Updated: The ACA should move its 2017 conference out of Tennessee

Updated May 10, 2016: They’re moving the conference. A written statement from President Thelma Duffey is here, and a video from CEO Richard Yep further explaining the decision is here.
 
Updated April 29, 2016: The ACA has released a statement on HB1840 and asking for patience as their leadership weighs its options for the 2017 conference. The full statement is available here.
 
Updated April 28, 2016: Tennessee Governor Bill Haslam signed the “religious freedom” bill allowing counselors to freely discriminate, and directly contradicting the ACA Code of Ethics. The ACA should move the conference. My original post, published April 21 under the headline “What should the ACA do about its 2017 conference?” follows. -bc

Tennessee capitol - public domain image via Wikimedia CommonsThe American Counseling Association has been vocal in its opposition to pending legislation in Tennessee that would allow counselors to turn clients away based on any personal belief, even if the refusal to treat is discriminatory in nature. They have said that the bill directly contradicts the ACA Code of Ethics and must be vetoed by the Governor.

If the bill passes, however, it puts the ACA in a quandary: Their 2017 conference — for which registration is currently open — is scheduled to be held in Nashville.

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Whose conscience matters?

When can a therapist decide their own morals and values outweigh those of their clients?

The AAMFT has kindly made my article on conscience clause laws in mental health the cover story for the September issue of Family Therapy Magazine. You can read the article here if you’re an AAMFT member.

Of course I’m biased here, but I think you’ll find it worth the read. While I’ve written about the topic a few times here on the blog (most recently, I wrote about conscience clause laws being considered in Washington, Texas, Arizona, and Michigan), my focus here has been much narrower than it is in the magazine. In the FTM piece I take a broad look at the issue, from the origins of conscience clauses to the best arguments for and against them. While these laws are often spurred by a desire to protect religious practitioners, you don’t need to be religious to be impacted by them, and you might be surprised at what the laws would appear to allow:

Most conscience clause laws are so broadly written that they could allow […] therapists to refuse to treat sexually active unmarried couples, or therapists morally opposed to immigration to refuse treatment to clients based on nationality, even in a mental health emergency.

Is this a price worth paying to protect therapists’ moral views? My skepticism is raised when considering that the religious practitioners and legislators backing these bills often seem to have a desire to legitimize discrimination against gay and lesbian clients. So, you know, that’s not okay. But the issue isn’t black and white, as I hope the magazine article illustrates.

In addition to the main article, a sidebar I had written about conscience clause laws being considered or adopted in various states around the country was transformed into a really cool national map infographic. I wish I could take credit for that — it’s great visual layout — but that’s all magazine staff. Check it out.

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I have another article in the works proposing a way therapists could consider the appropriateness of a conscience-based referral, within the fuzzy boundaries of existing law and the existing AAMFT Code of Ethics. So stay tuned for that (for several months, in all likelihood, but I’ll keep you updated).

Your comments are welcome. You can post them in the comments below, or email me at ben[at]bencaldwell[dot]com.

Is “relationship orientation” a thing?

A session on plural families at last week’s AAMFT Annual Conference in Portland used the term as a parallel to sexual orientation.

Teens from polygamous families
One of the workshops I attended at last week’s AAMFT Annual Conference focused on “plural families” — family structures that involve more than two partners and their children. The presenters argued that members of these families (seen most often in the US in Colorado, Nevada, and Utah, in offshoots of the Mormon church, which officially banned polygamy more than 120 years ago) may well wind up in a family therapist’s office, and that the therapist needs to be prepared to work with the realities of their complex family structures.

The presentation was fascinating, and appropriately non-controversial: These presenters were not arguing that a plural family structure was right or wrong, just that it exists, and that therapists may be confronted with it. Fair enough.

What piqued my interest was their use of the term “relationship orientation” to describe one’s leanings toward monogamous or polygamous relationships. Are we moving toward considering a preference for monogamy or polygamy as simply one more demographic variable, not subject to change and worthy of equal respect in all its forms?

In a pair of essays for Slate, Michael Carey (a pseudonym) has argued that exact thing. He first suggests that, like gays and lesbians, polyamorists often feel compelled to hide their relationships even from close family members for fear of judgment or even expulsion — and that the lack of societal acceptance reflects prejudice. In the second, he notes that half to two-thirds of polyamorists do not experience their relationship orientation as a choice. (These numbers are from Carey’s experience, and he doesn’t pretend they are research-based.) For this majority, their “innate personality traits make it very difficult to live happily in a monogamous relationship but relatively easy to be happy in an open one.”

Don’t focus too much on that word “innate,” though. How much of a desire for polyamory is nature and how much of it is nurture isn’t especially important when arguing for moral acceptance of poly relationships, Carey argues:

Nobody ever claimed that Mildred and Richard Loving were born with some kind of overwhelming predisposition to prefer partners of another race and that they thus couldn’t marry somebody of their own race. Choosing an interracial partner was, and is, a choice. So what? The correct response to the nature vs. nurture question is: There’s no way to know for sure, and it doesn’t matter. What matters is that people love each other, treat each other with respect, and live happy, productive lives.

