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Do your politics impact your clinical effectiveness?

August 10, 2016
by Jamie Marich, Ph.D., LPCC-S, LICDC-CS, REAT, RMT
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Nothing makes my stomach turn quite so vigorously as when I see a helping professional make public social media posts supporting right wing causes or candidates. One moment in particular stands out. A psychologist who attended one of my trainings on trauma-informed care, complimenting me as an expert in my subject matter, soon revealed himself as a Second Amendment warrior on social media. His gospel devotion to Second Amendment rights in and of itself didn’t bother me. Rather, his public shaming of trauma survivor Rep. Gabrielle Giffords using a vulgarity sent me into a tailspin. How could he possibly work with survivors of trauma and violence, particularly female survivors, if these are his true beliefs?

The interplay between a professional’s personal values and showing therapeutically appropriate amounts of empathy, unconditional positive regard and compassion is discussed in most graduate ethics classes and continuing education seminars on ethics. I’ve consistently learned that you bring who you are into your clinical role, and your values shape who you are. Thus, the expectation to be “value free” is not realistic. However, part of being ethical is committing not to impose your value judgments on your clients. Doing this, whether directly or indirectly, overtly or covertly, can negatively impact the therapeutic alliance. As providers committed to providing affirming and responsive services to members of the LGBT+ communities, assuring for such ethical practices in our clinical services is important and part of our commitment to craft spaces that are as safe as possible for members of our communities to seek services. The attention stirred by the national presidential election is forcing us to re-evaluate with renewed vigor the importance of how a provider’s personal beliefs may impact their ability to offer affirming services.

And yes—engaging in such self-evaluation is a two-way street if we are considering the traditional Republican vs. Democrat binary in this discussion. We must consider this multi-faceted nature of such issues in our self-examination. I once had a client, after several sessions of general rapport building hopefully leading to some meaningful trauma work, go all “Barack Hussein Obama” on me. The client voiced their beliefs that Obama was a vicious Muslim who would be ushering in the end times and many other standard tenets of attacks against the president fresh off of a conspiracy theorist website. As someone who respects President Obama and voted for him twice, hearing this was difficult. I kept breathing and trying to maintain my commitment to walking in my clients’ shoes as an expression of empathy. I asked questions like, “How does all of this affect you?” and “What do these beliefs mean to you?”

Then my client dropped the bomb: “Well, what do you believe, Jamie?”

As I took a breath, a million clinical judgment questions and decision-making issues flooded me at once. Do I lie to maintain the rapport? Should I be honest in the spirit of authenticity? Do I ask why it matters to her? Should I directly confront her excuse making (i.e., blaming President Obama for her life being miserable)?

For better or worse, what ultimately came out was, “Well, my beliefs are different than yours. I hope that doesn’t get in the way of us still working together to help you reach your goals.”

The client persisted, “It doesn’t bother you that he’s a Muslim?”

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