"Preserving religious freedom in the mental health profession"

[BlueDreams]

3 hours ago, MormonVideoGame said:

You have an MD? a PhD in Psychology? AASECT certified? 

Respect the worldview of the patient as long as his/her worldview isn't the problem. 
Patients need to be careful too with the therapists because "therapist" Title is not protected like MD, PhD are. 

I'm an LAMFT until probably January when I'll be an LMFT. I'm a state licensed therapist....I'm pretty sure I've already told you and the people here more than once this exact same thing. At some point going over my credentials every time I talk about my field to the exact same person/people gets pretty annoying. As I mentioned, I'm not AASECT certified and just, ironically, had a conversation with my boss about this (who is). Though he did it for the business it would have minimal effect on my actual career or practice, but would entail tons of money being dished out for a piece of paper that tells me something I already do for a supervisor meeting that I already have to discuss and get tips that my boss has mentioned wasn't actually all that ground breaking or extra beneficial. I'm more likely to shoot for an MFT supervision certificate, which would actually help the business I am in when the time comes.

"Therapist" is regulated. And the type of therapist (SW, MFT, Clinical Psych, etc) by differing licensing boards (to be clear, AASECT is not a licensing board...it's more like a large guild with a certificate). There's a reason Dehlin (for an easy public example), who has a PhD, can not describe himself as a therapist but as a life coach. Because he's not met qualifications for licensing.

 

With luv,

BD

Edited June 20, 2017 by BlueDreams

[Scott Lloyd]

17 hours ago, Gray said:

It sounds like he might be obliquely referring to conversion therapy. If so, that's quackery and harmful, and should be banned under any circumstances.

But my response would really depend on what he has in mind, which is not made explicit in the piece you're quoting.

I was present for the entire speech and not one word was said nor even a remote hint made about "conversion therapy." I think that a ridiculous inference on your part. It was all about discrimination or the threat of discrimination in the mental health counseling profession on the basis of religious faith, a thing that is inherently unconstitutional in that it violates the First Amendment guarantee against abridging the free exercise of religion. 

Edited June 20, 2017 by Scott Lloyd

[thesometimesaint]

I can not tell my clients that I'm of any religion or none.

SEE

1.05 Cultural Competence and Social Diversity

(a) Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.

(b) Social workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and to differences among people and cultural groups.

(c) Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.

Edited June 20, 2017 by thesometimesaint

[thesometimesaint]

2 hours ago, Scott Lloyd said:

I was present for the entire speech and not one word was said nor even a remote hint msde about "conversion therapy." I think that a ridiculous inference on your part. It was all about discrimination or the threat of discrmination in the health care profession on the basis of religious faith, a thing that is inherently unconstitutiional in that it violates the First Amendment guarantee against abridging the free exercise of religion. 

The First Amendment is not a shield for the unethical treatment of our clients.

[Gray]

9 hours ago, clarkgoble said:

Depends on the nature of the evidence. Really weak evidence is ambiguous enough that I think you just have to say you don't know. i.e. treat it as non-evidence. Typically initial studies are wrong, but tell you where to direct further research.

Surely weak evidence is better than guessing blindly?

[Gray]

5 hours ago, Scott Lloyd said:

I was present for the entire speech and not one word was said nor even a remote hint msde about "conversion therapy." I think that a ridiculous inference on your part. It was all about discrimination or the threat of discrmination in the health care profession on the basis of religious faith, a thing that is inherently unconstitutiional in that it violates the First Amendment guarantee against abridging the free exercise of religion. 

Lacking a clarification, I suppose we just don't know for sure what he meant.

Religious discrimination is unconstitutional, but it doesn't automatically follow that everything you might interpret as religious discrimination actually counts as religious discrimination.

[USU78]

6 hours ago, Scott Lloyd said:

I was present for the entire speech and not one word was said nor even a remote hint msde about "conversion therapy." I think that a ridiculous inference on your part. It was all about discrimination or the threat of discrmination in the health care profession on the basis of religious faith, a thing that is inherently unconstitutiional in that it violates the First Amendment guarantee against abridging the free exercise of religion. 

Talking points rarely have much to do with the subject at ✋.

[pogi]

14 hours ago, Gray said:

It should, in my view, be banned.

I am sorry you feel that way and can only hope that such will never be the case.

Holistic nursing principles were the cornerstone of my practice as a hospice nurse...and for good reason.  There is plenty of good evidence for the benefit of not just implementing physical/emotional interventions, but also spiritual interventions.

Good article here (Read this section: RESEARCH ON THE ROLE OF SPIRITUALITY IN HEALTH CARE)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305900/

A few interesting snippets:

Quote

 

One study showed that spiritual well-being was related to the ability to enjoy life even in the midst of symptoms, including pain. This suggests that spirituality may be an important clinical target (13).

