A message from the Nebraska Psychological Association

Yesterday, the Supreme Court of the United States issued its decision in Chiles v. Salazar, an 8–1 ruling addressing Colorado’s law protecting minors from conversion therapy delivered through talk therapy. The Court held that, as applied to speech-based psychotherapy, Colorado’s law regulates speech based on viewpoint and must be reviewed under the most rigorous First Amendment standard. The case now returns to the lower court for that review. NPA shares the concerns stated by the American Psychological Association about the ruling.

This is a significant legal development with implications for how states regulate psychotherapy and other speech-based health care. It is equally important to be clear about what this decision does and does not mean.

What This Decision Does Not Mean
This ruling does not:

• find conversion therapy to be safe, effective, or ethical
• change the overwhelming scientific consensus that conversion therapy is harmful
• alter psychologists’ ethical duties to avoid harm and practice within the standard of care
• eliminate licensing board discipline, malpractice exposure, or civil liability after harm occurs

The scientific and professional consensus remains unchanged: conversion therapy is harmful, especially for children and adolescents. Major medical and mental health organizations, including American Psychological Association, continue to reject it as unsafe and unsupported by evidence.

The Court addressed constitutional limits on one type of preventive state regulation. It did not validate the practice itself.

Why This Matters in Nebraska
This decision is especially relevant in Nebraska because our professional regulatory system relies on licensure standards and unprofessional conduct rules to protect the public. Nebraska law defines unprofessional conduct broadly as any departure from acceptable and prevailing standards of practice or professional ethics, even when no injury has yet been proven.

That means Nebraska psychologists remain fully accountable for:

• harmful or deceptive treatment
• practicing outside professional competence
• violating evidence-based standards
• conduct detrimental to the public interest

Nebraska licensing law still allows complaints, investigations, and discipline when clinicians depart from prevailing standards.

Implications for Teaching and Supervision
This ruling also matters for training clinics, supervision, and graduate education in Nebraska. While constitutional limits may affect certain state bans, educators, supervisors, internship sites, and training directors still retain responsibility to teach and evaluate the standard of care. This ruling does not change how psychologists need to approach training, supervision or teaching.

Courts may define constitutional limits on state regulation, but psychologists still define competence, supervision standards, and professional formation.

The Uneven Application Problem Still Matters
Across the country, courts and policymakers sometimes treat counseling conversations as protected speech when the goal is to restrict preventive regulation, yet treat similar clinical conversations as regulable conduct when restricting access to affirming or evidence-based care. Nebraska has already seen this tension in statute. For example, Nebraska law specifically identifies gender-affirming therapy (speech) for minors as grounds for professional discipline. When similar clinical interactions are categorized differently depending on the population affected, it raises serious concerns about consistency, fairness, and whether vulnerable communities are receiving equal protection under professional regulation. For psychologists, this is not only a constitutional issue — it is also a public protection and health equity issue. 

The Nebraska Psychological Association remains committed to:

• protecting the public from harmful mental health practices
• supporting evidence-based and affirming care
• preserving fair and consistent regulatory standards
• educating members and the public about legal developments affecting psychotherapy

Our ethical obligations remain unchanged: do no harm, protect vulnerable populations, and provide evidence-based care.

NPA’s DEI and Legislative Committees will continue monitoring how this ruling may affect Nebraska law, professional regulation, and member education. We anticipate future opportunities for member education and advocacy related to consumer protection, licensure authority, and access to safe evidence-based mental health care. If you are interested in working with NPA on these issues, please contact our Executive Director at npa@nebpsych.org.

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