Believe it…or not

New circumstances put a fresh emphasis on how political and social beliefs impact the relationships between psychologist and client

The United States 2020 Census results, released on August 12, confirms what many Americans already know: the US population is much more multiracial and more diverse than ever in history.1

While most Americans are more positive about racial and ethnic diversity,2 it appears to also trigger challenges. “The presidential election of 2020 is considered by many people to be historically contentious and reflective of strong differences and divides,” explained Scott A. Fischer, PhD, ABPP, representative of the APA Ethics Committee, during his APA 2021 Virtual session, The Ethics of Political Differences and Disclosure in Psychotherapy.

“These days, it’s not uncommon for a person to report estrangement from family, friends, coworkers, and others because of political differences. And this raises the question of the degree to which political differences impact the professional relationships between psychologists and their clients, the ethical implications of such differences, and the implications for psychologists about sharing their political beliefs with clients,” Dr. Fisher added.

The implications, Dr. Fischer emphasized, represent a hot topic among psychologists –as the psychologist’s professional world is a very different environment than it might have been 25 years ago, and yesteryear’s ethics codes may be outdated. “Psychologists are working in a political atmosphere that is increasingly polarized and they are in an environment where political beliefs are difficult to keep private.” 

Before any ethics code revisions can even be considered, Dr. Fischer suggests first shining a light on what he calls the elephant in the room. “The great majority of psychologists are left of center, so perhaps one lens for those revising ethics codes and practice guidance would be to ask if alterations are welcoming to a potential conservative client. Or, if you want to look at it another way, would this revision be welcoming to a radical leftist client—someone more liberal than most psychologists?”

In addition to that, is it even possible to treat a client whose political beliefs are abhorrent to the psychologist? “There appears to be a great increase in the phenomenon of finding beliefs we disagree with to be abhorrent, and psychologists are not immune to that,” Dr. Fischer stressed.

Public Knowledge

Participating in social media, Dr. Fischer pointed out, is one of the most common – and often seemingly innocent – ways to make one’s beliefs public knowledge. Although, some belief-sharing is unintentional. On this topic, Dr. Fischer shared and interpreted research addressing therapists’ intended versus unintended disclosure of political views to clients.3

“The study found that 50% of therapists believe that they have either explicitly or implicitly disclosed their political views to clients. The vast majority, 87%, report some discussion of political issues with clients,” Dr. Fischer said, and then he added an interesting note. “It was also found that most therapists’ guesses about their clients’ political beliefs closely mirrored their own political beliefs. In other words, therapists who describe themselves as Democrats are more likely to believe that the majority of their clients share these beliefs. The same is true for therapists who describe themselves as Republican or right-leaning. What this means is that either clients are self-selecting therapists with similar political beliefs or therapists are making inaccurate judgments about the congruence between their beliefs and those of their clients. It’s quite possible that both interpretations are true,” Dr. Fischer said.

True Colors

The concept of “colorized language” is another way psychologists may implicitly communicate their political beliefs.

“Colorized language refers to the use of the colors red or blue to designate conservative and liberal beliefs respectively. The basic idea is that people telegraph their political beliefs by the language they use,” Dr. Fischer explained.

Here are several examples of what Dr. Fischer described as colorized language.

  • Someone who uses the term “systemic racism” is more likely to be liberal-leaning, as a more conservative person might omit the word “systemic.”
  • The phrase “illegal immigrant” is likely to identify an individual as more conservative, since more liberal individuals tend to say “undocumented immigrant.”
  • “Reproductive freedom” and “canceled culture” are also terms more likely to be used by a liberal leaning individual.

“People can get in the habit of using these phrases, without any awareness of how the words telegraph their political beliefs to clients,” Dr. Fischer said.

Time for an Update?

“Political beliefs are not mentioned explicitly in the APA Ethics Code,” Dr. Fischer noted. “I don’t believe this is a deliberate oversight. But the fact that it isn’t in the ethics code underscores the point that this issue is of relatively new importance to psychologists.”

Here are a few areas where Dr. Fischer suggests that political beliefs might impact a psychologist’s ability to provide ethical treatment, and these beliefs might, therefore, drive Ethics Code revisions.

  • A lack of familiarity with certain political and cultural beliefs connected with a fringe political movement, such as QAnon, could block ethical treatment.
  • The issue of personal pronouns is a potential firestorm.
    • Some feel that personal pronouns may cause harm if a teen identifies as trans but later desists and suffers harm by premature treatment with hormones. “That may not be a mainstream view in our profession, but it is not an unprecedented view, either,” Dr. Fischer added.
    • Some psychologists feel that the personal pronoun issue might be off-putting to conservative clients.
    • Some psychologists feel that ignoring the personal pronoun issue will push certain potential clients away. “The trans client might view a psychologist who does not address the personal pronouns issue as alienating and discriminative. Might this violate the ethical standard?” Dr. Fischer asked.
  • Clients may present in ways that lead a psychologist to draw false conclusions. “If a client is wearing an hijab, you may draw conclusions about her social and political beliefs, and these assumptions may or may not be accurate,” Dr. Fischer said. “Many people associate strong Christian beliefs with political conservatism, but a person may be very publicly Christian and not be at all conservative. So, allowing people to reveal their beliefs on their time is a good practice and consistent with ethical awareness. It is also important to be mindful that your clients may be drawing conclusions about you – based on information that may or may not be accurate,” Dr. Fischer cautioned.

These are – or should be – the hot topics on every psychologist’s radar, Dr. Fischer advised. And while there are few yes/no, black/white, absolute answers yet, Dr. Fischer closed his session by adding, “I hope that as our political and social circumstances continue to change, that our ethical understanding of political differences and disclosure in psychotherapy will also continue to evolve.”

 

1. United States Census Bureau. 2020 Census Statistics Highlight Local Population Changes and Nation’s Racial and Ethnic Diversity
Available from https://www.census.gov/newsroom/press-releases/2021/population-changes-nations-diversity.html

2. Pew Research Center. Americans are more positive about the long-term rise in U.S. racial and ethnic diversity than in 2016
Available from https://www.pewresearch.org/fact-tank/2020/10/01/americans-are-more-positive-about-the-long-term-rise-in-u-s-racial-and-ethnic-diversity-than-in-2016/

3. Solomonov N, Barber JP. Conducting psychotherapy in the Trump era: Therapists’ perspectives on political self-disclosure, the therapeutic alliance, and politics in the therapy room. J Clin Psychol. 2019 Sep;75(9):1508-1518. doi: 10.1002/jclp.22801. Epub 2019 May 27. PMID: 31132301.