Legal, Social, Political, and Ethical Perspectives on Sexuality in Therapy Case Study

Introduction

A 32-year-old David struggles with his sexuality issues, which is why he came to seek my therapeutic help. He currently dates another financially stable man who is committed to the relationship. However, David is concerned about his future with another man because many of his male friends disapprove of homosexual relationships.

It is important to note that his currently divorced mother accepted him as he is. In addition, I am apparently about to meet David’s partner at my husband’s birthday party. Given these circumstances, this paper focuses on David’s case from legal, social, political, and ethical perspectives to determine the best practice.

Legal Framework

The legal framework is of particular value when studying the phenomenon of discrimination. It promotes equality and diversity and provides the context within the anti-discriminatory practice. The 1998 Human Rights Act embodies the European Convention on Human Rights (ECHR) into governmental law (Wolfsteller, 2020). For example, institutions in Wales, Northern Ireland, and Scotland perform their functions as per the rights laid out in the ECHR. More specifically, convention rights cover the teaching and learning environment, including freedom of thought, expression, religion, peaceful assembly, association, and freedom from interference.

Meanwhile, the Equality Act outlaws discrimination in various aspects of social life. In short, it states that it is socially unacceptable to discriminate against people who are not legally protected (Davillas & Jones, 2021; Lowndes, 2020). Apart from that, the Equality Act calls to actively advocate for people being discriminated against by race, age, sex, disability, reassignment, maternity and pregnancy, religion and belief, marriage and civil partnerships, and sexual orientation (Davillas & Jones, 2021; Vincent & Chiwandire, 2019). More specifically, the Act covers the public sector’s equality duties that require public bodies to eliminate discrimination, victimization, and other misconduct.

The notion that individual freedoms can be lawfully restricted if one’s behavior is categorized as a criminal offense has dramatically contributed to reducing the occurrence of discrimination. The specific acts that refer to freedom restriction include the Public Order Act of 1994, the Crime and Disorder Act of 1998, and the 1997 Protection from Harassment Act (Hamin & Rosli, 2020; Igwe, 2018; Lowe, 2022). The Acts and recent legislations, such as the Serious Organized Crime and Police Act 2005 and the Protection of Freedoms Act 2012, generally limit behavior that incites racism and inequality, provokes fear, and causes harassment (Amankwaa, 2019). Overall, based on the acts’ content, it can be concluded that legal practices aim at ensuring that services are accessible and fair to everyone.

Within the boundaries of the current case, I will have to work with the issue of the patient’s – David’s – doubts regarding his sexuality. First of all, I have to keep in mind his right to the freedom of thought and expression according to the ECHR to avoid biased judgment. Moreover, I would also draw his attention to this matter, highlighting that external opinions – namely, the opinions of his close friends – should not interfere with his decision-making.

Second, this case falls under the protection of the Equality Act since it refers to David’s sexual orientation. I might remind him that he is, in many ways, protected against severe forms of discrimination, such as intimidation and harassment, to contribute to his self-confidence. Allowing David to relax and not feel threatened can improve his psychological stability and well-being.

Social and Political Context

Despite the laws protecting human rights, discrimination persists in modern society. Undeniably, laws that previously endorsed discrimination have mostly been removed from legislatures, and apparent barriers to equality and diversity have been erased (Hamin & Rosli, 2020; Igwe, 2018; Lowe, 2022). However, while modern law is capable of dealing with cases of direct discrimination, it fails to defeat the unconscious bias toward minorities (Jalil & Oakkas, 2018).

The most challenging aspect of dealing with unconscious bias is that “unconscious” is genuinely challenging to control. According to Matthew (2018), several general interventions can ease the situation surrounding bias in the healthcare field, such as counseling and education, clinical interventions, and other long-lasting protective interventions. In this context, unconscious bias training can help raise my awareness of different perspectives and beliefs (Fuller & Murphy, 2022). These aspects may affect my opinions on discrimination based on experiences, beliefs, societal stereotypes, background, and cultural context.

