Marches protesting changes to ACC's criteria for counselling for sexual abuse victims have been held in the major cities.

Today was dedicated "national day of action" by organisers, with marches planned for Auckland, Wellington, Christchurch and Dunedin.

In Wellington, protesters took advantage of the good weather and met at the Cenotaph before marching past Parliament and ACC's head office.

Almost two hundred people held signs, chanted and left a rainbow of messages in coloured chalk on the pavement demanding "no cuts", "support survivors" and "I'm not crazy".

The changes would make it harder for sexual abuse victims to come forward, campaign spokeswoman Miriam Sessa said.

"We want to build communities that oppose the culture of silence around sexual abuse, rather than implementing reforms that effectively remove the voice of survivors," she said.

The changes meant victims would have to "jump through bureaucratic hoops" which would further disempower them, she said.

"This change is clearly a cost-cutting measure."

ACC general manager Denise Cosgrove said the changes were around internal management and having a stronger early clinical process.

People always had to be clinically assessed as having mental injury arising from the abuse to get counselling, she told NZPA.

The changes will mean the "right people" make the diagnosis and there will be "certainty up front".

Previously, a "mix" of people could diagnose mental injury, that was now likely to be limited to psychiatrists and pyschotherapists, Ms Cosgrove said.

There will be no limit made on counselling but everyone will be assessed after 16 weeks of counselling to check progress.

If they needed more they would get it, Ms Cosgrove said.

ACC was turning the Massey guidelines into protocol and creating a "higher level of rigor", she said.

Counsellor Cathy McPherson said researchers behind the Massey guidelines were "unhappy at the way their research had been used".

"There is a big difference in counselling requirements of a client who may have had a single incident of abuse with a good support system, as opposed to a client who has been subjected to years of sexual abuse by multiple perpetrators, both in childhood and adulthood," she said.

ACC had overlooked that they were dealing with "the most vulnerable, damaged and marginalised members of out society".

Respectful, appropriate, ethical and culturally sensitive counselling would not be possible under the changes, Ms McPherson said.

Last week Labour MP Lynne Pillay said counsellors had warned the changes at ACC would limit or prevent sexual abuse victims from getting counselling.

Clinicians in Wellington were making decisions about who would receive counselling, sometimes without meeting the victim, she said.

"Withholding much needed and deserved support from those who have suffered horrendously at the hands of a criminal is a disgrace."

However, ACC Minister Nick Smith said there had been no change to those eligible for ACC counselling for sensitive claims relating to crime.

New treatment guidelines, developed by Massey University, were being implemented.

The industry had been consulted on the changes for years, including under the Labour government, Dr Smith said.

"I have not asked ACC to make savings in counselling," he said.