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The Therapist's Dilemma: Political Neutrality or Disclosure?

An important mental health issue

Key points

  • Many conservatives are reluctant to seek mental health treatment because of politics.
  • Psychology and mental health are predominantly liberal fields.
  • Mental health treatments should welcome everyone regardless of politics.

Should therapists disclose their politics to clients deciding whether or not to pursue a client-therapist relationship? Many mental health professionals choose to disclose demographic characteristics such as race, gender, and sexual orientation. Should politics be included on that list?

The mental health profession overwhelmingly has progressive politics (Silander et al., 2020) that also affect public attitudes toward science (Mather, 2021). Conservatives are underrepresented in academia (around 9% of professors are Republican; Shields & Dunn, 2016), psychology (10.5 liberal professors to 1 conservative professor; Duarte et al., 2015), and social psychology (Inbar & Lammers, 2012). Politics can affect clinical practice and psychiatrist Sally Satel recently wrote about the dangers of activism in the realm of therapy (“When Therapists Become Activists”; Satel, 2021).

In July of 2020, I wrote “Conservative Psychologist Wanted: Perceived Unwelcome, Many Conservatives Opt Out of Treatment”. I am not a clinician. I am trained as a researcher in experimental social psychology and I study attitudes, persuasion, implicit biases, stereotypes and discrimination. Experimental social psychology is foundational to both clinical and counseling psychology (Hendrick, C., 1983; Hendrick, S., 1983; McGlynn, 1987). As a professor of psychology for 20 years, I taught many therapists. People bring the psychological needs of their family and friends to psychology professors, and I referred many people to trained clinicians.

Since early 2016, I have been contacted by many conservatives who felt comfortable disclosing to me the challenges they faced getting mental health treatment. Their main concerns were being judged for their political values or a therapist who would actively try to change their fundamental values. Many confided that they had exactly these experiences with their therapists.

After the “Conservative Psychologist Wanted” article was published, I was flooded with many stories of bad experiences due to politically misaligned therapists and clients. The professional discussion centered around how to solve the problem. Should therapists disclose their political beliefs or not?

There is room for both. There are therapists who will not change their social activist agenda, and their work with their clients reflects that social justice commitment. For clients who match with those values, that is a good fit.

Like any other diversity characteristic, it is important that clients and therapists match on the things that are important to them. There is now a new movement and website devoted to conservative therapists. Though a small number of therapists choose to publicly identify as conservative, it is an option for potential conservative clients concerned with a mismatch.

The problem for the potential client who values politics is how would they know the politics of the therapist? Clients are quite capable of reading both overt and covert political virtue signaling cues, but clarity is ideal.

There are also many therapists who are politically neutral. This is my preferred option. I don’t care about the politics of my car mechanic—just fix my car! I don’t care about the politics of the civil engineer who builds the bridge I drive over—just build a good bridge! My preference is for a good therapist to do good work and leave politics out of the sessions, unless politics are truly at the root of the problem for the client. In such a case, I expect the therapist to discuss the case with a colleague to ensure their own biases were not shaping their perspective of the issue.

I know many good clinicians ranging from progressive to conservative. I would send any family or friends of any political leaning to them with no concern over indoctrination or judgment. I know of some bad ones as well, and I would not send anyone to them. I prefer a free-market solution, where therapists choose to disclose or not, with the caveat that it is necessary to have an overall mental health professional environment that is welcoming to all.

Clinical psychologists, counseling psychologists, LPCs, MSWs, etc. must pull together on the same team as mental health professionals to make everyone feel welcome to mental health treatment. A potential client’s mainstream political values should not be an obstacle to mental health treatment. Let’s all work together to iron out this wrinkle in mental health.

References

Duarte, J. L., Crawford, J. T., Stern, C., Haidt, J., Jussim, L., & Tetlock, P. E. (2015). Political diversity will improve social psychological science. Behavioral and Brain Sciences, 38, 1-58.

Hendrick, C. (1983). Clinical social psychology. A birthright reclaimed. Journal of Social and Clinical Psychology, 1, 66-87.

Hendrick, S. (1983). Ecumenical (social and clinical and x, y, z…) psychology. Journal of Social and Clinical Psychology, 1, 79-87.

Inbar, Y., & Lammers, J. (2012). Political diversity in social and personality psychology. Perspectives on Psychological Science, 7, 496-503.

Mather, R. D. (2020, July 16). Conservative psychologist wanted. Psychology Today (online)

Mather, R. D. (2021). The inclusion of conservatives in science: Acknowledging liberal and conservative social cognition to improve public science attitudes. In J. D. Sinnott & J. S. Rabin, (Ed.), The Psychology of Political Behavior in a Time of Change (pp. 349- 363). Springer.

McGlynn, R. P. (1987). Research issues at the social, clinical, and counseling psychology interface. In J. E. Maddux, C. D. Stoltenberg, & R. Rosenwein (Eds.) Social processes in clinical and counseling psychology (pp. 14-25). New York: Springer-Verlag.

Satel, S. (2021, August 13). When therapists become activists. American Enterprise Institute (online)

Shields, J. A., & Dunn, J. M., Sr. (2016). Passing on the right: Conservative professors in the progressive university. New York, NY: Oxford.

Silander, N. C., Geczy, B., Marks, O., & Mather, R. D. (2020). Implications of ideological bias in social psychology on clinical practice. Clinical Psychology: Science and Practice.

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