The New Activist Therapists
Article from "Frontiers in Mental Health"
By Val Thomas, DPsych
The following article appears in the first issue of “Frontiers in Mental Health,” journal of the Open Therapy Institute. Download the full issue here.
During the last few years, a radical shift has been taking place in the therapy field in North America and the rest of the Anglophone world: Professional therapy institutions and mental health practitioners are adopting a politicized approach to therapy. Why does this matter? Because this activist therapy does not have a traditional patient-centered ethos, which foregrounds the individual’s unique experience, needs, and goals. Instead, activist therapists have a political agenda for societal change, which is then imposed on clients.
Despite its increasing dominance, there is hardly any empirical evidence supporting this politicized approach; on the contrary, there are many anecdotal reports of its detrimental impact on client welfare. This essay explains what activist therapy is, how it came to capture the field, and the implications for mental health.
What Is Activist Therapy?
For readers who have not been following the politicized path of therapy, here are some examples of current activism:
Practitioners who believe it is acceptable to attack therapists with different political views—see a recent attempt to blacklist “Zionist” therapists.
Reputable academic therapy journals that publish peer-reviewed papers advocating for highly dubious racialized concepts such as “Parasitic Whiteness” (capitalization in the original paper) (Moss, 2021).
Trans-activists’ influence on therapeutic services for vulnerable clients. For example, the recent scandal in the Scottish Rape Crisis services where traumatized women have faced charges of bigotry for wanting to know the biological sex of their counselor.
Mental health professionals who actively encourage polarization and division. See the Yale psychiatrist who urges people to shun Trump-supporting relatives.
What Are the Main Differences Between Activist Therapy and Traditional/Classical Therapy?
The issue here is not about the therapist having particular political views—this is inevitable—but that with regard to the client, as the American Counseling Association states explicitly, “Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors” (ACA, 2014, Section A.4.b). And this is the key difference between therapy as generally practiced until recently and the new politicized approaches: Activist practitioners deliberately impose their own political beliefs onto their clients.
The worldview of traditional/classical therapy is informed to a greater or lesser degree by the modern Western Enlightenment philosophic tradition. Consequently, traditional/classical therapists, no matter what approach they espouse, share a commitment to the uniqueness of the individual and the healing ethos of therapy; broadly speaking, their practices are designed to increase the client’s insight, agency, and grasp on reality.
This new politicized approach to therapeutic practice is informed by critical social justice (CSJ)—a term coined by Sensoy and DiAngelo (2017)—which is a worldview that blends postmodern ideas with elements of Critical Theory (Pluckrose and Lindsay, 2020). This ideology has a revolutionary political agenda and deploys an identitarian lens. Consequently, the client is viewed merely as an avatar of a particular group (or combination of groups), which is deemed either the oppressor or in an oppressed position within the wider societal matrix of power.
This worldview turns the therapeutic enterprise on its head. The activist therapist believes the client’s difficulties are caused by the wider unjust societal context; the only treatment offered is a form of moral reeducation that urges engagement in political action.
How Has Activist Therapy Captured the Professional Field?
How could a politicized approach to therapy—an approach that is being labeled by some as inherently antitherapeutic (Thomas, 2023) and explicitly antiscientific and antimeritocratic—get such a purchase on the mental health field? Broadly speaking, we can identify four groups that are driving this movement:
Activist Scholars
Hostile to Western European thought, which is deemed to be an expression of white supremacy, these scholars seek to dismantle and disrupt traditional schools of thought. They operate as gatekeepers in academic psychology, shutting down any critical debate and accusing critics of being reactionary—which has contributed to widespread self-censorship among academics (Corey et al., 2024).
Activist Clinicians
Influential clinician theorists such as Derald Wing Su (an early promoter of the contested notion of micro-aggressions) developed the theory and skills of multicultural competence. Their work established the ground for centering identity issues in clinical practice. Other theorists have built on this work, insisting on the salience of race in all clinical encounters, even if both practitioner and client are white (Dustrupp, 2021).
Activist Bureaucrats
Many professional organizations have been captured by activists deploying bureaucratic means such as: committing organizations to dismantling “systemic racism,” embedding Diversity, Equity, and Inclusion (DEI) policies at every level, and reengineering professional practitioner criteria along CSJ lines.
