Question on the ethics of therapy and religion...

[Humanist_Activist]

OK, so as I'm sure many people have heard, and I posted twice about now is the tragic story of Leelah Alcorn. This is also bringing to the forefront the debate as to whether conversion therapy should be legal, because her parents forced her to go to Christian therapists who apparently attempted to shame her into being a guy.

We aren't privy to the details of the therapy, and if these people are actually licensed, and not "spiritual advisers" or some other type of pseudo-bullshit "therapist" type, then their licenses need to be pulled. I would even go so far as to see how aware any of them were of her state of mind, they may be criminally liable for negligence.

Leelah also elaborated on her home life recently on reddit, and how her parents psychologically abused her on a, more or less, daily basis. Being an abuse victim, even she didn't recognize it as such. She also elaborated that she no longer was a Christian, and became an atheist. She talked about being forced to go to Christian therapist who simply reiterated her parent's and their church's beliefs about trangender people.

This brings up an interesting point though, about religion and therapy. I have heard that, ethically, religious therapists are supposed to keep their religion private and not make it a part of therapy, of course many people will tell you that doesn't always happen. Let's focus on secular therapists, those that actually do not bring up their own religion at all. How do they handle extremely religious patients? For many people, religion is tied to their self worth, so belief in it can have huge affects on treating depression, for example.

Even more interesting, what about those people who's religion may actually be damaging to their mental health? I'm thinking specifically of LGBT patients who are religious, particularly of religions that have passages and beliefs that directly contribute to beliefs that affect self worth and self esteem.

I'm not discounting other patients as well, I can easily imagine any Christian with a major depressive disorders taking the Christian adage, "we are all sinners" a little too personally. But we aren't talking about people who misapply specific beliefs to themselves, but those that the beliefs themselves do apply to, and the best you can do is try to sugar-coat a turd and try to sell it as chocolate. Specifically beliefs and passages in the Bible about sexuality and gender.

If an LGBT person, as a legal adult, goes to therapy due to depression, and its revealed during that therapy that part of their issue are some of their religious beliefs, do secular therapists address this? And how do they address it? Is it ethical to counter the religious arguments the patient believes in at all?

This is also brought on because of a previous post I posted here:

http://www.democraticunderground.com/1218126961

My end note was that I wished many of the people in the video went to competent secular therapists under the assumption that the therapist wouldn't encourage, and would, at least on some level, discourage the damaging beliefs the people in the video have about sexuality.

[Leontius]

1. What exactly do you think are the requirements to be "competent secular therapists" ?

[Humanist_Activist]

3. Those that keep up the the literature from the APA and other, similar organizations....

and tries to follow many of their recommendations and ethical standards. Someone who is properly licensed, etc.

[Leontius]

6. Do you automaticly exclude those who have religious beliefs?

[Humanist_Activist]

9. No, where do you get that from. As long as their religion doesn't interfere with...

their practice.

[Leontius]

10. Where do you draw the line of interference in their practice?

[Humanist_Activist]

11. Unnecessary insertion of their religious beliefs or practices into the therapy employed.

Why the 20 questions? Is the idea of secular therapy and therapists somehow antithetical to your worldview?

[Warren Stupidity]

14. wait for it, I'm sure he will be making a point real soon now.

[Warren Stupidity]

4. A licensed therapist? here:

Master's Degree

Your master's degree is where you will get the specialized training you need to become a licensed therapist. You will likely take classes in interpersonal, group, family, and child psychology, as well as classes on ethics in therapy, psychological theories, research methods, and clinical best practices. There are a wide variety of specialties you can choose in graduate school, and your choice should be dictated by the sort of therapist you hope to be. Some programs to consider include:
•Social work will prepare you to become a licensed clinical social worker.
•Child psychology programs train you to work with children.
•Counseling equips you to work with a wide variety of people across the lifespan.
•Marriage and family therapy courses can help you become a marriage and family therapist.
•Psychology programs prepare you for doctoral work to become a licensed psychologist.

As part of your master's program, you might have to complete a certain number of supervised clinical hours. Your school may assign you to a counseling center or organization, and these clinical hours may help you meet licensing requirements in your state. After you complete your master's degree, you may have a Master of Arts (MA) or a Master of Science (MS) or a related master's degree, depending upon the concentration you choose and the structure of your program.

Doctoral Degree

A doctoral degree is the highest educational level a therapist can achieve. While it is not required to practice as a therapist, you will have to get a doctorate if you want to become a licensed psychologist. A doctoral degree can also help you gain more knowledge and specialize in a particular area. For example, some therapists choose to complete doctoral degrees in child psychology so that they can learn more about treating children.

http://www.goodtherapy.org/become-a-therapist/education-requirements.html#

Qualifications and FAQs

What are the qualifications to be a Marriage and Family Therapist?

