Cognitive behavioral therapy rests on a simple insight: The way we think shapes how we feel and act. When thinking becomes distorted (when we see the world in black and white, assume the worst about others’ intentions or motivations), suffering follows. Decades of clinical research have established this across anxiety, depression, and personality disorders.
What happens when required trainings for therapists encourage those same distortions?
In a recent article in Open Inquiry in Mental Health, psychologist Andrew Hartz identifies six psychological dynamics commonly embedded in diversity, equity, and inclusion (DEI) programs that map onto the cognitive distortions clinicians spend years helping clients overcome. As Hartz clarifies, although the term “DEI” has fallen out of favor in many institutions, the underlying ideas have not disappeared; they continue to appear in clinical training programs and mental health workplaces, sometimes repackaged under different labels. He is also careful to note that not every training that falls under this umbrella exhibits all of the dynamics he describes, but it is also far from rare for some of them to show up. These programs are not just for corporate employees; they are increasingly standard in clinical training programs, professional development requirements, and mental health institutions. Many therapists who are supposed to treat cognitive distortions are trained in environments that promote them.
Take, for example, all-or-nothing thinking. Practitioners of cognitive behavioral therapy (CBT) are familiar with this cognitive distortion: Clients who suffer from it believe they’re either a total success or a complete failure, with nothing in between. Hartz argues that many DEI trainings reproduce this exact structure at the group level, framing entire demographic groups as either “having power” or not, as either perpetual victims or perpetual victimizers. The nuance that power varies by context, individual, and situation is ignored, lost, flattened into buckets of all good or all bad. Because clinicians are trained according to this framework, they risk importing the same distorted lens into their therapy sessions.
Then there’s “safetyism” (a term coined by Pamela Paresky). It involves reframing minor interpersonal slights as traumatic events via trigger warnings and the like. When these practices are embedded in clinical training programs, therapists learn to treat emotional discomfort as something to avoid rather than work through. Yet CBT approaches refer to this practice as accommodation, the well-meaning instinct to remove all sources of discomfort (which, ironically, makes anxiety worse). Indeed, recent research on trigger warnings supports this concern: trigger warnings do not reduce distress in people with trauma histories, and even reinforce their beliefs that trauma is central to their identity.
Finally, Hartz argues that many DEI frameworks present individual outcomes as almost entirely determined by systemic forces (think “structural racism,” “the patriarchy”), potentially undermining the very sense of agency that good therapists ought to cultivate in their clients. On this point, too, the research is consistent: People who believe external forces determine their outcomes tend to experience more depression, anxiety, and helplessness than those who maintain a sense of personal agency, and these externality trends have been rising for decades.
None of this means that inclusion, fairness, and respect for diversity are bad goals; the issue is that certain elements of these trainings actively encourage the very distortions effective therapy should be trying to reduce.
Hartz concludes that if diversity training is to be part of clinical education, it should look very different, emphasizing shared humanity, encouraging dialogue across viewpoints, fostering resilience, and discussing diversity within demographic groups, not just between them.
The irony of all this is hard to miss: The mental health field, which built its modern evidence base on identifying and correcting cognitive distortions, has allowed programs promoting those very distortions to flourish within its own training institutions. “Do as I say, not as I do” is not a credible clinical philosophy. Therapists who are trained to think in distorted ways are likely to bring those distortions with them; this shapes how they understand their clients, what they pathologize, and what they leave unexamined. If the field wants to maintain the trust of an ideologically diverse public, it might start by holding its own training programs to the same evidentiary standards it demands of its treatments.