Tag Archives: Psychology

Michigan’s Julea Ward “Freedom Of Conscience” Act Is Anything But

21 Jun

I’m gearing up to move across the country and don’t have a ton of time to write, but this is too ridiculous and awful not to mention. Michigan’s House recently passed HB 5040, which allows students in counseling, social work, and psychology programs to refuse to serve clients with ” goals, outcomes, or behaviors that conflict with a sincerely held religious belief.” 

According to Think Progress, Julea Ward “sued Eastern Michigan University after she was kicked out of her counseling graduate program — she refused to affirm a client’s gay orientation because it ‘goes against what the Bible says.’ A federal district court judge dismissed her suit, ruling that the university ‘had a right and duty’ to enforce the professional ethic rules that dictate its counseling accreditation… The 11th Circuit similarly ruled against Jennifer Keeton, who experienced a similar situation at Augusta State University in Georgia, stating that ‘counselors must refrain from imposing their moral and religious values on their clients.’  By advancing this legislation, Michigan lawmakers are essentially attempting to circumvent — if not dictate — counseling ethical standards.”

So what’s the big deal? How can a student counselor be expected to work with a client who is engaged in behavior he or she personally finds immoral? Shouldn’t the counselor’s values matter as much as the values of her or his client?

The answer is a definitive no. As noted by the 11th Circuit Court, counselors do not impose their moral and religious values on clients. By definition. End of story. Sure, there are some basic societal moral values we’re expressly charged to uphold – if a client tells me he’s abusing his children, I get to report that – but I don’t get to force my personal moral beliefs down my clients’ throats. Counselors choose to work in a profession in which they will be expected to help people whose background, behavior, and beliefs differ from their own on a daily basis. It’s the nature of the job. I wouldn’t become a veterinarian if I were opposed to working with animals, and I wouldn’t become a psychologist or professional counselor if I were opposed to working with people with backgrounds different than my own. There are plenty of career paths available to individuals who want to limit their helping services to heterosexuals and those who closely share their beliefs: religious counselor (for some institutions) and priest/minister (for some institutions) come to mind. (So does “typical conservative Republican lawmaker” if I’m being snarky.) The counseling programs attended by Julea Ward and Jennifer Keeton were nonreligious programs at secular institutions. Professional counseling is a secular job for individuals who are willing to honor its established code of ethics, and who are willing to do their best to avoid abusing the power they are entrusted with in the room.

Our ethical code (and by ethical code I’m talking about the one my classmates and I operate under, the APA Ethical Principles and Code of Conduct, although all ethical codes for counselors look more or less the same) specifically states the following:

Psychologists are aware of cultural, individual, and role differences, including those due to age, gender, race, ethnicity, national origin, religion, sexual orientation, disability, language, and socioeconomic status. Psychologists try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone unfair discriminatory practices.

Refusing to provide services to a person because of his or her sexual orientation is a discriminatory practice. The LGBT population is a minority population in the same way that Latino populations, African American populations, Jewish populations, and disabled populations are minority populations. A student in counseling would never be allowed to refuse to see a client because he was Black or Jewish or because she used a wheelchair. Sexual orientation is no different. Universities with programs in counseling and related fields must be allowed to uphold professional standards if we are to have a competent, ethical next generation of helping professionals.

But HB 5040 ensures that LGBT clients get services, right? Isn’t there a clause saying that clients must be referred to someone else who can provide them with the services they need?

That clause is present. And it’s true that psychologists are urged to consult on or refer clients with whom they feel they cannot competently work, and this could include a client with whom a therapist has difficulty empathizing for personal reasons. But – and this is a big but – you’re supposed to try to become competent. To unilaterally reject working with clients of a certain minority group without attempting to address the underlying personal bias present is to knowingly participate in or condone unfair discriminatory practices, practices our ethical code expressly forbids.

