Three recent federal circuit court decisions address how conservative Christian therapists may interact with homosexual clients in cases where personal beliefs may conflict with a duty of client care. Despite different outcomes, there may be common principles. Schools and employers may not require therapists to change their religious convictions, but under the American Counseling Association (ACA) code of ethics, therapists may not impose values on their clients. Referrals can solve the problem, if done tactfully.
The Eleventh Circuit decided the first case, Keeton v. Anderson-Wiley, on December 16, 2011. Ms. Keeton was a graduate student at August State University (ASU) in school counseling. She believed that homosexuality was immoral and that she should try to convert students/clients away from that orientation. ASU perceived her position to be contrary to the ACA code, and proposed putting Ms. Keeton on a remediation plan before letting her begin her clinical practicum. Ms. Keeton sued for violation of her First Amendment free speech rights, asking for a preliminary injunction. The district court denied her request, and the Eleventh Circuit took her appeal.
The district court had found that ACU did not impose a remediation plan because of Ms. Keeton's religious views, but because of her intent to impose those views on clients in violation of the ACA code of ethics. The Eleventh Circuit agreed and affirmed, denying the injunction. A concurring opinion strongly supported freedom of student speech.
The Sixth Circuit decided a similar case, Ward v. Polite, on January 27, 2012. Ms. Ward was also in a school counseling graduate program, but already in her clinical practicum. She was assigned a client seeking counseling about a same-sex relationship. At Ms. Ward's request, the client was reassigned and the client never knew about Ms. Ward's beliefs about same-sex relationships. The school then expelled Ms. Ward from its counseling program because Ms. Ward wanted to refer, rather than counsel, gay and lesbian clients who were seeking relationship advice. Ms. Ward filed suit based on her First Amendment rights. The district court granted summary judgment against her, and the Sixth Circuit took her appeal.
The court considered many of the same arguments as the Keeton court, but this time, the circuit court reversed the district court. The point of Ms. Ward's referral was to avoid imposing her values on gay and lesbian clients. This conformed to the ACA code of ethics, which permits values-based referrals. The school had allowed other referrals for other reasons, so it may have treated Ms. Ward differently based on her religious convictions, and may have been trying to compel her to alter or violate her beliefs. While this is not the end, the Sixth Circuit reversed the order for summary judgment and sent the case back to the district court.
The Eleventh Circuit decided another similar case, Walden v. CDC, on February 7, 2012. Ms. Walden was a counselor in a CDC program. She upset a lesbian client when she told the client that she would need to refer her because of her personal values. CDC spent considerable effort with Ms. Walden trying to find ways to refer gay and lesbian clients without making them feel worse because of Ms. Walden’s objections to their lifestyle. Ultimately, the CDC laid off Ms. Walden. She filed suit, and the district court granted summary judgment against her.
The circuit court affirmed the district court. It considered Ms. Walden's free exercise rights and concluded that Ms. Walden was not laid off because of her religious beliefs, but because of concern that she would convey her reasons in unacceptable ways to clients who were already in a vulnerable state.
The tension in these cases is between the therapist’s religious beliefs and her duty not to impose those values on a client, particularly given the imbalance of power between a therapist and a client, and the client’s already fragile emotional state (since people do not usually seek therapy when they feel fine). While there is no final legal answer, some principles seem to apply. A therapist may not be asked to change her religious beliefs, but under the ACA Code of Ethics, she is asked not to impose them on a client. Values-based referrals are proper under the ethical code if done tactfully, so as not to wound the client, and should be done if the therapist cannot provide what the client is seeking.