How the ACA Code of Ethics Puts Ideology Before Patient Well-being - Part 1

Counselors who refuse to conform to political dogma risk losing their careers

Mar 10, 2025

As a battered woman herself, Rachel became a therapist to start therapeutic groups for women who survived sexual assault. She didn't expect that according to the American Counseling Association (ACA) code of Ethics, she might be forced to allow men in the group if they identified as women. She knew that having such an individual in a group of traumatized women would destroy the emotional safety that allows women to open up about such difficult subjects. She was also aware that this could even re-traumatize some.

Rachel also knew that some abusers were using this loophole for their own gratification.

Rachel believed this situation was profoundly wrong, but if she bucked the ethical code she might get drummed out of the profession. She knew that had already happened at least once. One of her grad school textbooks had even written about such a case.

This situation is real, though the details changed to protect the practitioner’s identity.

Across the country, principled therapists are finding themselves confronted with similar dilemmas where even following the tenets of good therapy would conflict with the current code. All the while many clients are either forcefully indoctrinated to ignore obvious biological truths or left twisting in the wind.

The Promise and Pitfalls of Ethical Codes?

Codes of Ethics have become a popular way for various professions to establish standards and inspire public trust. Ideally, they provide a framework to ensure practitioners act in ways that prioritize client welfare and maintain practitioner integrity, thus inspiring trust.

Ethical codes cover many commonly touched-on sensitive areas like informed consent, protecting confidentiality, professional responsibilities, etc. These codes can work as both prevention by alerting practitioners of dangerous pitfalls like dual relationships, and as a source of accountability, they provide a benchmark for evaluating misconduct. Many professionals welcome having these codes as an easy reference to guide their decision-making in complex situations.

What goes unsaid is that ethical codes are also a reflection of underlying values. When those values are pushing towards an objectively healthy goal and in alignment with the dominant culture’s enlightenment values, the system works reasonably well.

When those underlying values are not generally accepted and are at odds with freedom of expression and belief, this creates dangerous justification for the leadership of counseling to overstep the boundaries of both practitioners and their clients. While Codes of Ethics may have value, they also have significant shortcomings, the worst of which are providing legal cover and support for totalitarian ideologies.

Where Codes of Ethics Can Go Dangerously Sideways

Risk of Ideological Bias - Like any set of rules, codes are based on underlying values that may or may not be verbalized in the text, yet become obvious when you examine the details. This can be coercive rather than protective.
Overregulation - Strict or prescriptive codes prevent individuals from exercising the leeway necessary to navigate complex and nuanced circumstances. This can even lead to internal conflicts within the code itself.
Functioning as a Tool for Control Rather than Ethics - Codes can be weaponized to enforce ideological purity rather than encourage ethical practice. Professionals who question the prevailing norms can be punished, limiting both critical thought and legitimate debate.
Enforcement Can be Politicized - Codes do not guarantee ethical practice either in practitioners or those enforcing the code. Violations can be overlooked due to corruption or personal relationships or likewise others may be targeted disproportionately.

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ACA’s Misson of Collectivism Over Clients

In the case of the ACA Code of Ethics, it is easily arguable that this document is internally contradictory and coercive.

The first indicator that something is off begins in the mission statement for the ACA which is the first passage at the top of the document. It reads as follows:

The mission of the American Counseling Association is to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.

Note that their goal is to enhance the quality of life in society, not client well-being. This reflects a collectivist orientation. To achieve these enhancements, they prescribe developing counselors, advancing the profession, and using the profession to promote their values of respect for human dignity and diversity.

While this may sound good on its face, it also directly states that this is a top-down approach. It dictates what values are important, and their goal is to improve society, not the lives of individual clients. Note that it directly states, “using the profession and practice of counseling to promote respect for human dignity and diversity.” Don’t you just wonder when and where that is going to happen?

In contrast, imagine a mission that said something like – Our mission is to enhance client well-being and reduce suffering by advancing counseling excellence through research into human psychology, expanding knowledge, and improving treatment and practitioner skills.

If that makes the problem clear, it will not be surprising that the ACA Code of Ethics doesn’t get better from there.

ACA Code of Ethics Mandates Support of A Political Worldview

Right from the preamble, cracks are showing. The ACA Code of Ethics prioritizes diversity, multiculturalism, and social justice from the outset. However, it assumes these values as universal and non-negotiable, rather than allowing for professional discretion or evidence-based nuance.

If there was an intention to be direct they would say, “to be considered ethical under our standard, counselors must embrace multicultural approaches to counseling and promote social justice.”

But what are multiculturalism and social justice? How do they improve client outcomes?

Judging by the many required textbooks on this subject, like Counseling the Culturally Diverse by Derald Sue, multiculturalism is a worldview that sorts people by race and other immutable characteristics as a way to define their identity. This is a belief structure. The ACA may as well tell counselors to embrace a flat-earth approach.

What right does the ACA or any professional body, outside of religious groups, have to demand practitioners take on these worldviews?

One supposes if you wanted to discount the basis of actual evidence, you could make the case that an enlightenment view based on the idea there is an objective reality is also a worldview tacitly forced on people who grow up in the West. Yet by the logic of multiculturalism, a worldview that includes objective reality should be supported as an “aspect of the uniqueness of people in their social and cultural contexts”.

At a minimum, their own standard should require informed consent that both counselors and clients are entering into therapy based on a racist worldview.

A Shell Game with Autonomy

Directly after that is a listing of the professional values for ethical principles. The very first thing mentioned is autonomy, or fostering the right to control the direction of one’s life.

It is generally agreed on that personal autonomy and agency, the ability to make independent decisions and feel in control are crucial for good mental health and well-being.

Yet the ACA Code of Ethics is playing a shell game. Autonomy is a stated value, but it is undermined by the prior core value of embracing a multicultural worldview.

That’s not the only place it turns up. You can see it in the case of Jennifer Keeton, which is related in the textbook Developing Multicultural Counseling Competence by Hayes and Erford. Citing the ACA Code of Ethics, she was booted from her training program for refusing to abandon her Christian beliefs.

If more students like Rachel understood that becoming a counselor meant surrendering their First Amendment rights—including freedom of thought and conscience—many would think twice before entering the profession.

The troubling reality is that ethical codes, while designed to protect both clients and practitioners, can be weaponized to enforce ideological conformity rather than ensure ethical practice. The ACA’s mandate to promote social justice and multiculturalism isn’t just a neutral guideline—it’s a fundamental shift in the role of the counselor, prioritizing a collectivist vision over individual client welfare.

For professionals like Rachel, this creates a no-win scenario: either comply with a code that contradicts therapeutic best practices or risk professional exile for upholding the principles of sound, client-centered care. This isn’t just an academic concern; it has real consequences for the integrity of the counseling profession and the well-being of those who seek its services.

If the goal of ethical codes is to promote trust and protect client autonomy, then they must be revisited with a critical eye. Codes that demand ideological allegiance rather than professional excellence do not serve clients—they serve an agenda. The question is, how many more therapists will be forced to choose between their conscience and their career before this system is challenged?

While lawmakers could and should take action to eliminate this form of compelled speech in state universities, practitioners like Rachel should consider starting a new mental health discipline. A new branch of therapy without the baggage of this massive scandal would ironically not only benefit clients, it would improve society.

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About

Diogenes in Exile began after I returned to grad school to pursue a Clinical Mental Health Counseling master’s degree 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