A few years back, values-based referrals by counselors were proper under the American Counseling Association (ACA) Code of Ethics if done tactfully, so as not to wound the client, and were ethically permissible if the therapist, because of personal beliefs, could not provide what the client was seeking. Since we first reported on this issue, several big changes have altered that premise, most importantly, a major change in the ACA Code of Ethics.
While it had previously permitted the practice, the ACA revised its code of ethics in 2014 and now provides:
Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.1
Many states use the ACA Code of Ethics in their licensing schemes, and recently, at least one state has modified its laws to create a work-around the ACA Code of Ethics prohibition on values-based referrals. In late April 2016, Tennessee, which uses the ACA Code of Ethics in its state licensing system, enacted legislation essentially overriding this provision. The law makes it such that Tennessee counselors will not be required to continue counseling clients where doing so would conflict with the therapist’s sincerely held principles. The law was opposed by the ACA, which argued that the bill was simply a mechanism to permit discrimination and denial of services; proponents stated that they were restoring the status quo.
While no court has addressed a case under the new ACA Code of Ethics, The Washington Post recently reported that a lawsuit has been filed challenging the new Tennessee law. According to the article, the lawsuit argues that the new law targets gay, lesbian, bisexual, and transgender people, denying them equal treatment under the Tennessee Constitution. This and similar issues are likely to continue to play out in the courts.