Critical Therapy Antidote

How did counseling education become so politically and ideologically contentious? Who decides what therapists are taught—and who ultimately shapes the future of the profession? In this episode of the Critical Therapy Antidote (CTA) Podcast, Dr. Michael Olan and Christine Sefein-Wolk sit down with Suzannah Alexander, author of Diogenes in Exile, to examine the evolution of counseling accreditation, the influence of CACREP, multicultural counseling, interstate licensure compacts, and the growing debate surrounding ideology in mental health.

Drawing on years of historical research, Suzannah traces the development of the counseling profession, explores how accreditation standards evolved, and argues that shifts toward advocacy and ideological frameworks have fundamentally changed counselor education. The discussion also examines interstate licensure compacts, professional governance, innovation in psychotherapy, and what these changes may mean for therapists, clients, educators, and policymakers.

In this episode: The origins and role of CACREP. How accreditation shapes counselor education. Multicultural counseling and ideological frameworks. Advocacy versus clinical practice. Interstate licensure compacts explained. Professional identity in counseling. Innovation versus standardization in psychotherapy. The future of mental health professions.

Guest: Suzannah Alexander Writer, researcher, and author of Diogenes in Exile, where she examines psychology, counselor education, culture, and the helping professions. Subscribe for more conversations exploring psychotherapy, clinical science, ethics, professional training, and the future of mental health. Follow Suzannah Alexander • Substack: Diogenes in Exile • X: @DiogenesInExile

Chapters

00:00 Introduction & Meet Suzannah Alexander 04:32 Why Suzannah Entered Counseling 06:12 Inside Counselor Training: Ideology vs Clinical Practice 10:00 Leaving the Program & Beginning the Investigation 12:22 What Is CACREP? Understanding Counseling Accreditation 16:39 How CACREP Shapes Counselor Education 18:30 Multicultural Counseling & Ideological Training 22:36 The History of Counseling Licensure 27:30 “Preferred Futures” and the Counseling Profession 30:32 When Advocacy Became the Profession’s North Star 36:40 Interstate Licensure Compacts Explained 42:54 Are Licensure Compacts Creating a “Shadow Government”? 52:28 Do Standardization & Portability Actually Help? 56:49 Can the Profession Change Course? 01:03:04 Where to Find Suzannah Alexander’s Work