Spiritual beliefs can help patients cope with disease and face death. When asked what helped them cope with their gynecologic cancer, 93% of 108 women cited spiritual beliefs.

Bereavement is one of life's greatest stresses. A study of 145 parents whose children had died of cancer found that 80% received comfort from their religious beliefs 1 year after their child's death. Those parents had better physiologic and emotional adjustment. In addition, 40% of those parents reported a strengthening of their own religious commitment over the course of the year prior to their child's death (18).

Spiritual commitment tends to enhance recovery from illness and surgery. For example, a study of heart transplant patients showed that those who participated in religious activities and said their beliefs were important complied better with follow-up treatment, had improved physical functioning at the 12-month follow-up visit, had higher levels of self-esteem, and had less anxiety and fewer health worries (19).

 

As a case manager, not only did I create spiritual interventions and implement them as a nurse based on the individual needs of my patients, but I also coordinated Chaplain services.  Chaplains are an integral part of the health care team (not just hospice).

To ban holistic care would be a tragic mistake!
 

[clarkgoble]

4 hours ago, Gray said:

Surely weak evidence is better than guessing blindly?

Not usually. Seriously. But more importantly the big issue is when weak evidence is used to deny other methods.

At a certain point we should just be up front to people that science doesn't know. Appeals to the best evidence when the evidence is lousy is just misleading at best.

Edited June 20, 2017 by clarkgoble

[Scott Lloyd]

7 hours ago, thesometimesaint said:

The First Amendment is not a shield for the unethical treatment of our clients.

CFR that LDS Family Services treats clients unethically or that Elder Wickman was advocating such a thing.

 

[Scott Lloyd]

4 hours ago, Gray said:

Lacking a clarification, I suppose we just don't know for sure what he meant.

 

This is nutty. Nothing whatsoever in his speech could be reasonably construed to mean he was referring to "conversion therapy." You are imposing guilt by innuendo and it is shameful. Stop it.

Quote

Religious discrimination is unconstitutional, but it doesn't automatically follow that everything you might interpret as religious discrimination actually counts as religious discrimination.

I believe Elder Wickman made a good case that threats of religious discrimination are emerging in the mental health care profession.

Edited June 20, 2017 by Scott Lloyd

[cacheman]

59 minutes ago, pogi said:

I am sorry you feel that way and can only hope that such will never be the case.

Holistic nursing principles were the cornerstone of my practice as a hospice nurse...and for good reason.  There is plenty of good evidence for the benefit of not just implementing physical/emotional interventions, but also spiritual interventions.

Good article here (Read this section: RESEARCH ON THE ROLE OF SPIRITUALITY IN HEALTH CARE)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305900/

A few interesting snippets:

As a case manager, not only did I create spiritual interventions and implement them as a nurse based on the individual needs of my patients, but I also coordinated Chaplain services.  Chaplains are an integral part of the health care team (not just hospice).

To ban holistic care would be a tragic mistake!
 

I have a lot of respect and admiration for people who work in hospice care.  Thanks!  I believe that people in hospice care deserve to have whatever spiritual / emotional / psychological tools at their disposal.... particularly those that are most meaningful and helpful to them.  From the data you present, it's clear that removing the spiritual component from hospice care would be a travesty for many people.

This highlights the difficulty of developing policies that ensure equality in mental health care.  Our state passed a law a year or two ago that allows mental health professionals to opt out of services when they feel it goes against their religious beliefs.  There are some safeguards in place in the event that a patient is in immanent harm, and that require a healthcare giver to refer individuals that they opt not to treat.  In general this seems like a decent option that has everyone covered.... but I'm still unsure.  I wonder about examples such as school counselors, where students might be limited to the one counselor.  I also know that the professional organizations for mental health practicioners were opposed to the bill, and that makes me question it.  It's been interesting to read through this thread and see the different perspectives.

cacheman

 

[Scott Lloyd]

4 hours ago, USU78 said:

Talking points rarely have much to do with the subject at ✋.

It's even more egregious when said talking points are used for well-poisoning, as Gray is endeavoring to do here.

 

[Scott Lloyd]

8 hours ago, thesometimesaint said:

I can not tell my clients that I'm of any religion or none.

SEE

1.05 Cultural Competence and Social Diversity

(a) Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.

(b) Social workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and to differences among people and cultural groups.

(c) Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.

Your quotation does not sustain your contention.

 

[thesometimesaint]

How so?

[Scott Lloyd]

28 minutes ago, thesometimesaint said:

How so?

Nothing in what you quoted could, on its face, be construed to mean what you asserted, that you "can not tell [your] clients that [you're] of any religion or none."

That may be your personal policy, but there's nothing in what you quoted that gives any apparent mandate for it.