Marriage and family therapy is a distinct professional discipline with graduate and post graduate programs. Three options are available for those interested in becoming a marriage and family therapist: master's degree (2-3 years), doctoral program (3-5 years), or post-graduate clinical training programs (3-4 years). Historically, marriage and family therapists have come from a wide variety of educational backgrounds including psychology, psychiatry, social work, nursing, pastoral counseling and education.
The Federal government has designated marriage and family therapy as a core mental health profession along with psychiatry, psychology, social work and psychiatric nursing. Currently all 50 states support and regulate the profession by licensing marriage and family therapists with the remaining states in the process of obtaining licensure laws.
The regulatory requirements in most states are substantially equivalent to the American Association of Marriage and Family Therapists Clinical Membership standards. After graduation from an accredited program, a period - usually two years - of post-degree supervised clinical experience is necessary before licensure or certification. When the supervision period is completed, the therapist can take a state licensing exam, or the national examination for marriage and family therapists conducted by the AAMFT Regulatory Boards. This exam is used as a licensure requirement in most states.

http://www.aamft.org/iMIS15/AAMFT/Content/about_aamft/Qualifications.aspx

[Warren Stupidity]

2. There is a difference between a "religious therapist" and "religious therapy".

I believe this unfortunate victim of religion was subject to the latter, which, as far as I am concerned, is equivalent to exorcism by delusional priests. Note that of course religious therapy, a bogus and harmful practice, is conducted by religious therapists.

[hrmjustin]

5. Conversion therapy should be illegal for minors and I would support banning it completely.

[Prophet 451]

19. I think it should be outright banned

[Act_of_Reparation]

7. Ideally, a therapist shouldn't be talking about themselves at all.

Sessions are about the patient, and the patient's problems. A trained therapist understands the importance of professional boundaries and unconditional positive regard.

Also, if a therapist specializes problems common in LGBTQ patients, they will typically make that clear up front.

[TM99]

8. I will share some of my thoughts and experiences being in the field.

I was trained decades ago. While it was not a requirement for licensure, it was still expected by my training facilities and supervisors that I received in depth therapy myself. In part to resolve my own issues but also more importantly so that I would have a firm handle on my own biases, beliefs, and such that would and could influence my work via the transference/counter-transference therapeutic relationship.

I received advanced diploma's in various schools of psychology that required further extensive therapy, and I benefited from it immensely. So did and have my clients/patients.

This is a very tragic situation. I know that you see it as a possible opposition between secular and religious counselors, and that is just not the reality. All that is required today, unfortunately, to hang out your shingle as a private practice counselor/therapist is a terminal masters program, scant few hours of direct supervision, no personal counseling, and the passing of a background check and a licensing exam. That's it. A person can do it in less than three years.

I supervise yearly hundreds of such people entering this field. And I see this kind of counter-transference with all types. Yes, I have challenged religious believers who try to bring their fundamentalism into the therapeutic relationship. But I have also seen it with non-religious secular types as well. Just a few months ago, I had to deal with a young woman fresh out of graduate school and soon to be licensed. She wore feminism like a religion. She would bring in things like the 'rape culture' and 'objectification theory' in all of her sessions. She just couldn't turn that off, and it was most certainly negatively impacting her work. Did she change? No, she requested to change supervisors because I challenged her beliefs. Another example was a man I worked with last year at the V.A. He was a very staunch liberal Democrat. He was anti-war and anti-guns. That's fine in his personal life, but he was bringing those strong convictions into the therapy room. He was useless with these vets suffering PTSD from various tours in Iraq & Afghanistan. I had to confront him repeatedly on this, and he still wouldn't change.

So my point is that this is a problem with therapy today NOT just with religious counselors versus secular ones. My mentor was a man of deep religious faith - a retired Lutheran priest - who never once brought his beliefs directly into the office. Was he influenced by his faith? Definitely! He worked tirelessly for campus ministries. He was very progressive and was at the fore-front of LGBT marriage equality before his death. The APA is no longer, if it ever was, a model of secular perfection. I am actively working on getting the psychologists involved in the CIA torture out-sourcing stripped of their licenses. I have no way of knowing if I and those of us who abhor these ethical violations will succeed. They are covered by legalities and therefore have not technically violated their licenses.

I agree with you that fundamentalist Christian counselors can be devastating to certain groups of clients/patients. The same is true as I have shared for secular one's as well.