Now, I should be up front about my own moral place here. I have no problem with poly relationships as long as there is no dishonesty involved and no one is getting hurt (at least, no more so than happens in the normal course of monogamous relationships). What concerns me here is where the parallel leads us. If “relationship orientation” is as inflexible as we now understand sexual orientation to be, and if participants in poly relationships are not being any more or less moral than anyone else, do we have a societal moral obligation to honor poly relationships with equal status as monogamous ones (whether straight or gay)?

In other words, do we owe them plural marriage?

The overwhelming science on gay and lesbian couples show that they and their children are harmed by societal discrimination and suffer from being unable to marry in a wide variety of ways. This is in spite of the fact that children of same-sex couples are just as healthy as those from straight couples.

The situation is different for poly marriage. While there may be many exceptions, poly relationships are generally understood to be oppressive to women, and polygamous families and cultures may have negative outcomes for children on a variety of measures. So there is ample reason to take a very cautious approach to polyamorists pushing for societal acceptance.

Status of polygamy worldwide
Legal status of polygamy worldwide (click the image for full details)

I’ll admit I have never been a big believer in the “slippery slope” line of reasoning, which essentially argues that if you raise the speed limit from 55 to 65, then you’re going to have to raise it to 200. You don’t, of course; raising it again even to 70 would be a different debate. Slippery slope arguments are often nonsensical fear tactics used to argue for the status quo, by suggesting that the alternative is an extreme alternate reality that no one has actually suggested. Applied to gay marriage, some argued that it would somehow logically follow that if we allowed same-sex couples to marry, we would then have to allow people to marry box turtles.

It is debatable whether re-legalizing polygamy equates with raising the speed limit to 70, or whether it would be more like raising the limit to 200. For now, I’m looking at it more like 200 — a radical and potentially damaging change.

But lots of people once felt that way about gay marriage, too. And it seems the language debate we once had around sexual orientation being a preference, a lifestyle, or an orientation is starting to replicate itself for plural families. As we saw with gay marriage, the outcome of the language debate has a lot to do with shaping what happens next.

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Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

Universities win two discrimination lawsuits brought by student therapists

Jennifer Keeton had refused to treat gay clients, and Maria Salcido alleged that racial bias kept her from finishing her family therapy degree.
                                                                                                                                                                                                                                                                                                           

JudgesTools IconThere have been at least three recent lawsuits involving students in the mental health professions and allegations of discrimination. In recent rulings, universities prevailed in two of those suits: Jennifer Keeton’s case against Augusta State University, and Maria Salcido’s case against Southern Miss University. The third case, in which Julea Ward sued Eastern Michigan University, remains in court.

In 2010, Jennifer Keeton sued Augusta State. The school had expelled her from its counseling program after she had said many times over in classes and in meetings with school officials that she would not counsel gay or lesbian clients. The university offered Keeton a remediation plan, with the hope of aiding her in not imposing her values on clients. Keeton claimed the university was trying to force her to change her religious beliefs. The university insisted that the intent of the remediation was in keeping with the ACA Code of Ethics. The ACA Code requires that counselors not impose their values on clients, regardless of what the counselor’s personal values may be.

A federal district court last month ruled in favor of the university. Importantly, the judge in the case also reinforced the importance of professional ethical codes, noting

[W]hen someone voluntarily chooses to enter a profession, he or she must comply with its rules and ethical requirements. […] The ACA and ASCA Codes, with their emphasis on the counselor’s role in facilitating personal client growth and self-determination, both expressly proscribe the imposition of a counselor’s personal views in counseling situations.

The AAMFT Code of Ethics, like most professional codes, includes a non-discrimination statement. Interestingly, the AAMFT Code does not include the kind of clear prohibition against professionals imposing their own personal values that is found in the codes of other organizations. At best, it is implied in the AAMFT Code. That could become important if an MFT program is ever challenged in court over similar issues.

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In a separate case last year, Maria Salcido filed a claim against Southern Miss, alleging that racial bias kept her from completing her MFT degree there. She had withdrawn after being unable to find a placement site for her required externship experience. Her suit accused the university of preventing her from getting a placement because of her race.

She not only lost her case, the language of the court ruling against her suggests frustration that she wasted everyone’s time:

[Salcido’s] bare factual allegations are seasoned with healthy doses of legal conclusions and fall far short of plausibly suggesting a discriminatory state of mind on the part of any defendant.

That was how the court reacted to her discrimination claim; she didn’t fare any better on the other claims she made against the university. The entirety of her suit was dismissed with prejudice.

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Together, these rulings appear to suggest that students cannot use accusations of discrimination to get what they want from graduate programs in mental health, particularly when (as in Keeton’s case) they are asking to overrule academic decisions tied to the ethical standards of the profession the student is trying to get into. Unfortunately, it is too early to say the question is settled: the Julea Ward case is still out there, and it bears more than a few things in common with Keeton’s. (The judge in Keeton’s case uses a lengthy footnote to discuss what is different between the Ward and Keeton cases [pages 49-50], one of many reasons that ruling is worth reading.) I’ve previously written about the Ward lawsuit, a recent ruling that keeps the Ward case alive, and “conscience clause” legislation proposed as a direct result of Ward’s experience.

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Post your comments on these cases below, email me at ben[at]bencaldwell[dot]com, or join the conversation on my Twitter feed.