Edited June 20, 2017 by Scott Lloyd

[Gray]

1 hour ago, Scott Lloyd said:

It's even more egregious when said talking points are used for well-poisoning, as Gray is endeavoring to do here.

 

It sounds like you're trying to poison the well by accusing me of well poisoning. The discussion isn't furthered when you automatically assume the worst about people you disagree with. 

[Daniel2]

On ‎06‎/‎19‎/‎2017 at 11:44 AM, thesometimesaint said:

As a mental health professional it is against our Code of Ethics to refuse treatment, or force my religious beliefs, on my clients.

While advocacy for or against certain values, ethics, and behaviors is and should understandably be part of any Faith, and although my belief in and unwavering support of religious freedom in America leads me to protect and preserve any and all religions' members' ability to practice their Faith so long as we all abide by the same laws governing us all, don't harm others, nor unjustly curtail others' civil rights and legally-recognized freedoms, it seems to me that any religion who's most notable and/or noticeable actions to non-members are to obsessively protect their own legal ability to refuse service to non-members or those who live by the tenants of their Faith is not likely to fare well. 

In today's increasingly diverse and increasingly global community, defining one's selves by exclusion (in other words, when others' perceive any organizations' main messages consist more about standing against something--or especially against some-one/s--rather than in support of something/one) doesn't strike me as a recipe for sustainability or long-term success.

And certainly from a personal standpoint, that message tells me all I need or want to know about any such Faith and the God it proposes is worthy of adoration or emulation.

Edited June 20, 2017 by Daniel2

[thesometimesaint]

4 hours ago, Scott Lloyd said:

CFR that LDS Family Services treats clients unethically or that Elder Wickman was advocating such a thing.

 

Never said they did. Just that it is not the shield you claim.

[thesometimesaint]

3 hours ago, Scott Lloyd said:

Nothing in what you quoted could, on its face, be construed to mean what you asserted, that you "can not tell [your] clients that [you're] of any religion or none."

That may be your personal policy, but there's nothing in what you quoted that gives any apparent mandate for it.

Because of transference issues we must not posit our religious views onto our clients.

[Daniel2]

On ‎06‎/‎19‎/‎2017 at 0:03 PM, BlueDreams said:

Interesting. I'm not sure how I feel about it, as a mental health professional, myself. It's a fine line. And in the mental health profession we definitely ride that line, I think. 

Currently in the mental health field there's a number of conflicting concepts in ethical treatment that can tie to this: The rule that you cannot simply deny service based off of religion, race, sexual orientation, etc. Mixed in with the general rule to do no harm. Mixed in with the ethos that if one does discontinue services that we give options for other forms of therapy or therapists to seek out. Because we're dealing with the mind, relationships, and personhood as opposed to the more physiological aspects of humanity, the balance can be far more sticky to get just right. 

Here's an example from my own boat. As a LDS sex therapist with an MFT degree, I can and will and have seen LGBT clientele. And will in the future.  But my clientele and current specialty focuses on religious heterosexual couples 9.9 times out of 10. It is what it is. I came to realize in my sexuality course, reading specific articles about sexual concerns for LGBT people that I would likely be a crappy therapist to go to for sexual concerns for LGB(and probably T, I just haven't had one yet)....because my knowledge in terms of sex therapy in this area is really really scant. So I would not feel comfortable helping a Same-sex couple with their sexual problems....not based on my own religious beliefs, but because I would feel really unqualified and would not be the best therapist to properly help them. Any other issue in this same area and I would be fine: helping with relational problems,  figuring out how or even if they want to express their sexuality in whatever way, weighing their varying identities to find a balance they feel at peace with...sure. No problem. But that one specific issue, not so much. So I would likely refer out. The next problem with that is, is there a therapist period that can be helpful and qualified in the region for them? Probably. But in some areas where there are very few options in mental health professionals, leaving them without help from you can be leaving them with subpar help or no help period. Which is worse. That changes the ball game, and I would need to take them with clear understanding as to my limitations as a therapist. 

I watched in smaller groups while at BYU, therapists wrestle with doing therapy for LGB couples (again, MFT....which means most of us are dealing with relationships/systems...ergo couples). I can understand some of their reticence. Luckily I assume many LGBT people also self-select therapists to meet up with their concerns. At first when I started self-selection by clientele would really really bother me. I would get a few who would assume my own behaviors and responses to situations based on one specific fact: I was LDS. They would asked just how LDS I was, some would have to convince their partner that I would be okay as a therapist, and others would want to make sure that religion would stay out of therapy.  Some of the most adamant have been people who are leaving/left the church. But at the same time I'm sure there are LDS who do similarly. Preferring therapists that "get them" or that seem more likely to promote similar standards. I think having the flexibility to pick and choose therapists on these bases makes sense. As is catering to specific demographics as a specialty (minorities, religious peoples, LGBT, etc) BUT on the therapists end there has to be at least some flexibility to meet with groups we may struggle with or not fully comprehend their issues. There's simply not a perfect therapist out there for every person and demographic niche.

