CACREP's Control Over Counseling: Is Your Therapist Compromised?

How accreditation power is shaping a new generation of ideologically-driven counselors.

Oct 07, 2024

We need to talk about the standards for mental health counseling education. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) is a non-profit organization that wields tremendous influence over mental health counseling education. Like most accreditation bodies, its original mission was to ensure the quality of education students and the government were funding. In practice, it hasn’t worked out as planned.

How Accreditation Makes Education Worse

There are at least two big problems with the accreditation model. The first is the assumption that what makes for good education is a settled question. It’s not. Standards encourage education to remain static, and instead of fostering innovation, they stifle it.

The second issue is that accreditation bodies, with unchecked power, can establish an orthodoxy in professional education. This allows them to inject ideology into the system, which then gets accepted as 'settled knowledge,' even if it's completely false. This is exactly what's happened in counseling.

CACREP’s New 2024 Standard Introduction

The best way to understand the problems in CACREP standards is to look at them. They cover every aspect of how counseling programs should be run, from how they should focus their hiring, who they should admit as students, what their mission and vision should be, and guidance on the curriculum.

Right from the introduction, CACREP lets you know that it has two goals. First is to push counseling education programs, “to consider to what end they engage in program evaluation and student assessment toward strengthening the counseling profession.” This is an odd goal, considering the objective of counseling should be to improve the mental health of clients. Making the profession look good, how ever that is defined today, is not necessarily linked to improved client outcomes.

While it can be easy for everyone to agree that having sex with a client or getting a client to do your taxes for free are objectively working against the client’s best interest, beyond that, therapy can be a murky business. Therapy involves working through painful emotions before feeling better. It is the quality of the relationship between the practitioner and the client that seems to have the most importance in achieving a productive outcome, not theory or training.

The process by which therapy heals is still so mysterious, that there is little explanation of why some practitioners have results that are head and shoulders above others. In other words, we don’t know what makes therapy work. Yet CACREP wants counseling programs to lead with an agenda that, ‘strengthens the counseling profession.’

CACREP’s second goal is even more sinister. Their, “standards were written with the intent to promote a unified professional counselor identity.” Aren’t we all wondering what the heck that must mean? While its newly published standards do have a glossary, “professional counselor identity” is not one of the terms defined there. As one of two overarching objectives for the entire standard, it speaks volumes that it is undefined.

They note that these 2024 standards, “came at a time when the United States and many parts of the world were addressing issues in diversity, equity, inclusion, belonging, and access.” This is an opinion, that hardly represents the dynamics at play. That it is mentioned, does seem to be a justification for what follows.

These guidelines cover large swaths of important psychological fields. The document even points this out. “The eight specialized practice areas that CACREP accredits: addictions; career; clinical mental health; clinical rehabilitation counseling; college counseling and student affairs; marriage, couple, and family counseling; rehabilitation counseling; and school counseling.”

The Meat of the Standard

To further illustrate what CACREP is demanding from accredited colleges and universities, I’m going to let the standards speak for themselves.

H. The counselor education program has a process for identifying underrepresented populations and makes continuous and systematic efforts to recruit, enroll, and retain students that enhance and support the diversity of the program.
I. The counselor education program intentionally creates and effectively maintains an inclusive and equitable learning community that respects individual differences.
J. Entry-level admission decision recommendations are made by the counselor education program and include consideration of each applicant’s

3. potential success in forming effective counseling relationships with diverse populations.

M. The student handbook, for all program delivery types, includes:

8. diversity, equity, inclusion, and accessibility policies;

N. Syllabi consistent with program delivery types are available to students enrolled in the course at the beginning of each academic term and include:

6. diversity, equity, inclusion, and accommodation statement;

Core counselor education faculty must have full-time appointment to the counselor education program. Core faculty must meet one of the following qualifications:

1. have an earned doctoral degree in counselor education, preferably from a CACREP-accredited program

The counselor education program has a mission statement that:

3. reflects counseling practice in a diverse, multicultural, and global society with marginalized populations;

Diverse Learning Community:

As part of identifying underrepresented populations and the continuous and systematic efforts to recruit, enroll, and retain a diverse group of students and faculty, the counselor education program analyzes, by program delivery type and CACREP specialized practice area, demographic data with regard to:

a) Students:

1) applicants,

2) enrolled students, and

b) Full-Time Faculty:

1) (if applicable) applicants for open faculty positions,

2) employed faculty,

Curriculum
Ethical behavior, diversity, equity, inclusion, and critical thinking are integral to counselor preparation and should be infused throughout the curriculum. Diversity refers to all aspects of intersectional and cultural identity.

