Um, wait... is that ethical?

[Bradester]

For some strange, possibly Freudian reason, this entered into my mind while I was baking ginger cookies this evening.

I'd like to preface this by saying that I have a fair knowledge of the theories and applications of psychology, but not so much the clinical side of things.

A few years ago, when I was maybe a sophomore in college, I was seeing a counselor in a practice connected to my primary physician's office. From my experiences with her, this counselor was a somewhat conservative Christian, but I don't believe the clinic advertised itself as Christian-, faith- or Bible-based. The therapist was not a doctor of psychology, but was a Licensed Mental Health Practitioner (I don't know if this is a title used across the US or mainly in my state of Nebraska).

During one session, I mentioned that I was frustrated about the attitudes of some people at my church toward homosexuality. My therapist responded that she was rather liberal as a youth, and that my views would probably change as I got older- sharing her opinion of abortion as an example. :confused: Um, that wasn't my point, and I'm not really paying an hourly fee to hear your political views, but thanks.

Regarding homosexuality, she remarked that a gay couple had once come to her for some relationship counseling. She told them she would try to help them, but that they should know up front that she didn't approve of their "lifestyle."

Needless to say, that was one of my last sessions.

Now, I don't want this to turn into a fratching debate as to whether this should be ethical- I'm wondering if anyone with more experience in clinical psych can tell me if this is right according to guidelines and ethics. Are therapists and counselors who do not hold a doctorate of psychology held to different standards than licensed psychologists? I know that this therapist used the DSM to diagnose me, and that manual hasn't considered homosexuality a mental disorder since the 70's- so wouldn't their orientation be a moot point anyway? Aren't counselors supposed to practice objectivity, and certainly not share their personal beliefs with their patients?

Better go check those cookies.

[RetailWorkhorse]

*Head scratchies*

......I have no idea.

*Snags a ginger cookie*

[BookstoreEscapee]

While I'm sure some people still hold to the belief that homosexuality is some kind of mental disease, there are plenty of others who consider it simply a bad choice some people make and not a "disorder." From a religious perspective, I think most people feel that the person is engaging in sin, but would not necessarily say they are ill. (For the record, I think that homosexuality is neither illness nor sin. Nor choice, for that matter. Also, I am not religious; I just read a lot of Fark.) From that standpoint, I can see how a therapist could reconcile their practice with their religious viewpoint, assuming they can keep the two separate, and keep the focus on the mental health issues the client is there to address.

As far as ethics goes, I don't think a therapist should be sharing their political/religious views (unless the client is looking for a religious bent to their counseling sessions, I suppose); I can't say for sure but I don't think that would be part of the guidelines. At any rate, unless the client is on the same page in those departments, I don't see how a therapist sharing political/religious opinions is conducive to a productive therapeutic relationship. For instance (to take from your experience), if I was seeing a therapist for something completely unrelated to reproductive issues, and they decided to tell me they are anti-abortion - that would be a red flag; not necessarily because I am pro-choice, but because it would seem to me that they are trying to push a political agenda that is unrelated to my reason for seeking therapy. I can't imagine that would fall under the ethical guidelines.

[SteverinoNY]

Stop! Do Not Pass Go! (Sorry for the length of the post, but hopefully it answers the questions you posed)

What your therapist told you about the homosexual couple is extremely unethical. I am a student getting my Masters Degree in School Counseling (not the same as becoming a Licensed Mental Health Counselor, but the ethical principles handed down by the American Psychological Association are universal for all therapists), but I am familiar with the ethical principles having just completed a course on it. The basic premise is that no human being is value neutral, but therapists should never pass judgment on their clients because often people who come into therapy have been judged in the past and that they view therapy as a place in which they can open up their internal thought processes and gain insight. This is not possible if they are being judged by the therapist. Your therapist was in violation of the ethical standards of the field and most likely should have been reported for such. They also breached confidentiality by talking about another patient with you.

