End the Stranglehold: Tools to Confront Antitrust Violations in Counseling: CACREP Antitrust Part 6

The monopolization of healing hurts everyone: clients, students, and practitioners alike.

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What do you do when you realize that mental health professions leadership has come under the sway of an ideology that pits people against each other, making pathology worse or even causing it? What if professional organizations are used to create monopolies in licensure and accreditation that spread this message across the country and silence dissenting voices?

While some may deny the documentation presented over the last several weeks meets the standard of proof for antitrust under the Sherman Act, those who feel otherwise may be wondering what they can do to get this or any future issue the attention it deserves, so that these questions can be adjudicated.

Fortunately, there are actions that both concerned practitioners and the public can take, to protect their interests and to ensure that our mental health systems serve clients first.

To be clear, while the Foundation Against Racism and Intolerance (FAIR) has filed an OCR complaint against the counseling accreditation body the Council for Accreditation of Counseling and Related Educational Programs (CACREP) on the grounds that:

1. CACREP's standard promotes a hostile educational environment,

2. Its standard mandates that students affirm race-based ideologies,

3. By tying accreditation to race-conscious ideologies, it pressures certain racial groups to conform, violating Title VI of the Civil Rights Act.

4. These practices have persisted despite legal precedent condemning similar ideological requirements in Ward v. Polite.

5. It is in conflict with Federal Policy established in the Trump administration's 23 April 2025 Executive Order to Reform Accreditation to be in compliance with the Constitution.

The Federal government has taken no public action against CACREP at this time, either with regard to breaches of civil rights or antitrust laws.

That said, as other voices join FAIR’s and my own in calling out bad behavior, that could change. For those who have found themselves unable to practice in their home state, due to accreditation requirements, or anyone concerned they may not be able to work with their preferred therapist due to licensing or other bureaucratic restrictions, read on.

A Quick Recap for Latecomers

The Council for Accreditation of Counseling and Related Educational Programs (CACREP) is a prominent accrediting body for graduate-level counseling programs, recognized as an accreditor by the Council for Higher Education Accreditation (CHEA).

Its standards cover graduate-level counseling education, but its dominance, particularly with state licensure requirements in places like Florida, Kentucky, North Carolina, and Ohio, raises questions about potential antitrust behaviors.

Antitrust laws, such as the Sherman Antitrust Act, were written to prevent monopolistic practices that restrict competition and harm consumers.

CACREP, with its significant influence, and actions taken both in conjunction with organizations like the counseling honor society Chi Sigma Iota (CSI) and on its own could limit competition. Particularly where it excludes other accreditors like the Masters in Psychology and Counseling Accreditation Council (MPCAC) or restricts consumer choice.

Learn more about all of that, by starting at the beginning of this series about licensure and antitrust law.

To learn what actions counselors and clients can take to address their concerns, read on.

Potential Actions for Counselors and Clients

Counselors and clients can take several steps to promote competition and address potential antitrust concerns:

1. Filing Complaints with Regulatory Bodies

   • Submit concerns to the Federal Trade Commission (FTC) or Department of Justice (DOJ) Practitionerscan address situations where they have been unable to practice due to licensure being limited to graduates of CACREP-accredited programs, particularly in FL, KY, NC, and OH. They can also detail problems with the limitations on the counseling compact, noting actions and information shared on this Substack regarding CACREP and Chi Sigma Iota. Have trouble writing the words? Ask ChatGPT to write it up for you. Clients can also file complaints citing a lack of choice in their state or after losing access to a preferred therapist due to a move to a state otherwise served by the counseling compact.

   • Submit a complaint to the U.S. Attorney General or your State Attorney General. Both federal and state attorney generals can file suits against accreditors or other organizations for breaking antitrust laws, civil rights, or specific state laws. Stay informed about your options by subscribing to this substack.

2. Contacting Nonprofits Promoting Competition

   • Groups like the American Antitrust Institute, support competition that protects consumers, businesses, and society.

3. Supporting Alternative Accreditors

   • Encourage counseling programs to seek accreditation from MPCAC or other accreditation bodies to diversify options (MPCAC Accreditation).

   • Advocate for state licensing boards to recognize MPCAC-accredited programs, reducing reliance on CACREP.

4. Advocating for Policy Changes

   • Collaborate with professional organizations like the American Mental Health Counselor Association (AMHCA) to push for policies that recognize multiple accreditors.

   • Lobby state legislatures to amend licensure requirements, ensuring flexibility for non-CACREP programs.

5. Raising Awareness

   • Educate counselors, students, and clients about the benefits of competition in accreditation through workshops, articles, X posts, or sharing these Diogenes In Exile articles.

   • Highlight MPCAC’s role as a viable alternative to foster informed decision-making.

6. Collaborating with Stakeholders

   • Form coalitions with counseling programs, faculty, and students to advocate for fair accreditation practices.

   • Engage with CHEA to ensure accreditors they approve operate transparently and competitively (CHEA Recognition).

7. Serving on Licensing Boards

   • Licensing boards need more members from the general public. They also need more members who are not ideologically captured. Many boards find their members directly from compromised organizations like the American Counseling Association (ACA). This can be changed with active involvement by the public and practitioners.

8. Building New Things

   • Form new professional organizations and accreditors that are specifically free from ideology.

Conclusion: Change Won’t Come Unless We Demand It

We are standing at a crossroads for the future of mental health in America.

The entrenchment of ideology within accrediting and licensing systems is not merely a bureaucratic issue—it’s a threat to the very integrity of the counseling profession. When gatekeeping bodies promote political conformity, suppress alternative frameworks, and consolidate power to the detriment of choice, innovation, and client care, they betray the trust the public has placed in them.

But no institution is immune to accountability when citizens, especially those directly impacted, take action.

FAIR’s OCR complaint is one step forward. This series, and the growing community around it, is another. The good news is that there are concrete steps available to both counselors and clients—whether it’s filing complaints, lobbying legislatures, forming new coalitions, or simply telling the truth in public.

For those shut out of the profession due to dogmatic gatekeeping, for the clients harmed by dwindling choice, and for the students seeking an education—not an indoctrination—there is still a path forward. But it won’t come from silence or resignation. It will come from many voices speaking together, refusing to accept a monopoly on mental health and insisting that the field return to its first principles: healing, truth, and service.

Change won’t come unless we demand it. So demand it.

And if you don’t know where to start—start here.

Further Reading

The Licensing Racket: How We Decide Who Is Allowed to Work, and Why It Goes Wrong by Rebecca Haw Allensworth

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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