NASW Social Work Talks - EP 143 - What Social Workers Need to Know About the Supreme Court's Decision in Chiles v. Salazar

Episode Date: May 12, 2026

In this episode of Social Work Talks, we break down the Supreme Court's ruling on conversion therapy bans, free speech, and the growing debate around "talk therapy." Our host NASW Member and Social Worker Lorrie Appleton sits down with our guest NASW Deputy General Counsel Ashlee Fox, JD, MSW, who leads the National Association of Social Workers Legal Defense Fund. Learn why many experts believe this case could have far-reaching implications for professional standards, evidence-based practice, and the future of mental health care. Tune in for this important conversation every social worker should hear. #MentalHealthAwarenessMonth #SocialWorkTalks #SocialWork #MentalHealth #Therapy #NASW #ConversionTherapy#BehavioralHealth

This episode of Social Work Talks is sponsored by the University of Cincinnati Online. So welcome to Social Work Talks. I'm your host, Laurie Appleton. Listeners, have you heard about the Supreme Court's decision in Childs v. Salazar? In 2019, Colorado's minor conversion therapy law prohibited licensed professionals from practicing conversion therapy with minors. Kaylee Childs, a licensed mental health counselor, challenged the Colorado law, arguing it violated her First Amendment right to free speech. On March 31, 2026, the Supreme Court issued an 8-1 decision reversing the ruling of the lower courts supporting Childs' assertion. The court held that Colorado's law constituted viewpoint discrimination. The case has been sent back to the federal district court, where Colorado must now prove

its law meets strict scrutiny, the highest and most demanding constitutional standard. This decision has far-reaching implications for licensed mental health professionals across the country, raising urgent questions about the future of conversion therapy bans, authority of state licensing boards, and the distinction between evidence-based clinical practice and constitutionally protected speech. Folks, have I gotten your attention yet? We are privileged to hear from our guest, Ashley Fox. She leads the NASW Legal Defense Fund, where she develops innovative educational programming and oversees member consultation services, providing social workers with timely, practical resources to navigate legal challenges. Ashley holds a JD and an MSW

from Georgia State University and a BA from Spelman College. Now, as a footnote, listeners, you will be hearing from inquiring social workers who took the time to write in their questions. So thanks so much for joining us, Ashley. Thank you so much for having me. I'm really excited to have this conversation today with you, Lori. Me too. So my first question may be a bit challenging. For those of us who are not familiar with the case, will you provide us with a summary using layman's language? It's important that we all understand the particulars in this case. Yes, and I think that's a really good point for us to start at because it is a case that is really important. And I think a lot of times what the takeaway is, is being a little missed.

So just building off of your great introduction, like you stated, Colorado passed a law in 2019. And this law prohibited licensed counselors from practicing conversion therapy, specifically with minors. This was about minors. And a licensed counselor, her name, Callie Childs, I think that's how you pronounce it. She challenged this law and she argued that because she's only using conversation when she's working with her clients. She's only conversing with them. She's not using any physical techniques, no medications, that restricting what she says violates her First Amendment right to free speech. And what we learned is that the Supreme Court in a shocking eight to one decision agreed with her. And what I really want the

takeaway to be is the court's reasoning. And I think that's really going to build the foundation for our discussion today. And so what the court reasoned is that Colorado's law allowed a counselor to say, I can help you accept your sexual orientation, but it prohibited the counselor from saying, I can help you change it. The court called that unconstitutional viewpoint discrimination. That is essentially the government is picking one side of a debate over the other. This is gender-affirming care versus conversion therapy. And so because of that, the case has been sent back down to the lower courts, as you mentioned, and it now must meet the highest constitutional standard in order to enforce

this ban, which is strict scrutiny. And I have to say that only a few laws can survive such a strict scrutiny review. With that being said, it's also very important to say what the court did not say. The court did not say that conversion therapy is safe or effective. That's important. The ruling was about how specifically Colorado's law was written, not about the impactful, harmful impact of conversion therapy. So you used the word shocking. I think that's a very, very good word. And we likely have assumptions regarding the practice of conversion therapy. So as you talked with us, I think that those assumptions are important to understand. So will you provide us a bit more detail regarding the intent of conversion therapy? That's a great question. And I think it's really important for us to understand. So the intent, very simplistically, of conversion therapy is the idea that you can change a person's sexual orientation or gender identity. And the premise is that being gay, lesbian, bisexual, or transgender is a disorder that can be fixed or corrected. However, we know this is not true in medical and mental health organizations, including the APA, the American Psychiatric Association, the American Medical Association, as well as NASW has rejected that premise entirely. And also, I want to discuss just historically, conversion therapy used deeply harmful physical techniques like electric shocks. Those methods, I believe, have largely disappeared.