Here are some relevant codes that apply to what you said and the codes the therapist violated (taken from http://www.apa.org/ethics/code2002.html#principle_b)

Principle E: Respect for People's Rights and Dignity
Psychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination. Psychologists are aware that special safeguards may be necessary to protect the rights and welfare of persons or communities whose vulnerabilities impair autonomous decision making. Psychologists are aware of and respect cultural, individual, and role differences, including those based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status and consider these factors when working with members of such groups. Psychologists try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone activities of others based upon such prejudices.

2.01 Boundaries of Competence
(b) Where scientific or professional knowledge in the discipline of psychology establishes that an understanding of factors associated with age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status is essential for effective implementation of their services or research, psychologists have or obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals, except as provided in Standard 2.02, Providing Services in Emergencies.

2.06 Personal Problems and Conflicts
(a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.

(b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties. (See also Standard 10.10, Terminating Therapy.)

2.06 Personal Problems and Conflicts
(a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.

(b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties. (See also Standard 10.10, Terminating Therapy.)

[Bradester]

Thanks for that very detailed response, Steverino. I have no idea why I recalled the incident today, but there was definitely something rotten in the state of... well, Nebraska.

I hadn't even considered the confidentiality angle.

And BSE, you're right- a comment like that is a very weak foundation for a counseling relationship. I don't know if the couple received therapy from her- I sure as heck wouldn't have wanted to.

[RetailWorkhorse]

Maybe you thought of it because something reminded you of it.

*Shrugs*

*Snags another cookie*

[Bradester]

Hey hey hey! Stop stealin' my cookies! :p

[draggar]

*grabs a cookie*

mmm

*grabs another cookie*

OK, so is she working for the clinic or on her own and "outsourced" or referred to?

If she's on her own, while I think it's unprofessional, it's her perrogative. Her business, if she doesn't want to serve a certain kind of client, then she has the right to do it. I know it sounds rather backwards thinking but I would seriously hope that if a client is unwelcome someplace, they wouldn't push it. Her business, her views, as long as she is up front and honest about it, so be it.

BUT -
*grabs another cookie*
If she is working for the clinic then she is representing the clinic and she needs to uphold the policies set fourth by the clinic (in regards to their policies on racism, prejudice, equal opprotunity, etc.). If SHE's saying she doesn't approve of their lifestyle, it coul dbe taken as if she is speaking on behalf of the clinic, which IMO (unless it was approved by the clinic) is quite unprofessional, but at least she's being honest.

*grabs another cookie*

Good cookies, BTW ;)

[BookstoreEscapee]

Hey! I didn't get my cookie when I was here yesterday!

*takes two*

nomnomnom...

[RetailWorkhorse]

Hey hey hey! Stop stealin' my cookies! :p

*Squeaks and skedaddles*

......

*Steals another cookie*

[JLRodgers]

....What your therapist told you about the homosexual couple is extremely unethical.....

I'm assuming you meant the info told itself was unethical - not the telling of it (with no unidentifiable info)? As, well, almost all my textbooks from psyc courses, professors, etc told actual case examples with names/etc changed so you couldn't ID the people.

[SteverinoNY]

I'm assuming you meant the info told itself was unethical - not the telling of it (with no unidentifiable info)? As, well, almost all my textbooks from psyc courses, professors, etc told actual case examples with names/etc changed so you couldn't ID the people.

From what I gathered from the original poster was that the therapist did not do a good job of concealing the identity of the couple mentioned. Also, regardless of whether they concealed the identity of the couple or not, a therapist should not go off and discuss their clients to other clients. The session is not for the therapist to talk about their other clients to the person in the room with them. If I were in the OP's position, I would have felt rather uncomfortable with the whole situation and would have wondered if the therapist talks about me when they are in session with other clients. That's why I felt the actions were unethical and the therapist was clearly in the wrong.

[JLRodgers]

From what I gathered from the original poster was that the therapist did not do a good job of concealing the identity of the couple mentioned.

Ahh, ok -- I didn't get the impression that they were identifiable from the original post when I first read it :)