You aren’t angry enough about what’s happening in therapy rooms across the country. It’s not hyperbole to say that at the clinical level, Marxist activism and social justice ideology are harming children or adolescent clients in the therapy setting.
Imagine this scenario: a non-white adolescent female, we’ll call her “Dellah,” is seen for counseling following a period of sexual abuse and possible trafficking while in foster care. The perpetrator, another foster teen living in the same home, is a non-white sexual minority. Dellah arrives at counseling with what trauma experts recognize as a complex constellation of psychological and physical injuries: terror, shame, confusion, profound violations of bodily autonomy, and a shattered relationship with her own sense of safety and worth.
Dellah is sent to a community mental health center for therapy. The therapist is a kind, eager, knowledgeable, and recently graduated clinician. She is excited to use her training to help the deeply wounded Dellah to heal and become the most empowered version of herself possible. Using the rule set of social justice therapy (SJT), a framework now codified in graduate training programs and professional competency guidelines across the country, Dellah’s sexual abuse and trafficking are not a clinical problem, they’re an ideological one.
As UK psychotherapist Val Thomas has documented in her book Cynical Therapies, SJT trains practitioners to view clients not as individuals but as “representatives of particular identity groups located within a matrix of power.” Viewed through this lens, Dellah’s race and the identity of her abuser become the central organizing facts of her care. Because Dellah is non-white and her abuser belongs to multiple intersections of marginalization, the framework is structurally predisposed to resist acknowledging his actions as the primary cause of her harm.
The implicit and explicit clinical message is that what is most consequential about Dellah’s suffering is not what was done to her personhood, but what her intersectional identity represents within an ideological taxonomy. Her racial and intersectional status is first, and her victimization of sexual abuse and trafficking is second.
The above scenario is not an exaggeration. It is the logical outcome of a value system that prioritizes group identity over objective truth. It doesn’t matter that Dellah is non-white like her abuser; what matters is that she is less disadvantaged. Put differently, her abuser has more intersections, making Dellah more privileged. Satel has documented that the American Counseling Association’s endorsed competencies instruct clinicians to help clients “unlearn their privilege” and develop “critical consciousness” regarding their position in an oppressive society, irrespective of what the client has presented as her reason for seeking care. The presenting problem becomes secondary. The ideological diagnosis is primary. The process is backward.
This is where Sally Satel and Val Thomas come in with their March 2026 article in Theory and Society, offering what they call a meta-critical post-progressive analysis of activist therapy, an examination of both ideological content and the institutional conditions that have allowed it to propagate and popularize with almost no critical analysis.
Professionals and clients alike have reported some variation of accept the dogma as truth or be punished. As a result, social justice activism, rooted not in clinical research but critical theory, has been allowed to flourish within institutions of governance and academia, largely uncontested by mental health professionals. The traditional healing telos of therapy, oriented around the relief of suffering through the restoration of the client’s mental wellness using the therapeutic relationship as the forcing function, has been replaced by an ideological agenda with apparent harmful implications for those seeking therapy.
What Satel and Thomas expose at the theoretical level has an insidious and pernicious effect in clinical practice, with implications that fall heavily on the most vulnerable: all adolescents and children.
‘Race Should Be the Dominant Lens’
There are two reasons we are in this position. The first is the abject failure of the behavioral health leadership charged with ensuring interventions are evidence-based, trial outcomes can be replicated, and the results are stable over time, to prevent ideological bias from corrupting therapy. The second is the intentional rejection by those same leaders to have anything close to a reasonable conversation about the implications of using Marxist theory to treat clients.
The first point is merely offensive, but the second is how we know the actual objective isn’t to help people heal, it’s to use psychological tools to re-educate clients identified as part of a privileged group. The problem with social justice activism isn’t just that it harms children and adolescents of one particular race, it’s that it harms every child regardless of race. To treat a child suffering from abuse according to a predetermined identity construct is to completely ignore the most salient features of what allows true healing in therapy. If graduate training programs simply treated social justice activism and decolonization theory as one of the many lenses through which a therapist can develop a plan of care, the outcry would be minimal. But it’s not optional in many cases.
For example, Satel and Thomas cite a student from Antioch University who reported, “We were taught that race should be the dominant lens through which clients were to be understood and therapy conducted.” Many programs treat Marxist ideology and decolonial practices as evidence of clinical competency, completely disregarding Irvin Yalom’s counsel that “a different therapy must be constructed for each client” because each person has a unique story.
The extent of the professional damage is profound. Professional organizations and training institutions are influenced from the top down. For instance, the American Psychological Association (APA) and academic accrediting entities have a tremendous amount of influence over what organizations like the American Association for Marriage and Family Therapists and the American Counseling Association require for membership, supervision, and licensing.
The Clinical Cost of Social Justice
To understand why this inversion is so clinically catastrophic, it is necessary to understand something about the nature of trauma and what survivors require to heal. Diane Langberg, one of the foremost clinical voices on the long-term effects of sexual trauma, has written with powerful clarity about what abuse does to the self. It does not merely wound from the outside; it disfigures from within. Sexual violence severs a survivor’s relationship with her own sense of purpose, meaning, and worth, disrupting identity formation at the most formative junctures of development. Survivors commonly internalize a shame so pervasive that it ceases to feel like an emotion and becomes, instead, an identity. This is documented throughout Langberg’s clinical work, including in Counseling Survivors of Sexual Abuse and Suffering and the Heart of God: How Trauma Destroys and Christ Restores, as well as her widely viewed lecture, Shame, Sexual Abuse, and Healing.
Langberg’s work underscores a foundational truth of trauma-informed care: the survivor must be met and cared for within the reality of what happened to her or him. The therapeutic relationship, at its most elemental, is a space where the client’s experience is safely disclosed, validated, named, and protected, where the therapist often becomes the first witness to a heartbreaking truth that predation violently silenced. For a young survivor of abuse or even trafficking, bearing witness to that suffering is the substance of restoration itself.
Social justice therapy devalues the bond of relationship by reframing the brutality of child abuse as less important than social identity. The priority isn’t her story, it’s the systematic deconstruction of her entire worldview so the soothing salve of Marxist ideology can reinterpret her pain as a political process of liberation from oppressive social structures. This isn’t therapy. Genuine empathy, which Carl Rogers described as requiring the suspension of one’s own values to enter the other’s world without prejudice, cannot coexist with an a priori determination about what the client’s experience means before she has even spoken a word of it.
For Dellah, this ideological reinterpretation of her story carries devastating weight. She enters the therapeutic space already having been subjected to profound abuse, her humanity reduced, her autonomy extinguished, her body treated as a resource to be exploited. What she requires from therapy is its categorical opposite: to be seen as an individual, wonderfully made, to have her agency respected and restored, to have her suffering met with compassion, patience, and grace.
A framework that re-objectifies her, that evaluates the suffering of a child according to degrees of privilege or marginalization, is a moral failure in the extreme. And a profession that has made its peace with that, that has exchanged the sacred obligation to bear one another’s burdens, to witness suffering, for ideological power, must be held to account. As Satel writes, it is “wholly inappropriate for therapists to promote their own commitment to ‘dismantling systems of oppression.’”
Therapists must put patients’ needs, not dogmatic activism, at the center of their practice. Dellah and countless others deserve no less, trusting that the person across from them won’t be one more person who hurts them.
