Tag: mental health ethics

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Conversion Therapy, SCOTUS, and the Ethical Mandate to “Do No Harm”

conversion therapy

The recent U.S. Supreme Court decision striking down Colorado’s ban on conversion therapy has reignited a critical conversation at the intersection of law, ethics, and mental health care. While the ruling reframes certain aspects of conversion therapy as protected speech under the First Amendment, it does not, and cannot, override the ethical responsibilities that govern licensed professionals.

For therapists, the takeaway is clear: just because conversion therapy may become legal again in Colorado does not mean it is ethical, safe, or professionally acceptable.

Conversion Therapy Remains a Harmful and Discredited Practice

Conversion therapy, also known as sexual orientation or gender identity change efforts (SOGICE), has been rejected by every major medical and mental health organization in the United States. Decades of research consistently demonstrate that conversion therapy is ineffective and associated with significant psychological harm.

Peer-reviewed studies highlight serious risks, particularly for LGBTQ+ youth who are subjected to these practices. These harms include:

  • Increased depression and anxiety
  • Heightened substance use
  • Elevated risk of suicidal ideation and suicide attempts

Green et al. (2020) found that exposure to sexual orientation or gender identity change efforts (SOGICE) was associated with significantly higher odds of lifetime suicide attempts. Similarly, Ryan et al. (2018) reported that LGBTQ youth exposed to conversion therapy were more than twice as likely to attempt suicide compared to those who were not.

These findings are widely accepted across the mental health field. Conversion therapy is not a neutral intervention. It is a harmful one.

Ethical Codes Are Clear: Do No Harm

All licensed mental health professionals, whether psychologists, counselors, social workers, or marriage and family therapists, are bound by core ethical principles. Chief among them is nonmaleficence, the obligation to “do no harm.”

Practicing sexual orientation or gender identity change efforts (SOGICE) violates this principle in multiple ways:

  • It relies on interventions lacking empirical support
  • It creates foreseeable psychological harm
  • It undermines client identity and autonomy
  • It falls outside accepted standards of care

Professional organizations such as the American Psychological Association (APA), the American Counseling Association (ACA), and the National Association of Social Workers (NASW) have all explicitly condemned conversion therapy.

Even if courts limit the ability of states to ban sexual orientation or gender identity change efforts (SOGICE), ethical standards remain fully enforceable through licensure boards.

The Supreme Court’s ruling addresses constitutional law and not clinical best practice. This distinction is essential.

A therapist engaging in conversion therapy may not face criminal penalties under state law, but they are still accountable to their licensing board. That accountability carries real consequences.

Therapists who practice sexual orientation or gender identity change efforts (SOGICE) risk:

  • Formal ethics complaints
  • Investigation by licensing boards
  • Suspension or revocation of their license

Licensing boards are tasked with protecting the public. When a clinician engages in a practice known to cause harm, the board has both the authority and the responsibility to intervene.

In other words, sexual orientation or gender identity change efforts (SOGICE) can still cost a therapist their career even if it is technically legal.

Why Reporting Conversion Therapy Matters

Given this legal shift, accountability becomes even more important. If sexual orientation or gender identity change efforts (SOGICE) begins to resurface under the protection of this ruling, harmful practices mustn’t go unchecked.

Clients, family members, and professionals should take action when they encounter conversion therapy:

  • Report practitioners to state licensing boards
  • Document harmful interventions
  • Support individuals harmed by conversion efforts
  • Advocate for affirming, evidence-based care

Reporting is not punitive. It is protective. It safeguards vulnerable individuals and upholds the integrity of the mental health profession.

The Role of Ethical Practice in Mindful Ecotherapy

At the Mindful Ecotherapy Center, we emphasize approaches that honor the whole person, including their identity, lived experience, and connection to the natural world. Conversion therapy stands in direct opposition to these values.

Mindfulness-Based Ecotherapy and Acceptance and Commitment Therapy (ACT) both emphasize:

  • Acceptance rather than a change of identity
  • Compassion and psychological flexibility
  • Alignment with authentic values

These approaches are grounded in evidence and ethics, unlike conversion therapy, which attempts to suppress or alter core aspects of self.

Conclusion: Ethics Must Lead the Way

The Supreme Court’s ruling on conversion therapy may change the legal landscape, but it does not change the science. It does not change the data. And it does not change the ethical obligations of mental health professionals.

Conversion therapy remains a harmful, discredited practice that violates the foundational principle of “do no harm.”

Therapists are entrusted with our clients’ well-being. That trust demands adherence to ethical standards, even when the law creates ambiguity. If conversion therapy re-emerges, the responsibility falls on the profession and the public to ensure it is challenged, reported, and ultimately rejected.

References

Green, A. E., et al. (2020). Association of conversion therapy with depression and suicide among LGBTQ individuals. JAMA Psychiatry, 77(1), 68–76.

Ryan, C., et al. (2018). Parent-initiated sexual orientation change efforts with LGBT adolescents: Implications for young adult mental health and adjustment. Journal of Homosexuality, 65(2), 159–173.