And frankly, refusing to work with LGBT clients (or clients in any minority group) directly opposes the ultimate goal of counseling: to help people recover from mental health problems. According to the APA, “Antigay victimization and discrimination have been associated with mental health problems and psychological distress (Cochran, Sullivan, & Mays, 2003; Gilman et al., 2001; Herek, Gillis, & Cogan, 1999; Mays & Cochran, 2001; Meyer, 1995; Ross, 1990; Rostosky, Riggle, Horne, & Miller, 2009).” Discriminating against LGBT clients perpetuates psychological problems. Transferring a client because of prejudice against his or her sexual orientation can convey extremely negative messages no matter how delicately the transfer is handled… and it’s a rare counseling student who has mastered “delicate” in the first place.

APA’s Code of Conduct states that “psychologists are aware of their professional and scientific responsibilities to the community and the society in which they work and live… Psychologists are concerned about and work to mitigate the causes of human suffering.” Bottom line: HB 5040 is designed to make it easier for psychologists and other counseling professionals to promote human suffering. Here’s hoping Michigan rejects it as the crappy piece of legislation it is.

Spoiled by PsycINFO

31 May

Ted and I are in the process of showing our house to potential buyers, meaning we spend a lot of time vacuuming and wondering what possessed us to choose long-haired cats instead of more practical pets like naked mole rats.

Oh wait, now I remember.

As per the holy wisdom of HGTV’s Designed to Sell, we’ve put a lot of time, money, and effort into staging our house (thanks again, by the way, to all the friends who helped us whip this place into shape!). Everything has been ruthlessly scrubbed, art and artificial plants are everywhere, the yard and garden look like someone actually cares about them,  the deck looks like someone actually uses it, all minor repairs have been made, and all evidence that real, slightly strange people live here has been erased as thoroughly as possible. There was no hiding my pet newt Spike, but hopefully people will just think he’s a deformed fish or something. Spike, UNLIKE our CATS, values our home-selling efforts and does not deposit hairs everywhere. Cats have a reputation for being imitative learners, so I make a point of complimenting Spike on his thoughtfulness whenever they’re around.

One thing I’ve realized as a product of house-staging is just how much I’ve come to rely on research to inform my decisions. Not just clinical decisions, although that’s where my research addiction began… we’re talking everyday, mundane issues. Should I be taking Omega 3 supplements? I’ll check PubMed. I don’t really feel like exercising. Is there any research that would justify me not exercising? (Not really, as it turns out. Maybe it’s just a matter of time?) This article says the “obesity epidemic” is overblown. What does the literature say? How does Ted’s and my retirement savings plan compare to the national average? Better see what I can pull up with Academic Search Premier. Don’t get me wrong – I’m as aware as anyone of the bias that can lurk in even the most objective-sounding study, and I’ve toyed with statistical software enough to know that you can often get the answers you’re looking for with enough prodding. Then again, “truth” is rarely clear-cut, and my faith in science as the best possible approximation of “truth” is still very much intact. My doctoral program has instilled a near-pathological need for empirical support in my brain, and with anecdotal methods still yielding less-than-accurate information (for example, our realtor insisted that we remove a peacock feather from its decorative location in our house because it would “bring bad luck”), I have yet to find a better source to guide my choices.

So you can imagine my disappointment when my search for controlled studies of how different house staging techniques affect buyer response yielded nothing. The only stuff I was able to dig up involved surveys of realtors (I might as well just watch HGTV) or comparisons of sale statistics for staged versus unstaged houses… funded, may I add, by the completely impartial Real Estate Staging Association. How’s a girl supposed to maximize sale potential in a research wasteland like this? I’ve been baking cookies like a fiend to make the house smell nice, but for all science knows, that could be totally pointless. It’s times like this that make me want to abandon my position of being a consumer, not a producer, of research… to get out there and answer important questions with the crushing power of SCIENCE!

But then I think about how much I hate SPSS. And who would fund a controlled study of house staging techniques, anyway? (The Real Estate Staging Association, duh.)

Anyone out there with loads of extra cash and a keen understanding of stats feel like doing some studies on home staging? I can provide cookies.

 

Psych Q&A: ADHD vs. Asperger’s, Hormonal Imbalances, Why Living Location Matters, and Bad Therapy

21 Nov

A friend teaching an abnormal psych course at a local community college asked me and a couple of my cohort members to serve as an “expert panel” for her class. I told her I’d be happy to help as long as the word “expert” stayed firmly between a pair of quotation marks. Her students ask great questions. Here are a few of them, with my two cents in response:

“On paper, ADHD and Asperger’s seem very different.  However, can a misdiagnosis happen to these patients?”

