Wayne has been living and working as a Licensed Professional Counselor (LPC) in Tennessee for the past three years. Prior to living in Tennessee, Wayne lived in Michigan where he completed his master’s in counseling. After graduating with his master’s degree, Wayne worked in a private practice, which allowed him to accumulate enough supervised clinical hours to become a LPC in Michigan. To date, Wayne has maintained licenses in both states because he has thought about moving back to Michigan. His current practice in Tennessee is thriving. He has branded himself well and has done a good job marketing his practice on various websites including a reputable nationally known website. He sees clients both in-person and via telehealth.
Last month, Wayne received a call from Casey. On the intake form, Casey identified himself as a 19-year old, African American male who lives in Michigan. Casey found Wayne on a nationally known website where counselors typically advertise. Wayne maintained advertisements as a counselor for both Michigan and Tennessee. Because Casey preferred telehealth counseling, Wayne agreed to take on Casey as a client. In their first two virtual-sessions together, Casey told Wayne that he wanted to work on managing depressive episodes and bouts of anxiety. However, at the end of their most recent telecounseling session, which was the third session, Casey nervously announced to Wayne, “I have been struggling with something for a long time…. and ummm… think that I…. ummm…. may be… I think I …umm…may be trans…and would like you to….ugh…start calling me Cassie and want to try…mmm…to use she/they pronouns.” Because it was the end the session, Wayne said, “Well, we can talk about this at our next session.”
After the session, Wayne struggled with what he was going to do because he holds fairly conservative beliefs about LGBTQ+ issues, but really struggles to understand transgender issues. After about a week of processing and engaging in his own research about what he was going to do, at the next session, he informed Cassie, “I can longer work with you because your presenting issues conflict with my ‘sincerely held principles’ and according to Tennessee Law, I do not have to work with you.” With tears in her eyes, Cassie said, “But your online ad said you worked with LGBTQ+ issues.” Wayne replied, “That box must have gotten checked by mistake, and I am sorry about that.” Wayne kept the session rather short and recommended to Cassie that she go back to the website to find another counselor in her area.
A few days later, Wayne received a call from a hospital in Michigan informing him that Cassie had attempted suicide and would be hospitalized for the next several days. Given that Wayne was the last clinician on record, the hospital sought his involvement and recommendations for Cassie’s future care.
Wayne feels stuck and unsure how to proceed.
Sample Ethical Standards Involved (Not Exhaustive):
- Client is a resident of MI, counselor using his MI license to see this client. However, Counselor who lives in Tennessee is using Tennessee law (SB 1566) to not see MI client.