American Psychological Association. (2015). Guidelines for psychological practice with sexual minority persons.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Ending conversion therapy: Supporting and affirming LGBTQ youth.

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Edinburgh: Ethics and Ecospirituality-Ethical Practice at the Intersection of Mental Health and Nature

Edinburgh
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At the Mindful Ecotherapy Center, PLLC, we spend a lot of time talking about healing, presence, and the quiet intelligence of the natural world. What we don’t do is pretend that moving therapy outdoors magically removes the need for ethical rigor. If anything, it raises the stakes.

Ecotherapy and nature-based counseling are gaining momentum as mental health professionals rediscover what should have been obvious all along: human beings are not separate from nature, and psychological healing often deepens when people reconnect with the living world. From forest walks to outdoor mindfulness practices, nature offers regulation, perspective, and a sense of belonging that no office décor can replicate.

But stepping outside the therapy room doesn’t mean stepping outside ethical responsibility. It means expanding it.

Dr. Charlton Hall, MMFT, PhD, founder of the Mindful Ecotherapy Center, addresses this directly in his presentation, Ethics and Ecospirituality: Ethical Practice at the Intersection of Mental Health and Nature. His work reflects a simple but inconvenient truth: good intentions are not enough. Ethical practice requires foresight, structure, and accountability, especially when the setting becomes less controlled and more dynamic.

Edinburgh Conference: Confidentiality

One of the most immediate concerns in ecotherapy is confidentiality. In a traditional office, privacy is engineered. Doors close, white noise hums, and interruptions are minimized. In a park, forest, or shoreline, none of that is guaranteed. Other people exist. Sound carries. The world refuses to cooperate with your treatment plan.

This means therapists must proactively address privacy risks with clients before sessions ever begin. Informed consent becomes more than a formality. Clients need to understand what can and cannot be controlled, and together, therapist and client must decide what level of exposure is acceptable. Ethical ecotherapy doesn’t ignore these risks. It names them clearly and plans around them.

Edinburgh Conference: Boundaries and Dual Relationships

Then there’s the issue of boundaries and dual relationships, which become far less theoretical once you leave the office. Community spaces blur roles. You might run into a client at a trailhead, a farmer’s market, or a meditation group. Suddenly, the clean lines between “therapist” and “person who also exists in the world” start to dissolve.

Dr. Hall emphasizes that maintaining professional boundaries in these contexts requires intentionality. Therapists must establish clear agreements about public interactions, social overlap, and expectations. Without that clarity, what feels like a casual encounter can quickly become ethically murky.

Edinburgh Conference: Risk Management

Risk management is another area where ecotherapy demands maturity. Nature is not a controlled environment, no matter how poetic people get about it. Weather shifts. Terrain changes. People trip, get lost, or underestimate their physical limits.

Ethical practice means anticipating these risks and preparing accordingly. This includes assessing client suitability for outdoor work, having emergency protocols, understanding the environment, and maintaining appropriate insurance and documentation. The goal is not to eliminate risk entirely. That would require locking everyone back indoors. The goal is to manage it responsibly.

Edinburgh Conference: Cultural Humility

Dr. Hall also highlights the importance of cultural humility, especially when working with ecospirituality. Nature-based practices often intersect with Indigenous traditions, spiritual worldviews, and cultural relationships to land that are not interchangeable or up for casual borrowing.

Ethical ecotherapy requires practitioners to examine their own assumptions and avoid appropriating practices without understanding their origins and significance. Respecting the land also means respecting the people and traditions connected to it. This is where ecotherapy moves beyond technique and into responsibility.

Edinburgh Conference: Integration

Finally, there is the question of integration. Just because nature is beneficial doesn’t mean every intervention is appropriate for every client. Ethical clinicians must ground their work in evidence-based practice while thoughtfully incorporating nature-based elements. This isn’t about replacing clinical skill with scenic views. It’s about enhancing therapeutic work in ways that remain accountable, measurable, and client-centered.

Dr. Charlton Hall brings decades of experience as a Marriage and Family Therapist, educator, and developer of mindfulness-based ecotherapy approaches. His work spans counseling, recovery programs, and international teaching, all grounded in the integration of mindfulness, evidence-based psychotherapy, and nature connection. At the Mindful Ecotherapy Center, that integration is not treated as a trend. It’s treated as a discipline.

Edinburgh Conference: The Takeaway

The takeaway is straightforward, even if people prefer to romanticize it: nature can deepen healing, but it doesn’t excuse sloppy practice. Ethical ecotherapy asks more of clinicians, not less. It requires awareness, preparation, and a willingness to hold complexity instead of pretending it isn’t there.

If you’re practicing, or planning to practice, ecotherapy in places like Edinburgh or anywhere else where people and landscapes intersect, the question isn’t whether nature helps. It’s whether you’re prepared to do the work responsibly.

Because the forest doesn’t care about your intentions. Your clients, however, should be able to trust them.

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