Mental health clinicians are taught to introspect about the degree to which their own background, culture, values, and beliefs may affect their reactions to their clients, and to strive to maintain objectivity in the process of assessment, diagnosis, and treatment. Clinical social workers are the largest professional group providing mental health services in the United States, providing services in urban and rural outpatient and inpatient settings. Social workers are seen as different from clinical psychologists, psychiatrists, and other occupational groups that provide therapy in the emphasis that social work places on social justice, cultural competence, and respect for diversity. According to the National Association of Social Workers Code of Ethics, the social work profession requires its members to:
“[A]ct to prevent and eliminate…discrimination against any person, group, or class on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, or mental or physical disability.”
An ethical dilemma may arise when the religious or moral beliefs of the social worker interfere with the duty of all health care professionals to provide optimal service to clients and to “do no harm.” This issue made national headlines in a related context, when Kim Davis, a clerk in Rowan County, Kentucky, was jailed after defying a federal court order to issue marriage licenses to gay couples. Her action was based on her contention that to do so would violate her religious beliefs. In his ruling, Judge David L. Bunning of the United States District Court stated:
“If you give people the opportunity to choose which orders they follow, that’s what potentially causes problems.”
In defense of Davis, Ryan Anderson of the Heritage Foundation wrote:
“Ms. Davis felt she had to follow her conscience… That, after all, is what religious freedom and religious accommodations are all about: creating the space for citizens to fulfill their duties, as they understand them, to God—regardless of what the rest of us think.”
A similar conflict between religious faith and the requirements of one’s job or one’s profession may be seen in social work practice in the following scenario:
A clinical social worker has been treating a 25-year-old man for depression and anxiety. In the fourth session, the client reveals that he is gay, and that he has not “come out” to his family. He states that he has been involved in a committed, monogamous relationship with another man, and is contemplating marriage. He would like to inform his parents of this good news, but is fearful that they may angrily reject him. He is seeking counseling around this issue. The social worker belongs to a faith tradition that believes that homosexuality is a sin, and whose leaders have been prominent in opposing same-sex marriage. The social worker, who had up to this point believed that treatment was going well, is concerned that his own religiously based objections to homosexuality will interfere with his ability to provide unbiased mental health treatment services. The social worker contemplates informing the client that he will have to transfer him to another therapist.