I would hope so. But what remains today is primarily talk-based. And talk-based is when a counselor uses conversation to steer a client towards changing who they are. The intent is the same, and the harm is just as real, whether you're using physical or just talking to a client. This can hurt the person. individuals that have spoke about the harmful impacts of conversion therapy have discussed lasting depression anxiety ptsd and even unfortunately suicidal ideation so the impact of conversion therapy is real and hard and then when you take that into consideration that this

ban was about minors, you can just imagine how harmful it can be and detrimental it can be for minors that encounter conversion therapy. I don't know about you listeners, but I would love to do a whole podcast on just that answer. So thank you for giving us some more guidance. And I want to take a little bit of a shift because we received a question from an NASW member in Maine, and she said, quote, the root of conversion therapy is in part a religious one. Since Colorado's law bans conversion therapy, is part of the ruling that the law violates the separation of church and state? And that's what she's asking. And Ashley, what are your thoughts about this intriguing question? You know, that really is an intriguing question, Maury, and it's a good one.

And I understand exactly where the member is coming from with this question. So I do want to answer it carefully because it touches on something real. But first, the short answer is no. The court's ruling was not based on the separation of church and states. The First Amendment does contain two religion clauses. That is the establishment clause as well as the three exercise clause. But that was not what was up for debate and discussion when we're talking about Childs' case. Childs did not make a religious liberty argument in her case. So therefore, the court did not really rule on that one. The ruling was primarily based on the free speech clause. So not the establishment clause, not the free exercise clause, the free speech clause.

And the court found that Colorado's law discriminated based on viewpoint. Not that it violated anyone's religious freedom. So that's an important distinction to make and why this really wasn't about religious freedom. That said, this member's question is an important one and it's right. Conversion therapy has deep roots in religious traditions and religious liberty arguments have been raised in numerous cases. It just wasn't raised in this one. Practitioners and organizations have argued that banning conversion therapy infringes on the free exercise of religion. But that was not the basis for this decision. And so what the court has decided for this is that it was a speech question, not a religion question. That is so helpful for us to

know because we could all go down rabbit holes about different things regarding this case. Childs, the petitioner in this case, is asserting that she is simply providing, which goes to your point, Ashley, quote, talk therapy, end quote, which she views as a First Amendment right to free speech. It appears that her premise dilutes the mandated standards, ethics, and practices for social workers, psychologists, psychiatrists, physicians, and others, and that you and everyone collaborating together certainly makes a lot of sense. And there are critical distinctions that you started to talk about between talk therapy and services provided by licensed mental health professionals. Do you want to add anything to that? So that's absolutely right, Laurie. And it's really an important distinction that you're bringing out this argument of talk-based therapy. So Chow's arguments and what the court has accepted is that she treats the clinical conversation as constitutionally equivalent to any other speech.

But that framing erases everything that makes clinical practice clinical. When a licensed social worker in LTSW, when an LPC, when a psychiatrist, when a psychologist, when they sit with a client, they are applying graduate-level training, evidence-based methods, and years of supervised practice. They absolutely operate within a relationship that is grounded in legal dutiness, where we understand that we have to work with the client's best interests. We have the duty to do no harm. We have to maintain confidentiality, informed consent. These are all legal duties that a clinical social worker, licensed counselor, these are all things that they bring to the clinical relationship. A standard of care exists precisely because the clinical relationship is like no other

conversation that you're having with a friend, with a colleague. It's different. And what concerns me deeply is what happens when we say this talk-speech therapy is the same as free speech, you know, this argument that's getting picked up. We cannot use this argument to move other arguments forward, and I want to highlight that. I know some social workers are wondering whether this ruling can be useful, particularly for protecting gender-affirming care in states where it's restricted. And we want to rely on this argument that Childs has brought to the conversation, this free speech argument. But here's the risk in bringing that to the arguments. If you accept that therapy is speech and not treatment, then our profession is conceding something that would undermine the very framework that gives social workers the professional authority.

You know, that argument would take away everything that social workers do in specialized training, in their legal duties, and they're subject to their standard of care. These are all things that social workers are bound by. And the it's just talking argument is a door that once it's opened, it's very difficult to close. You understand what I'm saying, Lori? We don't want that argument to be used. I get it. I get it. And I want to advise listeners, because of my experience in learning about this case and you helping me understand more, talk therapy. Look for that phrase. It has slipped into the

public vernacular. Social workers are on a very, very slippery slope, which requires swift and powerful action to prevent the universal perception that we are merely just talking. You will now start to see that phrase. It's showing up. And we're not just talking, as you said, we're talking with evidence-based methodology. This episode of Social Work Talks is sponsored by the University of Cincinnati Online. Are you looking to advance your impact in social work? The University of Cincinnati's Online Bachelors of Social Work is designed for working professionals ready to take their next step. Learn 100% online with opportunities for field education in your local community.

