Metro Weekly

Counseling Crisis

Mental health professionals balk at Tennessee bill allowing therapists and counselors to reject LGBT clients

Tennessee State Capitol building - Photo: photoua
Tennessee State Capitol building – Photo: photoua

“It’s outrageous,” says Dr. Gordon Cohen.

The D.C.-based psychologist is talking about a recently passed bill in Tennessee — and his reaction is far from overstated. As written, it allows therapists and counselors to refuse treatment to potential clients if their lifestyle or identity violates the therapist’s “sincerely held principles.”

“My partner is originally from Tennessee, and he was so upset he’s thinking we shouldn’t go back any longer to visit his family,” says Cohen. “And I’m saying, ‘Well, we’re not going to do that.’ But it really does upset me a lot that Tennessee is doing this right now.”

Supporters of the bill, which was signed into law by Gov. Bill Haslam (R) last week, have argued that it was essential to protect the religious liberty of therapists and counselors. Specifically, they objected to a 2014 change to the American Counseling Association’s (ACA) code of ethics, which instructs counselors not to turn away clients based solely on a number of different characteristics such as race or religion, as well as sexual orientation and gender identity.

The bill granted the exemption based on a therapist’s “sincerely held religious beliefs,” but was later amended to the much broader — and, critics contend, ill-defined — language of “sincerely held principles.”

“This bill could so easily be expanded to other groups,” says Joshua Riley, a certified counselor who serves as director of community relations and external affairs at Whitman-Walker Health. “Someone could say, ‘Okay, I’m racist, so I’m not going to see a person of color.’ Or, ‘I’m a pacifist, so I’m not going to work with someone in the military.’ You name it. There’s a whole number of places where this bill could go.”

Haslam argued that the bill contains two provisions that will ensure those seeking counseling or treatment will still be able to obtain it. The first provision says that the religious exemption “shall not apply” when a client is in “imminent danger of harming themselves or others.” The second requires the therapist or counselor objecting to providing treatment to refer that client or patient to another counselor or therapist who is willing to work with them.

Kris Oseth, a psychotherapist and licensed professional counselor, says the provisions referenced by Haslam may not be sufficient.

“Just because someone is not in ‘imminent danger’ of harming themselves, in that moment, on that particular day, does not mean that they are not at risk of being a danger to themselves or others later on,” she says. “The time that it takes the counselor and client to find another source of therapy could be detrimental to someone who is having chronic suicidal ideation, or homicidal ideation, or psychosis.”

While the bill does not specifically target LGBT people, allowing counselors and therapists to reject clients could end up having an equally negative impact on that community.

“We know from the studies and the statistics that LGBT folks experience higher levels of depression and anxiety,” he says. “Suicide rates are off the charts, particularly for young people and trans-identified people. So LGBT people’s mental health needs are certainly on par with, but sometimes greater than, the needs of other groups.”

For Cohen, the idea of rejecting a client because of personal views or beliefs is a gross violation of the code of ethics for anybody in the mental health profession. Each profession’s code of ethics already contains provisions that allow therapists to refer a client to another clinician if they feel uncomfortable working with that client. As a result, it makes the exemption bill “completely redundant and unnecessary.”

“You wouldn’t want a counselor to work with a transgender person if they weren’t going to be helpful, or were going to be harmful to them,” Cohen says. “But that clause is already written into the code of ethics. You already have an out. If there was a counselor in Tennessee who felt uncomfortable for that reason, they could simply let the client know that. They have that right. You don’t have to legislate over it with yet another law, which basically codifies discrimination.”

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