Curriculum
B. SOCIAL AND CULTURAL IDENTITIES AND EXPERIENCES

1. theories and models of multicultural counseling, social justice, and advocacy

2. the influence of heritage, cultural identities, attitudes, values, beliefs, understandings, within-group differences, and acculturative experiences on individuals’ worldviews

3. the influence of heritage, cultural identities, attitudes, values, beliefs, understandings, within-group differences, and acculturative experiences on help-seeking and coping behaviors

4. the effects of historical events, multigenerational trauma, and current issues on diverse cultural groups in the U.S. and globally

5. the effects of stereotypes, overt and covert discrimination, racism, power, oppression, privilege, marginalization, microaggressions, and violence on counselors and clients

6. the effects of various socio-cultural influences, including public policies, social movements, and cultural values, on mental and physical health and wellness

7. disproportional effects of poverty, income disparities, and health disparities toward people with marginalized identities

8. principles of independence, inclusion, choice and self-empowerment, and access to services within and outside the counseling relationship

9. strategies for identifying and eliminating barriers, prejudices, and processes of intentional and unintentional oppression and discrimination

10. guidelines developed by professional counseling organizations related to social justice, advocacy, and working with individuals with diverse cultural identities

11. the role of religion and spirituality in clients’ and counselors’ psychological functioning

This is just the first third of the standard, but the point is clear. The curriculum's focus on issues like stereotypes, discrimination, racism, oppression, privilege, and microaggressions lacks objective or proven evidence to be universally true for any racial group.

To properly develop a therapeutic relationship with someone you have to talk to the individual and find out if things like historical events, prejudice, or cultural beliefs have been an issue in someone’s life. This cultural framing literally requires stereotyping to implement. And we can see proof of that when we look at the textbooks.

How That Standard Shows Up in Textbooks

As with the standard, I’m going to let the textbooks speak for themselves.

From the text, Ethical, Legal and Professional Issues in Counseling

A core professional value of counselors, as articulated in the Preamble to the ACA Code of Ethics (2014), is “honori ng diversity and embracing a multicultural approach” in all aspects of our work.

The profession has moved from a position of cultural encapsulation to an awareness of our ethical responsibility to serve diverse clients effectively by practicing in a multiculturally competent manner and to an emphasis on social justice and advocacy aimed at improving the lives of all people in our society and across the world.

Social justice has been defined as a commitment to promoting access and equity that has the aim of empowering and ensuring full participation of all people in a society, especially those who have been marginalized and systematically excluded on the basis of race, ethnicity, gender, age, ability status, sexual or affectional orientation, socioeconomic status, immigration status, national origin, or other characteristic of group membership. Advocacy translates that commitment into action. When issues of power, privilege, and discrimination arise, counselors are called on to address client issues at successively broader levels (Durodoye, 2013). Counselors as advocates are able to intervene to improve the social context that affects clients’ lives.

Developing multicultural self-awareness takes conscious effort because they have not had to experience themselves as marginalized beings. McIntosh (1998), in a classic article about race and racism, argued that White privilege in our society allows and even encourages a lack of awareness. She described White privilege as an invisible package of unearned assets on which White people can rely and about which they are intended to remain oblivious. Her contention is that Whites have been taught not to see this inherited systemic advantage because remaining unaware of its existence maintains the status quo. For example, a White female would be unlikely to fear for her life if she were pulled over by the police for driving with a broken taillight, perhaps without realizing what a different experience that would be for a young Black male.

If you are a student in a CACREP-accredited counselor education program, you will be taking (or may already have taken) a course in multicultural counseling, where you will begin to acquire the knowledge you will need to serve a diverse clientele. You will want to keep up to date by reading books and articles on new developments in multicultural counseling or that focus on specific groups of clients, such as African American youth.

And When Textbooks Get Specific

Since they mention the CACREP required multicultural counseling course, let’s look at these selections from the textbook for that course Counseling the Culturally Diverse: Theory and Practice

CHAPTER 7

White Racial Consciousness: Implications for Counseling and Psychotherapy

CHAPTER OBJECTIVES

1. Acquire an understanding of what it means to be White. Be able to discern differences between how Whites and People of Color experience “Whiteness.”

