Prof Juan A Nel

Deputy Chair: PsySSA Sexuality and Gender Division/

Co-project leader: PsySSA African LGBTI Human Rights Project

On 19 April 2018, the Psychological Society of South Africa (PsySSA) launched the South African practice guidelines for psychology professionals working with sexually and gender-diverse people. The launch was held at the Johannesburg Holocaust & Genocide Centre and attended by 120 people, including many leading scholars, practitioners and community activists in the fields of sexuality, gender and reproductive health. The number of attendees, feedback provided during the event, and the extensive media coverage (including in peak times on national television), are indicative that the guidelines are long overdue and much needed. For highlights of the landmark event, see http://www.psyssa.com/launch-of-practice-guidelines-for-psychology-professionals-working-with-sexually-and-gender-diverse-people-2/

Following a four-year development period, and based on the latest local, continental and global research, the guidelines document is a first for PsySSA and a first of its kind on the African continent. The 85-page document contains 12 practice guidelines, each providing a review of current knowledge, globally and particularly locally, followed by potential application in psychological practice. The guidelines build on PsySSA’s ground-breaking Position Statement on Sexual and Gender Diversity (PsySSA, 2013) and aim to increase psychological knowledge of human diversity in sexual orientations, gender identities, gender expressions and sex characteristics. Towards this end, the practice guidelines communicate an affirmative stance on sexual and gender diversity, including Lesbian, Gay, Bisexual, Transgender, Intersex and Queer+. They offer a blueprint for mental health service providers to respond to the wellbeing and human rights of all sexually and gender-diverse people. Aimed primarily at psychology professionals in South Africa, they are also applicable to all mental health professionals on the continent of Africa. The guidelines are consistent with the South African Constitution and its Bill of Rights (Republic of South Africa, 1996), the South African Health Professions Act and associated general ethical rules for health professionals (Department of Health, 2006), as well as the PsySSA Constitution (PsySSA, 2012). They supplement a harm-avoidance approach by outlining specific themes to consider in psychological research and practice.

Informed by an assumption that some readers may be unfamiliar with the history of the project[1] that led to the development of the practice guidelines, herewith related background information. After ratification by the PsySSA Council in 2013 of the precursory position statement, a larger working group was established in 2014, consisting of six core members and fourteen expert contributors/critical readers (a.k.a. ‘the extended group’) all of whom are listed in the Acknowledgement section of the guidelines document[2]. The core group (see picture below), each with expertise in different areas of sexual and gender diversity practice, was tasked with the drafting of different sections of the document. Over a two-year period, the core group had several meetings to consider literature and initial drafts of the practice guidelines. Drafts of the guidelines document was shared with the extended group for feedback on iterations of the guidelines, including specific input from experts in particular areas.

The term ‘guidelines’ refers to pronouncements, statements, or declarations that suggest or recommend specific professional behaviour, endeavours, or conduct for psychology professionals (American Psychological Association [APA], 2002)[3]. Guidelines differ from standards in that standards are mandatory and may be accompanied by an enforcement mechanism. Guidelines, on the other hand, are aspirational in intent. They are intended to facilitate the continued systematic development of the profession and to help ensure a high level of professional practice. They should not be construed as definitive and are not intended to take precedence over the judgment of a psychology professional. Practice guidelines essentially involve recommendations to professionals regarding their conduct and the issues to be considered in particular areas of psychological practice. Importantly, practice guidelines are superseded by state law and policy and must be consistent with the current ethical principles and codes of conduct applicable to psychologists (APA, 2002).

In September 2017 the PsySSA Council approved the PsySSA practice guidelines for psychology professionals working with sexually and gender diverse people on proviso that the suggestion by its Ethics Standing Committee to expand the guidelines to reflect a broader diversity competence was incorporated. Of course, the importance of diversity competence is undeniable in a multicultural society, such as South Africa, that has had its fair share of related difficulties, also in recent years. In this regard, the International Union of Psychological Science (IUPsyS) International Declaration on Core Competences in Professional Psychology[4] outlines work with diversity, including cultural competence, as key for psychology professionals. This set of competences are: 1) knowledge and understanding of the historical, political, social, and cultural context of clients, colleagues, and relevant others; 2) cultural humility; 3) respecting diversity in relevant others; 4) realising the impact of one’s own values, beliefs, and experiences on one’s professional behaviour, clients, and relevant others; 5) working and communicating effectively with all forms of diversity in clients, colleagues, and relevant others; and, 6) inclusivity of all forms of diversity in working with clients, colleagues, and relevant others (IUPsyS, 2016).

In this manner, the PsySSA practice guidelines for psychology professionals working with sexually and gender diverse people now become one of several sets of practice guidelines that still need to be developed, should the required resources become available to do so. Each set of guidelines in the series will address separate, but sometimes also intersecting[5] target groups (including, but not limited to, diversity based on race, ethnicity, culture, language, religion and/or spirituality; nationality, internally and externally displaced people and asylum seekers; socio-economic status, poverty and unemployment; physical, sensory and cognitive-emotional disabilities; etc.).

It is sincerely hoped that members of PsySSA with expertise related to the areas outlined above will rise to the occasion and undertake the development of the requisite practice guidelines. In so-doing, the profile of PsySSA, as Learned Society, and leader on the continent and globally will be further advanced in the interest of psychology professionals but also those they serve.

References

[1] This Arcus Foundation-funded project was a collaboration between PsySSA’s Sexuality and Gender Division, the International Psychology Network for Lesbian, Gay, Bisexual, Transgender and Intersex Issues (IPsyNet) and the PsySSA African LGBTI Human Rights Project.

[2] See https://docs.google.com/viewerng/viewer?url=http://www.psyssa.com/wp-content/uploads/2018/04/PsySSA-Diversity-Competence-Practice-Guidelines-PRINT-singlesided.pdf&hl=en_US

[3] American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060­1073.

[4] International Union of Psychological Sciences. (2016). International Declaration on Core Competences in Professional Psychology. Retrieved from http://www.iupsys.net/dotAsset/1fd6486e-b3d5-4185-97d0-71f512c42c8f.pdf

[5] Intersectionality in psychology, as a concept, acknowledges diversity and focuses on attending to all the different forms of oppressions that occur in society – the different ’isms’ – racism, ableism, heterosexism, sexism, classism, etc. and the ways they overlap and often reinforce a power that can potentially subjugate one cultural group over another. Being a minority within a minority (for example, being intersex and an immigrant) can deepen one’s sense of isolation and disconnection from the statistical and cultural majority. The APA (2012) notes that the cumulative effects of heterosexism, sexism, and racism, for instance, may put a person at special risk for stress, which adds to the vast range of contextual factors that worsen the effects of stigma. Multiple layers of discrimination that a person can potentially experience can create multiple and intersecting levels of stress.

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