Apart from stereotypes and prejudice, another fundamental concept of discrimination is oppression. In this context, practicing active consciousness can help me learn about various forms of oppression and create an appropriate social therapist-patient relationship. Regarding the given case scenario, David may feel oppressed due to the hetero-normative social tendency. According to Javaid (2018), it refers to heterosexuality being compulsory and views other sexuality facets as a deviation.

Thus, I must engage in anti-oppressive practice and provide more sensitive services by responding to David’s needs rather than drawing attention to societal tendencies. One more aspect of therapeutic practice is the therapist’s position of power. Psychology practitioners and health professionals exercise power in their work with patients, including assessment, decision-making, and interventions. Therefore, I must be constantly aware of power dynamics in therapist-patient relationships and create some form of empowerment to help patients realize their power.

Straying off from my perspective on the matter, I will frame our therapies according to Clarkson’s model. I will establish and maintain the working alliance while ensuring that David views our communication as an honest, reparative relationship (McLeod, 2019). To do so, I will utilize transference and countertransference tools to explore David’s past experiences and expectations in the triangle of insight framework. Transference implies letting the patient revive his past experiences and analyze them with the therapist’s help (McLeod, 2019). Countertransference refers to the therapist’s response to the patient’s experience (McLeod, 2019). The latter tool can bring more harm than good, depending on whether it is proactive or reactive.

Consequently, I will focus on distinguishing David’s feelings from my past and issues. Additionally, I will not let resonating emotions cloud my analytical judgment. David’s indecisiveness in whether or not to commit to his current partner might be influenced by his parents’ divorce, which he witnessed as a kid. Therefore, there is a strong probability that working through this insecurity will provide many valuable insights into the current situation. In this context, I will cooperate with David to view his past from a different angle and, fortunately, repair hidden ruptures.

Ethical Perspective

In general, people who are discriminated against sensitive issues, such as sexuality, find it hard to trust other people, making it fundamental in my relationship with David. In the given case scenario, one ethical dilemma is posed by the circumstances surrounding David’s partner.

1. My husband invited David’s partner to a birthday party, where I would have to meet him in person.
2. The knowledge regarding our meeting might interfere with the therapeutic process and cause an unnecessary distraction for David.
3. The ethical issue is mine since I am the one who decides how to work through it.
4. According to BACP (2018), the issue has to be considered a dilemma because it arises from BACP principles contradicting each other.
5. On the one hand, I should adhere to the principle of beneficence, a commitment to promoting David’s well-being (BACP, 2018). In this context, any distractions can harm the therapy since well-being is its outcome. Thus, I suggest not telling David about the interaction. On the other hand, I face principles of non-maleficence and integrity – avoiding potential harm and being honest with David (BACP, 2018). From this perspective, I should have informed David as soon as possible about the interaction.
6. If David somehow learns about the interaction and that I hid it from him, his trust will be affected.
7. If I am indecisive, I can consult with my colleagues or supervisor. Overall, the dilemma is not complex enough to require further research.
8. The overarching ethical goal in this dilemma is to behave in David’s best interest.
9. If I inform him about the interaction, I do not see it as troublesome to explain the situation honestly and openly. This way, the damage to the therapeutic process would be minimal. Conversely, if I decide to hide the fact from David, it will not have any immediate consequences. However, David might eventually learn from his partner regarding our in-person meeting, which might trigger undesired thoughts and cause much more damage.
10. The ethical school of choice for the dilemma resolution would be the deontological, or duty-based, one. According to Stanescu (2020), this approach considers doing what is morally right as the best course of action. In this case, hiding anything from David is not morally right, so I will inform him of the interaction.

The outcomes of the situation are yet to be discovered. However, the resolution will provide valuable insight for my future practice. David will understand my feelings and will not exaggerate the matter, making the impact on the therapeutic process minimal.

Conclusion

David’s case falls under the category of sexuality issues and is slightly complicated by an unlucky coincidence that raised ethical concerns. From a legal perspective, David deserves the treatment that would support his freedom of expression and adhere to an anti-discriminatory practice in terms of sexual orientation. From a social and political perspective, David has to be relieved from societal oppression and realize his ability to advocate for himself. The ethical dilemma caused by my unexpected meeting with his partner should be resolved immediately, with me confessing it and proving it does not relate to our therapeutic relationship.

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