There is no easy solution. I hope that this counselor is investigated. I hope these parents are as well. This young woman's death may bring about some changes, and sadly, it may not as well.

Oh, to address your questions at the end of your post, I have worked with many LGBT persons over the years. If religious issues are brought up, then yes, I have and would discuss them. I can't recall any that would argue with me from a religious viewpoint. All were simply struggling with families, friends, communities, churches, etc. that were not accepting of them as they were. I could address self-confidence. I could address ownership of their beings and natures as being good and right. I could support them in their choices to leave but I also had to support them in their choices to stay whether it was a Mormon teenager unwilling or not yet able to leave his community or an older Catholic woman who was not going to leave the church that she very much belonged to and wanted to continue to belong to.

Change is not fast. It is not easy. There will sadly be more such tragedies. I wish there were not. And I know the reality. Like I said, I see so many gross ethical violations in the therapeutic relationship not only from those who are religious, but also secular.

[Humanist_Activist]

12. So you would say that, in the therapy room, being non-sectarian and/or secular and neutral...

on politics are necessary to be effective therapists?

[TM99]

15. In the therapy room,

there are two individuals. One is there to assist. The other is there for assistance. We both have our pasts. We both have traumas, beliefs, political positions, religious or non-religious positions, etc., etc., etc. The one needing assistance does not even need to be aware of those things. The one needing assistance should not even need to change any of those things if they are not wanting to or even able to do so to get the help they need and desire.

I, as the therapist, must be aware of all of those things about myself that I bring in. Sure, my politics, my belief or non-belief, my trauma's, my journey all influence and color my work with those who seek me out or are in need of my professional services, but I can not let any of those directly impact my work.

It is absolutely irrelevant to me if the vet in front of me is a Fox news watching, bigoted, racist, homophobic, born-again gun thumper. All that should matter to me is that this man is deeply traumatized. He can not sleep due to nightmares. He suffers chronic pain from the battlefield. He is depressed, has violent rages, and is slowly committing suicide by drinking excessively day after day.

So it is not that I would use the word 'neutral' as you have in order to be an effective therapist, however, we must be unconcerned and not bring our own 'stuff' into the therapeutic relationship. The moment any therapist does that it really is no longer about the person needing assistance, it has become about US! That is unethical and definitely not a recipe for effective and successful psychotherapy.

[Humanist_Activist]

16. That makes sense, its not like we are talking about group therapy where sharing is an important...

part of therapy.

Its the patient's well being and therapy we are talking about, as you said.

[TM99]

17. Well most of this still applies in group therapy.

As a the facilitator of say an eating disorder group, I can not allow an atheist and a fundamentalist to get into constant arguments about religion. It is neither the time nor the place for that. It is about the sharing of experiences and garnering support from others who are facing a similar problem, not arguing politics, religion, etc.

Even if I hold the same beliefs as one of those arguing members, I can not allow my agreement or disagreement to distract from all of their well-being.

[Dorian Gray]

13. Breathing out slowly

Not because of your questions. They're all natural and valid questions. This story makes me so sad.

Her parents confuse me. I love my daughter so much and her happiness and mental/emotional health is so important to me that I can't imagine anything that would make me try to force her to be something she isn't.

I don't understand these parents. At all. It makes me enormously sad.

As for the therapy, my honest answer is "I don't know." I suspect those with deeply help religious beliefs that may add to their depression do so because their families abuse their beliefs. Therapists do address that, I'm sure. How do they do so without negating the religious beliefs? I don't know.

[Prophet 451]

18. Conversion "therapy" should be outright illegal

Snake oil was banned because it was, at best, ineffective and, at worst, outright damaging. The same can be said of conversion "therapy". It's a dangerous, quack practice that can cause incredible psychological harm. AFAIK, suggesting it to a client can be enough to get a psychologist's BPS membership revoked here (equivalent to getting their license pulled).

Most modern therapists would say that, if prayer helps the client feel better, then by all means, pray (certainly, that's what my therapist has said to me). But there is a potential conflict in the regulations. On the one hand, we are supposed to keep our religious beliefs to ourselves and respect our client's religious convictions. But we are also supposed to help our client through their difficulties. So, if our client's religious convictions are either the source or a contributor to their psychological problems, then we're stuck between two opposing regulations and, AFAIK, there's no guidance from the BPS on how to proceed.

Now, it must be said that no religion is entirely anti-gay and pro-gay factions exist in most faiths. So I suspect the only thing we could do, while adhering to the regs, is to suggest and encourage our clients toward the more progressive elements of their faith.

My own faith, incidentally, has absolutely no problem with gay people. Father Lucifer is gay and straight and both and neither as the whim strikes him.