Kids with ADHD often miss the social cues their peers are able to catch, which can result in poor understanding of appropriate social behavior. They tend to have a hard time forming age-appropriate friendships, and eye contact is often poor. For these reasons (and possibly because Asperger’s is something of an “in vogue” diagnosis at the moment), we have quite a few parents who come into my departmental clinic for a child Asperger’s eval and leave with an ADHD diagnosis. In structured diagnostic observations, it’s usually not difficult to differentiate between the two. Kids with ADHD are more interested in reciprocal social interaction than kids on the spectrum, are more expressive, gesture normally, use normal intonation, and don’t have a clearly defined special interest. Autism spectrum disorders and ADHD are frequently comorbid, however.

“It seems like lots of disorders involve mood swings.  Are patients ever treated for hormonal imbalances?”

Psychologists who have had  exposure to integrated care models and cross-disciplinary research (and these days, most psychologists have) are very likely to consider the possibility of medical causes, although they can’t administer medical treatments themselves. When conducting intakes with clients in my departmental clinic, I usually ask about personal/family history of both medical and mental health conditions and any current medication or substance use. If a client has no relevant medical problems or family medical history, and did not begin using a new type of hormonal birth control or treatment around the time mood issues began, I usually abandon hope that a simple hormonal issue is implicated, especially if there’s a family history of mood disorders. (To be honest,  I’m always secretly hoping that clients struggling with fatigue or apathy will turn out to have hypothyroidism, because it’s so beautifully easy to treat. Unfortunately, hypothyroidism is much less common than mood disorders, and this rarely happens.)

 “Does where you live matter for developing mental illness?  Like in the city vs. suburbs, or East Coast vs. West Coast?”

That’s a tough question to answer. Cities often provide better access to care than more rural areas, so mental illness may be more quickly diagnosed and treated there. Poverty is more likely to be seen in inner cities or rural areas than suburbs, and since poverty is associated with increased risk of mental illness, you might see better mental health in suburbs if only because the people who live there tend to have a higher socioeconomic status. Supportive social networks serve as a protective factor, so living in isolation might put a person at higher risk for mental health problems than living near or among other people. Seasonal affective disorder (which isn’t a disorder in itself, but a depression modifier) is more common in less sunny states (like Washington state… might explain why no one in the Twilight movies ever seemed that cheerful). If you can find a relatively sunny place to live near people you like, a job with a middle-class salary, and good access to mental health care, your risk for mental health problems will be lower, although you’ll still be stuck with your genes.

“Does therapy ever make a person worse?  How often?  Why?”

Therapy can sometimes make things worse. I have no idea how often this happens, or how you’d track it. Sometimes it comes down to therapist variables – a therapist may behave unethically (it’s rare, but therapists do occasionally take advantage of clients), leading questions or comments might be directed toward a suggestible client, or a client may be so put off by a therapist’s personality, technique, or ignorance to cultural variables that he doesn’t seek psychological services he needs in the future. Sometimes it comes down to errors in treatment: some interventions are helpful for some disorders but contraindicated for others (ex: behavioral activation in the form of intense exercise can produce great results for a person with anxiety or depression, but it’s a bad choice for a client with an eating disorder). Psychology has a long history of unhelpful and dangerous treatments, including but not limited to rebirthing, “boot camp”/”scared straight” interventions for conduct disorder, recovered memory techniques, conversion therapy, and so on. Researchers can do a pretty good job of identifying treatments that don’t work, but it takes a lot of time and money to do this. As a client, you always have the right to ask your psychologist what techniques he/she plans to use and whether there’s research support for them. If a technique isn’t research-supported, it doesn’t necessarily mean it will be harmful, but it has yet to be proven that it works. On the whole, research indicates that therapy is an effective treatment for psychological disorders, and people with mental health conditions will generally benefit from it. You’re more likely to get worse by not going to therapy than you are by going.
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