The other issue is that to some extent I need to suspend my own personal preferences and beliefs. Not entirely, but enough that I'm not pushing my beliefs and attitudes onto my clients unnecessarily. Let's take abortion for a minute. When that comes up as an issue they're really really thinking about, I don't find it right for me to say: hey, you, don't do that! life is sacred!...though I do believe life is sacred, I would personally never get an abortion beyond really important medical reasons, etc. I don't label myself as pro-choice or pro-life, but I'm not a fan of elective abortions that are really about stupid choices more so than medical necessity, tight and difficult circumstances, or rape. But I can't just bring that up. I can explore their choice with them and I would think it would be also ethically unsound to let them go through it, without exploring, if they hold their own strong religious beliefs about abortion that may lead to later shame or grief for what they chose down the road. I will usually state that I have a bias, but that's just me and not this person currently thinking about it. 

I think both camps can be limiting in their scope of practice based on their beliefs and practices. I saw that once with an interview with LDSFS that I will not go in detail with here because I don't think it's necessary. And that therapists on the more secular end of things can end up isolating more religious clientele without meaning to. Both, I think they are two sides of the same coin: assuming they know the right way to do things and what should be, when they may not and may be inadvertently limiting their scope of treatment for specific demographics by assuming a blanket answer for all peoples. 

In the secular world, I remember the first time I went to this conference in AAMFT that had a presentation on spirituality in therapy. It was terrible. They were trying to incorporate spiritual concepts in an amorphous way that wasn't tied to any religion but could somehow apply to all. It felt like they just ended up taking the teeth out of religion as healing agents in people's lives. And were weary of talking about spirituality in their own constructed terms. In that sense I think the therapy world is still grappling with how to deal with people in people's terms, not just the secular formatting. And I do think that formatting can be limiting because it ignores large influences in people's life...or just acts really awkwardly with them. Whether one thinks things shouldn't entail religion, such as mental health, doesn't change the fact that many many people particularly in the US definitely do not separate the two. Done right, religion can be a powerful ally in the therapy world. Which I think LDSFS is one example of trying to broker it. I do think that shutting said things down would be a stupid move. I don't know how likely that is to actually happen currently, though.  

 

I do hope that we can maintain more flexibility in the Mental health field. Because it's needed. This isn't the same thing as the medical field, though there are definite efforts to make it as such. I think treating humans as a line of symptoms and clinical fixes is at some point bound to flop and make mental health fields less effective. But it is the push that I see happening at times in the Mental health field, insurance agencies, etc. I do agree that there needs to be protections to allow for more plurality in practices and ideologies. The more therapist feel like the humans they treat and are the greater the capacity for healing. 

 

With luv,

BD

  Well said, BD.  Thanks for sharing your approach and perspective.

[thesometimesaint]

16 minutes ago, Daniel2 said:

While advocacy for or against certain values, ethics, and behaviors is and should understandably be part of any Faith, and although my belief in and support of religious freedom in America leads me to support any and all religions' ability to practice their Faith so long as they abide by the same laws governing us all and don't harm others, it seems to me that any religion who's most notable and/or noticeable actions to non-members are to obsessively protect their own legal ability to refuse service to non-members or those who live by the tenants of their Faith is not likely to fare well. 

In today's increasingly diverse and increasingly global community, defining one's selves by exclusion (in other words, when others' perceive any organizations' main messages consist more about standing against something--or especially against some-one/s--rather than in support of something/one) doesn't strike me as a recipe for sustainability or long-term success.

And certainly from a personal standpoint, that message tells me all I need or want to know about any such Faith and the God it proposes is worthy of adoration or emulation.

As a voluntary organization I'm all for various religions establishing the rules of conduct for their own members. However when dealing with the public such voluntary religious organizations should have no expectation that their members rules apply to everyone here in this life.

[Daniel2]

1 minute ago, thesometimesaint said:

As a voluntary organization I'm all for various religions establishing the rules of conduct for their own members. However when dealing with the public such voluntary religious organizations should have no expectation that their members rules apply to everyone here in this life.

Well said. 

[Scott Lloyd]

23 minutes ago, thesometimesaint said:

Because of transference issues we must not posit our religious views onto our clients.

That's not what you said earlier. You said:

"I can not tell my clients that I'm of any religion or none."

[Scott Lloyd]

28 minutes ago, thesometimesaint said:

Never said they did. Just that it is not the shield you claim.

I never claimed the First Amendment is a shield for treating clients unethically. Nor do I believe such a thing.

Please address what I did say, not what I didn't.