If this bill becomes law, counselors could refuse to see clients for almost unlimited reasons. For instance, a counselor could refuse to see a lesbian simply because of her sexual orientation, or to see a couple involved in an interfaith relationship. A counselor who is an atheist could refuse to see a Catholic client—and the list goes on.

For people seeking counseling because they are faced with a critical dilemma in their lives and need objective guidance, allowing mental health professionals to discriminate could cause grave damage. Many who need care already face significant barriers, including trauma, marginalization, and a historic distrust of mental health providers. For some—like a woman who wants to escape her abusive spouse or a gay teen being bullied, for example—this bill could affect their very survival.

Turning away clients because of personal religious beliefs creates unethical barriers to access to care. Some places—such as schools—only have one counselor. If a school counselor refused care to a student, that child would have no other option to get the care he or she needed. Tennessee also has many rural communities that have few providers. If there is not another counselor nearby, it may be challenging or impossible for a client to get the child care, transportation and time off required to travel for treatment. Additionally, there may not be another provider within a reasonable distance that accepts a client’s insurance.

Referring a client to another counselor is not the same as a doctor making a referral to a specialist. A doctor refers a patient to a specialist because that specialist has different training from the referring doctor in an area where the patient needs particular assistance. This bill would allow referrals not just in cases where there is a need for specialized training or expertise, but simply because a counselor wants to use religion to discriminate.

The ethics of all major counseling professions prohibit unfair discrimination against clients. The American Association of Christian Counselors, the American Association of Pastoral Counselors, the National Association of Social Workers, the American Counseling Association, the Association of Marital and Family Therapists, and the American Psychological Association, among others, all have such expectations in their ethical codes. It is not the state government’s place to legislate the ethics of a profession.

Disagreeing with a client or being different from a client does not necessarily impair competency. All counselors inevitably work with clients who are different from them. Counselors are trained in school and in continuing education in methods to address and validate their personal feelings while still applying best practices to help their clients.

This bill could jeopardize counselors’ participation in managed care networks. If the network determines that the ethical standards of professional counselors in Tennessee differ materially from other states, they may no longer credential and include these professionals in their contracts. This hurts counseling professionals, who may struggle to find work or establish independent practice. It also harms the agencies they serve, which may need to find and replace staff to meet managed care credentialing requirements to maintain their contracts.