Activist Educators
Most therapists are trained within higher education institutions, which are monitored by DEI committees. Many psychology faculties have committed themselves to “decolonization of the curricula” (Phiri et al., 2023). This DEI bureaucracy, combined with an influx of educators wedded to a politicized education approach known as Critical Pedagogy (Gottesman, 2016), is instilling these practices in the next generation of practitioners.
What Do We Know About the Effectiveness of Activist Therapy?
The evidence that these practices improve outcomes is shockingly weak. This research typically relies on studies into clinical effects of training therapists in multicultural competence. A review of research studies (Benuto et al., 2016) suggests that, rather unsurprisingly, clients rate their therapists more highly if they have undergone multicultural training programs.
The lack of evidence can be explained by two factors. First, there is no general agreement on what constitutes the principles and methods of activist practice. If something isn’t operationalized, then it is very difficult to investigate. And second, activist scholars are generally averse to empirical evidence: Their interest is in changing cultural narratives (Pluckrose and Lindsay, 2020).
In contrast to activist claims, there are plenty of anecdotal reports published on Substacks, on social media, and in blogs about the harms of these approaches—see, for example, Critical Therapy Antidote’s collection of insider accounts of damaging therapy experiences. These writings, combined with podcast interviews of disillusioned therapy trainees, and the increasing volume of requests for “non-woke therapists” received at organizations such as the Open Therapy Institute point to significant disquiet.
Implications of Activist Therapy Practice for Culture and Mental Health Treatment
Potential negative impacts on the client include:
weakening self-efficacy and agency. Activist therapy can foster victimhood, a sense of powerlessness, and/or entitlement;
worsening interpersonal relationships. Activist therapy promotes polarization, fosters family divisions, and guides people to view all relationships through the lens of power;
promoting simplistic reductive thinking such as either/or thinking (e.g., good/bad, right/wrong, and victim/oppressor); and
encouraging lack of realism and delusions by rejecting ideas such as empiricism and biological sex.
Given the potential individual-level effects, it’s not a big leap to argue that the cumulative effects would help to weaken and destabilize society and culture over the long term.
Conclusion
Activist therapists are entrenched now in mental health treatment services, private practice, education counseling services, etc. This politicized approach to therapy is driven by academics, the therapy bureaucracies, and training institutions. The problem is growing. In response, we need to develop strategies to help mitigate the harmful effects of these practices on the individuals who seek out therapy.
References
American Counseling Association. (2014). Code of Ethics. https://www.counseling.org/docs/default-source/ethics/2014-aca-code-of-ethics.pdf
Benuto, L. T., Casas, J., & O’Donohue, W. T. (2018). Training culturally competent psychologists: A systematic review of the training outcome literature. Training and Education in Professional Psychology, 12(3), 125–134. https://doi.org/10.1037/tep0000190
Clark, C.J., Fjeldmark, M., Lu. L., Baumeister, R.F., Ceci, S., Frey, K., Miller, G., Reilly, W., Tice, D., von Hippel, W., Williams, W.M., Winegard, B. M., & Tetlock, P.E. (2024). Taboos and self-censorship among U.S. psychology professors. Perspect Psychol Sci, May 16:17456916241252085. Advance online publication, https://doi.org/10.1177/17456916241252085
Drustrup, D. (2021). Talking with white clients about race. J Health Serv Psychol, 47, 63–72. https://doi.org/10.1007/s42843-021-00037-2
Gottesman, I. (2016). The critical turn in education: From Marxist critique to poststructuralist feminism to critical theories of race. Routledge
Moss, D. (2021). On having whiteness. Journal of the American Psychoanalytic Association, 69(2), 355–371, https://doi.org/10.1177/00030651211008507
Phiri, P., Sajid, S., & Delanerolle, G. (2023). Decolonising the psychology curriculum: A perspective. Frontiers in Psychology, 14, 1193241. https://doi.org/10.3389/fpsyg.2023.1193241
Pluckrose, H., & Lindsay, J. (2020). Cynical theories: How activist scholarship made everything about race, gender, and identity—and why this harms everybody. Pitchstone
Sensoy, O., & DiAngelo, R. (2017). Is everyone really equal? (2nd ed.). Teachers’ College Press.
Thomas, V. (Ed.). (2023). Cynical therapies: Perspectives on the anti-therapeutic nature of critical social justice. Ocean Reeve.