Build skills in advocacy, case management, and community support. Prepare for professional social work roles and future graduate study. Explore the online Bachelor of Social Work from UC at online.uc.edu slash BSW. shimon an nasw member in maine asked an interesting question um he said how is nasw advocating to prevent harm to lgbtq plus individuals families and communities who will be harmed by practices like conversion therapy that's a big question and something that NASW is continuing to evaluate. How can we continue to support our members? What can we do on the front lines? And so I want to provide some information on what NASW is doing and what we will

continue to do. Legislatively, the ruling identified a specific flaw in how Colorado's law was written. Justice Hagan's concurrence signaled that a viewpoint-neutral law regulating therapeutic speech might survive scrutiny. NASW chapter executive directors have been on the ground getting conversion therapy bans passed and supporting the passing of conversion therapy bans. And so what this decision actually does is it gives us clear guidance on how those laws need to be written to hold up and forth. And so that is an actual information that we can take from this case and how we can use it. It's very important to understand what your state chapter is doing. Our chapter executives are amazing at the advocacy

in the work that they're doing and the laws that they're getting passed. In conversion, therapy vans is one of them. So we need to make sure that we continue to support them in those efforts. Beyond legislation, the NSW Code of Ethics, the practice standards, the political guidelines, those carry real professional consequences. These are things that employers have, that malpractice insurers use, that even with civil litigation that attorneys rely on

when they are representing families that have been harmed, right? They rely on these standards. They look to them to say what an ethical social worker would do. So even when licensing boards are facing legal constraints, other accountability mechanisms remain.

And I think that's important to remember. And the most important thing I can say is that Our ethical obligations have not changed. Social work speaks, which is our policy handbook, has not changed. It is very clear where we stand on conversion therapy. Conversion therapy is incompatible with social work ethics. And that is true regardless of what the courts decide. So let's summarize for a second.

So you have encouraged us and proposed that we advocate, support state and federal legislative efforts to protect minors from harmful practices and uphold evidence-based affirming standards of care in social practice. Do I have that right? Absolutely. Absolutely. A lot of our statements, this is what NASW has said that social workers can do. And we've also outlined exactly what NASW has done. Excellent. Did the NASW Legal Defense Fund play a role in acting as a conduit between NASW and the courts? Yes. And I thank you so much for bringing up the Legal Defense Fund. It is the arm of NASW that provides legal information and support to our members. And it's also what allows NASW to show up in courts as an institution. So in this case,

we joined Amika Spreeth along with the American Psychological Association and 12 other medical and mental health organizations presenting the social work professions positioned directly to the U.S. Supreme Court. But that's not the only time that we've done this. This is not a one-time thing for LDF. The LDF joins amicus briefs throughout the year before the U.S. Supreme Court, before state Supreme Court, before appellate courts. Any time a case impacts social workers or the communities we serve, we need one of the honor briefs that goes before a judge to provide that social work perspective. And we try to do that as much as possible. And I also want to highlight that beyond the courts, the LDF runs the LDF help desk, which is where we really want

every social worker listening to know about. It is where members can call in on Tuesdays and Thursdays to ask legal questions in real time. Someone's going to answer and they're going to speak with you. And although we can't provide specific legal advice, we can provide useful information and resources. So if you're practicing in a state where there's a gender affirming care ban and you're not sure how that impacts you in your practice, that's a call for the LDF help desk. if you've received a subpoena and you don't know your next steps, that's a call for the LDF help desk. We will walk you through that process. It's genuinely a valuable resource, and I really want to encourage everyone to use it. I'm going to go ahead and plug in our website.

It's www.socialworkers.org forward slash about and then forward slash legal defense line. Excellent. That's really good to know. And we'll be talking about where you can find more information within this podcast. Now, I'm going to talk to you, the listeners. I'm looking right at you. I have always believed if it is to be, it's up to me. This case acts as an alert to all of us to raise our voices when we hear language which does not comport with our professional code of ethics and standards. Our profession depends on it. So thank you, listeners, for tuning into this episode of Social Work Talks. We hope this program has enticed your curiosity and created questions which will lead you to become involved in rich,

meaningful discussions. You can find more information about the topic, the NASW Legal Defense Fund, and efforts being conducted at the NASW Colorado Chapter in the show notes section of socialworktalks.org. Thank you for listening.