2. Understand how Whiteness advantages White European American individuals and disadvantages People of Color.

5. Learn what a White person can do in order to develop a nonracist and antiracist White identity.

6. Learn what White helping professionals can do in order to prevent their Whiteness from negatively impacting clients of color.

Research on Whiteness and White privilege points to an important barrier to racial understanding for White Americans: the invisibility of their Whiteness to them and/or its impact on their lives (Bell, 2003; Hegarty, 2017; Helms, 1990; Spanierman, Poteat, Beer, & Armstrong, 2006; Tatum, 1992; Todd & Abrams, 2011). Just as ethnocentric monoculturalism and implicit bias achieve their oppressive powers through invisibility, so too does Whiteness (Boysen, 2010; Sue, 2004). During racial interactions or conversations, many Whites appear oblivious to the meaning of their Whiteness, how it shapes everyday situations, and how it disadvantages People of Color.

Some White Americans may deny that they are White. Some seem angered by being labeled as such, and/or become defensive when so labeled (e.g., saying, “I'm not White; I'm Irish,” “You're stereotyping, because we're all different.”

White people have experienced other identities in addition to race. They may also belong to marginalized groups that receive their own share of discrimination and stereotyping—White people may be gay or Jewish or people with regional accents that are mocked in the media.

Whiteness has sociohistorical roots that date back centuries, but its modern legacy has the capacity to sweep all of us along, whether we or our forebears were here at the inception or not. When White people have eyes to see them, the signs of Whiteness at work exist throughout everyday life. If we are White, we live in a world where, if we express interest in seeing a vacant apartment, it will most likely be shown to us.

White supremacy is global. Most of us have been socialized to believe the myth that White people and the things they produce are superior to People of Color. Unfortunately, part of this socialization includes adopting viewpoints about other racial groups that align with white supremacy.

Further, readers must understand that prejudice toward other groups occurs under an umbrella of White racial supremacy; although People of Color may hold prejudicial beliefs and act on those beliefs, they do not have the systemic power to oppress on a large‐scale basis (Sue, 2015). In other words, although they may be able to hurt one another on an individual basis, they possess little power to cause systemic harm, especially to White Americans.

Conclusion

What you see here in these passages is Critical Race Theory being implemented as a belief system, and it is now the underlying basis for how Counselors are being taught to treat clients in every CACREP accredited program.

Critical Race Theory is unproven and unprovable. There is no objective empirical evidence for any of these things. It can’t be measured, it is poorly defined, and lacks any framework to even describe what it would look like if you were reducing their made-up concepts of ‘Whiteness and white supremacy’.

With the help of the American Counseling Association (ACA) and other counseling organizations like Chi Sigma Iota, the American Association of State Counseling Boards (AASCB), The Association for Counselor Education and Supervision (ACES) etc. a CACREP accredited degree is now required to get licensure in North Carolina, Kentucky, and Ohio. It is required to work for Veterans Affairs, U.S. Department of Defense, the Army, and for the TRICARE Certified Mental Health Counselor credential.

A CACREP accredited degree is conditionally required for licensure in 23 states including Tennessee. While it may sound like that means there are other avenues to get counselor training in Tennessee, all 18 higher education institutions that offer graduate programs for counseling in the state, are CACREP accredited. Tennessee isn’t the only state with this problem.

Next week I’ll be writing about what steps can be taken to begin mitigating this problem.

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About

Diogenes in Exile began after I returned to grad school to pursue a degree in Clinical Mental Health Counseling at the University of Tennessee. What I encountered, however, was a program deeply entrenched in Critical Theories ideology. During my time there, I experienced significant resistance, particularly for my Buddhist practice, which was labeled as invalidating to other identities. After careful reflection, I chose to leave the program, believing the curriculum being taught would ultimately harm clients and lead to unethical practices in the field.

Since then, I’ve dedicated myself to investigating, writing, and speaking out about the troubling direction of psychology, higher education, and other institutions that seem to have lost their way. When I’m not working on these issues, you’ll find me in the garden, creating art, walking my dog, or guiding my kids toward adulthood.

You can also find my work at Minding the Campus

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