2012, on the other hand, the U.S. Court of Appeals for the 6th
Circuit remanded to the district court a case involving another
student expelled from a counseling program for refusing to
serve a gay client, asking that court to determine if religious
discrimination had occurred and prompting the program to
settle with the student.
In 2011, Arizona enacted a law preventing psychology,
counseling and social work programs from taking action against
students whose religious beliefs run counter to serving certain
clients, as long as they consult with supervisors about how to
avoid harming those clients. Legislators in two other states —
Michigan and Tennessee — have proposed similar legislation.
APA opposes such laws, says Forrest.
“Our position is that the training of psychologists requires
that students become competent to deal with a wide cross
section of future client populations and that trainees are not in
the position of dictating which populations they will or will not
see,” she says. “Those responsibilities rest with the faculty and
supervisors of professional psychology training programs.”
To help programs balance the need to produce competent
professionals while respecting students’ beliefs, the APA working
group has developed a pedagogical statement, sample program
policies, a flow chart that gives training programs step-by-step
guidance on preventing and responding to conflicts, and other
materials. The working group is also creating resources for state
psychological associations lobbying against conscience clause-
related legal cases or legislation.
The main idea undergirding the group’s materials and
workshops is psychology’s responsibility to prepare a workforce
trained to meet the needs of a diverse client population.
Attaining competence to work with a diverse public isn’t
optional, says Forrest, explaining that students can’t simply opt
out of training they don’t agree with. While there may be times
when reassigning a client to a different trainee would be best
— to make. Students who can’t or won’t attain competence in
serving all clients will be placed on remediation. If that fails, the
student may be dismissed.
Trainers have responsibilities, too. They need to respect the
fact that it can take a while for students to figure out how to
maintain their personal beliefs while still providing competent
care, for example. And they need to avoid acting in a way that’s
hostile to trainees’ religious beliefs, practices or values.
The working group’s stance doesn’t just apply to religious
students, Forrest emphasizes. It applies to any students with
beliefs that might conflict with providing competent care. “We
can’t allow a student committed to antiracist work to refuse to
provide services to clients with racist beliefs, for example,” says
Transparency is key, she says. Education and training
programs should promote these ideas in their admissions
materials, orientations and curricula so students with strong
beliefs fully understand training expectations.
Proposed revisions to APA’s Standards of Accreditation
in Health Service Psychology make these ideas much more
explicit, says Kathleen J. Bieschke, PhD, who heads Penn State’s
department of education psychology, counseling and special
education and serves on both the working group and APA’s
Commission on Accreditation. The proposed revisions are
expected to be approved this year.
“Our job is to hold students to developing the competence
to maintain who they are while providing high-quality services
to their clients,” says Bieschke. “The proposed standards make
it clearer that we expect programs to train students to navigate
these kinds of values differences.”
In the practice arena
In response to state legislation that would affect psychologists
in practice, the APA working group has expanded both its
membership and its focus.
Nebraska legislators have repeatedly introduced the
Health Care Freedom of Conscience Act, which would allow
“Institutions can’t afford to let their psychologists pick
and choose which clients they will see or not see based
on their personal beliefs. It could create organizational
nightmares and would be counter to a mission to
provide compassionate care to all.”
Linda Forrest, PhD
University of Oregon