The Argument the Field Isn't Making

Advocacy didn’t begin for me at the Capitol. It began in the therapy room.

Over the last several years, I’ve sat with clients who were burdened by trauma, anxiety, chronic stress, and the quiet forms of despair that rarely trend online. Their stories shared a pattern: before finding relief, many had cycled through seven, eight, even nine therapists. They were offered empathy, affirmation, and encouragement, but not formation, not strategy, and not outcomes. They weren’t lacking feelings. They were lacking tools.

Clinically, this chronicity is costly. Not just for the individual, but for their families, workplaces, churches, and communities. If counseling is meant to restore function and strengthen a life, then the field cannot be content with compassion alone. Compassion is necessary, but it is not sufficient. Without competence and accountability to results, compassion collapses into sentiment, and sentiment does not treat anxiety, resolve trauma, or rehabilitate meaning.

When I finally began to speak openly about this problem, the resistance came swiftly. And not from clients; from the industry itself. Some challenged my clinical stance. Others challenged my character. Still others questioned my ethics, as though insisting on outcomes were incompatible with care. It was a strange moment to realize that advocating for competence in mental health could be treated as a kind of trespass. But if the field cannot tolerate scrutiny from within, it is in no position to demand trust from without.

When I challenged this compassion-only orientation publicly, I learned something unexpected about the culture of our field. The resistance was not about outcomes, because outcomes were rarely discussed to begin with. The resistance was about identity. Many clinicians seemed to believe that questioning our methods was equivalent to questioning their goodness, and that insisting on measurement was a form of cruelty. The conflation of compassion with competence was so total that asking for both felt like a violation of the unspoken code.

I caught flak from all directions: professional, ideological, and personal. Not because I dismissed compassion, but because I refused to treat it as the sole metric of care. Yet clinicians demanding respect as healthcare providers cannot balk at the very notion of efficacy. Healthcare, by definition, requires outcomes.

This was the moment I understood that advocacy for the field would never begin at the level of policy. It would begin at the level of formation: how we imagine our work, how we define competence, and how willing we are to tolerate scrutiny. If an industry cannot withstand internal critique, it is not prepared for external accountability.

LPC Day was the initial spark. When I learned that licensed professional counselors would be going to the Capitol, it clarified something I had been circling privately for years: if I believe the field needs reform, I cannot expect others to make the case for me. Advocacy is part of the work.

Then, LPC Day was cancelled due to appropriations. The easy decision would have been to wait until the next LPC day, but waiting reinforces inertia. And inertia is how systems avoid scrutiny. I decided to go anyway and scheduled individual meetings with legislators who sit on committees that shape mental health policy.

Today, I found myself sitting with Senator John Albers, who chairs the Public Safety Committee. We spoke about outcomes, chronicity, and the quiet cost of ineffective care on individuals: first and last responders, and more. It was a grounded, policy-level conversation, not about stigma or awareness, but about function.

As I told Senator Albers, we have drifted far from the purpose of psychotherapy. The work was once defined by the direct confrontation of thoughts and behaviors that produced distress and dysfunction. Today, many clinicians default to affirmation, as though validation alone could resolve PTSD, reorganize cognition, or restore meaning. Our field treats discomfort as harm, and in doing so, abandons change.

Senator Albers agreed and raised a parallel concern that mirrors what I see clinically: the over-medication of individuals, particularly those with chronic anxiety and trauma. We discussed polypharmacy and the modern dilemma of treating a nervous system that is already managed by 2 or more psychotropic medications. At what point does affirmation replace confrontation, and at what point does medication replace treatment? More importantly, how do clinicians effect meaningful change on a brain that has been chemically flattened, blunted, or sedated into compliance?

Sitting in that room, I realized something that felt both obvious and unsaid: no one from our field is making this argument. We have become so conformist and so uncomfortable with scrutiny that we have confused sentimentality with care. An industry that insists on compassion but avoids confrontation cannot credibly call itself healthcare. Healthcare requires outcomes.

Advocacy in counseling isn’t a brand or a slogan. It is part of the ethical obligation of our work. Our Code of Ethics states that counselors must advocate for clients when systems limit access to appropriate care. What it doesn’t say, but what clinical reality demands, is that we must also advocate when systems limit outcomes. Access without outcomes does not relieve suffering. It preserves it.

Therapists often speak about doing “the hard work” of therapy, yet we rarely apply that same standard to ourselves. We expect clients to confront the thoughts and behaviors that keep them stuck, but the field has avoided confronting the beliefs and practices that keep us stuck. If direct confrontation is essential for transformation at the individual level, it is also essential at the professional level. Reform begins with the willingness to enter uncomfortable rooms.

Counseling is, at its best, a discipline of responsibility. Responsibility for the outcome of treatment. Responsibility for the dignity of the client. Responsibility for the formation of future clinicians. Responsibility for telling the truth about what works and what doesn’t. Responsibility for stepping into discomfort when silence is easier.

Walking into the Capitol was not symbolic. It was simply responsible. If the field expects to be taken seriously as healthcare, then we must be willing to join the conversation about outcomes, standards, and competence. I didn’t go to make a statement. I went because the work requires it. The clients I serve deserve more than access, and they deserve to see their therapist "walk the walk"; they deserve recovery. And recovery requires results.

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For those interested in the specifics I discussed with legislators, I left a brief one-pager for the Senate offices outlining the problem, the evidence, and the reforms I believe are necessary for the field to mature. It is not exhaustive, but it is direct. The work will need to continue from there.

One Pager Chronicity and Access.pdf

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