I’ve written quite a bit about Minnesota nutcase and member of the State House of Representatives Glenn Gruenhagen.  Mr. Gruenhagen, who has opposed LGBT rights and equality since being elected in 2010, has recently introduced a bill which misuses and misinterprets the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual (DSM-V) to draft a law referring to LGBT people as “mentally ill” and “in need of treatment.”

Today I read an article originally run in the Associated Press and picked up by LGBTQNation about a Tennessee bill giving counselors and therapeutic care givers the right to refuse service to LGBT individuals based on the provider’s religious beliefs.  The bill is on its way to the governor’s desk as we speak. 

You would think that the Republicans could be on the same page with their regressive tactics.  Are LGBT people “sick” and in need of “healing?”  Or should we just deny their humanity and hope they all succumb to depression and anxiety by refusing them treatment?

But, then again, logic isn’t really a character trait most people associate with fear mongering and Republican political tactics.

This is what I can tell you about this Tennessee bill that should encourage you.

First off, if you are a licensed professional counselor in the United States, you must abide by the American Counseling Association’s  (ACA’s) Code of Ethics.  This ethical code adopts that old medical mantra to do no harm.  This paper from 2012 summarizes this ethical mandate:

The ACA Code of Ethics clearly states that counselors encourage client growth and development in ways that foster the interest and welfare of clients, and that the primary responsibility of counselors is to respect the dignity and to promote the welfare of clients (ACA, 2005, p. 4). In fact, it is a fundamental assumption of the ACA Code of
Ethics, as well as other ethical codes within the mental health profession, to “avoid harm to clients . . .and to minimize or to remedy unavoidable or unanticipated harm” (p. 4). In other words, the needs of clients, not counselors, are the priority. Ethical codes and practice regulations exist to assure the welfare of clients, not accommodate the personal beliefs of providers. “Convictions of conscience” clauses imply that self-interest rather than devotion to client welfare can be the counselor’s priority.

The idea behind this, of course, is that simply refusing a client or patient based on an “ookiness” factor (the client is gay, the client is homeless and smells, the client drools when he talks, etc.) completely undermines the client’s dignity and more often than not compounds the very reason the client is seeking therapeutic services (addressing anxiety, identity, self-worth and self-concept, etc.). 

That being said, in order to appropriately treat a client or patient while understanding that a single individual cannot be all things to all people, the ACA Code of Ethics does provide a way out for providers who aren’t comfortable treating a client or patient for whatever reason.  Usually it’s invoked when the provider understands that the client’s needs lie outside of the provider’s capabilities.  In the scope of the current conversation it would amount to the provider doing the referral not because they find the LGBT client morally or religiously repugnant but rather because the provider does not feel competent to provide treatment.  The referral is always done respectfully, pointing to the fact that the current provider is not equipped to meet the client’s needs.  The responsibility, though, is for the current provider to facilitate the connection to the next, more qualified provider, so that the client is not left without care.

Leaving a client or patient without care, whether it’s a medical issue or a psychological issue, is not ethical no matter what your governing body is or what your professional organization’s code of ethics are.  “Do no harm” undergirds nearly all care giving vocations.

And, really, if you were an LGBT person, wouldn’t you want to be referred on to someone who’s more equipped to help you than to sit in an office with a closet homophobe who sees you as condemned because their interpretation of religious text declares you as “abomination?”  The point I’m driving at, however, is that the care provider has a professional responsibility to refer a client without any form of evaluative judgment on the client’s needs or condition that might affect the client’s well-being.

This Tennessee law defies this professional responsibility and gives homophobic individuals the power to do just that.  Imagine being the teenage child of a parent who has dragged you into counseling because you’re gay or lesbian.  You’ve (rightfully) dug in your heals and declared that this is who you are and there is no “cure” for it.  However your parent has brought you to the one therapist in town and, upon the initial consultation, the therapist pulls your parent into the room and says, “I can’t treat your child.  My religious convictions do not accept your child’s choice.” 

How many things can you count as wrong in that statement?  And yet you know it will happen because it does happen and has probably happened to you. 

We need to do better.

But here’s the thing.

For a party of “smaller government,” the Republicans have a habit of shoving their noses in where they don’t belong and then creating a bureaucracy to enforce their opinions.  As I’ve reminded you for the past few weeks it’s common for the Republicans to do this in an election year, to make something out of nothing in order to motivate their base.  There is no actual need for a law like this but what it does is gives the Republicans a talking point that can easily sidestep reason and abandon logic.  And, remember, this isn’t about the truth.  This is about creating truth by repeating a story often enough that people believe it’s truth. 

Though there isn’t an actual need for a law like this we can clearly see why the Republicans would endorse a law like this.  Or a law like the heinous bathroom laws.  Or any law that legalizes discrimination.  Such laws dehumanize people and, when it comes down to it, the Republicans work best when they have a group of people whose rights have been denied but continue to struggle for equality.  The Republicans have always and will always point to that struggle for equality and play on people’s fears with it.

The ACA’s Code of Ethics underscores the dignity and welfare of the individual.  This law and others like it, like one passed in Mississippi not too long ago, completely ignores and even reverses what years of professional research and observation have accomplished.  It’s another case of law makers, who don’t have a clue about what it is they’re actually talking about, pretending that they are doctors or teachers or scientists and know more than the entire profession they are trying to micromanage through the implementation of laws.  Laws, by the way, that are underwritten by special interest groups and financed by lobbyists.  It would be interesting to see what groups are backing this Tennessee law because, I guarantee, it’s not the ACA or any other credible professional organization. 

One last thing.  If you’re an LGBT teen in Tennessee or Mississippi or any of these other states in which politicians are literally playing games with people’s lives, including yours, and you’re not getting the help you need, please talk to someone safe.  I’ll leave contact info for The Trevor Project below.  I worry about all LGBT people facing such hateful resistance to common sense and decency, but I think LGBT teens are at a much higher risk and the world needs you.  Without you, how are we going to change the world?


866-488-7386

TrevorText -  Available on Thursdays and Fridays (4:00 p.m. - 8:00 p.m. ET / 1:00 p.m. - 5:00 p.m. PT). Text the word “Trevor” to 1-202-304-1200. Standard text messaging rates apply.




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